Proposed Rule Eases Cytology PT Requirements

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  • January 23, 2009
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Approximately 12,500 pathologists and cytotechnologists in the United States who screen and interpret Papanicolaou (Pap) tests to identify cervical cancers may soon be affected by a rule that alters their current requirements for cytology proficiency testing (PT).

Proposed changes made by the Centers for Medicare & Medicaid Services (CMS) to the Clinical Laboratory Improvement Amendments of 1988 (CLIA) for cytology PT include increasing the number of slides or other approved media in the first test and first retest from 10 to 20, and the time for completing the screening from two hours to four hours. The currently required passing score of 90 percent would remain, but with the increase in challenges, each error would count less. Test takers would also be allowed to miss up to two high-grade lesions or cancers and still pass. Under current rules, missing even one high-grade lesion or cancer is grounds for automatic failure. The proposed rule would also lessen the frequency requirement for PT testing from annually to biennially.
To ensure testing quality, the proposed rule includes a provision that requires providers to explain their appeals process prior to administering a test and impose more stringent obligations on PT programs.
You have until March 17 to comment on this proposed rule. More information about cytology PT and a link to the Medicare, Medicaid, and CLIA of 1988 Program; Cytology PT proposed rule are available on the CLIA main page of the CMS Web site.

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No Responses to “Proposed Rule Eases Cytology PT Requirements”

  1. Holly says:

    This is where healthcare has taken us…to save money we have to torture patients. There are so many ways to save money it should not be at our patients expense. What a sad day that would be. Just step back to the frontier days when they gave you a shot of whiskey and a bullet to bite on.

  2. judi says:

    I don’t see Holly’s point-this looks to me like testing of cytotechs to make sure they are interpreting patient tests correctly. Regular QA is necessary for correct patient care.

  3. Vivienne says:

    I’m not sure I understand what Holly thinks proficiency testing is. I am a Lab Technologist as well as a CPC. I’d like to understand why she thinks patients would be tortured due to proficiency testing.
    Proficiency samples come from places like the College of American Pathologists, (CAP), and do not involve current patient testing. Under the current program, cytologists must correctly identify 9 out of 10 samples in order to pass. The re-test occurs if there are errors, and must take place within 30 days. When a cytologist fails proficiency testing, he/she must re-qualify by reading 500 slides under a remedial program before he/she may continue to read PAP smears. These surveys also involve all cytologists and pathologists involved in reading PAP smears. Again, this impacts on, but does not involve patients directly. Because of all the back-ups that have been mandated, increasing to 20 challenges, requiring more stringent obligations of the PT programs, and incresing the interval from 1 to 2 or even 3 years would be a great help to cytologists without putting patients at risk.

  4. Marilyn says:

    I wonder about allowing even 1 missed call. (9 out of 10) I realize everyone is human and we all make mistakes but it concerns me that only 1 miss could equate to a late discovery of a potentially life threatening cancer for one of our patients. I am not a cytologist but have been “exposed” to slides and interpreting them and I know it can be difficult to see things. Perhaps having more time to inspect and interpret the testing slides should demand better accuracy in the results.

  5. BLADDER TUMOR says:

    this is great. another way to decrease the accuracy and cause error. we have done zero in any way to decrease the error. the majority of cytotechs in their ever need to be accurate have produced a low level of morbiditywhile the agencies that represent us,inspect us and the pathologists develop more ways to avoid the checking on the knowledge and visual accuracy of the cytotechs and pathologists,especially the pathologists.
    Also the clouding of issues of the needs of the cytology field and its regulations by corporations ,individuals and lab owners “greed”.
    its all political.