The following information was updated in the Lab Catalog.
Compliance & Safety, Education & Training, General Information, Test Utilization
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Test Utilization
General Information, Microbiology, Test Utilization
Discontinuation of Placenta Microbiology Cultures
As of April 12, 2022, Spectrum Health Laboratory will no longer add microbiology cultures to placental tissues received based on paper requisition forms.
Viral and bacterial cultures from placental tissue are rarely clinically beneficial and are no longer the gold standard diagnostic approach due to the relative insensitivity of culture methods.
If viral studies are desired (possible indications could include known CMV exposure with positive IgM or intrauterine fetal demise at < 28 weeks), then molecular testing is the recommended diagnostic approach. HSV and CMV PCR tests may be ordered in Epic.
• Herpes Simplex 1/2 Qualitative PCR, Tissue (LAB1230413)
• Cytomegalovirus (CMV) Qualitative PCR, Tissue (LAB1230291)
Bacterial cultures are challenging to interpret since they typically grow normal genital flora and histopathological analysis used to diagnose acute chorioamnionitis correlates poorly with growth from bacterial placenta cultures. If indicated, culture and PCR tests may be ordered in Epic.
• Metamycoplasma hominis, Molecular Detection, PCR, Varies (LAB848)
• Ureaplasma species, Molecular Detection, PCR, Varies (LAB848)
Placenta tissues sent to the lab in formalin are not acceptable for PCR or culture orders.
Education & Training, General Information, Test Utilization, Uncategorized
Specimen Collection and Test Updates – March 2022
The following information was updated in the Lab Catalog.
Education & Training, General Information, Test Spotlight, Test Utilization
Webinar: Managing Rhinitis Patients and the Role of Specific IgE Testing
LIVE Webinar –Managing Rhinitis Patients and the Role of Specific IgE Testing, available at Spectrum Health!
Featuring Guest Speaker Scott Duhaime, MPAS, PA-C
Please join us for a 30-minute webinar on the importance of the primary care providers’ role in regard to managing patients suffering with symptoms consistent with rhinitis—itchy watery eyes, runny nose, and congestion.
We are offering two training webinars for all providers and clinical staff on March 24th.
The goal of this webinar is to address:
♦ Importance of ruling in and ruling out allergies
♦ Debunking misconceptions around managing rhinitis
♦ Simplified patient care management
♦ Qualified referral
Education & Training, General Information, Test Utilization
Specimen Collection and Test Updates – February 2022
The following information was updated in the Lab Catalog.
Advanced Technology Laboratory, General Information, Main lab, Test Utilization
Outpatient Respiratory Viral Testing
Spectrum Health Lab has noticed an increase in outpatient orders for Respiratory Pathogens by Film Array [LAB3359]. This may be due to a shortage of supplies for some Point of Care (POC) testing platforms. Film Array is typically used for emergency and high acuity patients and therefore has a high cost that may not be covered by most patients’ insurance. To lesson out of pocket costs for your patients, please order the below for RSV, COVID, or Flu testing.
The mitigation strategies enacted during the COVID-19 pandemic to reduce the spread of this virus have also impacted the transmission of other respiratory viruses. Influenza is typically prevalent during the winter months (December through March), however, influenza cases were essentially non-existent during the 2020-2021 season and influenza is not currently circulating in our community.
In the absence of circulating influenza activity, it is recommended to use the most sensitive diagnostic test in order to obtain accurate and actionable results. Influenza antigen testing (e.g. Sofia instrument) is not appropriate at this time. More detailed information can be found as published by the CDC: Algorithm to assist in the interpretation of influenza testing results and clinical decision-making during periods when influenza viruses are NOT circulating in the community
| Low Influenza prevalence |
High influenza prevalence |
|
| Recommended order | Influenza PCR (LAB3255) | Influenza Rapid Antigen (LAB2111530) or Influenza PCR (LAB3255) |
TEST INFORMATION
| Test name | Epic code | Interface EMR Code | CPT Code |
| Influenza PCR | LAB3255 | 11594 | 87502 |
| Influenza Rapid Antigen | LAB2111530 | 11208 | 87804 x4 |
Effective September 15, 2021, Spectrum Health’s Epic will contain new ask-at-order questions to help improve clinical decision support and appropriate utilization of stool ova and parasite (O&P) testing. O&P testing may be used to diagnose several parasitic infections, though the staining of stool smears and their microscopic review is very labor intensive for laboratories. Historically, O&P testing has been widely ordered for patients with diarrhea, however, there are now other testing options able to detect the most common pathogens associated with community-acquired diarrhea. While Enteric Pathogens PCR and Giardia/Cryptosporidium testing is more appropriate for the identification of common bacterial/viral and parasitic pathogens, respectively, O&P testing should be reserved for patients with specific exposure or immune status criteria.
The Pharmacy and Infectious Disease Stewardship Committee has endorsed the following order criteria for O&P testing. If any of these criteria are met, then then order can be placed.
♦ Past foreign residence or recent foreign travel followed by at least 2 weeks of diarrhea.
♦ Immunocompromised status.
♦ Unexplained microcytic anemia or peripheral eosinophilia.
♦ Unique exposure (daycare, MSM, waterborne outbreak, etc.)
Note: If no criteria are met, cancel the order and consider Giardia/Cryptosporidium Screen (LAB258) or Enteric Pathogens PCR testing (LAB3618).
Please direct question to the Contact Us link above.
TEST INFORMATION
Ova and Parasites, Complete – Epic: #LAB9550, Interface Code #50033, CPT #87328, 87329, 87177, 87209
Enteric Pathogens by PCR – Epic #LAB3618, Interface Code #55078, CPT #87506
Giardia/Cryptosporidium Screen – Epic #LAB258, Interface Code #50025, CPT #87329, 87328