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Help with IHC coding for prostates re: P63/racemase

Leah Posted Wed 25th of March, 2015 15:26:59 PM

I do not often do pathology coding, and need some answers. We bill the charge globally, as we now have an in-house pathologist.
We do prostate biopsies. If needed for IHC, we use the p63/racemase cocktail. We are using 88344 and I am questioning if that is correct. I was told that a multiplex stain means there is more than one color. P63/racemase is mixed and stored in one vial, so there is only one color. Therefore, should we instead be billing 88342? Would it be 88342 AND 88341? Example: we took 12 biopsies of a prostate. Two of the biopsies needed the p63/racemase. What code combination should be submitted? Also, will you please clarify if a "specimen" in our case means the entire prostate itself is a specimen, or if each of the biopsies taken is considered a specimen?

Thank you for your help,

SuperCoder Answered Thu 26th of March, 2015 08:00:18 AM

88341 and 88342 are correct.
Each of the biopsies taken would be considered a specimen.
Multiple immunostains are normally performed on each specimen to more specifically identify the suspect neoplasm by providing known positive and negative responses specific to that neoplasm.

Leah Posted Thu 26th of March, 2015 08:52:57 AM

Thank you. Do you then bill an 88342 and 88341 per slide, or 88342 as the initial slide, and 88341 for each subsequent?

SuperCoder Answered Fri 27th of March, 2015 07:41:18 AM

Yes you are right the codes selection would be done per specimen.
Report 88342 for the initial single antibody identified,
88341 for each additional single antibody
and 88344 for each multiplex antibody identified.

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