Affairs Committee Report
By Jeffrey A.
Chair, Economic Affairs Committee
previously the ‘CPT Coding Subcommittee’ of the Professional
Relations Committee has morphed, following Council approval,
into the Economic Affairs Committee (EAC). A bylaws
amendment recognizing EAC as a standing committee will be
submitted to the membership for consideration with the
election ballot later. Jan Nowak ably
chaired this group until February 1 when the responsibility
was passed to me so Jan could focus on the AMP Presidency.
Replacing Jan as the AMP representative to the Pathology
Coding Caucus (PCC) is Aaron Bossler.
appreciation of the importance of economic-related matters
to the discipline and membership led to the establishment of
this Committee in early 2008. Here is what we have been
year a cross-organization workgroup (led by Aaron) which
included American Society for Microbiology (ASM),
American Clinical Laboratory Association (ACLA) and a
group of knowledgeable people in coding and
reimbursement developed a CPT code proposal for
bacterial identification via DNA sequence analysis.
After discussion and revision at the PCC, the proposal
appeared to be well-received at the CPT Editorial Panel
meeting in February, and we are hopeful there will be a
dedicated CPT code to address this area in 2010. For
this year we plan to resurrect this workgroup to discuss
genotyping assays for additional viruses beyond HIV-1
and HCV, and possibly to discuss the area of multiplex
viral assays. In our discussions we are ever mindful of
the adage “be careful what you wish for.” Member
suggestions for other areas needing CPT attention are
welcome; we will prioritize and do what we can. These
initiatives require considerable effort to realize.
has also been discussing models to ‘simplify’ CPT coding
for molecular diagnostic assays. The Abbott Diagnostics
Foundation has graciously provided support for several
face-to-face meetings of the Committee as they have
worked on this project. Assay costs for technologies
which might fall into common ‘bins’ are being
investigated. Joan Logue led EAC efforts
to analyze cost data for Factor V Leiden testing, and we
are now collecting information for lower volume and
higher complexity assays such as immunoglobulin heavy
chain rearrangement or DNA sequence analysis for genetic
disorders. An update on these activities will be
available by the time of this year’s Annual Meeting.
has initiated contacts with a carrier medical director
for a large Medicare jurisdiction which led to
withdrawal of a poorly-worded and penalizing local
coverage determination for genetic testing. Efforts
continue to have this coverage decision rescinded or
reconsidered/revised in other jurisdictions.
suggestion was made to develop a ‘column’ for the
Newsletter around examples or issues associated with
CPT coding and reimbursement.
installment of this new feature, “Show
Me the Money!” is a piece I prepared for the CAP CPT
Coding Tutorial describing the two major types of
coverage decisions that govern how labs get paid for
Medicare services. Ideas for subsequent columns are
welcome and encouraged.