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Special stains, including those for enzyme constituents, are critical laboratory procedures used to identify specific enzymes within blood, bone marrow, or tissue samples. These stains are particularly valuable in the field of cytopathology, as they assist in the identification of abnormal cells and provide additional diagnostic insights regarding cells that may appear normal under standard examination. The process begins with the preparation of a fresh specimen, which is smeared onto a glass slide. To ensure that the specimen adheres properly, a fixative is applied. Following this, the slide undergoes a washing step to remove any excess fixative before the staining reagent is introduced. After the staining reagent is applied, the slide is washed again to eliminate unbound stain, and counterstaining may be performed to enhance the visibility of cellular details. For quality control, a control sample of normal cells is stained concurrently, allowing for comparison and validation of the results. The outcome of the staining process is assessed based on the presence or absence of enzyme activity, which is indicated by the intensity and distribution of the stain across various cellular constituents. Common examples of enzyme stains include tartrate resistant acid phosphatase stain, myeloperoxidase (MPO) stain, and chloroacetate esterase stain, each serving specific diagnostic purposes in the evaluation of hematological and tissue samples.
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Special stains for enzyme constituents are performed for various clinical indications, particularly when there is a need to investigate abnormal cellular activity or to provide further diagnostic clarity in hematological and tissue evaluations. The following are specific indications for the use of these stains:
The procedure for performing special stains for enzyme constituents involves several detailed steps to ensure accurate results. Each step is critical to the overall effectiveness of the staining process.
After the staining procedure is completed, the slides are examined under a microscope by a qualified pathologist or laboratory technician. The results are interpreted based on the presence or absence of enzyme activity, which is indicated by the staining patterns observed. The findings are documented in a report that includes the interpretation of the results, any relevant observations, and recommendations for further testing if necessary. Proper storage of the stained slides may also be required for future reference or additional analysis. It is essential to follow any specific post-procedure protocols as outlined by the laboratory to ensure compliance and maintain the integrity of the results.
| Short Descr | ENZYME HISTOCHEMISTRY | Medium Descr | SPECIAL STAIN I&R GROUP III ENZYME CONSITUENTS | Long Descr | Special stain including interpretation and report; Group III, for enzyme constituents | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | T-Packaged Codes | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1G - Lab tests - other (Medicare fee schedule) | MUE | 11 | CCS Clinical Classification | 233 - Laboratory - Chemistry and Hematology |
This is a primary code that can be used with these additional add-on codes.
| 0759T | Add-on Code MPFS Status: Carrier Priced APC N Digitization of glass microscope slides for special stain, including interpretation and report, group III, for enzyme constituents (List separately in addition to code for primary procedure) |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | GC | This service has been performed in part by a resident under the direction of a teaching physician | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | CR | Catastrophe/disaster related | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | GW | Service not related to the hospice patient's terminal condition | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 90 | Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number. | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) |
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| 2012-01-01 | Changed | Description Changed |
| Pre-1990 | Added | Code added. |
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