01.13.2011

New High Risk HPV Test Effective January 13, 2011 Pathology Medical Services, PC will perform in house High Risk HPV testing with Cervista™ HPV HR, a FDA approved screening test for 14 high risk HPV (human papillomavirus) types associated with cervical cancer and its precursor conditions.

Indications for Cervista™ HPV HR testing include:

• To screen patients with ASCUS cervical cytology to determine the need for referral to colposcopy
• In women = 30, use with cervical cytology to screen for the presence or absence of high-risk HPV types

Specimen requirements: Cervical pap specimen collected using Broom-type (Rovers Cervex® Brush, Wallach Papette®) or Endocervical Brush/Spatula collection device/s submitted in ThinPrep® or SurePath™ pap vial.

Cervista™ methodology includes an internal control for the presence of human DNA in each patient sample. Specimens with low cellularity or contaminating substances* may have insufficient human DNA present for valid testing, causing an “Insufficient or Indeterminate” result.

*Note: contamination of the cervix with lubricant, contraceptive jelly, or anti-fungal creams (clotrimizole or miconazole), may result in an insufficient specimen for HPV testing.

Stability: Thin Prep® and SurePath™ specimens are stable for up to 30 days.

New Test Code: 87623

CPT Code: 86721
- New High Risk HPV Test.pdf

01.06.2011

LCD Policy for Vitamin D Assay WPS Medicare has added the Vitamin D Assay testing to the Limit Coverage Determination policies. Procedures affected by this change are:

25-Hydroxy Vitamin D (Order Code 29600; CPT 82306)
1,25-Dihydroxyvitamin D (Order Code 93480; CPT 82652)

The patient will need to sign an ABN if the diagnosis does not support the testing. A complete list of policies, including the covered diagnosis codes, can be printed by clicking here or viewed on WPS website: here

12.22.2010

Signatures on Requisitions for Clinical Diagnostic Laboratory Tests In the November 29, 2010 Medicare Physician Fee Schedule final rule, the Centers for Medicare and Medicaid Services (CMS) finalized its proposed policy to require a physician's or qualified nonphysician practitioner's (NPP) signature on requisitions for clinical diagnostic laboratory tests paid under the clinical laboratory fee schedule effective January 1, 2011. A requisition is the actual paperwork, such as a form, which is provided to a clinical diagnostic laboratory that identifies the test or tests to be performed for a patient.

08.28.2010

We recently received a letter from CMS introducing the Clinical Laboratory Improvement Amendment (CLIA) Complaint Brochure. This brochure contains information regarding mechanisms and resources for reporting complaints and concerns about the quality of a laboratory's testing when needed. According to the letter from CMS, this information should be made available to "all personnel in your laboratory, patients and their representatives, the public, physicians and other caregivers using the laboratory's services." We have placed a copy of this brochure on the PMS and NLL internet websites for your convenience. If you have questions on the brochure or its contents, please contact your account representatives or the call center.
- CLIA Brochure-COMPLAINTS

02.26.2010

2010 Medicare Medical Necessity Guide NLL/PMS is pleased to announce availability of the 2010 Medicare Medical Necessity Guide, again, as an electronic document. Please refer to the billing section of the website found here for instructions and use.

02.15.2010

D-Dimer Reagent and Reference Range Change Effective March 8, 2010
- D-Dimer Methodology Change

02.04.2010

Performing/Billing Medicare Services as Ordered Regarding CBC (Complete Blood Counts)
- CBC Ordering/Performing/Billing Medicare Clarification

11.30.2009

New specimen collection requirements for TB Interferon Antigen (QuantiFERON-TB Gold)

- QuantiFERON-TB Gold

09.09.2009

Updated H1N1 Information
To learn more about Swine Flu and specific recommendations for testing, please utilize the following CDC link:

- CDC H1N1 Web Site

09.04.2009

Updated Test Directory
The newly updated NLL test directory is now available. If you would like a hard copy, please contact Vivian Brittenham via e-mail at Vivian.Brittenham@lablinc.com, or phone 402-465-1960, and the test directory will be sent to you via courier. Although the hard copy is an excellent source for test information, the online test directory will continue to have the most up-to-date test information. You can access this test directory on our web site at www.lablinc.com and click on the Client tab.

06.12.2009

Specimen Type Change for 25 Hydroxy Vitamin D (29600)
Effective immediately, please draw 25 Hydroxy Vitamin D specimens in Red-Top tubes ONLY. Do not use gel-separator (SST or PST) tubes. This change is due to recent manufacturer recommendations.

05.12.2009

UPDATED NLL Critical-Alert Table
An updated version of Nebraska LabLinc Critical and Alert Values Table is now available. Analytes have been added and others deleted in accordance with recent publications.

- NLL Critical-Alerts Table

05.12.2009

UPDATED NLL Hematology Reference Ranges
Effective May 12, 2009, NLL has updated the reference ranges for the following hematology analytes: Hematocrit, Hemoglobin, MCH, MCHC, MCV, Platelet Count, RBC and WBC. The age ranges affected are in the pediatric age range from neonate to 18 years for all analytes, with the adult ranges also updated for Hematocrit and Platelet Count.

- NLL Hematology Reference Ranges

04.29.2009

Swine (H1N1) Influenza Update
Nebraska LabLinc encourages clients to communicate with the State Department of Health for specific guidance on how to approach patients with suspected Swine Influenza A (H1N1), especially patients with a travel history in areas currently affected by the Swine Influenza A or who have been exposed to patients with positive diagnosis of Swine Influenza A

Nebraska LabLinc offers Influenzae Antigen, A and B, Test Code 54050 which can be ordered in cases of suspected swine flu influenza A (H1N1). A nasopharyngeal mini-tip swab should be collected and placed in 1 mL Liquid Amies provided in the COPAN eSwab Kit or in 1 mL sterile saline. All personnel collecting the specimen should wear some kind of protective facial equipment and wash their hands thoroughly.

Since this is a screening method, if a positive type A result is detected, it will only indicate that influenza A is present in the sample, but it will not differentiate Swine Influenza A from human strains of the virus. Therefore any sample positive for type A will automatically be forwarded to the State Department of Health for further testing. If positive for Swine Flu, the State Department of Health will submit to the CDC for confirmation.

Symptoms of swine influenza infection include cough, sore throat, vomiting, diarrhea, headache, runny nose, and muscle aches. The new variant SI is resistant to the adamantine drugs (amantadine and rimantadine), but is susceptible to oseltamivir (Tamiflu) and zanamivir (Relenza).

To learn more about Swine Influenza A and specific recommendations for testing, utilize the following links:

• CDC Swine Flu Web Site at http://www.cdc.gov/swineflu/
• Interim Guidance on Specimen Collection and Processing for Patients with Suspected Swine Influenza A (H1N1) Virus Infection at http://www.cdc.gov/swineflu/specimencollection.htm
• Answers to frequently asked questions about Swine Flu from Mayo Clinic at http://newsblog.mayoclinic.org/2009/04/27/swine-flu-faqs/

03.18.2009

SAVE THE DATE! For the Spring Client Seminar to be held on Thursday, April 16, 2009
Dr. Mark R. Litzow will speak on Blood and Marrow Transplantation for Hematologic Malignancies and Solid Tumors. Please RSVP, by returning invitation, no later than Tuesday, April 14.

- Seminar Invitation

03.02.2009

2009 Medicare Medical Necessity Guide
NLL/PMS is pleased to announce availability, again, of the 2009 Medicare Medical Necessity Guide as an electronic document. The hard copy version has nearly doubled in number of pages for 2009, now totaling nearly 1,100 pages. To make the manual as accessible as possible, the decision was made to use an electronic version instead of the hard copy. Please refer to the following links/documentation for explanation and instructions for use.

- Medicare Medical Necessity Guide 2009 - Introduction
- Medicare Medical Necessity Guide 2009 – Instructions for Use
- NLL_PMS Tests w/ Medical Necessity Policies-2009 (Alpha)
- NLL_PMS Tests w/ Medical Necessity Policies-2009 (Numeric)
- Vol I: National Coverage Determinations (NCDs)
- Vol II: Local Coverage Determinations (LCDs)

10.10.2008

Specimen Requirement Changes Effective Immediately
The preferred specimen has changed for the following tests:

Respiratory Syncytial Virus (RSV) by EIA	Test Code: 52950
Influenzae Antigen, A and B	Test Code: 54050
Respiratory Viral Panel (DFA) with Reflex	Test Code: 55040

The specimen of choice for each of these tests is a nasopharyngeal flocked swab (COPAN). The new swabs are available and should be ordered as "COPAN flocked swabs" on your supply form. Please refer to the Nebraska LabLinc online catalog for specific specimen and collection requirements.

10.01.2008

2009 ICD-9 Code Changes
Effective October 1, 2008, ICD-9-CM diagnosis codes changes for 2009 will be in effect. There are a number of additions and deletions; valid ICD-9-CM codes must be used on laboratory claims to document that the testing is medically necessary.

- 2009 ICD9 Additions/Deletions

10.01.2008

Creatinine Reference Range Change
Effective 10/1/2008, the manufacturer of our Enzymatic Creatinine procedure has recalled the reagent nationwide. Due to this recall, we have had to change back to our previous Jaffe method. The creatinine reference ranges have been updated to reflect this change.

09.15.2008

**Cancelled**Fall Client Seminar on 'Using Cardiac Biomarkers for Diagnosis and Prognosis'
Due to unforeseen circumstances, Dr. Allan Jaffe of the Mayo Clinic College of Medicine is unable to come to Lincoln for his presentation on cardiac biomarkers, which had been scheduled for this Thursday, September 18th. Therefore, the seminar has been canceled.

We want to thank you for the interest you and your staff have shown in this seminar. We look forward to providing another educational opportunity for you in the future.

08.05.2008

Bordetella pertussis Ab, IgG/IgM (94770) Unavailable
Due to unavailability of FDA Approved reagents in the US, this assay will be unavailable until further notice. Suggest Bordetella by Rapid PCR (93890) as replacement.

07.25.2008

New ABN Form - Mandatory by Sept. 1, 2008
The Centers for Medicare and Medicaid Services (CMS) has recently issued a new, mandatory "Advance Beneficiary Notice of Noncoverage" (ABN). This new ABN form must be used by all providers to notify Medicare beneficiaries - prior to collection of the specimen – in situations where Medicare payment is expected to be denied. The new ABN form is substantially revised from the prior version. The new form can be put into use anytime, but use of the new ABN form is mandatory by September 1, 2008.

There are some new features about the updated form. They include:

• A mandatory field for cost estimates of the testing performed.
• A new beneficiary option, under which an individual may choose to receive the testing, and pay for it out-of-pocket, rather than have a claim submitted to Medicare.

For those locations using Labtest, the price of the tests is automatically completed on the form.

During the month of August you will be receiving the new ABN forms for your location. Please discard all old forms and begin using the new forms as soon as they are received. All providers are required to use the new form effective Monday, September 1.

If there are questions on the use of the form, please contact an account manager: Toni Goldenstein (465-1985), Sharon Pfeiffer (465-1997) or Amy Thomas (465-1990).

Thank you for your cooperation in abiding by this new CMS mandated requirement.

- NLL Advance Beneficiary Notice of Noncoverage (ABN)
- PMS Advance Beneficiary Notice of Noncoverage (ABN)

04.02.2008

Spring Client Seminar on 'Vitamin D'
Seminar to be held Thursday, April 24th.

- Seminar Invitation - Instructions for Online Evaluation and Certificates of Attendance (CME & P.A.C.E.)

03.06.2008

2008 Medicare Medical Necessity Guide
NLL is pleased to announce availability of the 2008 Medicare Medical Necessity Guide as an electronic document. The hard copy version has nearly doubled in number of pages for 2008, so to make the manual as accessible as possible, the decision was made to use an electronic version instead of the hard copy. Please refer to the following links/documentation for explanation and instructions for use.

- Medicare Medical Necessity Guide 2008 - Introduction - Medicare Medical Necessity Guide 2008 – Instructions - NLL Tests w/ Medical Necessity Policies-2008 (Alpha) - NLL Tests w/ Medical Necessity Policies-2008 (Numeric) - Vol I: National Coverage Determinations (NCDs) - Vol II: Local Coverage Determinations (LCDs)

10.01.2007

2008 ICD-9 Code Changes
Effective October 1, 2007, ICD-9-CM diagnosis codes changes for 2008 will be in effect. There are a number of additions and deletions; valid ICD-9-CM codes must be used on laboratory claims to document that the testing is medically necessary.

- 2008 ICD9 Additions/Deletions

04.26.2007

'ALT, Lipase and Gamma GT testing performed on Tuesday (4/24/07) and Wednesday (4/25/07) reported incorrect reference ranges due to a computer database update error. When this error was discovered on Wednesday morning, corrected reports were generated with an appended comment stating the correct reference range for each of these 3 tests. We apologize for the inconvenience this may have caused, to you or your patients. If additional testing was ordered, due to this error, please contact NLL Call Center (402-484-5462) to cancel or credit this testing.' Thank you.

12.19.2006

Effective 12/19/06, the Glomerular Filtration Rate (GFR), Estimated is included in the Comprehensive Metabolic Panel (22450), Basic Metabolic Panel (20900) and Renal Function Panel (28150). Order codes and CPTs will not change for these panels. We will continue to offer the test codes Creatinine w/GFR (22701) and GFR (23760).

10.01.2006

Coding Advisory
Effective October 1, 2006, ICD-9-CM diagnosis codes changes will be effective. There are a number of additions and deletions for 2006. ICD-9 codes must be used on lab claims to document that the testing is medically necessary. But this year, it is more important than ever to have your updates in place by the effective date because the Centers for Medicare & Medicaid Services is eliminating the 90-day grace period it has historically given for transitioning to the new codes.

- ICD9 Additions/Deletions