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88312 VS 88342 FOR H. PYLORI

Dawn Posted Thu 30th of July, 2015 11:37:12 AM

I think I read somewhere that Medicare requires an 88312 (diff quick stain) to be performed before an 88342 h pylori stain is ordered on a stomach biopsy. If the 88342 h pylori stain is still necessary after the results of the diff quick, it should be documented in the report why is was necessary. Is this correct?

SuperCoder Answered Fri 31st of July, 2015 01:23:09 AM

No, you can bill CPT 88342 and 88312 separeately. It is not mandatory to report 88312 before doing procedure CPT 88342.

Please read the below mentioned question for more clarification.
When we receive a tissue block for consultation and prepare additional H&E slides plus special-stain slides for microorganisms, can we separately bill for the special stains?

California Subscriber

Answer: Yes, you can separately bill for special stains with a referred pathology consultation if you prepare/evaluate the special stain slides yourself from the referred material.

You should bill 88323 (Consultation and report on referred material requiring preparation of slides) along with 88312 (Special stain including interpretation and report; Group I for microorganisms [e.g., acid fast, methenamine silver]). Because there’s a Correct Coding Initiative (CCI) edit that bundles these codes, you’ll need to append modifier 59 (Distinct procedural service) to 88312.

The same is true for other special stains with consultation such as 88313 (… Group II, all other [e.g., iron, trichrome], except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry) or 88342 (Immunohistochemistry or immunocytochemistry, each separately identifiable antibody per block, cytologic preparation, or hematologic smear; first separately identifiable antibody per slide).


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