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Combined staining

Heather Posted Wed 04th of September, 2013 14:31:48 PM

Regarding Supercoder Pathology/Lab Coding Alert article dated 8/8/05, Watch for 3 Complications When Coding Special Stains-

Example: The lab mixes periodic acid-Schiff (PAS) and Alcian blue and uses this single reagent to stain esophageal biopsy specimens when medically indicated. The PAS stain can help detect and definitively identify organisms such as fungi. Pathologists use the Alcian blue stain to assess cellular distortions indicative of Barrett's esophagus, which is a chronic peptic ulcer of the esophagus.

If the pathologist examines a PAS/Alcian blue-stained biopsy for the presence of micro-organisms and to investigate Barrett's syndrome, report the professional component (modifier 26, Professional component) of both 88312 and 88313 for the "cocktail," just as you would if the pathologist examined slides stained separately with PAS and Alcian blue. "The physician work is fundamentally the same whether the stains are separate or mixed, and I think that's why the AMA OK'd reporting two codes in this instance," Padget says.

If a lab performs a combined AB/PAS on a single slide for the same reasons above, it is able to bill for one unit of "88312" AND one unit of "88313" for that slide?

SuperCoder Answered Thu 05th of September, 2013 10:59:57 AM

Both of stains are performed on a single slide, it is known as Special stain- Cocktail,In this scenario both the stains have to be billed separately using 88312-26 & 8831-26 as per units billed by physician.

Heather Posted Tue 17th of September, 2013 16:47:24 PM

Why is it that this AB/PAS cocktail can be billed as two, separate stains ('88312' and '88313') but any IHC cocktail can only be billed as one unit of '88342'?

SuperCoder Answered Tue 17th of September, 2013 17:51:05 PM

My Editor is working on this

SuperCoder Answered Tue 17th of September, 2013 17:51:05 PM
Vinay, Please check
SuperCoder Answered Mon 23rd of September, 2013 05:34:55 AM

AB & PAS can be billed as two codes as – Per advise from the June 2004 issue CAP Today. It is appropriate to bill separately for Antibodies in a cocktail when each stains can be differentiated Microscopically, In this instance Pathologist provided a distinct interpretation for each of the 2 stains; Thus both stains has to be billed separately.
Alician Blue: for Group II stains- '88313'
PAS- used to identify fungus- it is reported as Group I Stain- 88312.
The key is clearly documenting the interpretation for each stain, & same is reason why two immunohistochemical billed as '88342',
as they cannot be interpreted separately.

SuperCoder Answered Tue 24th of September, 2013 08:44:50 AM


SuperCoder Answered Tue 24th of September, 2013 08:44:52 AM


SuperCoder Answered Tue 24th of September, 2013 08:44:54 AM


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