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- State Pathology Societies and CAP Continue to Seek Expanded Coverage of Special Stains LCD
State pathology societies and the CAP called on the Medicare Administrative Contractor (MAC) Wisconsin Physician Services (WPS) to remove certain coverage limitations to its Special Stains and Immunohistochemical Stains Local Coverage Determination (LCD). The CAP has long advocated for changes to the LCD and is collaborating with state pathology societies and subject experts to make necessary changes supported by medical evidence.
On October 25, WPS hosted a public meeting to hear comments for its proposed revisions to the LCD. Vaishali M. Pansare, MD, FCAP, Chief of Pathology at Beaumont Hospitals in Michigan; and, Matthew Wasco, MD, FCAP, Department of Pathology, Trinity Health Medical Group in Michigan presented evidence challenging the current limits of immunohistochemistry (IHC) and special stains for prostate pathology and kidney tumors. Pathology Contractor Advisory Committee members representing the Missouri pathology state society provided additional comments on the clinical necessity of IHC and special stains for prostate and renal tumors.
The CAP will send formal comments to the MAC on its proposed revisions by November 11, urging further coverage for IHC/special stains and additional clarification to the LCD language. The CAP maintains the MAC revisions do not go far enough and continues to advocate to further expand coverage of this LCD.