IN-NETWORK STATUS WITH UHC & AETNA

Several of our clients have received notices stating LabCorp and Quest have exclusive contracts with UHC and Aetna. It is our understanding that these announcements were specifically directed towards other national laboratories and are not applicable to local facilities. Physicians Laboratory wants to assure our clients that we are still in-network with UHC and Aetna. You do not need to send these samples to LabCorp and Quest for testing. If you have any questions, please call Kacey Moreland at 402-731-4145.


 

RAPID MOLECULAR STOOL TESTING AT PHYSICIAN LABORATORY

Physicians Laboratory Microbiology Department is now offering the Verigene® Enteric Pathogens Test (EP), a rapid PCR test to replace traditional stool culture. Verigene EP confirms negative samples and identifies positives in only 2 hours, resulting in faster and more sensitive results for clinicians and their patients. Most importantly, Molecular PCR testing has been shown to be up to twice as sensitive as current stool culture methods. 1

After January 25th, PLS (in- house) stool culture testing will no longer be performed. All requests for stool culture after this date will be forwarded to an outside reference lab. Test turn-around time and pricing will be affected.

Bacteria
Campylobacter Group (C. coli, C. jejuni and C. lari)
Salmonella spp.
Shigella spp.
Vibrio Group (V. cholerae and V. parahaemolyticus)
Yersinia enterocolitica
Viruses
Norovirus (GI and GII)
Rotavirus A
Toxins Shiga Toxin 1 (stx1)
Shiga Toxin 2 (stx2)

Note: When Shigella species is detected, an automatic reflex to culture isolation and susceptibility testing will occur

Rotavirus #324, Shiga toxin 1&2 #675, and Norovirus by PCR # 9339, will also be available as stand-alone tests using this same test methodology. CPT code 87798 – Client price: $100

Please contact Jean Fisher or Kayleigh Griffin in the Microbiology Department with any questions. 402-731-4145

Enteric Pathogens Panel by PCR #8446
CPT code: 87506
Client price: $150
Required sample:
Para-Pak C&S transport (orange vial) or Cary- Blair equivalent
Fill sample volume to red line only.
Overfilled samples will be rejected.
Stability:
48 hours refrigerated, preferred
Samples delayed >48 hours can be frozen.

1 Novak and Marlowe, Clinical Virology Symposium 2014 Poster: Evaluation of the Verigene EP IUO Test for the Rapid Detection of Bacterial and Viral Causes of Gastrointestinal Infection, Tuesday, April 29, 2014.


 

LAVENDER TUBES NO LONGER ACCEPTED FOR METALS TESTING

Effective November 12, 2018, Physicians Laboratory will no longer accept lavender tubes for any metals testing.
This includes:

820 Arsenic, Blood
1937 Cadmium, Blood
2408 Cobalt, Blood
1788 Heavy Metals Panel 3, Whole Blood
2816 Lead, Blood (Venous)
811 Lead, Industrial Exposure Panel, Adults
7941 Magnesium, RBC
9200 Manganese, Whole Blood
627 Mercury, Whole Blood

For all of the tests indicated above a BD Vacutainer Royal Blue (K2EDTA) Tube must be submitted. Testing will be cancelled if a lavender tube or noncertified trace element free transport tube is submitted.

 


 

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