I enjoyed the article by Carag et al,1 which analyzed the findings in additional histopathologic sections of actinic keratosis when the initial evaluation showed "moderate to focally severe atypia." Using their assumptions and assuming that their technical expense included professional expense, I found that the annual cost to our laboratory for an additional 10 slides for each of 1812 cases of actinic keratosis would be $57 150. This additional expense would not be reimbursed, and would fall to the laboratory to pay. In contrast, clinicians who perform biopsies and laboratories that process obviously benign lesions such as skin tags receive "painless" profit.
Penneys NS. Histopathologist: To Step Section or Not?. Arch Dermatol. 2001;137(3):375-376. doi: