Effective December 4th 2024, the Corewell Health Microbiology Laboratory will discontinue the following viral culture orders. Viral culture is relatively slow and insensitive as compared to molecular options that are now available as the recommended standard of care.
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Education & Training
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.
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)
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).
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.
Education & Training, General Information
Lab Specimen Label Printing Update for Corewell Health Epic Users
On 10/31/23, a change was made to lab specimen labels, which included a patient’s preferred name on the label, if it is documented in Epic. This highlighted a change in the names of label types seen by staff when reprinting specimen labels in Epic. Due to a mix of Intermec and Zebra printers across the entire Corewell Health system, defaults needed to be removed from Epic build to account for these differences. Users will now be required to manually choose the correct label type when reprinting labels. The Collection Activity behavior should remain the same.
Education & Training, General Information, Immunochemistry, Test Utilization
Webinar: Optimizing Care of the Respiratory Patient – The Role of Specific IgE Testing
It’s the season of sunshine and blooms which also means it can be a season of sneezing, itching, and a lot of trouble getting a good breath in for some.
⇒Are you prepared to meet the needs of your patients that may be suffering from some of these symptoms?
⇒Are you well versed in the difference between a sensitivity and a clinical allergy and how you can differentiate between the two?
⇒Do you know the resources we have at Corewell Health to assist in these determinations?
Tissue specimens less than 0.1cm may yield insufficient results if submitted for Tissue Pathology. To make the best use of diagnostic tissue material please follow the below guidelines:
| Biopsy Size | Order Code | Test | Preservative |
| <0.1cm | LAB2111263 | Fine Needle Aspiration (FNA) Cytology | *CytoLyt solution |
| >0.1cm | LAB8 | Tissue Pathology | 10% Formalin |
*Place entire specimen in CytoLyt. Do not attempt to make smears from specimen.
Please contact the Corewell Health Pathology Department at (616)267-2622 Mon-Fri, 8am-5pm, or the Corewell Health Laboratory Call Center at (616)774-7721, 24/7 to speak with a Pathologist.
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 |