Ensure you Clear Every ER/PR Coding Barrier

Use these ways to ensure you clear every MR/PR coding barrier.
CPT Assistant, CPT code, medical coding

The saying to 'always report the most specific CPT code' could ambush your estrogen receptor (ER) and progesterone receptor (PR) coding for breast instances. Here our experts will help you sort out the difference between specific analyte and specific method to ensure you select the right code each and every time.

Reserve 84233 and 84234 for Assays

If you are looking for specific codes when a surgical pathology references estrogen and/or progesterone receptor testing, you cannot miss 84233 and 84234. However are those always the right choice?

The 84233 and 84234 definitions create a dilemma for coders reporting ER/PR tests. The question is whether you must report 84233/84234 as the definitions specify ER/PR, or if you can instead report a generic immunohistochemistry code like 88342 for certain ER/PR testing.

Codes 84233 and 84234 talk of laboratory tests for estrogen and progesterone receptors that make use of a biochemical ligand-binding assay method like dextran-coated charcoal assay. However, most labs evaluate ER/PR using immunohistochemistry as clinical studies have consistently shown the superiority of immunohistochemistry over biochemical assay methods for ER/PR testing.

Be on the lookout for Immunohistochemistry

When the lab method involves immunohistochemistry (IHC) for tissue specimens like evaluating breast tumors for ER and PR status, you should look to the following codes to describe the service: 88342, 88360, 88361.

Differentiate qualitative/ quantitative codes

Choosing among 88342, 88360, or 88361 calls for knowing whether the immunohistochemistry analysis is qualitative or quantitative and whether quantification makes use of computer-assisted technology or “manual" counting, including visual approximation.

Count antibodies

You should report one unit of the appropriate code for each antibody stain, irrespective of which antibody you are coding.

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