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<br>Dr. Synovec

Dr. Synovec

CPT Codes Changes Examined at ASCP 2013 Chicago

Monday, May 13, 2013

The molecular pathology profession has been in turmoil since January, waiting for the Centers for Medicare and Medicaid to calculate a national reimbursement limit for molecular pathology Current Procedural Terminology (CPT) codes. The CPT codes play a vital role in ensuring pathologists are reimbursed for their medical laboratory services for Medicare and Medicaid patients and are among the hot topics in the current national dialogue about healthcare reform.

“Pathologists and laboratory professionals have still been providing services since January without reimbursement. However, if these services are poorly reimbursed, people will say: ‘Why do I want to provide the services?’ Then, patients and other clinicians will not trust innovation in laboratory medicine. It’s a travesty to be held in this situation.”
—Mark Synovec, MD, FASCP

“Pathologists and laboratory professionals have still been providing services since January many times without reimbursement,” says Mark Synovec, MD, FASCP, a nationally renowned expert on CPT codes, "its a travesty to be held in this situation". As some of the carrier fee schedules have been release, some have appear remarkably low. “If these services are poorly reimbursed, providers will ask: ‘Why do I want to provide the services?’ This will likely result in decreased access and inhibit innovation in laboratory medicine."

Dr. Synovec will present a session titled “CPT Coding and Related CMS Payment Policy: Trends for Pathology and Laboratory Medicine” at ASCP 2013 Chicago, on Sept. 18, from 1 to 3 p.m.

In his presentation, Dr. Synovec will discuss the impact of the CPT code changes pertaining to pathology and laboratory services published Jan. 1, 2013, as well as changes anticipated in CPT 2014, which include significant additions to molecular testing. The CPT codes continue to evolve as technology in health sciences changes, especially with the proliferation of new molecular tests that are coming on the market.

“We live in a new world of more scrutiny, oversight, and fears of fraud and abuse by government and other payers, so there are there are attempts on modifications of the current coding system to promote better characterization of the services rendered by providers,” Dr. Synovec says. “It is imperative that pathologists and laboratory professionals keep up with these changes.”

Dr. Synovec is a member of the Executive Committee of the American Medical Association’s CPT Editorial Panel and the national CPT Pathology Coding Caucus. In addition to serving as President of Topeka Pathology Group in Topeka, Kan., and as Medical Director of Stormont-Vail Healthcare laboratories, Dr. Synovec is the Immediate Past President of the Kansas Medical Society.