ࡱ> CFB_ bjbj 4<bbHFbb84<D ."}}}$?!#}}LLLLLLLCsL|0 L$$L$L0}L6L,+}}}N}}} $}}}}}}}}}b : Tift Regional Medical Center Clinical Laboratory Reflex testing and Order Interpretations TRMC Laboratory recognizes that in some instances it is medically appropriate to perform reflex testing based on initial laboratory results. It is also recognized that physicians may have certain ordering practices that include nomenclature that does not reflect current methods. In accordance with OIG compliance, the following reflex testing activity and order interpretations will apply for the following in-house testing: Test Order Reflexive/Associated Billable Tests Blood Bank Crossmatch ABO, Rh, Antibody Screen, Antibody ID, Antigen Typing, Absorption, Elution, DAT, and Compatibility testing. Sickle cell Category I patients must be phenotypically matched for C, E, c, e, and K antigens. Sickle cell Category II patients must be phenotypically matched for C, E, c, e, K, Fy(a), Jk(a), and Jk(b) antigens. Both categories must also be matched for any antigens to which the patient has antibodies. Platelets ABO, Rh, if indicated Fresh Frozen Plasma ABO, Rh, if indicated Cryoprecipitate ABO, Rh, if indicated RhoGam/RhIG ABO, Rh, Antibody Screen, Antibody ID, Fetal Bleed Screen, Kleihauer-Betke (acid elution). Chemistry HIV(Stat) If positive, HIV ELISA verification of positive result and Western Blot confirmation if indicated. Drug Screen (UDS) Each individual drug class, i.e. amphetamines, barbiturates, benzodiazepine, cocaine, phencyclidine, opiates, cannabinoids, oxycodone, methadone, methaqualone, ecstacy, etc. Drug screens referred to the reference lab may be sent for confirmation on any or all positive results. Test Order Reflexive/Associated Billable Tests Hepatitis B Surface Antigen If positive, Hepatitis B Surface Antigen confirmation is performed at ARUP. SMA SMA is an instrument, not a test. These orders may be interpreted as a Comprehensive Metabolic Panel, Basic Metabolic Panel, Liver Profile, Lipid Profile, Electrolytes, or any combination thereof. % Iron Saturation TIBC (see below) TIBC Iron and Transferrin. TIBC is a calculation. Thyroid Panel Thyroid Panel is no longer an AMA recommended test. TSH and FT4 will be performed in lieu of a panel. Hematology / Coagulation / Urinalysis CBC w/diff Manual differential if indicated; automated diff will be credited. Bone Marrow CBC w/diff, retic count, peripheral smear by pathologist, Aspirate smear by pathologist, cytogenetic analysis, flow cytometry, appropriate Pathology Level Code (I-VI) UA (Urinalysis) Automated microscopic exam will be performed. UA/Culture if indicated Indicated is defined as any bacteria seen, and/or more than 5 WBC seen. See Cultures. INR Protime. INR is a calculation and not billed. Microbiology / Serology Cultures Bacterial ID and Sensitivity on all pathogens. Kirby-Bauer sensitivity, Shiga toxin testing, if required. Reference lab testing if indicated. GBS GBS (Group B Strep) is an organism, not a test. The order will be interpreted as an Anogenital Culture See Cultures. RPR If positive, sent for confirmation by FTA-ABS Test Order Reflexive/Associated Billable Tests Respiratory Panel PCR testing for Adenovirus, Coronavirus HKU1, NL63, 229E, and OC43. Influenzas A, AH1, H1 2009, AH3, and B, Metapneumovirus, Parainfluenza 1 4, RSV, and Rhinovirus/Enterovirus, B. pertussis, Chlamydia pneumoniae, Mycoplasma pneumoniae. C. difficile/Epi by PCR C. difficile by PCR and the O27/NAP1/B1 epidemic strain of C. diff by PCR. Pathology Pathology Specimens Appropriate Pathology Level Code (I-VI), special stains, immunohistochemistry (IHC) stains, flow cytometry, FISH testing, ISH testing, gene typing, molecular testing, computer assisted quantitative IHC, and external consultations. Liquid based PAP test DNA probe testing for HPV if indicated by prior physician agreement, and immunocytochemistry. Reference testing: Reference Testing - Any tests sent out to a reference laboratory are subject to additional charges for any confirmation or reflex testing that may be necessary. Specifics include but are not limited to: Acetylcholine Receptor Abs Acetylcholine Receptor Modulating Antibody ANA, IgG by ELISA ANA, IgG by IFA APC Resistance Profile Factor V Leiden by PCR Arsenic Arsenic, Fractionated Autoimmune Hepatitis Panel ANA, IFA Titer IgG B. pertussis Antibody(s) B. pertussis Antibody(s), Immunoblot BCR-ABL1, Qualitative BCR-ABL1, Quantitative Test Order Reflexive/Associated Billable Tests Celiac Disease Reflexive Cascade tTG Antibody IgA, Endomysial Antibody IgA, tTG Antibody IgG, DGT Antibody IgA, DGT Antibody IgG. Cortisol Stimulation Test ACTH baseline, ACTH 30 minutes, ACTH 60 minutes. dsDNA Antibody, IgG by ELISA dsDNA (Crithidia luciliae) Antibody, IgG by IFA Drugs of Abuse Panel Individual drug class confirmation/quantitation. F-Actin Ab, IgG w/ reflex to Smooth Muscle Ab IgG titer ASM by IFA Factor XIII, Qualitative Factor XIII 1:1 Mix Fragile X Methylation Analysis FTA-ABS, IgG by IFA FTA by TP-PA Fungal Culture Fungal/Mold Identification H. pylori H. pylori IgA and IgG if not otherwise specified. HIV Antibody(s) HIV Antibody(s) Confirmation by Western Blot Heavy Metals Panel Arsenic, Fractionated Hemoglobin Electrophoresis Acid HGB Electrophoresis, Alkaline HGB Electrophoresis, Sickle Cell Solubility. Leukemia/Lymphoma Panel Up to 30 individual markers w/ interpretations Lupus Anticoagulant Reflex Panel Confirmation of any components Lyme Disease Acute Reflex Panel B. burgdorferi Antibody(s) by Western Blot ANA Panel ANA titer by IFA Smooth Muscle Antibody, IgG Smooth Muscle Antibody, IgG Titer By ELISA tTG Antibody IgA Endomysial Antibody IgA Titer VDRL VDRL Titer Test Order Reflexive/Associated Billable Tests Viral Culture Virus identification von Willebrand Panel von Willebrand Multmeric Analysis     Revised/Reviewed March 2016 PAGE  PAGE 2 01YZ[       " 6 8 ; < = G H   1 > Z f n s I K ] } }xtphcC~h *hWwhOhthR$8h hDh=?5>*hDh 5>*h#Fh 5>*h hh5h h=?5h h 5hDh3w| hDhDh|ahD hD5 hh5 h F5h Fh 5,1Z[  < = H I   @ A g h ^`gd ^`gd5&$d%d&d'dNOPQgd FgdD $`a$gd;@$a$gdD$a$gd Fh I J K uvw&$d%d&d'dNOPQgd;^gd 7 ^`gd5 ^`gd   *uvw;</0"#$123fgùЪЦНЃ{{{{h2}h_xhTKh hWw5hDhWw5>*h *hDha5>* h 5h.h{#hahthR$8h;h h;5h{8hOh 7h hrdhcC~0;</0#$ ^`gdWw ^`gda ^`gd5gd.gda123fghiIJK^_&$d%d&d'dNOPQgd; ^`gda ^`gd=? gh&:;Agtx.HIJK\]^_pr־־ֺ֪{h4hW9hwD-hSKhwD-hiJ5>* h45>*hwD-hwD-5>*hiJh;@hUhrhGhUheKh.:`huhWwh#h#FhhhTKhDha5>*hahghOh2}h_x0%&*+,rsYZ .0ABC&'l ),+,tܸشԤؠؠؠhbh6hZ}h,J[5h?hudhg h4Nh4Nh4N h;5h h;5h;h IGh 7h5zhhh' h,J[h4h2}hW9hwD-?_+,stZ[B ^`gd4N&$d%d&d'dNOPQgd;gd,J[BC%&`kl MN+gd,J[gdg ^`gd,J[+,tu"#ajk  HJKM&$d%d&d'dNOPQgd|!gd,J["jk "$,-7EGHIKLNOQRTVglpqrstuv|}~ÿh.0JmHnHu hud0Jjhud0JUh_xhudCJaJh|!CJaJh~%CJaJhudCJaJhudhtjhtUhWwhpgh|! h|!5h h|!5h?h4h,J[h5zh IGhb2MNPQSTrtu~ &`#$gdA$a$gd_xhWwhthud hud0J21h:pZ}/ =!"#$% ^ 2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH DA`D Default Paragraph FontRiR  Table Normal4 l4a (k (No List 4@4 DBHeader  !4 @4 DBFooter  !H@H t Balloon TextCJOJQJ^JaJ.)@!. ,J[ Page NumberPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭V$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! 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