Download April 2015 - Allina Health

April 2015
Billing and compliance
 ICD-10 go-live Oct. 1, 2015
Chemistry
 Phenytoin Free (LAB1993) referred to MedTox Scientific
 Thyroglobulin testing now performed in house
Help us help you
 Viral culture, non-respiratory (LAB7635) and dermal sources
Microbiology
 New blood culture rapid identification assay implemented
 2014 Antimicrobial susceptibility cards
Referral testing
 Neurokinin A testing changes
 MedTox Scientific reference range changes announced
Website
 Test number format changing
BILLING AND COMPLIANCE
ICD-10 go-live Oct. 1, 2015
Allina Health, along with other health care organizations nationwide, is working to transition
from ICD-9 to ICD-10 code sets to accommodate approximately 140,000 medical
documentation codes for diseases and procedures, as well as for billing to payers. The
Centers for Medicare & Medicaid Services (CMS) mandated date for transition is Oct. 1, 2015.
Are you ready?
Following is a link to a CMS website that includes a countdown, as well as links to helpful
information.
http://www.cms.gov/Medicare/Coding/ICD10/index.html
For future reference, this link has also been included on the AHL Lab Billing page of our
website.
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CHEMISTRY
Phenytoin Free (LAB1993) referred to MedTox Scientific
Due to a reagent issue, Allina Health Laboratory is currently unable to perform Phenytoin, Free
(LAB1993). Until further notice, all specimens received for this assay will be referred to
MedTox Scientific (test # 98) for analysis.
This test will be ordered as a Miscellaneous Sendout (LAB994). You can continue to order the
test per your usual workflow, however, if you place electronic orders for your testing, when the
specimen arrives at our Central Laboratory, you will be contacted with a request to re-order the
test as a LAB994 to facilitate transfer of the orders to MedTox, and resulting of the test.
Please note the following differences due to this temporary change in the performing
laboratory:
Specimen Requirements
Allina Health Laboratory: 2.0mL (0.5mL minimum) serum (SST) or Li Heparin Plasma (PST)
MedTox Scientific:
3.0mL serum (red top) or Heparinized plasma (green top)
Reference Ranges
Allina Health Laboratory: 1.2 - 2.5 µg/ml
MedTox Scientific:
1.00 - 2.00 µg/ml
Turn Around Time
Allina Health Laboratory: 1 day
MedTox Scientific:
2 days; Stat orders will receive a preliminary result within 4 hours of
receipt at MedTox.
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Thyroglobulin testing now performed in house
On Monday, March 16, 2015 Allina Health Laboratory began performing Thyroglobulin and Anti
-Thyroglobulin antibody testing in-house, using assays performed on a Beckman Unicel DxI
instrument. This testing is currently referred to Mayo Medical Laboratories (MML). Both the
Thyroglobulin and the Anti-thyroglobulin antibody assays, which will be performed on the
Beckman Unicel DxI at the Allina Health Central Laboratory, are identical to the assays that are
currently in use at MML. Note, however, that because MML converted to the Beckman Unicel
DxI Anti-thyroglobulin antibody assay in October of 2014, any Anti-thyroglobulin antibody
levels which had been sent to MML for testing prior to that time would not be comparable to
levels obtained by the Beckman assay.
The Beckman Access thyroglobulin assay is a one-step immuno-enzymatic sandwich assay.
Tumor marker assay values obtained with different assay methods cannot be used
interchangeably due to differences in assay methods and reagent specificity.
There are no changes to test ordering, reference ranges or CPT codes associated with this
performing laboratory change.
Test name:
Test code:
Days tested:
Thyroglobulin Antibody
LAB1654
Mo, We, Fr
Test name:
Test code:
Days tested:
Thyroglobulin Tumor Marker
LAB429
Mo, We, Fr
Complete test ordering and specimen requirement information can be found in our test catalog
at www.allinahealth.org/laboratory.
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HELP US HELP YOU
Viral culture, non-respiratory and dermal sources
Recently we have noted a increasing number of Viral culture, non-respiratory (LAB7635)
orders placed on specimens with dermal sources. When a dermal source is submitted for this
assay, referred to Mayo Medical Laboratories (MML), it will be tested for Enterovirus only.
In order to have a dermal specimen tested for Herpes simplex or Varicella zoster virus, you
must order the appropriate PCR assay:
 Herpes simplex Virus (HSV) by Rapid PCR (LAB4495)
 Varicella zoster Virus by Rapid PCR (LAB4771)
 Herpes simplex Virus (HSV) + Varicella zoster Virus (VZV) Molecular Detection, PCR
(LAB7898)
Complete specimen requirement/specimen collection and test ordering information for each of
these tests can be found in our test catalog.
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MICROBIOLOGY
New blood culture rapid identification assay implemented
On April 1, 2015 the Allina Health Laboratory Central Microbiology Lab implemented a new
assay for the rapid identification of organisms from positive blood culture bottles. The
FilmArray BCID Panel is a multiplexed nucleic acid test for the identification of the 24 most
common bacteria and yeasts in positive blood culture samples. In addition, the assay can
detect three antibiotic resistance genes, mecA of MRSA, vanA/vanB of VRE, and the KPC
gene found in some gram negative bacilli. While the normal process of growing the isolates for
18-24 hours before they can be identified, this assay takes one hour for detection and
identification.
The assay will be performed on a patient’s first positive blood culture. For the cultures
incubating at the Central Lab, the blood culture gram stain will not be called if the assay is
being performed. When the assay is completed in an hour, the identification and any
resistance gene detection will be called to the provider. On subsequent blood cultures, the
gram stain will be called upon detection and the assay will not be performed. The FilmArray
assay will not be performed on blood cultures showing gram positive bacilli.
Advantages:
Rapid identification and early detection of mechanisms of resistance will allow for more effective and appropriate antibiotic therapy.
Changes for Providers:
 The gram stain on the first positive culture will not be called until the assay is complete and
the full identification can be reported. Should the assay not yield an identification, the gram
stain will be called.
 Gram stains on subsequent positive blood cultures will be called as usual.
 No order is required for the FilmArray assay.
CPT:
87150
If you have questions regarding this new assay, please contact Mary Colson-Burns, Allina
Health Laboratory Microbiology Technical Specialist [email protected]
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2014 Antimicrobial susceptibility cards
Enclosed with this newsletter is a card with the summary of the antimicrobial susceptibilities
of the major pathogens isolated from outpatients tested at Allina Health Laboratory during
the year of 2014. This information, along with information regarding pathogens isolated from
Abbott Northwestern, Mercy, United and Unity Hospitals, is also available on our website
Antimicrobial Susceptibility page.
The intent of this card is to provide a preliminary guide to susceptibilities. This information
should be used together with the specific susceptibility results of the isolated organism and
guidelines from current publications.
For further information, contact Mary Colson-Burns, Microbiology Technical Specialist,
[email protected] or Brenda Katz, M.D., Medical Director of the Microbiology
Laboratories, [email protected].
If you would like additional copies of the outpatient card, contact either the Allina Health
Laboratory Client Services at (612) 863-4678 option 1, or your account representative.
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REFERRAL TESTING
Neurokinin A testing changes
Mayo Medical Laboratories (MML) has issued a notification that, effective immediately, the
Neurokinin A (Substance K) assay (LAB8737) is being referred to Inter Science Institute rather
than Cambridge Biomedical. Due to this, there changes in specimen collection, processing
and transport requirements. Our test catalog has been updated to reflect these changes,
which are also detailed below.
The new special collection tube for this assay (Inter Science Institute Z-Tube) has been added
to our supply catalog under Blood Collection Specialty Tubes. Please note that there is a limit
of 2 tubes per order.
Test Name:
Neurokinin A
Test Number:
LAB8737
Collect:
3.0 ml Plasma from Inter Science Institute Z-Tube
Mayo supply T701
Peds Collect:
1.0 mL Plasma from Inter Science Institute Z-Tube
Mayo supply T701
Alternate Collect:
NONE
Container:
Mayo - Screw Cap Transfer Vial
Processing:
Collect 10 mL of blood in special Z-tube (MML supply number
T701). Spin, separate and freeze 3.0 mL plasma as soon as possible
Transport/Stability:
Frozen – 2 months
Refrigerated - NO
Alternate Names:
Substance K, NKA
Performing Lab:
Inter Science Institute via Mayo (ZW71); R-MM
Days Set Up:
Not specified
Expected TAT:
Not specified
Ref. Ranges:
< 40 pg/ml
1) Patient should be fasting 10-12 hours prior to collection.
Collection/
Processing Details: 2) Patient should not be on any antacid medication or medications
that affect gastroentero-intestinal function, if possible, for at least 48
hours prior to collection. CPT:
83519
List price:
$315.50
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MedTox Scientific reference range changes announced
MedTox Scientific has announced reference ranges changes to multiple tests which went into
effect on April 13th. Following are details regarding the announced changes.
Test Name:
Test Code:
Previous Reference Range:
New Reference Range:
Carbamazepine, Free
LAB1958
0.4 - 3.6 µg/ml
0.6 - 4.2 µg/ml
Test Name:
Test Code:
Previous Reference Range:
New Reference Range:
Hydromorphone
LAB2087
10 - 30 ng/mL
1 - 30 ng/mL
Test Name:
Test Code:
Previous Reference Range:
New Reference Range:
Meprobamate
LAB2309
5.0 - 20.0 µg/mL
6.0 -12.0 µg/mL
Test Name:
Test Code:
Previous Reference Range:
New Reference Range:
Oxycodone
LAB1443
10 - 40 ng/mL
10 - 100 ng/mL
Test Name:
Test Code:
Previous Reference Range:
New Reference Range:
Propoxyphene
LAB1458
200 - 800 ng/mL
100 - 400 ng/mL
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WEBSITE
Test number format changing
Over the next several months, the test number format will be changing in our test catalog. The
test number will be changing to a strictly numeric code which will correlate with the codes on
our updated manual request forms.
The Excellian ordering codes (LABXXXX or CPT.X), along with the Beaker test
abbreviation/synonyms will appear in either the test name or the alternate name field which are
both searchable.
If you have any questions regarding these pending changes, please contact your account
representative.
Thank you for choosing Allina Health Laboratory
We value your business!
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