We are incorporating the new rules into our LIS/billing system for 2014. I just to verify how others are interpreting these rules.
Medicare - my understanding is that the G codes are used for all IHC, G0461 for the first IHC and G0462 for any additional antibody on the same specimen, regardless if it is a cocktail or not. I think this language is clear G0461 = "per specimen;first single or multiplex antibody" and G0462 = "per specimen; each additional single or multiples antibody" Third Party Payors - AMA changed the wording from specimen to block, to enable billing separate blocks on the same specimen. 88342 = "each separately identifiable antibody per block; first separately identifiable antibody per slide". 88343 = "each additional, separately identifiable antibody per slide". So it is clear that 88343 is for cocktail stains, but the guidelines changed from specimen to block. And the G-codes clearly state specimen, not block and it doesnt matter if it is a cocktail or not. My question is, do you agree with my understanding? Do you think that AMA means to say that a block equates to a specimen? Thanks, Roxanne_______________________________________________ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
