Re: [Histonet] Temperature for slides
We monitor room temp and record it as per CAP, and CLIA. Are you sure the request wasn’t for monitoring room temp because of paraffin blocks, not slides? The concern is for paraffin blocks melting, due to excessive heat. Akemi Allison BS, HT/HTL (ASCP) Pathology Manager Monterey Bay GI Consultants Laboratory 23 Upper Ragsdale Drive, Suite 200 Monterey, CA 93940 Email: aalli...@montereygi.com mailto:aalli...@montereygi.com Tele: (831) 375-3577 X117 On Aug 28, 2015, at 4:58 AM, Heckford, Karen - SMMC-SF via Histonet histonet@lists.utsouthwestern.edu wrote: Okay I just got a weird request for monitoring the room temperature where I have my slides for that I use for Histology. We are talking blank slides. I have never heard of this before. Who else does this??? Apparently JCAHO wants this. Karen Heckford HT ASCP CE Lead Histology Technician St. Mary's Medical Center 450 Stanyan St. San Francisco, Ca. 94117 415-668-1000 ext. 6167 karen.heckf...@dignityhealth.org Caution: This email message, including all content and attachments, is CONFIDENTIAL and may be of a nature that is LEGALLY PRIVILEGED. The information contained in this email message is intended only for the use of the recipient(s) named above. If the reader of this message is not the intended recipient or an agent responsible for delivering it to the intended recipient, you have received this document in error. Any further review, dissemination, distribution, or copying of this message is strictly prohibited. If you have received this communication in error, please notify us immediately by reply email. Thank you. ___ 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] Temperature for slides
Okay I just got a weird request for monitoring the room temperature where I have my slides for that I use for Histology. We are talking blank slides. I have never heard of this before. Who else does this??? Apparently JCAHO wants this. Karen Heckford HT ASCP CE Lead Histology Technician St. Mary's Medical Center 450 Stanyan St. San Francisco, Ca. 94117 415-668-1000 ext. 6167 karen.heckf...@dignityhealth.org Caution: This email message, including all content and attachments, is CONFIDENTIAL and may be of a nature that is LEGALLY PRIVILEGED. The information contained in this email message is intended only for the use of the recipient(s) named above. If the reader of this message is not the intended recipient or an agent responsible for delivering it to the intended recipient, you have received this document in error. Any further review, dissemination, distribution, or copying of this message is strictly prohibited. If you have received this communication in error, please notify us immediately by reply email. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] CLIA regulations in Histology
Under CLIA regulations, all six elements of competency assessment must be completed for every test a person performs, not just testing in general.Also while CLIA does not specifically require assessment of the competency of personnel performing only pre-analytic and post-analytic activities, it is good practice to do so. I have several questions in regards to these statements: What is considered testing each person performs specifically in the histology lab? What examples of pre-analytic and post-analytic activities are performed in the histology lab? There are so many examples given for the clinical side of the lab but virtually none given for histology. Yet we are expected to carry out this requirement. I got several citations in this area during my last CLIA inspection. So now I'm required to re-write my Competency Assessment Policy, which I don't really know how to do. If you ask the CLIA inspectors, they just tell you to go on-line and check out the guidelines which are so vague and confusing and don't give you any information on histology. I need specific histology examples of measurable/observable criteria that could be acceptable for each of the six assessment methods. We are just a tiny GI histology lab doing biopsies from a private physicians' GI scoping facility. I was told that HE staining was not considered testing, neither is embedding, microtomy, coverslipping, etc. I don't know what is considered pre-analytic or post-analytic activities in histology either. The guidelines given are so general and wide-ranging. I need specifics that pertain to histology. Another citation was also in the area where the pathologists read the slides. I'm required to re-write the competency assessment procedure on our pathologists since they are do provider performed microscopy (PPM) testing. I need specific examples to do competency assessments on them as well. I know their testing is reading slides under the microscope but I need to observe all 6 assessment methods. Proficiency testing on pathologists?? I really need to take a course or class on competency assessments, proficiency testing, pre-analytic and post-analytic activities. The guideline language is too confusing. Any suggestions or information would be greatly appreciated. Thanks Elaine Hoffman, HT(ASCP) The Gastroenterology Clinic Endoscopy Center, Inc.Warren, Ohio 44483 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Per Diem Histotech
Looking for a per diem histotech that can embed and cut our cases during requested vacations throughout the year. We start our day between 430am-7am, so any time to start in this time period works for us. Please send resume to plu...@biopath.org or fax to 714-755-2984 Thank you, Paula Fountain Valley, California Bio-Path Medical Group ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Harford online HT program
Hi Netters! Happy Friday! My assistant is starting the Harford HT program online and we are a Dermatology lab, program requires a few different normal tissues like lumen, Uterus, Gallbladder, etc.. was wondering if anyone out there has taken same or similar course and how did you acquire your tissue if in a GI or Derm lab? All we have is Derm tissue, is there a tissue bank out there somewhere? I thought I heard mention in the past. Or where can you buy tissue? Any information is greatly appreciated!! Thank you in advance!! ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Frozen Section WL and Billing
We set up our system this way - Example: A specimen for frozen is sent. You cut 2 blocks of frozen tissue, 2 levels ea. The PA/Pathologist submits 3 additional blocks for a total of 5 blocks on the specimen (1-2 are the previously frozen, 3-5 additional tissue) to be cut at one level each. 1. At accession, the technical bill for the Lev 4 gross and micro (88305) drop based on the specimen type (skin biopsy) 2. The tech enters a protocol for 5 blocks, 1 HE stain each block. 3. The tech modifies the stains, and changes the HE on the first block to a stain called FS1 (Frozen Section, first block) The charge for the first frozen block, 88341, drops in when this stain is ordered 4. The tech modifies the stains, and changes the HE on the second block to a stain called FSA (Frozen Section, Additional Block) The charge for the additional frozen block, 88342, drops in when this stain is ordered. 5. The tech then enters stains that are set up in the stain dictionary as a Label Only. There is no charge associated with these stains. Stain FL1, Block 1, Stain FL2, Block 1, Stain FL1, Block 2, Stain FL2, Block 2, 6. FL1 = Frozen Label, 1st level FL2 = Frozen Label, 2nd level 7. You can define as many of these Frozen Label levels as you will ever need. 8. Print the labels for the case (some systems will allow you to set up a print job for by Label Type, and you can select Labels Only) It sounds a bit complicated to set up, but the steps are simple, and once it has been set up to use this way, it is quick, easy and accurate to use. I don't know what LIS system you are using, but this is easily adaptable for almost any system We also set up the system to include the Label Only slides to be included in the total slide count, so you get work credit there. I hope this helps. Please feel free to call or contact for any questions. Also, I'm not that far from you, if you need a little help. Terri L. Braud, HT(ASCP) Anatomic Pathology Supervisor Holy Redeemer Hospital Laboratory 1648 Huntingdon Pike Meadowbrook, PA 19046 Ph: 215-938-3676 Fax: 215-938-3874 2. frozen section- workload and billing (Davis, Cassie) From: Davis, Cassie cda...@che-east.org To: histonet@lists.utsouthwestern.edu Hi Histofolks, I need to pick yours brains...we are in the middle of building a workable computer system for our lab we have run into a hiccup when it come to frozen sections. As a tech I know there is actual hands on, stop what you are doing, do this now work involved. My understanding from a billing perspective it is not billable workload but an interdepartmental consultation between surgery and pathology. The problem is how to build the system so we get labels for our frozen section slides that does not interfere with the billable workload that is. I was thinking maybe it should be built in the system the same way a control slide is, does anybody have any suggestions? Cassandra Davis Histology Technician Anatomical Pathology Laboratory Saint Francis Healthcare 701 N. Clayton Street Wilmington,DE 19805 Office: 302-575-8095 Email: cda...@che-east.orgmailto:n...@che-east.org www.saintfrancishealthcare.org ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] CLIA regulations in Histology
I always added competency for my staff in their annual evaluations. It did include:Accessions specimens accurately ( pre-analytical)-ie: specimen handlingKnows how to start and maintain tissue processor with competency ( pre-analytical)Grosses specimens accurately ( analytical) and high complexity Embeds tissue samples with accuracy ( analytical)Performs microtomy with few errors and acceptable quality ( analytical)Maintains HE stain line with competency ( analytical)- also should have PT 2 times a year for HE quality. purchasePerforms special stains with quality results and few errors ( analytical)Performs IHC with quality results and few errors ( analytical and high complexity)- also need PT 2 times a year. purchaseCoverslips and labels slides with few errors ( post analytical) -case assemblyPerforms transcription with few errors ( post-analytical) Performs frozen sections with high degree of quality ( analytical)Performs frozen sections 90% of time under 20 mins ( analytical) Above is many, not all that I've always included with my annual evaluation. In which you (the supervisor) and the Medical director sign and verify that you have observed your staff and monitored them during these procedures. This was part of the Quality assurance program and monitored daily under the Quality Management program. ie; keeping track of any errors, repeats, problems and computing that data into measurable stats. Reviewing data. Problem solving skills: Data for this can be extracted from your QM logs at How was the error fixed?, which should be recorded in your QM data. So while CLIA may not regulate( as far as extra educational requirements) microtomy, embedding, routine staining are certainly things you need to show competency on for your staff. As far as PPM's go,the providers had a test for competency that they had to have another provider check off on and sign that they observed the other provider performing the test and were competent in that test. They also have to have for each PPM type test they did 2 PT ( proficiency test) a year, 6 months apart. Either by second reviews, purchase from outside source or in house quiz. For pathologist reading slides, have another qualified pathologist do second reviews for so many cases a year. 2-3% usually was the amount they chose. ie: Blind reviews. Sorry this is so long. It should be longer but that's a bunch your asking and I tried to summarize best I could. I'm sure many others can add to this as its a big subject and honestly requires a lot. I recommend purchasing a CLIA manual. And I'm not sure but Anderson used to offer a 24 CE course on CLIA. I took it but that was back when rocks was money. :) Hope this helps. Kim D From: Elaine allison Hoffman via Histonet histonet@lists.utsouthwestern.edu To: Histonet List histonet@lists.utsouthwestern.edu Sent: Friday, August 28, 2015 10:12 AM Subject: [Histonet] CLIA regulations in Histology Under CLIA regulations, all six elements of competency assessment must be completed for every test a person performs, not just testing in general.Also while CLIA does not specifically require assessment of the competency of personnel performing only pre-analytic and post-analytic activities, it is good practice to do so. I have several questions in regards to these statements: What is considered testing each person performs specifically in the histology lab? What examples of pre-analytic and post-analytic activities are performed in the histology lab? There are so many examples given for the clinical side of the lab but virtually none given for histology. Yet we are expected to carry out this requirement. I got several citations in this area during my last CLIA inspection. So now I'm required to re-write my Competency Assessment Policy, which I don't really know how to do. If you ask the CLIA inspectors, they just tell you to go on-line and check out the guidelines which are so vague and confusing and don't give you any information on histology. I need specific histology examples of measurable/observable criteria that could be acceptable for each of the six assessment methods. We are just a tiny GI histology lab doing biopsies from a private physicians' GI scoping facility. I was told that HE staining was not considered testing, neither is embedding, microtomy, coverslipping, etc. I don't know what is considered pre-analytic or post-analytic activities in histology either. The guidelines given are so general and wide-ranging. I need specifics that pertain to histology. Another citation was also in the area where the pathologists read the slides. I'm required to re-write the competency assessment procedure on our pathologists since they are do provider performed microscopy (PPM) testing. I need specific examples to do competency assessments on them as well. I know their testing is reading slides under the microscope but I need to observe
Re: [Histonet] Harford online HT program
Dear future Hartford HT online student, This is a great course. Between the course work that they sent, Freida Carson's text, workbook, and flip cards, I was able to pass the ASCP test on my first attempt My online mentor and my in-house lab mentor were the also great with both encouragement and advice. But you will have to keep an on time because it's easy to get behind when you're not constantly in a class room. I set up reminders on my email to help me keep on track I don't know of any tissue banks but there was very little tissue that we didn't have on hand in our anatomic pathology lab. Also, you don't have to use human tissue for all of it. If you have a medical or vet school in the area, check with them to see if they are willing to work with you on tissue for your courses. You might check with an anatomic lab to see if they might be able to work out an agreement for any tissue that they are discarding into medical waste. Good luck. Angela D. Hall, BA, HT(ASCP)CM -Original Message- From: histonet-requ...@lists.utsouthwestern.edu [mailto:histonet-requ...@lists.utsouthwestern.edu] Sent: Friday, August 28, 2015 1:00 PM To: histonet@lists.utsouthwestern.edu Subject: Histonet Digest, Vol 141, Issue 26 Send Histonet mailing list submissions to histonet@lists.utsouthwestern.edu To subscribe or unsubscribe via the World Wide Web, visit http://lists.utsouthwestern.edu/mailman/listinfo/histonet or, via email, send a message with subject or body 'help' to histonet-requ...@lists.utsouthwestern.edu You can reach the person managing the list at histonet-ow...@lists.utsouthwestern.edu When replying, please edit your Subject line so it is more specific than Re: Contents of Histonet digest... ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Frozen Section WL and Billing
ACK! Yep, my bad Terri L. Braud, HT(ASCP) Anatomic Pathology Supervisor Holy Redeemer Hospital Laboratory 1648 Huntingdon Pike Meadowbrook, PA 19046 Ph: 215-938-3676 Fax: 215-938-3874 -Original Message- From: Cynthia Robinson [mailto:robin...@mercyhealth.com] Sent: Friday, August 28, 2015 3:24 PM To: Terri Braud; histonet@lists.utsouthwestern.edu Cc: Cassandra P. Davis Subject: RE: Frozen Section WL and Billing Aren't fs CPT codes 88331 and 88332? From: Terri Braud via Histonet [histonet@lists.utsouthwestern.edu] Sent: Friday, August 28, 2015 1:05 PM To: histonet@lists.utsouthwestern.edu Cc: Cassandra P. Davis Subject: Re: [Histonet] Frozen Section WL and Billing We set up our system this way - Example: A specimen for frozen is sent. You cut 2 blocks of frozen tissue, 2 levels ea. The PA/Pathologist submits 3 additional blocks for a total of 5 blocks on the specimen (1-2 are the previously frozen, 3-5 additional tissue) to be cut at one level each. 1. At accession, the technical bill for the Lev 4 gross and micro (88305) drop based on the specimen type (skin biopsy) 2. The tech enters a protocol for 5 blocks, 1 HE stain each block. 3. The tech modifies the stains, and changes the HE on the first block to a stain called FS1 (Frozen Section, first block) The charge for the first frozen block, 88341, drops in when this stain is ordered 4. The tech modifies the stains, and changes the HE on the second block to a stain called FSA (Frozen Section, Additional Block) The charge for the additional frozen block, 88342, drops in when this stain is ordered. 5. The tech then enters stains that are set up in the stain dictionary as a Label Only. There is no charge associated with these stains. Stain FL1, Block 1, Stain FL2, Block 1, Stain FL1, Block 2, Stain FL2, Block 2, 6. FL1 = Frozen Label, 1st level FL2 = Frozen Label, 2nd level 7. You can define as many of these Frozen Label levels as you will ever need. 8. Print the labels for the case (some systems will allow you to set up a print job for by Label Type, and you can select Labels Only) It sounds a bit complicated to set up, but the steps are simple, and once it has been set up to use this way, it is quick, easy and accurate to use. I don't know what LIS system you are using, but this is easily adaptable for almost any system We also set up the system to include the Label Only slides to be included in the total slide count, so you get work credit there. I hope this helps. Please feel free to call or contact for any questions. Also, I'm not that far from you, if you need a little help. Terri L. Braud, HT(ASCP) Anatomic Pathology Supervisor Holy Redeemer Hospital Laboratory 1648 Huntingdon Pike Meadowbrook, PA 19046 Ph: 215-938-3676 Fax: 215-938-3874 2. frozen section- workload and billing (Davis, Cassie) From: Davis, Cassie cda...@che-east.org To: histonet@lists.utsouthwestern.edu Hi Histofolks, I need to pick yours brains...we are in the middle of building a workable computer system for our lab we have run into a hiccup when it come to frozen sections. As a tech I know there is actual hands on, stop what you are doing, do this now work involved. My understanding from a billing perspective it is not billable workload but an interdepartmental consultation between surgery and pathology. The problem is how to build the system so we get labels for our frozen section slides that does not interfere with the billable workload that is. I was thinking maybe it should be built in the system the same way a control slide is, does anybody have any suggestions? Cassandra Davis Histology Technician Anatomical Pathology Laboratory Saint Francis Healthcare 701 N. Clayton Street Wilmington,DE 19805 Office: 302-575-8095 Email: cda...@che-east.orgmailto:n...@che-east.org www.saintfrancishealthcare.org ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet Confidentiality Notice: This e-mail, including any attachments is the property of Trinity Health and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Frozen Section WL and Billing
Aren't fs CPT codes 88331 and 88332? From: Terri Braud via Histonet [histonet@lists.utsouthwestern.edu] Sent: Friday, August 28, 2015 1:05 PM To: histonet@lists.utsouthwestern.edu Cc: Cassandra P. Davis Subject: Re: [Histonet] Frozen Section WL and Billing We set up our system this way - Example: A specimen for frozen is sent. You cut 2 blocks of frozen tissue, 2 levels ea. The PA/Pathologist submits 3 additional blocks for a total of 5 blocks on the specimen (1-2 are the previously frozen, 3-5 additional tissue) to be cut at one level each. 1. At accession, the technical bill for the Lev 4 gross and micro (88305) drop based on the specimen type (skin biopsy) 2. The tech enters a protocol for 5 blocks, 1 HE stain each block. 3. The tech modifies the stains, and changes the HE on the first block to a stain called FS1 (Frozen Section, first block) The charge for the first frozen block, 88341, drops in when this stain is ordered 4. The tech modifies the stains, and changes the HE on the second block to a stain called FSA (Frozen Section, Additional Block) The charge for the additional frozen block, 88342, drops in when this stain is ordered. 5. The tech then enters stains that are set up in the stain dictionary as a Label Only. There is no charge associated with these stains. Stain FL1, Block 1, Stain FL2, Block 1, Stain FL1, Block 2, Stain FL2, Block 2, 6. FL1 = Frozen Label, 1st level FL2 = Frozen Label, 2nd level 7. You can define as many of these Frozen Label levels as you will ever need. 8. Print the labels for the case (some systems will allow you to set up a print job for by Label Type, and you can select Labels Only) It sounds a bit complicated to set up, but the steps are simple, and once it has been set up to use this way, it is quick, easy and accurate to use. I don't know what LIS system you are using, but this is easily adaptable for almost any system We also set up the system to include the Label Only slides to be included in the total slide count, so you get work credit there. I hope this helps. Please feel free to call or contact for any questions. Also, I'm not that far from you, if you need a little help. Terri L. Braud, HT(ASCP) Anatomic Pathology Supervisor Holy Redeemer Hospital Laboratory 1648 Huntingdon Pike Meadowbrook, PA 19046 Ph: 215-938-3676 Fax: 215-938-3874 2. frozen section- workload and billing (Davis, Cassie) From: Davis, Cassie cda...@che-east.org To: histonet@lists.utsouthwestern.edu Hi Histofolks, I need to pick yours brains...we are in the middle of building a workable computer system for our lab we have run into a hiccup when it come to frozen sections. As a tech I know there is actual hands on, stop what you are doing, do this now work involved. My understanding from a billing perspective it is not billable workload but an interdepartmental consultation between surgery and pathology. The problem is how to build the system so we get labels for our frozen section slides that does not interfere with the billable workload that is. I was thinking maybe it should be built in the system the same way a control slide is, does anybody have any suggestions? Cassandra Davis Histology Technician Anatomical Pathology Laboratory Saint Francis Healthcare 701 N. Clayton Street Wilmington,DE 19805 Office: 302-575-8095 Email: cda...@che-east.orgmailto:n...@che-east.org www.saintfrancishealthcare.org ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet Confidentiality Notice: This e-mail, including any attachments is the property of Trinity Health and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
