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Background: Since 2003, the Korean Society of Pathologists (KSP) has been officially providing medical advisory services (MAS). We reviewed the cases submitted to the KSP between 2003 and 2014. Methods: In total, 1,950 cases were submitted, most by private health insurance companies. The main purposes of the consultations were to clarify the initial diagnoses and to assign a proper disease classification code. We comprehensively reviewed 1,803 consultation cases with detailed information. Results: In spite of some fluctuations, the number of submitted cases has been significantly increasing over the 12 study years. The colon and rectum (40.3%), urinary bladder (14.2%), and stomach (6.9%) were the three most common tissues of origin. The most common diagnoses for each of the three tissues of origin were neuroendocrine tumor (50.7%), non-invasive papillary urothelial carcinoma (70.7%), and adenocarcinoma (36.2%). Regardless of the tissue of origin, neuroendocrine tumor of the digestive system was the most common diagnosis (419 of 1,803). Conclusions: In the current study, we found that pathologic consultations associated with private health insurance accounted for a large proportion of the MAS. Coding of the biologic behavior of diseases was the main issue of the consultations. In spite of the effort of the KSP to set proper guidelines for coding and classification of tumors, this review revealed that problems still exist and will continue to be an important issue.
Key Words: Medical advisory service; Pathologic consultation; Private health insurance
Advisory services are widely used in the field of medicine in many countries. Doctors commonly use consultations, especially in surgical pathology practice. In the United States, the Association of Directors of Anatomic and Surgical Pathology has defined various kinds of pathology consultations and devised regulations to control the quality of each type.1-3
In Korea, pathologic consultations by doctors have also been performed in daily practice. However, most of these consultations have been conducted informally, without regulations or proper fees. Therefore, Korean pathologists agreed with the necessity for an official pathology advisory service system and organized the Medical Advisory Committee (MAC) as a subdivision of the Korean Society of Pathologists (KSP) in 2003. The MAC has been officially providing various kinds of advisory services, focusing on diagnostic pathology, since 2003. They have restrained the extent of users and contexts of pathologic...