CDx Diagnostics Leads In Digital Pathology
CDx Diagnostics (Suffern, NY), which specializes in oral, esophageal, and laryngeal cancer testing, is by far the biggest digital pathology lab as measured by volume of Part B claims for CPT 88361. CDx was paid for 55,082 Part B tests for CPT 88361 (including combined global, TC-only and PC-only claims) in 2019, according to provider utilization and payment data from CMS.
CPT 88361 is used to bill Medicare for digital quantification of HER2, estrogen receptor (ER), progesterone receptor (PR) and Ki-67 for breast cancer. This code can also be used for digital analysis of other cancers, including oral and esophageal cancers.
NeoGenomics has four labs (California, Florida, Michigan and Texas) in the top 25 with a combined total volume of 19,950 Part B allowed tests for CPT 88361 in 2019.
Sonic Healthcare USA has two lab locations (New York and Texas) that performed CPT 88361 with a combined volume of 6,760 allowed Part B tests for CPT 88361.
Overall, Medicare Part B allowed volume for CPT 88361 totaled 191,205 tests in 2019, down 10% from 212,003 tests in 2018.