Currently our dermatologists send their skin biopsies to a private lab.   Since 
we  now have our own Histology department we are proposing to do the technical 
component (grossing and preparation of slides) in house and sending the block 
and H&E slides to the same private company.  They call these type of clients " 
professional read only".   I understand the differences regarding billing since 
the CPT codes we are using have a professional component and a technical 
component.   My questions center around what other organizations do for 
accessioning and how they  meet CAP requirements for grossing, etc.

Normally we handle all of our other specimens in the normal way of 
accessioning, grossing (under the indirect supervision of a pathologist that 
comes to read the slides, processing, preparation of slides, and giving the 
slides to the pathologist who signs out the surgical report including the 
gross, and the rest of the surgical report.

The dermatology specimens would have to be handled differently. Our 
dermatologists want the slides read by the private company that only does 
dermatology specimens. (at least until we hire a dermatopathologist).  In the 
past the derm tissues were sent to the private company and they did all of the 
process including grossing.  Our organization has now decided that it is 
advantageous for us to do the technical portion in house and then send the 
slides to be read by the private company because of changes in billing.  The 
private company is perfectly willing to  help us make sure they get information 
they need  to diagnose the cases (they have even shown us how they like each 
type of skin biopsy sectioned and inked.  They will help us set up a system for 
them to get the slides and do the surgical reports.  Their report will have our 
gross description and surgical number, along with a statement that the gross 
and processing was done elsewhere.  They have done this with several other clien
 ts.  I have some unanswered questions since I have never done something like 
this.  Below is a list of my questions.  What I really need is someone to tell 
me how they are handling specimens that they prepare locally and then send the 
slides to a pathology group to read.


1.        Since the local pathologist group does not read these slides,  are 
our  grossing techs under the indirect supervision of the pathologists at the 
private company for these specimens?

2.       How do you accession these specimens locally so tracking, slide 
preparation, and technical component billing can be done, without a local 
surgical report.

3.       If you have to do a local report, who signs the gross report that just 
has a gross and maybe a statement that the slides will be read at the private 
company?

4.       Are there other CAP considerations I am not thinking of?

Am I making this too complicated?

Jim





Jim Vickroy
Histology Manager
Springfield Clinic, Main Campus, East Building
1025 South 6th Street
Springfield, Illinois  62703
Office:  217-528-7541, Ext. 15121
Email:  jvick...@springfieldclinic.com<mailto:jvick...@springfieldclinic.com>



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