Re: [Histonet] CAP Cytopathology checklist question

[Normington, Lacy via Histonet]

Hello Valerie,
Here is the policy we created to meet this question.

Standardized criteria for specimen adequacy are applied where available. This 
includes the
Paris System for Reporting Urinary Cytology, the Bethesda System for reporting 
Anal/Rectal
Cytology, and the Bethesda System for reporting Thyroid Cytopathology. The 
additional criteria
below apply to all other non-gynecological specimen types.

1. A specimen is unsatisfactory if there's an absence of abnormal cells AND any 
of the
following criteria are met:
* The complete absence of cellular material.
* Insufficient cellular material present to verify the source of the specimen 
(i.e.
mesothelial cells in a serous fluid, alveolar macrophages in a BAL, etc.).
* The absence of lymphocytes in a lymph node FNA
* The presence of benign cellular material on an FNA that cannot explain a 
clinically
suspicious mass or lesion.

2. All unsatisfactory non-gynecologic specimens include a description of the 
specimen's
limitations (i.e. low cellularity).

References
1. Rosenthal D, Wojcik EM, Kurtycz DF. The Paris system for reporting urinary 
cytology.
Switzerland: Springer International Publishing; 2016.
2. Nayar R, Wilbur DC. The Bethesda system for reporting cervical cytology - 
definitions,
criteria, and explanatory notes. 3rd ed. Switzerland: Springer International 
Publishing;
2015.
3. Ali SZ, Cibas ES. The Bethesda System for Reporting Thyroid Cytopathology. 
New York,
NY: Springer; 2010.

-Original Message-
From: Hannen, Valerie via Histonet 
Sent: Wednesday, November 29, 2023 2:41 PM
To: Histonet@lists.utsouthwestern.edu
Subject: [Histonet] CAP Cytopathology checklist question

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Hello Everyone,

I am hoping you can help me.  I am very confused by one of the questions in our 
CAP Cytopathology question. How are you handling/ answering this question in 
the NON-GYNCOLOGIC CYTOPATHLOOGY Section?  The question is CYP.07666, 
Unsatisfactory Specimens- Non-gynecologic CytoPathology:
It states " The Laboratory follows defined criteria for identification and 
reporting of unsatisfactory non-gynecologic specimens, as applicable".  It 
shows that I must write a policy for this question.  Our  reports  do state the 
reason for being deemed a "unsatisfactory" specoimen.

Thank you in advance!!

Valerie

Valerie A. Hannen,MLT(ASCP),HTL,SU(FL)
Histology Section Chief
Parrish Medical Center
951 N. Washington Avenue
Titusville, Florida 32796
P: 321-268-6333  Ext. 7506
F: 321-268-6149
valerie.han...@parrishmed.com
http://www.parrishmed.com/

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Re: [Histonet] Tissue Processor Schedule Validations

[Normington, Lacy via Histonet]

We have purchased several disposable core biopsy instruments of varying gauges 
and take samples of large resection specimens. We also use the same grossing 
tools to take small samples of GI, endo, ecc, ect.

Lacy
 

-Original Message-
From: Cooper, Brian via Histonet  
Sent: Thursday, March 23, 2023 1:54 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Tissue Processor Schedule Validations

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Good afternoon Histonet,

We're going to be validating a new tissue processor (Peloris 3) in the coming 
months, and I'm curious how people have validated small tissue processing 
protocols (GI bx's, liver/renal needle cores).  Larger tissues are much easier 
to do because we can readily gross duplicate sections. Obviously we can't adopt 
this approach for smaller samples because they're entirely submitted.  I have a 
game plan in mind, but would love some additional input! How'd you do it?

Thanks,

Brian D. Cooper, HT (ASCP)CMQIHCCM| Histology Supervisor Department of 
Pathology and Laboratory Medicine Children's Hospital Los Angeles
4650 Sunset Blvd MS#43- Los Angeles, CA 90027
Ph: 323.361.3357
bcoo...@chla.usc.edu

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Re: [Histonet] A question for my hospital lab peeps

[Normington, Lacy via Histonet]

Hello Terri,
Please see an excerpt from our frozen section manual.

For all sentinel lymph nodes and non-sentinel lymph nodes obtained
from breast and gynecologic surgeries, entirely submit the lymph node
after serially sectioning perpendicular to the long axis at 0.2 cm
intervals. It is essential that all unique surfaces be represented, i.e.
opposing surfaces should not be embedded in the same direction.

How many frozen levels? Seeing as we are serially sectioning the lymph node, we 
only do a single level.
How many permanent section Levels? All remnants are submitted after frozen, 
again we only perform the microtomy of a single level.
Any unstained ffpe sections saved or stained IHC? It is not uncommon for 
AE1/AE3 to be requested which we then cut the IHC request followed by an 
additional recut H

Thanks
Lacy Normington

Lacy Normington, HTL(CM)
She/Her/Hers
Manager, Clinical Laboratories
Surgical Pathology, Autopsy
600 Highland Ave, Mail 3224
Madison, WI  53792
Office: 608.890.9373


-Original Message-
From: Terri Braud via Histonet  
Sent: Thursday, February 23, 2023 12:17 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] A question for my hospital lab peeps

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I'd love to hear your input
On breast mastectomy cases with sentinel lymph nodes, what is your cutting 
protocol for sentinel lymph nodes sent for frozen section?
How many frozen levels?
How many permanent section Levels?
Any unstained ffpe sections saved or stained IHC?
I'm just trying to make sure that what we're doing is the norm.  Thanks in 
advance.

Terri L. Braud, HT(ASCP)
HNL Laboratories for
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-2021
  Honesty
AccouNtability
AgiLity
CoLlaboration
  CoMpassion

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[Histonet] Flooring

[Normington, Lacy via Histonet]

What does your institution do to mitigate paraffin collection on the floors? Do 
you strip the floors at defined periods of time? Do you use mats throughout 
entire laboratory, under microtomy stations? Currently our institution uses a 
sticky plastic green flooring, which is ripped up every quarter and replaced. 
However, during this time there are many spots which the plastic breaks down 
due to consistent activity over a spot. This requires the flooring to be 
scraped, stripped, etc.

Thanks
Lacy Normington
UW Health
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Re: [Histonet] X-ray machines for the lab

[Normington Lacy via Histonet]

Hologic has several different size radiologic image capture instruments. They 
are called Hologic Faxitron.

-Original Message-
From: Lima, Teresa via Histonet  
Sent: Friday, February 12, 2021 2:40 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] X-ray machines for the lab

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Hello all,
We are having issues with microcalcifications in breast tissue not being 
present in the H slides of breast biopsies. The pathologists would like to 
get an x-ray machine for the grossing room. Does anyone know where we can 
purchase a small, portable x-ray machine?
Thanks,
Terri

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[Histonet] Minimum Specimen Size Requirement

[Normington Lacy via Histonet]

Does your institution have a policy regarding minimum size requirement for 
biopsy collection (lung bx, core bx, cardiac, etc)? I will collate all 
responses.

Thank you
Lacy
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Re: [Histonet] Quality Measure for Pathology

[Normington Lacy via Histonet]

Some ideas:

Proficiency Testing
Corrected Results (Addendums/Amendment) volume
Turnaround Time Monitoring
Frozen Section TAT (critical call)
Rejected Tests (empty bottles, etc)


-Original Message-
From: Amy Self via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Tuesday, June 12, 2018 8:18 AM
To: 'histonet@lists.utsouthwestern.edu' 
Subject: [Histonet] Quality Measure for Pathology

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Good Morning,

I am looking for ideas/suggestions for QM Histology/Pathology.  My QM director 
wants me to "measure" something that I can place on the lab dashboard.

Thanks in advance for your help..

Amy Self
Histology Lab Senior Tech
Lab
Tidelands Georgetown Memorial Hospital
606 Black River Road
Georgetown, SC 29440
843-520-8711
as...@tidelandshealth.org
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Re: [Histonet] V600E

[Normington Lacy via Histonet]

I am thinking this might be BRAF, clone V600E.  We get ours from Ventana Roche.

Lacy Normington
UW Health 
Madison, WI


-Original Message-
From: Laurie Colbert via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Wednesday, June 06, 2018 8:50 AM
To: histonet@lists.utsouthwestern.edu
Cc: jtouchst...@pathmdlabs.com
Subject: [Histonet] V600E

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Can anyone tell me about the V600E antibody?  Our pathologist wants to add it 
to our menu of IHC stains, and I've never heard of it.  Sources?

Thanks,
Laurie Redmond
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Re: [Histonet] frozen sections

[Normington Lacy via Histonet]

My institution is an academic medical center; we have PA's, residents, specimen 
receiving technicians and histology technicians performing frozen sections.  We 
perform a yearly competency of frozen sectioning for non MDs.

Lacy Normington

Lacy Normington, HTL(ASCP)CM
Manager, Surgical Pathology Lab Services
UW Health - UW Hospital
600 Highland Avenue
Madison, WI 53792-2472



-Original Message-
From: Eck, Allison via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Wednesday, May 30, 2018 7:25 AM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] frozen sections

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Question for those of you who do not have PA's...Who cuts the frozen sections, 
the techs or the pathologists?

Thanks in advance
Allison

Allison Eck, HTL(ASCP)cm,QLS, AHI(AMT),CEAS1
Lead Tech Histology
Doylestown Hospital
595 W State St
Doylestown, PA 18901
215-345-2264
a...@dh.org


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[Histonet] FW: Antibody Validation CLIA

[Normington Lacy via Histonet]

For the validation, yes you have to run negative cases.  This is to verify that 
tissue you know should not stain, does not do so.  For example, let's say you 
are validation H.pylori.  You have 10 cases where you know the patient has 
H.pylori bacteria in a gastric biopsy (positive staining).  You also need to 
run 10 samples of normal gastric tissue to verify there is no staining 
(negative staining). What you are thinking about is negative reagent control 
which is used to determine if there is non-specific staining.

Lacy

-Original Message-
From: Heckford, Karen - SMMC-SF [mailto:karen.heckf...@dignityhealth.org] 
Sent: Friday, March 16, 2018 12:36 PM
To: Normington Lacy
Subject: RE: [Histonet] Antibody Validation CLIA

Do you have to run the negatives if you are using a Polymer Detection system?

Karen Heckford HT ASCP CE
Lead Histology Technician
St. Mary's Medical Center
450 Stanyan St.
San Francisco, Ca. 94117
415-668-1000 ext. 6167  
karen.heckf...@dignityhealth.org  

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-Original Message-
From: Normington Lacy via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Friday, March 16, 2018 10:17 AM
To: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Antibody Validation CLIA

Dignityhealth.org made the following annotations
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CAP suggests running 10 negative and 10 positive cases for non-prognostic 
markers.
CAP required running 20 negative and 20 positive cases for  prognostic markers.

In the event the case volume is less than the suggested 10 and 10 cases for 
non-prognostic markers, the reason for that decision should be stated in the 
validation.  Ultimately, the decision is up to your director.  


Lacy Normington, HTL(ASCP)CM
Manager, Surgical Pathology Lab Services UW Health
600 Highland Avenue
Madison, WI 53792-2472



-Original Message-
From: Paula via Histonet [mailto:histonet@lists.utsouthwestern.edu]
Sent: Friday, March 16, 2018 8:55 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Antibody Validation CLIA

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Hello,



We've been discussing about the quantity of slides to run as a validation for 
IHC antibodies. We are governed by CLIA, and we would like to know if there is 
a set number of slides to run for a particular antibody we would like to bring 
in-house for Validation.  I think CAP requires 20 slides..?
And so we are asking if there is  a requirement with CLIA to run a certain 
number of slides, or is it up to us (the laboratory director) to decide how 
many slides to run for Validation/Verification.



Thank you in advance

Paula

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Re: [Histonet] Antibody Validation CLIA

[Normington Lacy via Histonet]

CAP suggests running 10 negative and 10 positive cases for non-prognostic 
markers.
CAP required running 20 negative and 20 positive cases for  prognostic markers.

In the event the case volume is less than the suggested 10 and 10 cases for 
non-prognostic markers, the reason for that decision should be stated in the 
validation.  Ultimately, the decision is up to your director.  


Lacy Normington, HTL(ASCP)CM
Manager, Surgical Pathology Lab Services UW Health
600 Highland Avenue
Madison, WI 53792-2472



-Original Message-
From: Paula via Histonet [mailto:histonet@lists.utsouthwestern.edu]
Sent: Friday, March 16, 2018 8:55 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Antibody Validation CLIA

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system.
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Hello,



We've been discussing about the quantity of slides to run as a validation for 
IHC antibodies. We are governed by CLIA, and we would like to know if there is 
a set number of slides to run for a particular antibody we would like to bring 
in-house for Validation.  I think CAP requires 20 slides..?
And so we are asking if there is  a requirement with CLIA to run a certain 
number of slides, or is it up to us (the laboratory director) to decide how 
many slides to run for Validation/Verification.



Thank you in advance

Paula

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Re: [Histonet] ANtibody validation records

[Normington Lacy via Histonet]

Here is the document our developmental specialist uses when bring on new 
antibodies.  Hope this helps.

Lacy Normington

Lacy Normington, HTL(ASCP)CM
Manager, Surgical Pathology Lab Services

600 Highland Avenue
Madison, WI 53792-2472
Phone: 608-890-9373


-Original Message-
From: Charles Riley via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Thursday, February 16, 2017 7:55 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] ANtibody validation records

Would anyone be willing to share how the document their new antibody 
validations when adding a new antibody test to the panel of tests your lab 
performs. I currently have a basic packet but feel it could be better and 
wanted to see how everyone else performs/records their testing. The people who 
were in my position before me failed to keep track of all the new antibodies 
and now I am trying to redo them all before our upcoming CAP inspection. Any 
help would great be appreciated

-- 

Charles Riley HT(ASCP)CM

Histopathology Coordinator/ Mohs
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Re: [Histonet] Handling Breast Lumpectomy Specimens with radioactive seed localization

[Normington Lacy via Histonet]

James,

Luckly our breast surgeons are good at notifying our Pathologists' Assistants 
when a case with radioactive seeds is sent to our laboratory.  Everything under 
the sun is labeled with radiation stickers, and additional stickers are 
provided with the tissue requisition.  We also have a chain of custody sheet 
that is delivered with the specimen.  

1.   Since the lumpectomy is obviously "hot" what precautions are taken to 
remove the seed and give it back to radiology?  

The individual removing the seed wears a radiation detection ring.  The ring is 
evaluated monthly by our radiation safety department.  The specimen is scanned 
with a survey meter to located all seeds.   Once the seed is removed, the seeds 
are placed in a lead lined PIG and stored in a locked safe within our gross 
room.  A representative from our breast center is required to pick up the seeds 
within 24 hours and document this on the chain of custody form.  

2.   Does the pathologist  or pathology assistant remove the seed?

The Pathologists' Assistants performs the removal as they are required to 
perform CBT on radioactive safety training..  

3.   After seed removal is the specimen handled similarly to a wire-located 
specimen.In other words is the specimen then fixed for a period of time 
before grossing?

Yes, normal fixation procedure is followed.  Histology staff are notified of 
the case, however, no special radiation safety precautions are needed.

4.   How is the location of the seed marked in the lumpectomy specimen when 
the seed is removed?  Do the pathologists use an ink to mark the location, do 
they then fix the tissue as before?

We follow an inking protocol for lumpectomies, whether wire or seeds.

If you are interested in our procedure, please let me know and I can email it 
to you.

Lacy Normington, HTL(ASCP)CM
Manager, Surgical Pathology Lab Services
UW Health - UW Hospital
600 Highland Avenue
Madison, WI 53792-2472
Phone: 608-890-9373


-Original Message-
From: Vickroy, James via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Tuesday, October 04, 2016 12:31 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Handling Breast Lumpectomy Specimens with radioactive seed 
localization

Our organization is looking into the workflow necessary to handle breast 
lumpectomies with radioactive seed localization. Right now we have more 
questions than answers.  I have looked at several articles and am aware of the 
drastic changes that will need to be in place to handle the radioactive seed.   
My experience in the past has been handling a wire-located lumpectomy proceeded 
usually by a sentinel node biopsy by frozen section.   From what I read the 
sentinel node biopsy procedure will probably not be changed, however I have 
several questions regarding handling the lumpectomy specimen and would 
appreciate any thoughts from someone already handling these specimens.  I know 
there are precautions on how to handle and remove the seed as well as 
procedures in case the seed is cut during the removal.  I am trying to figure 
out how the workflow will proceed.

Wire-located lumpectomy procedure:

Currently the sentinel nodes are sent to the lab from surgery and frozen 
sections are performed.  The pathologist then calls the surgeon and depending 
on whether the sentinel nodes were positive further nodal dissections may or 
may not be necessary.   The  wire-located lumpectomy specimen is usually sent 
over to pathology after the sentinel node biopsies.  The lumpectomy specimen 
has usually been x-rayed to show the location of the wire prior to being 
received by pathology.   Pathology then usually gets a copy of the x-ray along 
with the fresh lumpectomy specimen.   Next the pathologist or pathology 
assistant would place the specimen in formalin and let it fix for sometimes 
overnight.  The next day the fixed lumpectomy specimen was grossed and 
sectioned for histologic examination.  Special care is taken to take specific 
sections where the wire was implanted.

Radioactive seed lumpectomy procedure questions:


1.   Since the lumpectomy is obviously "hot" what precautions are taken to 
remove the seed and give it back to radiology?

2.   Does the pathologist  or pathology assistant remove the seed?

3.   After seed removal is the specimen handled similarly to a wire-located 
specimen.In other words is the specimen then fixed for a period of time 
before grossing?

4.   How is the location of the seed marked in the lumpectomy specimen when 
the seed is removed?  Do the pathologists use an ink to mark the location, do 
they then fix the tissue as before?

Finally another "WRENCH"  to this new procedure is that we usually send our 
larger tissue specimens to be grossed and processed at a hospital lab.  We are 
being asked to perform the frozen section onsite and then send the fixed tissue 
left over from the frozen sections with the lumpectomy specimen to 

Re: [Histonet] Faxitron

[Normington Lacy via Histonet]

We use a Faxitron in our grossing room  for breast and prostate specimens.  We 
have also used it for calcium chases of a tissue block.  Do you have any 
specific questions?

Lacy Normington, HTL(ASCP)CM
Manager, Surgical Pathology Lab Services UW Health - UW Hospital
600 Highland Avenue
Madison, WI 53792-2472
Phone: 608-890-9373


-Original Message-
From: Lori Wright via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Wednesday, October 05, 2016 1:50 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Faxitron

Hi All, I was wondering if anyone was using a Faxitron in their Lab?

Thanks,
Lori Wright
Lead Technician
Surgical Pathology
Duke Medicine
Sent from my iPhone

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Re: [Histonet] those slippery lab floors

[Normington Lacy via Histonet]

Our laboratory has custodial staff put down a multi surface protection film.  
The film is sticky on one side and comes on a roll.  That way it can be pulled 
back up and changed out.  Go to www.surfaceshields.com.  Search "Multipurpose 
surface protection film:"  This stuff works wonders and the custodial staff 
love it because they don't have to scrape the floors.  We have ours changed out 
at least monthly, but call sooner if it starts to look bad before then.  Hope 
this helps.

Lacy Normington

Lacy Normington, HTL(ASCP)CM
Manager, Surgical Pathology Lab Services
UWHospital and Clinics
600 Highland Avenue
Madison, WI 53792-2472
Phone: 608-890-9373

-Original Message-
From: Sanders, Jeanine (CDC/OID/NCEZID) via Histonet 
[mailto:histonet@lists.utsouthwestern.edu] 
Sent: Tuesday, May 31, 2016 8:55 AM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] those slippery lab floors

All,

Do any of you use floor mats to help with paraffin issues around microtomy 
stations?

Thanks!

Jeanine H. Sanders
Infectious Diseases Pathology Branch
Centers for Disease Control and Prevention
1600 Clifton Rd., NE MS-G32
Atlanta, GA 30329


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Re: [Histonet] GLOMERULI ADEQUACY

[Normington Lacy via Histonet]

We have our histology technicians attend all native and transplant renal biopsy 
procedures.  Our institution has stereo scopes (dissecting scope) located in 
ultrasound, transplant clinic and an additional one on a mobile cart for cases 
that might occur in Pediatric sedation, ICU, or bedside biopsies.  The core 
biopsy is handed to the histology technician who then looks under the scope to 
look for glomeruli.  Some of our clinicians like an approximate glomeruli 
count, although, most just want to know if they have cortical tissue.  In each 
of our reports we place the following comment per CAP regulations regarding 
adequacy (see below).  If a sample is difficult to determine adequacy, we 
always leave it up to the Nephrologist discretion.  We have a lead technician 
in the renal laboratory.  This individual trains all new employees on adequacy 
assessment.  Modern Pathology has an excellent photo of the difference between 
cortex and medullary tissue.  Search google images for dissecting sc
 ope renal biopsy.
 
At the time of sample collection, this sample visibly contains cortical 
tissue and is Satisfactory for Evaluation.
At the time of sample collection, cortical tissue is not identifiable 
and is Unsatisfactory for Evaluation.

Lacy

-Original Message-
From: Melissa Likens via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Wednesday, April 13, 2016 9:22 AM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] GLOMERULI ADEQUACY

I have a question about how other institutions handle microscopic evaluation of 
glomeruli adequacy in renal specimens?  Specifically, who at you looks at the 
cores to determine if glomeruli are present before submitting specimens for 
further testing?  Do the pathologists look at them? Radiologists performing the 
cores?  Other staff?
Also, any links or recommendations for training for evaluating renal biopsies 
for glomeruli would be appreciated.
Thanks, Melissa
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Re: [Histonet] Grossing tech qualifications

[Normington Lacy via Histonet]

Essentially, an associates degree totals 60-80 semester hours depending on the 
program.  As long as 24 of those hours are in science or medical laboratory 
technology, they would qualify.  I think the confusion in "c." comes in when a 
student starts towards a bachelors degree, but then stops the program.  As long 
as they have 60 semester hours with 24 being in science, they too would qualify 
even though they have no degree.  Hope this helps.

Lacy

-Original Message-
From: Rachel Pinch [mailto:supervi...@galahistolab.com] 
Sent: Wednesday, April 13, 2016 9:15 AM
To: Normington Lacy; 'Vickroy, James'; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Grossing tech qualifications

I've had trouble understanding that as well.
Can an employee have 24 semester hours of biology and chemistry combined with 
an associate's degree in science, and it be sufficient for CLIA?
Does the person have to have an associates in laboratory science?

Rachel

-Original Message-----
From: Normington Lacy via Histonet
[mailto:histonet@lists.utsouthwestern.edu]
Sent: Wednesday, April 13, 2016 8:37 AM
To: 'Vickroy, James' <jvick...@springfieldclinic.com>; 
histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Grossing tech qualifications

James,
We base all of our high complexity testing on the semester hours as listed in 
"c."  If an individual has completed an associate degree in a laboratory 
science, they should meet the educational requirements as stated previously.
I would recommend obtaining a transcript from the applicants.  Our institution 
then will keep that in their personnel file.  As part of our policy for non-PA 
grossing, I have a form that I complete stating I reviewed the employee's 
educational requirements.  I have copied and pasted my document below.  If you 
are interested in receiving the entire procedure and attachments, please let me 
know and I can email them to you directly.

Employee Name:__

A review of this employee’s educational records was completed on 
___(date).

This employee has been   □approved □not approved   to perform high
complexity testing based on CLIA requirements as listed in the Federal Register 
493.1489 and 1491.

493.1489 states the following education requirements:

Each individual performing high complexity testing must--
(b) Meet one of the following requirements:
(1) Be a doctor of medicine, doctor of osteopathy, or doctor of
podiatric medicine licensed to practice medicine, osteopathy, or
podiatry in the State in which the laboratory is located or have earned 
a doctoral, master's or bachelor's degree in a chemical, physical, biological 
or clinical laboratory science, or medical technology from an accredited 
institution; OR
(2)(i) Have earned an associate degree in a laboratory science, or 
medical laboratory technology from an accredited institution or?
   (ii) Have education and training equivalent to that specified in 
paragraph (b)(2)(i) of this section that includes--
(A) At least 60 semester hours, or equivalent, from an 
accredited institution that, at a minimum, include either-
(1) 24 semester hours of medical laboratory technology 
courses; or
(2) 24 semester hours of science courses that
include--
(i) Six semester hours of chemistry;
(ii) Six semester hours of biology; and
(iii) Twelve semester hours of chemistry, 
biology, or medical laboratory technology in any combination


Full text on Federal Register qualifications can be viewed at:
http://wwwn.cdc.gov/clia/regs/toc.aspx




Review completed by: __ (printed name)

__ (signature)

-Original Message-
From: Vickroy, James via Histonet [mailto:histonet@lists.utsouthwestern.edu]

Sent: Wednesday, April 13, 2016 8:14 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Grossing tech qualifications


a.   We are experiencing trouble finding another tech that will meet
CLIA high complexity testing standards as well as has histotechnician
training.   Also the qualifications for who can gross is a little vague so I
wanted to see if anyone has any information that would help me.  A summary
of the grossing qualifications are listed below.   In the past we have hired
applicants with bachelor's degrees in biology and then trained them in
histotechnology.   We also went through the 90 day inhouse training for
grossing.   My questions have to do with a clarification regarding those
with an associate's degree. I have an applicant that has an associate's
degree in science with an emphasis on microbiology. My question has to
do with the language  "An earned associate degree in a laboratory science or
medical laboratory technology" .   How can I determ

Re: [Histonet] Grossing tech qualifications

[Normington Lacy via Histonet]

James,
We base all of our high complexity testing on the semester hours as listed in 
"c."  If an individual has completed an associate degree in a laboratory 
science, they should meet the educational requirements as stated previously.  I 
would recommend obtaining a transcript from the applicants.  Our institution 
then will keep that in their personnel file.  As part of our policy for non-PA 
grossing, I have a form that I complete stating I reviewed the employee's 
educational requirements.  I have copied and pasted my document below.  If you 
are interested in receiving the entire procedure and attachments, please let me 
know and I can email them to you directly.

Employee Name:__

A review of this employee’s educational records was completed on 
___(date).

This employee has been   □approved □not approved   to perform high 
complexity testing based on CLIA requirements as listed in the Federal Register 
493.1489 and 1491.

493.1489 states the following education requirements:

Each individual performing high complexity testing must--
(b) Meet one of the following requirements:
(1) Be a doctor of medicine, doctor of osteopathy, or doctor of
podiatric medicine licensed to practice medicine, osteopathy, or
podiatry in the State in which the laboratory is located or have earned 
a doctoral, master's or bachelor's degree in a chemical, physical, biological 
or clinical laboratory science, or medical technology from an accredited 
institution; OR
(2)(i) Have earned an associate degree in a laboratory science, or 
medical laboratory technology from an accredited institution or?
   (ii) Have education and training equivalent to that specified in 
paragraph (b)(2)(i) of this section that includes--
(A) At least 60 semester hours, or equivalent, from an 
accredited institution that, at a minimum, include either-
(1) 24 semester hours of medical laboratory technology 
courses; or
(2) 24 semester hours of science courses that include--
(i) Six semester hours of chemistry;
(ii) Six semester hours of biology; and
(iii) Twelve semester hours of chemistry, 
biology, or medical laboratory technology in any combination


Full text on Federal Register qualifications can be viewed at: 
http://wwwn.cdc.gov/clia/regs/toc.aspx 




Review completed by: __ (printed name)
   
__ (signature)

-Original Message-
From: Vickroy, James via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Wednesday, April 13, 2016 8:14 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Grossing tech qualifications


a.   We are experiencing trouble finding another tech that will meet CLIA 
high complexity testing standards as well as has histotechnician training.   
Also the qualifications for who can gross is a little vague so I wanted to see 
if anyone has any information that would help me.  A summary of the grossing 
qualifications are listed below.   In the past we have hired applicants with 
bachelor's degrees in biology and then trained them in histotechnology.   We 
also went through the 90 day inhouse training for grossing.   My questions have 
to do with a clarification regarding those with an associate's degree. I 
have an applicant that has an associate's degree in science with an emphasis on 
microbiology. My question has to do with the language  "An earned associate 
degree in a laboratory science or medical laboratory technology" .   How can I 
determine what that exactly means?   Would a person with an associate's degree 
in science with an emphasis in microbiology qualify?  I'm 
 not sure she has the sixty hours total.

Qualifications of a technician for performing gross descriptions and 
preparation for tissue processing under the direct or indirect supervision of a 
pathologist include:

b.   An earned associate degree in a laboratory science or medical 
laboratory technology,
Obtained from an accredited institution, OR

c.   Education/training equivalent to the above that includes at least 60 
semester hours or equivalent from an accredited institution.  This education 
must include 24 semester hours of medical laboratory technology courses, or 24 
semester hours of science courses that includes 6 semester hours of chemistry, 
6 semester hours of biology, and 12 semester hours of chemistry, biology or 
medical laboratory technology in any combination. In addition, the individual 
must have laboratory training including either completion of a clinical 
laboratory training program approved or accredited by the ABHES, the CAHEA, or 
other organization approved by HHS (note that this training may be included in 
the 60 semester hours listed above), OR at least 3 months 

[Histonet] IgG Subtyping on FFPE

[Normington Lacy via Histonet]

I am looking for information on where to purchase IgG-1, IgG-2, IgG-3 and IgG-4 
antibodies to be used on formalin fixed paraffin embedded tissue.  I would 
prefer that this be an IHC antibody instead of FITC.  Does anyone have 
experience with IgG subtyping?  If so, what do you do?

Thanks
Lacy Normington

Lacy Normington, HTL(ASCP)CM
Manager, Surgical Pathology Lab Services
UWHospital and Clinics
600 Highland Avenue
Madison, WI 53792-2472
Phone: 608-890-9373

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Re: [Histonet] Mycoplasma

[Normington Lacy via Histonet]

I do not believe it will stain with PAS.  The bacteria lack a cell wall.

-Original Message-
From: Bernice Frederick via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Tuesday, April 05, 2016 1:12 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Mycoplasma

Hello all,
Will PAS stain mycoplasma?
Bernice

Bernice Frederick HTL (ASCP)
Senior Research Tech
Pathology Core Facility
Robert. H. Lurie Cancer Center
Northwestern University
710 N Fairbanks Court
Olson 8-421
Chicago,IL 60611
312-503-3723
b-freder...@northwestern.edu

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Re: [Histonet] bx levels

[Normington Lacy via Histonet]

We take four levels with 20 microns between each level.  All four sections are 
placed on one single slide.

Lacy Normington, HTL(ASCP)CM
Manager, Surgical Pathology Lab Services
UW Health
600 Highland Avenue
Madison, WI 53792-2472
Phone: 608-890-9373

-Original Message-
From: Margiotta-Watz, Michele via Histonet 
[mailto:histonet@lists.utsouthwestern.edu] 
Sent: Friday, April 01, 2016 11:41 AM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] bx levels

Hi All,
We are wondering how many levels most hospitals are cutting on GI biopsies?  We 
currently cut 3 levels, thinking that is the standard of care. Please let us 
know how many are done at other hospitals.
Thanks for your help!

Michele Margiotta-Watz
Histology Supervisor
BMHMC
101 Hospital Road
Patchogue, NY 11772
631-654-7192

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Re: [Histonet] tests on old cases

[Normington Lacy via Histonet]

At our institution, if the request is received more than "30" days from the 
collect date, we create a new HOV for the patient.  That way the addendum is 
still on the same case number.  The collect date is changed by our LIS 
department to be the "request to pull from archive" based on Medicare 
requirements.  We add the requesting physician to the existing case.

Lacy Normington, HTL(ASCP)CM
Manager, Surgical Pathology Lab Services
UW Health
600 Highland Avenue
Madison, WI 53792-2472
Phone: 608-890-9373

-Original Message-
From: Cartun, Richard via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Friday, April 01, 2016 12:00 PM
To: Noelle Linke
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] tests on old cases

If the request is received more than "30" days from the original 
date-of-service, we re-accession the specimen, and bill and report the test 
result(s) under the new accession number.  The requesting MD now becomes the 
submitting MD.

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
(860) 545-2204 Fax

 
-Original Message-
From: Noelle Linke via Histonet [mailto:histonet@lists.utsouthwestern.edu]
Sent: Friday, April 01, 2016 11:42 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] tests on old cases

Hi all,

We have been getting a lot of requests for tests such as Lynch syndrome on old 
hospital cases.  How do all of you handle the billing on these?  Do you ask the 
clinician to send updated insurance information and then log in a new case?

Thank you,
Noëlle

Noëlle Linke, MS, HTL(ASCP) QIHC
Manager, Anatomic Pathology
Pacific Diagnostic Laboratories
nli...@sbch.org
Phone: (805) 324-9814
Fax: (805) 696-6433






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Re: [Histonet] cassette colors and scanning

[Normington Lacy via Histonet]

I would not recommend florescent pink, red or aqua.  The colors that we 
currently use are yellow, white, green, lilac, light pink (salmon), and orange 
(on Printmate's only).  We had many trials and tribulations when it came to the 
barcodes actually scanning.  We went through three different scanners until we 
found the one that was most consistent.  The scanner brand we have settled on 
is Honeywell, model 1900.  Good luck.


Lacy Normington, HTL(ASCP)CM
Manager, Surgical Pathology Lab Services
UWHospital and Clinics
600 Highland Avenue
Madison, WI 53792-2472
Phone: 608-890-9373

-Original Message-
From: Sanders, Jeanine (CDC/OID/NCEZID) via Histonet 
[mailto:histonet@lists.utsouthwestern.edu] 
Sent: Thursday, March 24, 2016 9:09 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] cassette colors and scanning

Good morning everyone!

Do any of you have any advice regarding which color cassettes do not work well 
with the barcode scanning systems currently in use today?

Thanks much!


Jeanine H. Sanders
Infectious Diseases Pathology Branch
Centers for Disease Control and Prevention
1600 Clifton Rd., NE MS-G32
Atlanta, GA 30329


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Re: [Histonet] Leica ASP6025 Tissue Processor and Cryostats

[Normington Lacy via Histonet]

Our laboratory has two Leica CM1950 cryostats in our frozen section area.  
Pro's:  1) quality and reproducibility of frozen sections have drastically 
improved  2) ease of use when using Peter's method of embedding  3) UV 
disinfection, saves many hours  4)  easy to use  5) optional vacuum system  
Con's: 1) specimen discs are not interchangeable with other models and are 
somewhat expensive  2)the vacuum can sometime clog

Overall we are extremely happy with the CM1950s. 

Lacy Normington, HTL (ASCP)CM
Manager, Lab Services Surgical Pathology
UW Health , Madison, WI

-Original Message-
From: Cooper, Brian via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Thursday, March 10, 2016 4:44 PM
To: Fortin, Joyce; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Leica ASP6025 Tissue Processor and Cryostats

So we actually have a Leica CM1950 in our Histo Lab, as well as a Fisher NX70 
Cryostar in our Frozen Section Room in the OR.  They are both excellent 
cryostats (I actually learned how to cryosection on the Leica).  When we were 
in the market for a new Cryostat a year ago, we went with the NX70 because of 
the ergonomic flexibility and cold disinfection--both really cool (ok, pun 
truly wasn't intended there) features!  Check em both out, and see all the cool 
bells and whistles.

Good luck!

Brian D. Cooper, HT (ASCP)CM | Histology Supervisor Department of Pathology and 
Laboratory Medicine Children's Hospital Los Angeles
4650 Sunset Blvd MS#43- Los Angeles, CA 90027 bcoo...@chla.usc.edu 

-Original Message-
From: Fortin, Joyce via Histonet [mailto:histonet@lists.utsouthwestern.edu]
Sent: Thursday, March 10, 2016 10:53 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Leica ASP6025 Tissue Processor and Cryostats

Could anyone who is using the Leica ASP6025 Tissue Processor please send me 
their opinions of it-pros and cons?
Also, which of the Leica cryostats you like the most?  We want the vacuum and 
UVC disinfection models.  Pros and cons...
Thank you!



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[Histonet] Histology Positions at UW Health Madison

[Normington Lacy via Histonet]

UW Health, located in Madison Wisconsin, is looking to hire multiple histology 
technicians.  UW Health offers a competitive compensation and benefits package. 
 Work experience that is relevant to the position will be taken into 
consideration when determining the starting base pay.  Please log onto 
www.uwhealth.org to apply.  Below are the positions 
posted.

160020TH  0.5 FTE  Monday through Friday 5:00am - 9:00am
160020TG 1.0 FTE  Monday through Friday 8:30am - 5:00pm
150004HF 1.0 FTE  Monday through Friday 8:30am - 5:00pm, primarily 
working in IHC
16002044  0.8 FTE  Monday through Wednesday 10:30am - 5:00pm, 
Thursday through Friday 9:30 - 5:00pm


Lacy Normington, HTL(ASCP)CM
Manager, Surgical Pathology Lab Services
UWHospital and Clinics
600 Highland Avenue
Madison, WI 53792-2472
Phone: 608-890-9373

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