Download Winter 2015 - HealthEast

HML Update
Winter 2015
Volume 21, No. 1
“Keeping Our Clients Informed”
Questions or Comments:
Call 651-232-3500
Inside:
Possible Weather Delays.................................... 1
PAPs Turn Around Time .................................... 2
Lead Testing ...................................................... 2
Thyroglobulin Antibody..................................... 3
Thyroglobulin, Tumor Marker ........................... 3
L/S Ratio and PG Levels ..................................... 4
Lamellar Body Counts ....................................... 4
We appreciate your
partnership with HealthEast
Medical Laboratories and
wish you a bright and Happy
New Year!
Deb Rodahl
Possible Weather Delays
HealthEast Medical Laboratory (HML) serves
our clients by utilizing outreach phlebotomists
to obtain blood specimens from patients.
Temp.Discontinued Tests at Mayo ................... 5
CDC recommends combo HIV ............................ 5
2015 CPT Code Changes..................................6-7
Online Ordering for Supplies.............................. 8
Pricing Contact Change ...................................... 9
Consultant’s Corner .....................................9-10
Education ......................................................... 10
This service operates 7 days a week, 18 hours
a day. During that coverage time, it is possible
that hazardous driving conditions may arise
and decisions need to be made to protect the
safety of our staff.
This is a notification that during Hazardous
Driving Conditions, there may be a potential
for limited services or cancellation of services.
If services are cancelled due to hazardous
weather, a member of the HML team will
contact your facility.
Please support our ability to provide services
by ensuring access to cleared and/or salted
parking and walk-ways.
www.healtheast.org/hml
HML Update Winter 2015
1
PAPs Turn Around Time
HML CYTOLOGY
Turn Around Times for PAP Smears
Our experienced team of Cytotechnologists works each and every day to provide the best patient
care and Turn Around Times (TAT’s) for our clients specimens.
As of late we have received some questions related to the Turn Around Times for PAP Smears.
Typically the expected Turn Around Times (TAT) is within 5 days. Our team typically exceeds this
expectation day in and day out!
Lately, however, the TAT has taken up to 7 days due to unexpected staffing changes.
We are making adjustments to achieve our goal of 5 days or less.
We appreciate your patience as we make these adjustments.
Your partnership is important to us. Should you have concerns please contact the HML Cytology
Team at 651-232-3500, Option 5.
Lead Testing
HealthEast Medical Lab transitioned to a new testing platform for lead on Wednesday October 1,
2014. The new testing platform uses electronic calibration and each sample is tested with an
individual testing electrode. This will improve reproducibility and accuracy, especially with samples
with small amounts of lead.
The reporting range for the new Lead instrument is: 1.9 – 65 ug/dL
A reminder regarding specimen collection – for venipuncture specimens, it is crucial to have the
EDTA tube at least half full. For capillary collection, please collect 250 ul of blood. Mix the
specimen well after collection.
The best way to avoid/reduce contamination in capillary lead samples is thorough hand-washing,
of the patient’s hands, with soap and water prior to blood collection.
There are no changes regarding ordering this test, how the test is reported, or billing.
If you have any questions, feel free to contact Craig Rousar, Chemistry Section Supervisor, at 651232-3002.
HML Update Winter 2015
2
Thyroglobulin Antibody
Effective 10/6/14, Thyroglobulin Antibody assay has changed from the Roche Cobas Thyroglobulin
Antibody assay to the Beckman Coulter Access Thyroglobulin Antibody II assay at Mayo Medical
Laboratory.
Note: The sample requirement for this test is now Red Top serum only. Serum gel tubes will be
unacceptable.
Current Method: Electrochemiluminescence Immunoassy
New Method: Immunoenzymatic
Assay
Current Reference Value: <116 IU/mL
New Reference Value: <4.0 IU/mL
Current Specimen Required: Serum, Red top or gel
New Specimen Required: Serum, Red
Top
For questions, please contact Craig Rousar at 651-232-3002
Thyroglobulin, Tumor Marker
Effective 10/6/14, the Thyroglobuin, Tumor Marker (panel name: TGL ) became obsolete, due to
ongoing reagent issues at Mayo Medical Laboratories. This test will be replaced with Mayo Medical
Laboratories test ID HTH2 which will need to be ordered as a miscellaneous test until a new panel
code is built in IT systems.
Panel Name: Thyroglobulin, Tumor Marker
Panel Code: Miscellaneous
CPT Code: Thyroglobulin 84432
Thyroglobulin Antibody 86800
Collect: Red top tube
Submit: 1 mL serum REFRIGERATED
Unacceptable: Serum collected in gel tube (SST).
Test Performed at: Mayo Medical Laboratories
Pricing: $30.30
Cautions:
Thyroglobulin antibody values determined by different methodologies will vary significantly
and cannot be directly compared with one another. Comparing values from different
methods might lead to erroneous clinical interpretation.
Ideally when changing thyroglobulin antibody methods, parallel testing using the old and
new method will allow establishing the patient’s thyroglobulin antibody baseline. For rebaselining, please call 651-232-3158 (HML Sendout Department).
For questions, please contact Craig Rousar at 651-232-3002.
HML Update Winter 2015
3
L/S Ratio and PG Levels
HealthEast Medical lab (HML) has received notice from Fairview-University Hospital that, effective
November 1, 2014; they will no longer perform L/S ratios and PG levels. They cited low volumes as
the reason for discontinuing this testing. There are no remaining labs in the Twin Cities metropolitan
area that perform L/S ratio testing.
Mayo Medical Labs (MML) does perform L/S ratios and PG levels. MML performs this testing seven
days a week, but they do not offer STAT testing. Monday – Saturday testing is set up at once per
day in the afternoon and reported the next day. On Sunday, the testing starts at 1100 and is
reported the next day. Most of the results are next day, but in the case of repeat testing, there is a
1-2 day turnaround time.
Panel Name: Fetal Lung Profile, Amniotic Fluid (FLP)
Panel Code: Please order a miscellaneous test. The future test code will be: FLP
CPT Code: Lecithin-sphingomyelin = 83661
Phosphatidylglycerol = 84081
Collect: Amniotic Fluid in Screw-Top Container
Submit: 6 mL Amniotic Fluid REFRIGERATED in a screw-top container. Unprocessed specimens
MUST arrive at HML within 2 hours of collection. If the specimen is not received at HML
within 2 hours, centrifuge specimen for 10 minutes at 1000 rpm or 200xG. Separate
supernatant from pellet, freeze both and ship FROZEN.
Test Performed at: Mayo Medical Laboratories. Testing is performed Mon, Tues, Wed, Thurs, Fri,
Sat until 2PM, Sun until 11AM.
----------------------------------------------------------------------------Fairview University still offers Lamellar body counts for fetal lung maturity on a STAT basis.
Panel Name: Lamellar Body Count (LBC)
Panel Code: Please order a Miscellaneous test. The future test code will be: LBC
CPT Code: 83664
Collect: Amniotic Fluid in Screw-Top Container
Submit: 6 mL Amniotic Fluid (tap only) REFRIGERATED on wet ice and uncentrifuged
Unacceptable: Clotted or vaginal pool. Frozen or centrifuged. Gross hemolysis, meconium or
mucous contamination.
Test Performed at: Fairview University of Minnesota. Testing is performed and reported 24
hours/day.
HML will be working to validate lamellar body counts on our hematology analyzers in the near
future.
If you have any questions or concerns, feel free to contact Craig Rousar, Chemistry/Hematology
Section supervisor, at 651-232-3002.
HML Update Winter 2015
4
Temporarily Discontinued Tests at Mayo Medical
Effective October 27, 2014, Mayo Medical Laboratories has announced that the following testing
will be temporarily unavailable due to a nationwide reagent shortage. There is NO alternative
testing available due to the nationwide reagent shortage. An update will be provided once the
testing resumes.
Western Equine Encephalitis Antibody, IgG and IgM, Spinal Fluid
Western Equine Encephalitis Antibody, IgG and IgM, Serum
St. Louis Encephalitis Antibody, IgG and IgM, Spinal Fluid
St. Louis Encephalitis Antibody, IgG and IgM, Serum
Arobvirus Antibody, IgG and IgM, Spinal Fluid
Arobvirus Antibody, IgG and IgM, Serum
California Virus (La Crosse) IgG and IgM, Spinal Fluid
California Virus (La Crosse) IgG and IgM, Serum
Eastern Equine Encephalitis Antibody, IgG and IgM, Serum
If questions arise, please contact Jean Chavez at 651-232-4289.
CDC recommends combo HIV test for faster detection of virus
The U.S. Centers for Disease Control and Prevention (CDC) recently released their recommendation
for a new type of HIV testing that utilizes diagnostics that can detect infection up to three to four
weeks faster, potentially preventing the spread of the virus that causes AIDS. The CDC is
recommending HIV combination tests that can detect the virus as well as specific antibodies in the
blood that would show the body is reacting to the presence of the virus.
HealthEast has offered the Abbott Diagnostics HIV Combo test since October 2010.
Nearly 1 in 6 people living with HIV in the United States do not know they have the virus, according
to the CDC. That means they may unknowingly transmit the virus as well as be delaying treatment
for themselves. Roughly half of the estimated 50,000 new HIV infections each year are transmitted
by people who do not know they are HIV-positive, the CDC said.
Speedier diagnosis is critical since many new infections are transmitted by people in the earliest
stage of infection, the CDC said.
"With consistent and widespread use of this new testing method, we can diagnose people several
weeks earlier than before," the CDC said in a statement, adding that it is encouraging medical
testing laboratories to adopt the new approach as quickly as possible.
HML Update Winter 2015
5
2015 CPT Code Changes
CPT Description
New
CPT/HCPC
Valproic acid
(dipropylacetic acid); free
80165
HC METHAQUALONE, SO
New CMS Code
(Medicare/Medicaid)
Current CPT Code
HML Panel
80165 - Valproic Acid, Free
80164
Valproic Acid, Free (VPA)
80299
80299
82542
Methaqualone
Confirmation, Urine (CMQ)
Alcohol
80320
G6040 - Alcohol; any specimen
except breath
82055
Alcohol, Ethyl, Blood (ALC)
Alcohol, Ethyl, Urine (ALU)
Alkaloids, not otherwise
specified
80323
G6055 - Nicotine
83887
Nicotine and Metabolites,
Urine (NIC)
Amphetamines; 1 or 2
80324
Analgesics, non-opioid; 1
or 2
Antidepressants, tricyclic
and other cyclicals; 1 or 2
Antiepileptics, not
otherwise specified; 1-3
Antipsychotics, not
otherwise specified; 1-3
80329
80335
80339
80342
Barbiturates
80345
Benzodiazepines; 1-12
80346
Buprenorphine
Cocaine
80348
80353
HML Update Winter 2015
G6042 - Amphetamine or
Methamphetamine,confirm
G0431 - Qualitative
Amphetamine
Confirmation, Urine (ACF)
G6039 - Acetaminophen
G6038 - Salicylate
82145
82003 Acetaminophen
80196 - Salicylate
G6030 - Amitriptyline
G6037 - Nortriptyline
G6032 - Desipramine
G6036 - Imipramine
G6034 - Doxepin
80299 - Clomipramine
80152 - Amitriptyline
80182 - Nortriptyline
80160 - Desipramine
80174 - Imipramine
80166 - Doxepine
82542 - Clomipramine
Amitriptyline (ATP)
Nortriptyline (NTR / ATP)
Desipramine (DSI / IMI)
Imipramine (IMI)
Doxepine (DXE)
Clomipramine (CPM)
80299 - Lacosamide
82542
Lacosamide (VIM)
80299 - Risperidone
82542
Risperidone (RSP)
G6043 - Barbiturates, confirm
G6043 - Pentobarbital
G6043 - Mephobarbital
G0431 - Barbiturates, Qual
Barbiturates Confirm.
(CBA)
Pentabarbital (PTB)
Mephobarbital (MEP)
G6031 - Benzodiazepines
82205 - Barbiturates
82205 - Pentabarbital
82205 Mephobarbital
80154 Benzodiazepine
80154 - Clonazepam
G6056 - Opiates, Drug and
Metabolites, each procedure confirmatory
Use G0431 for Drug Screens
83925
Buprenorphine (CBU /
BUP)
G6044 - Cocaine or metabolite,
Quant
G0431 - Cocaine,Qual
82520
Cocaine Confirmation
(CCO)
Acetaminophen (ACT)
Salicylate (SAL)
80154 - Benzodiazepine
80154 - Clonazepam
6
CPT Description
New
CPT/HCPC
Fentanyl
80354
Heroin metabolite
80356
Methadone
80358
Opiates, 1 or more
80361
Oxycodone
Tramadol
Drug(s) or substance(s),
definitive, qualitative or
quantitative, not
otherwise specified; 1-3
Infectious agent detection
by nucleic acid (DNA or
RNA); Human
Papillomavirus (HPV),
high-risk types (eg, 16, 18,
31, 33, 35, 39, 45, 51, 52,
56, 58, 59, 68)
80365
80373
CMS Code (Medicare/Medicaid)
Current CPT Code
HML Panel
G6056 - Opiates, Drug and
Metabolites, each procedure confirmatory
Use G0431 for Drug Screens
83925
G6056 - Opiates, Drug and
Metabolites, each procedure confirmatory
Use G0431 for Drug Screens
83925
G6053 - Methadone, Quant
G0431 - Methadone, qual
83840 (Quant)
G0431 (Qual)
Methadone, Serum (MTD)
Methadone Confirm,
Urine(CDO)
G6056 - Opiates, Drug and
Metabolites, each procedure confirmatory
Use G0431 for Drug Screens
83925
Opiates Confirmation
(COP)
6-Monoacetylmorphine,
Urine (MAM)
G6056 - Opiates, Drug and
Metabolites, each procedure confirmatory
Use G0431 for Drug Screens
82542
Oxycodone Confirmation,
Urine (COX)
80299 - Tramadol
82541
Tramadol, Urine (TRM)
80299 - Amiodarone
82542
Amiodarone (AMO)
87624
87621
HPV Cascade (HPP)
Fentanyl, Urine (FTL)
80375
87624
HML Update Winter 2015
7
Online Ordering for Supplies
HML Update Winter 2015
8
Pricing Contact
With the changes to a new computer system, so did some responsibilities. Please contact Tania
Hochhalter at 651-232-3528 for any pricing questions you might have for your site or for a patient.
CONSULTANT’S CORNER
Community Health Events are a great way for medical facilities to connect with the community.
With this in mind, we would like to share a notice that was recently sent by the Minnesota
Department of Health. You may have already received this information, but in the event that you
have not, we wanted to be sure all laboratory testing personnel are informed.
From MN Dept of Health:
Purpose: To remind laboratories of the importance of the proper use and maintenance of blood
glucose screening equipment, and to always follow the manufacturer’s instructions for use,
cleaning, and disinfecting.
Background: Almost all blood glucose testing equipment available at most pharmacies is designed
for single person use and should never be used on more than one person. Use on multiple people
can result in individuals being exposed to other people’s blood. In rare cases, this has led to
transmission of hepatitis B and could potentially transmit hepatitis C and HIV. Safe injection
practices are critical to ensure the safety of staff and patients during blood glucose screening.
People organizing blood glucose screening events:
Review your blood glucose screening protocols
Ensure you are following the package insert for all equipment
Groups performing blood glucose screening should:
Use only blood glucose meters approved for use on more than one person (see package
insert). Clean and disinfect the meter according to the package insert after every person. If
the package insert does not specify that the meter can be used for more than one person,
then it should never be shared.
Use only single-use disposable, auto-disabling finger stick devices; dispose in Sharps
container immediately after use.
Never use finger stick devices such as lancet holder or penlet devices for more than one
person.
Always wear disposable gloves; change gloves between patients and discard gloves in
regular trash.
Perform hand hygiene (use alcohol-based hand rub or soap and water if hands look dirty)
o Before touching patient
o Before putting on gloves
o Immediately after removing gloves
o Before touching medical supplies to be used on other patients
Clean and disinfect the glucose meter after every use, per the manufacturer’s instructions
HML Update Winter 2015
9
Additional information:
More details on safe injection practices during blood glucose screening can be found at:
http://www.health.state.mn.us/divs/idepc/dtopics/infectioncontrol/is/index.html
Infection Prevention during Blood Glucose Monitoring and Insulin Administration:
http://www.cdc.gov/injectionsafety/blood-glucose-monitoring.html
FDA Statement on Use of Fingerstick Devices on More Than One Person Poses Risk for Transmitting
Bloodborne Pathogens:
http://www.fda.gov/medicaldevices/safety/alertsandnotices/ucm224025.htm
The Minnesota Department of Health Diabetes Program: http://www.health.state.mn.us/diabetes/
EDUCATION
Basic Phlebotomy Techniques: The First Step in Quality Patient Results
Friday, April 17, 2015 8:00am-12:00 Noon
Woodwinds Health Campus – Auditorium A
For questions about registration only:
Linda Wagener at 651-232-6925 or email [email protected]
Karen Anderson at 651-232-3190 or email [email protected]
To register for a class:
Email [email protected]
HML Update Winter 2015
10