Corewell Health System, Referral/Sendouts

MTHFR Discontinuation

Effective October 14, 2026, the MTHFR will no longer be sent out for testing.

The American College of Medical Genetics (ACMG) and American College of Obstetricians and Gynecologist (ACOG) have determined that MTHFR testing should not be ordered as a part of a routine evaluation for thrombophilia, cardiovascular risk, pregnancy complications or routine screening.  Meta-analyses have disproven an association between hyperhomocysteinemia and risk for coronary heart disease and between MTHFR polymorphism status and risk for venous thromboembolism.

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October 7, 2026 by
Ambulatory, Outreach/Outpatient, Southeast Michigan

Urinalysis with Microscopy if Indicated Update (Ambulatory and Outreach/Outpatient)

Effective October 7, 2026, the reflex-to-microscopy criteria for Urinalysis with Microscopy if Indicated (LAB1231026) will be updated. These changes are intended to reduce unnecessary microscopic examinations while ensuring clinically significant findings continue to receive appropriate follow-up testing. Continue Reading

September 29, 2026 by
Corewell Health System, Emergency, Inpatient

Urinalysis with Microscopy if Indicated Update (Inpatient and Emergency)

Effective October 7, 2026, 10:00, the Urinalysis with Microscopy if Indicated (LAB12321026) order will be updated. The reflex-to-microscopy criteria for this order have been revised to reduce unnecessary microscopies. In addition, duplicate urinalysis (UA) orders will be discontinued. Ambulatory and Outreach physicians and APPs will receive separate guidance.

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September 29, 2026 by
Corewell Health System, Referral/Sendouts

Cyclospora Outbreak Has Ended

Starting in July 2026, the CDC and public health officials identified a nationwide outbreak of Cyclospora, a protozoan parasite that causes gastrointestinal illness and is transmitted by ingesting contaminated food. Epidemiological data was used to largely associate the outbreak with iceberg lettuce imported from Taylor Farms in Mexico.

As of 9/11/2026, the CDC has declared this outbreak to have ended. Please refrain from ordering Cyclospora testing for current patients with community-acquired diarrhea (Cyclospora stain, LAB3245). Testing data of Corewell Health patients showed a significant prevalence of Cyclospora from July through the first week of August as the outbreak came to an end.

For more information, please see updates from the CDC and MDHHS.

https://www.cdc.gov/cyclosporiasis/outbreaks/07-26/investigation.html

https://www.michigan.gov/mdhhs/keep-mi-healthy/infectious-diseases/infectious-disease-outbreaks

September 19, 2026 by
Corewell Health System, General Information, Outreach/Outpatient

Standing Order Clarification for As Needed Orders

Effective Date: Immediate

Key Update
The laboratory no longer accepts standing orders with a frequency ordered as “PRN,” “As Needed,” or “Indefinite.” Standing orders must include either:

• A frequency (interval) and a count (e.g., Weekly, 8 times), or
• A frequency (interval) and a duration (e.g., Weekly for 2 months)

These requirements provide clear guidance to support medical necessity, prevent misuse, and ensure compliance with federal regulations. This guidance aligns with requirements established by the Office of Inspector General (OIG). (Federal Register/Vol. 63, No. 163/Monday, August 24, 1998. 98-22559.pdf)
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September 10, 2026 by
Corewell Health System

Respiratory Pathogen Panel PCR Ordering Criteria Update

Effective: September 2, 2026

Key update

The Respiratory Pathogen Panel PCR (LAB3359) detects several viral and bacterial pathogens, however, is often overutilized and rarely impacts patient management. To promote evidence-based stewardship, reduce overutilization, and encourage more targeted molecular testing, effective September 2, 2026 clinicians must provide a clinical indication when ordering the Respiratory Pathogen Panel PCR in Epic. Continue Reading

August 20, 2026 by