CPT Codes*: 88341, 88342, 88360
Correct CPT coding is the sole responsibility of the billing party.What is CPT code 88341?
CPT® 88341 in section: Immunohistochemistry or immunocytochemistry, per specimen.
Is 88342 covered by Medicare?
Revision Explanation: Under Article Text removed the verbiage “Effective 01/01/2014 thru 06/11/2015, CPT® code 88342 and 88343 were not active for Medicare submission. Effective 6/12/2015, 88342 was reactivated by CMS for Medicare submission.
Does Medicare pay for 88341?
3. Medicare does not pay for duplicate testing. Immunocytochemistry (e.g., CPT codes 88342, 88341, 88344, 88360, 88361) and flow cytometry (e.g., CPT codes 88184-88189) should generally not be reported for the same or similar specimens.
How do you code immunohistochemistry?
The CPT Editorial Panel revised the existing immunohistochemistry code, CPT code 88342 and created a new add- on code 88343 for CY 2014.
Can 88344 and 88342 be billed together?
Note: Do not use more than one unit of 88341, 88342, 88344 for each separately identifiable antibody per specimen.
Can 88341 and 88360 be billed together?
CPTs 88342 & 88341 require a modifier to be billed with 88360. You should add modifier 59 if billing a commercial carrier or modifier 59 or XU if billing to Medicare.
Does CPT code 88341 need a modifier?
You bill the extra units of 88341 on additional lines, up to 9 per line, and add modifier 59 to the extra lines.
What is included in CPT 85025?
CPT Code 85025 includes an automated differential of the white blood cells or “diff” in which the following leukocytes are differentiated: neutrophils or granulocytes, lymphocytes, monocytes, eosinophils, and basophils.
Does CPT 88342 need a modifier?
Modifier 59 may be reported with CPT code *88342 if each procedure is for a different antibody. For example: A needle biopsy is performed on the left breast and an immunohistochemistry antibody stain procedure is performed using GATA3 and a morphometric analysis antibody stain procedure is performed using HER2.
What does Procedure Code 88305 mean?
Procedure code 88305 (Level IV - Surgical pathology, gross and microscopic examination) includes different types of biopsies. Diagnosis of malignancies and inflammatory conditions frequently requires numerous biopsies of a particular organ or suspicious site.
Ordering Recommendation
Recommendations when to order or not order the test. May include related or preferred tests.
Reported
Expected turnaround time for a result, beginning when ARUP has received the specimen.
New York DOH Approval Status
Indicates test has been approved by the New York State Department of Health.
Specimen Required
Patient Preparation: Instructions patient must follow before/during specimen collection.
Reference Interval
Normal range/expected value (s) for a specific disease state. May also include abnormal ranges.
Interpretive Data
Background information for test. May include disease information, patient result explanation, recommendations, details of testing, associated diseases, explanation of possible patient results.
CPT Codes
The American Medical Association Current Procedural Terminology (CPT) codes published in ARUP's Laboratory Test Directory are provided for informational purposes only. The codes reflect our interpretation of CPT coding requirements based upon AMA guidelines published annually.
What is the best test for breast cancer?
The clinical care of patients with breast cancer depends upon the accurate diagnosis and the assessment of biomarkers. Hormone receptor assays and Her2 testing are recommended on all primary invasive breast cancers, and on recurrent or metastatic cancers.
What is the purpose of IHC?
IHC is a powerful tool for identifying substances and cells in tissue sections using the specificity of antigen-antibody reactions, where the antibody is linked to a colored indicator (stain) that can be seen with a microscope.
What are the markers of non-small cell carcinoma?
The diagnosis of non-small cell carcinoma often requires additional stains but it is essential that tumor tissue be carefully triaged to allow the patient’s sample to be tested for molecular markers (EG FR, ALK, and others) when clinically indicated.
When to use special stains?
Use of added stains when the diagnosis is already known based on morphologic evaluation of the primary stain.
Is it necessary to perform a special stain?
In addition, it is not usually reasonable and necessary to perform special stains or IHC to determine the presence of H. pylori organisms. Other examples of special stains or IHC that are not reasonable and necessary on every specimen include: Esophagus – fungal stains, trichrome, DPAS, CDX-2 or other mucin stains.
Is it necessary to use a CDX-2 stains?
For most esophageal, gastric and duodenal specimens, it is not reasonable or necessary to perform special stains such as alcian blue – periodic acid Schiff (AB-PAS), or other mucin stains, such as diastase – PAS (D-PAS), or IHC stains such CDX-2 to determine if clinically meaningful intestinal metaplasia is present.
Can IHC be performed on lymph nodes?
In certain clearly defined circumstances, it may be reasonable to perform some IHC on sentinel lymph nodes when the frozen sections show they are free of tumor. The medical necessity for the special stain or IHC studies, and the results of the stain or IHC, must be documented in the surgical pathology report.
Document Information
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
CMS National Coverage Policy
This LCD supplements but does not replace, modify or supersede existing Medicare applicable National Coverage Determinations (NCDs) or payment policy rules and regulations for Special Histochemical Stains & Immunohistochemical Stains.
Coverage Guidance
This LCD does not designate specific special histochemical stains (aka special stains) and/or immunohistochemical (IHC) stains that should be used in the differential diagnosis of tissues or neoplasms because this information is readily available in text books and various scientific publications.
Ordering Recommendation
Recommendations when to order or not order the test. May include related or preferred tests.
Reported
Expected turnaround time for a result, beginning when ARUP has received the specimen.
New York DOH Approval Status
Indicates test has been approved by the New York State Department of Health.
Specimen Required
Patient Preparation: Instructions patient must follow before/during specimen collection.
Reference Interval
Normal range/expected value (s) for a specific disease state. May also include abnormal ranges.
Interpretive Data
Background information for test. May include disease information, patient result explanation, recommendations, details of testing, associated diseases, explanation of possible patient results.
CPT Codes
The American Medical Association Current Procedural Terminology (CPT) codes published in ARUP's Laboratory Test Directory are provided for informational purposes only. The codes reflect our interpretation of CPT coding requirements based upon AMA guidelines published annually.
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