RE: [Histonet] Re: Histonet Digest, Vol 83, Issue 20
I posted it when I found out about it last October. Sorry to everyone that didn't see it! j -Original Message- From: histot...@imagesbyhopper.com [mailto:histot...@imagesbyhopper.com] Sent: Saturday, October 16, 2010 08:17 To: Weems, Joyce Cc: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Re: Histonet Digest, Vol 83, Issue 20 Joyce, THANK YOU for the link! :o) Now I wonder, if this is over a year old, is the the first time it's been seen on Histonet, or did I just miss this important update? This is really going to help the widget count in my lab! My paths frequently want to test more than one block on their tumor cases and now I can charge for them! :o) Michelle -Original Message- From: Weems, Joyce [mailto:jwe...@sjha.org] Sent: Friday, October 15, 2010 10:45 AM To: histot...@imagesbyhopper.com Cc: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Re: Histonet Digest, Vol 83, Issue 20 http://www.flpath.org/rli2.asp Here is a link that will help.. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of histot...@imagesbyhopper.com Sent: Friday, October 15, 2010 09:59 To: Weems, Joyce Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Re: Histonet Digest, Vol 83, Issue 20 Can you please provide the specific CMS update number? The website doesn't seem to be too user friendly ... thanks! On Oct 14, 2010, at 12:22 PM, Weems, Joyce jwe...@sjha.org wrote: CMS/NCCI Update Dated October 1, 2009 8. The unit of service for special stains (CPT codes 88312-88313) and immunohistochemistry (CPT codes 88342, 88360, 88361) is each stain. If it is medically reasonable and necessary to perform the same stain on more than one specimen or more than one block of tissue from the same specimen, additional units of service may be reported for the additional specimen(s) or block(s). Physicians should not report more than one unit of service for a stain performed on a single tissue block. For example it is common practice to cut multiple levels from a tissue block and stain each level with the same stain. The multiple levels from the same block of tissue stained with the same stain should not be reported as additional units of service. Only one unit of service should be reported for the stain on multiple levels from the single tissue block. Additionally, controls performed with special stains should not be reported as separate units of service for the stain. -Original Message- From: Mike Pence [mailto:mpe...@grhs.net] Sent: Thursday, October 14, 2010 11:31 To: Weems, Joyce; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Re: Histonet Digest, Vol 83, Issue 20 Can you site your source, please. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Weems, Joyce Sent: Thursday, October 14, 2010 10:25 AM To: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Re: Histonet Digest, Vol 83, Issue 20 The change is that you can bill per block now and not per specimen. This is for immunos and special stains. It does make a huge difference! Best, Joyce Weems Pathology Manager Saint Joseph's Hospital 5665 Peachtree Dunwoody Rd NE Atlanta, GA 30342 678-843-7376 - Phone 678-843-7831 - Fax -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Chris Evanish Sent: Thursday, October 14, 2010 11:10 To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Re: Histonet Digest, Vol 83, Issue 20 Has anyone heard of a cpt coding change that allows us to bill 88342 per slide run instead of per antibody? One of our Pathologist was at a conference and was told that we could do that. It makes a big difference with running cytokeratins on multiple blocks and levels of sentinel nodes. Thanks, Chris Evanish Montgomery Hospital Norristown PA Chris D. Evanish Histology Supervisor Montgomery Hospital 610-270-2379 Please consider the environment before printing this email to your outgoing mail. Confidentiality Notice: This e-mail, including any attachments is the property of Catholic Health East and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet Confidentiality Notice: This e-mail, including any attachments is the property of Catholic Health
RE: [Histonet] AFB
I thought Fite's was more specific for leprosy.. whatever that bug is called now. j -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cheryl Crowder Sent: Saturday, October 16, 2010 10:49 To: histonet@lists.utsouthwestern.edu Subject: [Histonet] AFB Amy - The AFB (Ziehl-Neelsen, Kinyoun's, etc) will stain any acid-fast bacteria. The Fite's stain is usually considered specific for mycobacteria. Cheryl ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet Confidentiality Notice: This e-mail, including any attachments is the property of Catholic Health East and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Re: Histonet Digest, Vol 83, Issue 20
Joyce, Certainly not *your* fault that *I* missed it! THANK YOU for reposting the link. :o) Michelle -Original Message- From: Weems, Joyce [mailto:jwe...@sjha.org] Sent: Sunday, October 17, 2010 6:47 PM To: histot...@imagesbyhopper.com Cc: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Re: Histonet Digest, Vol 83, Issue 20 I posted it when I found out about it last October. Sorry to everyone that didn't see it! j -Original Message- From: histot...@imagesbyhopper.com [mailto:histot...@imagesbyhopper.com] Sent: Saturday, October 16, 2010 08:17 To: Weems, Joyce Cc: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Re: Histonet Digest, Vol 83, Issue 20 Joyce, THANK YOU for the link! :o) Now I wonder, if this is over a year old, is the the first time it's been seen on Histonet, or did I just miss this important update? This is really going to help the widget count in my lab! My paths frequently want to test more than one block on their tumor cases and now I can charge for them! :o) Michelle -Original Message- From: Weems, Joyce [mailto:jwe...@sjha.org] Sent: Friday, October 15, 2010 10:45 AM To: histot...@imagesbyhopper.com Cc: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Re: Histonet Digest, Vol 83, Issue 20 http://www.flpath.org/rli2.asp Here is a link that will help.. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of histot...@imagesbyhopper.com Sent: Friday, October 15, 2010 09:59 To: Weems, Joyce Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Re: Histonet Digest, Vol 83, Issue 20 Can you please provide the specific CMS update number? The website doesn't seem to be too user friendly ... thanks! On Oct 14, 2010, at 12:22 PM, Weems, Joyce jwe...@sjha.org wrote: CMS/NCCI Update Dated October 1, 2009 8. The unit of service for special stains (CPT codes 88312-88313) and immunohistochemistry (CPT codes 88342, 88360, 88361) is each stain. If it is medically reasonable and necessary to perform the same stain on more than one specimen or more than one block of tissue from the same specimen, additional units of service may be reported for the additional specimen(s) or block(s). Physicians should not report more than one unit of service for a stain performed on a single tissue block. For example it is common practice to cut multiple levels from a tissue block and stain each level with the same stain. The multiple levels from the same block of tissue stained with the same stain should not be reported as additional units of service. Only one unit of service should be reported for the stain on multiple levels from the single tissue block. Additionally, controls performed with special stains should not be reported as separate units of service for the stain. -Original Message- From: Mike Pence [mailto:mpe...@grhs.net] Sent: Thursday, October 14, 2010 11:31 To: Weems, Joyce; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Re: Histonet Digest, Vol 83, Issue 20 Can you site your source, please. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Weems, Joyce Sent: Thursday, October 14, 2010 10:25 AM To: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Re: Histonet Digest, Vol 83, Issue 20 The change is that you can bill per block now and not per specimen. This is for immunos and special stains. It does make a huge difference! Best, Joyce Weems Pathology Manager Saint Joseph's Hospital 5665 Peachtree Dunwoody Rd NE Atlanta, GA 30342 678-843-7376 - Phone 678-843-7831 - Fax -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Chris Evanish Sent: Thursday, October 14, 2010 11:10 To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Re: Histonet Digest, Vol 83, Issue 20 Has anyone heard of a cpt coding change that allows us to bill 88342 per slide run instead of per antibody? One of our Pathologist was at a conference and was told that we could do that. It makes a big difference with running cytokeratins on multiple blocks and levels of sentinel nodes. Thanks, Chris Evanish Montgomery Hospital Norristown PA Chris D. Evanish Histology Supervisor Montgomery Hospital 610-270-2379 Please consider the environment before printing this email to your outgoing mail. Confidentiality Notice: This e-mail, including any attachments is the property of Catholic Health East and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this
Re: [Histonet] AFB
Hi - Can't find the original question - must have deleted it, so I'll answer through Cheryl's, if that's OK with her. If I remember, the question was something like - are there other microorganisms besides TB that stain with Kinyoun (or something like that). First, any mycobacterium (acid fast bacteria AFB) will stain with Ziehl-Neelsen, Kinyoun, Auramine-Rhodamine or Fites (hence anything staining with these stains is called AFB positive, meaning staining with these AF stains) . So that means Mycobacterium tuberculosis (TB), Mycobacterium avium intracellular (found in birds and I've seen it in spleen and bone marrow of immune suppressed patients), Mycobacterium paratuberculosis (found in intestine of infected cows and goats, causing something similar to Crone's disease), and a lot of other Mycobacterium are AFB positive staining with these procedures. Mycobacterium leprae (leprosy) is a very thin walled mycobacterium, so needs the Fites stain with the peanut oil (or any other oil, such as mineral oil) to coat the leprosy microorganism, so it can withstand decolorization with aqueous alcohol. But Fites can also be used to demonstrate any of the Mycobacterium. These AFB stains will also demonstrate the sulfur clubs of actinomyces, and the filamentous strands of nocardia are also weakly AFB positive. (Sort of bacteria with some fungus characteristics.) Cryptosporidium found in the intestine (causing severe diarrhea) can also stain AFB positive. And there are bacterium (mycobacterium or others) in tap water that are AFB positive, which can adhere to your slides from the flotation bath water, or from the tap water. Usually non-pathogenic AFB, but I don't know their names. And I'm sure there are other less common bacteria that I've forgotten or never known about that will stain AFB positive, which are not in the Mycobacterium genus. And let's remember that hair follicles, sperm (heads with lipids), lipofucsin (wear and tear pigment of lipids) also stain AFB positive. And also Russell bodies (inclusions of antibodies in plasma cells) will stain AFB positive. And keratin which is dense can simply require longer differentiation, or else it will retain the red color of the dye. So, yes, Amy, there are other things that stain positive with Kinyoun that are not TB/mycobacterium. Peggy A. Wenk, HTL(ASCP)SLS Beaumont Hospital Royal Oak, MI 48073 -- From: Cheryl Crowder ccrow...@vetmed.lsu.edu Sent: Saturday, October 16, 2010 10:48 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] AFB Amy - The AFB (Ziehl-Neelsen, Kinyoun's, etc) will stain any acid-fast bacteria. The Fite's stain is usually considered specific for mycobacteria. Cheryl ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
