Pathology/Lab Coding Alert

Question: I've heard that if we use two IHC antibody stains on a single slide, we can no longer report two units of 88342. Sometimes we put two separate IHC stains on a single slide to conserve the specimen. Does that mean we can't bill two units of 88342 in those cases?

Ohio Subscriber

Answer: What you've heard is partially true, but it shouldn't restrict you to one unit of 88342 if you're applying two separate stains (from two separate "vials" in two separate procedures, providing two separate interpretations) even if you're using one slide.

Truth: For Medicare contractors, you can no longer report multiple units of 88342 (Immunohistochemistry [including tissue immunoperoxidase], each antibody) for "cocktail" stains containing multiple antibodies in a single "vial" applied in a single procedure, even if you document that each antibody provides distinct diagnostic information.

Medicare's National Correct Coding Initiative Policy Manual states: "Physicians should not report more than one unit of service per specimen for an immunohistochemical antibody(s) stain (procedure) even if it contains multiple separately interpretable antibodies."

Your example involves two separate staining procedures, so you should be able to continue to report the work as 88342 x 2 with proper documentation.