WELLCARE OF NEBRASKA REQUIRES PREAUTHORIZATION
FOR ALL HPV TESTING

Wellcare of Nebraska requires preauthorization for all HPV testing. This includes both HPV High Risk Screen (CPT87624) and HPV Genotyping 16 & 18/45 (CPT 87625). Physicians Laboratory has contacted Wellcare on several occasions and provided documentation showing the current ACOG, ASCCP, and US Preventative Services Task Force recommendations for HPV testing; however, this policy has not been overturned. Please contact your Wellcare representative if you have concerns regarding this requirement.

 


 

QUANTIFERON TB GOLD – TEST #9711 NOW REQUIRES NEW TEST KIT
EFFECTIVE JUNE 18TH

The additional tube (TB 2 antigen) detects CD8+ TCell IFNg production and enhances sensitivity of the assay, especially in those patients with recent exposure to Mycobacterium tuberculosis. Please collect 1 ml of blood by venipuncture directly into each of the four QuantiferonTB Plus blood collection tubes using only a vacutainer or syringe. The four tubes will consist of a gray cap (nil control), green cap (TB1 antigen), yellow cap (TB 2 antigen), and purple cap (mitogen positive control). It is recommended to collect in the following order: gray cap, green cap, yellow cap, and purple cap. Please call client services to order new kits.


 

PROCALCITONIN #7497 NOW PERFORMED IN‐HOUSE
EFFECTIVE IMMEDIATELY

Procalcitonin is a prohormone ubiquitously and uniformly expressed in multiple tissues throughout the body in response to sepsis. In healthy conditions, the PCT levels in circulation are very low (<0.05 ng/ml). Elevated circulating levels of PCT are important indicators in response to microbial infections and a powerful tool in the early detection of sepsis. PCT increases approximately 3 hours after bacterial infection, reaching maximum values after 612 hours with a halflife of 2530 hours. Elevated PCT may not always be caused by systemic bacterial infection. Certain patient characteristics, such as severity of renal failure or insufficiency, may influence Procalcitonin values and should be considered as potentially confounding clinical factors when interpreting PCT values.

Increased PCT levels may be observed in severe illness such as polytrauma, burns, major surgery, prolonged or cardiogenic shock. If there is a disagreement between the laboratory findings and the clinical signs, additional tests should be performed.

Specimen requirements:

     

Serum, EDTA or Heparinized Plasma separated from cells ASAP Refrigerated 72 hours or Frozen 3 months

Reference Range:

 

<= 0.5 ng/mL – Low risk of severe sepsis. Antibiotics discouraged
0.52.0 ng/mL – Increased likelihood for sepsis. Antibiotics encouraged
>2.0 ng/mL – High risk for sepsis/septic shock. Antibiotics strongly encouraged.


 

B. PERTUSSIS AND PARAPERTUSSIS #8201 ~ TEST METHOD & CPT CHANGE
EFFECTIVE JULY 1ST

PLS (inhouse) lab developed Bordetella testing will change to FDA approved ARIES® Bordetella Assay on July 1st. The ARIES® Bordetella Assay is a realtime PCR qualitative in vitro diagnostic test for the direct detection and identification of Bordetella pertussis and Bordetella parapertussis nucleic acid obtained from individuals suspected of having a respiratory tract infection attributable to B. pertussis or B. parapertussis.

Specimen Collection: Nasopharyngeal Swab in M4 Media or Universal Transport Media

Stability: Refrigerated 7 Days

CPT CODE CHANGE: 87798x2