Morphometric Analysis Pricing Update
July 3, 2006Effective retroactively for dates of service on or after November 01, 2005, CPT-4 codes 88367 and 88368 are Medi-Cal benefits. Also for the same dates of service, codes 88360, 88361, 88367 and 88368 have been assigned a specific price. No action is required on the part of providers. Claims submitted with these codes for dates of service beyond the six-month billing limit must include delay reason code “11†in the COB (Delay Reason) field (Box 24J) and documentation justifying the delay.
The full descriptions and prices for the codes are:
| CPT-4 Code | Description | Medi-Cal Rate |
| 88360 | Morphometric analysis, tumor immunohistochemistry (e.g., Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semi-quantitative, each antibody; manual | $90.06 |
| 88361 | Using computer-assisted technology | $136.67 |
| 88367 | Morphometric analysis, in situ hybridization, (quantitative or semi-quantitative) each probe; using computer-assisted technology | $169.79 |
| 88368 | Manual | $120.09 |
Codes 88360 and 88361 cannot be billed with code 88342 (immunochemistry [including tissue immunoperoxidase], each antibody) unless each procedure is for a different antibody for the same recipient, same provider and date of service. Providers must document the different antibody in the Reserved For Local Use field (Box 19) or on an attachment.