[Histonet] Salt Split DIF

[Pratt, Caroline via Histonet]

Has anyone every had a very difficult time getting the skin to split even after 
soaking for days in 2N saline?


Caroline M. Pratt, MBA
Practice Administrator Dermpath
3020 Market Street, Ste 201
Philadelphia, PA  19104
Phone 215-349-8178
Cell 610-800-1381
Fax 215-662-6150

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Re: [Histonet] Cameras in the Laboratory

[Pratt, Caroline via Histonet]

Thank you!

-Original Message-
From: Miranda Giorgi  
Sent: Monday, January 28, 2019 4:54 PM
To: Pratt, Caroline 
Cc: 'histonet@lists.utsouthwestern.edu' 
Subject: [External] RE: Cameras in the Laboratory

Hello,

We have cameras at gross and embedding.  They are really helpful for 
troubleshooting potential errors that would otherwise be difficult to trace. 
Originally, the staff was nervous about how these cameras would be used but 
have since realized their value.

Miranda Giorgi

-Original Message-
From: Pratt, Caroline via Histonet [mailto:histonet@lists.utsouthwestern.edu]
Sent: Tuesday, January 22, 2019 12:29 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Cameras in the Laboratory

If anyone is using cameras in the laboratory.  Can you share your experience 
with me and the placement/use/effectiveness, etc?  
caroline.pr...@uphs.upenn.edu<mailto:caroline.pr...@uphs.upenn.edu>.  Thank you!


Caroline M. Pratt, MBA
Practice Administrator Dermpath
3020 Market Street, Ste 201
Philadelphia, PA  19104
Phone 215-349-8178
Cell 610-800-1381
Fax 215-662-6150

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[Histonet] Cameras in the Laboratory

[Pratt, Caroline via Histonet]

If anyone is using cameras in the laboratory.  Can you share your experience 
with me and the placement/use/effectiveness, etc?  
caroline.pr...@uphs.upenn.edu.  Thank you!


Caroline M. Pratt, MBA
Practice Administrator Dermpath
3020 Market Street, Ste 201
Philadelphia, PA  19104
Phone 215-349-8178
Cell 610-800-1381
Fax 215-662-6150

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[Histonet] Buffy Coat Subspecialty

[Pratt, Caroline via Histonet]

Good afternoon,

Does anyone know the correct subspecialty for Buffy Coats on the CLIA 
certificate?

Any feedback would be appreciated!


Caroline M. Pratt, MBA
Practice Administrator Dermpath
3020 Market Street, Ste 201
Philadelphia, PA  19104
Phone 215-349-8178
Cell 610-800-1381
Fax 215-662-6150

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Re: [Histonet] Missing specimen

[Pratt, Caroline via Histonet]

I agree with using caution, but these are not truly comparable as a Pathologist 
can tell the difference between a child's skin and the skin of a mature adult 
under the microscope.


From: Aimee Tolentino via Histonet [histonet@lists.utsouthwestern.edu]
Sent: Friday, October 02, 2015 6:15 PM
To: Kim Donadio
Cc: Frazier, John; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Missing specimen

I've had something like this occur before. Unfortunately things did not end 
well. The prostate needle biopsies were labeled for two separate patients were 
labeled the same accession number and patients name. After playing the guessing 
game and sent those results out without a DNA they had removed a perfectly 
healthy prostate from the patient who did not have prostate cancer while the 
other had not received treatment. We later found this out through DNA after the 
healthy patient had gone through surgery for them to realize he didn't have 
cancer. So you MUST do the DNA.

Sent from my iPhone

> On Oct 2, 2015, at 1:00 PM, Kim Donadio via Histonet 
>  wrote:
>
> Stand your ground. Youre right! Patients lives are not guessing games. I 
> wish you the best and must forewarn you. Choosing integrity in this day and 
> age is a lonely road and often doesnt pay well. But your conscious will 
> be clear and its the right thing to do.
> ___
> Histonet mailing list
> Histonet@lists.utsouthwestern.edu
> http://lists.utsouthwestern.edu/mailman/listinfo/histonet

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RE: [Histonet] NY State regulations

[Pratt, Caroline]

Just a CLIA reg, but you are correct microtomy, embedding and routine stains 
are only Moderate Complexity testing.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Garreyf
Sent: Wednesday, April 22, 2015 3:26 PM
To: Gail Marcella
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] NY State regulations

I believe grossing of small biopsies and  performing ihc are both considered 
high complex testing. You must fulfill the clia personnel requirements of high 
complex testing.

I also believe a histotech who only cuts and performs routine stains is not 
considered highly complex. I'm not sure why? Anyone know?

Garrey 

Sent from my iPhone

 On Apr 22, 2015, at 10:55 AM, Gail Marcella gmarce...@nj-urology.com wrote:
 
 Hi - I was wondering if anyone knows the regulations regarding the NY State 
 Clinical Laboratory license. I have been a Histotech and have worked in IHC 
 for 20+ years and was required to obtain a NY State Clinical Lab License in 
 2007. I don't have and associates or bachelor degree and was not required to 
 prior to 2007. I was told on a job interview that if I don't have either of 
 these degrees that I cannot gross any specimens or run IHC. I've never heard 
 this before. Has anyone else ever heard of this??? Thanks - Gail
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[Histonet] Question about POC testing

[Pratt, Caroline]

Does anyone know if a Tzanck Smear falls under Virology or Cytology for POC 
testing in a Dermatology clinic.  I have heard conflicting theories.  Thanks!


Caroline M. Pratt, MBA
Practice Administrator Dermpath
3020 Market Street, Ste 201
Philadelphia, PA  19104
Phone 215-349-8178
Cell 610-800-1381
Fax 215-662-6150

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RE: [Histonet] New code 88343

[Pratt, Caroline]

Per specimen, but CAP is fighting for approval from CMS for per block billing.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Weems, Joyce K.
Sent: Tuesday, January 07, 2014 3:12 PM
To: histonet
Subject: RE: [Histonet] New code 88343

Does everyone charge non-Medicare per block or per specimen?

Thanks, j

Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
joyce.we...@emoryhealthcare.org



www.saintjosephsatlanta.org
5665 Peachtree Dunwoody Road
Atlanta, GA 30342

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review, use, disclosure, or distribution is prohibited. If you are not the 
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-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of 
rmweber...@comcast.net
Sent: Tuesday, January 07, 2014 1:56 PM
To: histonet
Subject: Fwd: [Histonet] New code 88343



- Forwarded Message -
From: Joe W. Walker, Jr. joewal...@rrmc.org
To: Paula Lucas plu...@biopath.org, histonet@lists.utsouthwestern.edu
Sent: Wednesday, December 18, 2013 4:15:39 PM
Subject: RE: [Histonet] New code 88343

Yes, this appears to be correct.  Excerpted from Dennis Padget:

AMA prescribes codes 88342 and 88343 for qualitative IHC:
The AMA's CPT-2014 codebook offers two codes for reporting with qualitative 
immunohistochemistry (IHC) testing. The codes and official parenthetical 
instructions for their use starting Jan. 1 are as follows:
88342  Immunohistochemistry or immunocytochemistry, each separately 
identifiable antibody per block, cytologic preparation, or hematologic smear; 
first separately identifiable antibody per slide
(Do not report 88342 in conjunction with 88360 or 88361 for the 
same antibody)
(For quantitative or semi-quantitative immunohistochemistry, see 
88360, 88361)
88343 each additional separately identifiable antibody per slide (List 
separately in addition to code for primary procedure)
  (Use 88343 in conjunction with 88342)
  (When multiple antibodies are applied to the same slide, use one unit of 
88342 for the first separately identifiable antibody and one unit of 88343 for 
each additional identifiable antibody)

CMS prescribes codes G0461 and G0462 for qualitative IHC:
CMS will not accept CPT code 88342 or 88343 on a claim effective with dates of 
service on and after Jan. 1, 2014: Those two codes are not valid for Medicare 
purposes and will be summarily denied if billed. To report a professional, 
technical or global charge for qualitative immunohistochemistry (IHC) testing 
for a Medicare beneficiary on and after Jan. 1, 2014, you must use the 
applicable HCPCS Level II code as follows:
G0461 Immunohistochemistry or immunocytochemistry, per specimen; first single 
or multiplex antibody stain
G0462   each additional single or multiplex antibody stain (List separately 
in addition to code for primary procedure) Codes G0461 and G0462 have 26 and TC 
modifier lines in the 2014 physician fee schedule, so you'll bill them using 
the modifier (or no modifier, if entitled to bill the global service) that 
applies to your practice and any given Medicare beneficiary claim.
CMS prescribes that you continue to bill for qualitative IHC testing 'per 
specimen' as you have since Jan. 1, 2012. Furthermore, you'll continue to bill 
for quantitative IHC testing 'per specimen' using CPT codes 88360 and 88361 
just as you do today and have done since Jan. 1, 2012.

Hope this helps.  We are still working through how we are going to accomplish 
this in our LIS,

Joe W. Walker, Jr. MS, SCT(ASCP)CM
Manager of Anatomical Pathology, Microbiology and Reference Rutland Regional 
Medical Center 160 Allen Street, Rutland, VT 05701
P: 802.747.1790  F: 802.747.6525
Email joewal...@rrmc.orgwww.rrmc.org

Our Vision:
To be the Best Community Healthcare System in New England

Rutland Regional...Vermont's 1st Hospital to Achieve Both ANCC Magnet 
Recognition® and the Governor's Award for Performance Excellence


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Paula Lucas
Sent: Tuesday, December 17, 2013 2:46 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] New code 88343

Hello,



Can someone shed some light for me on this new code for IHC?  I think the code 
refers to double stain antibodies?

Thanks in advance

: )
Paula Lucas

Lab Manager

Bio-Path Medical Group

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RE: [Histonet] Thermo Fisher Slide Mate printer

[Pratt, Caroline]

We are using them at Penn Medicine Dermatopathology.  We interface with
our homegrown LIS.  We like the printers.  We have had some ribbon
issues causing the print to move and some numbers to be cut off and the
ink on the fisher slide can be wiped off so we are looking at other
slides to see if they are more resistant to chemicals and oils with that
printer, but overall we have been happy with them.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Moe,
Barbi A
Sent: Thursday, October 10, 2013 3:52 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Thermo Fisher Slide Mate printer

If anyone is currently utilizing this printer, could you please share
pros and cons of your experience?  Specifically interested if anyone has
the unit interfaced with Power Path computer system.



Thank you!



Barb Moe

Gundersen Health System

1910 South Ave

La Crosse WI 54601



ba...@gundersenhealth.orgmailto:ba...@gundersenhealth.org


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[Histonet] Medicare Retractions

[Pratt, Caroline]

Has anyone out there in an Office Lab or Independent Lab seen Medicare
rejections or retractions lately on the TC portion of biopsies
originating in practices that are billing Outpatient Hospital?  I would
appreciate anyone's input.  Thanks!  

 

 

Caroline M. Pratt, MBA

Practice Administrator Dermpath

3020 Market Street, Ste 201

Philadelphia, PA  19104

Phone 215-349-8178

Cell 610-800-1381

Fax 215-662-6150

 



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RE: [Histonet] RE: Two Patient Identifiers on slides

[Pratt, Caroline]

Just for clarification, patient first and last name? Thanks!

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Tom
McNemar
Sent: Wednesday, July 31, 2013 5:49 AM
To: 'Jean Wood'; histonet@lists.utsouthwestern.edu
Subject: [Histonet] RE: Two Patient Identifiers on slides

Our cassettes are printed with the accession number, patient name, and a
barcode that also contains the DOB.  When sectioning, this barcode is
scanned at the microtome when the slides are cut.  Labels are printed,
again at the microtome, and the slides are labeled.  The slide label
contains the accession number, patient name, level number or special
stain, the pathologist's initials, and the hospital address.

Tom McNemar, HT(ASCP)
Histology Co-ordinator
Licking Memorial Health Systems
(740) 348-4163
(740) 348-4166
tmcne...@lmhealth.org
www.LMHealth.org


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jean
Wood
Sent: Tuesday, July 30, 2013 3:37 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Two Patient Identifiers on slides

Hello Histonetters,

   Recently we started utilizing a slide labeling component that is
built into our AP Easy LIS system and has accession number, levels and
patients first and last name when labels are printed out. Dymo does not
have a chemically resistant label (we have a Dymo 450 printer) and we
have been putting the labels on AFTER the slides are stained and cover
slipped.

In the meantime, the HT is writing in pencil the accession # and levels
on the slide which is then covered up with the permanent label after
cover slipping. Our Lab Manager is worried that we are not compliant as
we do not have two patient identifiers on throughout the whole process
(she wants us to write patient names on slides in pencil (before
staining) and then cover that up with the pre-printed label after
staining.

1. What is everyone else doing?
2. Have any of you found a chemically resistant label compatible with
the Dymo labeler?


Jean Wood BS, HT
Fairchild Medical Center Pathology Dept.
Ph:530.841.6243 Fax:530.841.6232
jw...@fairchildmed.orgmailto:jw...@fairchildmed.org
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RE: [Histonet] Two Patient Identifiers on slides

[Pratt, Caroline]

My understanding was the same as Joe's and at least to date, that is what we 
have presented during survey and it has been deemed acceptable.  However, we 
are accredited by TJC not CAP.  My question to those of you who are providing 2 
patient identifiers on blocks?  How do you make it fit?  If anyone could scan 
an image to caroline.pr...@uphs.upenn.edu I would greatly appreciate it!  As of 
now, we have the unique patient accession number and a barcode with the 
accession number as well.  We are in our survey window I would like to be sure 
we are compliant.  

One more question, if you label slides and blocks with a name and DOB from the 
requisition and find out during insurance validation that the name is 
misspelled or the DOB is inaccurate, how do you handle that?  Thanks for your 
help.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Joe W. Walker, 
Jr.
Sent: Tuesday, July 30, 2013 4:31 PM
To: Michelle Moore; Jean Wood; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Two Patient Identifiers on slides

I don't think this is technically correct according to the CAP.  The question 
in the most recent checklist states:

**REVISED** 07/11/2011

ANP.52000 Specimen ID   Phase II
The identity of every specimen and image, including blocks, slides, and 
electron micrographs, is maintained through each step in processing.

NOTE: Each block of tissue must be individually labeled with unique patient 
identifier(s), e.g.
accession number etched onto the block or embedded into it. Storage of 
unlabeled blocks in separate containers that are labeled with patient number or 
name does not meet this requirement.
Evidence of Compliance:

✓ Written procedure describing system for maintaining specimen identity

This question does not state that 2 identifiers must be on the slides and 
blocks, etc.  It states it must be a unique identifier throughout the process.  
A specimen accession number would technically suffice.  You can add additional 
identifiers if that helps in your process but they are not required.

I believe that this is often confused with the General lab question GEN.40491 
which requires that any specimen that is collected and submitted to the lab 
must have 2 unique identifiers on it.  Once the specimen is in the lab, the 
unique accession number would suffice.

Now, if you are utilizing the 2 identifiers to help prevent mislabeling, then I 
think it is a good idea as an extra precaution step.  We are fortunate to have 
a xylene resistant label and printer that allows us to label the slides prior 
to processing.

My two cents as a manager,

Joe W. Walker, Jr. MS, SCT(ASCP)CM
Anatomical Pathology Manager
Rutland Regional Medical Center
160 Allen Street, Rutland, VT 05701
P: 802.747.1790  F: 802.747.6525
Email joewal...@rrmc.orgwww.rrmc.org

Our Vision:
To be the Best Community Healthcare System in New England

Rutland Regional…Vermont’s 1st Hospital to Achieve Both ANCC Magnet 
Recognition® and the Governor’s Award for Performance Excellence


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Michelle Moore
Sent: Tuesday, July 30, 2013 3:46 PM
To: Jean Wood; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Two Patient Identifiers on slides

We are writing path #, date of birth  patient initials as identifiers. Michelle



From: Jean Wood jw...@fairchildmed.org
To: histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu
Sent: Tuesday, July 30, 2013 2:37 PM
Subject: [Histonet] Two Patient Identifiers on slides


Hello Histonetters,

  Recently we started utilizing a slide labeling component that is built 
into our AP Easy LIS system and has accession number, levels and patients first 
and last name when labels are printed out. Dymo does not have a chemically 
resistant label (we have a Dymo 450 printer) and we have been putting the 
labels on AFTER the slides are stained and cover slipped.

In the meantime, the HT is writing in pencil the accession # and levels on the 
slide which is then covered up with the permanent label after cover slipping. 
Our Lab Manager is worried that we are not compliant as we do not have two 
patient identifiers on throughout the whole process (she wants us to write 
patient names on slides in pencil (before staining) and then cover that up with 
the pre-printed label after staining.

1. What is everyone else doing?
2. Have any of you found a chemically resistant label compatible with the Dymo 
labeler?


Jean Wood BS, HT
Fairchild Medical Center Pathology Dept.
Ph:530.841.6243 Fax:530.841.6232
jw...@fairchildmed.orgmailto:jw...@fairchildmed.org
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[Histonet] Per Diem Techs

[Pratt, Caroline]

The Dermatopathology lab at Penn Medicine is looking for per diem HT's
that can work immediately any shift but preferably nights.  We operate
24/5.  If you are interested, please email me your resume at
caroline.pr...@uphs.upenn.edu. 

 

Thanks!

 

 

Caroline M. Pratt, MBA

Practice Administrator Dermpath

3020 Market Street, Ste 201

Philadelphia, PA  19104

Phone 215-349-8178

Fax 215-662-6150

 



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RE: [Histonet] HE Stainer Leica vs Sakura (Sophia Lin)

[Pratt, Caroline]

We recently purchased a Sakura and we are very, very pleased with the
results and ease of use. :)

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of
kgrob...@rci.rutgers.edu
Sent: Thursday, March 21, 2013 9:32 AM
To: histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] HE Stainer Leica vs Sakura (Sophia Lin)

I have the Leica stainer and coverslipper, and I don't have anywhere
near
as many problems with the coverslipper as  described by Contact below.

Mine alerts once in a while; if his alerts that much, then something is
seriously wrong.  (The last time mine alerted that much, it needed a new
brain-this is an older machine that had 5 circuit boards and one gave
out-and one new sensor.  Still worth it to us to fix it.)  Anything as
complex as staining and coverslipping robots will be fussy from time to
time.  But I love my Leica!

Kathleen

Principal Lab Technician
Neurotoxicology Labs
Molecular Pathology Facility Core
Dept of Pharmacology  Toxicology
Rutgers, the State University of NJ
41 B Gordon Road
Piscataway, NJ 08854
(848) 445-1443
FAX (732) 445-6905

 We have both and love them both. IF you are using tape coverslips then
 perhaps Sakura is your best bet. We use glass coverslips on BOTH the
Leica
 and Sakura and find fewer problems with the Leica.

 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of
Contact
 HistoCare
 Sent: Wednesday, March 20, 2013 6:49 PM
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] HE Stainer Leica vs Sakura (Sophia Lin)

 Both stainers are powerhouses. The Leica has a plain menu screen with
a
 simple interface while the Sakura has a LCD screen with detailed
 information about what stage the staining process a rack is along with
 multiple menus.  The difference between the performance changes
 drastically when the respective coverslipper attachments become
involved.

 The Leica is seriously no match for the Sakura in this respect. The
 Leica's coverslipper is its Achilles heel and requires a LOT more
 attention and alerts frequently, very frequently. It takes a separate
rack
 for staining the slides at the beginning of the process and eventually
 transfers them to a different rack one the cover slip is complete.
This
 one uses glass and frequently drops glass, creates bubbles, drops and
 breaks slides. You will have to frequently purge the system and clean
the
 cover medium needle dropper.  Once done, it only holds. Two racks of
30
 slides and will alert until you remove it. You can't leave this one
alone
 for more than 5 minutes without an alert. Seriously.

 The Sakura's coverslipper uses cover tape which won't need to be
replaced
 not even remotely as soon as the glass in the Leica.  Finished slides
 remain in a carousel at the top and can hold about 10 racks of 20
before
 it alerts. For high volume, the Sakura pair wins hands down. You won't
 lose productivity time by needing to check on this machine pair.

 HistoCare.com






 Hi,

 We are currently looking to switch out our linear MKII stainer for
either
 a Leica XL autostainer or the Sakura Tissue-Tek Prisma. Any
 recommendations?
 Are quantity of HEs is increasing and we need adequate equipment to
meet
 our workload. The incorporated oven seems excellent on both stainers.
Any
 pros/cons would be greatly appreciated! Also, if you are currently
using
 the stainer, does it meet your workload and what is your volume?

 Thanks!

 Sophia
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RE: [Histonet] Grossing Qualifications

[Pratt, Caroline]

Your tech is grandfathered in because she was grossing prior to 88.  You just 
need documentation to prove it.  We have a similar situation in our lab.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sullivan, 
Beatrice
Sent: Wednesday, March 06, 2013 7:39 AM
To: Ian R Bernard; Debbie Granato; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Grossing Qualifications

The standard was changed for CAP. There is no more processing vs. grossing.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Ian R Bernard
Sent: Wednesday, March 06, 2013 7:35 AM
To: Debbie Granato; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Grossing Qualifications

Just did some work on this. There is a difference in non-pathologist processing 
versus grossing of specimens.  The prostate biopsies is considered a processing 
versus a grossing.

CAP and thus CLIA 88 states these as the qualifications for grossing For a 
technician to perform grossing procedures, he or she must possess either an 
associate degree or educational equivalent i.e. completion of 60 semester hours 
from an accredited institution which include 24 hours of medical laboratory 
technology courses or 24 hours of science courses that includes 6 semester 
hours of biology, chemistry or medical laboratory technology in any 
combination, or earn an associate degree in a laboratory science or medical 
laboratory technology, obtained from an accredited institution

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Debbie Granato
Sent: Tuesday, March 05, 2013 9:11 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Grossing Qualifications

We have an  employee who has attended a School of Medical Technology Program 
for one year (1974-75) and passed the registry in 1975. They have grossed since 
2006 and have 8 hours of biology from a local college. 
Do these qualifications make them eligible to gross in prostate biopsies in an 
in- house laboratory?

 We are going over the requirements and are not sure if the experience that she 
has counts for her grossing in our lab. Does the time in the school fulfill the 
requirements?
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RE: [Histonet] Re: Question

[Pratt, Caroline]

For example, we have a 35+ year Immunotech with a Bachelors of Science who 
learned bench techniques by hand, when the automated stainer malfunctions, she 
is able to identify how to pick up where the machine left off and complete the 
test, saving the tissue. As Rene said, by understanding the science and theory 
behind the mechanics, you improve patient outcomes and are capable of high 
complexity testing even if you have mechanic assistance under most 
circumstances.  

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J Buesa
Sent: Thursday, January 24, 2013 12:43 PM
To: histot...@imagesbyhopper.com; 'Sullivan, Beatrice'; 'Mark Tarango'; 'Tim 
Higgins'
Cc: histonet@lists.utsouthwestern.edu; courtney.pie...@quintiles.com
Subject: Re: [Histonet] Re: Question

We have to remember that it is not just putting slides in/out of automated 
stainer. 
It is also understanding what the histotech is doing, how to design a 
validation experiment, how to look for an antibody the pathologists wants to 
test, how to troubleshoot a problem, how to justify switching from a detection 
system to another more convenient to the procedure on hand that for any reason 
no longer works.
A histotech needs to know what s/he is doing. And to do all of the above has to 
have knowledge besides the training and the mechanics of what s/he is doing.
Designating a task as high complexity demands that the histotech has the 
basic theoretical knowledge and therefore deserves a better pay.
As some people has said before, putting slides in/out of an automated stainer 
of any kind) can be done by a monkey.
Understanding what is involved in IHC is above a monkey's pay grade.
René J.

From: histot...@imagesbyhopper.com histot...@imagesbyhopper.com
To: 'Sullivan, Beatrice' bsulli...@virtua.org; 'Mark Tarango' 
marktara...@gmail.com; 'Tim Higgins' thiggin...@msn.com 
Cc: histonet@lists.utsouthwestern.edu; courtney.pie...@quintiles.com 
Sent: Thursday, January 24, 2013 11:18 AM
Subject: RE: [Histonet] Re: Question

It also depends on the State you are in.  Florida considers this a high
complexity test and requires that a licensed technologist either do the test
or oversee a licensed technician who is performing the test.

From my view, especially with all the automatic stainers out there, simply
putting the slides on/off the stainer should not be considered high
complexity!  The interpretation of the stain should be done by a trained
individual though.

Just my $0.02.

Michelle

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sullivan,
Beatrice
Sent: Thursday, January 24, 2013 7:57 AM
To: Mark Tarango; Tim Higgins
Cc: histonet@lists.utsouthwestern.edu; courtney.pie...@quintiles.com
Subject: RE: [Histonet] Re: Question

I called CAP a short time ago about who was qualified to run these. I was
told then that there was no requirement for a degreed person to run these. 

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Mark Tarango
Sent: Wednesday, January 23, 2013 4:20 PM
To: Tim Higgins
Cc: histonet@lists.utsouthwestern.edu; courtney.pie...@quintiles.com
Subject: Re: [Histonet] Re: Question

If anyone has any documentation that says the staining of IHC slides is NOT
high complexity it would help a histonetter out there.  I got an e-mail from
someone who is HT(ASCP)QIHC but does not have an AA degree.  Their lab
director is threatening their job saying they aren't qualified to do IHC
staining.  If anyone has something to refer to it would be helpful for this
person.  I already suggested contacting CAP and getting a written response.

I believe IHC is high complexity but not the staining portion.  Since no
result is being produced by the IHC tech how can this be high complexity?

thanks

Mark

On Wed, Jan 23, 2013 at 11:44 AM, Tim Higgins thiggin...@msn.com wrote:


 The professional interpretation is considered a high complexity test 
 but not the actual technical component.



 Thanks,



 Timothy N. Higgins, HT (ASCP), QIHC

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RE: [Histonet] CLIA

[Pratt, Caroline]

That's our policy at Penn Medicine as well.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Webb,
Dorothy L
Sent: Wednesday, January 23, 2013 1:14 PM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] CLIA

According to CLIA and CAP, IHC is considered High Complexity testing
which is why some labs only allow a degreed tech to perform  IHC tests.



  
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[Histonet] Interstate Pathology and Consultations

[Pratt, Caroline]

 

I know this is a relatively hot topic and there are varying
interpretations of the law on the issue of Interstate Pathology and
Consultations.  I have read CAP's stance, but I was wondering if anyone
has any good articles, grids, charts, tables, etc. on interstate
pathology practices.  I am particularly looking for the states that do
not allow even consultations by out of state pathologists and details on
guidelines for interstate consultation for the more stringent states.
Thanks for any guidance you can provide.

 

Car J

 

Caroline M. Pratt, MBA

Practice Administrator Dermpath

3020 Market Street, Ste 201

Philadelphia, PA  19104

Phone 215-349-8178

Fax 215-662-6150

 



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RE: [Histonet] 88305TC starting to hit the fan...

[Pratt, Caroline]

This statement is ridiculous and not worth responding to further than to say, 
clearly you don't understand the CMS process.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of David Kemler
Sent: Monday, November 19, 2012 9:49 PM
To: Fellow HistoNetters
Subject: Re: [Histonet] 88305TC starting to hit the fan...

Hmmm...I think more people should have paid attention to Obamacare two years 
ago when it was being shoved down eveyones throat. Oh well.. as old saying 
goes...You ain't seen nottin' yet! I'm just amazed that there are so many in 
the profession who are surprised about the changes beginning to take place, 
there are many, many more to come in 2013  14 and all of them affect your job 
or lack thereof. :)
 
Everyone had the opportunity to change things on November 6th - they chose not 
to. So, you live with it.
 
Yours,
David
 
 



From: Davide Costanzo pathloc...@gmail.com
To: Webster, Thomas S. twebs...@crh.org 
Cc: histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu 
Sent: Monday, November 19, 2012 6:46 PM
Subject: Re: [Histonet] 88305TC starting to hit the fan...

While this stinks on many levels, I have to take issue with the shift
wealth from specialists to family practice - family practice docs
have been the frontline of medicine, all the while earning less than a
quarter of what specialists earn. It's about time they get a boost.
Too many specialists earn over a million a year, while the family
practice guys/ladies can barely pay their student loans.

Sent from my iPhone

On Nov 19, 2012, at 1:25 PM, Webster, Thomas S. twebs...@crh.org wrote:

 CAP had a webinar last week about the cut. These are some very scary times. 
 For some reason the government has decided to shift wealth from specialists 
 to family practice. I am becoming more angry with the affordable care act 
 everyday.

 http://www.cap.org/apps/cap.portal?_nfpb=truecntvwrPtlt_actionOverride=%2Fportlets%2FcontentViewer%2Fshow_windowLabel=cntvwrPtltcntvwrPtlt%7BactionForm.contentReference%7D=advocacy%2Fadvocacy_related_webinars.html_state=maximized_pageLabel=cntvwr


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RE: [Histonet] 88305TC starting to hit the fan...

[Pratt, Caroline]

Agreed!

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J Buesa
Sent: Tuesday, November 20, 2012 8:55 AM
To: Davide Costanzo; Webster, Thomas S.
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] 88305TC starting to hit the fan...

Very well said! 
René J.



From: Davide Costanzo pathloc...@gmail.com
To: Webster, Thomas S. twebs...@crh.org 
Cc: histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu 
Sent: Monday, November 19, 2012 6:46 PM
Subject: Re: [Histonet] 88305TC starting to hit the fan...

While this stinks on many levels, I have to take issue with the shift
wealth from specialists to family practice - family practice docs
have been the frontline of medicine, all the while earning less than a
quarter of what specialists earn. It's about time they get a boost.
Too many specialists earn over a million a year, while the family
practice guys/ladies can barely pay their student loans.

Sent from my iPhone

On Nov 19, 2012, at 1:25 PM, Webster, Thomas S. twebs...@crh.org wrote:

 CAP had a webinar last week about the cut. These are some very scary times. 
 For some reason the government has decided to shift wealth from specialists 
 to family practice. I am becoming more angry with the affordable care act 
 everyday.

 http://www.cap.org/apps/cap.portal?_nfpb=truecntvwrPtlt_actionOverride=%2Fportlets%2FcontentViewer%2Fshow_windowLabel=cntvwrPtltcntvwrPtlt%7BactionForm.contentReference%7D=advocacy%2Fadvocacy_related_webinars.html_state=maximized_pageLabel=cntvwr


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RE: [Histonet] Devasting news on 88305TC component--Where the $18came from

[Pratt, Caroline]

Anyone who is willing to share how they calculate their cost per slide,
can you please email it to caroline.pr...@uphs.upenn.edu?  Thanks!

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Lester
Raff MD
Sent: Tuesday, November 06, 2012 2:20 PM
To: histonet@lists.utsouthwestern.edu
Subject: FW: [Histonet] Devasting news on 88305TC component--Where the
$18came from

Sent: Tuesday, November 06, 2012 12:35 PM
To: 'histonet-boun...@lists.utsouthwestern.edu'
Subject: RE: [Histonet] Devasting news on 88305TC component--Where the
$18 came from

The $18.00 figure came from an article published in Archives of
Pathology and Lab Medicine: 

Pathology Economic Model Tool
A Novel Approach to Workflow and Budget Cost Analysis in an Anatomic
Pathology Laboratory
David Muirhead, BSc; Patricia Aoun, MD, MPH; Michael Powell, MS, FASHP;
Flemming Juncker, MBA; Jens Mollerup, MSc, PhD


(Arch Pathol Lab Med. 2010;134:1164-1169)

Thanks to Joe Plandowski of IOL for providing me with the reference.

Lester J. Raff, MD
Medical Director
UroPartners Laboratory
2225 Enterprise Dr. Suite 2511
Westchester, Il 60154
Tel 708.486.0076
Fax 708.492.0203
-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Webster,
Thomas S.
Sent: Monday, November 05, 2012 3:01 PM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] Devasting news on 88305TC component

I wish there was a way to put a positive spin on this but  I can't think
of any. We can only hope it kills off client billing somehow.

Whomever the stakeholder was that told CMS a typical 88305 costs 18
bucks, I'd love to know how he/she came up with that number. It's
insultingly low.

http://www.acla.com/sites/default/files/ACLA%20comments%202012%20PFS%20p
roposed%20rule%208-30-11_3.pdf

I believe whoever it was had the goal to stop the proliferation of POLs.
Wouldn't surprise me if they worked for a large national lab that had
lost a lot of business to POLs.



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RE: [Histonet] RE: Two identifiers...

[Pratt, Caroline]

It doesn't meet criteria for TJC, we used that for years and it was acceptable 
until our last survey.  We were written up for it and had to send labeling 
instructions to all of our submitting clinicians and conduct bottle audits to 
evidence that 90% of all bottles had patient full name (last and first), DOB 
and site along with the accession number.  It is a tremendous ongoing effort, 
but we are there now. 

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Ron
Sent: Wednesday, August 15, 2012 12:39 PM
To: pamar...@uams.edu; tmcne...@lmhealth.org; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] RE: Two identifiers...

We do the same as Pam with the patient name and case number

Sent from my Verizon Wireless 4G LTE smartphone



Marcum, Pamela A pamar...@uams.edu wrote:

We use the specimen or accessioning number and the patient name as the two 
identifiers and that seems to meet the criteria.  We use the Thermo cassette 
writer and it transfers the information to the slides.

Pam Marcum
UAMS

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Tom 
McNemar
Sent: Wednesday, August 15, 2012 10:03 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Two identifiers...

Hello all,

For those of you using cassette and slide labelers
Does your system permit you to print the accession number, patient name, and  
DOB on the face of the cassette?  Are you using the specimen number and name 
as your two identifiers?

Tom McNemar, HT(ASCP)
Histology Co-ordinator
Licking Memorial Health Systems
(740) 348-4163
(740) 348-4166
tmcne...@lmhealth.orgmailto:tmcne...@lmhealth.org
www.LMHealth.orgfile:///C:\Documents%20and%20Settings\TMCNEMAR\Applica
tion%20Data\Microsoft\Signatures\www.LMHealth.org


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RE: [Histonet] RE: Two identifiers...

[Pratt, Caroline]

I am so sorry to cause confusion, I am referring to specimen bottles, my 
apologies.

-Original Message-
From: Tom McNemar [mailto:tmcne...@lmhealth.org] 
Sent: Thursday, August 16, 2012 9:51 AM
To: Pratt, Caroline; Ron; pamar...@uams.edu; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] RE: Two identifiers...

I am a little confused.  Are you referring to specimen bottles?  I was 
inquiring about what identifiers are being used on printed cassettes.

Tom McNemar, HT(ASCP)
Histology Co-ordinator
Licking Memorial Health Systems
(740) 348-4163
(740) 348-4166
tmcne...@lmhealth.org
www.LMHealth.org

-Original Message-
From: Pratt, Caroline [mailto:caroline.pr...@uphs.upenn.edu]
Sent: Thursday, August 16, 2012 9:47 AM
To: Ron; pamar...@uams.edu; Tom McNemar; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] RE: Two identifiers...

It doesn't meet criteria for TJC, we used that for years and it was acceptable 
until our last survey.  We were written up for it and had to send labeling 
instructions to all of our submitting clinicians and conduct bottle audits to 
evidence that 90% of all bottles had patient full name (last and first), DOB 
and site along with the accession number.  It is a tremendous ongoing effort, 
but we are there now.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Ron
Sent: Wednesday, August 15, 2012 12:39 PM
To: pamar...@uams.edu; tmcne...@lmhealth.org; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] RE: Two identifiers...

We do the same as Pam with the patient name and case number

Sent from my Verizon Wireless 4G LTE smartphone



Marcum, Pamela A pamar...@uams.edu wrote:

We use the specimen or accessioning number and the patient name as the two 
identifiers and that seems to meet the criteria.  We use the Thermo cassette 
writer and it transfers the information to the slides.

Pam Marcum
UAMS

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Tom
McNemar
Sent: Wednesday, August 15, 2012 10:03 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Two identifiers...

Hello all,

For those of you using cassette and slide labelers
Does your system permit you to print the accession number, patient name, and  
DOB on the face of the cassette?  Are you using the specimen number and name 
as your two identifiers?

Tom McNemar, HT(ASCP)
Histology Co-ordinator
Licking Memorial Health Systems
(740) 348-4163
(740) 348-4166
tmcne...@lmhealth.orgmailto:tmcne...@lmhealth.org
www.LMHealth.orgfile:///C:\Documents%20and%20Settings\TMCNEMAR\Applica
tion%20Data\Microsoft\Signatures\www.LMHealth.org


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RE: [Histonet] RE: CAP vs. CLIA

[Pratt, Caroline]

Thank you!

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn,
Hazel V
Sent: Thursday, May 17, 2012 8:26 AM
To: 'Courtney Pierce'
Cc: histonet@lists.utsouthwestern.edu
Subject: [Histonet] RE: CAP vs. CLIA

CAP does not consider us testing personnel. How they come by this is a
mystery to me.   In a recent memo from CAP it describes this:

 Why does CAP require the completion of the Laboratory Personnel
Evaluation Roster form and when was this process implemented? 

As part of CAP's deemed status with CMS as an accrediting organization,
CMS required CAP to implement a more stringent process to document that
accredited laboratories have appropriately qualified personnel and
adequate documentation of personnel qualifications. The Laboratory
Personnel Evaluation Roster form requires laboratories to confirm that
personnel files contain the information necessary for laboratories to be
in compliance with the CLIA personnel qualification regulations and CAP
Checklist requirements prior to the inspection. It is also used by the
inspection team to assist in the auditing of the records during the
inspection to confirm compliance with the Checklist requirements. The
process of completing the personnel form took effect in August 2009.

And goes on to say:
Do I need to list histologists on the Laboratory Personnel Evaluation
Roster?  

Typical histologist duties (e.g., fixation, embedding, microtomy,
staining and cover slipping) are not considered testing. Therefore, it
is not necessary to list these personnel on the roster. However, if the
histologist is performing any part of the macroscopic tissue examination
which is considered high complexity testing, it is necessary to list
those personnel on the roster. Such personnel must provide documentation
at minimum of an associate's degree/transcripts or high school diploma
or equivalent for individuals performing grossing at the same laboratory
prior to September 1, 1997.

Hazel Horn
Supervisor of Histology/Autopsy/Transcription
Anatomic Pathology
Arkansas Children's Hospital
1 Children's Way | Slot 820| Little Rock, AR 72202
501.364.4240 direct | 501.364.1302 office | 501.364.1241 fax
hor...@archildrens.org
archildrens.org




100 YEARS YOUNG!
JOIN THE PARTY AT
ach100.org


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Courtney
Pierce
Sent: Wednesday, May 16, 2012 2:27 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] CAP vs. CLIA


Can someone help me with the High Complexity Test with CAP vs. CLIA.
Thanks
Courtney Pierce
IHC Specialist
Quintiles
Translational RD - Oncology
Innovation
Navigating the new health

610 Oakmont Lane
Westmont, IL 60559

Office: + 630-203-6234
courtney.pie...@quintiles.com

clinical | commercial | consulting | capital


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RE: [Histonet] Aetna and In-Office Lab Accreditation

[Pratt, Caroline]

There are pros and cons to both business structures.  I love the
information I get on histonet, but why does everything have to turn into
an argument?  Can't we just respect each other's opinions? 

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Kim
Donadio
Sent: Monday, April 09, 2012 5:58 PM
To: Daniel Schneider
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Aetna and In-Office Lab Accreditation

To suggest that any physician who goes into private practice and has
their own lab is any more of a money hound than any other physician at a
hospital would also be disingenuous . And of course this is about money.
It's about one group of people trying to get another group of people out
of the lab business because they want that money. It's also about the
government squeezing insurance companies into these more stringent
regulations. Now I'm not against more stringent regulations but I do
find it offensive of how they are going about it. The little guy will
take the hits on this one. I guess what they want is a bunch of walmart
like labs. Private practices serve a patient care cause just as hospital
labs do. They all make a diagnosis.  They all deserve to be paid. 

My 2 cents

Sent from my iPhone

On Apr 9, 2012, at 4:47 PM, Daniel Schneider dlschnei...@gmail.com
wrote:

 This is all about the money. The rest is rationalization.
 
 The reason a group of non-pathologist physicians opens an in-house
 pathology lab and hires an employee pathologist is first and foremost
 to harvest profit from pathology reimbursement. Be a fly on the wall
in the
 partners' meetings and you would know that's what they are talking
about.
 
 To suggest otherwise is disingenuous.
 
 And the implication that the generalist anatomic pathologist is
unqualified
 to be signing out skins, prostates, GI's and whatever is
reprehensible.
 This is not cardiac bypass surgery, and AP pathologists *are* trained
to do
 all of the above. I eagerly defer to subspecialty expert consultants
as
 needed, but most of the time they're not needed.
 
 Hospital labs that see few, if any skins, prostates, GI's, are only in
that
 pickle because of the cherrypicking they've already been subjected to.
 
 *in-office AP labs are an emerging frontier of employment for
histologists
 and pathologists.  In an era of high unemployment, another source of
 employment for our professions is a good thing.*
 
 Really? The jobs follow the specimens. Given the same number of
specimens,
 there's the same number of jobs, more or less, just under different
 circumstances and in different locations   Unless you're suggesting
that
 in-office labs will generate increased specimens, and thus increased
jobs
 though overutilization, i.e. excessive numbers of unnecessary biopsies
and
 abuse of the patient and the taxpayer.  In which case I have to say
there's
 a grain of truth. And the truth hurts.  And it's not  a good thing.
 
 None of this should be taken as criticism of histotechs and
pathologists
 who find themselves working in an in-office lab. I know there's bills
to
 pay, families to take care of, and god knows it's hard for a
pathologist to
 find a job these days with the numbers our residency programs keep
churning
 out (but that's another rant...).
 
 Dan Schneider, MD
 Amarillo, TX
 
 
 
 
 
 
 
 
 
 
 
 
 On Mon, Apr 9, 2012 at 12:52 PM, jdcoch...@aol.com wrote:
 
 
 Histonetters:
 
 In-office AP labs provide a valuable service to the practices they
serve
 by facilitating 1) better communication between pathologists and
ordering
 clinicians, 2) quality metrics that are practice-specific, and 3)
high
 volume, sub-specialization for both histotechnologists and
pathologists.
 In other words, the more of one type of histopathology a lab does
(e.g.,
 skin, prostate, GI), the better it gets.  Most people would not think
of
 having their cardiac bypass surgery done at a community hospital
doing
 50/year; you want to go where more than 500/year are done.  In
 histopathology, the kinds of volume you want are in the thousands for
each
 tissue type.  Many hospital labs do little skin or prostate histology
 anymore.  Many sub-specialty in-office AP labs may do thousands of
cases of
 one tissue type every year.
 
 Aside from that, in-office AP labs are an emerging frontier of
employment
 for histologists and pathologists.  In an era of high unemployment,
another
 source of employment for our professions is a good thing.
 
 This requirement by an insurer for accreditation will help to
validate
 these in-office AP labs' commitment to quality and put them on the
level
 with their hospital counterparts.
 
 John D. Cochran, MD, FCAP
 
 
 
 
 
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RE: [Histonet] Microwave processors

[Pratt, Caroline]

I believe there was a conference this month in your area and they were
introducing a new to the market rapid traditional constant feed
processor.  Let me see if I can track down the info. :)

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Martin,
Erin
Sent: Tuesday, April 10, 2012 10:38 AM
To: histonet
Subject: [Histonet] Microwave processors

Hi histonetters!

Our pathologists want to turn around skin biopsies same day and are
again looking at microwave processors.  Due to a bad past experience,
I'm not enthused but perhaps there is someone out there who loves their
microwave processor?  Even on derm?  Or has anyone worked out a good
rapid derm processing protocol on a conventional processor?



Thank you so much!

Erin



Erin Martin, Histology Supervisor
UCSF  Dermatopathology Service
415-353-7248

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RE: [Histonet] RE: Microwave processors

[Pratt, Caroline]

We cannot say the same, we had issues with shaves appearing cooked.
We had specialists out several times and after many suggestions, nothing
resolved the issue.  It doesn't happen consistently but it definitely
happens and we even attempted to track by tech or shifts or when the
solutions were changed and no patterns could be found after several
years.  Sakura has a new vendor for reagents now and they are going to
come run some test slides but the VIP quality for derm keeps the
pathologists much happier based on our experience.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of
Bartlett, Jeanine (CDC/OID/NCEZID)
Sent: Tuesday, April 10, 2012 12:14 PM
To: Martin, Erin; histonet
Subject: [Histonet] RE: Microwave processors

Erin,

We have Sakura's Xpress and skins have always turned out just fine for
us. It is very easy to use and maintain. 

Jeanine H. Bartlett
Centers for Disease Control and Prevention
Infectious Diseases Pathology Branch
404-639-3590
jeanine.bartl...@cdc.hhs.gov

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Martin,
Erin
Sent: Tuesday, April 10, 2012 10:38 AM
To: histonet
Subject: [Histonet] Microwave processors

Hi histonetters!

Our pathologists want to turn around skin biopsies same day and are
again looking at microwave processors.  Due to a bad past experience,
I'm not enthused but perhaps there is someone out there who loves their
microwave processor?  Even on derm?  Or has anyone worked out a good
rapid derm processing protocol on a conventional processor?



Thank you so much!

Erin



Erin Martin, Histology Supervisor
UCSF  Dermatopathology Service
415-353-7248

Confidentiality Notice
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which it is addressed and may contain confidential and/or priviledged
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from any computer.


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RE: [Histonet] Aetna and In-Office Lab Accreditation

[Pratt, Caroline]

I don't think it was meant as a personal attack, it's a larger
conceptual issue on ethics of the business principle behind the model
for in-office laboratories and the debate isn't about jobs, it's about
the best interest of the patient.  I am sure your skill set is
exceptional.


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Nicole
Tatum
Sent: Tuesday, April 10, 2012 11:56 AM
To: Davide Costanzo; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Aetna and In-Office Lab Accreditation

Rude is when you attack someone who is your equal. Yes, your right im a
schmuck because I work in private practice. I didnt know that having my
education, and completing my internship, and having 12yrs in the field
made me a lesser histologist because I work in private practice.
Seriouly
get a grip. The conflict lies in you, if you cant see that we all are
working to support our families. I really dont care where my fellow
Histologist work, because I am happy they have a job and our
professional
is able to grow and that there are other opportunities for Histologist
outside of hospitals. These in-house lab have created all new
opportunities for Histologist and I back them 100%. Great thing about
being an American, is I dont have to agree with you. This field has
supported my family and allowed me to live comfortably, I will defend it
for myself and others who will be entering the work force. I can only
hope
they have me for a mentor. I choose to promote my field and work with my
collegues to ensure the survival of all of our jobs.

Nicole Tatum HT ASCP










 You're just plain rude. Whenever someone is wrong, it is easy to
 criticize others. Takes the focus off you.

 Unlike you, I will not post my personal rude comments on the entire
 list serv.

 You are right, I shouldn't argue with a lesser educated schmuck
either.

 Sent from my Windows Phone
 From: Nicole Tatum
 Sent: 4/10/2012 8:18 AM
 To: Davide Costanzo; histonet@lists.utsouthwestern.edu
 Subject: RE: [Histonet] Aetna and In-Office Lab Accreditation
 Really, An undertaker. Yea, theres definately a conflict here, you. No
 since in wasting my time.


 Nicole






  Start with reading Dr. Schneider's post. Then read Richard Cartun's
 post. Those should deal will what you are talking about very well.

 These in-office labs should not exist, for the very same reason the
 undertaker is no longer the ambulance driver. There is a very real,
and
 significant conflict of interest.

 Sent from my Windows Phone
 From: Nicole Tatum
 Sent: 4/10/2012 6:45 AM
 To: Davide Costanzo; histonet@lists.utsouthwestern.edu
 Subject: Re: [Histonet] Aetna and In-Office Lab Accreditation
 Money is at the root of all finicial decisions, in-house labs and
 hospitals. There are many over utilization of resources within the
 health
 care field. Many gallbladder surgerious are performed unneccesarly by
 general surgeous who's practice are within hospitals walls.
 Tonsilectomy.
 etc. How are those specimens not self reffered to the hospitals AP
lab.
 David you made the comment about specialities staying with there
 specialty
 and not branching out. A dermatopathologist specializes in derm
 specimens
 so why is it so far fetched that he would read derm specimens from
all
 sources, hospitals or in-house labs. My in-house lab has a higher
turn
 around rate, lower overhead, and cuts courier fees out. We also do a
 service to our patients by allowing them one stop shopping. We can
 service
 all there needs and they do not have to have multiple appointments at
 different facilities. This cuts down on their copay and billing from
 multiple doctors. Also, it would cost more for a person to have Mohs
 surgery in a hospital setting. As we all know cost are higher at a
 hospital because they have higher overhead. The hospital is self
 reffering
 when they let a surgery center or group be affiliated with them. The
 surgery center was allowed to join the hospital so the hospital could
 reep
 the revenue generated and process their specimens. Either way, we are
 all
 joined by a common form of employment, and one facility is not better
 than
 another. My field provides jobs and creates revenue just like yours.
 Insurance company are going to make changes to try and make revenue
 during
 this change into OBAMA CARE. Remeber we are not the enemy they are.
 Who
 are they to dictate how my company runs. Insurance companies have to
 much
 power and the decisions they force us to make do not always provide
the
 best patient care. And that is the ultimate goal for any provider, to
 give
 best patient care right? This is just another hurdle we all must jump
 through in these comming changes. I vote we stick together and try
our
 best to protect all our jobs. Wasnt that long ago that each of us we
 trying to get pay increases and bring the importance of our jobs to
the
 fore front of pathology. The financial squeeze of 

RE: [Histonet] Aetna and In-Office Lab Accreditation

[Pratt, Caroline]

THANK YOU!

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of
jdcoch...@aol.com
Sent: Monday, April 09, 2012 1:53 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Aetna and In-Office Lab Accreditation


Histonetters:

I was informed today by The Joint Commission that an oversight was made
in the original letter from Aetna regarding a new requirement for
in-office AP lab accreditation.  
Aetna's Medical Director states in a letter to The Joint Commission: It
can be CAP or JCAHO certification of their laboratory.  We want to
encourage providers to obtain 
either one of these accreditations. We will be updating the physician
letter with this change...  To my knowledge, TJC and CAP are the only
CMS-deemed authorities for 
Anatomic Pathology lab accreditation since a third accreditation
organization has exited that arena.  

In-office AP labs provide a valuable service to the practices they serve
by facilitating 1) better communication between pathologists and
ordering clinicians, 2) quality metrics that are practice-specific, and
3) high volume, sub-specialization for both histotechnologists and
pathologists.  In other words, the more of one type of histopathology a
lab does (e.g., skin, prostate, GI), the better it gets.  Most people
would not think of having their cardiac bypass surgery done at a
community hospital doing 50/year; you want to go where more than
500/year are done.  In histopathology, the kinds of volume you want are
in the thousands for each tissue type.  Many hospital labs do little
skin or prostate histology anymore.  Many sub-specialty in-office AP
labs may do thousands of cases of one tissue type every year.  

Aside from that, in-office AP labs are an emerging frontier of
employment for histologists and pathologists.  In an era of high
unemployment, another source of employment for our professions is a
good thing.

This requirement by an insurer for accreditation will help to validate
these in-office AP labs' commitment to quality and put them on the level
with their hospital counterparts.

John D. Cochran, MD, FCAP





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RE: [Histonet] Aetna requiring CAP accreditation for non-hospital labs

[Pratt, Caroline]

Actually, I called the contact person on the letter and received a call
back within 24 hours.  I asked her if TJC and COLA would be acceptable
in lieu of CAP and she is going to get an answer to me by next week.  I
am hoping the goal of this is simply to ensure and support high quality
patient care, but I agree that the letter should not read as an
advertisement for preferred laboratories.



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Carol
Torrence
Sent: Thursday, April 05, 2012 3:17 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Aetna requiring CAP accreditation for non-hospital
labs

We have received notification from AETNA that they now require
non-hospital
labs to be accredited by CLIA and CAP.  The letter makes it obvious that
by
making such a request that they are not aware that CLIA assigned deemed
status to CAP and CLIA is actually the gatekeeper.  Secondly we are told
to
be registered by May 1st and accredited by August 1st (which CAP says is
impossible) or we will have to send our lab to either Quest or Ameripath
which includes Dermpath Diagnostics division.  It fails to mention that
there are other CAP accredited non hospital labs in our state.  The
Aetna
contact number is either 'mailbox full or even after leaving a message,
no
return call.  Me thinks me smells a rat.

 

If you are a non-hospital lab, have you heard of this?  Does your
dematopathologist or pathologist know this is coming?  I am interested
in
your comments.

 

Carol M. Torrence, HT(ASCP)CM 

 

 

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RE: [Histonet] Certified techs/high complexity testing

[Pratt, Caroline]

Exactly, we are trying to educate our staff on this currently.  It is
important to understand because the regulatory bodies do focus on this
issue.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Kelly
Boyd
Sent: Wednesday, March 21, 2012 1:30 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Certified techs/high complexity testing

I would be very careful when you say you need a CLIA certified tech to
do gross (high complexity testing). You actually need someone who meets
the CLIA requirements to perform High Complexity Testing. You can have a
tech who is certified, but they may not meet the educational
requirements. That person MUST have 60 semester hours, 24 of those in
science, 6 hours must be Biology and 6 must be Chemistry and documented
training in the area of high complexity testing. It has NOTHING to with
certification, unfortunately. 


Kelly D. Boyd, BS, HTL (ASCP)
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RE: [Histonet] CLIA qualified

[Pratt, Caroline]

The risk of that rate is the candidates that will likely apply might not
have a strong skill set and if you find one that does, as soon as you
train them, they will likely leave for more money, but at the end of the
day, you will have to let the budget weigh in. 

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jay
Lundgren
Sent: Tuesday, March 20, 2012 3:21 PM
To: Bruce Gapinski
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] CLIA qualified

Bruce,


 You need a recent college grad with the requisite hours of science
courses.  If a PA would be overkill, I suspect you need someone to just
describe your small bx's and dump them in a cassette.
 In the facilities where I have worked where they have such a
position,
the grossing tech with a B.S. makes much less than a HT (ASCP) with a
high school diploma.  It is a position of great responsibility, with low
pay.  I would start in the neighborhood of $10- $12. an hour, but I have
no
idea what that equates to in California money.  About 40-50% what you
pay a
starting Histotech.
 By the way, I would suggest you hire someone with no experience
and train them yourselves.  No experience equals no bad habits.  Finding
a
person with the right attitude, who understands that the Histology
lab literally deals with matters of life and death, is the hard
part.  Technique can be taught.

Sincerely,

 Jay A.
Lundgren M.S., HTL (ASCP)













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RE: [Histonet] SALARY

[Pratt, Caroline]

I would say $28 to $32 dollars an hour depending on experience and education.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of 
kcasti...@frii.com
Sent: Friday, October 28, 2011 7:54 AM
To: Histonet@lists.utsouthwestern.edu
Subject: [Histonet] SALARY

HI EVERYONE,

WOULD LIKE TO KNOW WHAT LEAD TECHS AND SUPERVISORS ARE GETTING PAID 
THESE DAYS.  HAVE A FELLOW HISTO PERSON THAT IS RUNNING THEIR OWN DERM 
LAB AND DOING MOHS ALSO.  THANKS FOR YOUR HELP.  KRISTY

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RE: [Histonet] SALARY

[Pratt, Caroline]

If that is an option, I would agree, but non-profit teaching hospitals
have compensation ranges and grids according to education and
experience.  We keep every employee with the same education and skill
set at the same compensation for an equitable pay system.  If we feel
our employees are being under paid we will conduct a market analysis and
the rates will be increased for all applicable employees if the market
analysis justifies it.

Car :)

-Original Message-
From: Richard Cartun [mailto:rcar...@harthosp.org] 
Sent: Friday, October 28, 2011 12:52 PM
To: kcasti...@frii.com; Histonet@lists.utsouthwestern.edu; Pratt,
Caroline
Subject: RE: [Histonet] SALARY

I think that's low.  If you find a good candidate with years of
experience I would pay them whatever it takes to get them in the door.
It's like Free Agency in baseball; if you want a good player, you need
to put the money on table.  Histotechnologists are the most valuable
employees in the laboratory today! 

Richard

Richard W. Cartun, MS, PhD
Director, Histology  Immunopathology
Director, Biospecimen Collection Programs
Assistant Director, Anatomic Pathology
Hartford Hospital
80 Seymour Street
Hartford, CT  06102
(860) 545-1596 Office
(860) 545-2204 Fax


 Pratt, Caroline caroline.pr...@uphs.upenn.edu 10/28/2011 9:21 AM

I would say $28 to $32 dollars an hour depending on experience and
education.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of
kcasti...@frii.com 
Sent: Friday, October 28, 2011 7:54 AM
To: Histonet@lists.utsouthwestern.edu 
Subject: [Histonet] SALARY

HI EVERYONE,

WOULD LIKE TO KNOW WHAT LEAD TECHS AND SUPERVISORS ARE GETTING PAID 
THESE DAYS.  HAVE A FELLOW HISTO PERSON THAT IS RUNNING THEIR OWN DERM 
LAB AND DOING MOHS ALSO.  THANKS FOR YOUR HELP.  KRISTY

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RE: [Histonet] Slide/Block Retention

[Pratt, Caroline]

Wow, that is very unusual that the director suggests 2 years, normally
the medical directors fault to saving everything! :)  

10 years is definitely the requirement by TJC and CAP to my knowledge.
If I come across some supporting documentation, I will forward it on but
I am positive that 2 years will definitely not constitute compliance.

Caroline M. Pratt
Penn Medicine

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Dessoye,
Michael J
Sent: Monday, October 03, 2011 9:50 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Slide/Block Retention

Hello Histonet,
 
What policy is everyone following for slide and block retention?  We are
not CAP, however we currently keep slides and blocks for 10 years.  My
director wants to decrease that period to 2 years, which is the Joint
Commission standard.  I would like to keep 10 years because we
frequently are asked to send slides for consult and review that are
several years old.  It is also helpful when looking for hard-to-find
control tissue.  However these reasons are apparently not sufficient.  
 
I'm leaning towards keeping the 10 year policy, but I need additional
justification.  Or does anyone think the 2 year period is sufficient?
 
Thanks,
Mike
 
Michael J. Dessoye, M.S. | Histology Supervisor | Wyoming Valley Health
Care System | mjdess...@wvhcs.org mailto:mjdess...@wvhcs.org  |
575 N. River Street | Wilkes Barre, PA 18764 | Tel: 570-552-1485 | Fax:
570-552-1526 
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RE: [Histonet] Online program for histotechnician program

[Pratt, Caroline]

We have an HT trained at our site while attending Harford, great end
result. :)

Caroline M. Pratt, MBA
Practice Administrator 
Dermatopathology
Penn Medicine
3020 Market Street, Ste 201
Philadelphia, PA 19104
cell 610-800-1381
phone 215-349-8178
fax 215-662-6150
 
 
 
-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bryan
Watson
Sent: Friday, August 12, 2011 2:01 PM
To: histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Online program for histotechnician program

I went through the IU program. I'd like to think I'm a swell histotech
as a result.


From: histonet-boun...@lists.utsouthwestern.edu
[histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Patrick Laurie
[foreig...@gmail.com]
Sent: Friday, August 12, 2011 1:53 PM
To: Kimmie Rabe
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Online program for histotechnician program

We've had several students go throught the Indiana University program, I
believe that the program creats very good histotechs.

On Fri, Aug 12, 2011 at 7:00 AM, Kimmie Rabe k...@ncpath.com wrote:

 I am exploring the possibilty of recruiting a student to work at our
 facility and obtain histology training online (leading to a
histotechnician
 certificate).  I have found programs through the University of North
Dakota,
 Indiana University School of Medicine, and Harford Community College
in
 Maryland.

 Does anyone have any experience/insight to offer?

 Kimmie E. Rabe, MD
 North Central Pathology, PA
 3701 12th Street North, Suite 201
 St. Cloud, MN 56303
 Phone:  320-253-6554
 Fax:  320-253-1218
 k...@ncpath.commailto:k...@ncpath.com

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--
Patrick Laurie HT(ASCP)QIHC
CellNetix Pathology  Laboratories
1124 Columbia Street, Suite 200
Seattle, WA 98104
plau...@cellnetix.com
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[Histonet] Laboratory Licensing

[Pratt, Caroline]

We were recently surveyed by the Joint Commission.  We have our
laboratory at one physical address and our Dermatopathologists at
another physical address (the hospital).  The surveyor indicated that we
need a separate CLIA and state license for the hospital location where
the slides are being read even though no tests are performed there.
These are high complexity Tissue Pathology.  Has anyone heard of this
before or have a similar set up and how are you licensed.  It doesn't
sound accurate to me.  My understanding was that any test being
performed required licensure, I have never heard of laboratory licensure
being required for the reporting of results.  Please provide any
assistance or experience you can!!! Thanks!

 

Caroline M. Pratt, MBA

Practice Administrator 

Dermatopathology

UPHS

3700 Market Street, Ste 312

Philadelphia, PA 19104

phone 215-349-8178

fax 215-662-6150

 



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