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

This policy allows immunohistochemical (IHC) testing for ER, PR, and HER2/neu in patients with primary invasive breast cancer and in patients with recurrent or metastatic breast cancer. Routine H&E staining is included in pathology services and is not separately billable; claims must document medical necessity and follow the related LCD L36351, using the specified CPT codes and units of service for stains and morphometric analyses.

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

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