You Be the Coder: Find Dividing Line for ISH Codes

Question: When our lab performs ISH procedures, we have PhD scientists who give the results of the test. We've been told that if our physician medical director reviews a certain percentage of cases, that we can use the 88367 instead of 88271 codes. Is that correct, and if so, what is the required percentage of cases?

Tennessee Subscriber

Answer: There is no acceptable percentage of physician (medical director) review that allows you to report in situ hybridization (ISH) performed by a PhD scientist using physician codes.

Based on CMS and AMA direction for using the codes in question, you can report 88365 (In [...]

- Published on 2012-02-07