Billing Number of Units on Multiple Blocks Per CMS (Medicare), the American Medical Association (AMA) and the College of American Pathologists (CAP), codes 88342, 88360 and 88361 are to be reported for all insurance carriers as follows:
• A single immunohistochemical stain (procedure) for one or more antibody(s) performed on multiple blocks from a surgical specimen, multiple slides from a cytological specimen or multiple slides from a hematologic specimen will only be reported as one unit of service for each separate specimen. For example, a pancytokeratin stain performed on Blocks A1 & A2 would be reported as 88342 x 1.
Billing Cocktail Stains CMS indicated in its January 1, 2012, National Correct Coding Initiative (CCI) Policy manual that pathologists should not report more than one unit of IHC service per specimen for an immunohistochemistry antibody stain, even if it contains multiple separately-interpretable antibodies. Per this policy:
• IHC stains that are made up of multiple antibodies (ie. double stain, triple stain or cocktail stains) should not be reported more than one time, or one unit of service, per specimen for each immunohistochemical antibody stain procedure. • This NCCI policy applies to Medicare and Medicaid accounts. When coding for cocktail stains APS is asking that our clients continue to report all immunohistochemical stains per antibody, per specimen. We have programmed pre-billing edits into our billing system to handle any needed unit of service adjustments on patient accounts affected by this policy.
APS stepped in and took control of the transition and generated normal collections in our second month, improving billing, which is a huge accomplishment for our business.