Our pathologists are now doing an IHC stain (CD3) routinely on small bowel bxs to r/o subtle early changes associated with celiac sprue. The changes may not be obvious on routine H&E staining. This is to r/o sprue. The stain is of great value in that it may increase diagnostic accuracy. Some specimens show no abnormality and the lab requisition does not state r/o celiacs, so would this stain be considered a medical necessity? Is it valid charging for the IHC stain? Does the referring Dr. have to request the pathologist to do whatever is appropriate to r/o a diagnosis for us to bill additional services aside from the surgical specimen?
Any advice appreciated.
Any advice appreciated.