[Histonet] NCCI interpretation for ISH coding

[Bitting, Angela K.]

That's my understanding as well.

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Mark Tarango
Sent: Monday, January 06, 2014 6:03 PM
To: Johns, Jill
Cc: histonet <@t> lists.utsouthwestern.edu
Subject: Re: [Histonet] NCCI interpretation for ISH coding

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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