charles Aiesi Posted Tue 11th of March, 2014 13:37:41 PM
Alcian blue over pas ABP can you bill for 88312 and 88313 in a biopsy taken from the esophagus where the pathologist looks at one slide but interprets the stains independently (alcain blue for metaplasia and pas for organisms)
SuperCoder Answered Wed 12th of March, 2014 10:11:18 AM
Because the pathologists performed one stain -- albeit a combined stain -- you should report only one unit of service. And although the PAS would identify any fungus present, the pathologist does not perform the stain on an esophagus biopsy to identify micro-organisms. That's why you shouldn't report this stain as +88312 (Special stains [list separately in addition to code for primary service]; Group I for micro-organisms [e.g., Gridley, acid fast, methenamine silver], each).
The primary purpose of the Alcian Blue/PAS stain for the esophagus biopsy is to identify goblet cells, which are diagnostic for Barrett's esophagus. You should report the service as +88313 (...; Group II, all other [e.g., iron, trichrome], except immunocytochemistry and immunoperoxidase stains, each).