[Histonet] Advice needed on doing the technical component and professional component at two different sites

[Vickroy, James]

Currently our dermatologists send their skin biopsies to a private lab.   Since we  now have our own Histology department we are proposing to do the technical component (grossing and preparation of slides) in house and sending the block and H&E slides to the same private company.  They call these type of clients " professional read only".   I understand the differences regarding billing since the CPT codes we are using have a professional component and a technical component.   My questions center around what other organizations do for accessioning and how they  meet CAP requirements for grossing, etc.

Normally we handle all of our other specimens in the normal way of accessioning, grossing (under the indirect supervision of a pathologist that comes to read the slides, processing, preparation of slides, and giving the slides to the pathologist who signs out the surgical report including the gross, and the rest of the surgical report.

The dermatology specimens would have to be handled differently. Our dermatologists want the slides read by the private company that only does dermatology specimens. (at least until we hire a dermatopathologist).  In the past the derm tissues were sent to the private company and they did all of the process including grossing.  Our organization has now decided that it is advantageous for us to do the technical portion in house and then send the slides to be read by the private company because of changes in billing.  The private company is perfectly willing to  help us make sure they get information they need  to diagnose the cases (they have even shown us how they like each type of skin biopsy sectioned and inked.  They will help us set up a system for them to get the slides and do the surgical reports.  Their report will have our gross description and surgical number, along with a statement that the gross and processing was done elsewhere.  They have done this with several other clients.  I have some unanswered questions since I have never done something like this.  Below is a list of my questions.  What I really need is someone to tell me how they are handling specimens that they prepare locally and then send the slides to a pathology group to read.


1.        Since the local pathologist group does not read these slides,  are our  grossing techs under the indirect supervision of the pathologists at the private company for these specimens?

2.       How do you accession these specimens locally so tracking, slide preparation, and technical component billing can be done, without a local surgical report.

3.       If you have to do a local report, who signs the gross report that just has a gross and maybe a statement that the slides will be read at the private company?

4.       Are there other CAP considerations I am not thinking of?

Am I making this too complicated?

Jim





Jim Vickroy
Histology Manager
Springfield Clinic, Main Campus, East Building
1025 South 6th Street
Springfield, Illinois  62703
Office:  217-528-7541, Ext. 15121
Email:  jvickroy at SpringfieldClinic.com<mailto:jvickroy at SpringfieldClinic.com>



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