Napoleon1801

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I have an aging flow cytometer on it's last legs but admin is not interested in replacing it. Wondering if anyone has won the battle to keep their flow cytometry on-site? My two hemepath partners are notably upset, but the only option I'm seeing is sending out for tech-only flow.
 

mikesheree

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I have an aging flow cytometer on it's last legs but admin is not interested in replacing it. Wondering if anyone has won the battle to keep their flow cytometry on-site? My two hemepath partners are notably upset, but the only option I'm seeing is sending out for tech-only flow.

Well, if you’ve got 2 heme paths you must have a decent amount of work for them. If there is local hospital competition, have the heme folks tell admin how bad it will look (“THEY don’t even have their OWN equipment to deal with these sick patients and must rely on time delaying outside sources which will have to be approved by the exec committee of the medical staff, yada, yada, yada). I’ve pulled off that kind of stuff before. And get the oncologists to act up in a tizzy.
 
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Med Director New England

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Depends on your volume, case mix, TAT needs and feasibility of logistics to partner with a nearby larger lab. Many smaller hospitals are sourcing flow to a nearby academic group or commercial lab, depending on above.

you gotta look at it like any other major cap ex decision. If you feel it is critical to remain in house - justify why to your med exec and C - suite.
 
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LADoc00

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I assume you are not billing for TC of flow? I guess then who cares. Do TC-PC split, send it to Neo. Add FISH markers to taste. Profit.

Better yet, if your volume is good tell Neo you want TC-PC shared revenue NGS....

Not sure what they would be "notably upset about" unless you had some ex-stripper CLS who was running the flow who the hospital now has to fire.....??


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AZpath

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Neo is a great option. They often get the flow done the next day.
 
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Thr0mbus

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Neo is a pathologists best friend! Flee quest and lab corps now!
 

Alteran

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Flow cytometry, once a printing press for money, is now a hollowed out husk of its former self. Flow cytometry is literally on CMS's s--- list and every year without fail they clobber it as if it were a red-headed stepchild at Walmart. If you don't have sufficient economy of scale to bring your fixed costs down for a reasonable ROI, don't bother. Have someone else like Neo do it for you as a TC-PC split. And if you were never getting the TC to begin with, who cares who does it so long as you can still bill 100% of the PC.
 
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LADoc00

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Flow cytometry is a turd now. The only reason to do it is to get the FISH follow on.

This is the classic medical scenario where a "field of CPT codes" is fertile for a short time before CMS tanks it to garbage.

Modern medicine is a monkey branch economic landscape where codes that folks pack into just get nerfed, forcing the herd to move to a new, more fertile field which now is molecular.

I dont think flow has been the fertile field since the bundle PC payment dropped reimbursement like -90% around 13-14 years ago?
 

octopusprime

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Flow cytometry, once a printing press for money, is now a hollowed out husk of its former self. Flow cytometry is literally on CMS's s--- list and every year without fail they clobber it as if it were a red-headed stepchild at Walmart. If you don't have sufficient economy of scale to bring your fixed costs down for a reasonable ROI, don't bother. Have someone else like Neo do it for you as a TC-PC split. And if you were never getting the TC to begin with, who cares who does it so long as you can still bill 100% of the PC.
agree.
we have 2 hemepaths, flow TC owned by the hospital, fairly decent volume to justify it on site, but so far in 2020 we've collected more from pap interps than 16-panel flow...but it's like lots of things in this field-- individually there's nothing that brings in great revenue, it's simply volume based and scraping every nickel and dime together to equal a dollar.
 
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