Billing and Coding: Lab: Special Histochemical Stains and Immunohistochemical Stains

H&E staining is considered routine pathology and is not separately billable. This A/B MAC allows IHC testing for ER, PR, and HER2/neu for patients with primary invasive breast cancer and for recurrent or metastatic breast cancer, and specifies CPT coding and units of service for IHC and morphometric analysis (88342, 88341, 88360, 88361). Each billing entity must document medical necessity and follow the per-specimen unit-of-service rules; the policy's UOS listing for CPT 88341 is ambiguous and should be reviewed.

"Immunohistochemical (IHC) testing for estrogen receptor (ER), progesterone receptor (PR), and HER2/neu is covered for patients with primary invasive breast cancer."

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