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

This policy allows IHC testing for ER, PR, and HER2 for patients with primary invasive breast cancer and for recurrent or metastatic breast cancer, with reporting using CPT codes 88342 (first stain) and 88341 (additional stains) and morphometric analysis with CPT 88360/88361. H&E staining is considered routine pathology and is not separately billable; providers must document medical necessity, follow LCD L36805 and relevant professional guidelines, and report units of service per separately identifiable specimen.

"Immunohistochemical (IHC) testing for estrogen receptor (ER) is covered for patients with primary invasive breast cancer."

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