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  Payment and Performance of the Autopsy Service

 

Policy Synopsis

The autopsy is used to assess the quality of patient care, to evaluate diagnostic accuracy, to monitor effectiveness of new technologies and to determine the efficacy of therapeutic regimens. The autopsy also provides valuable information to the decedent’s family. Pathologists should be compensated for their professional autopsy services. Compensation may be determined in several ways and may be dependent upon the person or entity requesting the autopsy service. Hospital medical staff, in consultation with pathologists, should develop criteria that identify deaths in which an autopsy should be performed. Autopsy suites should be compliant with all applicable standards.

Policy

The autopsy is a medical procedure and service performed by physicians specializing in pathology. The autopsy is of value to medicine as an educational tool, a measure of performance and outcomes, a resource for research, and a valuable tool for all physicians. The autopsy is used to assess the quality of patient care, to evaluate diagnostic accuracy, to monitor effectiveness of new technologies and to determine the efficacy of therapeutic regimens. The autopsy also provides the decedent’s family valuable information about genetic and communicable diseases and provides the greater community critical data regarding prevalent or emerging infectious or environmental disease.

The Joint Commission and the CAP state that autopsy information should be used as a source of clinical information in the quality assessment and improvement programs of the hospital. Collaboration between pathologists and clinicians to translate autopsy data into information useful in hospital quality management can lead to improved organizational systems and processes as well as clinical performance and, therefore, error reduction and improved patient safety.

Pathologists should be compensated for their professional autopsy services. A variety of methods for payment of autopsy services provided by pathologists are available. Such payment can be made in various ways. The pathologist may seek a per-autopsy payment from the hospital. Alternatively, the pathologist may negotiate a fixed amount for a package of designated services that includes the autopsy (e.g., providing hospital medical staff requested autopsies, serving on committees, providing education programs).

When the autopsy service is provided at the request of the family of the deceased, the pathologist who performs the autopsy may bill the family of the deceased for the professional service. The amount of the fee and the manner of payment should be discussed with the family in advance. Similarly, when the autopsy is provided at the request of law enforcement officials or other third parties, the pathologist who performs the autopsy may bill the requesting entity. Once again the amount of the fee and manner of payment should be discussed in advance.

Pathologists who perform autopsies must practice in a safe medical environment. Autopsy suites should be compliant with all applicable federal, state and local standards.

Numerical standards or minimum autopsy rates for hospital deaths are inappropriate. Instead, the hospital medical staff should develop criteria that identify deaths in which an autopsy should be sought.

Revision History

Adopted August 2000
Revised August 2008
Reaffirmed December 2013