PHYSICIAN QUALITY REPORTING INITIATIVE (PQRI) PROGRAM FOR PATHOLOGY UPDATE
NEW CPT II CODE
A new CPT II code has been added to the three existing CPT II codes for 2009. This new code (3250F) is used to identify specimens that contain metastatic breast or colon carcinoma, but are not themselves the primary tumor and that are not amenable to pT and pN staging. These cases would be coded 88307 or 88309 with an ICD-9 code indicating breast or colon as the primary site.
The two pathology-specific performance measures that require pathologic staging and histologic grading for breast and colon malignancies remain the same for 2009.
- Breast cancer patients'pathology reports must have pT and pN categories and histologic grading (excluding biopsies)
- Colorectal cancer patients'pathology reports must have a pT and pN category and histologic grading (excluding biopsies)
PARTICIPATION
It is the responsibility of the pathologist to provide Rand with the required measurement data in a form or format that will allow for complete reporting. A recommended reporting form is attached. Retroactive submittal of quality codes is not permitted.
QUALITY AUDIT
Rand will audit pathology charges to assure compliance. Breast or colon cancer specimens that have not been assigned a CPT II code will be returned to the pathologist before charges are submitted.