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June 2016

Clampdowns on out-of-network billing climb

June 2016—To the average reader, “out-of-network billing” might seem like a technical concept that should mainly concern hyperaware insurance wonks. Media outlets from NBC News to Time to the Huffington Post have found that phrases like “surprise medical bill,” “angry patients,” and sometimes “sticker shock” in recent stories are much more likely to grab attention.

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Glucose PT criteria reset stirs standards debate

June 2016—It may not be an exact science, but resetting standards is a long-established means of improving quality of testing, and it can also be a way of adapting to improvements in quality that have already been realized. In the case of the CAP’s recent tightening of proficiency testing criteria for hospital glucose testing, both purposes are at work.

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All for one, one for all? Laboratory consolidation

June 2016—Consolidation among hospitals and laboratories can sometimes seem like too massive a tide for independent and hospital-based laboratories to effectively resist. What are the advantages that large size provides to a hospital system or national lab in a competitive marketplace? And will there be any space left in which smaller laboratories can survive?

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From the President’s Desk: CAP16: All in one place, 6/16

June 2016—Even though I had a good idea of what would be in the CAP16 program, my heart raced when the final curriculum arrived. Perhaps because of my role as CAP president, I found myself taking a slightly different perspective than in the past and thinking about just how ambitious an undertaking it is. A program this complex involves serious choreography. Those who construct it must be thoughtful, forward-looking, and sensitive to many compelling needs and interests competing for limited time and space. It’s a big job.

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In memoriam: Raymond C. Zastrow, MD | 1930–2016

June 2016—Raymond C. Zastrow, MD, the 24th president of the CAP, died April 28 at age 85 following complications of surgery. A member of the CAP Board of Governors from 1985 to 1988, Dr. Zastrow also served as CAP secretary-treasurer from 1988 to 1993, president-elect from 1993 to 1995, and president from 1995 to 1997. In 1998, the CAP recognized him as Pathologist of the Year.

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More clarity over time for heart failure biomarkers

June 2016—Robert Christenson, PhD, a professor of pathology and of medical and research technology at the University of Maryland School of Medicine, likens the U.S. mortality rate for myocardial infarction to three or four jumbo jets crashing daily. For heart failure, it’s about half that many deaths, “so maybe one and one-half jumbo jets,” Dr. Christenson said in a session on cardiac biomarkers at the CAP annual meeting last year.

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On a quest for the eureka moment in Zika virus testing

June 2016—The Zika virus testing challenges facing laboratories are many, including the virus’ low and short-term viremia and its resemblance to other flaviviruses, especially dengue and chikungunya. “These viruses present extremely similarly, and it’s very difficult to tell them apart based on clinical characteristics alone,” said Benjamin Pinsky, MD, PhD, who presented the details of diagnostic tests for Zika in an Association for Molecular Pathology webinar in April.

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Antiphospholipid Antibodies

June 2016—CAP Press has released the second edition of its 2008 book, An Algorithmic Approach to Hemostasis Testing, edited by Kandice Kottke-Marchant, MD, PhD. She is chair of the Robert J. Tomsich Pathology and Laboratory Medicine Institute and section head of hemostasis and thrombosis, Cleveland Clinic Foundation.

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SS18-SSX2 fusion transcript in the diagnosis of a poorly differentiated synovial sarcoma

June 2016—CAP TODAY and the Association for Molecular Pathology have teamed up to bring molecular case reports to CAP TODAY readers. AMP members write the reports using clinical cases from their own practices that show molecular testing’s important role in diagnosis, prognosis, and treatment. The following report comes from Penn State Milton S. Hershey Medical Center and Penn State College of Medicine. If you would like to submit a case report, please send an email to the AMP at amp@amp.org. For more information about the AMP and all previously published case reports, visit www.amp.org.

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Clinical Pathology Abstracts, 6/16

June 2016—Fasting or nonfasting lipid measurements: The joint American College of Cardiology and American Heart Association “2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults” replaces low-density lipoprotein cholesterol treatment thresholds with a more global measurement of risk.

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Q&A column, 6/16

June 2016—Can you offer feedback on the growing trend of using type A fresh frozen plasma in emergencies instead of type AB? Is this being used mainly in trauma hospitals and military sites or is the trend becoming more popular in smaller hospitals too?

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Put It on the Board, 6/16

June 2016—Guidance seen as sign of FDA openness to digital pathology, Eco effort cuts biohazard waste, saves money, EGFR mutation liquid biopsy OK’d as companion Dx, Qiagen adds Horizon QC to next-generation system, Siemens enters molecular oncology services market, Roche PD-L1 tabbed as complementary test

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Open house: CMS welcomes lab input in fee talks

October 2002—Laboratory specialty groups praised the Centers for Medicare and Medicaid Services for how it handled its recent meeting on payments for new clinical laboratory tests. CMS went so far as to say it would reconsider previous pricing decisions, a surprising and welcome change from its traditional “black box”approach.

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Quick on the draw—coagulation tube response

October 2002—As the sensitivity of coagulation testing has increased, the preanalytical phase has been getting more attention as a potential source of error. Variables that have long been known to affect the accuracy of activated partial thromboplastin times are the reagents and instruments used in testing and the delays between acquiring and processing a blood sample.

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