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subject: Four Ways To Ensure You Get Past Every Er/pr Coding Hurdle [print this page]


Here our experts will help you sort out the difference between specific analyte and specific method to ensure you select the right code each and every time.

Keep 84233 and 84234 for assays

If you are looking for specific codes when a surgical pathology report references estrogen and/or progesterone receptor testing, you cannot miss 84233 and 84234. However are those always the right choice?

The 84233 and 84234 definitions create a dilemma for coders reporting ER/PR (estrogen receptor and progesterone receptor tests). The question is whether you must report 84233/84234 as the definitions specify ER/PR, or if you can in its place report a generic immunohistochemistry code such as 88342 for certain ER/PR testing.

Watch out for immunohistochemistry

When the lab method involves immunohistochemistry (IHC) for tissue specimens like evaluating breast tumors for ER and PR status, you should look to the following codes to describe the service: 88342, 88360, 88361.

Distinguish qualitative/ quantitative codes

Choosing among 88342, 88360, or 88361 requires knowing whether the immunohistochemistry analysis is qualitative or quantitative (including semiquantitative), and whether quantification uses computer-assisted technology or manual counting, including visual approximation. You might use any of these three codes for ER, PR, Her- 2/neu, Ki-67, or any of several other IHC analyses.

Count antibodies

You should report one unit of the appropriate code for each antibody stain, irrespective of which antibody you are coding.

For the entire CPT code list, sign up for a one-stop medical coding website. Such a site comes stocked with all updated codes which you need to know to code right for your practice.

by: James Article




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