Laboratory Question for the Week of April 6, 2020

Question:

Do you have any tips for determining billable units when applying an antibody cocktail?

Answer:

When applying an “antibody cocktail” which contains two or more separately interpretable antibodies, providers should read the statement applicable to determine billable units of service as published in the NCCI policy narrative. The NCCI defines the unit of service for immunohistochemistry as “each single or multiplex antibody stain procedure per specimen. A multiplex antibody immunohistochemical staining procedure is one that uses multiple antibodies to obtain multiple separately reportable medically reasonable and necessary results. An antibody stain containing multiple antibodies that yields a single reportable result is not a multiplex stain and shall be reported with a single antibody staining procedure CPT® code. An immunohistochemistry stain procedure with multiple antibodies that are not separately interpretable (e.g., antibody cocktail) shall only be reported as one (1) unit of service per specimen.”

This question was answered in our Coding Essentials for Laboratories. For more hot topics relating to laboratory services, please visit our store or call us at 1.800.252.1578, ext. 2.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.

Laboratory Question for the Week of April 6, 2020

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