[Histonet] NCCI interpretation for ISH coding

[Mark Tarango]

My understanding was that this is just for Medicare patients...



On Mon, Jan 6, 2014 at 12:35 PM, Johns, Jill <jjohns3 <@t> cpallab.com> wrote:

> The following was taken from the NCCI manual, Chapter 10, effective 1/1/14:
>
> 9. The unit of service for in situ hybridization reported as CPT codes
> 88365, 88367, or 88368 is each probe staining procedure per specimen. If a
> single probe staining procedure for one or more probes is performed on
> multiple blocks from a surgical specimen, multiple slides from a cytologic
> specimen, or multiple slides from a hematologic specimen, only one unit of
> service may be reported for each separate specimen. Physicians should not
> report more than one unit of service for CPT codes 88365, 88367, or 88368
> per specimen for a probe staining procedure even if it contains multiple
> separately interpretable probes.
>
> I'm wondering how other labs are interpreting this, because I'm not sure
> how we continue to offer FISH testing and not go "in the hole" financially,
> if we can only bill for ONE probe on ONE specimen, regardless of the actual
> number of interpretable probes (Example: currently, for a HER2 FISH test,
> we bill for 2 units of service--1 for the HER2 probe and 1 for the CEP17
> probe--both of which have to be enumerated by a professional and a ratio
> generated). Any insight from others would be greatly appreciated....Thanks!
>
>
> Jill A. Johns, MT(ASCP)SH, QCym, CCy
> Manager of Molecular Pathology
> Central PA Alliance Laboratory (CPAL)
> 1803 Mt. Rose Ave., Suite C3/C4
> York,  PA    17403
> phone: (717) 851-4320
> fax:  (717) 851-1450
> email:  jjohns3 <@t> cpallab.com<mailto:jjohns3 <@t> cpallab.com>
>
>
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