The American 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 innovation.
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 Solutions.
"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 Health Solutions.
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 healthcare system.
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.