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Accounting for the professional work of pathologists performing autopsies

John H Sinard
Archives of Pathology & Laboratory Medicine 2013, 137 (2): 228-32

CONTEXT: With an increasing trend toward fee-code-based methods of measuring the clinical professional productivity of pathologists, those pathologists whose clinical activities include the performance of autopsies have been disadvantaged by the lack of generally accepted workload equivalents for autopsy performance and supervision.

OBJECTIVE: To develop recommended benchmarks to account for this important and often overlooked professional activity.

DESIGN: Based on the professional experience of members of the Autopsy Committee of the College of American Pathologists, a survey of autopsy pathologists, and the limited additional material available in the literature, we developed recommended workload equivalents for the professional work associated with performing an autopsy, which we elected to express as multiples of established Current Procedural Terminology codes.

RESULTS: As represented in Table 3 , we recommend that the professional work associated with a full adult autopsy be equivalent to 5.5 × 88309-26. Additional professional credit of 1.5 × 88309-26 should be added for evaluation of the brain and for a detailed clinical-pathologic discussion. The corresponding value for a fetal/neonatal autopsy is 4.0 × 88309-26.

CONCLUSION: Although we recognize that autopsy practices vary significantly from institution to institution, it is hoped that our proposed guidelines will be a valuable starting point that individual practices can then adapt, taking into account the specifics of their practice environment.

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