[Histonet] immunohistochemisty coding

[Michael LaFriniere]

Hi Sarah, 

Joyce is correct, under medicare changes in pathology coding, you can not bill for each of the blocks of the same antibody applications, only one charge per specific antibody mentioned in the pathology report is allowable. Medicare immuno billing is per "specimen" only for each specific antibody used, example if you used s100 for the same specimen (wide melanoma excision)on 15 different blocks, under medicare you can only bill one GO461, yes- not fair when the need is appropriate, 

I must voice my opinio)- this probably will lower some of the over utilization and inappropriate billing practices that many of us have seen in the immunohistochemistry world and the labs that have capitalized on the practice, the problem with the lower reimbursements and change in medicare coding hurts many of our labs who have used the utilization of immunohistochemistry appropriately.     

However, "under current 2014" CPT coding on non medicare can you bill for the additional work per block using the 88342 and 88343 cpt code, I am sure moving forward we are going to continue to see adjustments to the pathology coding processes!

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 Weems, Joyce K.
Sent: Monday, May 19, 2014 12:21 PM
To: 'Sarah.Dysart <@t> stdavids.com'; histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] RE: Billing

No - one G0461.

If you had AE1/AE3, Melan A, S100 you would charge G0461 x 1 and G0462 x 2. 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 Sarah.Dysart <@t> stdavids.com
Sent: Monday, May 19, 2014 12:00 PM
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] Billing

When it comes to the medicare codes...question...

So you have one specimen that has 10 blocks.
AE1/AE3 is ordered on all 10 blocks.
Can you bill AE1/AE3 1st Antibody once (G0461), then AE1/AE3 Additional (G0462) nine times?

Thanks,

Sarah E. Dysart, BA, HT (ASCP), QIHC (ASCP) Pathology Supervisor St. David's North Austin Medical Center
12221 North Mopac Expressway
Austin, Texas  78758
(512)901-1220

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