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88344 and 88342 on the same specimen part

Christine Posted Tue 03rd of February, 2015 21:28:48 PM

What would the proper charges be for a Pin4 and EGR done on one part of a prostate core bx?
Would it be 88344 and 88342?
The Pin4 is a multiplex stain and the EGR is an immuno stain.
Someone said we cannot charge these 2 charges on the same specimen part. That is not how we understood it to be. Can you clarify?

SuperCoder Answered Thu 05th of February, 2015 09:41:30 AM

We are researching and will get back to you ASAP.

SuperCoder Answered Thu 05th of February, 2015 09:41:30 AM
Mail sent to CE.
SuperCoder Answered Thu 05th of February, 2015 11:15:59 AM

You are correct that you can report multiple, unique qualitative IHC stains on the same specimen (even if it’s the same “part”). For instance, you could perform and bill for a qualitative ER and PR on a single breast biopsy (88342 and +88341). The only difference in your prostate case is that one of the stains happens to be a multiplex stain (meaning that you apply more than one stain to a slide, and the pathologist can separately visualize/interpret the stains). So you should code your prostate case as 88342 for the EGR qualitative IHC stain, and 88344 for the PIN4 multiplex stain.

Thanks !!

Christine Posted Sat 07th of February, 2015 23:27:00 PM

OUr billing company is saying we need to use the 59 modifier on the 88342 if we have the 88344 and 88342 together.
Does this sound correct?

SuperCoder Answered Mon 09th of February, 2015 09:37:00 AM

Yes, 88342 is a column 2 code bundled with 88344 according to CCI. Because you are not billing the two codes for the same antibody stain on the same specimen, you can override the edit pair using an appropriate modifier such as 59.

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