Immunohistochemistry Services Coding Guidelines

POLICY NUMBER

DESCRIPTION

None

POLICY

As an adjunct to surgical pathology tissue exams, pathologists use immunohistochemistry (IHC) tests as an aid in diagnosing certain cancers by identifying specific characteristics of proteins. In addition, IHC can also help determine appropriate treatment regimens for certain cancers.

The following codes are used to report IHC testing:

When reporting IHC testing, each service must be selected and reported based on specific clinical indications. To decide which codes should be reported, you must also determine if the test is qualitative or quantitative.

The first IHC antibody procedure, per specimen, should be reported with CPT code 88360, 88361 or 88342 as appropriate. Each additional single antibody stain procedure, per specimen is reported with CPT code 88341, 88360 or 88361, as indicated. For multiplex antibody procedures, CPT code 88344 is reported.

Pathologist should report codes 88341, 88342, and/or 88344 with the following attributes:

• Antibody(ies) used

• Results of stain: negative or positive

• Controls reviewed

Pathologist should report codes 88360(manual) or 88361(digital cellular imaging) with the following attributes:

• Antibody(ies) used

• Numerical quantitation

• Staining intensity

POLICY EXCEPTIONS

None

POLICY GUIDELINES

The coding guidelines outlined in Coding Policy should not be used in lieu of the Member's specific benefits plan language.

POLICY HISTORY

5/23/2016: Policy added.

5/30/2017 – Policy Modified - Source

7/15/2017 - Policy Effective

SOURCE(S)

The Immunohistochemistry Services Coding Guidelines are taken from the CPT manual. The codes can be found on pages 574-575 of CPT 2017 Professional Edition.

CODE REFERENCE