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Test Code HPWET Hematopathology Consultation, MML Embed


Advisory Information


1. If requesting a peripheral blood smear evaluation only, order SPSM / Morphology Evaluation (Special Smear).

2. If requesting a Hematopathology consultation on paraffin-embedded tissue and slides, order PATHC / Pathology Consultation.

3. If requesting a Hematopathology consultation and only paraffin-embedded biopsy/clot samples and bone marrow aspirate are submitted, order HPCUT / Hematopathology Consultation, Client Embed.



Additional Testing Requirements


 



Necessary Information


1. Collection date and patient date of birth are required.

2. The referring pathologist's and clinician's name and phone numbers are required.

3. All specimens must be labeled with specimen type.

4. All specimens, patient history, and requests should be clearly labeled with correct patient information, and case number.

5. Although a complete pathology report is not expected a brief history and patient information is required. Use the Hematopathology Request form.



Specimen Required


Information on collecting, packaging, and shipping specimens, is available in Special Instructions:

-Bone Marrow Core Biopsy, Clot, and Aspirate Collection Guideline 

-Assistance with Bone Marrow Collection 

 

Submit the following specimens:

 

Transport Container: Bone Marrow Collection Kit (T793)

 

1. Unprocessed bone marrow core biopsy and/or clot

2. Bone marrow biopsy touch prep slides (3)

3. Bone marrow aspirate

a) Fresh, unfixed, unstained slides

-i. Direct prep (2)

-ii. Unit prep (3)

b) Liquid (order of collection)

-i. EDTA (lavender): 3mL

-ii. ACD (yellow): 4 mL

-iii. Sodium Heparin (green): 3 mL

4. Unstained peripheral blood smears (2) (fingerstick preferred)


Forms

1. Hematopathology Patient Information Sheet (T676) in Special Instructions

2. If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request Form (T726) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/hematopathology-request-form.pdf

Secondary ID

70343

Useful For

Obtaining a rapid, expert opinion on unprocessed specimens referred by the primary pathologist

 

Obtaining special studies not available locally

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
PBPC Peripheral Blood No, (Bill Only) No
BMBPC Bone Marrow Biopsy No, (Bill Only) No
BMAPC Bone Marrow Aspirate No, (Bill Only) No
PPPC Particle Prep No, (Bill Only) No
PBTC Peripheral Blood, TC No, (Bill Only) No
DCALP Decalcification No, (Bill Only) No

Testing Algorithm

A Mayo Clinic hematopathologist will provide a full bone marrow workup that includes an evaluation of the specimen and determination of a diagnosis provided within a formal pathology report.

 

Ancillary Testing:

Based on Mayo Clinic-approved algorithms and/or a staff hematopathologists' discretion, ancillary testing may be performed in order to render an accurate diagnosis and provide important prognostic information. These test results will be reported and separately billed. While reported separately, these results will continue to be considered and referred to in the Pathology final interpretation.

-Tier 1 testing (eg, cytochemical stains on bone marrow aspirate smear, immunohistochemical stains on bone marrow biopsy or clot sections, chromosome analysis, FISH, flow cytometry, and/or molecular testing) will be added as appropriate. Results will be incorporated into the pathology report, as well as, some separate standalone results may be released. All will be charged.

-Tier 2 testing (eg, next-generation sequencing: NGS or microarray testing) will only be added upon approval of the ordering physician/pathologist (client).

 

If ancillary testing (eg, flow cytometry) is desired by the client outside of this consultation, each test must be ordered separately. Tests ordered outside of the consultation may or may not be integrated into the final pathology report based on staff hematopathologist's discretion.

 

If the volume of bone marrow aspirate is limited, prioritization of testing will be determined by the staff hematopathologist. Testing requested or suggested by the referring physician (immunostains, molecular studies, etc) may not be performed if deemed unnecessary by the reviewing staff hematopathologist.

 

Note: Calls are not routinely made; however, depending on the nature of the case, a call may be placed to the ordering provider or pathologist. These situations include, but are not limited to, a new diagnosis of acute leukemia or aggressive high grade lymphoma. To contact a Mayo Clinic Hematopathologist, call the Hematopathology Communications tech at 507-284-5600.

 

See Pathology Consultation Ordering Algorithm in Special Instructions.

Reporting Name

Hematopathology Consult

Specimen Type

Varies

Specimen Stability Information

Specimen Type Temperature Time
Varies Ambient

Reject Due To

No specimen should be rejected. Any tissue specimen will be sent to Hemepath to assess and determine next steps.

Paraffin-embedded biopsy/clot samples without bone marrow aspirate. Call the client and change the order to PATHC / Pathology Consultation.

Paraffin-embedded biopsy/clot samples with bone marrow aspirate. Call the client and change the order to HPCUT/ Hematopathology Consultation, Client Embed.

Clinical Information

Diagnosis of a hematologic disease requires thorough and accurate morphologic examination of peripheral blood, bone marrow and interpretation of ancillary testing results (eg, cytochemistry, immunohistochemistry, flow cytometric immunophenotyping, chromosome analysis, FISH testing, and molecular genetics) by a highly qualified hematopathologist. With recent advent of new understanding and more treatment options, more ancillary tests are available. Efficient utilization and accurate interpretation of these tests are crucial in patient care. These tests can not only assist to render accurate diagnosis but also could provide prognostic prediction and potential indication or guidance of therapy.  

 

It is the Division of Hematopathology's mission to provide the highest possible level of diagnostic consultative service, trying to balance optimal patient care with a cost-conscious approach to solving difficult diagnostic problems for all patients. If a bone marrow consult is requested, the Mayo Clinic Hematopathologist will approach the diagnosis in the same way as Mayo Clinic's own in-house cases.

Reference Values

The laboratory will provide a pathology consultation.

Interpretation

Results of the consultation are reported in a formal pathology report that includes a description of ancillary test results (if applicable) and an interpretive comment. When the case is completed, results may be communicated by a phone call. The formal pathology report is faxed.  

 

In our consultative practice, we strive to bring the physician and patient the highest quality of diagnostic pathology, in all areas of expertise, aiming to utilize only those ancillary tests that support the diagnosis in a cost-effective manner, and to provide a rapid turnaround time for diagnostic results.

Day(s) and Time(s) Performed

Monday through Sunday

Reporting Monday through Friday; Varies

Analytic Time

3 days (from arrival date) (additional time may be required for ancillary test results)

Performing Laboratory

Mayo Medical Laboratories in Rochester

CPT Code Information

85007 (if appropriate)

85060 (if appropriate)

85097 (if appropriate)

88305 (if appropriate)

88311 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HPWET Hematopathology Consult In Process

 

Result ID Test Result Name Result LOINC Value
71098 Interpretation In Process
71099 Participated in the Interpretation No LOINC Needed
71100 Report electronically signed by In Process
71101 Addendum In Process
71102 Gross Description In Process
71446 Material Received 81178-6
71103 Disclaimer 62364-5
71827 Case Number In Process