Browsing Tag

Internal Medicine

Human Papillomavirus (HPV) Testing Update

Corewell Health South and Corewell Health West Laboratories

Effective Date: February 3, 2025

Human Papillomavirus (HPV) Genotypic testing will be updated to expand acceptable sources and collection methods. The following two HPV tests will be available, and the corresponding testing algorithm will be driven by the clinician specified specimen source and collection method/device.

New Test: Self-Collect HPV High-Risk Screen with HPV Genotype Reflex (LAB1231853)

Testing Restricted to HPV only –Co-testing Not Available: PAP or STI (CT, NG, TV)
Detection of 14 HR HPV genotypes:
- HPV Genotype 16
- HPV Genotype 18
- Other HR HPV – includes 31,33,35,39,45,51,52,56,58,59,66,68
Collection Information:
- Acceptable Source: Patient Self-collected vaginal
- Collection Device: Rovers® Evalyn® Brush (ITM-1303902)
- Collection Instructions: Patients must use the Evalyn Brush in a healthcare setting (i.e. physician office or clinic) to self-collect a vaginal specimen following the Evalyn Brush collection instructions. (Spanish instructions)
- A trained healthcare staff member must immediately suspend the Evalyn Brush into a vial of ThinPrep PreservCyt solution following transport instructions. The ThinPrep PreservCyt vial can then be transported to the lab at 2 to 30°C.
- This may not be collected at home or in an outpatient draw site.

Corewell Health Southwest: Effective February 3, 2025, PAP and HPV results will once again be bundled for all orders placed from that date onward.

January 28, 2025 by Laboratory Services

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

Resources: https://www.michigan.gov/flu/resources
Surveillance information: https://www.michigan.gov/flu/surveillance

December 24, 2024 by Laboratory Services

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.

December 2, 2024 by Laboratory Services

General Information, Hemostasis/Coagulation

Reference Range Updates Coagulation Laboratory

Effective December 2, 2024 at 08:00 AM, Corewell Health West Laboratory Coagulation Department will be updating the reference range for several assays. The following will be impacted by these changes:

APTT testing for the BCS XP analyzers will be updating to 22.0 – 27.0 seconds.

This will include the following tests:

Effective December 2, 2024 at 08:00 AM, the Corewell Health West and South Coagulation Departments will be updating the reference range of the Fibrinogen Level (LAB 314) to 190-450 mg/ dL.

Questions may be directed to the Coagulation Laboratory using the Contact Us link above.

November 27, 2024 by Laboratory Services

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.

November 19, 2024 by Laboratory Services

Compliance & Safety, Education & Training, General Information

IMPORTANT: Lipid Testing Changes

Effective Monday, September 16, 2024 all Corewell Health ambulatory offices will see an increase in Frequency Advance Beneficiary Notices (ABN) when ordering Lipids. This ensures compliance with Medicare requirements. ABNs serve as an indication to ordering physicians and APPs that the order has a stipulation for coverage and that Medicare may not reimburse for services; the patient will need to acknowledge potential financial responsibility. Having this completed ABN on file allows Corewell Health to provide and bill for services.

Specific to lipid frequency ABNs:

• Screening: Medicare covers testing once every 5 years. Per CMS, lipid testing in asymptomatic individuals is considered screening regardless of the presence of other risk factors such as family history, tobacco use, etc.
• Monitoring: Medicare covers testing once annually for monitoring the lifestyle and/or pharmaceutical treatment of lipid disorders. If more frequent testing is medically necessary after initiation of therapy, Medicare will cover up to six total cholesterol or LDL labs in the first year of therapy.

Lab will collect any ABNs needed if not collected prior to patient collection at our Patient Service Centers. If collection occurs in the office, be sure to follow the process: Ambulatory Clinical – Completing the Advance Beneficiary Notice (ABN) from the Epic Education Team SharePoint page. Any Medicare patient specimen submitted for lipid panel testing without an ABN will NOT be tested by the laboratory.

For more information on the CMS requirements for lipid testing, please review the NCD – Lipid Testing (190.23) (cms.gov)

September 13, 2024 by Laboratory Services

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: