Anatomic CPT coding contribution to downward spiral of private practice

[RE-Tired]

I have been reading comments on this site for the last 10 years and agree with most commenters that the job market (private practice) has worsened steadily over that time period. Now retired I want to start a thread and entertain comments on how the CPT coding break for reimbursement has contributed to this. I always have worked in practices were we all read everything including the sacrosanct derm. This leads to my perspective and bias. The rise of pod labs where someone labels their-self as a GU pathologist but only reads prostate and similar GI and even derm labs in my opinion has denigrated our profession. What these labs all have in common is that for the most part they only read 88305. We general pathologists read all of the resections including frozen skin margins (including melanoma without having the bx to review). Why is this so? My opinion is that the CPT specific labs arose to make money and not needed expertise as they claim. If it were about expertise then where are the breast, bladder, liver, and lung biopsy labs? Why don' t anatomic site specific labs insist on reading the resections or at leas reviewing them to ensure their quality control?

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[deleted314957]

I have been reading comments on this site for the last 10 years and agree with most commenters that the job market (private practice) has worsened steadily over that time period. Now retired I want to start a thread and entertain comments on how the CPT coding break for reimbursement has contributed to this. I always have worked in practices were we all read everything including the sacrosanct derm. This leads to my perspective and bias. The rise of pod labs where someone labels their-self as a GU pathologist but only reads prostate and similar GI and even derm labs in my opinion has denigrated our profession. What these labs all have in common is that for the most part they only read 88305. We general pathologists read all of the resections including frozen skin margins (including melanoma without having the bx to review). Why is this so? My opinion is that the CPT specific labs arose to make money and not needed expertise as they claim. If it were about expertise then where are the breast, bladder, liver, and lung biopsy labs? Why don' t anatomic site specific labs insist on reading the resections or at leas reviewing them to ensure their quality control?

Well you said it all. The main reasons are money, money and money.


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[KeratinPearls]

I have been reading comments on this site for the last 10 years and agree with most commenters that the job market (private practice) has worsened steadily over that time period. Now retired I want to start a thread and entertain comments on how the CPT coding break for reimbursement has contributed to this. I always have worked in practices were we all read everything including the sacrosanct derm. This leads to my perspective and bias. The rise of pod labs where someone labels their-self as a GU pathologist but only reads prostate and similar GI and even derm labs in my opinion has denigrated our profession. What these labs all have in common is that for the most part they only read 88305. We general pathologists read all of the resections including frozen skin margins (including melanoma without having the bx to review). Why is this so? My opinion is that the CPT specific labs arose to make money and not needed expertise as they claim. If it were about expertise then where are the breast, bladder, liver, and lung biopsy labs? Why don' t anatomic site specific labs insist on reading the resections or at leas reviewing them to ensure their quality control?

Well, yeah it’s obvious. It’s because of the money. Why do you think derm is one of the most competitive fieldS? You think people really love looking at skin?

Anyone know the status of Pod labs? They are here to stay? I know CAP got that lawyer (Jane Pine Wood) to perform that study showIng that there are more biopsies coming from these labs. Haven’t heard much since.

 

[WEBB PINKERTON]

More biopsies is a good thing. It equals more jobs.

I noticed Jane Pine Wood went to work for bioreference labs/opko health. I thought that was kind of funny after the articles about them on street sweeper.

 

[KeratinPearls]

Talking about Opko, what happened to Dr Oppenheimer?

Former CEO-Physician and Drug Testing Laboratory Pay $9.35 Million to Settle False Claims Act Allegations

 

[WEBB PINKERTON]

Looks like he is doing well despite all that has happened.

Our Story — Center for Sustainable Stewardship

www.cssfamily.org

He overcame that case and his libel case from years ago.

Aliases Subject of Internet Libel Case (Published 2000)

Last week Judge Richard L. Williams of the federal district court in Richmond, Va., rejected a series of motions and gave his seal of approval to a jury's verdict that awarded $675,000 in compensatory and punitive damages to Dr. Sam D. Graham Jr., a urologist in private practice in Virginia and...

www.nytimes.com

I also noticed David Bostwick is still around.

Diagnostics | PathAI

PathAI Diagnostics. Evolving pathology using machine learning and deep learning techniques to drive faster more accurate diagnosis of disease.

www.poplarhealthcare.com

Is Tennessee where prostate experts end up?

 

[path19]

Is Tennessee where prostate experts end up?

"experts"

 

[RE-Tired]

Anecdotes- I once interviewed for a part-time position. In the interview with one of the GI pathologists in the group was the comment that only the GI pathologists read the colon biopsies. So I asked about colon resections and was told any of the pathologists could sign them out. Another comment:
Got to work with many junior residents (remember we read derms in our practice). Some were terrified of them, sending banal nevi to the dermpath for consultation. Could not blame them, most got little training in skin in residency. I actually have a very high respect for dermatopathologists, I just don't believe every skin biopsy needs to be read by one. A general pathologist can learn with training what needs to be sent for review.