Wiki 88341 88342 Medicaid Denials

annettebec

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In the State of MI, Medicaid is denying 88341 and 88342 as these codes are not on the current fee schedule. Medicaid also does not recognize the G-codes. Is anyone else encountering this issue. Any help appreciated. Annette
 
yes, in PA we are also getting the same denials...MA has not updated the fee schedule to accept them yet in PA, but they are still accepting the G codes.
 
Yes. In CA, they released a statement saying to not use the new code as they have not updated their fee schedule yet.
 
"WhenNdoubt"

Would someone please give me your opinion on this?
It's still a bit confusing for me...Should this be viewed as---one specimen (it was one piece of nerve), but because there is block A & B for CD4, CD8, and CD68 should I bill 88342x3, and 88341x3??
From what I understand we should bill 88342 and 88341 per antibody/specimen?
Also---the statement ?do not report 88341 more than one time for specific antibody? in my opinion eliminate coding 88341 x 5? What do you think?
 
If I understand correctly, we're talking about 3 IHC stains on 1 specimen; so that would be coded as: first stain, 88342 plus two additional, 88341 x2.
IHC, (immunohistochemical) stains are per specimen, not per block; as opposed to histologic/histochemical stains - i.e. 88312,88313 - which the AMA and Medicare say are per block.
Anyway that's my two cents!

Megan
GO ROYALS !!:D
 
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