The following information was updated in the Lab Catalog.
All changes are for Corewell Health Laboratories in Southwest and West Michigan. For Laboratories in Southeast Michigan, please visit: corewellhealth.org/labcatalog
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Test Utilization
Effective April 2, 2025, the Reflex HPV algorithm will more closely align with ASCCP recommendations. HPV testing will no longer be performed for a normal Pap result in patients aged 30 years and older when a provider orders HPV Reflex.
Specimens will qualify for HPV Reflex with a cytologic diagnosis of:
- ASCUS (Atypical Squamous Cells of Undetermined Significance) for patients aged 21 and older.
- LSIL (Low Grade Squamous Intraepithelial Lesion) for patients aged 25 and older.
HPV testing will continue to be performed for all Paps, regardless of results, for patients aged 30 years or older when a provider orders Co-Testing.
If a provider wishes to request HPV testing on a normal pap for patients under 30, they must either place an electronic order at the time of the initial pap order or request an add-on test for:
- HPV High Risk Screen with HPV Genotype Reflex – Cervical Source (LAB1231770)
- HPV High Risk Screen with HPV Genotype Reflex – Vaginal Source (LAB1230722)
Updated Pap and HPV Testing Algorithm
A reagent bulletin from Roche has informed us that the recovery of the Anti-TPO assay has been falsely elevated for a reagent lot that was in use at Corewell Health Grand Rapids from September 2024 until March, 3, 2025. Based on the product evaluation, and in conjunction with a product and safety risk assessment, the remaining risk of false positive results with the Elecsys Anti-TPO assay is in the acceptable range.
We apologize for the inconvenience. Please reach out with any concerns or questions.
Best,
Dr. Alvarez
Yasel Alvarez, Ph.D.
Clinical Chemistry and Immunology
Corewell Health Reference Laboratory, West Michigan
Test Information
Thyroid Peroxidase Antibody, Blood Level [LAB516]
Clinical Implications
The risk of false positive results with the Elecsys anti-TPO assay is generally acceptable with respect to the given discrepancy.
Resources
Roche Customer Bulletin TP-02316
Written by Yasel Fleitas Alvarez, Ph.D., Chemistry Clinical Advisor, Corewell Health Reference Laboratory West, Michigan Pathology Specialists.
This January we are celebrating the National Thyroid Awareness Month. In United States of America, it is estimated that approximately 20 million people have thyroid disease and most importantly, according to the American Thyroid Association (ATA) as many as 60% of people suffering from a thyroid disorder are not aware they have it.The thyroid is a butterfly shaped-gland located at the front of the neck that produces and release thyroid hormones (See Figure 1).
Figure 1. Thyroid Gland Anatomy and Histology
It regulates important physiological functions as:
-
- Breathing
- Heart rate
- Energy production
- Muscle strength
- Body temperature
- Weight
- Mood
Thyroid disease can present in two main forms:
- Hypothyroidism (under functioning thyroid)
- Hyperthyroidism (over functioning thyroid)
Confirmation or exclusion of thyroid disease requires a clinical examination combined with biochemical determination of thyroid hormones (TH) and thyrotropin (TSH)concentrations.
In this blog we discuss the best practices for ordering thyroid function tests for the initial screening of thyroid disease at Corewell Health.
Advanced Technology Laboratory, Compliance & Safety, General Information
Genetic Testing Informed Consent
Submission of an order for any predictive genetic tests and pre-symptomatic genetic tests, as defined by MCL 333.17020, contained in Corewell Health laboratory catalog constitutes certification to Corewell Health Laboratories that the ordering physician understands that written, informed consent is required for these tests and that, by submitting an order for these genetic tests, ordering physician has obtained “Informed Consent” of subject patient as required by any applicable state or federal laws with respect to each test ordered. On occasion, we forward a specimen to an outside reference laboratory. Corewell Health laboratories may request that ordering physician provide such consent to Corewell Health upon a reasonable request.
Effective October 3, 2023, Corewell Health Laboratories will discontinue the Influenza Rapid and Respiratory Syncytial Virus (RSV) Rapid tests. These antigen tests are less sensitive than the nucleic acid amplification tests (NAAT; such as PCR) that are now the standard of care for diagnosing these respiratory viruses. Specimen collection remains unchanged with PCR testing available for nasopharyngeal and nasal swabs collected in a universal transport media (UTM) tube.
Discontinued:
• Influenza (Flu) A/B Rapid – Epic Code: LAB9240
• Influenza (Flu) A/B Rapid, Influenza A/B PCR if Negative – Epic Code: LAB2111530
• Respiratory Syncytial Virus (RSV) Rapid – Epic Code: LAB495
Replace with:
• Influenza (Flu) A/B PCR – Epic Code: LAB3255
• COVID-19, Influenza A/B, RSV PCR – Epic Code: LAB1230746
General Information, Main lab, Test Utilization
Complete Blood Count (CBC) with Manual Differential Order Discontinuation
Effective October 3, 2023, the orderable Complete Blood Count (CBC) with Manual Differential [LAB2111032] will be discontinued and Manual Differential, Blood [LAB815] will be made a Lab Only Orderable.
Effective September 13, 2023, Corewell Health Laboratory will discontinue the Chlamydia Culture orderable. For patients 14 years of age and older, please order Chlamydia PCR.
• This specimen can be either a swab (genital, rectal, or throat) or a urine sample.
• The collection container is the STD-Multi-Collection Kit.
• For more information please visit: Chlamydia PCR
For patients that are under 14 years of age, a “Reference Miscellaneous Test” [LAB 848], must be ordered.
• This specimen can be either a swab (genital, rectal, or throat) or a urine sample.
• The collection container is the Aptima
• For more information please visit: APTIMA Chlamydia, NAAT, ThinPrep, Swab, Urine
As a reminder, PCR testing is also preferred for gonorrhea, when the specimen types are compatible.
Monoclonal gammopathies are characterized by the secretion of a monoclonal protein or M-protein. A wide variety of conditions can produce an M-protein, and the initial screening and monitoring of these patients require an array of tests. Herein we described best practices for protein electrophoresis ordering at Corewell Health.