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Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry

CPT4 code

Name of the Procedure:

Special Stain (Group II: Iron, Trichrome, etc.)

Summary

Special stains are a range of laboratory techniques applied to tissue samples to highlight specific components such as iron or connective tissue. These stains provide additional detail that routine stains might not reveal, helping doctors make more accurate diagnoses.

Purpose

Special stains in Group II are used to detect various substances in tissues, such as iron (to identify disorders like hemochromatosis) or collagen (to evaluate fibrosis). The goal is to provide a more precise diagnosis and guide patient treatment.

Indications

  • Abnormalities detected on routine histological examination
  • Suspected disorders involving iron (e.g., hemochromatosis) or connective tissue (e.g., fibrosis)
  • Cases where routine stains do not provide definitive information

Preparation

  • No specific preparation required for the patient.
  • The tissue sample is usually obtained via biopsy or surgical procedure.

Procedure Description

  1. A tissue sample is obtained through a biopsy or surgery.
  2. The sample is fixed, processed, and embedded in paraffin.
  3. Thin sections of the tissue are cut and placed on microscope slides.
  4. Special stains (e.g., Prussian blue for iron, Masson's trichrome for collagen) are applied to the slides.
  5. The stained slides are examined under a microscope by a pathologist.

Tools and equipment:

  • Microtome for sectioning tissue
  • Microscope
  • Specific staining kits and reagents

Duration

  • Tissue staining and analysis typically take several hours to a couple of days, depending on the complexity of the stain.

Setting

  • The procedure is performed in a histopathology laboratory.

Personnel

  • Pathologist
  • Histotechnologist

Risks and Complications

  • Minimal to no risk involved in the staining process itself.
  • Rarely, there might be a delay in diagnosis due to technical issues with the stain.

Benefits

  • Provides detailed information that routine stains cannot
  • Helps in accurate diagnosis and treatment planning
  • Can identify specific diseases and conditions more clearly

Recovery

  • No recovery needed; the procedure pertains to tissue analysis in the lab.

Alternatives

  • Standard H&E staining for routine examination
  • Molecular testing for specific genetic information
  • Ultrasound, MRI, or CT scans for structural information

Patient Experience

  • The patient will not directly experience the staining process.
  • Any discomfort is associated with the initial biopsy and not the staining itself.
  • Effective pain management and comfort measures are applied during the biopsy.

Medical Policies and Guidelines for Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry

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