Question:
What are Medicare’s rules regarding duplicate testing and interpretation of special stains, immunohistochemical stains, and flow cytometry?
Answer:
Medicare does not pay for duplicate testing. In general, 88312, 88313, 88342, 88184, 88187, 88188, and 88189 should not be reported for the same or similar specimens. When special stains or immunohistochemical stains are prepared in addition to the routine stain, they should be coded separately only if no prior interpretation has been performed by another pathologist. It is not appropriate to bill for the interpretation of special stains, immunohistochemical stains, or flow cytometry when the referring pathologist has already performed an interpretation of the stain, slide, or material.
This question was answered in our annual Laboratory Coding Update webcast. For more hot topics relating to laboratory services, please visit our store or call us at 1.800.252.1578, ext. 2.
