Pathology/Lab Coding Alert

Question: CPT 88342 specifies that it should be listed for "each antibody." Can 88342 be reported for the same antibody tested on multiple blocks from a single specimen? And, can 88342 be reported each time the same single antibody is tested on multiple specimens from a single patient?

Pennsylvania Subscriber

Answer: Code 88342 (immunocytochemistry [including tissue immunoperoxidase], each antibody) is reported once per antibody tested on each specimen. Assuming the specimen is tissue, it would not be appropriate to report multiple units of 88342 for multiple tissue blocks from a single specimen, just as you could not report each tissue block as an individual specimen. If the same antibody is tested on multiple specimens from a single patient, it is appropriate to report multiple units of 88342 as well as the appropriate surgical pathology code for each specimen.
 
However, the situation is different if the specimen is a bone marrow aspirate and an additional cell block is prepared from the clot following smear preparation. In this case, it is appropriate to report 85097 for evaluation of the aspirate, and a unit of 88305 for the cell block. If immunoperoxidase stains for the same antibody are used for the smears and the cell block, two units of 88342 could be reported.

 -- You Be the Coder and Reader Questions were answered with the assistance of Laurie A. Castillo, MA, CPC, CPC-H, CCS-P, president of Physician Coding & Compliance Consulting in Manassas, Va.; William K. Dettwyler, MT, AMT, president, Codus Medicus Inc. in Oregon; and R.M. Stainton Jr., MD, president of Doctors' Anatomic Pathology Services in Jonesboro, Ark.