october 2014 • volume 2 - Health Network Laboratories

LAB-LINK
VOLUME 2 • October 2014
Health Network Laboratories
2024 Lehigh Street
Allentown, PA 18103
877-402-4221 • www.healthnetworklabs.com
As your laboratory partner,
Health Network Laboratories is
In This Issue
pleased to keep you
TABLE OF CONTENT............................... 2
connected to new and updated
ADDITIONAL INFORMATION............... 3-8
laboratory testing information.
CPT (Current & Procedural Terminology) is a trademark of the AMA. Codes listed are guidelines and are for informational
purposes only. Coding questions should be directed to the third party payor and/or the AMA. OIG guidelines recommend
tests ordered should be reasonable and necessary for the patient, given their clinical condition. Physicians who order medically
unnecessary tests for which Medicare reimbursement is claimed may be subject to penalties. Individual components of profiles
or panels may be ordered individually at an additional charge. Physicians who consider Reflex testing unnecessary may order an
initial test without the Reflexed test. Reflex or confirmation tests are performed at an additional charge.
Health Network Laboratories 877-402-4221Page 1 of 8October 2014
Test Name/Subject
2024 Lehigh Street • Allentown, PA • 18103-4798
(610) 402-8170 • Toll Free (877) 402-4221
www.healthnetworklabs.com
Effective Date
ADDITIONAL INFORMATION
vonWillebrand Disease Testing Guideline
09/01/2014
MEDICARE Information
TEST CHANGE Information
RESPIRATORY VIRUS UPDATE – ENTEROVIRUS D68
SEASONAL FLU TESTING
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2024 Lehigh Street • Allentown, PA • 18103-4798
(610) 402-8170 • Toll Free (877) 402-4221
www.healthnetworklabs.com
ADDITIONAL INFORMATION
vonWillebrand Disease
von Willebrand Disease is the most common congenital bleeding disorder.
vWD may result from either a quantitative (Types 1 and 3) or qualitative (Type 2) abnormality of von
Willebrand factor.
HNL has developed the following guideline to assist in the proper test selection and result interpretation
for suspected von Willebrand Disease. (Please see next page for guideline.)
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For more information, please contact Kim Pacella at 877-402-4221
2024 Lehigh Street • Allentown, PA • 18103-4798
(610) 402-8170 • Toll Free (877) 402-4221
www.healthnetworklabs.com
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For more information, please contact Kim Pacella at 877-402-4221
2024 Lehigh Street • Allentown, PA • 18103-4798
(610) 402-8170 • Toll Free (877) 402-4221
www.healthnetworklabs.com
ADDITIONAL INFORMATION
MEDICARE Information
PLEASE NOTE: the Welcome to Medicare visit and Annual Wellness visit does not include laboratory
testing. All laboratory testing still follows all the routine/preventative services and diagnostic testing
NCD/LCD guidelines. Links to these guidelines are provided below. There is no special laboratory
coverage for these visits.
Welcome to Medicare Visit
http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MPS_QRI_IPPE001a.pdf
(From page 4)
Are clinical laboratory tests part of the IPPE?
No, the IPPE does not include any clinical laboratory tests, but you may make
referrals for such tests as part of the IPPE, if appropriate.
Annual Wellness Visit
http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/AWV_chart_ICN905706.pdf
(From page 6)
Are clinical laboratory tests part of the AWV?
No, the AWV does not include any clinical laboratory tests, but you may make
referrals for such tests as part of the AWV, if appropriate.
QUICK REFERENCE INFORMATION: Preventive Services
http://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/Downloads/MPS_QuickReferenceChart_1.pdf
CMS NCD LISTING
http://www.cms.gov/medicare-coverage-database/indexes/lab-ncd-index.aspx?bc=BAAAAAAAAAAA&
NOVITAS LCD LISTING
http://www.novitas-solutions.com/webcenter/faces/oracle/webcenter/page/scopedMD/
sad60252a_5537_4c5d_9350_ca405e36e159/Page129.jspx?wc.contextURL=%2Fspaces%2FMedicareJL&wc.
originURL=%2Fspaces%2FMedicareJL%2Fpage%2FLcdSearch&_afrLoop=414789284036000#%40%3F_
afrLoop%3D414789284036000%26wc.originURL%3D%252Fspaces%252FMedicareJL%252Fpage%252FLcdS
earch%26wc.contextURL%3D%252Fspaces%252FMedicareJL%26_adf.ctrl-state%3Dnn1l9pxl2_159eJL%26_
adf.ctrl-state%3Dnn1l9pxl2_159
For more information, please contact Julia Oswald at 877-402-4221
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2024 Lehigh Street • Allentown, PA • 18103-4798
(610) 402-8170 • Toll Free (877) 402-4221
www.healthnetworklabs.com
ADDITIONAL INFORMATION
TEST CHANGE Information
Please note changes for the following tests:
For more information, please contact Gayle McCarthy at 877-402-4221
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2024 Lehigh Street • Allentown, PA • 18103-4798
(610) 402-8170 • Toll Free (877) 402-4221
www.healthnetworklabs.com
ADDITIONAL INFORMATION
RESPIRATORY VIRUS UPDATE – ENTEROVIRUS D68
In August 2014, several children’s hospitals in the Midwest reported an increase in pediatric patients
hospitalized with severe respiratory illness. These viral isolates, initially identified by screening as Rhino/
Enterovirus, were sequenced by the Centers for Disease Control and Prevention (CDC) Picornavirus
Laboratory and EV-D68 was identified in a majority of the specimens. Since then, several other states have
noted similar clusters of respiratory illness with an increase in Rhino/Enterovirus isolates. The Pennsylvania
Department of Health on 9/16/2014, announced three confirmed cases of EV-D68 in Pennsylvania residents.
The cases were identified from specimens sent to the CDC from a Philadelphia hospital.
The State lab has stated that once the presence of EV-D68 has been identified in a region, there is no need for
further testing for this pathogen.
SEE BULLETIN:
PENNSYLVANIA DEPARTMENT OF HEALTH
2014– PAHAN –290 – 09-16-14 ADV
Severe Respiratory Illness Associated with Enterovirus D68- Multiple States, 2014
Rhinovirus and enterovirus are genetically similar and cannot be separated with the currently available
molecular assays. Enterovirus will be called Rhinovirus on our comprehensive Respiratory Viral panel
(RVPPR). When the RVPPR is positive for Rhinovirus the report contains a disclaimer stating that there is
cross reactivity between Rhinovirus and Enterovirus. At HNL we have seen a 20% increase in Rhinovirus
activity
Recommendations from: “Severe Respiratory Illness Associated with Enterovirus D68 – Multiple States,
2014” from the Centers for Disease Control and Prevention (CDC). CDC Advisory #290:
Clinical Care:
• Health care providers should consider EV-D68 as a possible cause of acute, unexplained severe
respiratory illness, even in the absence of fever.
• Although the findings to date have been in children, EV-D68 may also affect adults.
Laboratory Testing:
• HNL offers an enterovirus culture (ENVC) for testing of respiratory specimens for enteroviruses
when the cause of respiratory infection in severely ill patients is unclear. The culture cannot, however,
determine if the enterovirus is a D 68.
• If testing is requested the specimen should be collected with a nasopharyngeal swab (NP) and sent in
UTM viral transport media.
• Confirmation of the presence of EV-D68 requires typing by molecular sequencing that is currently
only being performed by CDC.
• CDC is currently prioritizing respiratory specimens from hospitalized patients with severe respiratory
illness who are known to be positive for rhinovirus/enterovirus from initial screening assays. TAT is
expected to be 6-8 weeks.
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For more information, please contact Georgia Colasante at 877-402-4221
2024 Lehigh Street • Allentown, PA • 18103-4798
(610) 402-8170 • Toll Free (877) 402-4221
www.healthnetworklabs.com
ADDITIONAL INFORMATION
SEASONAL FLU TESTING
On October 6, 2014, HNL will make available its Influenza A, B and RSV testing, (FLABR). The assay
will be performed 2 times per shift, 3 shifts per day, 7 days a week.
We will also continue to offer the Respiratory Virus; panel (RVPPR), which includes influenza A, B,
RSV, parainfluenza 1, 2, 3, adenovirus, Human metapneumovirus, and rhinovirus. This test is run once
per day and is offered 7 days per week.
Collection for these tests remains the same:
Nasopharyngeal flock swab placed in a UTM (universal viral transport media) sent on ice.
For more information, please contact Georgia Colasante at 877-402-4221
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