FAQs

CLIENT SERVICES

Who do I contact about courier needs or problems?
Sue Grigg, Client Service Representative can be reached at 906-225-7489.
Who do I contact with questions regarding billing?
Polly Hockberger, Laboratory Manager, can answer most billing questions. Reference accounts that need information regarding prices and CPT codes can contact Client Services, or Polly Hockberger. Polly can be reached at 906-225-7489.
What information is mandatory on test requisitions?
The requirements will vary depending on the type of billing being done. Full name, date of birth, social security number, sex, physician, collection date and time, and tests being done must all be included on a requisition when a laboratory reference account or physician office will be billed. Please mark the box "Bill Account". When a patient will be billed, all of the above information must be included as well as billing information (self-pay, insurance, Medicare/Medicaid), and the patient diagnosis. In addition, Microbiology, Cytology, and Histology requisitions all require the specimen type/source.
When must an ABN be completed?
An ABN (Advanced Beneficiary Notice) must be completed for testing that is covered under a local Medical Review Policy and which could possibly be denied for payment by Medicare. Documentation of medical necessity will help to ensure reimbursement from Medicare. ABN's are not required for routine or screening tests, as they are never covered services. However, you should inform the patient of non-coverage for screening tests via the ABN.
What do I do if I cannot find a test or specimen requirements in your test catalog?
You can search our test catalog on-line for information regarding laboratory testing and specimen requirements. If you cannot find what you are looking for, contact Client Services at 888-818-3879.
How do I obtain supplies from UPHSM Laboratory?
UPHSM Laboratory will provide supplies to our satellite labs and reference accounts that are necessary for specimen collection. We provide those locations with supply order forms. Simply fill out your form and return it with your courier. We will send your supplies as soon as possible. Questions regarding supplies for special collections or unusual testing should be directed to Client Services at 888-818-3879.
How do I set up an account?
You can set up an account by contacting our Laboratory Manager, Polly Hockberger, at 906-225-7489.

TRANSFUSION SERVICE

What are the labeling requirements for specimens used in pretransfusion testing?
All pretransfusion specimens must be labeled with the patient's full name, medical record number, the date drawn, and the identity of the person who drew the specimen (first initial, entire last name). The specimen must be labeled at the time it is drawn. Once the specimen has left the patient's side, no changes or additions may be made to the patient's name or medical record number. It is allowable to add the date or phlebotomist initials afterwards if it can be definitely tracked.
What is a pretransfusion specimen?
A pretransfusion specimen is any specimen that is drawn from a patient that could possibly be used for preparing blood products for that patient. This includes orders for type, screen and hold, screen and crossmatch, and preadmission testing.
Why are the labeling requirements for Blood Bank so strict when they are not for other sections of the lab?
Because Blood Bank and Transfusion Service is preparing a prescribed blood product that is given directly to a patient, we fall under the strict regulations and standards of the FDA, AABB, & JCAHO. If we fail to meet these regulations and standards, we may loose the ability to prepare blood products for patients.

MICROBIOLOGY

What information is needed for a microbiology request?
In addition to the necessary patient information, microbiology testing requires the specimen type, body site, and the collection date and time. Include information for special requests or cultures for unusual organisms that may require special media.
What information is required for a referral request for organism ID and/or sensitivity and how should it be sent?
Organisms must be fresh, pure, isolated growth on a culture plate or tube media. Send in the appropriate environment for viability: aerobic, anaerobic, or CO2. Do not send organisms on a swab or on plates with mixed flora. On the requisition, include any preliminary testing information, gram stain reaction, and body site the organism was isolated from.
What is the proper transport media for an anaerobic culture?
  • Body fluids may be sent in an anaerobic transport tube (Cary Blair tube media). Fluids collected in a syringe must be aseptically transferred to the tube media by pushing the needle through the rubber stopper in the cap, filling the tube. Do not remove the cap from the anaerobic transport tube.
  • Tissues should be sent in a sterile specimen cup or tube.
  • Specimen types that are unacceptable for anaerobic culture include; fluids not received in an anaerobic transport tube, and swabs.
  • Remember that anaerobes grow in the absence of oxygen and that oxygen is toxic to strict anaerobes. Any specimen source that has contact with the air is not acceptable for anaerobic culture. Tissues are an exception to this rule because anaerobes can survive within the tissue in areas that are not exposed to the air.
How should microbiology specimens be stored before and during transport to UPHSM Laboratory?
Specimens should be delivered to the laboratory as soon as possible. Refer to the UPHSM Laboratory Test Catalog for specific transport conditions. Many microbiology tests and cultures require different storage conditions.

HEMATOLOGY / COAGULATION / ROUTINE TESTING

What should I do before sending coagulation testing to your laboratory?
Double centrifuge the specimen by centrifuging it, removing the plasma, then centrifuging the plasma again. Place the plasma in a capped plastic vial and freeze. Either method will remove platelets from the plasma as they can cause inaccurate results for many of the tests.
What are the specimen requirements for an ESR (Erythrocyte Sedimentation Rate)?
The specimen must be collected by venipuncture into an ESR vacuum tube or an EDTA tube. The test cannot be performed on specimens collected in microtainers or by finger-stick. The specimen is stable for 24 hours if refrigerated.
What information is needed to request a smear for pathologist review (SMP - Smear to Pathologist)?
If smears to be reviewed by a pathologist are coming from a satellite lab or reference account, the following must accompany the request:
  • Two good unstained blood smears
  • A CBC report from the requesting lab
  • Patient's diagnosis
  • Reason for pathology review (e.g. Dr. request, blasts seen by tech, etc.)
What is the difference between a blood count and a CBC?
If a differential is not needed, a blood count order will have a much faster TAT than a CBC. Both include the cell counts and indices, but a CBC requires a peripheral smear to be made, stained and read microscopically.
What is a "urine culture if indicated" order?
If this comment is attached to a urinalysis order, and there is >6 WBC's/hpf and/or >2+ bacteria and/or any yeast the urine will be sent to Microbiology. Also, if the leukocyte esterase is >trace, regardless of the number of WBC's or presence of bacteria, the urine will be sent to Microbiology.
What is a MACUA?
It is a macroscopic urinalysis. It includes color, appearance, pH, specific gravity, ketone, glucose, protein, blood, bilirubin, urobilinogen, and leukocyte esterase. This test can be used as a quick urinalysis screen as there is no microscopic exam.

SPECIAL CHEMISTRY

What is the difference between a serum pregnancy test and a HCG test?
A serum pregnancy test is used as a screening test to determine the presence of HCG. The result is reported as either positive or negative. The HCG test gives a quantitative value as the result. and is requested when a HCG titer is needed.
How do I order a TIBC (total iron binding capacity)?
To obtain a TIBC result, you must order a transferrin. The TIBC is automatically calculated from the transferrin result. There is no test code in our computer system for TIBC.
How do I order a "% saturation" test?
To obtain a % saturation result, you must order an iron and a transferrin. A comment must be put on the requisition and/or in our LIS system to do the % saturation. There is no test code in our computer system for % saturation.

SEROLOGY

What serology tests can be run STAT?
Bacterial Meningitis panel (BMEN), mononucleosis (MONO), and Source Patient HIV (Rapid HIV for needle stick source patients) can all be run on a STAT basis. Many of our other serology tests are time consuming and are therefore not run STAT.
Which positive/reactive serology tests are automatically sent out for confirmation?
HIV and RPR are sent out for confirmation when positive or reactive results occur. HCV is sent out only when results are indeterminate.
How are HIV results reported?
HIV results are sent via confidential letter directly to the ordering physician or in the case of reference accounts, the Laboratory Director. Only a physician can obtain HIV results over the phone. If there is an emergency or question regarding a result, contact the ordering physician or the Serology Supervisor at UPHSM (7am-3pm).
Which positive/reactive serology tests are automatically sent out for confirmation?
HIV, HTLV-I / II, and RPR are sent out for confirmation when positive or reactive results occur.
What are the acceptable sources for Chlamydia and GC DNA probes?
The urethra, cervix, and endocervix are acceptable sources for both Chlamydia and GC DNA probes. The eye is an acceptable source for Chlamydia only. Test performance with other specimens has not been accessed by Gen-Probe. Specimens must be collected using the Gen-Probe collection kit.

CYTOLOGY / HISTOLOGY

How much CytoLyt preservative do I add to my non-gyn specimen?
Non-gyn specimens (urine, CSF, FNA, Body Fluid) need a minimum of one part CytoLyt to three parts sample ratio (i.e. 30 ml CytoLyt will preserve up to 90 ml urine). Since non-gyn specimens are processed on the Thin Prep Processor, samples with greater concentrations of CytoLyt (i.e. 5 ml CSF in 30mls CytoLyt) are not compromised. (The Thin Prep Processor draws the sample through a filter until sensors detect that the filter is covered with cells, or the entire sample is used up.)
How long can a non-gyn specimen (i.e. urine, CSF, FNA, Body Fluid) sit without preservative before the quality of the sample is compromised?
Cells degenerate quickly, so an optimal specimen is one that has had preservative added immediately upon specimen collection.
How long can a preserved specimen be stored and still be suitable for processing?
For optimal results, all specimens should immediately be transported to the laboratory for processing. Cytology preservative will maintain the integrity of the sample for a short period of time. The shelf life of preserved cytology specimens are as follows: Conventional "spray-fixed" Pap Smears- are preserved for up to 3 weeks. Thin Prep Pap Smears- are preserved for approximately 3 weeks when stored @ 4-37¡xc. Non-gyn Specimens (preserved in CytoLyt Solution)- are preserved for 8 days at room temperature, providing the sample has a minimum of one part CytoLyt to three parts sample ratio (i.e. 30ml CytoLyt / 90ml urine).
What information is required on a Cytology / Histology requisition?
In order to process a specimen, requisitions must include the following information:
  • Patient's full first and last name. This must match the one on the specimen.
  • Date of Birth
  • Name of Referring Physician (supervising physician must be listed on requisition in addition to Nurse practitioner or P.A.)
  • Source of specimen collection.
  • A test must be requested (i.e. cancer screen, maturation index, etc)
  • A billing box must be marked (i.e. "Bill Patient" or "Bill Facility")
  • A diagnosis box must be marked (low-risk vs. high-risk)
What additional information is helpful to the Cytotechnologist / Pathologist when reviewing a Pap Smear?
The patient's last menstrual period- (endometrial cells are generally only shed during the first 14days of the patient's LMP. Their presence can be a significant finding after day 14 in women over 40yrs of age). Hormone therapy- Hormone therapy increases the maturation of the squamous cells in the Pap smears of post-menopausal women. Endometrial disease processes (hyperplasia, cancers, etc.) can also produce squamous maturation or "estrogen effect" in the smear. Clinical History - It is especially helpful to know the patient's clinical history, including any previous gyn disease processes (ASCUS, HPV, Dysplasia, cancer), gyn surgical procedures (cone biopsies, laser treatment, etc.), history of cancer, in general, and chemotherapy and / or radiation therapy.