Pathology information, Papers of Pathology

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PATHOLOGY

LABORATORY

Field Range Field Range Organ or Disease-oriented Panels 80047 – 80076 Drug Testing 80100 – 80104 Therapeutic Drug Assays 80150 – 80299 Evocative/ Suppression testing 80400 – 80440 Consultations (Clinical Pathology) 80500 – 80502 Urinalysis 81000 – 81099 Molecular Pathology 81200 – 81479 Multianalyte Assays with Algorithmic Analyses

Chemistry 82000 – 84999 Hematology and Coagulation 85002 – 85999 Immunology 86000 – 86849 Tranfusion Medicine 86850 – 86999 Microbiology 87001 – 87999 Anatomic Pathology 88000 – 88099 Cytopathology 88104 – 88199 Cytogenic Studies 88230 – 88299 Surgical Pathology 88300 – 88399 In Vivo Laboratory Procedures 88720 – 88749 Other Procedures 89049 – 89240 Reproductive Medicine Procedures

Pathology Terminology

Reference Range (Normal Range): The range of values considered typical for a specific test, often used to interpret whether a result is within normal limits. Abnormal Result: A test result that falls outside the reference range, suggesting the presence of a disease or condition. Complete Blood Count (CBC): A common blood test that measures various components of blood, including red and white blood cells and platelets. Blood Chemistry Panel: A set of blood tests that assess the levels of various chemicals, electrolytes, and proteins in the blood. Culture and Sensitivity (C&S): A microbiology test that involves growing bacteria or other microorganisms from a sample and determining their susceptibility to antibiotics. Polymerase Chain Reaction (PCR): A technique used to amplify and detect DNA or RNA, often used to identify genetic material of pathogens. Immunoassay: A laboratory test that uses antibodies to detect the presence of specific substances, such as hormones, drugs, or infectious agents. Tumor Marker: A substance produced by cancer cells or other cells in response to cancer, used to monitor the progression of cancer or the effectiveness of treatment. Panel: A group of related tests performed together to assess a specific condition or aspect of health. These are just a few examples of the terminology used in the field of laboratory and pathology. The terminology can vary based on the specific tests, procedures, and contexts being discussed. If you encounter unfamiliar terms, it's important to consult medical references or healthcare professionals for accurate understanding and interpretation.

Terminology Definition Antibodies Are elements the human body creates to deal with antigens Antigens May be viruses, bacteria or other immune triggers the body fights off by creating antibodies Autopsy Exam of a dead body to determine the cause(s) of death (also called necropsy). Bacteriology The study of bacteria. Bills for test Include the CLIA number of the testing locations. Block Frozen piece of specimen Chromatography Procedure in which multiple drugs identified, Some machines identify all drugs present in one procedure. Others require two or more procedures to identify two or more drugs Clinical laboratory The place where tests are performed on clinical specimens in order to get info about the health of a patient as pertaining to the diagnosis, treatment, and prevention of disease. Clinical laboratory improvement amendments (CLIA) Quality standards for all lab testing to ensure the accuracy, reliability and timelines of patient test results CLIA waived tests - simple tests that may be performed in non-lab settings.

gross exam of the entire specimen without sectioning of the specimen into thin slides that can be examined without the use of a microscope. Growth hormone suppression panel (glucose administration) requires glucose be measure three time and human growth hormone be measured four times. Indicators allow additional test to be performed without a written order from the physician Level 1 identifies specimen that normally do not need to be viewed under a microscope for pathologic diagnosis those for which the probability of disease or malignancy is minimal. (tooth) Level 2 Deals with those tissues that are usually considered normal tissue and have been removed not because of the probability of the presence of disease or malignancy, but for some other reason. (a fallopian tube for sterilization, foreskin of a newborn) Level 3 a assigned for specimens with a low probability of disease or malignancy. Level 4 designates a higher probability of malignancy or decision making for disease pathology. Level 5 classifies more complex pathology evaluation Level 6 includes examination of neoplastic tissue or very involved specimens, such as a total resection of a colon.

microbiology the study of microscopic life. microscopy (microscopic) exam under a microscope. molecular diagnostics the measurement of DNA, RNA, proteins or metabolites to detect genotypes, mutations or biochemical changes mycology the study of fungi. necropsy exam of a dead body to determine the cause(s) of death (also called autopsy). nonspecific tests performed on urine panel a group of tests that are performed together and are listed in the code description Pap smear which are examinations of cerival and/or vaginal cells, parasitology the study of parasites pathology the study of diseased tissue and cells. hematology the study of the components and behavior of blood. immunology the study of the immune system and its components and function. In Vivo studies performed within the living body.

Pathology and Laboratory MODIFIERS

22 - Increased Procedural Services

26 - Physician component

32 - Mandated Services

52 - Reduced Services

53 - Discontinued Procedure

59 - Distinct Procedural Service

90 - Reference (Outside) Laboratory: When laboratory procedures are performed by

a party other than the treating or reporting physician, the procedure may be

identified by adding the modifier 90 to the usual procedure number.

91 - Repeat Clinical Diagnostic Laboratory Test

QW- CLIA Waived Lab

Don’t use modifier 51 in pathology

DRUG ASSAY Drug procedures are divided into three subsections: ❑ Therapeutic Drug Assay (80143 – 80299) ❑ Drug Assay

• Presumptive/Screening/Preliminary (80305-80307)
• Definitive/Confirmatory (80320 – 80377) ❑ Chemistry (82009-84999)

▪ The material for drug class procedures may be any

specimen type unless otherwise specified in the code

descriptor (eg, urine, blood, oral fluid, meconium,

hair).

▪ When the same procedure(s) is performed on more

than one specimen type (eg, blood and urine), the

appropriate code is reported separately for each

specimen type using modifier 59.

DRUG ASSAY

• Identifies if the patient is using a drug or not i,e Presence

or absence of a drug

• It is a Qualitative test

(80305- 80307) Presumptive/Screening/Preliminary:

• Confirm the drug and also quantifies the amount of drug
• It may be Qualitative or Quantitative

(80320-80377) Definitive/Confirmatory:

• Performed to monitor clinical response to a known,

prescribed medication.

(80150-80299) Therapeutic Drug Assays:

Evocative/Suppression Testing (80400-80439)

▪ Evocative Testing: Used to stimulate a particular physiological response or increase the

production of a specific substance in the body.

▪ Suppression Testing: Used to inhibit or decrease the production of a specific substance.

Thyroid Function: Evocative and suppression tests can assess the function of the thyroid gland by

measuring the response to certain medications (such as TSH stimulation test).

Pituitary Function: Some tests assess the function of the pituitary gland and its control over

hormone release.

Examples:

▪ Insulin Tolerance Test (ITT): Used to assess pituitary-adrenal axis function by inducing

hypoglycemia.

▪ Dexamethasone Suppression Test: Used to diagnose disorders like Cushing's syndrome by

assessing cortisol production.

▪ Thyroid Function Tests: Including TSH stimulation tests and TRH stimulation tests to evaluate

thyroid gland function.

Evocative/Suppression Testing (80400-80439)

What is the primary purpose of evocative testing?

a) To suppress the production of specific hormones

b) To diagnose conditions related to excessive hormone secretion

c) To assess the response of a target organ or system by stimulating activity

d) To monitor chronic conditions in the endocrine system

Which of the following tests involves inducing hypoglycemia to assess pituitary-adrenal axis

function?

a) Glucagon Stimulation Test

b) Dexamethasone Suppression Test

c) Thyroid Function Test

d) Insulin Tolerance Test (ITT)

A dexamethasone suppression test is used to diagnose which condition?

a) Hyperthyroidism

b) Hypothyroidism

c) Cushing's syndrome

d) Addison's disease

Which of the following statements about evocative and suppression testing is true?

a) Both types of testing involve inhibiting specific responses in the body.

b) Evocative testing is used exclusively for diagnosing hormone deficiencies.

c) Suppression testing is used to diagnose conditions characterized by excessive hormone

production.

d) These tests are used to evaluate only the function of the thyroid gland.

In a glucagon stimulation test, what is the primary purpose of administering glucagon?

a) To suppress the release of insulin

b) To stimulate the release of growth hormone

c) To induce hyperglycemia

d) To assess adrenal gland function

Which of the following is an example of evocative testing?

a) Thyroid suppression test

b) Insulin tolerance test

c) Dexamethasone suppression test

d) Glucagon stimulation test

Consultations

Clinical

Pathology