The Squeeze on Molecular Pathology
This presentation will highlight two issues impacting the delivery of molecular pathology procedures: 1. Coding and reimbursement of molecular pathology and genomic sequence procedures and 2. Regulation of laboratory developed tests by the FDA as indicated in the 2014 draft guidance that is pending implementation. Details regarding the Association for Molecular Pathology project to determine costs and value of performing next generation sequencing based testing will be provided. Discussion of alternative options to the FDA draft guidance will also be presented.
Originally presented on December 17, 2015 in Salt Lake City, Utah.
Aaron Bossler, MD PhD
Clinical Associate Professor, University of Iowa Carver College of Medicine
Director, Molecular Pathology Laboratory, University of Iowa Carver College of Medicine
Dr. Bossler is a clinical associate professor in the Department of Pathology at the University of Iowa and directs the molecular pathology laboratory and molecular genetic pathology fellowship program. His research interests center on the role of HPV infection in the development of squamous cell carcinoma and the development of new molecular diagnostic assays. He currently serves as chair of the Association for Molecular Pathology’s Economic Affairs Committee, as a member of the American Medical Association Molecular Pathology Advisory Group (MPAG), and as a member of the economic affairs committee for the College of American Pathologists (CAP). He has served as the AMP representative to the CAP Pathology Coding Caucus (PCC) and is a member of the editorial board for The Journal of Molecular Diagnostics.
After this presentation, participants will be able to:
- Understand the process by which Current Procedural Terminology (CPT) codes are established and methods by which Centers for Medicare and Medicaid Services (CMS) determine pricing.
- Identify who writes and publishes local coverage determination (LCD) policies.
- Describe the rules imposed by the Protecting Access to Medicare Act (PAMA) and CMS’ current interpretation of the legislation.
- Knowledge regarding the implications of implementing the FDA draft guidance and alternatives to this proposal.
University of Utah School of Medicine, Department of Pathology, and ARUP Laboratories