Effective October 3, 2023, the orderable Complete Blood Count (CBC) with Manual Differential [LAB2111032] will be discontinued and Manual Differential, Blood [LAB815] will be made a Lab Only Orderable.
Test Utilization
Effective September 13, 2023, Corewell Health Laboratory will discontinue the Chlamydia Culture orderable. For patients 14 years of age and older, please order Chlamydia PCR.
• This specimen can be either a swab (genital, rectal, or throat) or a urine sample.
• The collection container is the STD-Multi-Collection Kit.
• For more information please visit: Chlamydia PCR
For patients that are under 14 years of age, a “Reference Miscellaneous Test” [LAB 848], must be ordered.
• This specimen can be either a swab (genital, rectal, or throat) or a urine sample.
• The collection container is the Aptima
• For more information please visit: APTIMA Chlamydia, NAAT, ThinPrep, Swab, Urine
As a reminder, PCR testing is also preferred for gonorrhea, when the specimen types are compatible.
Effective August 30, 2023, the COVID-19 Total Antibody test, which includes the qualitative detection of spike and nucleocapsid antibodies against COVID-19, will be discontinued as an orderable test at Corewell Health West Laboratories. Symptomatic patients suspected to have acute COVID-19 infection should be tested using a molecular assay.
To aid in the clinical diagnosis of multisystem inflammatory syndrome in children or adults (MIS-C or MIS-A), the COVID-19 IgG, Qualitative by CIA will be available as a send out test. This test is a qualitative detection of IgG antibodies against the nucleocapsid protein of COVID-19 that develop in response to natural infection with COVID-19. This test is performed on Monday, Wednesday, and Fridays, and reported within 1-5 days.
Webinar: Optimizing Care of the Respiratory Patient – The Role of Specific IgE Testing
It’s the season of sunshine and blooms which also means it can be a season of sneezing, itching, and a lot of trouble getting a good breath in for some.
⇒Are you prepared to meet the needs of your patients that may be suffering from some of these symptoms?
⇒Are you well versed in the difference between a sensitivity and a clinical allergy and how you can differentiate between the two?
⇒Do you know the resources we have at Corewell Health to assist in these determinations?
Monoclonal gammopathies are characterized by the secretion of a monoclonal protein or M-protein. A wide variety of conditions can produce an M-protein, and the initial screening and monitoring of these patients require an array of tests. Herein we described best practices for protein electrophoresis ordering at Corewell Health.
The test Pathologist Review Peripheral Smear [LAB7550] will become a lab only orderable in the near future. Effective, Monday, May 1, 2023, all provider ordered pathology smear reviews on outpatients will be cancelled by the hematopathologist. If a pathologist interpretation of the blood smear is still desired, please order a Pathology Consult [LAB1230850], ask for a “general pathology consult” and indicate your question for the pathologist who will be interpreting the blood.
For Corewell Health West Epic Providers (Epic Hyperspace, Epic Community Connect and Epic Care Link) a tip sheet is available for ordering in Epic. If you cannot access the tip sheet or have further questions, please use the contact us link above.
TEST INFORMATION:
Pathology Consult [LAB1230850]
Pathologist Review Peripheral Smear (lab only orderable) [LAB7550]
This winter, West Michigan influenza infections peaked in December 2022 and significantly declined throughout February and March 2023. Now with a low prevalence of circulating influenza, using the most sensitive diagnostic test is recommended in order to obtain accurate and actionable results. Influenza antigen testing (e.g. Sofia instrument) is no longer appropriate at this time and Influenza PCR testing should be ordered when clinically indicated.
Inform: RSV Testing – Age Restrictions
Respiratory syncytial virus (RSV) primarily infects pediatric patients, but occasionally infects adults and may be of particular concern for the elderly and immunocompromised. Corewell Health Laboratories offers two tests for RSV. A rapid antigen test may be used to confirm RSV diagnosis in pediatric patients. This test is not approved by the FDA for testing adult patients, so tests will be cancelled if ordered on an off-label age group. There are no age restrictions for RSV testing by way of a molecular panel that also includes COVID and influenza as viruses with overlapping symptoms.
Test name | Epic Test ID | Methodology | Specimen | Age restriction |
RSV Rapid | LAB495 | Antigen | Nasopharyngeal (NP) swab | Approved for patients 0 – 18 years of age |
COVID, Influenza, RSV PCR | LAB1230746 | Molecular/PCR | Nasopharyngeal (NP) swab | No age restriction |
Influenza cases numbers are currently increasing throughout West Michigan. Influenza prevalence guides the most appropriate testing approach and sufficient prevalence has now been reached for influenza rapid antigen testing (e.g. Sofia instrument) to have improved performance. The use of rapid antigen testing as a screening method during high prevalence reduces both the cost to the patient and turn-around-time as compared to lab-based molecular methods. Rapid antigen tests generally have high analytical specificity, but lack the sensitivity of nucleic acid amplification methods (e.g. PCR). For this reason, PCR testing is still recommended for hospitalized patients and for outpatients with a negative antigen result if influenza is still suspected and if the result will impact clinical decision making.