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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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.
This winter, West Michigan influenza infections peaked in February 2024 and significantly declined throughout March and April 2024. Now with a low prevalence of circulating influenza, using the most sensitive diagnostic test is recommended in order to obtain accurate and actionable results. Influenza antigen testing (e.g. Sofia instrument) is no longer appropriate at this time and Influenza PCR testing should be ordered when clinically indicated.
| Low Influenza Prevalence |
High Influenza Prevalence |
|
| Recommended Order | Influenza PCR (LAB3255) | Influenza antigen testing (e.g. Sofia instrument) or Influenza PCR (LAB3255) |
More detailed information can be found as published by the CDC:
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.
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.
Influenza cases numbers are currently increasing throughout West Michigan. Influenza prevalence guides the most appropriate testing approach and sufficient prevalence has now been reached for influenza rapid antigen or point of care testing (e.g. Sofia instrument) to have improved performance. The use of point of care testing as a screening method during high prevalence reduces both the cost to the patient and turn-around-time as compared to lab-based molecular methods. Point of care 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 result if influenza is still suspected and if the result will impact clinical decision making.
| Low influenza prevalence | High influenza prevalence | |
| Recommended order | Influenza PCR | Influenza Point of Care Testing or Influenza PCR |
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.
Effective August 30, 2023, the COVID-19 Total Antibody test, which includes the qualitative detection of spike and nucleocapsid antibodies against COVID-19, will be discontinued as an orderable test at Corewell Health West Laboratories. Symptomatic patients suspected to have acute COVID-19 infection should be tested using a molecular assay.
To aid in the clinical diagnosis of multisystem inflammatory syndrome in children or adults (MIS-C or MIS-A), the COVID-19 IgG, Qualitative by CIA will be available as a send out test. This test is a qualitative detection of IgG antibodies against the nucleocapsid protein of COVID-19 that develop in response to natural infection with COVID-19. This test is performed on Monday, Wednesday, and Fridays, and reported within 1-5 days.