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Deanna Posted Sun 19th of November, 2017 11:32:21 AM
A. Left lateral prostate, biopsies: B. Left midline of prostate, biopsies: C. Right lateral prostate, biopsies: D. Right midline of prostate, biopsies: High molecular weight cytokeratin immunostains are performed on all four of the biopsy specimens. They help to confirm the diagnoses. How would you report the cytokeratin immunostains on all specimens? Would you report 88342 x 4 units for each "specimen"? Or since the "specimen" is different tissues of the prostate - would this be considered 1 unit? Currently we are receiving denials using 4 units. They are denying for exceeding the number units allowed, which is 3 per day. Thanks in advance!
SuperCoder Answered Mon 20th of November, 2017 01:53:31 AM

>The CPT manual clarify that if the lab cuts multiple levels from a single tissue block and stains each level with the same stain, you should not report additional units of service for the stain.

>You should report only one unit of service "for the stain on multiple levels from the single tissue block," according to the CCI manual. Since the lab may prepare multiple slides from different levels, logic extends the restriction of not coding per level to not coding per slide.

>So, you should report only 1 unit of service.

>Hope that helps!

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