# 88341 and 88344



## jmoretto (Jan 13, 2015)

Hello- I work for a dermatopathologist - questions regarding the 2015 cpt change deleting 88343 - being replaced with 88341 and 88344

case scenario = one specimen 2 blocks (slides).  Immunochemistry x3 on one slide and x2 on the other. 
i interpret the new cpt this way - can anyone provide feedback

88342 initial
88341 one add'l   for one block/slide that is x2
and
88344 for the other block/slide that is x3 

Since cpt says I cannot bill more than 1 unit of any of these codes, the alternative is 88344 for 3 or more.
All of these are separately identifiable antibodies ( no cocktails)

Or, since this is just One specimen, do I only get to bill 88344?

thanks for any input.


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## Brandykub (Jan 13, 2015)

I am also hoping for some clarification on this. These new IHC codes are confusing!!


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## wkc12981 (Jan 13, 2015)

I will give it a shot.  Basically this has been reversed back to per specimen instead of per block.  So even though you have two slides, (lets call them A1 and A2), it is still just one specimen.  So there were 5 IHC done on specimen A even though there were two slides. 

As far as the 88344 goes, your physician must clearly document when a multiplex/cocktail stain procedure has been performed.  For example if a PIN-4 IHC is performed containing three different antibodies in that one staining procedure, that is one unit of service of 88344.  the different antibodies in that single staining procedure has to be separately identifiable (i.e., different colors) in order to consider this a multiplex stain. If there are multiple antibodies in the staining procedure but those antibodies cannot be separately identified (i.e., AE1/AE3), then that is NOT a multiplex stain and must be assigned code 88342 or 88341 (depending on whether any other IHC stains are done on that specimen). DO NOT code 88344 for these stains that are not separately identifiable (i.e., not different colors).

So without seeing your path report to see what is documented, I can't say whether 88344 would be appropriate.  At our facility, our doctors do not do multiplex staining.  Since you state it is not a cocktail, then I would code this 

88342 x1
88341 x4


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## psacco (Jan 14, 2015)

agree with hoseluver....as the CPT states per specimen, how many blocks you have is now irrelevant....the coding of 88342 x 1 and 88341 x 4 would seem correct


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## jmoretto (Jan 14, 2015)

psacco said:


> agree with hoseluver....as the CPT states per specimen, how many blocks you have is now irrelevant....the coding of 88342 x 1 and 88341 x 4 would seem correct


Hi and thank you for your input.  I was under the impression  (it's noted in CPT) that 88341 cannot be billed in units.  Is this not the case? 
thanks again


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## jmoretto (Jan 14, 2015)

Hi and thank you for your input. I was under the impression (it's noted in CPT) that 88341 cannot be billed in units. Is this not the case? 
thanks again


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## bbooks (Jan 14, 2015)

psacco said:


> agree with hoseluver....as the CPT states per specimen, how many blocks you have is now irrelevant....the coding of 88342 x 1 and 88341 x 4 would seem correct



Agree if 5 different IHC were done on the specimen. If the same IHC was done on blocks A1 and A2, that could only be counted as one charge.

I found this link that gives some useful examples for the new codes:

http://apsmedbill.com/whitepapers/2...itative-ihc-morphometric-analysis-and-fishish


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## jmoretto (Jan 15, 2015)

thanks everyone for your input.


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## psacco (Jan 22, 2015)

i have found this video by Dennis Padgett that explains the new IHC and ISH/FISH excellently....it should clear up any lingering questions.

http://training.neogenomics.com/course/view.php?id=55


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## aleigh (Mar 2, 2015)

Is anyone noticing denials for 88341. I am getting LOADS. They will pay the 88342, but deny the 88341 saying either because 1. based on industry standards, this service does not require pc/tc components (False!) or a provider of this specialty does not perform this service (False!). 
It's really frustrating as their suggestion is to just do an appeal. Which becomes very time consuming when you have a bunch.


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## bbooks (Mar 3, 2015)

Are your denials coming from a particular payer or is it across the board? We haven't had trouble with these codes, yet. Although, we did have Coventry insurance tell us that they now require preauthorization for 88367 and 88368 and have denied these claims. Our executive director is working with that payer on that issue.


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## aleigh (Mar 3, 2015)

So far it's only been Blue Shield of CA and Tricare. 
Wow, that's very strange.


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## psacco (Mar 12, 2015)

aleigh, 
yes, tons of denials for 88341...highmark (all of them), advantra medicare, and a host of others...


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## LINAHENN (May 31, 2019)

I am getting denials for 88342 and 88341 as well for - this service does not require pc/tc components or a provider of this specialty does not perform this service and Requires Preauthorization. This is happening mostly with HIP. And sometimes they are paying the Professional and not Technical stating No Auth Obtained.


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## Ramesh2018 (Jun 21, 2019)

jmoretto said:


> case scenario = one specimen 2 blocks (slides). Immunochemistry x3 on one slide and x2 on the other.



Answer: 88342 X 2,88341 X 3


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