Pathology/Lab Coding Alert

Question: I understand that coding for immunofluorescence studies to aid in the diagnosis of conditions such as lupus will change under CPT^® 2016. Can you please explain the change?

Texas Subscriber

Answer: Currently, you report immunofluorescence studies using one of two codes depending on whether the method is direct (direct immunofluorescence, called DIF) or indirect. The codes are 88346 (Immunofluorescent study, each antibody; direct method) and 88347 (… indirect method). You should report one unit of either code for a single antibody test.

For example: In a DIF test, the lab analyst covers a tissue specimen with a solution containing fluorescently labeled antibodies. During an incubation period, the antibodies, typically IgA, IgM, or IgG, bind to specific antigens that indicate autoimmune disorders, such as lupus.

Beginning in 2016, you no longer need to worry about whether the lab method is DIF or indirect immunofluorescence. CPT^® 2016 revises 88346 (Immunofluorescence, per specimen; initial single antibody stain procedure) to describe either a direct or indirect immunofluorescence study. Notice that you’ll use the code for the first (or only) antibody stain procedure on a single specimen.

CPT^® 2016 deletes the code for indirect immunofluorescence (88347), and adds a new code to report additional antibody immunofluorescence studies on a single specimen following the initial study. The new code is +88350 (…each additional single antibody stain procedure). This is an add-on code, so you should report it only in addition to 88346 for the initial antibody immunofluorescence study. You may report multiple units of +88350 if the lab performs more than two immunofluorescence antibody studies on the same specimen.