[Histonet] RE: IHC billing question

[Mike Pence]

Ouch!

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cartun, Richard
Sent: Thursday, April 30, 2015 4:34 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] IHC billing question

Effective January 1, 2015, our LIS team removed all of the CPT 88342 codes for 
IHC from our CoPath stain dictionary since you couldn't tell whether a 
Cytokeratin-7 was being performed as an "88341" or as an "88342".  Now, as you 
might have expected,  none of the "inpatient" IHC testing has been accounted 
for (the outpatient IHC has been billed manually from the pathology report), 
and they want someone to go back and enter all the CPT codes into the system 
(hopefully, not me!).  Has anyone else encountered this problem?  Thanks (I 
think).

Richard

Richard W. Cartun, MS, PhD
Director, Histology & Immunopathology
Director, Biospecimen Collection Programs Assistant Director, Anatomic 
Pathology Hartford Hospital
80 Seymour Street
Hartford, CT  06102
(860) 972-1596
(860) 545-2204 Fax


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RE: [Histonet] RE: IHC Billing Question

[Joelle Weaver]

No charge  to patient account for negative or positive controls. Only the 
patient test (s). The controls verify that the test ran accurately, and for 
interpretation. You just have to figure this into your cost/test. As many have 
already posted in this string it is why many labs aside from QC reasons,  have 
adopted the single slide for postive/patient and have also eliminated negatives 
when polymer detection is used. 


Joelle Weaver MAOM, HTL (ASCP) QIHC


  

 
> From: mw...@wakehealth.edu
> To: bburn...@capecodhealth.org; jmore...@sidra.org; 
> histonet@lists.utsouthwestern.edu
> Date: Thu, 16 Apr 2015 14:35:59 +
> CC: 
> Subject: [Histonet] RE: IHC Billing Question 
> 
> We have not been charging for the negative control, assuming that it was just 
> a cost of doing business.  I would be interested to hear if anyone has been 
> charging for their negative controls as well.
>  
> Martha Ward, MT (ASCP) QIHC
> Manager
> 
> Molecular Diagnostics Lab
> Medical Center Boulevard  \  Winston-Salem, NC 27157
> p 336.716.2109  \  f 336.716.5890  
> mw...@wakehealth.edu  
>  
>  
> 
> 
> 
> -Original Message-
> From: histonet-boun...@lists.utsouthwestern.edu 
> [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Burnett, 
> Brandy
> Sent: Thursday, April 16, 2015 9:48 AM
> To: 'Joana Moreira'; histonet@lists.utsouthwestern.edu
> Subject: [Histonet] RE: IHC Billing Question 
> 
> We recently added HER2 IHC testing in our lab which we are required to use a 
> negative reagent control For each case. Is there a cpt code for negative 
> reagent control reimbursement? Any information on this Would be much 
> appreciated!
> Thanks
> 
> Brandy Burnett
> Histotechnoligist, QIHC(ASCP)
> CCH Pathology/Histology
> 
> 
> Expert physicians. Quality hospitals. Superior care. 
> 
> 
> -Original Message-
> From: histonet-boun...@lists.utsouthwestern.edu 
> [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Joana Moreira
> Sent: Thursday, April 16, 2015 7:25 AM
> To: histonet@lists.utsouthwestern.edu
> Subject: [Histonet] IHC Billing Question 
> 
> Greetings from Doha!
> 
> This was much probably discussed before, but I was wondering if you could 
> help me with a query in regards to billing.
> For the sites that are still doing an IHC negative reagent control for each 
> patient specimen, do you bill for the negative control? Using code 88341?
> 
> I believe it should be billed (since when and if performed correctly the 
> negative control follows a normal IHC technique) however I am completely new 
> to the billing subject. My previous experience is based in Portugal and UK 
> (where billing does not exist) and I've been introduced to this topic since I 
> joined my current institution that will be following the North American 
> Healthcare model. So... any help will be GREATLY appreciated!!
> 
> Many Thanks in advance,
> Joana
> 
> Joana Moreira
> Supervisor - Anatomical Pathology
> Department of Pathology
> 
> Sidra Medical & Research Center
> PO Box 26999 | Doha, Qatar
> Direct Line  +974-4404-2036
> jmore...@sidra.org | www.sidra.org
> 
> 
> 
> 
> 
> Disclaimer: This email and its attachments may be confidential and are 
> intended solely for the use of the individual to whom it is addressed. If you 
> are not the intended recipient, any reading, printing, storage, disclosure, 
> copying or any other action taken in respect of this e-mail is prohibited and 
> may be unlawful. If you are not the intended recipient, please notify the 
> sender immediately by using the reply function and then permanently delete 
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> the author and do not necessarily represent those of Sidra Medical and 
> Research Center.
> 
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[Histonet] RE: IHC Billing Questions & Controls

[Hanson, Dawn]

Brandy & Joana

Controls are never billable, a control test does not produce a usable result 
based on the patient's specimen. The results of control tests - positive or 
negative only tell you that your reagents, stains, antibodies etc. are 
performing as expected.


| Dawn Hanson | Lab Manager | Outreach | Saint Agnes Hospital, Baltimore, MD |
| * p: 410-368-3083 | * dhan...@stagnes.org | ý 
www.stagnes.org |



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[Histonet] Re: IHC Billing Question

[Bryan Szpunar]

I have never heard of anyone billing for a negative control and would
highly recommend against doing so. As mentioned, it is a cost of doing
business--which is why when CAP clarified that polymer detection systems
did not require them, most cost-conscious labs quit running them.

Regards,

Bryan Szpunar, HT(ASCP)


> -Original Message-
> From: histonet-boun...@lists.utsouthwestern.edu [mailto:
> histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Joana Moreira
> Sent: Thursday, April 16, 2015 7:25 AM
> To: histonet@lists.utsouthwestern.edu
> Subject: [Histonet] IHC Billing Question
>
> Greetings from Doha!
>
> This was much probably discussed before, but I was wondering if you could
> help me with a query in regards to billing.
> For the sites that are still doing an IHC negative reagent control for
> each patient specimen, do you bill for the negative control? Using code
> 88341?
>
> I believe it should be billed (since when and if performed correctly the
> negative control follows a normal IHC technique) however I am completely
> new to the billing subject. My previous experience is based in Portugal and
> UK (where billing does not exist) and I've been introduced to this topic
> since I joined my current institution that will be following the North
> American Healthcare model. So... any help will be GREATLY appreciated!!
>
> Many Thanks in advance,
> Joana
>
> Joana Moreira
> Supervisor - Anatomical Pathology
> Department of Pathology
>
> Sidra Medical & Research Center
> PO Box 26999 | Doha, Qatar
> Direct Line  +974-4404-2036
> jmore...@sidra.org | www.sidra.org
>
>
>
>
>
> Disclaimer: This email and its attachments may be confidential and are
> intended solely for the use of the individual to whom it is addressed. If
> you are not the intended recipient, any reading, printing, storage,
> disclosure, copying or any other action taken in respect of this e-mail is
> prohibited and may be unlawful. If you are not the intended recipient,
> please notify the sender immediately by using the reply function and then
> permanently delete what you have received. Any views or opinions expressed
> are solely those of the author and do not necessarily represent those of
> Sidra Medical and Research Center.
>
>
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[Histonet] RE: IHC Billing Question

[Martha Ward-Pathology]

We have not been charging for the negative control, assuming that it was just a 
cost of doing business.  I would be interested to hear if anyone has been 
charging for their negative controls as well.
 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Burnett, Brandy
Sent: Thursday, April 16, 2015 9:48 AM
To: 'Joana Moreira'; histonet@lists.utsouthwestern.edu
Subject: [Histonet] RE: IHC Billing Question 

We recently added HER2 IHC testing in our lab which we are required to use a 
negative reagent control For each case. Is there a cpt code for negative 
reagent control reimbursement? Any information on this Would be much 
appreciated!
Thanks

Brandy Burnett
Histotechnoligist, QIHC(ASCP)
CCH Pathology/Histology


Expert physicians. Quality hospitals. Superior care. 


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Joana Moreira
Sent: Thursday, April 16, 2015 7:25 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] IHC Billing Question 

Greetings from Doha!

This was much probably discussed before, but I was wondering if you could help 
me with a query in regards to billing.
For the sites that are still doing an IHC negative reagent control for each 
patient specimen, do you bill for the negative control? Using code 88341?

I believe it should be billed (since when and if performed correctly the 
negative control follows a normal IHC technique) however I am completely new to 
the billing subject. My previous experience is based in Portugal and UK (where 
billing does not exist) and I've been introduced to this topic since I joined 
my current institution that will be following the North American Healthcare 
model. So... any help will be GREATLY appreciated!!

Many Thanks in advance,
Joana

Joana Moreira
Supervisor - Anatomical Pathology
Department of Pathology

Sidra Medical & Research Center
PO Box 26999 | Doha, Qatar
Direct Line  +974-4404-2036
jmore...@sidra.org | www.sidra.org





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[Histonet] RE: IHC Billing Question

[Burnett, Brandy]

We recently added HER2 IHC testing in our lab which we are required to use a 
negative reagent control 
For each case. Is there a cpt code for negative reagent control reimbursement? 
Any information on this 
Would be much appreciated!
Thanks

Brandy Burnett
Histotechnoligist, QIHC(ASCP)
CCH Pathology/Histology


Expert physicians. Quality hospitals. Superior care. 


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Joana Moreira
Sent: Thursday, April 16, 2015 7:25 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] IHC Billing Question 

Greetings from Doha!

This was much probably discussed before, but I was wondering if you could help 
me with a query in regards to billing.
For the sites that are still doing an IHC negative reagent control for each 
patient specimen, do you bill for the negative control? Using code 88341?

I believe it should be billed (since when and if performed correctly the 
negative control follows a normal IHC technique) however I am completely new to 
the billing subject. My previous experience is based in Portugal and UK (where 
billing does not exist) and I've been introduced to this topic since I joined 
my current institution that will be following the North American Healthcare 
model. So... any help will be GREATLY appreciated!!

Many Thanks in advance,
Joana

Joana Moreira
Supervisor - Anatomical Pathology
Department of Pathology

Sidra Medical & Research Center
PO Box 26999 | Doha, Qatar
Direct Line  +974-4404-2036
jmore...@sidra.org | www.sidra.org





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solely for the use of the individual to whom it is addressed. If you are not 
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unlawful. If you are not the intended recipient, please notify the sender 
immediately by using the reply function and then permanently delete what you 
have received. Any views or opinions expressed are solely those of the author 
and do not necessarily represent those of Sidra Medical and Research Center.

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[Histonet] RE: IHC billing

[Terri Braud]

Our institution is billing IHC identical to what Joyce stated.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Holy Redeemer Hospital Laboratory
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3676
Fax: 215-938-3874


Message: 3
Date: Wed, 8 Oct 2014 14:44:54 -0500
From: "Horn, Hazel V" 
Subject: RE: [Histonet] RE: New CPT Codes for IHC
I would like the correct answer for this.  I have always billed as Joyce
states.  But a sister hospital says it's like Andrew's email.  Who is
right?

Hazel Horn
Supervisor of Histology/Autopsy/Transcription
Anatomic Pathology
Arkansas Children's Hospital

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[Histonet] RE: ihc billing

[Michael LaFriniere]

Allsion

It is my understanding, and I have gone over this with many billing experts as 
well and performed endless research on.  For medicare appropriate billing with 
multiplex anitbodies, use the GO461 for first multiplex antibody then GO462 for 
each "separately identified" antibody that the pathologist specifically 
diagnostically mentions in the report. An example; if you perform a PIN4 
antibody that consist of 3 distinct antibodies the code GO461 for the first 
antibody mentioned; example(racemace) then GO462 for each additional separately 
identified antibody (examples would be the 2 cytokeratins in many cocktails).

GO462 is also used for each additional antibody used on each SPECIMEN; example 
a tissue that was submitted a specific specimen, example "bx of left arm" 
Pathologist orders pan-cytoketatin, s100, ki67, for medicare you would bill 
GO461 for the first antibody then GO462 x 2 for the (2) additional antibodies, 
again the pathologist must mention each result on the pathology report.

Hope this helps 



Michael R. LaFriniere, HT (ASCP) 
Executive Director
 

Capital Choice Pathology Laboratory
12041 Bournefield Way, Suite A * Silver Spring, MD 20904  
P: 240.471.3427 * F: 240.471.3401 * Cell 410-940-8844
michael.lafrini...@ccplab.com
 

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Hutton, Allison
Sent: Thursday, May 08, 2014 2:21 PM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] ihc billing

Would anybody be able to shed some light on the 2014 updated IHC billing.  I 
understand the 88342 and 88343 codes but am looking for some clarification on 
the G0461 and G0462 codes.  Do these pertain to multiple antibodies on one 
slide as the 88343 does or is the G0461 for the 1st antibody and G0462 for all 
remaining antibodies performed for one specimen site?
Thank you in advance
Allison

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[Histonet] RE: ihc billing

[Weems, Joyce K.]

The G codes are for Medicare/Medicaid. G0461 -  the first and G0462 - each 
additional per SPECIMEN.

88342 is per BLOCK. And you understand 88343...

Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
joyce.we...@emoryhealthcare.org



www.saintjosephsatlanta.org
5665 Peachtree Dunwoody Road
Atlanta, GA 30342

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-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Hutton, Allison
Sent: Thursday, May 08, 2014 2:21 PM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] ihc billing

Would anybody be able to shed some light on the 2014 updated IHC billing.  I 
understand the 88342 and 88343 codes but am looking for some clarification on 
the G0461 and G0462 codes.  Do these pertain to multiple antibodies on one 
slide as the 88343 does or is the G0461 for the 1st antibody and G0462 for all 
remaining antibodies performed for one specimen site?
Thank you in advance
Allison

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