Browsing Tag

Corewell Health West

General Information, Microbiology

Influenza Antigen Testing (December 2024)

Influenza prevalence fluctuates seasonally, and case numbers are currently increasing throughout West Michigan. The onset of “flu season” varies year-to-year though typically begins its upswing in the month of December. It is important for providers to have an awareness of influenza prevalence (in addition to other respiratory viruses) to help guide when influenza testing should be pursued.

The use of point of care (POC) antigen testing reduces both the cost to the patient and turn-around-time as compared to lab-based molecular methods. POC antigen tests are typically available for COVID-19, influenza A/B, and as a COVID-19/influenza A/B combination test. During warmer months when influenza prevalence is negligible yet COVID-19 may be circulating, a COVID-only antigen test may be helpful for diagnosis. As influenza increases into colder months, a COVID-19/Influenza A/B combo test would act as a screen for both viruses.

POC tests generally have high analytical specificity but lack the sensitivity of nucleic acid amplification methods (e.g. PCR). For this reason, PCR testing is still recommended for hospitalized patients and for outpatients with a negative POC result if influenza is still suspected and if the result will impact clinical decision making. Influenza PCR may be ordered as a standalone test (LAB3255) or as a part of a panel alongside COVID-19 and RSV (LAB1230746).

 

Test Information

  • Influenza PCR Epic Code: LAB3255, Interface EMR Code: 11594, CPT Code 87502
  • COVID-19, Influenza A/B, RSV PCR Epic Code: LAB1230746, Interface EMR Code: 1230746, CPT: 0241U

 

Contact/Resources

Local Infection Prevention Team

Michigan Department of Health and Human Services

 

General Information, Gerber Laboratory, Ludington Laboratory

Corewell Health Gerber and Ludington Outpatient Laboratory Hours of Operation Update

Effective January 1, 2025, the outpatient laboratory (“draw station”) in Gerber Hospital and in Ludington Hospital will have new hours of operation.

New Hours: Monday to Friday, 6 a.m. to 5:30 p.m.; Saturday 8 a.m. to 12 p.m.; closed Sunday and all major holidays

Corewell Health Gerber Laboratory

212 Sullivan, Fremont, MI 49412

Corewell Health Ludington Laboratory

1 Atkinson Drive, Ludington, MI 49431

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General Information

Ludington Lab Test Discontinuation

Effective Wednesday, January 1, 2025, Corewell Health Ludington Laboratory will discontinue the send out test, Semen Analysis with Strict Morphology.

We recommend to our healthcare providers they send patients to a specialty clinic for fertility testing.

Post-vasectomy testing will not be affected.

If you have any further questions or concerns, please use the contact us link above.

General Information, Immunochemistry

Update to Breath Tests

Effective December 4, 2024, breath methane will be added to Bacterial Overgrowth, Breath Test (LAB3295) and Lactose Intolerance, Breath Test (LAB3097). As a result, the test will include both breath hydrogen and methane. Methane is being added as a small percentage of patients who have either bacterial overgrowth or lactose intolerance will not produce hydrogen when challenged during the test. These patients are considered methane-producers.
In addition, the collection time point of 150 minutes is being eliminated to align with system-wide standards.
Questions may be directed to the Immunochemistry Laboratory using the Contact Us link above.
Compliance & Safety, General Information, Test Utilization

Lipid & Vitamin D policy for Medicare patients

Traditional Medicare insured patients who have a Lipid Panel or Vitamin D 25 ordered more than once per 12 months are not covered due to medical necessity.*

If testing is indicated, you will need to provide an appropriately executed Advance Beneficiary Notice (ABN) for Corewell Health Southeast Laboratories and Advance Beneficiary Notice for Corewell Health Southwest and West Laboratories signed by the patient indicating they would like testing and understand they may be financially responsible for payment (ABN: Option 1). ABN must be submitted with specimen.

For testing ordered inside this frequency range without an ABN, Corewell Health will implement an automatic cancellation. Continue Reading

Chemistry, Compliance & Safety

Parathyroid Hormone Corrections

An equipment issue resulted in artificially high parathyroid hormone results for some patients from July 31- August 17, 2024. We have repeated testing on the potentially affected samples, corrections were made as necessary, and providers for the impacted patients have been notified.

Review of quality indicator data suggested that issue affecting the results began July 31. Not all patient values were affected, but those that were had artificially high values. The laboratory repeated all PTH testing from this instrument for which remaining sample was available, corrected results, and contacted providers via epic inbox message for CHW providers and other appropriate means for CHW affiliates and external providers whose lab work is performed at CHW in Grand Rapids. Providers of potentially impacted patients whose samples could not be repeated have also been notified.

Recommendations Continue Reading

Advanced Technology Laboratory, Cytology, Education & Training, Referral/Sendouts

New Test: HPV High Risk Screen with HPV Genotype Reflex

Effective August 26, 2024,  Corewell Health Laboratories West will be updating their High-Risk HPV testing.  The new assay will be performed on the Abbott Alinity m at Corewell Health Reference Laboratory West, Grand Rapids.  Testing will now automatically include HPV Genotype results whenever HPV is detected.  There will no longer be a separate charge to the patient for HPV Genotype testing.

There will also be an expanded number of High-Risk HPV Genotypes reported:

  • HPV Genotype 16
  • HPV Genotype 18
  • HPV Genotype 45
  • HPV Genotype 31/33/52/58
  • HPV Genotype 35/39/51/56/59/66/68

The new assay is FDA approved for Primary screening in addition to co-testing.

Post hysterectomy vaginal specimens will still be a send out test (LAB1230722). Continue Reading

Test Utilization

Influenza Testing Update: April 2024

This winter, West Michigan influenza infections peaked in February 2024 and significantly declined throughout March and April 2024. Now with a low prevalence of circulating influenza, using the most sensitive diagnostic test is recommended in order to obtain accurate and actionable results. Influenza antigen testing (e.g. Sofia instrument) is no longer appropriate at this time and Influenza PCR testing should be ordered when clinically indicated.

 

Low Influenza
Prevalence
High Influenza
Prevalence
Recommended Order Influenza PCR (LAB3255) Influenza antigen testing (e.g. Sofia instrument)
or
Influenza PCR (LAB3255)

More detailed information can be found as published by the CDC:

Algorithm to assist in the interpretation of influenza testing results and clinical decision-making during periods when influenza viruses are NOT circulating in the community, and in previous lab newsletters: Influenza Diagnosis and Test Utilization