Healthcare Industry News:  KMedic 

Diagnostics Oncology Reimbursement

 News Release - September 27, 2010

Positive Reimbursement Coverage Issued for RedPath's PathFinderTG(R) Technology

PITTSBURGH--(Healthcare Sales & Marketing Network)--RedPath Integrated Pathology, Inc. ("RedPath"), a cancer molecular diagnostics company headquartered in Pittsburgh, PA, announced today that Highmark Medicare Services, Inc. (HMS), the contractor that administers Medicare programs for providers in Pennsylvania, New Jersey, Maryland, Delaware and the District of Columbia, has issued a positive Local Coverage Decision (LCD) for the company's PathFinderTG Technology for pancreatic cancer, cysts, and masses.

PathFinderTG Technology will be covered as a “reasonable and necessary” service for the analysis of pancreatic cysts and masses when traditional diagnostic evaluations are inconclusive. Inconclusive diagnostic evaluations result from such occurrences as indeterminate cytology results and inconsistent or conflicting results from fluid chemistry tests, imaging studies, and cytology. PathFinderTG is the key element of RedPath’s comprehensive menu of tests for the characterization of pancreatic cysts. The company’s integrated approach enables gastroenterologists and gastrointestinal clinicians to obtain an unparalleled level of detailed, integrated diagnostic information to make informed patient management decisions about their patients with pancreatic cysts.

Dennis M. Smith, Jr., M.D., RedPath’s CMO commented “HMS’s recognition of PathFinderTG as “reasonable and necessary” in the evaluation of patients with pancreatic cysts and masses will ensure continued access for Medicare patients and their doctors to this important molecular technology platform. Molecular technologies are being increasingly used to make treatment decisions when traditional diagnostic tests provide inconclusive results.”

HMS stated that the positive coverage decision was determined in light of “extensive comments from physicians and providers from across the country, many from distinguished, highly reputable universities and physicians specifically on their use and results of the PathFinderTG Technology, very specifically for patients with pancreatic cysts where “traditional” fluid chemistry and/or cytology evaluations were inconclusive. Several institutions provided their own research results of their use of PathFinderTG Technology specifically for patients with pancreatic cysts where fluid chemistries and/or cytology evaluations were inconclusive.”

Gregory Haber, M.D., Chief, Division of Gastroenterology, Lenox Hill Hospital, New York, and Chairman of the Executive Committee of the Scientific Advisory Board of RedPath’s Pancreatic Cyst Registry, added, “This determination confirms the importance of RedPath’s molecular diagnostic platform in managing these complex patients. This announcement is very good news for my patients with pancreatic cysts and for all the physicians who treat these challenging cases.”

The HMS decision was posted on its website on September 20, and the coverage is scheduled to become effective for services performed on or after November 5, 2010. Medicare claims for PathFinderTG are billed through HMS because the analysis is performed in RedPath’s CLIA-licensed, CAP-certified clinical reference laboratory in Pittsburgh, PA. The LCD is posted at https://www.highmarKMedicareservices.com/policy/mac-ab/l31144.html

About PathFinderTG

PathFinderTG is a molecular analysis of mutations in genomic DNA for cases where traditional pathology or other diagnostics tests such as imaging, cytology and fluid chemistry analysis result in an "indeterminate", "suspicious", or "atypical" diagnoses. The objective molecular information from PathFinderTG can help resolve diagnostic dilemmas and lead to a more personalized treatment plan.

About RedPath Integrated Pathology, Inc.

RedPath is a genomics-based molecular diagnostics company that provides complex cancer diagnostic tests for pathologists, oncologists, surgeons, and other clinicians. RedPath’s pathologists integrate its patented molecular-based analysis, PathFinderTG®, with the results of routine biopsy, cytology, and fluid chemistry studies to render earlier, more informative diagnoses which improve patient outcomes and reduce healthcare costs. For more information, please visit http://www.redpathip.com.


Source: Integrated Pathology

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