[counting tests for CLIA-CBCs]

Also, CLIA certification fees are dependent on test volume.

[counting tests for CLIA-CBCs]

Hi Scott,

Billing is an entirely different matter than counting tests for CLIA.  Refer to page 9 of CMS form 116.  For hematology then, hematocrit and MCHC are not counted because they are calculated, not measured. Thanks,

Rachel

cms116.pdf

[counting tests for CLIA-CBCs]

Hi,

I just want to make sure my interpretation of counting tests for CBCs is correct.  CLIA says

 

For complete blood counts, each measured individual analyte that is ordered and reported is counted separately.

So for example, if we did 100 CBCs, and we're counting WBC, RBC, Hgb, MCV, RDW, Plt count, Neut, lymph, mono, eos, and baso (11 tests) it's reported as 1100?

Thank you in advance.

Rachel

 

[Man diff when lymph>neut]

We are going to the ILHS recommendations for lymphocytosis instead.  >5.0 (adult) or >7.0 (<12 yrs old)

[Man diff when lymph>neut]

Hi,

Are you doing manual diffs when the %neut>%lymphs, and if so, do you do them if the difference is only for example 1%?  Or if lymphs exceed neutrophils by >5 or 10%?  (Assuming there are no IG or band flags...)

thanks,

Rachel

[Grading Morphology]

Thank you, very helpful.

[Grading Morphology]

Hi,

I'd like to revive this old thread, because I am running into issues with the techs using & feeling comfortable with our new grading scale.  Also, although I'm the supervisor, I'm pretty rusty on reading smears (trying to improve!)

Our scale for most RBC morphology parameters skips 1+ and starts with 2+ (5-20%).  Schistocytes is the only parameter that we will report at 1+ (1%).  I think that part of the problem is getting them to actually enumerate & quantitate abnormalities, they still want to eyeball it.

The specific question that I'd like to pass on from one of my techs is for Howell-Jolly bodies.  We are using 1+ (NA); 2+ (2-3%); 3+ (>3%).  The tech thinks that seeing any number of HJ bodies is significant (eg one HJ body on the whole slide review).  Is this true?  I haven't found any reference to support that.  Thank you.

Rachel

[Hematology analyzers--looking at new ones]

Thanks for your reply.  We are going tomorrow and next week to see analyzers in our area.

[Hematology analyzers--looking at new ones]

Hi,

We are a small clinic with most of our CBC's in the normal range, some adults and some peds. We currently have an Abbott Cell-Dyn 3200 that is about 10 years old.  We're in the process of selecting a new analyzer, and are looking at the Abbott Ruby, Sysmex XS-1000i, and Beckman Coulter analyzers.   I haven't seen a current thread comparing hematology analyzers, so if anyone would like to comment on any of these analyzer advantages or disadvantages here is your opportunity.  Since I'm not a hematologist, any suggestions on good questions to ask before committing to an analyzer would be appreciated!  Thank you,

Rachel 

[Reporting out both auto diff and manual diff]

Hi,

Is it permitted to bill for both the full CBC/auto diff (CPT code 85025) and the manual diff (CPT code 85007)?  Thanks,

Rachel

[Tan EDTA for CBC]

Hi,

Is the only difference between tan & lavender EDTA tubes that tan tubes are lead free?  They're both K2 EDTA.  What about the concentration of EDTA, or liquid vs. dry? Occasionally our phlebotomists will draw only a tan EDTA tube for lead testing, missing the lavender for the CBC. I would love to run a CBC off the tan in when the lavender is missed.  How would that skew the results?  I don't have the resources to validate CBCs on tan tops. Thanks,

Rachel