July Billing and Compliance. Chemistry. Help Us Help You. Referral Testing

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Arlene Wheeler
5 years ago
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and cancellations; Hepatitis C testing Referral Testing Adenovirus IgG antibody Coxsackie A Ab panel Coxsackie B Ab

1 July 2018 Billing and Compliance New Medicare card mailings have begun for Minnesota and Wisconsin residents Chemistry Beta hydroxybutyrate, whole blood specimen requirement change Help Us Help You Preventing duplicate orders and cancellations; Hepatitis C testing Referral Testing Adenovirus IgG antibody Coxsackie A Ab panel Coxsackie B Ab panel Echovirus antibody panel Giardia lamblia IgG, IgA, IgM Ab Rickettsial disease panel Tick analysis and identification by PCR

BILLING AND COMPLIANCE New Medicare card mailings have begun for Minnesota and Wisconsin residents The mailing of new Medicare cards for Minnesota and Wisconsin residents has now started.

2 BILLING AND COMPLIANCE New Medicare card mailings have begun for Minnesota and Wisconsin residents The mailing of new Medicare cards for Minnesota and Wisconsin residents has now started. Mailing of the new cards will take at least one month to complete. Centers for Medicare & Medicaid Services (CMS) is removing Social Security (SSN) numbers from Medicare cards and replacing them with a new Medicare Beneficiary Identifier (MBI) unique to them to help prevent fraud and combat identity theft for people with Medicare benefits. The new Medicare numbers will not change Medicare benefits, and patients can begin using their new cards as soon as they get them. The photo above shows what the current Medicare card looks like, and what the new Medicare card will look like. People with Medicare can check the status of card mailings in their area on go.medicare.gov/ newcard or sign up to get an when their card mails. They can also look up their MBI by logging in to mymedicare.gov. 2

3 CHEMISTRY Beta hydroxybutyrate, whole blood specimen requirement change Effective July 17, 2018, the preferred specimen for the Beta Hydroxybutyrate, whole blood assay (12724/ ) changed from Na Heparin whole blood to Li Heparin whole blood. Previous NEW Collect: 5.0 ml Na Heparin whole blood - dk green 5.0 ml Li Heparin whole blood - dk green Alternate Collect: Container: Processing: Transport/ Stability: Collection/ Processing Details: 5.0 ml Li Heparin whole blood - PST Do not spin Dk green (Na Heparin) or Plasma Separator (PST) tube, UNSPUN Submit entire specimen Do not open and do not spin. Refrigerated - 30 minutes Time sensitive Test must be run within 30 minutes of collection. Bring specimen to department immediately after collection. This test is available at: the Central Laboratory, Buffalo, Cambridge, District One, Mercy, New, Ulm, Owatonna, Regina, River Falls, St. Francis, Unity, United Hospitals, and WestHealth. Clients who cannot get the specimen to one of these sites within 30 minutes of collection should order the Beta Hydroxybutyrate, Serum (994/LAB994) referred to Mayo Medical Laboratories (MML). Note differing specimen collection/transport requirements 5.0 ml Li Heparin whole blood - PST 5.0 ml Na Heparin whole blood - dk green Dk green (Li or Na Heparin) or Plasma Separator (PST) tube, UNSPUN No change No change No change HELP US HELP YOU Preventing duplicate orders and cancellations; Hepatitis C testing In order to prevent duplicate test orders, when ordering a Hepatitis C virus with reflex, (527) it is not necessary to order an HCV RT-PCR Viral load (5940) also, as test will automatically reflex when appropriate. If the viral load is ordered in addition to the HCV w/ reflex, duplicate orders will be created. 3

4 REFERRAL TESTING Adenovirus IgG antibody Mayo Medical Laboratories (MML) has shared that effective July 31, 2018, the Adenovirus IgG antibody assay (1807/ ) will become obsolete. Because antibodies to Adenovirus may remain elevated for months to years following recovery from an active infection, the clinical utility of this methodology for diagnosis of infections with Adenovirus is limited. MML offers Polymerase chain reaction (PCR) testing which features improved clinical sensitivity and specificity when compared to serologic methodologies. The following PCR test will be available and is recommended to assist in the diagnosis of adenovirus infections: Adenovirus DNA by rapid PCR, plasma 994/LAB994, MML# LCADP Coxsackie A Ab panel Mayo Medical Laboratories (MML) has shared that effective July 31, 2018, the Coxsackie A Ab panel assay (390/LAB390) referred to Quest Diagnostics Disease Laboratory, will become obsolete. Communications from MML indicate that diagnosis of central nervous system infection with Coxsackie A virus, or other enterovirus, should be performed using a molecular assay able to detect this family of viruses. Polymerase chain reaction (PCR) methods offer improved clinical sensitivity and specificity when compared to serological methodologies. MML offers the following PCR test for the detection of enterovirus: Enterovirus RNA PCR, plasma 994/LAB994, MML# ENTP Coxsackie B Ab panel Mayo Medical Laboratories (MML) has shared that effective July 31, 2018, the Coxsackie B Ab panel assay (1818/LAB1818) referred to Quest Diagnostics Disease Laboratory, will become obsolete. Communications from MML indicate that diagnosis of central nervous system infection with Coxsackie B virus, or other enterovirus, should be performed using a molecular assay able to detect this family of viruses. Polymerase chain reaction (PCR) methods feature improved clinical sensitivity and specificity when compared to serological methodologies. MML offers the following PCR test for the detection of enterovirus: Enterovirus RNA PCR, plasma 994/LAB994, MML# ENTP 4

5 Echovirus antibody panel Mayo Medical Laboratories (MML) has shared that effective July 31, 2018, the Echovirus antibody panel assay (1819/LAB1819) referred to Quest Diagnostics Disease Laboratory, will become obsolete. Communications from MML indicates that because Polymerase chain reaction (PCR) methods feature improved clinical sensitivity and specificity when compared to serological methodologies, the diagnosis of echovirus infection, or infection with other enterovirus, should be performed using a molecular assay able to detect this family of viruses. MML offers the following PCR test for the detection of enterovirus: Enterovirus RNA PCR, plasma 994/LAB994, MML# ENTP Giardia lamblia IgG, IgA, IgM Ab Mayo Medical Laboratories (MML) has shared that effective July 31, 2018, the Giardia lamblia IgG, IgA, IgM Ab panel, referred to Quest Diagnostics Infectious Disease Laboratory, will become obsolete. Because antibodies to Giardia lamblia can remain detectable for months, or even years, following resolution of disease, detection of antibodies to this parasite may not indicate acute disease. The following alternate test is recommended: Giardia antigen 6695/ Rickettsial disease panel Mayo Medical Laboratories (MML) has shared that effective July 31, 2018, the Rickettsial disease panel, referred to Quest Diagnostics Infectious Disease Laboratory, will become obsolete. MML recommends targeted test ordering based upon the patient s potential exposure history, in place of this test panel. The following tests are recommended: Murine Typhus Ab, IgG 994/LAB994, MML # FMTAG Q fever IgG + IgM Ab 308A/LAB308A Spotted fever group 994/LAB994, MML # SFGP 5

6 Tick analysis and identification by PCR Mayo Medical Laboratories (MML) has shared that effective July 31, 2018, the Tick analysis and identification by PCR (994/LAB994, MML # FFTIK), referred to IMUGEN, Inc, will become obsolete. According to MML, Ixodes scapularis ticks (black-legged/deer ticks) may carry Borrelia burgdorferi, the causative agent of Lyme disease and/or Babesia microti, the causative organism of human Babesiosis. They share that testing for the presence of infections agents within the tick body itself is not recommended by the Center for Disease Control (CDC) as it is not directly correlated to the presence or absence of infection in the patient. Also, male ticks do not bite humans, and the test does not differentiate male or female. The following tests are recommended for the detection of B. burgdorferi and B. microti. Babesia species 8076/LAB8076 Ehrlichia/Anaplasma PCR 2780/LAB2780 Lyme disease serology, polyvalent, w/ reflex 659/LAB659 Tick-borne panel, molecular detection, PCR 994/LAB994, MML # TKPNL Thank you for choosing Allina Health Laboratory - we value your business! 6

Seroprevalence of Babesia microti in Individuals with Lyme Disease. Sabino R. Curcio, M.S, MLS(ASCP)

Seroprevalence of Babesia microti in Individuals with Lyme Disease Sabino R. Curcio, M.S, MLS(ASCP) Lyme Disease Most common vectorborne illness in the United States Caused by the tick-transmitted spirochete