Evolving regulatory guidance, changing reimbursement rules, staffing shortages and other concerns are creating more challenges for laboratory leaders.

The latest edition of the Laboratory Administration for Pathologists (https://capatholo.gy/2F1uLzT) provides laboratory managers with practical knowledge to identify situations which could lead to sanctions as well as strategies to improve their laboratory. Understanding and responding to changes in regulation can help to improve patient safety, ensure laboratory viability and reduce risk of sanctions or loss of accreditation, explains leading pathologist and co-author of this second edition, Dr. Elizabeth Wagar in this CAPcast.

Practicing pathologists continue to be vexed by issues that are related to payment for the services that they provide. However, better understanding the payment structure will enable pathologists to examine their own practices and adapt to reimbursement changes. In this CAPcast, Dr. Jonathan Myles, a member of the CAP Board of Governors and an expert on pathology reimbursement policies, discusses the fundamental processes associated with payment for services under Physician Fee Schedule Medicare Part B as well payment associated with the Clinical Laboratory Fee Schedule, both topics which he will discuss during a course he will be leading with Dr. Marc Synovec at CAP19 in Orlando, Florida: www.capannualmeeting.org.

Since pathologists have oversight responsibility for testing, they should be involved in the pre-analytic and post-analytic phases of testing, as well as optimizing the analytic phase, to deliver the highest quality of care to our patients. In addition, pathologists are often leaders in the hospital and healthcare setting, where the cost of care delivery is scrutinized. Pathologists are in a unique position to recommend the appropriate testing algorithms that optimize patient care and decreases waste, both of which in turn saves healthcare dollars, according to Cleveland Clinic pathologist Dr. Gary Procop, who will be teaching a course on this topic at on Sept. 21 at CAP19 in Orlando, Florida. Register now: www.capannualmeeting.org.

Genitourinary (GU) neoplasia is a continuously evolving diagnostic area and GU cases are among some of the most common diagnoses in today’s practice. In this CAPcast, Dr. Donna Hansel will discuss recent guideline changes and advancements in this pathology specialty.

Dr. Hansel will be one of the faculty members teaching a day-long course on GU pathology at CAP19 in Orlando, Florida. Her co-faculty members include Drs. Mahul B. Amin; John C. Cheville, Peter A. Humphrey, Anil Parwani, and Debra L. Zynger. For more information and to register for CAP19, please visit capannualmeeting.org.

Pathology practices are entering a new value-based payment era and the ability to successfully demonstrate contributions to the quality of care provided will likely have a significant impact on their ability to positively impact their own reimbursement in the Merit-based Incentive Payment System, also known as MIPS. The Centers for Medicare & Medicaid Services (CMS) has finalized several changes to the program for 2019, which is year 3 of MIPS.

In this CAPcast, Dr. Emily Volk, vice chair of the CAP’s Council on Government and Professional Affairs and chair of the CAP Qualified Clinical Data Registry Ad Hoc Committee, discusses what pathologists need to know and do for 2019 in order to be successful in year 3 of the program. For more information on MIPS, please visit the Advocacy section of CAP.org: https://capatholo.gy/2KhOIpR.

Thyroid nodules are a common source of diagnostic difficulties for practicing pathologists. The correct diagnosis of these nodules is often difficult given some of the controversies associated with their interpretation and evolving criteria for diagnosis.

In this CAPcast, Dr. Saul Suster discusses controversial areas in thyroid nodule interpretation and recent changes in terminology for papillary carcinoma. Dr. Suster will be teaching a course on this topic on Saturday, Sept. 21 at CAP19 in Orlando, Florida. For more information and to register for CAP19, visit www.capannualmeeting.org.

Advances in minimally invasive thoracic sampling techniques allow pathologists and laboratories to perform multiple ancillary studies on small biopsy and cytology specimens. But with small specimens, ensuring optimum diagnostic yield and judicious triaging of these limited volume samples to perform an ever-growing list of ancillary studies is a challenge, according to Dr. Sinchita Roy-Chowdhuri.

In this CAPcast, Dr. Roy-Chowdhuri, discusses the new CAP guideline, Collection and Handling of Thoracic Small Biopsy and Cytology Specimens for Ancillary Studies, which provides recommendations for pathologists and proceduralists to optimize testing outcomes for patients with suspected thoracic abnormalities. Dr. Roy-Chowdhuri will be teaching a course on this new guideline at CAP19, which will be held Sept. 21-25 in Orlando, Florida (www.capannualmeeting.org).

Endometrial biopsy is amongst the most frequent specimens evaluated by pathologists. But difficulties in interpretation of findings and the presence of common morphologic mimics, including metaplastic and reactive changes, may lead to misdiagnosis, with important consequences for patient management.

In this CAPcast, Dr. Ricardo Lastra discusses the common pitfalls in diagnosis as well as classification of endometrial precursor lesions and neoplasia, as well as the rare diagnoses that may be present in endometrial biopsy specimens. Dr. Lastra will be teaching a CAP19 course on this topic with Dr. Mamta Gupta on Monday, Sept. 21 in Orlando, Florida.

Colorectal carcinoma remains the most common gastrointestinal malignancy and a common cause of morbidity and mortality. Pathologists are seeing considerable change in the diagnosis, testing, and reporting of colorectal carcinoma. In this CAPcast, Dr. Raul S. Gonzalez will discuss three common areas of concern related to stains, deposits and buds as well as the recent publication of the International Tumor Budding Consensus Conference proceedings is likely to lead to a further increase in applying tumor budding in routine practice.

Dr. Gonzalez will be teaching a course on this topic at CAP19, which will be held Sept. 21-25 in Orlando, Florida. For more information on CAP19, please visit www.capannualmeeting.org.

Colon biopsies, especially polyps, are the bread and butter of many pathologists and issues surrounding these specimens are not uncommon. In this CAPcast, Dr. Lysandra Voltaggio discusses issues and challenging diagnoses as it pertains to colon polyps. Dr. Voltaggio is teaching a course on this topic at CAP19; learn more and register at www.capannualmeeting.org.