RE: Grossing by non-pathologists.

From:"LaFriniere, Mike" <>


CLIA rulings and CAP guidelines may be best to find the answers you are
looking for. If I remember correctly, if you were an HT(ASCP) performing
grossing duties prior to CLIA ruling, you were "grandfathered" in, such with
regards to the types of specimens one may gross. For example if one was
performing all grossing duties of all organ systems prior to the CLIA ruling
on "non pathologists performing gross prosecting" you may continue to do so
as long as you have such proof of experience and it is under the direct
supervision of a pathologist. However CLIA has implemented a date I think in
the mid 1990's that after this date and not grandfathered in, you must have
a science degree to perform such "advanced" testing. 

Now, the question is what is advanced testing? This is a good question, I
would take advance testing or (grossing) to be considered as whole organs
that demonstrate major neoplastic disease (kidneys, lungs, colons etc). As a
Manager, CAP inspector, and a gross prosector myself, Our policy allows most
of all small specimens, skins, GI bx's, gyn bx's, bones and up to routine
gallballders to include non carcinoma hysterectomies, and colons with
diverticula be considered "non-complicated" specimens that can be grossed by
a HT(ASCP)under the direct supervision of a pathologist who has been
grandfathered in and demonstrates the appropriate experience. However this
area is very subjected and the person performing prosecting and should have
appropriate documentation of training by a pathologist to include a yearly
evaluation. Additional information is noted on page 6 of the 38 page CAP
check off list that require a CAP lab to have documentation of which type of
specimens are examined by a "non pathologist" I will be happy to fax this to
you if you do not have a copy.  

Michael R. LaFriniere
Manager Dept Pathology
Memorial Hospital, Chattanooga

-----Original Message-----
From: Tricia Hughey []
Sent: Tuesday, February 06, 2001 10:14 AM
Subject: Grossing by non-pathologists.

Group:    I would appreciate your help in determining the
qualifications/certifications required for grossing by non-pathologists.
Outside of the advanced Pathology Assistant's degree, under what conditions
can a non-physician perform grossing (under the technical supervision of a
pathologist) of course.  Can a HT gross specimens, especially those that are
fully embedded?  Can a non-HT do any grossing?  Where can I find clear and
definitive guidelines?  In our situation, this pertains almost entirely to
non-hospital specimens.  Does this make a difference?   Thank you for any
input.  Tricia Hughey, Pathology Partners, Denver, CO

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