|By Business Wire
|February 26, 2013 12:01 AM EST
Medical Association (AMA) and McKesson
have entered into a licensing relationship to offer the healthcare
system a consistent and transparent way to identify and track molecular
diagnostic (MDx) tests. Under the agreement, McKesson
Z-Code™ Identifiers will be grouped and indexed with corresponding
molecular pathology codes in the AMA’s Current
Procedural Terminology (CPT®) code set. With identifiers
and codes working in tandem to create a comprehensive reference for
identifying and tracking MDx tests, the healthcare industry can better
understand the growth in this area to support advanced diagnostics
Today, over 3,000 molecular and genetic diagnostics are marketed for
clinical use. According to Frost
& Sullivan, MDx
is the fastest growing sector of clinical pathology lab testing,
with revenues expected to reach $6.2 billion by 2014 and a projected
compound annual growth rate (CAGR) of more than 11 percent. Although
these diagnostics hold great promise to influence the cost and quality
of care by informing care decisions, their impact has not been clearly
articulated and quantified. With the introduction of next-generation and
whole genome sequencing, the scale of this challenge grows exponentially.
“CPT is a foundational component of healthcare, a shared terminology
that physicians, hospitals and payers use to report and reimburse for
services delivered to patients. With MDx tests growing so quickly,
understanding their clinical and financial impact across the healthcare
system is challenging. Identifying new tests as they evolve is critical
to support smarter and more informed care decisions to address the
quality and cost of care,” said Matthew
Zubiller, vice president of decision management at McKesson Health
“We are pleased to be working with the AMA to help improve test
identification, which will enhance transparency for physicians,
hospitals, laboratories and payers when it comes to diagnostics,
treatment selection and prognosis. Greater clarity will bring healthcare
stakeholders one step closer to the collaboration needed to assess these
tests and make the most informed test selection, coverage and payment
decisions, resulting in better business for providers and payers and
better care for patients,” said Emad Rizk, M.D., president of McKesson
In 2011, McKesson created the McKesson
Diagnostics Exchange™, a software-as-a-service catalog and shared
workflow solution that laboratories and diagnostics manufacturers can
use to submit information about their specific MDx tests, and providers
and payers can use to understand and evaluate them. The McKesson
Diagnostics Exchange issues a unique Z-Code Identifier to each test and
catalogs it for reference and understanding by other stakeholders in the
The relationship between the AMA and McKesson will result in the
creation of a new reference product that maps Z-Code Identifiers to CPT
codes. The AMA will use the information that labs and manufacturers
submit and then share in the McKesson Diagnostics Exchange to assign CPT
code mappings where appropriate. Not all Z-Code Identifiers will
immediately map to a CPT code, and, in many cases, multiple Z-Code
Identifiers will map to a single CPT code. The new product will be
available for licensing from the AMA early in 2014.
“The McKesson Diagnostics Exchange provides an infrastructure that will
support the AMA’s efforts to advance personalized medicine, promote
access to innovative diagnostic capabilities and improve patient
outcomes,” said James
L. Madara, M.D., AMA chief executive officer and executive vice
president. “The added capabilities will complement the AMA’s ongoing
development and maintenance of a CPT code set for molecular diagnostic
services and provide a valuable tool for physicians, hospitals, payers
and the diagnostics industry that will help organize vital information
about MDx tests.”
The AMA has been involved with coding solutions for molecular pathology
services since 1998. New, more detailed CPT codes for molecular
pathology services became effective in 2012 to capture and describe the
latest scientific advances in this rapidly expanding field of medicine.
The ongoing process has so far created more than 100 codes for reporting
innovative diagnostic services. This collaboration complements the
recent efforts that the AMA and McKesson have undertaken to work closely
to share terminology with the National Institutes of Health’s Genetic
Connecting Z-Code Identifiers with CPT codes is expected to yield many
Laboratories will have an opportunity for their tests to be mapped to
CPT codes where appropriate, which will give them the ability to more
precisely identify which test was performed and then reported with the
appropriate CPT code, potentially improving efficiencies in the
Clinicians will be able to access a tool to help them accurately
identify and select tests.
Payers will have additional detailed test information to help identify
the tests being performed, thus providing the industry with the
ability to track outcomes on specific tests and analyze the value of
Patients will benefit from this collaboration as it supports
medicine’s overarching goals of reducing disease burdens and improving
For more information on McKesson Health Solutions, please visit our Web
site, hear from our experts at MHSdialogue,
and follow us on Twitter at @McKesson_MHS.
About the American Medical Association
The American Medical Association helps doctors help patients by uniting
physicians nationwide to work on the most important professional, public
health and health policy issues. The nation’s largest physician
organization plays a leading role in shaping the future of medicine. For
more information on the AMA, please visit www.ama-assn.org.
About McKesson Corporation
McKesson Corporation, currently ranked 14th on the FORTUNE 500, is a
healthcare services and information technology company dedicated to
making the business of healthcare run better. We partner with payers,
hospitals, physician offices, pharmacies, pharmaceutical companies and
others across the spectrum of care to build healthier organizations that
deliver better care to patients in every setting. McKesson helps its
customers improve their financial, operational, and clinical performance
with solutions that include pharmaceutical and medical-surgical supply
management, healthcare information technology, and business and clinical
services. For more information, visit us at www.mckesson.com.
Tags: AMA, American Medical Association, McKesson, McKesson
Health Solutions, CPT codes, Z-Code Identifiers, MDx, molecular
diagnostics, evidence-based medicine, EBM, molecular pathology,
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