which specimens will see cuts?

[Arctic Char]

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the subject of reimbursements came up today in the context of thyroid disease . . . according to a well-respected endocrinologist, the Medicare/Medicaid reimbursements will soon be falling for thyroid biopsies, due to the low-impact nature of the procedure (i.e. majority are for benign nodules). his argument may have been more convincing than what i've just outlined, but then again he understands it better than me.

but, my question is: could we possibly see the same change selected for derm specimens (shaves and punches)? i mean, most are a lot less involved than obtaining a gastric bx or a colon bx, but currently most are billed as 88305's just the same. Will Medicare catch on?

consider the endarterectomy: what was once a procedure that could bill up to $10,000, is now something in the $1,500 range due to the fact that, well, people just got better at them . . . (give me a break on the exact numbers, its the principle of a specific procedure/specimen being singled out for reduced reimbursement that is the point i am trying to get at) . . .

thoughts . . . ?

 

[KeratinPearls]

the subject of reimbursements came up today in the context of thyroid disease . . . according to a well-respected endocrinologist, the Medicare/Medicaid reimbursements will soon be falling for thyroid biopsies, due to the low-impact nature of the procedure (i.e. majority are for benign nodules). his argument may have been more convincing than what i've just outlined, but then again he understands it better than me.

but, my question is: could we possibly see the same change selected for derm specimens (shaves and punches)? i mean, most are a lot less involved than obtaining a gastric bx or a colon bx, but currently most are billed as 88305's just the same. Will Medicare catch on?

consider the endarterectomy: what was once a procedure that could bill up to $10,000, is now something in the $1,500 range due to the fact that, well, people just got better at them . . . (give me a break on the exact numbers, its the principle of a specific procedure/specimen being singled out for reduced reimbursement that is the point i am trying to get at) . . .

thoughts . . . ?

i would think reimbursements will fall for everything sooner or later...the best thing is to be a well-rounded pathologist who is able to sign out everything (i know easier said than done).

 

[exPCM]

the subject of reimbursements came up today in the context of thyroid disease . . . according to a well-respected endocrinologist, the Medicare/Medicaid reimbursements will soon be falling for thyroid biopsies, due to the low-impact nature of the procedure (i.e. majority are for benign nodules). his argument may have been more convincing than what i've just outlined, but then again he understands it better than me.

but, my question is: could we possibly see the same change selected for derm specimens (shaves and punches)? i mean, most are a lot less involved than obtaining a gastric bx or a colon bx, but currently most are billed as 88305's just the same. Will Medicare catch on?

consider the endarterectomy: what was once a procedure that could bill up to $10,000, is now something in the $1,500 range due to the fact that, well, people just got better at them . . . (give me a break on the exact numbers, its the principle of a specific procedure/specimen being singled out for reduced reimbursement that is the point i am trying to get at) . . .

thoughts . . . ?

The thing that helps with GI, GU, and derm biopsies is you have not only pathologists fighting to preserve adequate reimbursement but you also have dermatologists, gastroenterologists, and urologists fighting to preserve adequate reimbursement since so many of them are now billing for pathology. The number of non-pathologists (mainly endocrinologists from what I have seen) billing for thyroid biopsies is a much smaller group.

 

[pathstudent]

Personally I think a good way to save money in medicine would be to ban pulmonologists, gastros and endocrinologists from doing FNA of anything. Those things are rarely diagnostic and usually end up going straight surgery or CT biopsy.

Radiologists can core anything these days. Let them at it first.

The worst is pulmonologist FNAs. What a waste of time and money.