[Histonet] Precision in IHC validations

[Martha Ward-Pathology via Histonet]

Thanks to everyone that has responded to my question.

We specifically interested in the procedure for this CAP question:

COM.40350 Validation of Test Performance Specifications - Modified FDA-cleared/
approved Tests and LDTs

Prior to clinical use of each modified FDA-cleared or approved test and 
laboratory developed
tests (LDTs), the laboratory has performed a validation study and prepared a
written assessment of each of the following test method performance 
specifications, as
applicable, using a sufficient number of characterized samples:

● Analytical accuracy
● Analytical precision
● Reportable range
● Analytical sensitivity (lower detection limit)
● Analytical specificity
● Any other performance characteristic required to ensure analytical test 
performance




Do you comment at all regarding precision…..do you run the same slide each day 
over 3 days, or something like that?
NOTE 3: Precision is validated by repeat measurement of samples at varying 
concentrations or
activities within-run and between-run over a period of time.

We are just not sure what number of repeats is best…..




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[Histonet] How are you documenting precision in IHC validations

[Martha Ward-Pathology via Histonet]

We are working on IHC antibody validations and I want to know if there is a 
minimum number of slides you must run to demonstrate precision? I have not 
been able to find a definitive number or procedure.   What is everyone doing 
for this?

Thanks in advance for everyone's help.

Martha Ward
Atrium Health Wake Forest Baptist



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[Histonet] Bone marrow clot IHC tissue sections washing

[Martha Ward-Pathology via Histonet]

It was brought to my attention that we had significant washing on  3 of 8 bone 
marrow clot sections the other day; this is not the first time so we would like 
to get to the bottom of this.   We use positively charged slides and all 8 
cases were cut and run the same morning but allowed to air dry and then bake at 
60C for 20 minutes before being run on our Bond 3 stainer.   Has anyone out 
there experienced this type of problem and if so, what were your solutions?
The repeat of the 3 cases today showed similar washing of tissue.

This hasn't just started but has occurred periodically but the pathologists 
have tried to live with it and usually we can finally get enough tissue to stay 
on after 1-2 attempts.   Suggestions include cutting and drying the slides 
overnight and/or going to a gelatinated  slide versus a sialylated slide.   We 
have been using this particular brand of positive charged slide with good 
results for several years and rarely have issues with other tissue types unless 
they are particularly bloody.

Thoughts or suggestions are greatly appreciated.


Martha Ward MT(ASCP) QIHC
Atrium Health Wake Forest Baptist



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[Histonet] antibody protocol for CXCL13

[Martha Ward-Pathology via Histonet]

Our heme path docs are interested in this antibody and I wondered if anyone has 
a protocol they can share?We have the Leica Bond 3 as our staining 
platform/detection system.

Thanks in advance for your help.


Martha Ward MT(ASCP) QIHC
Manager, Molecular Diagnostics Lab
Atrium Health Wake Forest Baptist Health




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Re: [Histonet] HSV1 and HSV2

[Martha Ward-Pathology via Histonet]

Thank you for the information.   I will look into your antibody source.

Martha

-Original Message-
From: Cartun, Richard  
Sent: Tuesday, June 15, 2021 3:26 PM
To: Martha Ward-Pathology 
Cc: histonet@lists.utsouthwestern.edu
Subject: [EXTERNAL] RE: HSV1 and HSV2

Hi Martha:

We are using type-specific monoclonals from BioSB (Santa Barbara, CA).  They 
also sell a cocktail of the two antibodies which is what we use for screening.  
Rarely, do we get requests for type-specific identification.

Richard

Richard W. Cartun, MS, PhD
Director, Histology & The Martin M. Berman, MD Immunopathology/Morphologic 
Proteomics Laboratory Director, Biospecimen Collection Programs Assistant 
Director, Anatomic Pathology Hartford Hospital
80 Seymour Street
Hartford, CT  06102
(860) 972-1596 (Office)
(860) 545-2204 (Fax)
richard.car...@hhchealth.org


-Original Message-
From: Martha Ward-Pathology via Histonet 
[mailto:histonet@lists.utsouthwestern.edu]
Sent: Tuesday, June 15, 2021 3:10 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] HSV1 and HSV2

CAUTION: This email is from outside HHC. USE CARE when opening attachments or 
links.

We have always offered these two antibodies separately but recently we have 
begun having issues with our HSV2.   In researching a new source I am seeing 
that some places do some sort of cocktail mixture of the two.   What are others 
out there doing for this?

Thanks in advance for your help.

Martha Ward, Manager
Molecular Diagnostics  Lab
Wake Forest Baptist Medical Center
Winston-Salem, NC 27157
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[Histonet] HSV1 and HSV2

[Martha Ward-Pathology via Histonet]

We have always offered these two antibodies separately but recently we have 
begun having issues with our HSV2.   In researching a new source I am seeing 
that some places do some sort of cocktail mixture of the two.   What are others 
out there doing for this?

Thanks in advance for your help.

Martha Ward, Manager
Molecular Diagnostics  Lab
Wake Forest Baptist Medical Center
Winston-Salem, NC 27157
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[Histonet] Filed slides sticking together

[Martha Ward-Pathology via Histonet]

I am posting this question for our Histology manager:

Does anyone dry coverslipped slides in an oven before filing and if so how long 
and at what temperature.  We are having issues with filed slides sticking 
together.


Thanks in advance for your help with her question.

Martha  Ward, MT ASCP (QIHC)
Manager, Molecular Diagnostics Lab
Wake Forest Baptist Medical Center
Winston-Salem, NC 27157

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[Histonet] Antibody validation question

[Martha Ward-Pathology via Histonet]

When doing an initial antibody validation CAP requires at least 90% concordance 
between the new test and the comparator test or expected values.Are there 
specified requirements for sensitivity,  specificity and accuracy?

Thanks in advance for any help provided!

Martha Ward, Manager, Molecular Diagnostics Lab
Wake Forest Baptist Medical Center
Winston-Salem, NC 27157
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[Histonet] Question about accessioning outside consult cases

[Martha Ward-Pathology via Histonet]

We are in the process of switching to AP Beaker and in the midst of the build.  
  My question involves how others are handling outside consult surgical and/or 
cytology cases.   Do you assign them an unique number that identifies them as a 
consult as opposed to an inside case - SO20- verses S20-? We 
currently assign them as just another surgical case but I know some places do 
have outside consult designations.

What is everyone doing?

Thanks in advance for your input.

Martha Ward, MT ASCP (QIHC)
Manager, Molecular Diagnostics Lab
Wake Forest Baptist Medical Center
Winston-Salem, NC 27157
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[Histonet] "Floaters" in surgical or cytology specimens

[Martha Ward-Pathology via Histonet]

I am posting this question for a colleague in our Cytology department. How 
often do you see floaters on surgical or cytology specimens?Obviously we 
would never want to see any type of carryover but is there a standard rate 
published somewhere that he can reference?

Thanks in advance for your help.

Martha Ward, MT ASCP, QIHC
Manager, Molecular Diagnostics Lab
Wake Forest Baptist Medical Center
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[Histonet] Tissue processor validation

[Martha Ward-Pathology via Histonet]

I am posting this question for my colleague in the Histology lab.   She is 
working on a plan for a new tissue processor validation, including special 
stains, and would like to get input from anyone that has already gone through 
it.This is the first time anyone here has ever been involved in validating 
a new processor.   Current ones are 25+ years.


Any help or advice would be appreciated.   Thanks in advance!

Martha Ward, MT (ASCP) QIHC
Wake Forest Baptist Health
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[Histonet] IHC validation after a new tissue processer is installed

[Martha Ward-Pathology via Histonet]

Hello all,

After a very long time our histology department is getting a new tissue 
processor, and hopefully several more in the near future.   Of course for IHC 
that means a revalidation/reverification of our IHC stains.  Since I have not 
had to do this before I wanted to get some guidance on how to go about doing 
this.  I feel like I have to completely revalidate the ER, PR and Her2 (20 
positive, 20 negative) but wasn't sure about the other antibodies.   We have a 
menu of around 130do I have to test every one of them or can we chose a 
representative sample? How many antibodies would you suggest?   How many 
positive and negative cases of each should we run?   It says it is left up to 
the medical director but with our CAP inspection next spring we want to make 
sure we will be fully prepared.What have others done?

Thank you in advance for your help with this.


Martha Ward, MT (ASCP) QIHC
Wake Forest Baptist Medical Center
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[Histonet] Mounting media for immunofluorescence slides

[Martha Ward-Pathology via Histonet]

This may be an odd request but I am hoping someone out there can help us with 
this problem. Our institution is purchasing new digital scanners (Olympus 
200) to scan all our pathology case slides. It has come to our attention 
that the mounting media we have all been using for cover slipping our direct 
immunofluorescence slides (skins and renal biopsies using FITC IgG, etc. 
antibodies) is incompatible with the use of these new scanners.   We use a hard 
set mounting media from Vector but it is never quite hard enough to prevent any 
movement of the cover slip, which is apparently critical to the scanning 
process and potentially damaging to the scanner.The techs that are using 
the scanners are advising us to use a permanent mounting media such as Cytoseal 
60. Has anyone encountered this problem and was there any downside to using 
something like Cytoseal 60 on the slides?   We plan to test a few control 
slides to see how they look.

Thanks in advance for any advice you can give me.

Martha Ward
Molecular Diagnostics Lab
Wake Forest Baptist Health
Winston-Salem, NC 27157
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[Histonet] PPE for the Histology lab

[Martha Ward-Pathology via Histonet]

Our department is looking at safety issues and one suggestion from our CLIA 
director is that everyone in the lab (our lab performs IHC only) should wear 
gloves, a gown and eye or face protection at all times and requiring it for 
anyone that enters the lab.   We have task specific PPE requirements for these 
items to be worn when changing solutions on the stainers or working with serum 
for our indirect immunofluorescence for example but don't require it for FFPE 
microtomy or loading the IHC stainers.   What are others requiring in their 
labs?

Thanks in advance for your feedback on this issue.

Martha Ward
Manager, Molecular Diagnostics Lab
Wake Forest Baptist Health
Winston-Salem, NC 27157
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[Histonet] RUO vs IVD antibodies in immunofluorescence procedures

[Martha Ward-Pathology via Histonet]

We are looking for IVD antibodies for C1q and C4d for use on frozen tissues 
(renal). What vendors are folks using for these direct immunofluorescence 
stains?

Thanks in advance for your help.

Martha Ward
Wake Forest Baptist Health
Winston-Salem, NC 27157
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[Histonet] Looking for vendor for Zeus Wash solution

[Martha Ward-Pathology via Histonet]

I am having trouble locating a distributor for the Zeus Wash solution (cat#103) 
that we use to wash our skin and renal biopsies.Cardinal and Fisher do not 
seem to carry it and we do not have Zeus Scientific in our system as a vendor 
we can use.   Any help would be appreciated!

Thanks,

Martha Ward
Wake Forest Baptist Health
Winston-Salem, NC 27157
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[Histonet] Vendors closed on Presidents Day

[Martha Ward-Pathology via Histonet]

Am I the only one that finds it odd and frustrating that some vendors are 
closed on Presidents Day?   I just tried to call the technical service number 
for Dako about a problem and the message said to call back tomorrow!

Hospital labs don't close and I would have thought they would at least have 
someone staffing the number to cover issues that come up.   Thankfully my call 
isn't urgent but it could have been and then I would be stuck.


Martha Ward
Wake Forest Baptist Medical Center
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[Histonet] Reproducibility in IHC validations

[Martha Ward-Pathology via Histonet]

My medical director and I are working on our procedure for reproducibility in 
our IHC validations and would like to know how others are handling this. 
How many slides do you run and over how many days/runs?If someone would 
share their procedure with us that would be wonderful.
Thanks in advance for your help.
Martha Ward
Wake Forest Baptist Health
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[Histonet] HPV testing on head and neck tumors and reimbursement

[Martha Ward-Pathology via Histonet]

Hello,

My billing group wanted me to ask if anyone is seeing denials for reimbursement 
for HPV testing on male Medicare patients when it is performed on ffpe for head 
and neck tumors? We have seen a few denials recently and they wanted to see 
how everyone is handling the coding.   This is for CPT code 87624.

Thank you in advance for any input you may have on this issue.


Martha Ward, MT (ASCP) QIHC
Wake Forest Baptist Medical Center
Winston-Salem, NC 27157

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[Histonet] Recycling formalin

[Martha Ward-Pathology via Histonet]

I am posting this for our Histology lab manager:

Is anyone recycling formalin and if so, exactly what are you using the recycled 
formalin for?Putting it on processors, adding to specimens, etc?
Apparently our EHS department is pushing this.


Also thank everyone for their help with our questions about unstained slides 
for prostate biopsies.It was very helpful.

Thanks in advance for your help with our recycled formalin question.

Martha Ward
Wake Forest Baptist Health
336-716-2109
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[Histonet] Prostate needle biopsies

[Martha Ward-Pathology via Histonet]

I am posting this question for our Histology manager.For prostate needle 
biopsies how many levels and unstained slides are people cutting and also how 
long after the case is signed out is everyone keeping the unstained slides that 
have been cut?

Thanks in advance for everyone's help.

Martha Ward
Wake Forest Baptist Health
Winston-Salem, NC 25157
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Re: [Histonet] Beaker with or without Vantage

[Martha Ward-Pathology via Histonet]

"They" aren't the ones that will have to use it.therein lies the rub!   I 
have not heard many positive things about AP Beaker.


 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: Morken, Timothy via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Tuesday, November 28, 2017 11:48 AM
To: Histonet
Subject: Re: [Histonet] Beaker with or without Vantage

I am interested as well. "They" are threatening us with a move to Beaker in the 
future


Tim Morken
Pathology Site Manager, Parnassus
Supervisor, Electron Microscopy/Neuromuscular Special Studies Department of 
Pathology UC San Francisco Medical Center

-Original Message-
From: Blake Taylor via Histonet [mailto:histonet@lists.utsouthwestern.edu]
Sent: Tuesday, November 28, 2017 8:10 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Beaker with or without Vantage

I'm looking for anyone out there that has switched to Beaker for AP, Also do 
you use Ventana Connect with Beaker?  Did you choose to use the Beaker tracking 
system or is anyone using Beaker in conjunction with Vantage?  Our Hospital is 
in the beginning phase of moving from Copath Sunquest to Beaker (2017 version) 
.  Any thoughts of what has gone well and what has not would be appreciated.

Thanks so much

Blake Taylor
Surgical Pathology Supervisor
Lexington Medical Center
803-936-8214
bcdu...@lexhealth.org

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[Histonet] Looking for a C4d ffpe control block

[Martha Ward-Pathology via Histonet]

Hello everyone,

I am trying to find someone who can share a C4d ffpe control block with us.  
Ours is almost gone and I don't have access to any suitable tissues in house.   
If anyone has a block they are willing to share please contact me.   I can try 
to help out with any controls that you may be in need of as well.

Thanks in advance for everyone's help.

Martha Ward, MT (ASCP) QIHC
Manager, Molecular Diagnostics Lab
Wake Forest Baptist Health
Winston-Salem, NC 27157
mw...@wakehealth.edu

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[Histonet] Merkel cell polyomavirus antibody

[Martha Ward-Pathology via Histonet]

Good morning,

I have had a request for this antibody but I am having trouble locating a 
vendor for it.If anyone has any information on vendor, etc. , I would 
appreciate it.   We have Leica Bond 3s.

Thank you in advance for your help.

Martha Ward
Wake Forest Baptist Health

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[Histonet] New IHC instrument validation process

[Martha Ward-Pathology via Histonet]

How is everyone handling new instrument validation processes?   We are looking 
at getting a new immunostainer.Beyond the varication process that the 
installers do what are our responsibilities from a lab stand point?   We have a 
large menu of antibodies.Would it be sufficient to run one of each antibody 
to demonstrate that the new instrument compares to the old.The detection 
kits, retrieval solutions, antibodies, etc. would all remain the same.

Thanks in advance for your help.

Martha Ward
Molecular Diagnostics Lab
Wake Forest Baptist Health
Winston-Salem, NC 27157
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[Histonet] Looking for a maintenance form

[Martha Ward-Pathology via Histonet]

Does anyone have a specific form that they use to indicate that a particular 
instrument is functioning as expected after service repairs or PMs?   We need 
to document this information and I would like a simple form to fill out and 
include with the service reports.Just trying to not have to reinvent the 
wheel and would like to see what others are doing.

Thanks in advance for your help.

Martha Ward
Molecular Diagnostics Lab
Wake Forest Baptist Health
Winston-Salem, NC 27157
336-716-2109
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[Histonet] Dako Herceptest Link kit question

[Martha Ward-Pathology via Histonet]

We just installed a new Dako Link Autostainer and have started using the 
Herceptest Link kit.   We had been using two drop zones with our other, older 
instrument but that was applying only 100 uL in the 2 drop zones.   With this 
new program we  set it up to apply two zones of 200 uL but discovered that we 
will be cutting our test capability in half  (50 to about 25 slides).  How are 
other users handling this?   Do you use two drop zones, one on each end to 
cover the control and case material or do you have the reagents apply in one 
drop zone in the middle of the slide?  I am just concerned about the reagents 
spreading evenly across the slide.   What is everyone else's experience with 
this issue?

Thanks in advance for your help!

Martha Ward
Wake Forest Baptist Health

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[Histonet] PLA2R assay question

[Martha Ward-Pathology via Histonet]

I have been asked to look into offering PLA2R on our renal biopsies and in 
doing some research on the subject I find that some people are staining frozen 
tissue via an indirect IMF procedure and some are staining ffpe tissues, also 
using an indirect IMF procedure.I would prefer to do this via traditional 
IHC (we have Bond 2 stainers).Is anyone doing this way?   If so, could you 
provide some tips on getting it to work successfully?

Thanks in advance for any help.


 
Martha Ward, MT (ASCP) QIHC
Manager
 
Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  


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Re: [Histonet] Blog Post Not lab related

[Martha Ward-Pathology via Histonet]

I agreethe delete button is very easy to use.  



-Original Message-
From: Jennifer MacDonald via Histonet 
[mailto:histonet@lists.utsouthwestern.edu] 
Sent: Thursday, April 14, 2016 12:16 PM
To: Rene J Buesa
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Blog Post Not lab related

In addition to the Histonet, I am on a listserve for clinical laboratory 
educators.  Dr. Raff posts his blog link on that listserve as well.   He 
also responds to some of the questions.  There has never been one public 
complaint regarding his posts.  It is very clear in the subject line and the 
ability to delete his posts are quite easy.  Please don't give credence to the 
myth that the clinical lab has more patience and common sense than the 
histology world. 



From:   Rene J Buesa via Histonet 
To: Caroline Miller , Lester Raff MD 

Cc: "histonet@lists.utsouthwestern.edu" 

Date:   04/14/2016 06:02 AM
Subject:Re: [Histonet] Blog Post Not lab related



Amen!!!But you have to concede that Lester is a very  persistent, almost 
obstinate individual, probably used to impose his will and this postings are 
just an example of it: he likes his blog and tries to impose it to everyone. 
Evidently he has all the time in the world and just does not know what to do 
with it and enjoys sharing his "witty" side. René 

On Wednesday, April 13, 2016 3:24 PM, Caroline Miller via Histonet 
 wrote:
 

 Lester, I do believe this is the second 'non lab related' blog post this
week. As we have spoken about before I do not think histonet is an
appropriate place for your blog posts. I, personally, was totally OK with
you co-posting with other lab related topics. However you are now pushing
it and I respectfully ask that you refrain from sending out your blog 
posts
to the whole list, let people sign up if they are interested.

The issue is that this is a histology related list, if everyone posted
non-lab stuff here it would soon be chaos!

Respectfully yours,
mills

On Wed, Apr 13, 2016 at 11:38 AM, Lester Raff MD via Histonet <
histonet@lists.utsouthwestern.edu> wrote:

> Just some philosophy towards the end of a long day.
>
>
> 
http://www.chicagonow.com/downsize-maybe/2016/04/kitten-power-can-get-things-done/

>
>
>
> Just a reminder-I try to limit my blog invitations here. If you enjoy 
the
> blog, remember to subscribe (no charge, no spam) on the ChicagoNow blog
> site.
>
> Thanks for your readership.
>
> Lester J. Raff, MD MBA
> UroPartners
> Medical Director Of Laboratory
> 2225 Enterprise Dr. Suite 2511
> Westchester, Il 60154
> Tel: 708-486-0076
> Fax: 708-492-0203
>
> ___
> Histonet mailing list
> Histonet@lists.utsouthwestern.edu
> http://lists.utsouthwestern.edu/mailman/listinfo/histonet
>



-- 
Caroline Miller (mills)
Director of Histology
3Scan.com
415 2187297
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Re: [Histonet] Billing

[Martha Ward-Pathology]

Yes that is how we do it as well.



 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: Vickroy, James [mailto:jvick...@springfieldclinic.com] 
Sent: Friday, May 29, 2015 3:13 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Billing


Just need a reminder:

If a pathologist orders the same  several IHC stains on two blocks from the 
same specimen am I correct to think that we can only charge the stains on one 
of the blocks? 88342 and the remainder 88341's

Jim

Jim Vickroy
Histology Manager
Springfield Clinic, Main Campus, East Building
1025 South 6th Street
Springfield, Illinois  62703
Office:  217-528-7541, Ext. 15121
Email:  jvick...@springfieldclinic.commailto:jvick...@springfieldclinic.com



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Re: [Histonet] IHC billing question

[Martha Ward-Pathology]

That's what we do as well.   

Martha Ward
Wake Forest Baptist Health

From: Weems, Joyce K. [joyce.we...@emoryhealthcare.org]
Sent: Friday, May 01, 2015 9:13 AM
To: 'Cartun, Richard'; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] IHC billing question

I do it every day  - change every first to 88342.

Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
joyce.we...@emoryhealthcare.org



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-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cartun, Richard
Sent: Thursday, April 30, 2015 5:33 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] IHC billing question

Effective January 1, 2015, our LIS team removed all of the CPT 88342 codes for 
IHC from our CoPath stain dictionary since you couldn't tell whether a 
Cytokeratin-7 was being performed as an 88341 or as an 88342.  Now, as you 
might have expected,  none of the inpatient IHC testing has been accounted 
for (the outpatient IHC has been billed manually from the pathology report), 
and they want someone to go back and enter all the CPT codes into the system 
(hopefully, not me!).  Has anyone else encountered this problem?  Thanks (I 
think).

Richard

Richard W. Cartun, MS, PhD
Director, Histology  Immunopathology
Director, Biospecimen Collection Programs Assistant Director, Anatomic 
Pathology Hartford Hospital
80 Seymour Street
Hartford, CT  06102
(860) 972-1596
(860) 545-2204 Fax


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[Histonet] RE: IHC Billing Question

[Martha Ward-Pathology]

We have not been charging for the negative control, assuming that it was just a 
cost of doing business.  I would be interested to hear if anyone has been 
charging for their negative controls as well.
 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Burnett, Brandy
Sent: Thursday, April 16, 2015 9:48 AM
To: 'Joana Moreira'; histonet@lists.utsouthwestern.edu
Subject: [Histonet] RE: IHC Billing Question 

We recently added HER2 IHC testing in our lab which we are required to use a 
negative reagent control For each case. Is there a cpt code for negative 
reagent control reimbursement? Any information on this Would be much 
appreciated!
Thanks

Brandy Burnett
Histotechnoligist, QIHC(ASCP)
CCH Pathology/Histology


Expert physicians. Quality hospitals. Superior care. 


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Joana Moreira
Sent: Thursday, April 16, 2015 7:25 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] IHC Billing Question 

Greetings from Doha!

This was much probably discussed before, but I was wondering if you could help 
me with a query in regards to billing.
For the sites that are still doing an IHC negative reagent control for each 
patient specimen, do you bill for the negative control? Using code 88341?

I believe it should be billed (since when and if performed correctly the 
negative control follows a normal IHC technique) however I am completely new to 
the billing subject. My previous experience is based in Portugal and UK (where 
billing does not exist) and I've been introduced to this topic since I joined 
my current institution that will be following the North American Healthcare 
model. So... any help will be GREATLY appreciated!!

Many Thanks in advance,
Joana

Joana Moreira
Supervisor - Anatomical Pathology
Department of Pathology

Sidra Medical  Research Center
PO Box 26999 | Doha, Qatar
Direct Line  +974-4404-2036
jmore...@sidra.org | www.sidra.org





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[Histonet] Her2 IHC validation

[Martha Ward-Pathology]

In advance of preparing for our CAP inspection window, I am working on our 
validation write-up for our Her2 IHC and was looking for some data concerning 
the correlation rates.We compared our IHC staining to FISH Her2 results on 
the same case.  Is there a minimum correlation rate?   I have been unable to 
find one in my reading.   Thank you in advance for your help.


 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 


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RE: [Histonet] p16 Antibody

[Martha Ward-Pathology]

We dilute ours 1:5 from the predilute and run it on the Bond 3.   It works very 
well.

 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Burnett, Brandy
Sent: Wednesday, January 14, 2015 10:15 AM
To: 'sarah.dys...@stdavids.com'; lseb...@uwhealth.org; 
veronique.bar...@gmail.com; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] p16 Antibody

We use the Ventana (INK4a) clone as well. What dilution do you use?

Brandy Burnett
Histotechnoligist, QIHC(ASCP)
CCH Pathology/Histology
508-862-5267
bburn...@capecodhealth.org


Expert physicians. Quality hospitals. Superior care. 


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of 
sarah.dys...@stdavids.com
Sent: Wednesday, January 14, 2015 10:01 AM
To: lseb...@uwhealth.org; veronique.bar...@gmail.com; 
histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] p16 Antibody

Ventana unfortunately has the market on the good clone...you can dilute it 
out pretty far (it comes pre-diluted) and still get good results however...


Sarah Dysart  BA, HT (ASCP), QIHC (ASCP) Pathology Supervisor North Austin 
Medical Center
12221 North Mopac Expressway
Austin, TX  78758
512-901-1220 (lab)
512-901-6659 (office)



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sebree Linda A
Sent: Wednesday, January 14, 2015 8:41 AM
To: 'Véronique Barrès'; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] p16 Antibody

We use one from BD, Veronique, with good results. 

Linda A. Sebree
University of Wisconsin Hospital  Clinics IHC/ISH Laboratory, Rm A4/204-3224
600 Highland Ave. 
Madison, WI 53792
(608)265-6596
FAX: (608)262-7174 


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Véronique Barrès
Sent: Wednesday, January 14, 2015 8:06 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] p16 Antibody

Hi Histonetters!

I am working in a research lab and we sometimes need to do p16 staining, but 
our pathologist told us that the antibody we are using right now is not good. 
I'd like to know which antibody you're using in your labs?

Thanks for your help and happy Wednesday!
Véronique
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[Histonet] back orders from various vendors

[Martha Ward-Pathology]

I just need a moment to ventis it just me or is everyone seeing more and 
more back order issues with their various vendors?   It is not specific to any 
one particular vendor, product or even category of product, but lately I am 
being told more and more often that an item is not availableexpected 
release dates anywhere from a few days to 6-8 weeks!  This is starting to 
cause real problems .

Thanks for letting get this off my chest.I will resume my frantic search 
for another antibody vendor now. 

 
Martha Ward, MT (ASCP) QIHC
Manager
 
Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  





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[Histonet] RE: back orders from various vendors

[Martha Ward-Pathology]

At least I know I am not crazy or being paranoid!   :) this year just seems 
to be worse than I ever remember it beingand the worse part is while I am 
freaking out because I can't get something I desperately need, the customer 
service person can only say  We are sorry for the inconvenience.   
Argg



-Original Message-
From: Marcum, Pamela A [mailto:pamar...@uams.edu] 
Sent: Tuesday, December 02, 2014 10:59 AM
To: Martha Ward-Pathology; histonet@lists.utsouthwestern.edu
Subject: RE: back orders from various vendors

Happens every year at this time with various vendors and end of year.  I always 
over order in October to be sure I am good through the end of the year or as 
close as I can.  I know the things I use most and those are just what is always 
in backorder at the end of the year.  October became my answer as long as 
expiration dates are not an issue.

Pam Marcum
UAMS

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Martha 
Ward-Pathology
Sent: Tuesday, December 02, 2014 9:48 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] back orders from various vendors


I just need a moment to ventis it just me or is everyone seeing more and 
more back order issues with their various vendors?   It is not specific to any 
one particular vendor, product or even category of product, but lately I am 
being told more and more often that an item is not availableexpected 
release dates anywhere from a few days to 6-8 weeks!  This is starting to 
cause real problems .

Thanks for letting get this off my chest.I will resume my frantic search 
for another antibody vendor now. 

 
Martha Ward, MT (ASCP) QIHC
Manager
 
Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157 p 336.716.2109  \  f 
336.716.5890 mw...@wakehealth.edu  





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[Histonet] RE: EDTA decalcification solution follow up questions

[Martha Ward-Pathology]

Thank you to everyone who has responded.   They have a more specific question:


Currently they are using SurgiPath DeCal solution II. They are being asked 
to use an EDTA decal solution that will provide the best preservation of RNA 
and DNA proteins.   What is everyone using for this purpose?

Thanks again for any information


 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 





-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Martha 
Ward-Pathology
Sent: Monday, December 01, 2014 2:21 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] EDTA decalcification solution

I am asking this question for our Histology Lab.  They are being asked about 
using EDTA as a decal solution for bone and wondered if anyone else is using 
this?Is this available as a ready to use?   Or do you have to make it up?   
What vendors are you using and could you provide a procedure about how you use 
itlength of time in solution, etc.

Thanks in advance for your help.
 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157 p 336.716.2109  \  f 
336.716.5890 mw...@wakehealth.edu  
 
 






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[Histonet] EDTA decalcification solution

[Martha Ward-Pathology]

I am asking this question for our Histology Lab.  They are being asked about 
using EDTA as a decal solution for bone and wondered if anyone else is using 
this?Is this available as a ready to use?   Or do you have to make it up?   
What vendors are you using and could you provide a procedure about how you use 
itlength of time in solution, etc.

Thanks in advance for your help.
 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 






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[Histonet] RE: questions

[Martha Ward-Pathology]

Sounds like we are all working at the same place!   LOL   
I hear exactly the same questions.is it something they teach to all 
pathology residents

 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Morken, Timothy
Sent: Thursday, August 07, 2014 1:18 PM
To: 'Grantham, Andrea L - (algranth)'; Webb, Dorothy L; 
'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] RE: questions

... and I can still hear myself explaining to them that there could only be 
ONE first!

Yes, DAILY!!! Every time someone wants to change things around so they get 
theirs first, this is our only defense as to why everyone can't get theirs 
first. 8 years of college doesn't seem to help here...

Tim Morken
Supervisor, Histology, Electron Microscopy and Neuromuscular Special Studies UC 
San Francisco Medical Center San Francisco, CA


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Grantham, 
Andrea L - (algranth)
Sent: Thursday, August 07, 2014 10:08 AM
To: Webb, Dorothy L; 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] RE: questions

When I worked in clinical labs the order was first the priority cases 
(biopsies, bone marrows, etc.) then numerically.
I remember once two physicians brought small biopsies and were in a hurry for 
the results, both wanted to be first out and I can still hear myself explaining 
to them that there could only be ONE first!

Andi

From: histonet-boun...@lists.utsouthwestern.edu 
[histonet-boun...@lists.utsouthwestern.edu] on behalf of Webb, Dorothy L 
[dorothy.l.w...@healthpartners.com]
Sent: Thursday, August 07, 2014 9:54 AM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] questions

I have a couple of questions to ask where there is no right or wrong answer, 
just curious as to the process that other labs use.
1.  After processing, how do you determine the order in which to cut and stain 
the blocks..numerical or priority driven?  2. Do you adhere to the 6-72 hours 
of fixation for breasts or make certain all breast tissue is fixed for a 
minimum time of, say, 24 hours but, of course no longer than 72?

I appreciate your responses and thanks for your time!!  I am retiring at the 
end of this year and trying to optimize some processes beforehand:).

Dorothy Webb, HT (ASCP)
Regions Histology Technical Specialist
651-254-2962



  
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[Histonet] RE: rolling sections

[Martha Ward-Pathology]

We do the same thing on our lab.   It isn't necessary for them to rollwe 
just catch them and fold them up and  put them in the tube.
 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Helen Fedor
Sent: Thursday, June 12, 2014 10:55 AM
To: 'Roberta Horner'; Histonet (histonet@lists.utsouthwestern.edu)
Subject: [Histonet] RE: rolling sections

Hi, I think that it is not necessary to actually get them to roll. We just 
collect all of the sections and put them into the tube. Scrunched, not rolled.

Helen

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Roberta Horner
Sent: Thursday, June 12, 2014 10:42 AM
To: Histonet (histonet@lists.utsouthwestern.edu)
Subject: [Histonet] rolling sections

I have some researchers that want to do PCR.  They want 10 - 10u sections in a 
micro-centrifuge tube.  The only way to get the sections in the tube is for the 
sections to roll.  How do you get sections to roll when you want them to roll?  
I've tried room temperature, on ice, brand new sharp blade, dull blade and I 
can still get some really nice ribbons.  When I want a thick ribbon it will 
roll, darn that Murphy and his laws.
Roberta Horner
Animal Diagnostic Lab
Penn State University
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RE: [Histonet] Re: Negative Controls

[Martha Ward-Pathology]

So do we.

 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sebree Linda A
Sent: Wednesday, April 30, 2014 8:35 AM
To: 'Campbell, Tasha M.'; Terri Braud; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Re: Negative Controls

Tasha,

We use the negative elements within our patient sample as our negative tissue 
control.

Linda A. Sebree
University of Wisconsin Hospital  Clinics IHC/ISH Laboratory
600 Highland Ave. 
Madison, WI 53792
(608)265-6596
FAX: (608)262-7174 

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Campbell, Tasha 
M.
Sent: Wednesday, April 30, 2014 6:48 AM
To: Terri Braud; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Re: Negative Controls

So this has confused me more. So before you would run a negative control for 
each block you were testing and you would use the negative mouse or rabbit 
reagent.  Now you don't have to do that but you still need a negative tissue 
control.  So what exactly does this mean?  Does it mean for every antibody that 
you are running you need to have a negative tissue control for it?  So instead 
of using the negative mouse serum you would run a known negative tissue control 
with the antibody, say CD3 or whatever it is?  So are most people doing a 
control slide with a negative tissue and a positive tissue on it?

 
 
Tasha Campbell, B.S.,HTL(ASCP)
Frederick Gastroenterology Associates
310 W. 9th St.
Frederick, MD 21701
301-695-6800 ext. 144 (w)
304-685-9307 (c)
-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Terri Braud
Sent: Tuesday, April 29, 2014 1:30 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Re: Negative Controls

On Message 7 - Negative Controls
While it is true that if you run polymers, you no longer have to run a negative 
reagent control, HOWEVER, you still must have a negative tissue control, which 
to quote CAP: must  show no staining of tissues known to lack the antigen
Any of the following can serve as a negative tissue control:
1. Multi tissue blocks.  These can provide simultaneous positive and negative 
tissue controls and are considered best practice...
The type of negative tissue control used (i.e. separate sections, internal 
controls, or multitissue blocks) must be specified in the laboratory manual.
Thus sayeth CAP, the almighty.  Please see ANP.22570 Our lab has defined our 
negative controls as a piece of Uterus as the negative tissue in a multitissue 
block as a negative tissue control for most of our antibodies, though for a few 
that might be too reactive in uterus, we use a piece of skin.
I hope this helps.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Holy Redeemer Hospital Laboratory
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3676
Fax: 215-938-3874

Message: 7
From: Beth Brinegar bbrinegar...@gmail.com
Subject: [Histonet] Negative controls
Hello fellow histonetters,

What is are other labs doing to satisfy the ANP.22570 QC - Antibodies 
Appropriate negative controls are used.



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[Histonet] CAP question ANP.22978 - Her2 assay validation

[Martha Ward-Pathology]

Hello all,

I have been reading through the most recent revisions and want to see how 
others are handling this question.   The explanation states that it is for new 
and existing assays and that if your validation does not meet current standards 
that you must supplement and bring it into compliance.  Furthermore if you do 
not have any documentation from the initial validation the assay must be fully 
revalidated and documented.

Our lab has been performing the Herceptest from Dako (FDA approved) since 
before 2008 and participating in the HER2 proficiency testing since it was 
first offered.   We have our statistical results comparing our IHC patient 
results to FISH Her2 results since 2008 and we have always done well on our CAP 
proficiency testing (95%-100%).We do inter-pathologist result comparisons, 
using know CAP slides and have 95% to 100% agreements.   

What I do not have however is the original results of the slides that were 
stained to set up the original assay.   Under these circumstances will we need 
to completely revalidate the assay, using the mandated 20+/20- cases, or can we 
simply do a retroactive formal review and write up of our past performances on 
our proficiency testing challenges?

Thanks in advance for your help with this!

 
Martha Ward, MT (ASCP) QIHC
Manager
 
Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157


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[Histonet] RE: Instrument Verification

[Martha Ward-Pathology]

I'm with you.   There really appears to be no value to this particular 
requirement.I would only be concerned with it if I had just purchased it, 
or moved it into our lab from another location.


 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cynthia Robinson
Sent: Thursday, April 03, 2014 3:03 PM
To: Terri Braud; histonet@lists.utsouthwestern.edu
Subject: [Histonet] RE: Instrument Verification

I agree with you in that CAP is just looking for things to change and doesn't 
seem to be considering the change and decrease in staffing seen in clinical 
settings. Cryostat validation? Reallycut a slide after you have cleaned and 
pm'd the thing and go on. Good grief...I don't need any more paper and 
documentation on routine processes. As for tissue processors, I have 20 year 
old VIP's that have been running and producing specimens acceptably. I did 
validate them prior to being put in use but we didn't document like we do now. 
And I don't see the need to do it at this stage of use. We did do a very 
extensive validation on the Peloris we put into use last year and will going 
forward on new equipment.  To me the daily QC of stain should provide our 
'validation' of the process and include the processor. I am interested in 
others thoughts as well.

Thanks for allowing me to rant.

Cindi Robinson, HT(ASCP)
Mercy Medical Center-Sioux City
Dunes Medical Laboratories
350 W Anchor Drive
Dakota Dunes SD 57049




-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Terri Braud
Sent: Thursday, April 03, 2014 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] RE: Instrument Verification

I just received my midcycle CAP and for cryostat validation, we are planning to 
cut and stain a piece of frozen tonsil and have the path sign off on it. For 
the tissue processors, we will run a one minute test program. I hope this will 
fly.  Is it just me, or is CAP insanely out of control with new or modified 
regulations and policies for AP?  

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Holy Redeemer Hospital Laboratory
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3676
Fax: 215-938-3874

6. Validation of cryostat (Gloria Tharp)

Message: 6
Date: Thu, 3 Apr 2014 09:59:26 -0500
From: Gloria Tharp gth...@pcasoutheast.com Could anyone tell me how you are 
handling the new CAP ANP.23045 question on function and verification of 
equipment regarding a cryostat.
Gloria Tharp, BA, HTL(ASCP)
--

Message: 7
Date: Thu, 3 Apr 2014 15:26:17 +
From: Leann M. Murphy lmurp...@aultman.com How is everyone validating the 
tissue processor for new CAP ANP.23045 question on function and verification of 
equipment?
LeAnn Murphy
Aultman Hospital
Canton, Ohio

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RE: [Histonet] RE: Negative Controls for IHC

[Martha Ward-Pathology]

We discontinued them over a year ago.


 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of joelle weaver
Sent: Wednesday, February 12, 2014 11:04 AM
To: Cheri Miller
Cc: histonet@lists.utsouthwestern.edu; histonet-boun...@lists.utsouthwestern.edu
Subject: RE: [Histonet] RE: Negative Controls for IHC

Cheryl
Yes, I understand. It is highly likely this will be the way things go here 
also. 




Joelle Weaver MAOM, HTL (ASCP) QIHC
 
 From: cmil...@physlab.com
 To: joellewea...@hotmail.com
 CC: histonet-boun...@lists.utsouthwestern.edu; 
 histonet@lists.utsouthwestern.edu
 Date: Wed, 12 Feb 2014 08:04:43 -0600
 Subject: RE: [Histonet] RE: Negative Controls for IHC
 
 I just stopped using the reagent controls on all our IHC due to the drastic 
 cuts in reimbursement. It will be a significant immediate savings for our 
 tiny lab.
 Cheryl A. Miller HT ASCP cm
 Histology Supervisor
 Hygiene Officer
 Physicians Laboratory, P.C.
 4840 F St.
 Omaha , NE. 68117
 402 731 4145 ext. 532
 Cell 402 493 0403
 
 From: histonet-boun...@lists.utsouthwestern.edu 
 [histonet-boun...@lists.utsouthwestern.edu] On Behalf Of joelle weaver 
 [joellewea...@hotmail.com]
 Sent: Tuesday, February 11, 2014 1:54 PM
 To: Sebree Linda A; 'Abbott, Tanya'; histonet@lists.utsouthwestern.edu
 Subject: RE: [Histonet] RE: Negative Controls for IHC
 
 Not too long ago, there was a posting about labs that had discontinued. You 
 technically don't need with a polymer, non-biotin system. I still do them- 
 for now. The pathologist never uses them, internal controls only. But I do, 
 but this may be a good cost cutting idea for the future.
 
 
 
 
 Joelle Weaver MAOM, HTL (ASCP) QIHC
 
  From: lseb...@uwhealth.org
  To: tanyaabb...@catholichealth.net; 
  histonet@lists.utsouthwestern.edu
  Date: Tue, 11 Feb 2014 19:44:37 +
  CC:
  Subject: [Histonet] RE: Negative Controls for IHC
 
  Hi Tanya,
 
  We have made the decision to continue running negative reagent control 
  slides.
 
  Linda A. Sebree
  University of Wisconsin Hospital  Clinics IHC/ISH Laboratory
  600 Highland Ave.
  Madison, WI 53792
  (608)265-6596
  FAX: (608)262-7174
 
  -Original Message-
  From: histonet-boun...@lists.utsouthwestern.edu 
  [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of 
  Abbott, Tanya
  Sent: Tuesday, February 11, 2014 12:54 PM
  To: histonet@lists.utsouthwestern.edu
  Subject: [Histonet] Negative Controls for IHC
 
  I just read in Advance Dec 2013 that there is a possibility of laboratories 
  utilizing fewer QC controls to cut costs? Has anyone stopped running 
  negative controls for IHC?
 
  Tanya G. Abbott RT (CSMLS)
  Manager Technologist, Histology/Cytology St. Joseph Medical Center 
  Reading, PA 19603-0316 ph  610-378-2635 fax 610-898-5871
  email: tanyaabb...@catholichealth.net
 
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RE: [Histonet] Turn Around Time

[Martha Ward-Pathology]

Rene,

No not the quality of the slides at all.  Actually my lab does not do the 
processing and initial HE, which is done in our main histology lab.   My 
concern is that the push for quicker TATs sometimes leads to inadequate 
fixation, etc., which affects our lab.I'm just saying that fast does not 
always with better, but there is no reason not to stream line our processes and 
try to provide more timely results.

Of course any case requiring our lab services (IHC, ISH, PCR) is going to have 
a longer TAT.   We generally have a 24 hour TAT on our IHC and ISH and of 
course longer on our PCR testing as those are batched.

More of an editorial comment that anything else

Martha

From: Rene J Buesa [mailto:rjbu...@yahoo.com]
Sent: Monday, February 03, 2014 4:38 PM
To: Martha Ward-Pathology; Dawn Bugge; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Turn Around Time

Martha:
So, do you mean that you are not satisfied with the quality of your slides?
If you are, I just do not understand your concerns about a 24 h TAT!
The fundamental issue is to develop adequate protocols assuring quality as well 
as a convenient (24 h) TAT.
Just my 3 cents (after inflation!)
René J.

From: Martha Ward-Pathology mw...@wakehealth.edumailto:mw...@wakehealth.edu
To: Dawn Bugge drbu...@gmail.commailto:drbu...@gmail.com; 
histonet@lists.utsouthwestern.edumailto:histonet@lists.utsouthwestern.edu 
histonet@lists.utsouthwestern.edumailto:histonet@lists.utsouthwestern.edu
Sent: Monday, February 3, 2014 2:05 PM
Subject: RE: [Histonet] Turn Around Time

While I recognize the need for a quick result in some cases, I also subscribe 
to the theory that speed kills.  I'm not sure that these quick TATs are 
always medically necessary, but rather more of a convenience.However that 
is another discussion altogether.  That said, our institution shoots for the 
80% in 24 hours as well.



Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890
mw...@wakehealth.edumailto:mw...@wakehealth.edu





-Original Message-
From: 
histonet-boun...@lists.utsouthwestern.edumailto:histonet-boun...@lists.utsouthwestern.edu
 
[mailto:histonet-boun...@lists.utsouthwestern.edumailto:histonet-boun...@lists.utsouthwestern.edu]
 On Behalf Of Dawn Bugge
Sent: Monday, February 03, 2014 12:43 PM
To: histonet@lists.utsouthwestern.edumailto:histonet@lists.utsouthwestern.edu
Subject: [Histonet] Turn Around Time

Hello Histonet

I am just curious what the standard for Turn Around Time is for most labs.
I think a two day turn around time from the time the biopsy gets to the lab to 
the time the pathologist signs out a case is pretty fast.

Thanks for your input.
--
Dawn R Bugge
Seattle Histology
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RE: [Histonet] Turn Around Time

[Martha Ward-Pathology]

While I recognize the need for a quick result in some cases, I also subscribe 
to the theory that speed kills.   I'm not sure that these quick TATs are 
always medically necessary, but rather more of a convenience.However that 
is another discussion altogether.  That said, our institution shoots for the 
80% in 24 hours as well.


 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Dawn Bugge
Sent: Monday, February 03, 2014 12:43 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Turn Around Time

Hello Histonet

I am just curious what the standard for Turn Around Time is for most labs.
I think a two day turn around time from the time the biopsy gets to the lab to 
the time the pathologist signs out a case is pretty fast.

Thanks for your input.
--
Dawn R Bugge
Seattle Histology
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[Histonet] RE: HER2/NEU

[Martha Ward-Pathology]

That is an interesting observation, as we have seen something of the same thing 
and we use the Dako Herceptest.I would be interested in hearing others 
responses as well.   Thank you for asking the  question.


 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Knutson, Deanne
Sent: Wednesday, January 15, 2014 11:46 AM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] HER2/NEU

I just wanted to see what others in the histology world might be experiencing.

We have seen a marked increase in the percentage of HER2 cases resulting as 
Indeterminate, when we compare our last year patient predictive marker results 
to this year's results.
The clone we are using is CB11 from Cell Marque.

We did a HER2 study last year where we sent out our cases for a second opinion, 
and the study showed others interpreted our Indeterminates as that also.
Has anyone else also noted this increase in their annual comparison, and what 
clone are you using?

It is so nice to be able to reach out to our peers with these types of 
questions.
Thank you for responding back!

Deanne Knutson
Anatomic Pathology Supervisor
St. Alexius Medical Center
701-530-6730
dknut...@primecare.orgmailto:dknut...@primecare.org




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[Histonet] Vendor suggestions for IgG subclass antibodies

[Martha Ward-Pathology]

I am looking for a vendor for FITC labeled IgG1, IgG2 IgG3 and IgG4 antibodies 
for use in our immunofluorescence panels when staining renal biopsies. We 
get most of our FITC antibodies for our panel from Dako but I didn't see these 
others.   Any suggestions are appreciated.   Thanks in advance for your help!


 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 






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[Histonet] cell block staining issues

[Martha Ward-Pathology]

We have something of a mystery here and I am hoping someone can help.  My 
cytopath docs are saying that our B72.3 (TAG-72) antibody is not working well 
in cell blocks created from fluids (plural), etc. and that this is a fairly 
recent development (over the past 5-6 weeks or so).The surgical cases we 
have stained look great as does our control, which is placed on each slide.   
We have not changed lot numbers of antibody or made any up recently and the 
antibody is not expired, or even close.The only thing we can find that is 
different is that cytology has been rinsing the needles out with a product 
called Cytolyt, instead of saline and they started this around the first of 
August.Does anyone know if this product could cause any interference with 
our staining?  The docs just say that the tumor cells are not staining and we 
are sort of at a loss here.

Thanks in advance for your help.
Martha Ward, MT (ASCP) QIHC
Manager
[Wake Forest Baptist Health]
Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157 p 336.716.2109  \  f 
336.716.5890 mw...@wakehealth.edu


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[Histonet] RE: cell block staining issues

[Martha Ward-Pathology]

Well actually it does help because we are trying to eliminate possible causes 
and it is nice to know that someone else uses Cytolyt with no problems.   It is 
just frustrating because we are doing nothing different that I can find.The 
next step is to see if the samples are coming from the same doctor/clinic and 
see if they are doing anything different.

Martha

-Original Message-
From: Tom McNemar [mailto:tmcne...@lmhealth.org] 
Sent: Thursday, October 31, 2013 9:17 AM
To: Martha Ward-Pathology; histonet@lists.utsouthwestern.edu
Subject: RE: cell block staining issues

We have not used B72.3 for quite awhile now but all of our NGYNs are either 
collected in or processed with Cytolyt and we have had no issues.  Sorry, I 
know this isn't much help.

Tom McNemar, HT(ASCP)
Histology Co-ordinator
Licking Memorial Health Systems
(740) 348-4163
(740) 348-4166
tmcne...@lmhealth.org
www.LMHealth.org


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Martha 
Ward-Pathology
Sent: Thursday, October 31, 2013 8:19 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] cell block staining issues



We have something of a mystery here and I am hoping someone can help.  My 
cytopath docs are saying that our B72.3 (TAG-72) antibody is not working well 
in cell blocks created from fluids (plural), etc. and that this is a fairly 
recent development (over the past 5-6 weeks or so).The surgical cases we 
have stained look great as does our control, which is placed on each slide.   
We have not changed lot numbers of antibody or made any up recently and the 
antibody is not expired, or even close.The only thing we can find that is 
different is that cytology has been rinsing the needles out with a product 
called Cytolyt, instead of saline and they started this around the first of 
August.Does anyone know if this product could cause any interference with 
our staining?  The docs just say that the tumor cells are not staining and we 
are sort of at a loss here.

Thanks in advance for your help.
Martha Ward, MT (ASCP) QIHC
Manager
[Wake Forest Baptist Health]
Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157 p 336.716.2109  \  f 
336.716.5890 mw...@wakehealth.edu



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[Histonet] RE: Submitting Questions

[Martha Ward-Pathology]

I have had the same problem over the past few months...
 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Nails, Felton
Sent: Tuesday, September 24, 2013 2:58 PM
To: 'Joanne Clark'; histonet@lists.utsouthwestern.edu
Subject: [Histonet] RE: Submitting Questions

I am in the same situation??? 

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Joanne Clark
Sent: Tuesday, September 24, 2013 12:54 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Submitting Questions

Can anyone out in histoland explain to me why my submitted questions are not 
making it through to histonet?  I submitted a question on the 19th of 
September, and I still have not seen it appear in the group emails I get daily. 
 I sent the question to the correct address (I checked it to be sure).  When I 
respond to someones question, I can see my responses, I just can't seem to get 
an original question submitted.  Can anyone tell me what I am doing wrong?




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[Histonet] Minimum sample size for breast markers

[Martha Ward-Pathology]

Is there a minimum number of cells that should be present when testing for ER, 
PR and Her2? I have looked on the CAP website but cannot see anything about 
this.  We are constantly getting these small biopsies or FNAs for testing and I 
sometimes wonder what the lowest threshold is for testing...20 tumor cells, 50 
tumor cells   Any information would be appreciated.   Thanks in advance for 
your help.
 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 





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RE: [Histonet] Minimum sample size for breast markers

[Martha Ward-Pathology]

Thanks everyone

From: Rene J Buesa [mailto:rjbu...@yahoo.com]
Sent: Thursday, September 12, 2013 10:56 AM
To: Martha Ward-Pathology; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Minimum sample size for breast markers

No, there are no written instructions on the subject. You just have to state 
how many cells you found and the clinician is supposed to act accordingly.

René J.
From: Martha Ward-Pathology mw...@wakehealth.edumailto:mw...@wakehealth.edu
To: Rene J Buesa rjbu...@yahoo.commailto:rjbu...@yahoo.com; 
histonet@lists.utsouthwestern.edumailto:histonet@lists.utsouthwestern.edu 
histonet@lists.utsouthwestern.edumailto:histonet@lists.utsouthwestern.edu
Sent: Thursday, September 12, 2013 10:24 AM
Subject: RE: [Histonet] Minimum sample size for breast markers

Thanks Rene.  I realize that it is ultimately up to the Pathologist but I was 
wondering if there are any written guideline/suggestions because I have had 
pathologists ask me if there is minimum.

From: Rene J Buesa [mailto:rjbu...@yahoo.com]
Sent: Thursday, September 12, 2013 9:23 AM
To: Martha Ward-Pathology; 
histonet@lists.utsouthwestern.edumailto:histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Minimum sample size for breast markers

I do not think this is the adequate forum to ask this question because you may 
get a wrong answer that could determine your decision.
Your pathologist is the one who should decide about this issue.
René J.

From: Martha Ward-Pathology mw...@wakehealth.edumailto:mw...@wakehealth.edu
To: 
histonet@lists.utsouthwestern.edumailto:histonet@lists.utsouthwestern.edu 
histonet@lists.utsouthwestern.edumailto:histonet@lists.utsouthwestern.edu
Sent: Thursday, September 12, 2013 9:06 AM
Subject: [Histonet] Minimum sample size for breast markers



Is there a minimum number of cells that should be present when testing for ER, 
PR and Her2? I have looked on the CAP website but cannot see anything about 
this.  We are constantly getting these small biopsies or FNAs for testing and I 
sometimes wonder what the lowest threshold is for testing...20 tumor cells, 50 
tumor cells  Any information would be appreciated.  Thanks in advance for 
your help.

Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890
mw...@wakehealth.edumailto:mw...@wakehealth.edu







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RE: [Histonet] Re: Minimum sample size for breast markers

[Martha Ward-Pathology]

Thanks to everyone that responded to my question.   It has encouraged a nice 
discussion and I have learned from it.


 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bob Richmond
Sent: Thursday, September 12, 2013 1:56 PM
To: Histonet@lists.utsouthwestern.edu
Subject: [Histonet] Re: Minimum sample size for breast markers

Pathologists need to be very ready to note that a breast cancer sample size is 
small, and that the markers need to be repeated on the lumpectomy or mastectomy 
specimen.

This is easier said than done. Popping a Dolly-size breast into too-small 
container and dribbling a little formalin on it is not going to preserve the 
specimen adequately. Even with a moderate-sized lumpectomy specimen the 
formaldehyde penetration is going to be chancy.

This is an issue that surgeons, OR nurses, and too many pathologists are unable 
to understand. The pathologist has to arrange to receive the specimen promptly 
and get the tumor cut into formalin. Easier said than done.

The woman's cancer care depends on this getting done. It's non-trivial. And 
colon cancer is distinctly the next frontier for this problem.

Bob Richmond
Samurai Pathologist
Maryville TN
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RE: [Histonet] EPIC Beaker

[Martha Ward-Pathology]

I would be interested in any information as well.   We do not plan to  
implement for a year or more but one of our hospitals is working on Beaker now 
and finding that it does not adapt to AP as well as it does CP.


 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Pam Marcum
Sent: Wednesday, September 04, 2013 10:16 AM
To: Histonet
Subject: [Histonet] EPIC Beaker




I know asked this a couple of months ago however; we are just getting ready to 
work with the EPIC people on the Histology/IHC/Slide  Block/Gross Room issues 
we need in AP.  I am looking for any advise or recommendations anyone who is 
running Epic Beaker now or is in the process as we are to implement it in the 
next 6 months or so.  I would prefer this is off line if anyone resonding is OK 
doing it that way.  If others want the info then please to Histonet will work 
too.  



We are having issues getting our IT group and Epic to understand AP is not the 
same as CP. 



Thank You, 

Pam Marcum 

UAMS Histology Supervisor 



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[Histonet] Immunofluorescence on paraffin sections

[Martha Ward-Pathology]

We do quite a number of renal biopsies and sometimes the frozen tissue is not 
sufficient for the immunofluorescent panel and we have to use paraffin sections 
for our fluorescence staining.   It has never really worked all that well and 
so we are looking for alternative methods.   
We get all our FITC labeled antibodies from Dako and would like to use them on 
our Bond III stainer, not for immunofluorescence but for immunoperoxidase 
staining.   Has anyone out in Histoland tried this on the Bond, and if so, 
would you share your procedure with me?

Thanks in advance for any help you can give me.

 
Martha Ward, MT (ASCP) QIHC
Manager
 
Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  





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[Histonet] Unstained slides

[Martha Ward-Pathology]

We are looking at ways to improve our work processes, save time and labor and 
reduce costs, all while maintaining patient quality...as we all are of course.

During our conversations the subject of cutting unstained slides has come up 
and we are looking for bench marking data to see if we are where we need to be. 
   Currently we are cutting unstained slides for various protocols (including 
prostate biopsies), where the specimens are tiny,  but we are also cutting a 
lot of just in case unstained slides.   Our research has shown that about 50% 
of the time the unstained slides requested are never used and we are trying to 
find out if that is high, low or about what other institutions are seeing.   If 
anyone has any data they could share with us we would appreciate it.   

Thanks in advance for your help.   I can share what I find out if others are 
interested.


Martha Ward, MT (ASCP) QIHC
Manager
 
Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157 p 336.716.2109  \  f 
336.716.5890 mw...@wakehealth.edu  





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[Histonet] DAB enhancer

[Martha Ward-Pathology]

I have been asked by a new pathologist to look into a DAB enhancer for use on 
our Bond III instruments.   Are many of you using this on the Bond, or any 
other staining platform and what are the pros and cons of its use?

Thanks!

 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



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[Histonet] DAB enhancer

[Martha Ward-Pathology]

Sorry but I cannot get my messages to go through to the Histonet so I am 
piggybacking onto a previous message:


I have been asked by a new pathologist to look into a DAB enhancer for use on 
our Bond III instruments.   Are many of you using this on the Bond, or any 
other staining platform and what are the pros and cons of its use?

Thanks!

 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157 p 336.716.2109  \  f 
336.716.5890 mw...@wakehealth.edu  

-Original Message-




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RE: [Histonet] Billing ???

[Martha Ward-Pathology]

At our institution the hospital bills the technical and the pathologist bills 
the professional.


 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of 
jmasla...@stpetes.org
Sent: Friday, June 21, 2013 11:49 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Billing ???

Happy Friday
This is a question to those who work at a hospital that have contracted 
pathologists. Does your hospital bill the technical component and the 
pathologist bill the profession component or does the pathologist bill 
everything and pay the hospital for technical component?


Joe Maslanka BS, CT,HT (ASCP)
Anatomical Pathology Technical Supervisor

Give thanks for ALL things.
Kindness is the language the blind can see  the deaf can hear- Mark Twain



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[Histonet] p16 on the Bond

[Martha Ward-Pathology]

I am having trouble posting to the histonet for some reason.  I am looking for 
condition and incubation times for p16 on the Bond.  Our new pathologist says 
our p16 looks overstained to him and not at all what he is accustomed to seeing 
and I am trying to get the staining more to his liking, without much success.

Thanks in advance for the help.


 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 





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[Histonet] RE: negative controls

[Martha Ward-Pathology]

We eliminated them on August 1st, except in cases where they are specifically 
requested.  So far we have run 10 negative slides.


 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V
Sent: Friday, August 17, 2012 12:36 PM
To: 'Romundstad, Pamela K'; histonet@lists.utsouthwestern.edu
Subject: [Histonet] RE: negative controls

For everyone performing immunos are you not running negative controls now with 
this new ruling from CAP?

Hazel Horn
Supervisor of Histology/Autopsy/Transcription Anatomic Pathology Arkansas 
Children's Hospital
1 Children's Way | Slot 820| Little Rock, AR 72202
501.364.4240 direct | 501.364.1302 office | 501.364.1241 fax 
hor...@archildrens.org archildrens.org




100 YEARS YOUNG!
JOIN THE PARTY AT
ach100.org



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Romundstad, 
Pamela K
Sent: Friday, August 17, 2012 10:25 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] RE: Histonet Digest, Vol 105, Issue 20

Yes, the negative control updated change is in effect as of July 31. 2012. I 
contacted CAP personally this week and was directed to the revised ANP.22570. 
It only applies to polymer based detection systems (biotin-free).

Respectfully,
Pamela Romundstad HT, QIHC

Gundersen Lutheran

608-775-3139


From: histonet-boun...@lists.utsouthwestern.edu 
[histonet-boun...@lists.utsouthwestern.edu] on behalf of 
histonet-requ...@lists.utsouthwestern.edu 
[histonet-requ...@lists.utsouthwestern.edu]
Sent: Thursday, August 16, 2012 12:02 PM
To: histonet@lists.utsouthwestern.edu
Subject: Histonet Digest, Vol 105, Issue 20

Send Histonet mailing list submissions to
histonet@lists.utsouthwestern.edu

To subscribe or unsubscribe via the World Wide Web, visit
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When replying, please edit your Subject line so it is more specific than Re: 
Contents of Histonet digest...


Today's Topics:

   1. protocol for EGFP IHC in frozen rat brains (Bass, Caroline)
   2. Re: Two identifiers... (Bob Richmond)
   3. RE: Re: Two identifiers... (joelle weaver)
   4. RE: Re: Two identifiers... (Michael Mihalik)
   5. Negative Control (Pardue, Judith)
   6. RE: Special Stain documentation (hymclab)
   7. Peloris (Pardue, Judith)
   8. RE: RE: Two identifiers... (Pratt, Caroline)
   9. RE: RE: Two identifiers... (Tom McNemar)
  10. marker specific  for mouse fibroblasts (Kim Merriam)
  11. RE: RE: Two identifiers... (Pratt, Caroline)
  12. RE: marker specific  for mouse fibroblasts (Elizabeth Chlipala)


--

Message: 1
Date: Wed, 15 Aug 2012 18:07:46 -0400
From: Bass, Caroline ceb...@buffalo.edu
Subject: [Histonet] protocol for EGFP IHC in frozen rat brains
To: histonet@lists.utsouthwestern.edu
histonet@lists.utsouthwestern.edu
Message-ID: abc535ec-9fcd-45e0-957c-617fa7aa8...@buffalo.edu
Content-Type: text/plain; charset=Windows-1252

Hello Everyone,

I have some rat brains that should express GFP, the brains were collected fresh 
and snap frozen in dry ice/isopentane. They have been stored for several months 
in a -80. I'd like to collect 500 um sections, thaw mount them to a slide an 
reserve these for mRNA collection. I would then like to take intervening 
sections to stain for GFP. I have a staining protocol for perfused, formalin 
fixed, sucrose protected floating brain sections that works fine. I'm a little 
more concerned about moving to unfixed sections. I know I need to cut 
everything on a cryostat and I assume that I have to process the thinner 
sections on the slide instead of free floating. What is the best way to 
proceed? Here are some specific questions?

1) what thickness should I cut, 50 um works great for my fixed sections.
2) should I fix these sections by either paraformaldehyde vapors or dunking 
in fix? If so, what kind/concentration?
3) could I then proceed as though this were a normal GFP immuno, with DAB stain?
4) should I used plus slides or subbed slides?
5) will the sections stay on without fixation?

Any and all suggestions would be appreciated!

Thanks,

Caroline


--

Message: 2
Date: Wed, 15 Aug 2012 21:11:12 -0400
From: Bob Richmond rsrichm...@gmail.com
Subject: [Histonet] Re: Two identifiers...
To: histonet@lists.utsouthwestern.edu
Message-ID:

RE: [Histonet] Negative Reagent Control

[Martha Ward-Pathology]

What wonderful news


 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Angela Bitting
Sent: Wednesday, July 18, 2012 7:26 AM
To: Richard Cartun; Histonet
Subject: Re: [Histonet] Negative Reagent Control

Our Prayers have been answered!!!

 Richard Cartun rcar...@harthosp.org 7/17/2012 7:04 PM 
Most of you know that I have been advocating for the elimination of the 
Negative Reagent Control when using a non-avidin-biotin detection system 
(polymer) in immunohistochemical testing.  In my opinion, it is a waste of 
healthcare dollars and, more importantly, precious patient specimen.  Last year 
at the NSH IHC Forum in Denver I met James Dvorak, MT(ASCP) from the College of 
American Pathologists.  We had a long discussion about this and he agreed to 
support my position within CAP.  With the support of James, and the help of Dr. 
Regan Fulton (from the CAP IHC Committee), the wording on the CAP Anatomic 
Pathology checklist for question ANP.22570 will be changed.  The new wording 
includes the following sentence:

Immunohistochemical tests using polymer-based detection systems (biotin-free) 
are sufficiently free of background reactivity to obviated the need for a 
negative reagent control and such controls may be omitted at the discretion of 
the laboratory director.

I announced this change at the 2012 NSH IHC/ISH Forum this past weekend in 
Windsor, CT to loud applause.  This one change stands to save the healthcare 
system millions of dollars.  Thank you Jim and Dr. Fulton for making this 
happen!

Richard

Richard W. Cartun, MS, PhD
Director, Histology  Immunopathology
Director, Biospecimen Collection Programs Assistant Director, Anatomic 
Pathology Hartford Hospital
80 Seymour Street
Hartford, CT  06102
(860) 545-1596 Office
(860) 545-2204 Fax



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RE: [Histonet] Beaker module in EPIC

[Martha Ward-Pathology]

Again, we would be interested in any replies as well.   Our institution is 
going live with Epic this fall but the labs will not be using Beaker until 
later on.   We are still trying to figure out how all this will work and 
welcome all information.
Paula, how soon will Duke be up and using Beaker?

Martha Ward
Wake Forest Baptist Health
336-716-2109

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Paula Sicurello
Sent: Thursday, July 12, 2012 4:05 PM
To: HistoNet; microsc...@microscopy.com
Subject: [Histonet] Beaker module in EPIC

Hello all Listers,

I've already asked the Histonet but I'm wondering about a different thing this 
time.

Does anyone have experience with Beaker in conjunction with Anatomic Pathology, 
Surgical Pathology or the multiple other clinical labs that are in hospitals 
today?

I work in Anatomic/Surgical Pathology which encompasses all the Clinical 
Laboratory services here at Duke.  We have been told to determine what we need 
for the Beaker module to be useful to us.  I've seen a brief demo. as to how it 
will work for the ordering clinicians (they can order every test STAT!).

Please, send me any of the pluses or minuses that you've experienced using 
Beaker.

Thanks,

Paula :-)

--
Paula Sicurello, HTL (ASCP)
Supervisor, Clinical Electron Microscopy Laboratory Duke University Health 
System Rm.#251M, Duke South, Green Zone Durham, North Carolina 27710
P:  919.684.2091
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RE: [Histonet] Beaker module in EPIC

[Martha Ward-Pathology]

So far we have not had any responses so I assume the answer is no.   


 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: Michael Mihalik [mailto:m...@pathview.com] 
Sent: Friday, July 13, 2012 2:03 PM
To: Martha Ward-Pathology; 'Paula Sicurello'; 'HistoNet'; 
microsc...@microscopy.com
Subject: RE: [Histonet] Beaker module in EPIC

I'm curious.  Are ANY labs using Epic for their APLIS?   The last I heard
was a sales presentation a couple of years ago where the sales person declined 
to show the APLIS because it wasn't ready.

I do know of hospitals using Epic for order entry, though.

Michael Mihalik
PathView Systems | cell: 214.733.7688 | 800.798.3540 | fax: 952.241.7369


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Martha 
Ward-Pathology
Sent: Friday, July 13, 2012 7:42 AM
To: Paula Sicurello; HistoNet; microsc...@microscopy.com
Subject: RE: [Histonet] Beaker module in EPIC

Again, we would be interested in any replies as well.   Our institution is
going live with Epic this fall but the labs will not be using Beaker until
later on.   We are still trying to figure out how all this will work and
welcome all information.
Paula, how soon will Duke be up and using Beaker?

Martha Ward
Wake Forest Baptist Health
336-716-2109

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Paula Sicurello
Sent: Thursday, July 12, 2012 4:05 PM
To: HistoNet; microsc...@microscopy.com
Subject: [Histonet] Beaker module in EPIC

Hello all Listers,

I've already asked the Histonet but I'm wondering about a different thing this 
time.

Does anyone have experience with Beaker in conjunction with Anatomic Pathology, 
Surgical Pathology or the multiple other clinical labs that are in hospitals 
today?

I work in Anatomic/Surgical Pathology which encompasses all the Clinical 
Laboratory services here at Duke.  We have been told to determine what we need 
for the Beaker module to be useful to us.  I've seen a brief demo. as to how it 
will work for the ordering clinicians (they can order every test STAT!).

Please, send me any of the pluses or minuses that you've experienced using 
Beaker.

Thanks,

Paula :-)

--
Paula Sicurello, HTL (ASCP)
Supervisor, Clinical Electron Microscopy Laboratory Duke University Health 
System Rm.#251M, Duke South, Green Zone Durham, North Carolina 27710
P:  919.684.2091
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RE: [Histonet] Epic Beaker module

[Martha Ward-Pathology]

We would interested in any replies as well.


 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Paula Sicurello
Sent: Thursday, July 12, 2012 8:54 AM
To: HistoNet
Subject: [Histonet] Epic Beaker module

Good Morning One and All,

Does anyone out there have any experience with the Beaker module of the LIS 
system EPIC?  We have tests that require tables and charts to be inserted into 
the final report, pathologists need to have a case queue and other items.

If you are using Epic/Beaker- please let me know if your experiences and what 
if anything have you had Epic build into it for you.

Thanks,

Paula

--
Paula Sicurello, HTL (ASCP)
Supervisor, Clinical Electron Microscopy Laboratory Duke University Health 
System Rm.#251M, Duke South, Green Zone Durham, North Carolina 27710
P:  919.684.2091
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[Histonet] Napsin A

[Martha Ward-Pathology]

Hello.   I was wondering if anyone had used the NapsinA from BioCare on the 
Bond III and if so, would you mind sharing your protocol?
Thanks in advance for any advice you can give.

Martha Ward, MT (ASCP) QIHC
Manager, Molecular Diagnostics Lab
Dept. of Pathology
Wake Forest University Baptist Medical Center
Winston-Salem, NC 27157
336-716-2109

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RE: [Histonet] NCCI policy on IHC billing

[Martha Ward-Pathology]

From what we understand from the new policy the cocktailed antibodies, such as 
PIN4, are not to be charged separately.


Martha Ward, MT (ASCP) QIHC
Manager, Molecular Diagnostics Lab
Dept. of Pathology
Wake Forest University Baptist Medical Center
Winston-Salem, NC 27157
336-716-2104



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rae Staskiewicz
Sent: Thursday, January 05, 2012 9:00 AM
To: 'Clare Thornton'; 'Sally Price'; histonet@lists.utsouthwestern.edu
Cc: Dana Spears
Subject: RE: [Histonet] NCCI policy on IHC billing

Clair,

I agree that the cocktailed antibodies would be charged as a single test,
however, with the dual and triple stains, since these are technically done
with separate procedures, would not each antibody be able to be charged?
This is what we are thinking. How are others interpreting this

Rae Staskiewicz

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Clare
Thornton
Sent: Thursday, January 05, 2012 5:35 AM
To: Sally Price; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] NCCI policy on IHC billing

Sally,

The way I read it, I don't think it's one antibody per specimen; I think
what they are saying is that if you are running one antibody on multiple
blocks from one specimen, you can only bill once for that antibody.  I think
if you are running a panel of antibodies one one block from a specimen, you
can still charge for each antibody.  However, I completely agree with you.
This change came as a big surprise for our lab, until Dorothy posted it on
Histonet we had no idea.  How can that be?  (And thanks, Dorothy!)  The day
that post came out we happened to be running 20 pankeratin/p63 double stain
slides, all on multiple blocks from one specimen.  The two antibodies from
that double stain are applied at different times (to the same slide) and we
use two different detections.  So had we ran them after the new year, we
would've been able to charge only once for those 20 slides, never mind 20
tests being used from each antibody and 20 tests being taken from two
different detection kits.  And the tech time put into cutting those 20
slides!  We have several double and triple stains that we run on a daily
basis, and only one component from the triple stain is a cocktail; the rest
are separate antibodies being applied to the same slide using two different
detections.  I'm not sure exactly what our lab is going to do about it, but
somehow this change should have been made aware to everyone well before it
happened.  There are going to be labs who are no longer in compliance, and
we all know what that means..



Clare J. Thornton, HTL(ASCP)
Assistant Histology Supervisor
Dahl-Chase Diagnostic Services
417 State Street, Suite 540
Bangor, ME 04401
cthorn...@dahlchase.com

From: histonet-boun...@lists.utsouthwestern.edu
[histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sally Price
[sprice2...@gmail.com]
Sent: Thursday, January 05, 2012 12:16 AM
To: histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] NCCI policy on IHC billing

Histonetters:
I waited a few days to see how others might weigh in after this information
was posted.  Call me crazy, but I expected quite a bit more reaction from
our community.  How is it that such a signifcant change in how IHC testing
may be conducted and will be paid for in the future can produce so little
response?

The way this new policy is stated, it looks pretty straightfoward: one
antibody (IHC procedure) per specimen; so, when it's necessary to use a
battery of IHC stains to determine the origin of an undifferentiated
neoplasm, the lab can only bill for one procedure.  How could such an
approach be possible?  And what about multi-antibody procedures, which
are usually more cost effective than single-antibody procedures?

Come on folks, this is a big deal becuase IHC staining is essential to to
the practice of anatomic pathology and provides a lot of us with our
livelihood.  I know I'm not alone in thinking that the CMS needs to know
that this new policy is completely impractical and must be changed.  Sure,
there's some unnecessary IHC procedures being performed, but this isn't the
way limit the problem.
Sally
--

Message: 6
Date: Fri, 30 Dec 2011 12:33:17 -0600
From: Webb, Dorothy L dorothy.l.w...@healthpartners.com
Subject: [Histonet] NCCI policy update
To: 'histonet@lists.utsouthwestern.edu'

Is everyone aware that beginning 1/1/12, we can no longer bill for each
block regarding IHC billing, only one unit of billing for each part type no
matter how many blocks are stained? Also IHC cocktail stains, such as
PIN4 must now be billed as one unit even though multiple antibodies are
reported out.

Kind of a surprising reversal of the policy set in motion 10/1/2009.
SPECIMEN becomes the unit of 

[Histonet] RE: Epic LIS

[Martha Ward-Pathology]

I would also be interested in any replies concerning EPIC-beaker.


Martha Ward, MT (ASCP) QIHC
Manager, Molecular Diagnostics Lab
Dept. of Pathology
Wake Forest University Baptist Medical Center
Winston-Salem, NC 27157
336-716-2104



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of 
jessica.va...@hcahealthcare.com
Sent: Wednesday, January 04, 2012 1:29 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Epic LIS 

Is anyone currently using the EPIC-beaker LIS system? Can you contact me if you 
are?

Thanks

Jessica Vacca

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[Histonet] RE: NCCI policy update

[Martha Ward-Pathology]

Oh yes, we are very aware and quite upset at the change!


Martha Ward, MT (ASCP) QIHC
Manager, Molecular Diagnostics Lab
Dept. of Pathology
Wake Forest University Baptist Medical Center
Winston-Salem, NC 27157
336-716-2104



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Webb, Dorothy L
Sent: Friday, December 30, 2011 1:33 PM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] NCCI policy update

Is everyone aware that beginning 1/1/12, we can no longer bill for each block 
regarding IHC billing, only one unit of billing for each part type no matter 
how many blocks are stained?  Also IHC cocktail stains, such as PIN4 must now 
be billed as one unit even though multiple antibodies are reported out.

Kind of a surprising reversal of the policy set in motion 10/1/2009.  SPECIMEN 
becomes the unit of service rather than block(s) for IHC codes 88342, 88360, 
and 88361.

Happy New Year to everyone out there.  May 2012 find you happiness and health!

Dorothy Webb, HT
Regions Histology TS
651-254-2962



  
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[Histonet] C4d immunofluorescent positive controls

[Martha Ward-Pathology]

We are interested in finding out what type of positive control tissue everyone 
is using when performing C4d immunofluorescence on heart biopsies.   Thanks in 
advance for any and all responses.

Martha Ward, MT (ASCP) QIHC
Manager, Molecular Diagnostics Lab
Dept. of Pathology
Wake Forest University Baptist Medical Center
Winston-Salem, NC 27157
336-716-2104

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[Histonet] PAX 2 antibody

[Martha Ward-Pathology]

Hello all,

I am still hunting for a source for the PAX 2 antibody.Is this antibody 
currently available?   I have heard in the past that there was a manufacturing 
issue.

Martha Ward, MT (ASCP) QIHC
Manager, Molecular Diagnostics Lab
Dept. of Pathology
Wake Forest University Baptist Medical Center
Winston-Salem, NC 27157
336-716-2104

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[Histonet] MHC-class 1 antibody

[Martha Ward-Pathology]

Thank you to the people who responded to my inquiry about the IDH1 antibody.   
I think we have found one to try.

I have also have a  request for the MHC-Class 1 antibody for muscle biopsies.   
 Could anyone performing this suggest a vendor.   So far I am coming up with 
antibodies for frozen tissue but they are looking for an antibody for paraffin 
embedded tissues.   Any help would be appreciated.

Hope everyone has a good Thanksgiving holiday.

Martha Ward, MT (ASCP) QIHC
Manager, Molecular Diagnostics Lab
Dept. of Pathology
Wake Forest University Baptist Medical Center
Winston-Salem, NC 27157
336-716-2104

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[Histonet] IDH1 and IDH2 antibodies, MHC-Class I

[Martha Ward-Pathology]

Hello all,

I have had a request from our neuropathologists to bring these antibodies in 
house but I am having some trouble finding vendors for them.   I would 
appreciate any information.

Thanks!

Martha Ward, MT (ASCP) QIHC
Manager, Molecular Diagnostics Lab
Dept. of Pathology
Wake Forest University Baptist Medical Center
Winston-Salem, NC 27157
336-716-2104

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