HML UPDATE. Keeping Our Client Informed Questions or Comments Call Winter Inside: Panel Changes

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1 HML UPDATE Keeping Our Client Informed Questions or Comments Call Winter 2016 Inside: Panel Changes CPT Code Changes... 5 Hazardous Weather... 6 Draw Requests during Holiday Week... 6 Critical Value Reporting... 6 Online Ordering... 7 Rejected Claims... 8 Consultant Corner... 9 Education Happy Holidays! Wishing you every happiness this holiday season and throughout the coming year! Deb Rodahl Panel Changes Effective January 17, 2016, Mayo Medical Laboratories has performed studies with Beta- CrossLaps (Beta-CTx) and will be updating the reference range for males ages 18 to 30 years. Panel Name: Beta-CrossLaps (Beta-CTx) Panel Code: CTX CPT Code: Collect: Red Top Submit: 1 ml serum FROZEN within 8 hours in a separate tube. Unacceptable: Markedly hemolyzed specimen. Note: Reduced renal function may lead to reduced urinary excretion and a consequent increase of serum CTx. Patients receiving high doses of biotin should wait 8 hours before having CTx drawn. Erroneous findings occur in patients treated with monoclonal mouse antibodies.

2 2 Panel Changes Con t. Effective October 17, 2016 HealthEast Medical Laboratories is no longer offering Cardiolipin Antibodies testing in house due to low volumes. New panel has been built and testing will be performed at Mayo Medical Laboratories. Panel Name: Phospholipid (Cardiolip) Antibodies, IgG and IgM Panel Code:LAB3082 CPT Code: 86147x2 Collect: Red Top Submit: 0.5 ml serum REFRIGERATED Unacceptable: Markedly hemolyzed or lipemic specimen. List Price: $37.25 If you have questions, please contact Jean Chavez at Ceruloplasmin Effective November 28, 2016 Ceruloplasmin pricing changed. Due to reagent issues Mayo Medical Laboratories is referring Ceruloplasmin testing to Quest Diagnostics Nichols Institute Laboratories which uses a different methodology and has different reporting ranges. Panel Name: Ceruloplasmin Panel Code: LAB703 (CPN) CPT Code: Collect: Red Top Submit: 1 ml serum REFRIGERATED. List Price: $78.56

3 3 Panel Changes Con t. Chromium Effective November 18, 2016, HealthEast Medical Laboratory has created an orderable panel for Chromium, Serum due to increased volume. Panel Name: Chromium, Serum Panel Code: LAB3085 (CRS) CPT Code: Collect: Navy Top-No Additive Submit: 2 ml serum REFRIGERATED in a metal-free tube. Unacceptable: Specimen not received in metal-free tube or markedly icteric specimen. Note: Draw blood (Navy-No Additive), clot 30 min., centrifuge, pour serum (liquid) into a metal-free tube avoiding the transfer of cellular components. List Price: $24.16 Cobalt Effective November 18, 2016, HealthEast Medical Laboratory has created an orderable panel for Cobalt, Serum due to increased volume. Panel Name: Cobalt, Serum Panel Code: LAB3086 (COS) CPT Code: Collect: Navy Top-No Additive Submit: 2 ml serum REFRIGERATED in a metal-free tube. Unacceptable: Specimen not received in metal-free tube or markedly icteric specimen. Note: Draw blood (Navy-No Additive), clot 30 min., centrifuge, pour serum (liquid) into a metal-free tube avoiding the transfer of cellular components. List Price: $55.01

4 4 Panel Changes Con t. Effective 9/13/16 Mayo Medical Laboratories notified HML that Cerebrospinal Fluid (CSF) is no longer an acceptable specimen type for two tests: Herpes Simplex Virus, Molecular Detection, PCR (LAB917) Herpes Simplex Virus and Varicella-Zoster Virus, Molecular Detection, PCR (LAB1310). This test included both the Herpes Simplex Virus and Varicella Zoster Virus by ordering one test. Now, if you want both Herpes Simplex Virus and Varicella Zoster Virus, Molecular Detection, PCR, you need to order two tests: Varicella-Zoster Virus, Molecular Detection, PCR (LAB1372) Herpes Simplex, Molecular Detection, PCR, Spinal Fluid(LAB3077). This has been built as follows: Panel Name: Herpes Simplex Virus, Molecular Detection, PCR, Spinal Fluid Panel Code: HSVC (LAB3077) CPT Code: Collect: Sterile Container Submit: 0.2 ml Cerebrospinal Fluid (CSF) REFRIGERATED Note: DO NOT centrifuge If you have questions, please contact Jean Chavez at Effective November 3, 2016 Mayo Medical Laboratories updated the specimen stability for Thyroid- Stimulating Immunoglobulin (TSI) to preferred frozen. Panel Name: Thyroid-Stimulating Immunoglobulin (TSI) Panel Code: TSI (LAB746) CPT Code: Collect: Red Top Submit: 0.5 ml serum FROZEN. Unacceptable: Markedly hemolyzed specimen. Note: Acceptable refrigerated for 7 days and ambient for 24 hours. List Price: No change

5 5 Panel Changes Con t. HealthEast Medical Laboratory (HML) is always looking at ways to save money and pass these savings onto our clients. Medtox used to perform our Tramadol testing, but due to cost savings, HML has decided to refer Tramadol and Metabolite, Urine testing to Mayo Medical Laboratories. This test is reported out quantitatively. This change is effective November 1 st. Panel Name: Tramadol and Metabolite, Urine Panel Code: TRM CPT Code: Collect: Random Urine in a Screw-Top Container Submit: 10 ml aliquot of random urine collection (no preservative) REFRIGERATED. List Price: $53.50 Effective 1/1/17: 2017 CPT Code Changes Test Name Current CPT Code 2017 CPT Code DRUGS OF ABUSE CASCADE,UR ACETAMINOPHEN ALCOHOL, SERUM BUPRENORPHINE,URINE DRUG SCREEN,PLASMA DRUG SCREEN,URINE DRUGS ABUSE 10,MECONIUM DRUGS ABUSE 4,MECONIUM DRUGS ABUSE 8,LEGAL DRUGS OF ABUSE DRUGS OF ABUSE DRUGS OF ABUSE DRUGS OF ABUSE PAIN SURVEY,URINE SALICYLATE TESTOSTERONE, TOTAL AND BIOAVAILABLE / / THC SCREEN,URINE

6 6 Hazardous Weather HealthEast Medical Laboratory (HML) serves our clients by utilizing outreach phlebotomists to obtain blood specimens from patients. 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. Please call HML customer service option # 5, with questions or concerns. Draw Requests during a Holiday Week HealthEast Medical Laboratory (HML) takes pride in accommodating all our client s lab draw requests. However, when a holiday is upon us, we often experience a high volume of draw requests with fewer fully-staffed days to accomplish those draws. Unfortunately, this can create delays with our phlebotomy staff reaching your facility at your normally scheduled time. Your patience is greatly appreciated during these times. We ask for your patience during a Holiday Week and have provided a list of the upcoming Holidays where you may experience a delay: Holidays New Year s Day New Year s Day Observed Easter Memorial Day Independence Day Labor Day Thanksgiving Christmas Day Christmas Day Observed Critical Value Reporting When a test result falls within a critical value range, the facility will be called with the result. When results are called and verbally given, HML is required to have the results repeated back, and to record the date and time of the call as well as the first and last name of the person accepting the results. Please call HML Customer Service option #5, with questions or concerns.

7 7 Online Ordering In an effort to improve our supply ordering process HML would like all clients to use our on-line supply request form. Beginning January 1st, 2017, HML is no longer accepting faxed supply requests.

8 Rejected Claims 8

9 9 Consultant s Corner CHANGES? HOW DO YOU SPREAD THE WORD? In our roles as Technical Consultants, we are constantly reviewing documents from package inserts, memos from the manufacturer or distributor of products, reference laboratories, management, and each other. In today s world, there are many changes due to technology or in response to compliance issues. How do you spread the word to the front-line staff or to those staff members who need this new information in order to perform their jobs? First question, do you know when changes occur? When opening rapid kit tests or reagents from the manufacturer or distributor, look for notices or memos indicating a change has been made in the procedure sometimes on bright colored paper or highlighted. Check the package insert often to verify no changes to the procedure have been made. Who in your facility receives the memos or announcements sent by HealthEast Medical Laboratory or the manufacturer of an analyzer? The next step, spread the word to staff members so they can perform their jobs, continue to report accurate results, and run the laboratory efficiently and effectively. Rewrite policies and procedures as needed to ensure staff members are following the correct steps to obtain the patient test result. Discuss information at staff meetings to bring changes to their attention. This process sounds simple but many times, the new information does not reach the staff members who need to know about any changes. As technical consultants, we see break-downs in the communication process. Examples include changes to policies and procedures not read or signed by staff members or Laboratory Directors, new or revised documents not in the appropriate binder or folder so everyone who needs to use those documents can find them easily, or staff members performing tests incorrectly because they did not know about a crucial change. Suggestions to alleviate communication break-downs in regard to changes: 1. Develop a document workflow or standard practice for handling changes to policies and procedures. 2. Write the process down and encourage all staff members to participate in the setup of standard practice documents. 3. Pay attention to package inserts. Review for any changes and notify the manager of your department, lead member of the laboratory staff, or technical consultant. Review and put a new package insert with the procedure in the Procedure Manual annually. Write the date at the top of the package insert indicating when you added the insert to the manual. 4. Ensure that memos and announcements from HML reach appropriate staff members. Contact HML Customer Service if a contact or name of contact has changed. 5. Read and sign your name to new policies and procedures. Refer back to the procedures as needed to ensure that you are performing a test correctly. Stay on top of changes! Don t ignore changes! Changes occur all the time and we must be constantly alert to implementation of changes in order to provide our patients with accurate test results.

10 10 Education Vector Borne-Blood Suckers Monday, February 20 th, 2017 Wet Prep Class Wednesday, March 15 th, 2017 TB or Not TB? Wednesday April, 11 th, 2017 Basic Phlebotomy Techniques: The First Step in Quality Patient Results Friday, January 27, 2017 Friday, March 31, 2017 Friday, June 30, 2017 Friday, September 29, 2017 Friday, November 10, 2017 Information to register will be available approximately 6 weeks prior to the date each class. If you have questions or if you would like more information regarding HML continuing education classes please us at hmledu@healtheast.org