The coverage decisions focus on whether or not special or UHC stains are reasonable and necessary.
Examples not considered reasonable and necessary on every specimen, according to the report, include:
• Esophagus — fungal stains, trichrome, DPAS, CDX-2 or other mucin stains
• Gastric — AB-PAS, D-PAS, CDX-2 or other mucin stains, or special stains or IHC for H. pylori, or neuroendocrine markers, such as synaptophysin or chromogranin
• Duodenum — AB-PAS, D-PAS, CD3 and trichrome, or other mucin stains
• Colon — CD3, p53 trichrome
• Hyperplastic polyps — Ki67, CK20, p53, CEA, BRAF
• Tubular or tubulovillous adenoma — Ki-67, CK20, CEA, p53, MMR
More articles on gastroenterology:
6 must-reads on colonoscopy
CCFA names new president, CEO: 5 things to know
AGA raises $10.5M for digestive disease, hepatology research
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.