FISH (fluorescent in situ hybridization) methodology is a cytogenetic technique, but this website receives inquiries about changes in CPT coding in 2015 related to this technique. The recent article “CAP proposals on IHC, PQRS accepted for Medicare in ’15” by Charles Fiegl in CAP TODAY November 2014 (page 80) issue includes interesting materials on in situ hybridization services, but is not informative enough for laboratory practitioners.
CPR codes for In Situ Hybridization (FISH) in 2015.
88365 – In situ hybridization (e.g. FISH), per specimen; initial single probe stain procedure. The previous per probe is eliminated.
88364 – Each additional single probe stain procedure (List separately in addition to code for primary procedure.)
88366- Each multiplex probe stain procedure.
Codes 88365, 88364, and 88366 are for qualitative FISH procedure.
The unit of service is per specimen, not per block. Multiplex (88366) refers to two or more probes, including dual and triple color probe tests. Single presumes only one probe.
Although ISH CPT codes for quantitative and semi-quantitative analysis is rarely the object of interests by visitors of this website, just for completeness on the subject. They are represented by
88367 – Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen: initial single probe stain procedure
88373 – each additional single probe stain procedure (List separately in addition for primary procedure)
88374 – each multiplex probe stain procedure
By the way, the article in CAP TODAY is listing codes 88368, 88369, and 88377, which do not exist now, but 88367 is not mentioned. This is confusing.
CMS reimbursement “allawables” are beyond the scope of this website. The general tendency is decrease for ISH with increase for IHC.