[Histonet] Who can perform Histology Duties

[Weems, Joyce]

That's in the new CAP regs.. 

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Luck,
Greg D.
Sent: Thursday, January 10, 2008 2:44 PM
To: Terri Braud; Bonnie Whitaker; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Who can perform Histology Duties

Hello All,
Can anyone show me where in the CLIA regs that "they" (not CAP)
distinguish between "grossing" and "processing"? Thanks, Greg


-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Terri
Braud
Sent: Thursday, January 10, 2008 9:03 AM
To: Bonnie Whitaker; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Who can perform Histology Duties

CLIA considers "grossing" to be a high complexity test.  The
transference of the all tissue received in a container to a cassette,
using a standard dictation is not defined as grossing, but as
"processing", which is not a high complexity test.  CLIA uses this
clarification but it must be clearly defined in your procedure.  

-----Original Message-----
From: Bonnie Whitaker [mailto:bwhitaker <@t> brownpathology.com]
Sent: Thursday, January 10, 2008 11:37 AM
To: Terri Braud; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Who can perform Histology Duties


Hi Terri,

CAP has changed it's definition of grossing but most CAP labs are also
required to follow CLIA, even though they aren't inspected by CLIA.
Don't forget about that if you bill Medicare.  They COULD come in and do
an unannounced inspection and zap you if your grossers don't meet the
CLIA standards for high complexity testing one way or another.

Bonnie Whitaker


-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Terri
Braud
Sent: Thursday, January 10, 2008 9:55 AM
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] Who can perform Histology Duties



"Sharon.Davis-Devine" <Sharon.Davis-Devine <@t> carle.com> wrote:
  Ok, all of you Histonetters I have another question for you. Who the
histology laboratory can perform these job functions: embedding,
cutting, performing special stains and IHC? Can a lab assistant perform
these duties if properly trained or do you have to be classified as a
Histotech in training? Can a Cytotech or Med Tech perform such duties,
again if properly trained? All opinions and references to such
requirements would be greatly appreciated.

Though some may not like to admit it, ANYONE properly trained and
documented as competent can perform the duties listed above.  The only
exception is for those states that have licensure requirements for the
performance of Histological duties, and then, the licensure requirements
must be met. IHC is still a stain.  The interpretation of that stain by
the pathologist is the high complexity part of the test.  Anyone
properly trained and documented as competent can stain IHC. Even
grossing has now been re-defined by CAP to allow submission of smaller
tissues by personnel without the qualifications for High Complexity
Testing (see below) (CAP checklist question and notes: ANP.11600)
1) Processing is defined as a tissue examination limited to description,
inking and cutting of the specimen (if applicable), and submission of
the entire specimen to histology.  Tissue processing can be performed
according to standardized protocols.  Processing is generally limited to
small specimens (skin ellipses, small biopsies, curettings, etc.) and
does not require knowledge of anatomy.
2) Grossing (or gross examination) is defined as a tissue examination
requiring a greater exercise of judgment and a knowledge of anatomy.
Dissection of the specimen and selection of tissue samples for
submission to histology are generally required.  The specimen
description is not necessarily standardized.

Please save your flames.  The scenerio of a Non-Histotech embedding,
cutting, and staining my surgical tissue does not thrill me, but that
was not her question.  Maybe the reality of the answer is why many
Histology Labs have always been considered the evil red-headed
stepchildren of the Lab.

Terri
Terri L. Braud, HT(ASCP)
Anatomic Pathology Supv.
Laboratory, Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
(215) 938-3689

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Thank you for your cooperation.

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