Re: [Histonet] Billing IHC on MOHS
Carol, Its nice to hear this isn't a regular thing. In reading your original question, it sounded like you were excited to be charging five times for those immunos and you were ready to argue for it. Apparently that was not the case, you wanted more information and thoughts on the subject. I once worked for a MOHS surgeon who had billing practices with which I did not agree. It was the reason I quit. I'm glad there are people of high integrity, such as your group, doing this work. Mark On Wednesday, June 20, 2012, Carol Torrence wrote: > I have nothing more to add regarding this subject but would like to > address concerns expressed here that touch on fairness, frequency, cost and > the abilities of techs and surgeons. > > ** ** > > This was a very rare incident involving scar tissue and tumor. Our Mohs > lab does not do immunos, our pathology lab does. My quest was to learn > more about what constitutes a block. We stained 5 slides that were the > same ‘stage’ (one block)….’to be sure there would be no ‘fall offs’. We do > not want to put the patient through more waiting than necessary. I was > not trying to charge for each slide I stained or gouge the patient. My > quest was for “correct coding” not what “can” I charge. I certified as a > CPC in 2005 but do not practice in that field. That said, I have a good > grasp as to the seriousness of the subject of coding and documentation.*** > * > > ** ** > > I have 30 plus years of experience in histology including management. I > have always had the pleasure of working with physicians of high integrity > and continue to do so in the area of dermatology. The majority of my time > has been spent in a large medical center where coding questions could be > addressed ‘in house’ so to speak. When I was consulted by the surgeon > regarding coding this case, our search for the correct coding stems from > the level of integrity we practice on a daily basis. I consulted the > *American > Society for Mohs Surgery* (*ASMS*) as was suggested and they do not offer > coding advice. I was told that they are an administrative office and > suggested that I contact AAD. > > ** ** > > Thanks for sharing your thoughts and listening to mine. > > ** ** > > Have a good day! Onward and upward! > > Carol M. Torrence, HT(ASCP)CM > > ctorre...@kmcpa.com *** > * > > ** ** > > Confidentiality Note: This message is intended for use only by the > individual or entity to which it is addressed and may contain information > that is privileged, confidential, and exempt from disclosure under > applicable law. If the reader of this message is not the intended recipient > or the employee or agent responsible for delivering the message to the > intended recipient, you are hereby notified that any dissemination, > distribution or copying of this communication is strictly prohibited. If > you have received this communication in error, please contact the sender > immediately and destroy the material in its entirety, whether electronic or > hard copy. Thank you > > ** ** > > ** ** > > * * > ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] formalin substitute
Hi Gale - For more than seventeen years we used a product called HistoChoice from Amresco http://www.amresco-inc.com/ . It's worth checking out. Dave Kemler Histology Consultant From: Gale Limron To: "histonet@lists.utsouthwestern.edu" Sent: Wednesday, June 20, 2012 10:10 AM Subject: [Histonet] formalin substitute Good Morning, I would appreciate opinions and pricing on formalin substitute from anyone who is using it. We will be supplying our OB Dept. with this since they have trouble handling regular formalin... Thanks, Gale Gale Limron CT,HT (ASCP) Histology Supervisor Union Hospital 659 Boulevard Dover, Ohio 44622 330-343-3311 ext 2562 This e-mail is intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. Dissemination, distribution or copying of this e-mail or the information herein by anyone other than the intended recipient, or an employee or agent responsible for delivering the message to the intended recipient, is prohibited. If you received this message in error, please delete without copying and kindly e-mail a reply to inform us of the mistake in delivery.___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] elastic stain
Why would an elastic stain work on a positive control, but the patient did not stain?? The patient tissue is from a temporal artery which should show some staining due to internal control?? Thanks ahead for any input on this puzzle! Dorothy Webb, HT (ASCP) This e-mail and any files transmitted with it are confidential and are intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient or the individual responsible for delivering the e-mail to the intended recipient, please be advised that you have received this e-mail in error and that any use, dissemination, forwarding, printing, or copying of this e-mail is strictly prohibited. If you have received this communication in error, please return it to the sender immediately and delete the original message and any copy of it from your computer system. If you have any questions concerning this message, please contact the sender. Disclaimer R001.0 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Re: Eosin staining for small biopsies
Carol Freeman asks about using eosin and other dyes to mark small specimens for better recovery during embedding. I've found safranin O to be the best of these. Use the Gram stain counterstain used in microbiology. You mark the specimens directly, on those blue biopsy pads. It doesn't dissolve out, and supposedly it isn't fluorescent and doesn't interfere with fluorescence procedures such as FISH. - The disadvantage is that marking the specimens with it is time-consuming. I'd want it used in conjunction with a grossing log sheet that the embedder checks while embedding (dream on). Eosin is easy to put in the processor, but its fluorescence supposedly precludes its use, a serious drawback. Hematoxylin - I have no experience with it. It isn't fluorescent, but in some situations can quench fluorescence. Mrs. Stewart's Bluing - No experience with it. It's made by the same company that makes Davidson marking inks. I don't know if it's particulate. Davidson's marking inks: They do the job, but as a pathologist I find particulate material distracting when it's on the slide with a small biopsy specimen, so I'd rather they not be used, though obviously they're necessary for evaluating surgical margins on breast and skin cancer resection specimens. Only a minority of pathology labs do small specimen marking of any kind, but I think it's a good idea. I don't know of any refereed literature on this subject - don't know if it's covered in any of the standard books - I'm away from my library right now. Bob Richmond Samurai Pathologist Knoxville TN ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Looking for a recruiter to work with me!
Recruiters can be cruel. I have had them laugh at me as well, but not for the same reasons I guess. My opinion is that the markets I have worked in, they are glad to get someone with any background, and certainly you have shown your willingness to do what it takes to re-enter. I think that you should find some opportunities out there. I usually find that the recruiters who were histotechs for awhile and then went into recruiting are better. You have to keep after some of them, some of them are more focused on just getting names to their clients and don't concern themselves with making sure you it is a good fit for you or the organization. I learn about positions through others a lot too. Try posting your profile targeting your geographic area of interest. Joelle Weaver MAOM, HTL (ASCP) QIHC > Date: Wed, 20 Jun 2012 09:15:06 -0700 > From: araniqks...@yahoo.com > To: histonet@lists.utsouthwestern.edu > Subject: [Histonet] Looking for a recruiter to work with me! > > Hello, > > I am looking for a recruiter to work with me in getting back into the field > of histology. I have been out a long time but I know I can re-learn. I have > an A.A. in histotechnology and I am HT certified. > > I need a recruiter that won't laugh at me (it happened in the past) and that > will answer my emails. I am in Raleigh, North Carolina. I had one person > totally interested but when he realized I was not a new graduate he wanted to > get off the phone as fast as possible. > > I am willing to work at this, take a class or whatever, buy new textbooks and > refresh my knowledge. There is no school nearby for me to re-take a clinical, > or I would do it. > > Thanks, > > Paula > ___ > Histonet mailing list > Histonet@lists.utsouthwestern.edu > http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Eosin staining for small biopsies
We also use safranin on all our small biopsies and also our breast biopsies with no adverse effects to any of our IHC or ISH. Cindy Cindy Pyse, CLT, HT (ASCP) Laboratory Manager X-Cell Laboratories 716-250-9235 etx. 232 e-mail cp...@x-celllab.com -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cynthia Robinson Sent: Wednesday, June 20, 2012 10:32 AM To: histonet@lists.utsouthwestern.edu; Carol Freeman Subject: Re: [Histonet] Eosin staining for small biopsies We use safranin (used in Microbiology as a counterstain) on our small biopsies. We apply a small drop during grossing. It does not affect staining of H&E, IHC or ISH. We like this because it is an intense red that doesn't leach out in the alcohols of processor. Cindi Robinson HT(ASCP) Mercy Medical Center Dunes Medical Laboratories 350 W Anchor Dr Dakota Dunes SD 57049 phone-712-279-2768 robin...@mercyhealth.com >>> "Freeman, Carol" 6/20/2012 8:46 AM >>> Good Morning all, Happy Wednesday! I have a question and I am not finding much on my google search...First does anyone have any papers written or studies done on the use of Eosin to stain small biopsies or the use of eosin on the tissue processor in the last alcohol?? I have read snippets on eosin having an effect on FISH testing?? Does anyone know of this to be true and have any papers or studies to refer back to or any documentation showing this result?? One more thing does anyone use Hematoxylin to mark small tissue biopsies and/or any thoughts on its use to do so?? My thoughts are that because of it's precipitation qualities it could gunk up the tissue processor and leave residue precipitate at embedding.. agree? Disagree? Thanks for any responses. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Looking for a recruiter to work with me!
Let me get this straight. You are an HT (ASCP) living in the North Carolina Research Triangle and you can't find a job? Hmmm, UNC Health Care in Chapel Hill, Duke Medicine in Durham, and Rex Healthcare in Raleigh are all looking for histotechs RIGHT NOW. And this was from a 5 second Google search. This is why the recruiter laughed at you, not your being out of the field. Any anxiety you feel about getting back in the lab is something you are doing to yourself. If you can cut, and the lab is busy enough, they won't care. By the way, we old timers are "registered" histotechs, not certified. Some of us are certifiable. Sincerely, Jay A. Lundgren, M.S., HTL(ASCP) ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Looking for a recruiter to work with me!
Call James Elliott at Ampian staffing. One of the best in the business. Knows histology in and out. (877) 229-6996 Will Sent from my iPhone On Jun 20, 2012, at 12:15 PM, Paula wrote: > Hello, > > I am looking for a recruiter to work with me in getting back into the field > of histology. I have been out a long time but I know I can re-learn. I have > an A.A. in histotechnology and I am HT certified. > > I need a recruiter that won't laugh at me (it happened in the past) and that > will answer my emails. I am in Raleigh, North Carolina. I had one person > totally interested but when he realized I was not a new graduate he wanted to > get off the phone as fast as possible. > > I am willing to work at this, take a class or whatever, buy new textbooks and > refresh my knowledge. There is no school nearby for me to re-take a clinical, > or I would do it. > > Thanks, > > Paula > ___ > Histonet mailing list > Histonet@lists.utsouthwestern.edu > http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Looking for a recruiter to work with me!
Hello, I am looking for a recruiter to work with me in getting back into the field of histology. I have been out a long time but I know I can re-learn. I have an A.A. in histotechnology and I am HT certified. I need a recruiter that won't laugh at me (it happened in the past) and that will answer my emails. I am in Raleigh, North Carolina. I had one person totally interested but when he realized I was not a new graduate he wanted to get off the phone as fast as possible. I am willing to work at this, take a class or whatever, buy new textbooks and refresh my knowledge. There is no school nearby for me to re-take a clinical, or I would do it. Thanks, Paula ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Billing IHC on MOHS
I have nothing more to add regarding this subject but would like to address concerns expressed here that touch on fairness, frequency, cost and the abilities of techs and surgeons. This was a very rare incident involving scar tissue and tumor. Our Mohs lab does not do immunos, our pathology lab does. My quest was to learn more about what constitutes a block. We stained 5 slides that were the same ‘stage’ (one block)….’to be sure there would be no ‘fall offs’. We do not want to put the patient through more waiting than necessary. I was not trying to charge for each slide I stained or gouge the patient. My quest was for “correct coding” not what “can” I charge. I certified as a CPC in 2005 but do not practice in that field. That said, I have a good grasp as to the seriousness of the subject of coding and documentation. I have 30 plus years of experience in histology including management. I have always had the pleasure of working with physicians of high integrity and continue to do so in the area of dermatology. The majority of my time has been spent in a large medical center where coding questions could be addressed ‘in house’ so to speak. When I was consulted by the surgeon regarding coding this case, our search for the correct coding stems from the level of integrity we practice on a daily basis. I consulted the American Society for Mohs Surgery (ASMS) as was suggested and they do not offer coding advice. I was told that they are an administrative office and suggested that I contact AAD. Thanks for sharing your thoughts and listening to mine. Have a good day! Onward and upward! Carol M. Torrence, HT(ASCP)CM ctorre...@kmcpa.com Confidentiality Note: This message is intended for use only by the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering the message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please contact the sender immediately and destroy the material in its entirety, whether electronic or hard copy. Thank you ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Eosin staining for small biopsies
Here is a paper I found: Capillary Electrophoresis Artifact Due to Eosin Journal of Molecular Diagnostics, Vo. 7, No. 1, February 2005 Our molecular people are studying this issue to see how big of a problem it is. Tim Morken Supervisor, Electron Microscopy Department of Pathology UC San Francisco Medical Center tim.mor...@ucsfmedctr.org Tim Morken -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Freeman, Carol Sent: Wednesday, June 20, 2012 6:46 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Eosin staining for small biopsies Good Morning all, Happy Wednesday! I have a question and I am not finding much on my google search...First does anyone have any papers written or studies done on the use of Eosin to stain small biopsies or the use of eosin on the tissue processor in the last alcohol?? I have read snippets on eosin having an effect on FISH testing?? Does anyone know of this to be true and have any papers or studies to refer back to or any documentation showing this result?? One more thing does anyone use Hematoxylin to mark small tissue biopsies and/or any thoughts on its use to do so?? My thoughts are that because of it's precipitation qualities it could gunk up the tissue processor and leave residue precipitate at embedding.. agree? Disagree? Thanks for any responses. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] 3rd Shift HT/HTL Opening Near Fort Myers, FL
Allied Search Partners is currently looking for a qualified applicant for a Histotechnologist or Histotechnician willing to work the third shift within a Fort Myers, FL laboratory. Position: Histotechnologist or Histotechnician Schedule: Monday-Friday, Overnight hours/Third Shift hours. Summary: Perform a variety of routine and specialized histology techniques and procedures. Embedding, Microtomy, Grossing, Processing, and H&E staining Special Staining Equipment maintenance Requirements: FL Laboratory License Previous experience with automated IHC Technical and QC protocols AA or BS/BA degree in life science preferred but not required Benefits: Competitive salaries, Health, Dental, Life & Disability insurances, a section 125 plan, a 401K, FSA, ESPP and relocation assistance. To Apply: Please send resume to bran...@alliedsearchpartners.com -- Brannon Owens Recruitment Manager Allied Search Partners T: 888.388.7571 ext. 106 F: 888.388.7572 To view a complete list of Allied Search Partners current openings go to: http://www.alliedsearchpartners.com/careers.php LinkedIn: http://www.linkedin.com/pub/brannon-owens/28/528/823 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Eosin staining for small biopsies
We use safranin (used in Microbiology as a counterstain) on our small biopsies. We apply a small drop during grossing. It does not affect staining of H&E, IHC or ISH. We like this because it is an intense red that doesn't leach out in the alcohols of processor. Cindi Robinson HT(ASCP) Mercy Medical Center Dunes Medical Laboratories 350 W Anchor Dr Dakota Dunes SD 57049 phone-712-279-2768 robin...@mercyhealth.com >>> "Freeman, Carol" 6/20/2012 8:46 AM >>> Good Morning all, Happy Wednesday! I have a question and I am not finding much on my google search...First does anyone have any papers written or studies done on the use of Eosin to stain small biopsies or the use of eosin on the tissue processor in the last alcohol?? I have read snippets on eosin having an effect on FISH testing?? Does anyone know of this to be true and have any papers or studies to refer back to or any documentation showing this result?? One more thing does anyone use Hematoxylin to mark small tissue biopsies and/or any thoughts on its use to do so?? My thoughts are that because of it's precipitation qualities it could gunk up the tissue processor and leave residue precipitate at embedding.. agree? Disagree? Thanks for any responses. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: formalin substitute
We have had great success using Prefer from Anatech. We have used it for outside locations with bone marrow aspirations. It is formaldelyde-free, and comes in either pre-filled containers or by larger containers. Our pathologists were happy with the nuclear detail.and when your docs are happy, it's a happy day!!! Lynette Lynette Pavelich, HT(ASCP) Histology Supervisor Hurley Medical Center One Hurley Plaza Flint, MI 48503 ph: 810.262.9948 mobile: 810.444.7966 From: histonet-boun...@lists.utsouthwestern.edu [histonet-boun...@lists.utsouthwestern.edu] on behalf of Gale Limron [ga...@unionhospital.org] Sent: Wednesday, June 20, 2012 10:10 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] formalin substitute Good Morning, I would appreciate opinions and pricing on formalin substitute from anyone who is using it. We will be supplying our OB Dept. with this since they have trouble handling regular formalin... Thanks, Gale Gale Limron CT,HT (ASCP) Histology Supervisor Union Hospital 659 Boulevard Dover, Ohio 44622 330-343-3311 ext 2562 This e-mail is intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. Dissemination, distribution or copying of this e-mail or the information herein by anyone other than the intended recipient, or an employee or agent responsible for delivering the message to the intended recipient, is prohibited. If you received this message in error, please delete without copying and kindly e-mail a reply to inform us of the mistake in delivery.___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Eosin staining for small biopsies
We also add liquid eosin (~75mL) to our "dirtiest" 100% to help aide the sight of the small biopsies for embedding. You are correct though, that eosin does fluoresce. I understand why you would be concerned about FISH, so wanted to share this. I have heard from fellow techs in the field that use a common bluing agent (used for laundry!) called Mrs. Stewart's Concentrated Liquid Bluing (found locally at a discount store called Meijers). It is applied at the grossing board. These techs actually use it for skin, but the bluing withstands the processor and helps them embed the skins much easier by showing the epidermis. I do believe that this harmless liquid does not fluoresce. Hope this helps, Lynette Lynette Pavelich, HT(ASCP) Histology Supervisor Hurley Medical Center One Hurley Plaza Flint, MI 48503 ph: 810.262.9948 mobile: 810.444.7966 From: histonet-boun...@lists.utsouthwestern.edu [histonet-boun...@lists.utsouthwestern.edu] on behalf of Freeman, Carol [carol.free...@utoledo.edu] Sent: Wednesday, June 20, 2012 9:46 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Eosin staining for small biopsies Good Morning all, Happy Wednesday! I have a question and I am not finding much on my google search...First does anyone have any papers written or studies done on the use of Eosin to stain small biopsies or the use of eosin on the tissue processor in the last alcohol?? I have read snippets on eosin having an effect on FISH testing?? Does anyone know of this to be true and have any papers or studies to refer back to or any documentation showing this result?? One more thing does anyone use Hematoxylin to mark small tissue biopsies and/or any thoughts on its use to do so?? My thoughts are that because of it's precipitation qualities it could gunk up the tissue processor and leave residue precipitate at embedding.. agree? Disagree? Thanks for any responses. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] formalin substitute
Good Morning, I would appreciate opinions and pricing on formalin substitute from anyone who is using it. We will be supplying our OB Dept. with this since they have trouble handling regular formalin... Thanks, Gale Gale Limron CT,HT (ASCP) Histology Supervisor Union Hospital 659 Boulevard Dover, Ohio 44622 330-343-3311 ext 2562 This e-mail is intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. Dissemination, distribution or copying of this e-mail or the information herein by anyone other than the intended recipient, or an employee or agent responsible for delivering the message to the intended recipient, is prohibited. If you received this message in error, please delete without copying and kindly e-mail a reply to inform us of the mistake in delivery.___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Eosin staining for small biopsies
We use eosin in our last 100% alcohol on the processor. It is a great help for our person embedding to be able to see and orient the small biopsies. We have been doing this for years and have never had any problem with the processor or any subsequent staining that has been performed. We also at times ink translucent esophageal biopsies at the grossing station to help in embedding. This also has never presented a problem. Linda -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Freeman, Carol Sent: Wednesday, June 20, 2012 9:46 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Eosin staining for small biopsies Good Morning all, Happy Wednesday! I have a question and I am not finding much on my google search...First does anyone have any papers written or studies done on the use of Eosin to stain small biopsies or the use of eosin on the tissue processor in the last alcohol?? I have read snippets on eosin having an effect on FISH testing?? Does anyone know of this to be true and have any papers or studies to refer back to or any documentation showing this result?? One more thing does anyone use Hematoxylin to mark small tissue biopsies and/or any thoughts on its use to do so?? My thoughts are that because of it's precipitation qualities it could gunk up the tissue processor and leave residue precipitate at embedding.. agree? Disagree? Thanks for any responses. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Eosin staining for small biopsies
Good Morning all, Happy Wednesday! I have a question and I am not finding much on my google search...First does anyone have any papers written or studies done on the use of Eosin to stain small biopsies or the use of eosin on the tissue processor in the last alcohol?? I have read snippets on eosin having an effect on FISH testing?? Does anyone know of this to be true and have any papers or studies to refer back to or any documentation showing this result?? One more thing does anyone use Hematoxylin to mark small tissue biopsies and/or any thoughts on its use to do so?? My thoughts are that because of it's precipitation qualities it could gunk up the tissue processor and leave residue precipitate at embedding.. agree? Disagree? Thanks for any responses. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] MGMT antibody
I am using MGMT , clone MT23.2 from Invitrogen and having problems. Does anyone have a protocol for this antibody that is working and yielding consistent positive results? Thanks! ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Billing IHC on MOHS
The terminology is confusing< stage and per layer are not the same thing to me, depends on how you think about it >. Seems that Moh's and yes I have done this, can be done different. You have the Dr Mohs way of getting the what we call Donut specimen, which gets inked, nicked, embedded flat then frozen. This is your 1st stage. or block "A" if you will. Now some people will cut this into 2 pieces and even more and this creates more blocks. All of that first specimen is still the 1st stage and considered block A. You bill for block A, not for A1, A2 etc. and yes you are correct each additional stage( had to go back because 1st stage was positive) would be billiable again, same senario above. The second stage Block "B" billiable for "B" only, not B1, B2 etc. This was something we had much discussion about here as they recently changed multiple billing on the same site, or for Mohs you would call it Same Stage. This is my interpretation. and to make sure I am not mis-interpreting you, you're not considering every section as you mentioned a seperate stage? While I can see that Carol's post has (stage) next to per layer, I have to wonder if this is exactly out of the book? Because I would disagree with the two terms meaning the same as well. Refer to above comment for my definition of Stage and hopfully it has clarity. :) As far as ignoring Medicare, I would never suggest that. And for ignoring insurance companies, well you can try all they can do is deny payment and then you get to haggle with them. I'm not sure I can add anything else to this conversation so I will let the rest have at it for now. Hope everyone has a fantastic week! Kim D From: William Chappell To: Kim Donadio Cc: Carol Torrence ; "histonet@lists.utsouthwestern.edu" ; 'Ingles Claire' Sent: Tuesday, June 19, 2012 9:45 PM Subject: Re: [Histonet] Billing IHC on MOHS Well, I don't know if that settles that. I haven't responded, because I have not worked for a Mohs dermatopahtologist who runs Immunos (I have worked at numerous Mohs laboratories), however, this explanation is contradictory. "Each stain is reported only once per block, not per slide or per layer (stage)." Yet the definition of a block, "Tissue flattened by cutting into pieces, embedded, and frozen in mounting medium used by histotechnologists to embed tissue for frozen sections." Every stage represent a new block in which slides are cut. These two statements are contradictory and need clarification. Now, my own opinion (again I have talked with my dermatopathologist and billing specialist and they are as lost as we) is that by definition, Mohs is a frozen section diagnosis that must be made by the surgeon (i.e., for a Mohs to be a mohs the surgeon removing the tissue must diagnose the tissue -- look it up). Every section taken, at every stage is a separate block of the same case. In the event you can charge immunos per case, only one charge can be made. If it can be shown that immunos can be charged per block (per the definition below), every immuno on every block from every stage can be charged. Now for the practicality -- we always start questions like this because medicare sets standards for billing that other insurance companies then adopt. We should NEVER ask, "what can we charge for," but should always ask, "what work did we do that it is fair for a patient to pay for." Ignore what medicare and insurance companies say, bill clients for the work we perform and for the results they get. How much more raw cost is there in staining two Mohs blocks with the same immuno? Is it fair to charge a patient double the amount for MUCH less than twice the work? Will Chappell HTL(ASCP), QIHC On Jun 19, 2012, at 9:15 PM, Kim Donadio wrote: > Great team work! Job well done and a absolute answer is given. > > Thank you > > > > From: Carol Torrence > To: 'Kim Donadio' > Cc: "'Weems, Joyce K.'" ; 'Ingles Claire' > ; histonet@lists.utsouthwestern.edu > Sent: Tuesday, June 19, 2012 2:10 PM > Subject: RE: [Histonet] Billing IHC on MOHS > > > The following is the response I recived from a coding specialist at the > American Academy of Dermatology. I am trying not to be concerned that the > reference is 6 years old but I think it clears up what we thought to be > true. > 88342 for IHC > 88314 other “special stains” > Here is the description for 88314 according to November 2006 cpt Assistant > article, the companion piece to the AMA CPT Code Book. > The work of processing and interpreting one routine stain is included in the > procedure 17311- 17315. This stain is usually hematoxylin and eosin, or > toluidine blue. If other special stains are necessary after one routine > stain, then the code for special stains may be used (88314) as well as > immunoperoxidase stains (88342) or decalcification procedures (88311). > Special stains a
RE: [Histonet] RE: Macrophage stain
Hiro, You are correct, alveolar macrophages do express less F4/80 than other tissue macrophages. I refer you to, for example: Zhang X, Goncalves R, Mosser DM. The isolation and characterization of murine macrophages. Curr Protoc Immunol. 2008 Nov;Chapter 14:Unit 14.1. PubMed PMID: 19016445; PubMed Central PMCID: PMC2834554. Here they state: Alveolar macrophages are functionally different from peritoneal macrophages. Peritoneal macrophages are F4/80high, CD11bhigh, and CD68+. Bone marrow-derived macrophages also express F4/80high, CD11bhigh, and CD68+. However, alveolar macrophages display a F4/80low, CD11blow, and CD68+ phenotype under normal physiological conditions. Staining alveolar macrophages with CD68 (clone FA-11) would be a practical alternative for cryostat material, it just looks less pretty. Good luck. Peter Tree Technical Data Manager AbD Serotec Morphosys UK Ltd Endeavour house Langford Lane Kidlington Oxon OX5 1GE e.mail: peter.t...@abdserotec.com MorphoSys UK Ltd., Registered in England No: 1604642 Registered office: Greyfriars Court, Paradise Square, Oxford OX1 1BB, UK This message may contain confidential and/or privileged information. If you are not the addressee or authorized to receive this for the addressee, you must not use, copy, disclose or take any action based on this message or any information herein. If you have received this message in error, please advise the sender immediately by reply e-mail and delete this message. Thank you for your cooperation. Diese E-Mail kann vertrauliche und/oder rechtlich geschuetzte Informationen enthalten. Wenn Sie nicht der richtige Adressat sind oder diese E-Mail irrtuemlich erhalten haben, informieren Sie bitte sofort den Absender und vernichten Sie diese Mail. Das unerlaubte Kopieren sowie die unbefugte Weitergabe dieser Mail ist nicht gestattet. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Billing IHC on MOHS
I'm trying to think this through. Like Will said, if it can be shown that you can charge immunos per block... I thought we could only charge IHC per specimen these days. Wouldn't each stage be a different specimen? I would think billing per block of the same stage would be over charging. Why would the logic change because this is MOHS? It is still the same pathology billing code after all (88342). I would also think that if this situation is coming up often that someone is having trouble reading the H&Es. Mark On Tuesday, June 19, 2012, William Chappell wrote: > Well, I don't know if that settles that. > > I haven't responded, because I have not worked for a Mohs > dermatopahtologist who runs Immunos (I have worked at numerous Mohs > laboratories), however, this explanation is contradictory. "Each stain is > reported only once per block, not per slide or per layer (stage)." Yet the > definition of a block, "Tissue flattened by cutting into pieces, embedded, > and frozen in mounting medium used by histotechnologists to embed tissue > for frozen sections." Every stage represent a new block in which slides > are cut. These two statements are contradictory and need clarification. > > Now, my own opinion (again I have talked with my dermatopathologist and > billing specialist and they are as lost as we) is that by definition, Mohs > is a frozen section diagnosis that must be made by the surgeon (i.e., for a > Mohs to be a mohs the surgeon removing the tissue must diagnose the tissue > -- look it up). Every section taken, at every stage is a separate block of > the same case. In the event you can charge immunos per case, only one > charge can be made. If it can be shown that immunos can be charged per > block (per the definition below), every immuno on every block from every > stage can be charged. > > Now for the practicality -- we always start questions like this because > medicare sets standards for billing that other insurance companies then > adopt. We should NEVER ask, "what can we charge for," but should always > ask, "what work did we do that it is fair for a patient to pay for." > Ignore what medicare and insurance companies say, bill clients for the > work we perform and for the results they get. How much more raw cost is > there in staining two Mohs blocks with the same immuno? Is it fair to > charge a patient double the amount for MUCH less than twice the work? > > Will Chappell HTL(ASCP), QIHC > > On Jun 19, 2012, at 9:15 PM, Kim Donadio wrote: > > > Great team work! Job well done and a absolute answer is given. > > > > Thank you > > > > > > > > From: Carol Torrence > > To: 'Kim Donadio' > > Cc: "'Weems, Joyce K.'" ; 'Ingles > Claire' ; histonet@lists.utsouthwestern.edu > > Sent: Tuesday, June 19, 2012 2:10 PM > > Subject: RE: [Histonet] Billing IHC on MOHS > > > > > > The following is the response I recived from a coding specialist at the > American Academy of Dermatology. I am trying not to be concerned that the > reference is 6 years old but I think it clears up what we thought to be > true. > > 88342 for IHC > > 88314 other “special stains” > > Here is the description for 88314 according to November 2006 cpt > Assistant article, the companion piece to the AMA CPT Code Book. > > The work of processing and interpreting one routine stain is included in > the procedure 17311- 17315. This stain is usually hematoxylin and eosin, or > toluidine blue. If other special stains are necessary after one routine > stain, then the code for special stains may be used (88314) as well as > immunoperoxidase stains (88342) or decalcification procedures (88311). > Special stains are not typically used and in most Mohs practices are of low > frequency. Each stain is reported only once per block, not per slide or per > layer (stage). > > AMA CPT definition of a Block:Tissue flattened by cutting into pieces, > embedded, and frozen in mounting medium used by histotechnologists to embed > tissue for frozen sections. > > ___ > > Histonet mailing list > > Histonet@lists.utsouthwestern.edu > > http://lists.utsouthwestern.edu/mailman/listinfo/histonet > > > ___ > Histonet mailing list > Histonet@lists.utsouthwestern.edu > http://lists.utsouthwestern.edu/mailman/listinfo/histonet > ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
