Browsing Category

Compliance & Safety

Compliance & Safety, Education & Training, General Information

Reminder: Thin Prep Collection

With the August changes to STI testing Corewell Health Reference Laboratory West has seen an influx of incorrect orders. As a reminder, not all STI testing can be performed off of a Thin Prep® specimen. The STI Panel includes four different tests: Gonorrhea PCR, Chlamydia PCR, Trichomonas PCR and Mycoplasma Geniltalium PCR (Mgen). Unlike the other testing, Mgen cannot be added on to the Thin Prep® container.

 

If an STI Panel is ordered and the only specimen that is collected is a Thin Prep®, laboratory staff will independently cancel the STI panel and reorder the three tests that are able to be completed off of the specimen that is submitted. If an Mgen test is still needed, please submit a separate urine or swabbed collection using the Alinity -M collection kit.

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

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)

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

Compliance & Safety, Cytology, General Information

Resolved: HPV Error 3/17/2024

This issue is resolved. It was identified as an issue within Corewell Health Epic Preference Lists. If you are still encountering issues, please reach out to Service Now. This post will be archived in 7 days.

Due to an error from our system changes that happened on Sunday, March 17, 2024, the HPV reflex on the Pap testing orderable is not reflexing appropriately based on ASCCP Guidelines.

The Cytology Laboratory (Corewell Health Reference Laboratory West) and our Digital Services teams are aware of the error and working on a solution to correct the missed HPVs that were processed this week.  As the correction may cause a slight delay in HPV results, please hold add-on requests for HPV until Friday (3/29).  If you are concerned about an HPV being missed after this date (3/29/24), please fill out an Add-On form and fax to the number on the form (Note: Pap Specimens are held for 30 days).

We apologize for any inconvenience and confusion. If you have any further questions or concerns, please use the contact us link above.

Compliance & Safety, General Information

Lab Specimen Drop Off Policy Change

Effective Tuesday, February 20, 2024, the policy for home collected specimen drop offs for Outpatient Laboratories (“draw sites”) has been updated.

For all Corewell Health West Michigan locations: after registration, patients or their designated person will verify the specimen at the laboratory. Laboratory team members will verify the specimen is properly labeled and ensure they have everything needed to be able to test the specimen before the patient or their designated person leaves the building. This does not include specimens collected by a home health nurse or provider.

This will standardize our patient flow when arriving with a home collected specimen and will reduce the need for recollection due to missing information or improper collection.

When specimen collection orders are placed, please notify patients of the change to this process.

RELATED RESOURCES

Lab Specimen Home Collection Guide

Find a Lab Location

Compliance & Safety, Referral/Sendouts, Test Utilization

Reminder: Send Out Referral Testing Notice

As a reminder, referral testing, tests that are sent to another laboratory to perform, is dependent on the weather. Inclement weather can affect both the turnaround time of testing, and the testing capabilities of the organization. Our referral testing is dependent on outside transportation facilities (such as FedEx and UPS). When those organizations face challenges in weather, our testing capabilities must remain flexible. 

If there is inclement weather in and around Memphis, TN (the main FedEx hub), there may be delays and cancellations of testing. We will try our best to communicate these changes as soon as possible via our blog: https://lab.corewellhealth.org/

For any questions or concerns please “Contact Us” via the link above. 

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.

Continue Reading

Compliance & Safety, Education & Training, General Information, Main lab, Test Utilization

Inform: RSV Testing – Age Restrictions

Respiratory syncytial virus (RSV) primarily infects pediatric patients, but occasionally infects adults and may be of particular concern for the elderly and immunocompromised. Corewell Health Laboratories offers two tests for RSV. A rapid antigen test may be used to confirm RSV diagnosis in pediatric patients. This test is not approved by the FDA for testing adult patients, so tests will be cancelled if ordered on an off-label age group. There are no age restrictions for RSV testing by way of a molecular panel that also includes COVID and influenza as viruses with overlapping symptoms.

Test name Epic Test ID Methodology Specimen Age restriction
RSV Rapid LAB495 Antigen Nasopharyngeal (NP) swab Approved for patients 0 – 18 years of age
COVID, Influenza, RSV PCR LAB1230746 Molecular/PCR Nasopharyngeal (NP) swab No age restriction
Compliance & Safety, Education & Training, General Information, Main lab

COVID-19 Test Update for Regional Hospital Lab Clients

Effective Tuesday, September 27, 2022, the following laboratories will be going live with the GeneXpert Xpress for COVID-19 testing: Big Rapids, Gerber, Ludington, Pennock, Reed City, United, and Zeeland.

Please ensure your sites are stocked with the correct collection devices listed below in preparation of the changeover. Continue Reading