[Histonet] GO461 GO462

[Michael LaFriniere]

Sorry forgot to add a specific billing issue with medicare GO461 GO462 codes

If you performed (5) cytokeratins on a (1) large sentinel lymph node that was grossed in five separate blocks, under medicare you can only bill GO461 x 1 NOT x 5 like you can do for non medicare cases!  

Michael


-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Michael LaFriniere
Sent: Friday, May 09, 2014 11:40 AM
To: Hutton, Allison; 'histonet <@t> lists.utsouthwestern.edu'
Subject: [Histonet] RE: ihc billing

Allsion

It is my understanding, and I have gone over this with many billing experts as well and performed endless research on.  For medicare appropriate billing with multiplex anitbodies, use the GO461 for first multiplex antibody then GO462 for each "separately identified" antibody that the pathologist specifically diagnostically mentions in the report. An example; if you perform a PIN4 antibody that consist of 3 distinct antibodies the code GO461 for the first antibody mentioned; example(racemace) then GO462 for each additional separately identified antibody (examples would be the 2 cytokeratins in many cocktails).

GO462 is also used for each additional antibody used on each SPECIMEN; example a tissue that was submitted a specific specimen, example "bx of left arm" Pathologist orders pan-cytoketatin, s100, ki67, for medicare you would bill GO461 for the first antibody then GO462 x 2 for the (2) additional antibodies, again the pathologist must mention each result on the pathology report.

Hope this helps 



Michael R. LaFriniere, HT (ASCP) 
Executive Director
 

Capital Choice Pathology Laboratory
12041 Bournefield Way, Suite A * Silver Spring, MD 20904  
P: 240.471.3427 * F: 240.471.3401 * Cell 410-940-8844
michael.lafriniere <@t> CCPLab.com
 

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Hutton, Allison
Sent: Thursday, May 08, 2014 2:21 PM
To: 'histonet <@t> lists.utsouthwestern.edu'
Subject: [Histonet] ihc billing

Would anybody be able to shed some light on the 2014 updated IHC billing.  I understand the 88342 and 88343 codes but am looking for some clarification on the G0461 and G0462 codes.  Do these pertain to multiple antibodies on one slide as the 88343 does or is the G0461 for the 1st antibody and G0462 for all remaining antibodies performed for one specimen site?
Thank you in advance
Allison

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