[Histonet] RE: New CPT Codes for IHC

Thu Oct 9 07:42:32 CDT 2014

Here are the descriptions per the 2014 CPT and HCPCS books:

88342 – Immunohistochemistry or immunocytochemistry, each separately identifiable antibody per block, cytologic preparation, or hematologic smear; first separately identifiable antibody per slide

88343 – Each additional separately identifiable antibody per slide (list separately in addition to code from primary procedure)

G0461 – Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain

G0462 – Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure)

So, if you have a specimen with multiple blocks (A1-A3) and you do a multiplex stain with 3 antibodies on A1 and A3, for 88342/88343 you would bill:
A1 - 88342 x 1 and 88343 x 2
A3 - 88342 x 1 and 88343 x 2

For G0461 and G0462 the above case in both situations would be billed as follows:
A1 and A3 - G0461 x 1 and G0462 x 2

If there is a block A and block B and you did the multiplex stain for the G-codes:
A - G0461 x 1 and G0462 x 2
B - G0461 x 1 and G0462 x 2

What causes confusion for me is if an immunohistochemical or multiplex stain is done on levels.  With the 88342 saying per block in the first part of the description, I feel I cannot bill for immuno stains done on additional levels, but then the second part of the description says first separately identifiable antibody per slide and that's when my brain begins to ooze out of my ears.  It seems a bit contradictory to me.  I'd love to read other's thoughts on this.

Brendal C. Finlay, HT (ASCP)

-----Original Message----- 
From: "Miller, Suzie" <millers <@t> emhs.org> 
To: "Blazek, Linda" <lblazek <@t> digestivespecialists.com>, "Horn, Hazel V" <HornHV <@t> archildrens.org>, "Weems, Joyce K." <Joyce.Weems <@t> emoryhealthcare.org>, "Andrew Horvath" <ahorvath <@t> cogipath.com>, "Adesupo, Adesuyi (Banjo)" <abadesuyi <@t> nrh-ok.com>, histonet <@t> lists.utsouthwestern.edu 
Date: 10/08/2014 15:33 
Subject: RE: [Histonet] RE: New CPT Codes for IHC 

We also interpret the coding to be as stated below by Joyce.
________________________________________
From: histonet-bounces <@t> lists.utsouthwestern.edu [histonet-bounces <@t> lists.utsouthwestern.edu] on behalf of Blazek, Linda [lblazek <@t> digestivespecialists.com]
Sent: Wednesday, October 08, 2014 3:51 PM
To: Horn, Hazel V; 'Weems, Joyce K.'; 'Andrew Horvath'; 'Adesupo, Adesuyi (Banjo)'; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] RE: New CPT Codes for IHC

Joyce

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V
Sent: Wednesday, October 08, 2014 3:45 PM
To: 'Weems, Joyce K.'; 'Andrew Horvath'; 'Adesupo, Adesuyi (Banjo)'; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] RE: New CPT Codes for IHC

I would like the correct answer for this.  I have always billed as Joyce states.  But a sister hospital says it's like Andrew's email.  Who is right?

Hazel Horn
Supervisor of Histology/Autopsy/Transcription Anatomic Pathology Arkansas Children's Hospital
1 Children's Way | Slot 820| Little Rock, AR 72202
501.364.4240 direct | 501.364.1241 fax
hornhv <@t> archildrens.org
archildrens.org

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Weems, Joyce K.
Sent: Monday, October 06, 2014 3:41 PM
To: 'Andrew Horvath'; 'Adesupo, Adesuyi (Banjo)'; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] RE: New CPT Codes for IHC

Sorry, I left that part out. We don't do them, so I just didn't think.

I understand the 88343 codes to be for multiple stains on the same slide. The first is 88342 additional 88343 - e.g. PIN4.

So has that changed?

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

This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s).  It may contain information that is privileged and confidential.  Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email.

-----Original Message-----
From: Andrew Horvath [mailto:ahorvath <@t> cogipath.com]
Sent: Monday, October 06, 2014 3:36 PM
To: Weems, Joyce K.; 'Adesupo, Adesuyi (Banjo)'; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] RE: New CPT Codes for IHC

Actually, for non-Medicare if there are multiple stains performed on a block, where the initial CPT is 88342, any subsequent billing for stains on that block would actually be 88343 from the information I see.

Please refer to the links below for more information...

http://ahsrcm.com/assets/2014-Pathology-CPT-Code-Changes.pdf

https://www.aapc.com/memberarea/forums/showthread.php?t=101402

quote from the forum:

Quite and uproar about this in our office - and a lot of confusion. Go to page 360 in this document to read Medicare's decision about this. (inactive link removed)

"The CPT Editorial Panel revised the existing immunohistochemistry code, CPT code 88342 and created a new add-on code 88343 for CY 2014. Current coding requirements only allow CPT code 88342 to be billed once per specimen for each antibody, but the revised CPT codes and descriptors would allow the reporting of multiple units for each slide and each block per antibody
(88342 for the first antibody and 88343 for subsequent antibodies). We believe that this coding would encourage overutilization by allowing multiple blocks and slides to be billed.
To avoid this incentive, we are creating G0461 (Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain) and G0462 (Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (List separately in addition to code for primary procedure)) to ensure that the services are only reported once for each antibody per specimen. We believe this will result in appropriate values for these services without creating incentives for overutilization."

Some of our docs are participating in conference call today with CAP to help clarify what this all means.

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Weems, Joyce K.
Sent: Friday, October 03, 2014 12:33 PM
To: 'Adesupo, Adesuyi (Banjo)'; histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] RE: New CPT Codes for IHC

For non-Medicare it is per block - CPT code 88342.

For Medicare - per specimen. G0461 for the first antibody and G0462 for each additional different ab.

Best, 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

This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s).  It may contain information that is privileged and confidential.  Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email.

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Adesupo, Adesuyi (Banjo)
Sent: Friday, October 03, 2014 2:07 PM
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] New CPT Codes for IHC

 Hi,
       I hope you guys are doing well. Please I have a question about billing the IHC. My question is do we bill by the number of antibodies or blocks?

Thanks,

Banjo Adesuyi, BSMT, HT (ASCP) HTL, QIHC, QLS  Histology Supervisor  Norman Regional Health System,  Norman, OK 73071.
Tel: 405- 307- 1145

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