General Information

Introduction

Greenville Pathology, P.A. is dedicated to providing the best pathology services possible. The quality of the results from lab testing is dependent upon the proper collection and subsequent handling of each specimen. This booklet is provided to help your office collect, package, and transport your patient’s specimens.

Greenville Pathology, P.A. will only accept those specimens submitted by providers licensed to practice medicine in their appropriate field of medicine.

Please note that if ever there is a change in the laboratory result that creates a significant difference in the interpretation of test results, a comprehensive explanation will be made to any affected client immediately.

Members of our staff are available for medical and technical consultation at your request. Feel free to contact us whenever necessary.

As new technologies emerge, we will strive to offer these services to your patients. Because the medical field changes so rapidly, all of the available tests may not be listed in your version of the Directory of Services, so please feel free to call the office to inquire about additional ancillary services.

Supplies

All supplies necessary for submitting specimens are provided to clients as part of our service to you. The type/quantity of supplies must correlate with the type/number of specimens submitted to Greenville Pathology, P.A. for testing.

To order supplies:
Click here 
Send a request via your courier
Call our lab at 252-561-7992 extension 4 or 0
Fax us at 252-561-7993, Attention: Linda

Health and Safety Precautions

As always, every specimen should be handled as though it were infectious. The most serious risk to healthcare workers is exposure to blood and body fluids containing the Human Immunodeficiency Virus (HIV) and hepatitis viruses. Information regarding safe specimen handling may be obtained from the U.S. Occupational Safety and Health Administration  (OSHA) and the Centers for Disease Control and Prevention (CDC). Because leaking containers pose a health hazard, all specimens must be placed in a well-constructed container with a secure lid and then placed in specimen bag. Care should also be taken when collecting each specimen to prevent contamination of the exterior of the specimen container and accompanying requisition. Specimens in syringes, with needles, are not allowed by law to be transported. Please properly discard used needles or other sharps prior to transport.

Proper Identification of Specimens

All specimen containers and slides must be labeled with two unique identifiers at the time of collection. Examples of acceptable identifiers include but are not limited to:

1. Patient Name
2. Medical Record Number
3. Date of Birth

All surgical pathology specimen containers also require a specific anatomic site/source. Specimens must be accompanied by a paper requisition, prepared either by hand or printed. During the collection procedure, keep the requisition free of contamination and place it in the side pouch of the specimen transport bag. The requisition should include:

1. Patient name
2. Date of Birth
3. Sex
4. Medical Record Number
5. Social Security Number
6. Collection Date
7. Submitting Provider’s Name
8. Insurance Information with ICD10 code
9. Anatomic Site/Source of Tissue
10. Pertinent clinical impression and information

Instructions for completing Greenville Pathology, P.A. Paper Requisitions

1. The preprinted information in the upper right hand corner will include:
   • The name and phone number of your facility.
   • A cryptic interface abbreviation (for Greenville Pathology, P.A. use only). This information is identical to our computer data for reporting and billing purposes. Please notify us of any changes as soon as possible.
2. Patient information section should include:
   • Last and first name PRINTED
   • Any name change within the last five (5) years. (i.e., marriage, divorce)
   • Birth date/sex/race
   • Medical record number or patient ID number.
   • Social security number
   • Collection date of specimen
3. The financially responsible party section, must include:
   • Name and address and phone number (including area code) of the financially responsible party.
   • The Submitting Provider (please use the name as it would be used on the NPI website)
   • Referring Provider
   • If additional physicians or institutions need a copy of the report, please designate under “Copy to”.
4. Priority status
   • If you want the results called or faxed, please fill in the information on the requisition.
   • RUSH status-check the box on the top of the form
5.  Billing
   • Check the desired type of billing
   • An appropriate ICD-10 code or diagnosis must be provided.
   • Billing Information
     • Provide all insurance information, including any photocopies available
     • If no insurance is available, note patient/self pay and provide all demographic information for patient contact
   • Medicare (routine or diagnostic) or Medicaid-check the appropriate box. (If choosing Medicare, the patient must sign the non-covered services statement located on the left side of the requisition directly above the header “Cytology GYN”)
6. Insurance Information
   • If the patient has Medicare and/or Medicaid, please provide a complete ID # on the appropriate line. (If either of these are secondary to other provided insurance, please specify)
   • For primary or secondary insurance, the following information is needed:
     • Insurance company name
     • Insurance company address
     • Policy # in full
     • Group # if applicable
     • Subscriber name
     • Employer of the subscriber
7. Specimen Information-Choose and complete the appropriate section
   • Cytology-Gyn: Please include the following information:
     • If the specimen is “ThinPrep®”, check the appropriate box.
     • The source of the specimen (i.e. vaginal, cervical, endocervical)
     • Last menstrual period (LMP)
     • Result of previous pap smear.
     • Number of slides if conventional.
     • Check all that apply for clinical information, previous history (i.e. oral contraceptives, postmenopausal bleeding, pertinent procedures or treatments).
   • Molecular Pathology: Please utilize any applicable sections or free text fields
   • Cytology-Non-Gyn Section must include source of specimen and any pertinent clinical history
   • Histology Section: Please include the following information:
     • Date of operation
     • Clinical information, pertinent history or operative findings
     • A pre-operative diagnosis
     • A post-operative diagnosis
     • Operation performed-The source(s) of the specimen(s), indicate the type of tissue, (i.e. skin, lymph node) and the anatomic site from which the tissue was removed (i.e. arm, cervix)
     • Special studies required (i.e. special stains, DNA analysis, etc.)

Completing all the information on the requisition provides the laboratory with information necessary to process the specimen appropriately.

Unacceptable Specimens

Greenville Pathology, P.A. can only perform tests on properly labeled specimens. It is equally important that requisition forms be filled in completely and accurately. There are a number of conditions that will cause a specimen to be considered “unacceptable”, including:

• Specimen and/or requisition received without a patient name
• Empty specimen container
• Name on specimen container and name on requisition do not match
• Specimens received without a requisition
• Requisition received without a specimen
• Multiple specimens received on one patient without specific identification of source on each specimen.
• Any specimen beyond its specific processing life (please refer to particular collection requirements).

Any specimen received with any of the above listed criteria will be given an accession number and logged into the computer as “TNP” (Test Not Performed). A report will be issued showing that the specimen was not processed and the reason for rejection will be listed. The specimen along with the original requisition and a copy of the report will be re-bagged and returned to you. After you have received the rejected specimen, please correct the problem and send the specimen and the original requisition back to us. We will make every effort to expedite its processing.

Billing

The extent of tissue examination can be determined only at the time that the pathologist examines the specimen. The fee for our services will vary based on the number of specimens, size and complexity of the specimen and difficulty of diagnosis. The fees for our service and submission of bills to patients, and third parties will be based upon Current Procedural Terminology. Surgical Pathology CPT Codes encompasses procedures 85060 through 89399. Please refer to Physicians Current Procedural Terminology, American Medical Association, P.O. Box 10946, Chicago, Illinois 60610.

Routine Handling Procedures

• We strongly recommend that you submit only one specimen per container. However, if multiple specimens are placed in one container, differentiate them by noting their size or by marking with a suture.  In any case, only one requisition form is needed for multiple specimens.  Just be sure to identify each specimen on the request separately.
• Be careful when handling a freshly collected specimen not to crush it with hemostats, forceps or other instruments.
• Do not allow specimens to dry out. For specimens not requiring special studies such as flow cytometry, place each specimen in an appropriately sized container of 10% neutral buffered formalin.  Formalin must surround the entire specimen for it to receive proper fixation.
• Keep all specimens at room temperature unless otherwise noted on the specimen requirements.
• A Greenville Pathology, P.A. courier will pick up specimens from your office daily or on a “call-in” basis depending on your office needs.

Specimens with Special Submission Requirements

• Bone Marrow: Submit six air-dried bone marrow smears, two peripheral blood smears and blood clot containing marrow particles and/or bone marrow core biopsy.  Fix bone marrow clot and/or biopsy in 10% formalin.  Keep marrow smears and clot in separate airtight containers, as fixative fumes interfere with staining and make interpretation difficult.  Include CBC results and other pertinent clinical data.
• Breast: Breast biopsies should be placed in 10% formalin within one hour of resection.  The time of removal of the tissue from the patient and the time of immersion of the tissue in formalin should both be recorded on the patient’s requisition.
  • If a frozen section is needed, then submit the specimen on a saline-soaked gauze and call 252-561-7992, press “2” or “0” for immediate pick up.
• Lymph Nodes: Lymph nodes should be submitted fresh on saline-soaked gauze and stored in the refrigerator until pick up.  Do not place in any fixative.  Call 252-561-7992 and then press “2” or “0” for immediate pick up.
• Nails: For the analysis of nail clippings or scrapings, collect the fragments in a sterile urine cup with no fixative.  Greenville Pathology, P.A. will provide the sterile urine cups if needed.  Please specify on the requisition if a culture is needed in addition to histological examination.  If both culture and histology are requested, please submit more than one fragment in the sterile urine cup and we can divide the specimen at Greenville Pathology, P.A.  We need more than one fragment because we do not have sterile scalpels in our lab to cut the nails with.
• Frozen Sections: Tissues submitted for frozen section diagnosis must be prevented from drying out.  Saline-soaked gauze works well.  Do not submerge tissue in any type of fixative.  If the specimen’s anatomic orientation is critical to the diagnosis, make sure to include clear instructions or markings.  Contact the lab for immediate pick up by dialing 252-561-7992.  Then press “2” or “0”.
  • Note:  Scheduling Frozen Sections – Whenever possible, schedule frozen sections in advance by calling 252-561-7992, then press “1”.  You will be connected with someone who will help you arrange a convenient time.
• Special Stains and Immunoperoxidase Studies:These studies may be requested on the patient requisition
• Gross Examination Only:These studies may be requested on the patient requisition
• Microbiology Cultures:Greenville Pathology, P.A. does not provide this service.  Please consult the laboratory with which you have contracted to handle clinical laboratory tests.
• Kidney Stones or Calculus Analysis: Place these air-dried specimens in a clean dry urine cup or other small container with no saline or fixative
• Cytogenetics Request: Specimen can be submitted at room temperature or kept in the refrigerator if immediate pick up is not possible.  Do not freeze or put on ice.  Do not place specimens in formalin, saline, or any other transport media.  Immediately after the specimen is collected, call Greenville Pathology, P.A. at 252-561-7992, then press “2” for STAT pick up.  When filling out the requisition form, include all pertinent clinical information including length of gestation or LMP, previous pregnancies and their outcome, family history or suspected chromosomal anomaly.
• Flow Cytometry: Place fresh specimens on saline-soaked gauze in a sterile container and keep refrigerated until it is picked up.  Call Greenville Pathology, P.A. at 252-561-7992, and then press “2” for STAT pick up.
• Muscle Biopsies: Muscle tissue should be secured in a special muscle clamp if possible and placed on saline-soaked gauze.  Contact Greenville Pathology, P.A. for immediate pick up by dialing 252-561-7992, then press “2” or “0”.