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Article ID Number: A57611 Status: A-Approved
Article Title: Billing and Coding: Lab: Special Histochemical Stains and Immunohistochemical Stains
Original Article Effective Date:
12/01/2019
Revision Effective Date:
11/02/2025
Article Text:
The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Lab: Special Histochemical Stains and Immunohistochemical Stains L36351.
Hematoxylin and eosin (H&E) staining provides excellent detail required for tissue-based diagnosis. This is NOT a separate service, as pathology services include routine H&E staining.
Some physicians, groups, laboratories and hospitals submit global claims for the services described in the related LCD. In other instances, there are separate individuals or entities providing the professional and the technical services. It is the obligation of each party to recognize that they are responsible for the medical necessity of the services submitted.
Based on recommendations from the College of American Pathologists (CAP), the American Society of Clinical Oncologists (ASCO) and the National Comprehensive Cancer Network (NCCN), hormone receptor assays, estrogen receptor (ER), progesterone receptor (PR), and Her-2/neu are biomarkers that demonstrate standardized value in breast cancer pathology evaluation. Therefore, this A/B MAC will allow ER, PR, and Her2 testing by IHC for patients with primary invasive breast cancers and recurrent or metastatic cancers.
To report IHC service for an ER, PR or Her2, submit the following claim information:
| CPT Code |
Specimen |
UOS |
| 88342 |
First single/multiplex stain |
1 |
| 88341 |
Each additional |
2 |
To report analysis, select 1 of the following codes based on the type of morphometric analysis:
| CPT Code |
Specimen |
UOS |
| 88360 |
Manual |
3 |
| 88361 |
Computer-assisted |
3 |
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