Browsing Tag

Internal Medicine

East, Emergency, Inpatient, South, West

De-Implementation of Fecal Occult Blood Testing: Adult Emergency Room (ED) and Inpatient

Effective October 1, 2025, Fecal Occult Blood Testing (FOBT) will be unavailable for ordering in adult ED and inpatient units.

Fecal Occult Blood Testing (FOBT) is frequently performed in the ED and inpatient units of Corewell Health hospitals. Evidence supports that this testing is not appropriate for evaluation of acute or chronic GI bleeding. The use of fecal occult blood testing for indications outside of colorectal cancer screening is considered low-value and unnecessary. Utilizing this testing inappropriately results in increased lab costs, potential for unnecessary consults and procedures, delays in diagnosis, and increased length of stay (LOS).

FOBT supplies will be removed from unit stock. Orders will be restricted and removed from relevant order sets. Areas impacted include all adult ER and inpatient spaces, in all three regions, beginning with inpatient units (Helen Devos and Corewell Children’s Hospitals are excluded at this time).

Please refrain from initiating FOBT orders and use alternative assessment methods as needed.

For questions, please reach out to your unit leadership or clinical education team.

TEST INFORMATION:

  • Occult Blood, CRC Screening [LAB1230599]
  • Occult Blood, FIT Diagnostic Stool [LAB1230898]
  • Occult Blood Screen, Stool [LAB695]
  • Occult Blood Diagnostic, Stool [LAB2111554]
September 15, 2025 by
General Information

MRSA PCR: Updated indications for ordering

Effective Date: September 3, 2025

The MRSA Screen PCR [LAB1231076] detects the presence or absence of colonization with methicillin-resistant Staphylococcus aureus (MRSA) and may be used to guide antimicrobial prophylaxis decisions. To improve and standardize test utilization across all Corewell Health regions, the following restrictions will be added to this test order:

  • Ordering will be restricted to one test every 7 days.
  • An indication for ordering must be provided for each order. Acceptable indications are:
    • Pneumonia
    • Skin and soft tissue (use for non-purulent infections)
    • Surgical prophylaxis

Studies have shown that there is minimal utility in re-testing within 2 weeks as MRSA conversion rates are low and the PCR negative predictive values remain high for at least 14 days after initial testing.

Absence of nasal colonization with MRSA cannot be used to reliably rule out MRSA infection in scenarios other than those listed above.

Test Information

MRSA Screen PCR [LAB1231076]

August 20, 2025 by
General Information

Test Update: Vitamin D Testing Via Tandem Mass Spectrometry (LAB1230925)

Corewell Health Laboratories has discontinued routine Vitamin D testing via Tandem Mass Spectrometry (LAB1230925). The new test for diagnosing Vitamin D insufficiency and monitoring therapy is Vitamin D, 25-Hydroxy (LAB1231583), performed daily using an in-house immunoassay method.

Vitamin D screening for deficiency/insufficiency will now be conducted via immunoassay. Current requests for Vitamin D2/D3 by Mass Spectrometry will be sent out.

For any questions or concerns, please contact the Corewell Health West Laboratory.

 

TEST INFORMATION

Discontinue: LAB1230925 25-Hydroxyvitamin D2 and D3, Serum

Replacement: LAB1231583 Vitamin D 25 Hydroxy

June 27, 2025 by
Chemistry

βhCG Preliminary Results

Effective June 4, 2025, Corewell Health Laboratories will include a preliminary result of >10000 mIU/mL for Beta Human Chorionic Gonadotropin (hCG + β) (LAB142) specimens that require dilution. The preliminary result will provide a quick insight on the status of the βhCG quantification analysis. It is important to remember that these results are not definitive, therefore final interpretation should be made alongside the fully validated results.

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June 2, 2025 by
Advanced Technology Laboratory

Human Papillomavirus (HPV) Testing Update

Corewell Health South and Corewell Health West Laboratories 

Effective Date: February 3, 2025 

Human Papillomavirus (HPV) Genotypic testing will be updated to expand acceptable sources and collection methods. The following HPV test will be available, and the corresponding testing algorithm will be driven by the clinician specified specimen source and collection method/device.  

New Test: Self-Collect HPV High-Risk Screen with HPV Genotype Reflex (LAB1231853)  

  • Testing Restricted to HPV only –Co-testing Not Available: PAP or STI (CT, NG, TV)  
  • Detection of 14 HR HPV genotypes:  
    • HPV Genotype 16  
    • HPV Genotype 18
    • Other HR  HPV – includes 31,33,35,39,45,51,52,56,58,59,66,68  
  • Collection Information:  
    • Acceptable Source: Patient Self-collected vaginal  
    • Collection Device: Rovers® Evalyn® Brush  (ITM-1303902)
    • Collection Instructions: Patients must use the Evalyn Brush in a healthcare setting (i.e. physician office or clinic) to self-collect a vaginal specimen following the Evalyn Brush collection instructions. (Spanish instructions) 
    • A trained healthcare staff member must immediately suspend the Evalyn Brush into a vial of ThinPrep PreservCyt solution following transport instructions. The ThinPrep PreservCyt vial can then be transported to the lab at 2 to 30°C.  
    • This may not be collected at home or in an outpatient draw site. 

Corewell Health Southwest: Effective February 3, 2025, PAP and HPV results will once again be bundled for all orders placed from that date onward. 

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January 28, 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
General Information

Ludington Lab Test Discontinuation

Effective Wednesday, January 1, 2025, Corewell Health Ludington Laboratory will discontinue the send out test, Semen Analysis with Strict Morphology.

We recommend to our healthcare providers they send patients to a specialty clinic for fertility testing.

Post-vasectomy testing will not be affected.

If you have any further questions or concerns, please use the contact us link above.

December 2, 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