Vachette Pathology

Defending Your Pathology Practice or Lab; "Fight Back Against the Outsourcing of Pathology Specimens."Friday, February 12, 2010 prior to the opening of the Florida Society of Pathologists 36th Annual Anatomic Pathology Conference.

Practices and labs across the country are losing pathology work due to insourcing by GI and GU practices. Learn how to fight back and defend your specimen work! Discover how others are winning the battle and keeping their practices strong and thriving. An expert panel including:

• Dr Kenneth Batts of Hospital Pathology Associates, Minneapolis, MN
• James Richard, D.O. of Capital Area Pathologists, Lansing, MI
• Jane Pine Wood, ESQ. of McDonald Hopkins LLC

will present an arsenal of practical solutions to this lingering problem. Reserve your seat today. For the price of a single 88305-GB, you'll leave armed with solid ideas to help you defend your pathology practice or laboratory. 

Registration: $103.85

Disney's Grand Floridian Resort Palm Beach Boardroom

Friday, February 12, 2010 11:00am - 1:30pm

Reserve your spot by calling Vicki Hilty at 419-467-7759

Recently the 2010 National Physician Fee Schedule Relative Value File was released. This file shows us the Relative Value Unit (RVU) for each CPT code that is billed. The RVU is multiplied by a Conversion Factor (CF) to get the payment for that CPT code. This is how Medicare (CMS) determines what you get paid.

For example the RVU for an 88305-26 in 2008 was 1.04. This was multiplied by the 2008 conversion factor of $38.08 ($38.08 x 1.04) to come up with the payment of $39.60.  In 2008, $39.60 was the national payment for this CPT code.

Recently, we sent information which reflects the CPT coding changes, additions and deletions for
2010. The purpose of this document is to provide further clarification on Medicare’s decision to
eliminate payment on physician consultation services and a focused review of two NCCI edit changes Per CMS’ latest version of the National Correct Coding Initiative (NCCI), the following first two items have been modified

1.) The unit of service for “special” stains (88312-88313) and immunohistochemistry (88342,
88360 and 88361) will be per block. When it is medically necessary and reasonable to
perform the same stain on more than one specimen or more than one block of tissue from the
same specimen, additional units of service may be coded and billed.

In some ways, hospitals are in the driver’s seat when negotiating a contract with community pathologists who want to provide pathology services and laboratory direction for patients at a hospital. More than one pathology group is often knocking at the hospital’s door to do business, and hospitals control the Part A payment for the professional component of clinical pathology services.

But contracting acumen and savvy bargaining skills can boost pathologists’ odds of getting and keeping favorable hospital agreements. And pathology groups that become highly valuable players to a hospital’s administrators and medical staff may have a special ace up their sleeves at contract renewal time.

“A lot of contract negotiation is just jousting,” says consultant Mick Raich, president and CEO of Vachette Pathology, Blissfield, Mich. As bargaining chips, provisions are put into the contract that the hospital is likely to remove when the wrangling begins, such as asking the hospital to pay for part of the cost of a pathology assistant or second opinions, he says.

In many cases hospitals allow pathology groups to purchase the technical component of the histology lab. In this case the pathology group purchases the technical component at a fair market price and then bills a global charge to insurance carriers. The group is responsible for paying the hospital for the agreed-upon rate for each technical charge billed out. This can be done for all carriers with the exception of the government payers unless the purchasing lab is grandfathered in under certain CMS rules.

The reason some groups chose to have the ability to bill the technical component is that this process allows the pathology practice to garner more revenue and to help the hospital understand the direct revenue available from this technical work.

Creating online tests can be complicated and time-consuming. i-Path’s new product PathXL OLT, an online wizard, makes the design and creation of online tests, for any number of students, quick and easy. Once the test is up and running, i-Path provides continuous support to ensure the tests run seamlessly.