Billing Special Stains on Surgical Cases -Reply

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From:Richard Cartun <>,
Date:Thu, 13 May 1999 19:50:38 -0400
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Duplicate histochemical stains (or immunoperoxidase stains) can be charged on a case as long as they are performed on specimens from different sites or the specimens are separately identified by the surgeon or clinician.  For example, let's say you receive a 4 part specimen on a 16 y.o. patient with dysphagia.  The separately submitted specimens are:

1.  Biopsy, duodenal bulb,
2.  Biopsy, gastric antrum,
3.  Biopsy, distal esophagus, and
4.  Biopsy, mid esophagus.

The pathologist wants to rule out H. pylori on biopsies 2. and 4. (part 4 contains a small piece of gastric fundic mucosa) after failing to identify organisms on H&E stains.  He/she would order histochemical stains or immunoperoxidase stains on parts 2. and 4. and bill for both (i.e., 88312x2 or 88342x2) in addition to the four 88305's for each biopsy.  

I  would not feel comfortable billing duplicate stains on two liver biopsies even though they are blocked separately.  Why not put both biopsies in one paraffin block and do one set of stains?  If you received two liver biopsies, one being identified as "tumor" and the other as "? normal", I guess it is conceivable that you could charge twice.

R. Cartun

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