FISH and flow 2014 cuts

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Anonymous

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I recently heard about 60-75% proposed CMS cuts for TC FISH and TC flow for 2014..... whats the chance of this really happening? Are these just stupid rumors by competitors?
 


















will be a while (lobby) but will happen - keep screwing the people who give the diagnosis.

Flow is dead. FISH will still have some value as some new test are FISH based.......I guess I should say Hem is dead - sorry blood cancer patients.
 






















































CAP is vigorously fighting the laboratory cuts in the medicare physician fee schedule for 2014.

According to the most recent CAP STATLINE report, CAP has admitted the proposed cuts to in-situ hybridization and immunohistochemistry are inevitable.

IMO Abbott, Quest, or LabCorp buys this company or it's lights out.

Just to emphasize the impact of these cuts, see below:

CPT code Description 2013 payment 2014 payment

88367 TC A Insitu hybridization auto $198.35 $40.30 (-80%)

88365 TC A Insitu hybridization (fish) $120.44 $40.30 (-67%)

88342 TC A Immunohistochemistry $73.15 $40.30 (-45%)


CMS to Finalize Proposed Physician Fee Schedule Rule by Nov. 27; CAP Expects Cuts to Some Key Pathology Codes; Other Key Payment Decisions

CAP expects the final 2014 rule to include cuts to the following pathology code families.

Immunohistochemistry – 88342 (PC & TC)
Enhanced Cytology Services – 88112 (PC & TC)
In situ Hybridization – 88365, 88367, and 88368 (PC & TC)

CMS also requested additional information on the payment level for 88305 TC. CMS reduced payment for 88305 TC by 52 percent last year. The College has provided additional information to CMS on the valuation of the technical component and has argued that the TC was reduced too steeply in 2013 and did not include some key input costs.

CMS has expanded its “misvalued code” initiative by targeting the top expenditure codes from each specialty as potentially overvalued, which triggered the review of the three additional code families.

As regular readers of this newsletter know, CAP has strongly opposed the CMS proposal to link payment for 39 pathology services to the Hospital Outpatient Rates and the additional proposal to “bundle” pathology and laboratory services into the Hospital Outpatient Payment Rates. Since July 8, 2013, CAP has vigorously advocated for the withdrawal of these policy proposals through multiple channels, including comment letters to CMS and member visits to Capitol Hill and the White House.

At the same time, the CAP has also been working through the AMA Relative Value Update Committee to mitigate the payment reductions to specific pathology services by ensuring that the revaluations of pathology services accurately account for the cost of delivering the service. Nevertheless, some reductions are inevitable, particularly to some services, which may not have been revalued for many years.

As the clock ticks down, and as we wait for publication of the proposed rule, CAP’s policy team will continue to keep members updated on any new developments.
 






Anonymous said:
CAP is vigorously fighting the laboratory cuts in the medicare physician fee schedule for 2014.

According to the most recent CAP STATLINE report, CAP has admitted the proposed cuts to in-situ hybridization and immunohistochemistry are inevitable.

IMO Abbott, Quest, or LabCorp buys this company or it's lights out.

Just to emphasize the impact of these cuts, see below:

CPT code Description 2013 payment 2014 payment

88367 TC A Insitu hybridization auto $198.35 $40.30 (-80%)

88365 TC A Insitu hybridization (fish) $120.44 $40.30 (-67%)

88342 TC A Immunohistochemistry $73.15 $40.30 (-45%)


CMS to Finalize Proposed Physician Fee Schedule Rule by Nov. 27; CAP Expects Cuts to Some Key Pathology Codes; Other Key Payment Decisions

CAP expects the final 2014 rule to include cuts to the following pathology code families.

Immunohistochemistry – 88342 (PC & TC)
Enhanced Cytology Services – 88112 (PC & TC)
In situ Hybridization – 88365, 88367, and 88368 (PC & TC)

CMS also requested additional information on the payment level for 88305 TC. CMS reduced payment for 88305 TC by 52 percent last year. The College has provided additional information to CMS on the valuation of the technical component and has argued that the TC was reduced too steeply in 2013 and did not include some key input costs.

CMS has expanded its “misvalued code” initiative by targeting the top expenditure codes from each specialty as potentially overvalued, which triggered the review of the three additional code families.

As regular readers of this newsletter know, CAP has strongly opposed the CMS proposal to link payment for 39 pathology services to the Hospital Outpatient Rates and the additional proposal to “bundle” pathology and laboratory services into the Hospital Outpatient Payment Rates. Since July 8, 2013, CAP has vigorously advocated for the withdrawal of these policy proposals through multiple channels, including comment letters to CMS and member visits to Capitol Hill and the White House.

At the same time, the CAP has also been working through the AMA Relative Value Update Committee to mitigate the payment reductions to specific pathology services by ensuring that the revaluations of pathology services accurately account for the cost of delivering the service. Nevertheless, some reductions are inevitable, particularly to some services, which may not have been revalued for many years.

As the clock ticks down, and as we wait for publication of the proposed rule, CAP’s policy team will continue to keep members updated on any new developments.
Click to expand...

What about FLOW?
 


















that post above means what? Yes, FLOW makes some money but not as much as the old days. And the new cuts do not focus on FLOW as that was the question asked.

Just like FLOW survived, so will FISH (for some) not sure why they undervalue FISH so much. I get why FLOW got cut (Genoptix billing for 24242424 markers) but FISH is a few probes that give prognostic data in most new CDX.
 






I predict by November 27th, Neo will be the premier go-to lab for cancer diagnostics--if not nationally, then for sure regionally. The anemic competition will fall by the wayside after CMS issues its final decisions.

We'll all know if I am right shortly.
 






Anonymous said:
I predict by November 27th, Neo will be the premier go-to lab for cancer diagnostics--if not nationally, then for sure regionally. The anemic competition will fall by the wayside after CMS issues its final decisions.

We'll all know if I am right shortly.
Click to expand...

CEO keeps touting the genetic (plasma) test for prostate cancer. They need to get this out early next year to stay competitive.
 












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