PAPs

[musom]

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I'm in a place in which all PAPS go to LabCorp. I never have placed much thought or interest into that arrangement. But maybe I should....? I'm curious if there is any volume of PAPs that should make me consider bringing ThinPrep in-house? Of course I would need a cytotech as well, as no way would I screen any. What volume would make it reasonably worth it? If any...?

 

[AZpath]

I was thinking about doing PAPs and HPV at one time too.

These are on the CLFS. Did you review the PAMA cuts on these?
10% next year on both with four years it will add up to 35-40%

My last lab always complained they did not make money on PAPs. (We just billed the -26)

Now I think no one is going to make much money in PAPs including LabCorp and Quest.
Let them keep their business.

 

[Pathbusiness]

PAP's were not worth doing in house even when we had more than 30K cytology volume and four full time techs.

 

[WEBB PINKERTON]

We still screen about 20 a day and rotate the duty among our group. We used to do nearly 50 a day. Client billing prices were extremely low in our area so it was a money loser for the lab. You can make money doing lot of ancillary testing. Labs are taking the vial and ordering HPV, GC/chlamydia, Trich, BV, Fungus testing etc. The actual screening for cervical cancer is pretty low on the priority list nowadays.

CAP and ASCP have a monopoly on proficiency testing so the price is ridiculous. We are paying over 2000 dollars a year right now. It is like a tax that CAP will continue to collect on till the field dies off (if it isn't dead already). Yet another example of how little CAP cares about us.

For god's sake do not go into cytopathology, it is a dying field despite what anyone tells you. Once the dust clears, it will be some thyroid FNA, lymph nodes and the disappearing Pap test. HPV and cores are replacing everything.

 

[musom]

Yea, all of the responses are expected. Not to mention the potential liability/litigation surrounding cervical cytology. My interest has diminished back down to nil.