CurrentBlue Cross Blue Shield - OklahomaPolicy CPCPLAB069

Immunohistochemistry

Defines BCBS Oklahoma laboratory reimbursement and coding guidance for immunohistochemistry (IHC) procedures and applicable code usage; applies to providers billing BCBS OK products. Some requirements may vary by product and plan document.

Policy Summary

PayerBlue Cross Blue Shield - Oklahoma

PolicyImmunohistochemistry

Policy CodePolicy CPCPLAB069

Change TypeNew policy

Effective DateNov 1, 2022

Next Review Date

Key ActionProviders must submit accurate documentation and may be asked to provide additional documentation upon request; claims are subject to claim review and coding edits.

SourceLink

POLICY UPDATE CHANGES

New policy

1.0policy version

11/01/2022Plan Effective Date

up to 488342 units/specimen

max 1388341 units

up to 688344 specimens

Immunohistochemistry (IHC) Reimbursement Criteria

IHC reimbursement and billing criteria

Billing and reimbursement criteria for immunohistochemistry (IHC) procedures and general coding expectations.

Use code 88342 for the first single antibody procedure; reimbursed at one unit per specimen, up to four specimens per date of service.

Use code 88341 for each additional single antibody per specimen; reimbursed up to a maximum of 13 units per date of service.

Use code 88344 for each multiplex antibody per specimen; reimbursed for up to six specimens per date of service.

Claims must be submitted using valid HIPAA‑approved code sets and conform to industry standard coding guidelines; claims are subject to code edit protocols and claim review.

Policy Summary

PayerBlue Cross Blue Shield - Oklahoma

PolicyImmunohistochemistry

Policy CodePolicy CPCPLAB069

Change TypeNew policy

Effective DateNov 1, 2022

Next Review Date

Key ActionProviders must submit accurate documentation and may be asked to provide additional documentation upon request; claims are subject to claim review and coding edits.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

CPT Codes and Reimbursement Limits

IHC CPT codes and reimbursement limitsCPTCovered

88342	First single antibody procedure — reimbursed at one unit per specimen, up to four specimens per date of service
88341	Additional single antibody per specimen — reimbursed up to a maximum of 13 units per date of service
88344	Multiplex antibody per specimen — reimbursed up to six specimens per date of service

88342 specimen unit limit

Code88342

Limit1 unit per specimen

Specimen capUp to 4 specimens per date of service

88341 unit maximum

Code88341

UsageAdditional single antibody per specimen

Maximum unitsUp to 13 units per date of service

88344 specimen limit

Code88344

UsageMultiplex antibody per specimen

Specimen limitUp to 6 specimens per date of service

Documentation and Claims

Documentation Required

Submit accurate documentation and respond to claim review requests

Providers are responsible for submission of accurate documentation of services performed and must submit claims using valid HIPAA‑approved code sets; claims should be coded according to industry standard coding guidelines. Claims are subject to code edit protocols and claim review, and providers may be requested to submit additional documentation to support the claim.

Submit claims using valid HIPAA‑approved code sets (CPT, HCPCS, ICD‑10, NDC, DRG, etc.).
Code claims according to industry standard coding guidelines (AMA CPT, UB Editor, CMS NCCI/CCI edits, CMS guidelines).
If requested, provide additional supporting documentation to BCBS OK for claim review.

Key Definitions

Plan documents

DefinitionPlan documents include Certificates of Health Care Benefits, benefit booklets, Summary Plan Descriptions, and other coverage documents.

AuthorityIf a conflict exists, the plan document will govern coverage specifics over the CPCP.

Provider noteNot all policy requirements apply to every product; providers should review plan documents for eligible coverage.

Clinical Payment and Coding Policy (CPCP)

DefinitionClinical Payment and Coding Policy (CPCP) — a payer policy setting coding and payment guidance.

Conflict resolutionIf a conflict arises between a CPCP and a plan document, the plan document governs; if a conflict arises with a provider contract, the provider contract governs.

ScopeCPCPs provide coding/payment guidance but may be superseded by plan documents or provider contracts; BCBS OK may exercise discretion in applying CPCPs.