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Pathology/Lab Coding Alert

Reader Question:

Use New Code for Computer-Assisted ER/PR

Published on Sat Oct 30, 2004

Question: We perform ER/PR as immunoperoxidase stains, and the pathologist manually scores the slides to quantify the percent staining. How should we report this service?

Pennsylvania Subscriber Answer: Before CPT 2005 clarified coding for this scenario, yours was a loaded question. Now the correct answer to your question is clear: Report 88360 (Morphometric analysis, tumor immunohistochemistry [e.g., Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual]) because the pathologist performs a manual morphometric analysis of the immunohistochemistry (IHC)-stained slides.

Under the old code set, you had to choose between 88342 (Immunohistochemistry [including tissue immunoperoxidase], each antibody) and 88361 (Morphometric analysis; tumor immunohistochemistry [e.g., Her-2/neu, estrogen receptor/progesterone receptor) quantitative or semiquantitative) for IHC estrogen receptor (ER) assay and progesterone receptor (PR) assay.  

The code choice depended on whether the test was qualitative or quantitative/semiquantitative. But because CMS stated that you should only report 88361 for computer-assisted IHC morphometric analysis, coders did not have a code that accurately described a manual quantification of the ER/PR (or other IHC) slides. The addition of 88360 in CPT 2005 solves this coding dilemma.  
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