RE: [Histonet] RE: [IHCRG] Re: another point on billing codes

From:"Weems, Joyce"

Fine with me!

Joyce Weems
Pathology Manager
Saint Joseph's Hospital 
5665 Peachtree Dunwoody Rd NE
Atlanta, GA 30342
404-851-7376 - Phone
404-851-7831 - Fax

-----Original Message-----
[]On Behalf Of Patsy
Sent: Wednesday, August 29, 2007 11:06 AM
Cc: 'IHCRG Resource Group (E-mail)'
Subject: [Histonet] RE: [IHCRG] Re: another point on billing codes

I find this thread interesting and was wondering if I have everyone's
permission to use this as one of the questions for the NSH IHC Forum?

-----Original Message-----
From: [] On Behalf Of
Richard Cartun
Sent: Wednesday, August 29, 2007 6:49 AM
Cc: IHCRG Resource Group (E-mail)
Subject: [IHCRG] Re: another point on billing codes

Interesting point.  We use semiquantitative scoring for ER, PR, and HER2
performed on primary breast CAs.  Therefore, we use 88360x3 for these
markers whether they are positive or negative.


Richard W. Cartun, Ph.D.
Director, Immunopathology & Histology
Assistant Director, Anatomic Pathology
Hartford Hospital
80 Seymour Street
Hartford, CT  06102
(860) 545-1596
(860) 545-0174 Fax

>>> "Orr, Rebecca"  08/29/07 7:24 AM >>>

I'm interested in everyone's input on this thread.
Charging for Breast cases seems to be as unclear as the processing
We are now in the process of figuring out charges if the ER PR Her2
results are negative.

ER PR Her2 are quantitative (2+, 3+) or semi quantitative (weakly or
strongly positive, etc)
Assuming these markers are ordered on a breast cancer (not a benign
breast), even a negative result is quantitative and contributes to the
outcome of the therapy., isn't this right?  
Please steer me in the right direction if this is an incorrect point.

So we are being told by our billing folks that we must change the code
on the negative resulted ER PR her2 to a lesser charge.
I can understand if CPT may think doctors are charging on unnecessary
IHC tests, but they are focusing on the wrong tests.
(in my opinion).
A negative or 0  result on these particular markers should NOT be
synonymous with "

Quite perplexing and frustrating. 

---Original Message-----
> From: 
> []On Behalf Of Parker,
> Helayne
> Sent: Tuesday, August 28, 2007 4:25 PM
> To: 
> Subject: [Histonet] CPT codes
> Hi all,
>  Does anyone know the correct charges to charge a breast lump that
> be inked.  Someone told us we could only charge a -307 if it has
> in the micro margins.  As much gross work is done either way (cancer
> not) so what is the real truth ?  We have given most lumps 305 and I
> thinking we are undercharging.
> Thanks,
> Helayne Parker, HT (ASCP)
> Histology Section Head
> Skaggs Community Health Center
> Branson, Missouri
Anatomic Pathology
Evanston Northwestern Healthcare

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