Kim,
In our department, we assist in the collection of FNA's in radiology, the
Pathologist comes there after the slides are prepared and gives a quick
interpretation.
If the specimen is deemed adequate or not, and if more material is requested,
this is noted on the requisition and signed and
Hello Histonetters,
I have a PI who made a very large TMA and it is half detatched from the base of
the cassette. Does anyone have any tips on trying to stabilize it prior to
cutting?
Kathryn Stoll
Supervisor Histology
Clinical and Translational Research Core Lab
Medical College of Wisconsin
We perform something similar to Valerie. The pathologist provides a written
immediate interpretation on a FNA requisition form. If the sample is
insufficient, it is documented on this form. This is performed on each pass
performed. The rapid interpretation is transcribed into the final
You can try to fill the TMA through the cassette from the bottom. Place the
TMA in a mold that fits the TMA, heat it for about 2 min and then try filling
the TMA from the cassette side. You can also dip the heated TMA block in a
paraffin bath to fill the hole or use a plastic pipette to fill
Hi all
My pathologist would like our techs to do H pylori IHC stains on all stomach,
GE Junction and esophagus BX's. What I was wondering, if there were any
indication in Regulations or anything that we couldn't do this? Any advice
would be greatly appreciated :)
S Kathy Baldwin
Kathy,
My understanding is CMS (Medicare) has ruled that h.Pylori stains cannot be a
standing order. The Pathologist must look at the HE's first and deem the
stain is needed based on the inflammation.
WANDA G. SMITH, HTL(ASCP)HT
Pathology Supervisor
TRIDENT MEDICAL CENTER
9330 Medical
You might be able to get around this by doing the IHC on all of these as
requested, but only charging for those which are indicated as being medically
necessary. This could benefit your TAT, if that's the reason the pathologist
wants these done routinely. The pathologist would also have to
You might find that the financial impact wouldn't be that great. There is a
reason they are doing an EGD, most commonly for gastritis which is a valid
reason to look for H pylori. There is a pretty standard list of ICD 9 codes
that would trigger the justification for doing an H pylori.
I think the real question here is, Why do your pathologists want H. pylori IHC
on all of these specimens? If it's TAT, maybe something can be done to
improve it so that you not have to do all this unnecessary work. We only
order H. pylori IHC on those cases that show the appropriate
