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Why Doesn't Medicare Treat All Diagnostic Tests Equally?

Published:October 26, 2021DOI:https://doi.org/10.1016/j.oooo.2021.10.014
      When a patient presents with an oral lesion or signs and/or symptoms of disease, a biopsy is frequently required to determine the underlying cause. Tissue biopsies are a critical link in the chain of patient care because a single, definitive diagnosis for a lesion is rarely provided on the basis of its clinical or radiographic features alone. Such diagnostic uncertainty can delay proper treatment or lead to interventions that inadvertently make the condition worse. After the biopsy sample is received by a surgical pathology laboratory, it receives a gross (macroscopic) evaluation followed by processing and routine histologic (microscopic) examination of stained tissue sections. The specimen may also require the use of additional tests such as special stains, immunohistochemistry, immunofluorescence, or molecular/genetic studies. In most cases, tissue biopsy results in a definitive diagnosis, permitting effective treatment to begin as soon as possible. The critical importance of this diagnostic test has been confirmed in all forms of health care as early and accurate diagnosis is associated with the best patient outcomes.
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