[Histonet] TWO SPECIMENS IN ONE CONTAINER

Tue Jan 27 20:34:32 CST 2004

Hi Wayne,

Currently, I would advise against separation of the two specimens received
in one container and labeling received as A&B and charging two distinct
separate cpt codes. I would only charge separate cpt codes if RECEIVED
separately. However, this is a very interesting subject and seeing the
different ways laboratories are dealing with this issue. I personally will
go one step further and seek advisement from CAP and will put their advice
here on the histonet as soon as I receive a response. 

Regards,

Michael LaFriniere PA,HT(ASCP)

-----Original Message-----
From: Wayne Holland [mailto:wayneholland1959 <@t> msn.com] 
Sent: Tuesday, January 27, 2004 6:17 PM
To: pruegg <@t> colobio.com; DDittus787 <@t> aol.com; Histonet <@t> pathology.swmed.edu
Subject: RE: [Histonet] TWO SPECIMENS IN ONE CONTAINER

I have a new twist to this question of two or more specimens in one 
container. Often we receive two or more skin lesions, but mostly skin punch 
biopsies in one specimen container from outside doctors offices. However; 
usually these specimens are labeled as the same area of excision, but 
obvious distinct different sites. I have expressed my concern for obvious 
reasons, both for the pathologist and the physician. But the main question I

need answers to is, can we separate these specimens into a,b,c- etc; ??? I 
guess I have not looked in the right place for the answer, until now 
hopefully. Is it legal to separate and charge accordingly? I know we can 
separate and process in a number of ways, but this will not provide correct 
billing. Any feedback would be great.

>From: "Patsy Ruegg" <pruegg <@t> colobio.com>
>To: <DDittus787 <@t> aol.com>, <Histonet <@t> pathology.swmed.edu>
>Subject: RE: [Histonet] TWO SPECIMENS IN ONE CONTAINER
>Date: Tue, 27 Jan 2004 14:32:09 -0700
>
>Dana I can't answer your question but this reminds me of something that
>really happened to me.  Bare with me folks I am in a mood.....
>
>There was once a cytotechnologists who was not allowed to screen cytologies
>anymore because they had signed out too many positive cases as negative.
>The department could not get rid of this person outright (don't ask me why
>not) so they made them work as a gofer for all the other labs.  I was
>running the heme/path lab at the time by myself and very understaffed.
>Besides all the laboratory duties I had I also assisted with bone marrow
>biopsies which took me out of the lab away from my duties even more.  Since
>the demoted cytotech had experience with assisting with FNA's etc., the
>administration put them on bone marrow assistance duty to help me out.  
>When
>word got around that this person was helping out, my pathologists came to 
>me
>an said specifically "do not let that person touch my samples".  Well, the
>admin. person said send them on bm duty anyway.  On a very busy day, this
>person came back to my lab with one vial with 2 bone marrow biopsies in the
>vial and said to me as they handed me the vial "the longer sample belongs 
>to
>patient Joe Blow and the shorter sample belongs to patient Mary Doe".  The
>tech had run out of fixative vials and decided to put two samples from two
>different patients in the same vial instead of coming back to the lab for
>more vials.  Imagine my horror!  I carefully recorded the description of
>which sample belonged to who so that at least that would not get lost.  I
>then walked the tech with the vial with 2 bm samples in it to the office of
>the administrator and said that I would not take responsible for this
>situation and wanted nothing to do with it.  I also told the admin. what my
>pathologists had just said to me about not letting that person touch their
>samples.
>I was told to process the samples as usual and label them as had been
>described.  I did.  As  it turned out there was no difference in diagnosis
>in these two samples.  They were the same.  These were renal patients being
>biopsied to test for aluminum bone disease and they both were negative.
>Imagine if it had come out some other way.  One positive and one neg. or if
>they were leukemia patients and one was in remission and the other not.  As
>I recall it still took months to finally get rid of this person, but they
>did not do bm assistant duty anymore.  It matters what we do and how we do
>it!
>Best regards,
>Patsy
>
>
>
>-----Original Message-----
>From: histonet-bounces <@t> lists.utsouthwestern.edu
>[mailto:histonet-bounces <@t> lists.utsouthwestern.edu]On Behalf Of
>DDittus787 <@t> aol.com
>Sent: Tuesday, January 27, 2004 1:23 PM
>To: Histonet <@t> pathology.swmed.edu
>Subject: [Histonet] TWO SPECIMENS IN ONE CONTAINER
>
>
>Hi, once more i am asking for your assistance, what are you guys doing, 
>when
>two vas or fallopian tube come in one container? as i understand it, for
>compliance when one container one cassette, you cannot designate right and
>left unless indicated.am i barking up the wrong tree or is this the
>compliance issue so that all things are correct. help me out here.
>thanks
>                            Dana
>
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