[Histonet] RE: "Know Error"

[Terri Braud]

Great advice, Teri!
While I've not had the same request for the DNA identity test, I've had
a similar circumstance with a request for "routine" testing of a
specimen type that was beyond the scope of what our pathologists thought
as necessary diagnostic or prognostic testing.  Our response was, and
is, exactly what Teri Johnson proposed.  After discussing and addressing
their concerns, we agreed that they would send us a signed patient
release to send the block to their office for them to manage further
testing, including any billing.
It is a system that has worked well for us.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Holy Redeemer Hospital Laboratory
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3676
Fax: 215-938-3874

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Message: 1
Date: Mon, 2 Feb 2015 18:13:33 +0000
From: Teri Johnson <tejohnson <@t> genoptix.com>
Subject: [Histonet] RE: "Know Error"

That sounds like a valid concern, Richard. Thank you for being an
advocate for good utilization of patient testing. What is behind their
concern? Do they think there has been a mistake with patient
identification in your lab? Or are they trying to reconcile low PSA or
other discordant screening test results with a diagnosis of prostate CA?
I would offer to send whatever they need from the lab (paraffin section
curls, unstained slides, etc) back to their office, so long as they
provide patient consent. The urologist's office can then package that
material with the buccal swabs they get from the patient. The onus can
be on them to manage the cost of the testing, and they can then try to
justify it with the patient when insurance will not reimburse for it.
Is this option feasible?
Teri
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Date: Mon, 2 Feb 2015 16:52:40 +0000
From: "Cartun, Richard" <Richard.Cartun <@t> hhchealth.org>
Subject: [Histonet] "Know Error"
Our laboratory has a new urology group who is demanding that we send-out
every "Positive" (with CA) prostate biopsy for the "Know Error" DNA
identity test.  The test is used to confirm the identity of the patient
diagnosed with cancer by matching the DNA in the cancer cells to that
obtained from a buccal swab from the patient obtained in the doctor's
office.  In my opinion, this test is absolutely unnecessary; another
expense ($1,700 list price) to our healthcare system that is not
justified.   In addition, the laboratory ends up doing a lot of work
that it cannot get reimbursed for.  However, I would like to hear from
those of you who have experience with it.  Thank you.

Richard

Richard W. Cartun, MS, PhD
Director, Histology & Immunopathology
Director, Biospecimen Collection Programs Assistant Director, Anatomic
Pathology Hartford Hospital
80 Seymour Street
Hartford, CT  06102
(860) 972-1596
(860) 545-2204 Fax
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