There have been changes to immunofluorescence codes for 2016: CPT code 88346 has been revised, CPT code 88347 has been deleted, and CPT code 88350 has been added.
Prior to 2016, these studies were reported using either 88346 for immunofluorescence study for each antibody (direct method) or 88347 (indirect method); and it was reported once for each single antibody test. Most often, this study is done on kidney biopsies or some skin specimens.
For 2016, CPT code 88346 has been revised to describe both direct and indirect immunofluorescence studies rendering code 88347 obsolete. CPT code 88346 (Immunofluorescence, per specimen; initial single antibody stain procedure) will be used as the only antibody stain procedure on a single specimen or for the first antibody stain procedure on a single specimen. New CPT code 88350 will be used for each additional single antibody procedure. This is an add-on code and should only be reported in conjunction with code 88346.
Additionally, CPT added new parenthetical notes to clarify the appropriate reporting of these services.
1) Report 88350 in conjunction with 88346
2) Do not report 88346 and 88350 for fluorescent in situ hybridization studies; see 88364, 88365, 88366, 88367, 88368, 88369, 88373, 88374, and 88377
3) Do not report 88346 and 88350 for multiplex immunofluorescence analysis. Instead, use 88399. For example: IgA, IgG, IgM, C3, C4, C1q, kappa and lambda are done on a kidney biopsy. Report: 88346 x 1 and 88350 x 7
Document the name of each immunofluorescence stain or antibody tested and any results relevant to the case. Codes 88346 and 88350 have a professional and technical component, so modifiers 26 and TC must be applied when billing the two parts separately.
In working through the wide variety of billing arrangements, APS found payments that we had been missing.