Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends
Kaye: Sure! The odd thing that struck me is that this fictitious scenario was planted on Histonet just a few day before the presidential election and I am suspicious of the final intent of the posting. Is it to link a frightening scenario with the so called Obama care? Is it the possible solution of this imaginary scenario to eliminate Obama care as has been promised by Romney? Is this a way to get a few additinal votes for Romney? I would not be surprised at all! I am always very suspicious of coincidences because coincidences do not exist. René J. From: Kaye Ryan kr...@nfderm.com To: Rene J Buesa rjbu...@yahoo.com Sent: Wednesday, October 31, 2012 10:55 AM Subject: RE: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends THANK YOU SO MUCH, RENEE! Kaye -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J Buesa Sent: Wednesday, October 31, 2012 10:51 AM To: Brendal Finlay; Webster, Thomas S. Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends To everybody worrying for something that has NOT happen yet and that NOBODY knows if will happen. These are pure speculations. Do not put the cart before the horses. I do not think that this scary scenario is in the near future. René J. From: Brendal Finlay brendal.fin...@medicalcenterclinic.com To: Webster, Thomas S. twebs...@crh.org Cc: histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu Sent: Wednesday, October 31, 2012 9:39 AM Subject: Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) and future trends This is disturbing news. As an employee of an in-house lab (which started in 1996/1997) that does mostly skins, GI biopsies, and outpatient surgery specimens I'm pretty disheartened to hear about the 88305 issue. Melanoma excisions, prostates (even lower block # cases, we don't always get 12), breast biopsies, and other more difficult cases can be a lot of work on both the professional technical end of things. As for prostate biopsies, CMS has already lowered reimbursement with the G codes. This is despite the wording that they are for saturation biopsies. We rarely have saturation biopsies, but Medicare denies us the 88305 charge if more than 5 specimens. Other insurance companies tend to follow their lead after a little time. I believe reimbursement is 50-75% less for 5-20 biopsies, but don't quote me on that. I expect we may see the end of saturation and multi-container prostate biopsies in the near future. Another issue for many outpatient labs in my area is that larger insurances are requiring their patients to go to large multinational labs. We cannot accept many PPOs or Medicare replacement plans because of this. I feel it can be a disservice to the patient because they do not get the same personal, local service with good turn around times. Even my insurance requires me to go to one of these labs where I feel inconvenienced and frustrated at the wait time required to submit my sample and get results to my physician. On Oct 31, 2012, at 8:17 AM, Webster, Thomas S. twebs...@crh.org wrote: Here is what CAP has on their website about the issue. Only the TC of 88305 is being discussed for 2013. We should know fairly soon the decision. More codes have been flagged as overvalued as well that could be cut for 2014 (PC and TC at this point). http://www.cap.org/apps/docs/advocacy/advocacy_issues/revaluation.pdf CONFIDENTIALITY NOTICE: This e-mail message, including all attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. You may NOT use, disclose, copy or disseminate this information. If you are not the intended recipient, please contact the sender by reply e-mail immediately. Please destroy all copies of the original message and all attachments. Your cooperation is greatly appreciated. Columbus Regional Hospital 2400 East 17th Street Columbus, Indiana 47201___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends
Here we go with the political opinions again. They have no place on this forum. It's bad enough that Facebook is polluted with them. Have a nice day! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J Buesa Sent: Wednesday, October 31, 2012 11:03 AM To: Kaye Ryan Cc: Histonet Subject: Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends Kaye: Sure! The odd thing that struck me is that this fictitious scenario was planted on Histonet just a few day before the presidential election and I am suspicious of the final intent of the posting. Is it to link a frightening scenario with the so called Obama care? Is it the possible solution of this imaginary scenario to eliminate Obama care as has been promised by Romney? Is this a way to get a few additinal votes for Romney? I would not be surprised at all! I am always very suspicious of coincidences because coincidences do not exist. René J. From: Kaye Ryan kr...@nfderm.com To: Rene J Buesa rjbu...@yahoo.com Sent: Wednesday, October 31, 2012 10:55 AM Subject: RE: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends THANK YOU SO MUCH, RENEE! Kaye -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J Buesa Sent: Wednesday, October 31, 2012 10:51 AM To: Brendal Finlay; Webster, Thomas S. Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends To everybody worrying for something that has NOT happen yet and that NOBODY knows if will happen. These are pure speculations. Do not put the cart before the horses. I do not think that this scary scenario is in the near future. René J. From: Brendal Finlay brendal.fin...@medicalcenterclinic.com To: Webster, Thomas S. twebs...@crh.org Cc: histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu Sent: Wednesday, October 31, 2012 9:39 AM Subject: Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) and future trends This is disturbing news. As an employee of an in-house lab (which started in 1996/1997) that does mostly skins, GI biopsies, and outpatient surgery specimens I'm pretty disheartened to hear about the 88305 issue. Melanoma excisions, prostates (even lower block # cases, we don't always get 12), breast biopsies, and other more difficult cases can be a lot of work on both the professional technical end of things. As for prostate biopsies, CMS has already lowered reimbursement with the G codes. This is despite the wording that they are for saturation biopsies. We rarely have saturation biopsies, but Medicare denies us the 88305 charge if more than 5 specimens. Other insurance companies tend to follow their lead after a little time. I believe reimbursement is 50-75% less for 5-20 biopsies, but don't quote me on that. I expect we may see the end of saturation and multi-container prostate biopsies in the near future. Another issue for many outpatient labs in my area is that larger insurances are requiring their patients to go to large multinational labs. We cannot accept many PPOs or Medicare replacement plans because of this. I feel it can be a disservice to the patient because they do not get the same personal, local service with good turn around times. Even my insurance requires me to go to one of these labs where I feel inconvenienced and frustrated at the wait time required to submit my sample and get results to my physician. On Oct 31, 2012, at 8:17 AM, Webster, Thomas S. twebs...@crh.org wrote: Here is what CAP has on their website about the issue. Only the TC of 88305 is being discussed for 2013. We should know fairly soon the decision. More codes have been flagged as overvalued as well that could be cut for 2014 (PC and TC at this point). http://www.cap.org/apps/docs/advocacy/advocacy_issues/revaluation.pdf CONFIDENTIALITY NOTICE: This e-mail message, including all attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. You may NOT use, disclose, copy or disseminate this information. If you are not the intended recipient, please contact the sender by reply e-mail immediately. Please destroy all copies of the original message and all attachments. Your cooperation is greatly appreciated. Columbus Regional Hospital 2400 East 17th Street Columbus, Indiana 47201___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo
RE: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends
Let's face it POL's were established to make more money for the groups, which takes money from the big reference labs who have large lobbyist groups. HUM, I wonder who maybe driving these efforts. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bitting, Angela K. Sent: Wednesday, October 31, 2012 10:07 AM To: Rene J Buesa; Kaye Ryan Cc: Histonet Subject: RE: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends Here we go with the political opinions again. They have no place on this forum. It's bad enough that Facebook is polluted with them. Have a nice day! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J Buesa Sent: Wednesday, October 31, 2012 11:03 AM To: Kaye Ryan Cc: Histonet Subject: Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends Kaye: Sure! The odd thing that struck me is that this fictitious scenario was planted on Histonet just a few day before the presidential election and I am suspicious of the final intent of the posting. Is it to link a frightening scenario with the so called Obama care? Is it the possible solution of this imaginary scenario to eliminate Obama care as has been promised by Romney? Is this a way to get a few additinal votes for Romney? I would not be surprised at all! I am always very suspicious of coincidences because coincidences do not exist. René J. From: Kaye Ryan kr...@nfderm.com To: Rene J Buesa rjbu...@yahoo.com Sent: Wednesday, October 31, 2012 10:55 AM Subject: RE: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends THANK YOU SO MUCH, RENEE! Kaye -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J Buesa Sent: Wednesday, October 31, 2012 10:51 AM To: Brendal Finlay; Webster, Thomas S. Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends To everybody worrying for something that has NOT happen yet and that NOBODY knows if will happen. These are pure speculations. Do not put the cart before the horses. I do not think that this scary scenario is in the near future. René J. From: Brendal Finlay brendal.fin...@medicalcenterclinic.com To: Webster, Thomas S. twebs...@crh.org Cc: histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu Sent: Wednesday, October 31, 2012 9:39 AM Subject: Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) and future trends This is disturbing news. As an employee of an in-house lab (which started in 1996/1997) that does mostly skins, GI biopsies, and outpatient surgery specimens I'm pretty disheartened to hear about the 88305 issue. Melanoma excisions, prostates (even lower block # cases, we don't always get 12), breast biopsies, and other more difficult cases can be a lot of work on both the professional technical end of things. As for prostate biopsies, CMS has already lowered reimbursement with the G codes. This is despite the wording that they are for saturation biopsies. We rarely have saturation biopsies, but Medicare denies us the 88305 charge if more than 5 specimens. Other insurance companies tend to follow their lead after a little time. I believe reimbursement is 50-75% less for 5-20 biopsies, but don't quote me on that. I expect we may see the end of saturation and multi-container prostate biopsies in the near future. Another issue for many outpatient labs in my area is that larger insurances are requiring their patients to go to large multinational labs. We cannot accept many PPOs or Medicare replacement plans because of this. I feel it can be a disservice to the patient because they do not get the same personal, local service with good turn around times. Even my insurance requires me to go to one of these labs where I feel inconvenienced and frustrated at the wait time required to submit my sample and get results to my physician. On Oct 31, 2012, at 8:17 AM, Webster, Thomas S. twebs...@crh.org wrote: Here is what CAP has on their website about the issue. Only the TC of 88305 is being discussed for 2013. We should know fairly soon the decision. More codes have been flagged as overvalued as well that could be cut for 2014 (PC and TC at this point). http://www.cap.org/apps/docs/advocacy/advocacy_issues/revaluation.pdf CONFIDENTIALITY NOTICE: This e-mail message, including all attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. You may NOT use, disclose, copy or disseminate this information. If you are not the intended recipient, please contact the sender by reply
RE: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends
Thank you!!! I couldn't agree with you more. Those were my exact thoughts when I read the initial e-mail. Hermina Hermina M. Borgerink, MA, HT(ASCP)HTL, QIHC Wake Forest University Primate Center Department of Pathology Medical Center Blvd. Winston-Salem, N C 27157 Tel. (336) 716-1538 Fax (336) 716-1515 Email: hborg...@wakehealth.edu -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J Buesa Sent: Wednesday, October 31, 2012 11:03 AM To: Kaye Ryan Cc: Histonet Subject: Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends Kaye: Sure! The odd thing that struck me is that this fictitious scenario was planted on Histonet just a few day before the presidential election and I am suspicious of the final intent of the posting. Is it to link a frightening scenario with the so called Obama care? Is it the possible solution of this imaginary scenario to eliminate Obama care as has been promised by Romney? Is this a way to get a few additinal votes for Romney? I would not be surprised at all! I am always very suspicious of coincidences because coincidences do not exist. René J. From: Kaye Ryan kr...@nfderm.com To: Rene J Buesa rjbu...@yahoo.com Sent: Wednesday, October 31, 2012 10:55 AM Subject: RE: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends THANK YOU SO MUCH, RENEE! Kaye -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J Buesa Sent: Wednesday, October 31, 2012 10:51 AM To: Brendal Finlay; Webster, Thomas S. Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends To everybody worrying for something that has NOT happen yet and that NOBODY knows if will happen. These are pure speculations. Do not put the cart before the horses. I do not think that this scary scenario is in the near future. René J. From: Brendal Finlay brendal.fin...@medicalcenterclinic.com To: Webster, Thomas S. twebs...@crh.org Cc: histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu Sent: Wednesday, October 31, 2012 9:39 AM Subject: Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) and future trends This is disturbing news. As an employee of an in-house lab (which started in 1996/1997) that does mostly skins, GI biopsies, and outpatient surgery specimens I'm pretty disheartened to hear about the 88305 issue. Melanoma excisions, prostates (even lower block # cases, we don't always get 12), breast biopsies, and other more difficult cases can be a lot of work on both the professional technical end of things. As for prostate biopsies, CMS has already lowered reimbursement with the G codes. This is despite the wording that they are for saturation biopsies. We rarely have saturation biopsies, but Medicare denies us the 88305 charge if more than 5 specimens. Other insurance companies tend to follow their lead after a little time. I believe reimbursement is 50-75% less for 5-20 biopsies, but don't quote me on that. I expect we may see the end of saturation and multi-container prostate biopsies in the near future. Another issue for many outpatient labs in my area is that larger insurances are requiring their patients to go to large multinational labs. We cannot accept many PPOs or Medicare replacement plans because of this. I feel it can be a disservice to the patient because they do not get the same personal, local service with good turn around times. Even my insurance requires me to go to one of these labs where I feel inconvenienced and frustrated at the wait time required to submit my sample and get results to my physician. On Oct 31, 2012, at 8:17 AM, Webster, Thomas S. twebs...@crh.org wrote: Here is what CAP has on their website about the issue. Only the TC of 88305 is being discussed for 2013. We should know fairly soon the decision. More codes have been flagged as overvalued as well that could be cut for 2014 (PC and TC at this point). http://www.cap.org/apps/docs/advocacy/advocacy_issues/revaluation.pdf CONFIDENTIALITY NOTICE: This e-mail message, including all attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. You may NOT use, disclose, copy or disseminate this information. If you are not the intended recipient, please contact the sender by reply e-mail immediately. Please destroy all copies of the original message and all attachments. Your cooperation is greatly appreciated. Columbus Regional Hospital 2400 East 17th Street Columbus, Indiana 47201___ Histonet mailing list Histonet@lists.utsouthwestern.edu http
RE: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends
I'm going back to Facebook now. Let me know when this thread poops out. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Hermina Borgerink Sent: Wednesday, October 31, 2012 11:33 AM To: Rene J Buesa; Kaye Ryan Cc: Histonet Subject: RE: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends Thank you!!! I couldn't agree with you more. Those were my exact thoughts when I read the initial e-mail. Hermina Hermina M. Borgerink, MA, HT(ASCP)HTL, QIHC Wake Forest University Primate Center Department of Pathology Medical Center Blvd. Winston-Salem, N C 27157 Tel. (336) 716-1538 Fax (336) 716-1515 Email: hborg...@wakehealth.edu -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J Buesa Sent: Wednesday, October 31, 2012 11:03 AM To: Kaye Ryan Cc: Histonet Subject: Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends Kaye: Sure! The odd thing that struck me is that this fictitious scenario was planted on Histonet just a few day before the presidential election and I am suspicious of the final intent of the posting. Is it to link a frightening scenario with the so called Obama care? Is it the possible solution of this imaginary scenario to eliminate Obama care as has been promised by Romney? Is this a way to get a few additinal votes for Romney? I would not be surprised at all! I am always very suspicious of coincidences because coincidences do not exist. René J. From: Kaye Ryan kr...@nfderm.com To: Rene J Buesa rjbu...@yahoo.com Sent: Wednesday, October 31, 2012 10:55 AM Subject: RE: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends THANK YOU SO MUCH, RENEE! Kaye -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J Buesa Sent: Wednesday, October 31, 2012 10:51 AM To: Brendal Finlay; Webster, Thomas S. Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends To everybody worrying for something that has NOT happen yet and that NOBODY knows if will happen. These are pure speculations. Do not put the cart before the horses. I do not think that this scary scenario is in the near future. René J. From: Brendal Finlay brendal.fin...@medicalcenterclinic.com To: Webster, Thomas S. twebs...@crh.org Cc: histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu Sent: Wednesday, October 31, 2012 9:39 AM Subject: Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) and future trends This is disturbing news. As an employee of an in-house lab (which started in 1996/1997) that does mostly skins, GI biopsies, and outpatient surgery specimens I'm pretty disheartened to hear about the 88305 issue. Melanoma excisions, prostates (even lower block # cases, we don't always get 12), breast biopsies, and other more difficult cases can be a lot of work on both the professional technical end of things. As for prostate biopsies, CMS has already lowered reimbursement with the G codes. This is despite the wording that they are for saturation biopsies. We rarely have saturation biopsies, but Medicare denies us the 88305 charge if more than 5 specimens. Other insurance companies tend to follow their lead after a little time. I believe reimbursement is 50-75% less for 5-20 biopsies, but don't quote me on that. I expect we may see the end of saturation and multi-container prostate biopsies in the near future. Another issue for many outpatient labs in my area is that larger insurances are requiring their patients to go to large multinational labs. We cannot accept many PPOs or Medicare replacement plans because of this. I feel it can be a disservice to the patient because they do not get the same personal, local service with good turn around times. Even my insurance requires me to go to one of these labs where I feel inconvenienced and frustrated at the wait time required to submit my sample and get results to my physician. On Oct 31, 2012, at 8:17 AM, Webster, Thomas S. twebs...@crh.org wrote: Here is what CAP has on their website about the issue. Only the TC of 88305 is being discussed for 2013. We should know fairly soon the decision. More codes have been flagged as overvalued as well that could be cut for 2014 (PC and TC at this point). http://www.cap.org/apps/docs/advocacy/advocacy_issues/revaluation.pdf CONFIDENTIALITY NOTICE: This e-mail message, including all attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. You may NOT use, disclose, copy or disseminate this information. If you
RE: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends
Great observation Rene'. Thank you -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J Buesa Sent: Wednesday, October 31, 2012 10:03 AM To: Kaye Ryan Cc: Histonet Subject: Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends Kaye: Sure! The odd thing that struck me is that this fictitious scenario was planted on Histonet just a few day before the presidential election and I am suspicious of the final intent of the posting. Is it to link a frightening scenario with the so called Obama care? Is it the possible solution of this imaginary scenario to eliminate Obama care as has been promised by Romney? Is this a way to get a few additinal votes for Romney? I would not be surprised at all! I am always very suspicious of coincidences because coincidences do not exist. René J. From: Kaye Ryan kr...@nfderm.com To: Rene J Buesa rjbu...@yahoo.com Sent: Wednesday, October 31, 2012 10:55 AM Subject: RE: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends THANK YOU SO MUCH, RENEE! Kaye -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J Buesa Sent: Wednesday, October 31, 2012 10:51 AM To: Brendal Finlay; Webster, Thomas S. Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) andfuture trends To everybody worrying for something that has NOT happen yet and that NOBODY knows if will happen. These are pure speculations. Do not put the cart before the horses. I do not think that this scary scenario is in the near future. René J. From: Brendal Finlay brendal.fin...@medicalcenterclinic.com To: Webster, Thomas S. twebs...@crh.org Cc: histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu Sent: Wednesday, October 31, 2012 9:39 AM Subject: Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) and future trends This is disturbing news. As an employee of an in-house lab (which started in 1996/1997) that does mostly skins, GI biopsies, and outpatient surgery specimens I'm pretty disheartened to hear about the 88305 issue. Melanoma excisions, prostates (even lower block # cases, we don't always get 12), breast biopsies, and other more difficult cases can be a lot of work on both the professional technical end of things. As for prostate biopsies, CMS has already lowered reimbursement with the G codes. This is despite the wording that they are for saturation biopsies. We rarely have saturation biopsies, but Medicare denies us the 88305 charge if more than 5 specimens. Other insurance companies tend to follow their lead after a little time. I believe reimbursement is 50-75% less for 5-20 biopsies, but don't quote me on that. I expect we may see the end of saturation and multi-container prostate biopsies in the near future. Another issue for many outpatient labs in my area is that larger insurances are requiring their patients to go to large multinational labs. We cannot accept many PPOs or Medicare replacement plans because of this. I feel it can be a disservice to the patient because they do not get the same personal, local service with good turn around times. Even my insurance requires me to go to one of these labs where I feel inconvenienced and frustrated at the wait time required to submit my sample and get results to my physician. On Oct 31, 2012, at 8:17 AM, Webster, Thomas S. twebs...@crh.org wrote: Here is what CAP has on their website about the issue. Only the TC of 88305 is being discussed for 2013. We should know fairly soon the decision. More codes have been flagged as overvalued as well that could be cut for 2014 (PC and TC at this point). http://www.cap.org/apps/docs/advocacy/advocacy_issues/revaluation.pdf CONFIDENTIALITY NOTICE: This e-mail message, including all attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. You may NOT use, disclose, copy or disseminate this information. If you are not the intended recipient, please contact the sender by reply e-mail immediately. Please destroy all copies of the original message and all attachments. Your cooperation is greatly appreciated. Columbus Regional Hospital 2400 East 17th Street Columbus, Indiana 47201___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http
