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Advanced Technology Laboratory, Cytology, General Information

Reflex HPV Testing Update

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

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March 28, 2025 by
Chemistry, General Information

Collection Device Update: Chemistry β-hCG testing

Effective March 21, 2025, Corewell Health Laboratories will update the preferred specimen type for β-hCG testing from plasma to serum (mint green top, lithium heparin gel to gold top, serum separator-SST gel). The move to serum is mostly driven by the laboratory’s need to reduce assay performance problems that can occur sporadically with the use of plasma. Although serum is the preferred specimen type plasma will remain an acceptable container.
If you have questions regarding the preanalytical handling process and the optimum tube offering, contact the lab for support.
TEST INFORMATION
March 17, 2025 by
Immunochemistry, Test Spotlight

Update to Reporting for Urine Protein Electrophoresis Tests

On March 12th, 2025, the reporting for Protein Electrophoresis, 24 Hour Urine, do IFE if Indicated (LAB111444) and Protein Electrophoresis, Random Urine, do IFE if Indicated (LAB111445) will be updated to harmonize with Monoclonal Gammopathy Screen (LAB1230573) and Protein Electrophoresis, Serum, IFE if Indicated (LAB844).

The changes that will occur include the following.

  1. A single interpretive comment (Pathologist Interpretation Urine Protein Electrophoresis) that will encompass both the electrophoresis portion of the test and any immunotyping.
  2. Quantitation of monoclonal proteins will no longer be part of the interpretation but rather documented as discrete fields under Urine Protein Electrophoresis in result review. As a result, the interpretation will not include a comment about how the monoclonal protein has changed between studies.
  3. The quantitation of the monoclonal protein will only include mg/24-hour concentration and not the percentage.

TEST INFORMATION

  • Protein Electrophoresis, 24 Hour Urine, do IFE if Indicated (LAB111444)
  • Protein Electrophoresis, Random Urine, do IFE if Indicated (LAB111445)

Performing department: Immunochemistry (Corewell Health Reference Laboratory-West, Grand Rapids, MI)

March 9, 2025 by
Chemistry, General Information

Discontinuation of CKMB

Effective Wednesday, January 1, 2025, the in-house test, Research Creatine Kinase MB Fraction (CK-MB) (LAB2111534) will be made inactive. Recommended alternative testing is CK-MB (CK-2) (TC:17581) which is referred to Quest Diagnostics.

For questions or additional information, please use the Contact Us link above.

January 13, 2025 by
General Information, Microbiology

Influenza Antigen Testing (December 2024)

Influenza prevalence fluctuates seasonally, and case numbers are currently increasing throughout West Michigan. The onset of “flu season” varies year-to-year though typically begins its upswing in the month of December. It is important for providers to have an awareness of influenza prevalence (in addition to other respiratory viruses) to help guide when influenza testing should be pursued.

The use of point of care (POC) antigen testing reduces both the cost to the patient and turn-around-time as compared to lab-based molecular methods. POC antigen tests are typically available for COVID-19, influenza A/B, and as a COVID-19/influenza A/B combination test. During warmer months when influenza prevalence is negligible yet COVID-19 may be circulating, a COVID-only antigen test may be helpful for diagnosis. As influenza increases into colder months, a COVID-19/Influenza A/B combo test would act as a screen for both viruses.

POC 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 POC result if influenza is still suspected and if the result will impact clinical decision making. Influenza PCR may be ordered as a standalone test (LAB3255) or as a part of a panel alongside COVID-19 and RSV (LAB1230746).

 

Test Information

  • Influenza PCR Epic Code: LAB3255, Interface EMR Code: 11594, CPT Code 87502
  • COVID-19, Influenza A/B, RSV PCR Epic Code: LAB1230746, Interface EMR Code: 1230746, CPT: 0241U

 

Contact/Resources

Local Infection Prevention Team

Michigan Department of Health and Human Services

 

December 24, 2024 by
Compliance & Safety, Hemostasis/Coagulation

Update: Platelet Aggregation Studies Scheduling

Effective immediately, platelet aggregation testing will require a pathology consult prior to scheduling for testing performed at Corewell Health Reference Laboratory West, Grand Rapids. This consult request must be completed prior to scheduling the patient for testing.

After consultation the testing may be ordered and scheduled.

As a reminder testing is performed for scheduled patients Monday – Thursday from 7:30 am-9:30 am at the 35 Michigan Street Laboratory. Patients should be resting, fasting, non-smoking, and should not be pregnant. Patients should avoid taking any prescription or over the counter medications known to affect platelet function for ten (10) days to two (2) weeks prior to the test. Click for a list of medications with known anti-platelet effects.

Test Information:

 

December 19, 2024 by
General Information, Hemostasis/Coagulation

Reference Range Updates Coagulation Laboratory

Effective December 2, 2024 at 08:00 AM, Corewell Health West Laboratory Coagulation Department will be updating the reference range for several assays. The following will be impacted by these changes:

APTT testing for the BCS XP analyzers will be updating to 22.0 – 27.0 seconds.

This will include the following tests:

Effective December 2, 2024 at 08:00 AM, the Corewell Health West and South Coagulation Departments will be updating the reference range of the Fibrinogen Level (LAB 314) to 190-450 mg/ dL.

Questions may be directed to the Coagulation Laboratory using the Contact Us link above.

November 27, 2024 by
General Information, Immunochemistry

Update to Breath Tests

Effective December 4, 2024, breath methane will be added to Bacterial Overgrowth, Breath Test (LAB3295) and Lactose Intolerance, Breath Test (LAB3097). As a result, the test will include both breath hydrogen and methane. Methane is being added as a small percentage of patients who have either bacterial overgrowth or lactose intolerance will not produce hydrogen when challenged during the test. These patients are considered methane-producers.
In addition, the collection time point of 150 minutes is being eliminated to align with system-wide standards.
Questions may be directed to the Immunochemistry Laboratory using the Contact Us link above.
November 19, 2024 by
Cytology, General Information

Update to PAP-HPV Reflexing Algorithm

The algorithm that reflexes HPV testing off the PAP Test (LAB1230097) when the “HPV Reflex” option is selected during PAP ordering will no longer include pregnancy status as a criterion for reflexing on LSIL patients. Prior to this update, if HPV Reflex was selected, a PAP Diagnosis of LSIL on patients 25 and older would only reflex HPV testing if the patient was non-pregnant. Starting 11/6/2024, if HPV Reflex was selected, a PAP Diagnosis of LSIL on patients 25 and older will reflex HPV testing regardless of pregnancy status. This update aligns with current ASCCP Risk-Based Management Consensus guidelines.

November 7, 2024 by