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Pathology group

A pathology group is an organization of clinical pathologists working on the diagnosis of disease based on laboratory analysis of bodily fluids such as blood and urine, as well as tissues, using the tools of chemistry, clinical microbiology, hematology and molecular pathology. Clinical pathologists work in close collaboration with medical technologists, hospital administrations, and referring physicians.

The business model of a pathology group has traditionally been as a private group practice, including solo practitioner, medical group partnership, professional corporation (PC), limited liability company (LLC), and similar professional business organizations. It is common for pathology groups to have contracts with one or more hospitals to provide anatomic pathology professional services and clinical pathology professional services.

Pathology itself is a significant component of the causal study of disease and a major field in modern medicine and diagnosis. The term pathology may be used broadly to refer to the study of disease in general, incorporating a wide range of bioscience research fields and medical practices, or more narrowly to describe work within the contemporary medical field of “general pathology,” which includes a number of distinct but inter-related medical specialties which diagnose disease mostly through the analysis of tissue, cell, and body fluid samples.

Pathologists in hospital labs and pathology groups practice as consultant physicians, developing and applying knowledge of tissue and laboratory analyses to assist in the diagnosis and treatment of individual patients. As scientists, they use the tools of laboratory science in clinical studies, disease models, and other experimental systems, to advance the understanding and treatment of disease.

Clinical pathologists in a pathology group administer a number of visual and microscopic tests and an especially large variety of tests of the biophysical properties of tissue samples involving automated analyzers and cultures. Sometimes the general term “laboratory medicine specialist” is used to refer to those working in clinical pathology, including medical doctors, PhDs and doctors of pharmacology.

Immunopathology, the study of an organism’s immune response to infection, is sometimes considered to fall within the domain of clinical pathology.

Becoming a pathologist entails one of the lengthiest education and training tracks of all physicians. Requirements include four years of undergraduate study, plus four years of medical school, plus a minimum of four to five years of post-graduate training in pathology residency.

Labs Have New Hurdles as Some Payments Start

CEO SUMMARY: Some payments are beginning to flow for claims submitted under the new molecular test CPT codes. But there is a new issue. Medicare contractors, Medicaid programs, and private health insurers are deeming certain molecular tests to be medically unnecessary. Th…

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Big Lab Industry Stories Reveal Trouble Ahead

CEO SUMMARY: One after another, a series of breaking news stories points to more rough waters ahead for the entire clinical lab industry. Of greatest interest is the ongoing questions about when clinical labs and pathology groups will get paid for the molecular test claims they have submi…

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Health Insurers See Big Increase in Lab Utilization

CEO SUMMARY: In a recent public workshop, managed care executives revealed that the annual cost of outpatient laboratory testing is increasing at twice the rate of all other medical services. One big driver in the increased spending on lab testing is increased utilization…

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Much Uncertainty About Pay for Molecular Codes

CEO SUMMARY: Having gone unpaid since January 1 for the 114 new molecular CPT codes, many clinical labs and pathology groups have stopped running these tests or laid off staff. Some are considering closing their doors. Evidence indicates that certain Medicare contractors are deciding that…

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Aetna To Lower Lab Test Prices, New Fees Are Effective on July 1

IN RECENT MONTHS, labs are reporting the receipt of letters from Aetna, Inc., announcing that it will pay dramatically less than Medicare prices for many key lab tests. Aetna said that these lower prices will take effect on July 1, 2013. Three examples illustrate the deep fee cuts t…

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Unpaid for Molecular Tests, Some Labs Are Closing

THERE IS GREAT FRUSTRATION ACROSS THE LABORATORY MEDICINE PROFESSION on the subject of getting paid for claims covered by the new Tier I and Tier II molecular test CPT codes. We are now in the fifth month of the year and pathologists are still waiting for an acceptable resolution to this situation. …

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Executive War College Sessions Center Upon Three Trends

CEO SUMMARY: There was an interesting blend of anxiety and optimism as a record crowd gathered in New Orleans last week for the 18th annual Executive War College on Laboratory and Pathology Management. The anxiety was rooted in the shrinking prices paid by payers for lab testing services….

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Labs Should Prepare for Larger Patient Deductibles

CEO SUMMARY: Employers are taking active steps to control the year-over-year increases in the cost of health benefits. One strategy gaining favor is to move employees away from traditional health plans and enroll them in high-deductible health plans (HDHPs). This is a trend with huge fina…

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Standard Bar Code Labels Can Reduce Lab Errors

CEO SUMMARY: Standardization of bar code labels is a concept whose time has come. After implementing CLSI standard AUTO12-A, first-mover clinical labs report fewer specimen identification errors, a reduction of costs associated with specimen handling errors, and a boost in lab productivit…

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Reimbursement System Fails Labs and Patients

There is confusion and disruption in the molecular testing sector of the clinical lab testing industry. That’s because both government and private payers were not ready to process and reimburse for the 100+ new molecular CPT test codes on January 1, 2013. That is the date when the Medicare program…

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