[Histonet] New code 88343

Tue Jan 7 14:11:37 CST 2014

Does everyone charge non-Medicare per block or per specimen?

Thanks, j

Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
joyce.weems <@t> emoryhealthcare.org

www.saintjosephsatlanta.org
5665 Peachtree Dunwoody Road
Atlanta, GA 30342

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-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of rmweber113 <@t> comcast.net
Sent: Tuesday, January 07, 2014 1:56 PM
To: histonet
Subject: Fwd: [Histonet] New code 88343

----- Forwarded Message -----
From: "Joe W. Walker, Jr." <joewalker <@t> rrmc.org>
To: "Paula Lucas" <plucas <@t> biopath.org>, histonet <@t> lists.utsouthwestern.edu
Sent: Wednesday, December 18, 2013 4:15:39 PM
Subject: RE: [Histonet] New code 88343

Yes, this appears to be correct.  Excerpted from Dennis Padget:

AMA prescribes codes 88342 and 88343 for qualitative IHC:
The AMA's CPT-2014 codebook offers two codes for reporting with qualitative immunohistochemistry (IHC) testing. The codes and official parenthetical instructions for their use starting Jan. 1 are as follows:
88342  Immunohistochemistry or immunocytochemistry, each separately identifiable antibody per block, cytologic preparation, or hematologic smear; first separately identifiable antibody per slide
            (Do not report 88342 in conjunction with 88360 or 88361 for the same antibody)
            (For quantitative or semi-quantitative immunohistochemistry, see 88360, 88361)
88343 each additional separately identifiable antibody per slide (List separately in addition to code for primary procedure)
      (Use 88343 in conjunction with 88342)
      (When multiple antibodies are applied to the same slide, use one unit of 88342 for the first separately identifiable antibody and one unit of 88343 for each additional identifiable antibody)

CMS prescribes codes G0461 and G0462 for qualitative IHC:
CMS will not accept CPT code 88342 or 88343 on a claim effective with dates of service on and after Jan. 1, 2014: Those two codes are "not valid for Medicare purposes" and will be summarily denied if billed. To report a professional, technical or global charge for qualitative immunohistochemistry (IHC) testing for a Medicare beneficiary on and after Jan. 1, 2014, you must use the applicable HCPCS Level II code as follows:
G0461 Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain
G0462       each additional single or multiplex antibody stain (List separately in addition to code for primary procedure) Codes G0461 and G0462 have 26 and TC modifier lines in the 2014 physician fee schedule, so you'll bill them using the modifier (or no modifier, if entitled to bill the global service) that applies to your practice and any given Medicare beneficiary claim.
CMS prescribes that you continue to bill for qualitative IHC testing 'per specimen' as you have since Jan. 1, 2012. Furthermore, you'll continue to bill for quantitative IHC testing 'per specimen' using CPT codes 88360 and 88361 just as you do today and have done since Jan. 1, 2012.

Hope this helps.  We are still working through how we are going to accomplish this in our LIS,

Joe W. Walker, Jr. MS, SCT(ASCP)CM
Manager of Anatomical Pathology, Microbiology and Reference Rutland Regional Medical Center
160 Allen Street, Rutland, VT 05701
P: 802.747.1790  F: 802.747.6525
Email joewalker <@t> rrmc.org    www.rrmc.org

Our Vision:
To be the Best Community Healthcare System in New England

Rutland Regional...Vermont's 1st Hospital to Achieve Both ANCC Magnet Recognition® and the Governor's Award for Performance Excellence

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Paula Lucas
Sent: Tuesday, December 17, 2013 2:46 PM
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] New code 88343

Hello,

Can someone shed some light for me on this new code for IHC?  I think the code refers to double stain antibodies?

Thanks in advance

: )
Paula Lucas

Lab Manager

Bio-Path Medical Group

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Thank You

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