New CPT Digital Pathology Codes Help Make the Case for AI-Driven Digital Pathology Workflows

Updated August 2, 2022.

The College of American Pathologists (CAP), working with the American Medical Association (AMA) CPT Editorial Panel, has successfully advocated for the inclusion of (13) new digital pathology add-on codes to be effective January 1, 2023. According to the CAP, these new digital pathology CPT codes will be “used to report additional clinical staff work and service requirements associated with digitizing glass microscope slides for primary diagnosis.”

The new codes have been accepted for Cat III – Digital Pathology:

The CAP also worked with the AMA CPT Editorial Panel to improve reporting of digital pathology services and these new codes will help laboratories and pathologists better report on digital pathology digitization procedures. The 13 new digital pathology codes are Category III codes which may be reported in addition to the appropriate Category I code. Category III codes do not have an assigned RVU and therefore payments for these services or procedures are based on the policies of payors and not on yearly fee schedules. While Medicare contractors and commercial payors have not released payment policies regarding these new codes, the addition of these codes will allow payors to distinguish when a diagnosis was made using digital pathology. This is an important first step for payors to understand the utilization and impact.  

This long-awaited announcement will help pathology laboratories recoup some of their costs for operating a digital pathology program. Prior to this announcement forward-thinking laboratories that implemented digital pathology programs could not charge for much of the clinical staff work and services associated with processing and scanning glass slides. This announcement adds another incentive for labs to adopt digital pathology and realize all its benefits.

This news makes it more important than ever for laboratories and pathology practices to consider the advantages of using artificial intelligence (AI) tools in their digital pathology workflows. For example, the ability to effectively and efficiently use FDA-approved algorithms to provide the pathologist with additional diagnostic insights and triage cases into high or low priority to ensure that high-impact cases are reviewed first. While every case is important to review, AI-driven digital pathology workflows present an opportunity to reduce a lab’s risk of losing or misdiagnosing a critical case and offer significant process improvements and improve turn-around time.

In addition, successfully integrating a digital pathology system into an LIS lets a lab take advantage of a host of benefits including:

1. Improved case throughput, which enables scaling of test volume
2. Better patient outcomes due to collaboration with subspecialty expertise, QA protocols, and AI insights
3. Case triaging via artificial intelligence
4. Integrated image analysis and reporting (with images and analysis)
5. Better pathologist ergonomics and experience including support for remote work and workload balancing

The XiFin LIS, for example, can be fully integrated with histology automation, such as the Leica Cerebro, to pass case information to the digital pathology system, and prepare barcoded slide labels that can be read by the imaging device. Once slides are scanned and the whole slide images are ready for review, pathologists should be notified of their availability via the LIS.

The ideal digital workflow includes access to all case-related whole slide images via an image viewer integrated with the LIS. Pathologists can then capture regions of interest and include them in the LIS report if desired. If pathologists are utilizing automated image analysis, they should be able to seamlessly incorporate those results in the LIS and the final report. In addition to improving existing processes, digital pathology can be used in a TC/PC environment to grow business outside of a lab’s community, providing additional revenue.

Pathologists should also be able to order test add-ons in the LIS and monitor this on a test-add-on worklist as slides are prepared and digitized. Your LIS should also allow the ability to digitally share cases with colleagues, should a secondary consult be required. Forward-looking labs understand that their data is valuable to precision medicine programs. An LIS that facilitates sharing test results data to a precision medicine collaboration or informatics platform is essential to capturing the full value of that data.

The adoption of a digital pathology platform with an integrated LIS helps make pathology an active part of the care team. It enables a more patient-centric approach for treatment planning and tracking. Without this integration, scalability is hampered. The right digital pathology platform with AI-driven workflows enhances efficiency, quality, and innovation. Likewise, the integrated LIS workflow supports growth and scale.

Learn more about how XiFin LIS can support your integrated digital pathology strategy.

Additional Readings:

XiFin’s Joe Nollar recently authored a blog post published in Today’s Clinical Lab. In the blog titled “The Rapid Adoption of Digital Pathology,” Nollar explains why scalable digital pathology workflows are critical to a lab’s growth.

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