Pathology/Lab Coding Alert

Question: The lab report states, “progesterone receptor negative: 0 staining in all cells. Should we bill 88342 or 88360?

Ohio Subscriber

Answer: Although the information you’ve provided is a little ambiguous, it appears that the correct code for this test is 88342 (Immunohistochemistry or immunocytochemistry, each separately identifiable antibody per block, cytologic preparation, or hematologic smear; first separately identifiable antibody per slide). 

Code 88342 represents a quantitative immunohistochemistry test, which typically results in a statement of “positive” or “negative” findings, in this case, for progesterone receptor (PR). 

If the lab performs quantitative or semi-quantitative immunohistochemistry, you would select between 88360 (Morphometric analysis, tumor immunohistochemistry [e.g., Her-2/neu, estrogen receptor/progesterone receptor], quantitative or semiquantitative, each antibody; manual) or 88361 (… using computer-assisted technology). These tests typically result in a quantitative statement of findings, such as percent cellular staining or a numeric score based at least in part on counting stained cells. Because this report also lists “0 staining,” it’s possible that the lab ran a morphometric analysis. You really need a better description of the lab test to ensure that you select the proper code for this lab service.