Laboratory Question for the Week of April 6, 2020

Laboratory Compliance Question of the Week


Do you have any tips for determining billable units when applying an antibody cocktail?


When applying an “antibody cocktail” which contains two or more separately interpretable antibodies, providers should read the statement applicable to determine billable units of service as published in the NCCI policy narrative. The NCCI defines the unit of service for immunohisto­chemistry as “each single or multiplex antibody stain procedure per speci­men. A multiplex antibody immunohistochemical staining procedure is one that uses multiple antibodies to obtain multiple separately reportable medically reasonable and necessary results. An antibody stain containing multiple antibodies that yields a single reportable result is not a multiplex stain and shall be reported with a single antibody staining procedure CPT® code. An immunohistochemistry stain procedure with multiple antibodies that are not separately interpretable (e.g., antibody cocktail) shall only be reported as one (1) unit of service per specimen.”

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