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A Look Ahead: Pathology CPT Changes for 2015

In 2015, Pathology will see many CPT changes.  Some of the bigger changes will include changes to immunohistochemistry codes (88342, 88360 and 88361) as well as the ISH series of codes (88365, 88367 and 88368).  As we have seen in previous years there will be revisions, deletions and additions to these code sets
First, there will be revisions clarifying the “per block,” “per slide” and “per specimen” issue.  The code descriptor for IHC and ISH will now include “per specimen” for each primary code.  Second, each primary code will read, “initial single antibody procedure” for IHC and “initial single probe stain procedure” for ISH which leads to the addition of a new IHC add-on code for “each additional antibody stain procedure” and three new ISH add-on codes for “each additional single probe procedure,” one for qualitative results and two for quantitative/semi-quantitative; manual or computer-assisted.    Third, CPT has added four new codes for IHC and ISH to report for multiplex procedures.  The descriptor for these new codes will also include “per specimen.”  These new codes will not be add-on codes and, per CPT there will be an either/or choice.  You will assign either the initial single procedure or you would assign the multiplex stain procedure (see pages to follow for CPT codes and descriptions).  Last, code 88343 has been deleted for 2015 and replaced with 88341.

Two things that had not changed for both IHC and ISH will be whether the study is a qualitative versus quantitative/semi-quantitative result and whether the procedure is manual or computer-assisted. Overall the CPT changes for 2015 should clarify and simplify coding of these services.

***Note that some of the new codes will be out of numerical sequence and there have also been parenthetical revisions to keep in line with these changes. 

The new/revised/deleted codes for 2015 are as follows:

Immunohistochemistry

Revised Code 88342

2014: Immunohistochemistry or immunocytochemistry, each separately identifiable antibody per block, cytologic preparation or hematologic smear; first separately identifiable antibody per slide 

2015: Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure

Deleted   

88343: Immunohistochemistry or immunocytochemistry, per specimen; each additional separately identifiable antibody per slide

New Pathology Codes for 2015  

+88341 Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure)
(Use 88341 in conjunction with 88342)

88344  ………………each multiplex antibody stain procedure
(Do not use more than one unit of 88341, 88342, 88344 for each separately identifiable antibody per specimen)

(Do not report 88341, 88342, 88344 in conjunction with 88360, 88361, unless each procedure is for a different antibody)

(When multiple separately identifiable antibodies are applied to the same specimen [ie, multiplex antibody stain procedure], use one unit of 88344)

(When multiple antibodies are applied to the same slide that are not separately identifiable [eg, antibody cocktails], use 88342, unless an additional separately identifiable antibody is also used, then use 88344)

Revised Code 88360/88361 

2014: 

88360  Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen, progesterone receptor), quantitative or semi-quantitative, each antibody per specimen, each single antibody stain procedure; manual
88361  …………using computer-assisted technology

2015: 

88360     Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen, progesterone receptor), quantitative or semi-quantitative, per specimen, each single antibody stain procedure; manual

88361  …………using computer-assisted technology
(Do not report 88360, 88361 in conjunction with 88341, 88342, or 88344 unless each procedure is for a different antibody)

(Morphometric analysis of a multiplex antibody stain should be reported with one unit of 88360 or 88361, per specimen)

In situ Hybridization

Revised code 88365

2014 In situ hybridization (eg, FISH), each probe

2015 In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure

New Pathology Codes for 2015  

+88364 …………in situ hybridization (quantitative or semi-quantitative); per specimen; each additional single probe stain procedure
(Use 88364 in conjunction with 88365)

88366  …………each multiplex probe stain procedure

(Do not report 88365, 88366 in conjunction with 88367, 88368, 88374, 88377 for the same probe)

Revised code 88367

2014 Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) each probe, using computer-assisted technology

2015 Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen, initial single probe stain procedure

New Pathology Codes for 2015  

+88373 …………each additional single probe stain procedure
(Use 88373 in conjunction with 88367

88374  …………each multiplex probe stain procedure
(Do not report 88367, 88374 in conjunction with 88365, 88366, 88368, 88377 for the same probe)

Revised code 88368

2014 Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) each probe, manual

2015 Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual per specimen, initial single probe stain procedure

New Pathology Codes for 2015  

+88369 …………each additional single probe stain procedure
(Use 77369 in conjunction with 88368)

88377  …………each multiplex probe stain procedure
(Do not report 88368 or 88377 in conjunction with 88365, 88367, 88374 for the same probe) 
 

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