MACs release new coverage determinations for GI/endoscopy special stains

Three Medicare Administrative Contractors have issued coverage decisions on special stains and immunohistochemical stains for GI/endoscopy, according to an AGA eDigest report.

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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

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