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Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure)

CPT4 code

Name of the Procedure:

Immunofluorescence, per specimen; each additional single antibody stain procedure.

Summary

Immunofluorescence is a laboratory technique used to detect specific proteins in a tissue sample using antibodies that are bound to a fluorescent dye. This description pertains to the application of an additional single antibody stain to a specimen, done in conjunction with a primary procedure.

Purpose

Immunofluorescence is used to diagnose or study various diseases, including autoimmune disorders, infections, and certain types of cancer. The procedure helps visualize the presence and distribution of specific proteins within tissue samples, providing critical information for diagnosis and treatment planning.

Indications

  • Suspicion of autoimmune diseases such as lupus or pemphigus.
  • Evaluation of kidney biopsy samples for glomerulonephritis.
  • Assessment of skin conditions like bullous pemphigoid.
  • Identification of specific bacterial or viral infections.
  • Analysis of tumor samples to determine cancer type and stage.

Preparation

  • Patients may need to provide a tissue sample through a biopsy.
  • No special preparation is usually required from the patient.
  • It's essential to inform the healthcare provider about any medications or allergies.

Procedure Description

  1. A tissue sample is collected, usually via biopsy.
  2. The sample is prepared and fixed on a microscope slide.
  3. The primary antibodies specific to the target proteins are applied.
  4. After the primary staining, an additional single antibody stain procedure is performed using a different fluorescently-labeled antibody.
  5. The sample is incubated and washed to remove excess antibodies.
  6. A fluorescence microscope is used to visualize the stained sample, allowing for the detection of specific proteins.

Duration

The entire immunofluorescence staining process, including preliminary preparation of the tissue sample, can take several hours to complete.

Setting

The procedure is typically carried out in a pathology laboratory equipped with a fluorescence microscope.

Personnel

  • Pathologists specialized in immunohistochemistry.
  • Laboratory technicians trained in immunofluorescence techniques.

Risks and Complications

  • Generally, the procedure itself has minimal risks as it is conducted on a tissue sample and not directly on a patient.
  • Potential for sample contamination or mislabeling.
  • Rarely, the fluorescence signal might be weak or nonspecific, necessitating repeat testing.

Benefits

  • Precise identification and localization of specific proteins within tissue samples.
  • Can provide critical information for accurate diagnosis and treatment.
  • Helps in understanding the underlying pathology of various diseases.

Recovery

  • As this is a laboratory procedure on a collected tissue sample, no direct recovery is involved for the patient.
  • Patients may have minor recovery associated with the biopsy, following standard post-biopsy care instructions.

Alternatives

  • Conventional histopathology using H&E (Hematoxylin and Eosin) staining may be used in some cases but provides less specific information.
  • Enzyme-linked immunosorbent assay (ELISA) for protein detection, which is less precise in spatial localization.
  • Flow cytometry for cellular protein analysis, which may not be suitable for tissue architecture assessment.

Patient Experience

  • The patient typically does not experience the laboratory procedure directly but may have undergone a tissue biopsy, which might involve local anesthesia and minor discomfort.
  • Pain management and comfort measures are provided as per the biopsy procedure requirements.

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