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Test Code PATH15: Specimen to Pathology, Muscle or Nerve Sendout Specimen to Pathology, Muscle or Nerve Sendout

Additional Codes

Epic EAP: PATH15

Epic Description: SPECIMEN TO PATHOLOGY 

 

Synonym

Pathology

Muscle

Nerve

Specimen Type

Muscle or Nerve Biopsy

Patient Instructions/Preparation

  • If the specimen documentation requirements are not met, specimens may be rejected, which will delay final diagnosis. Certain specimens may be rejected with recommendation to recollect.
  • Each specimen container/jar must be labeled with the following information: 
    • Full patient name
    • MRN
    • Date of birth
    • Sex
    • Specimen source, including laterality, that fully matches the source on the order requisition. If the source is abbreviated on the printed label, a handwritten source must be provided on the container/jar.
  • Specimens are accompanied with Epic orders that include:
    • Full patient name
    • MRN
    • Date of birth
    • Sex
    • Patient location
    • Full name of physician and unique doctor number (if applicable)
    • Date of collection
    • Clinic history, if applicable
    • ICD-9 code of all outpatient specimens
    • Specimen source and description with site specific words, including laterality, that fully matches the source and description on the specimen container.
  • The appropriate form for the sendout laboratory must be filled out entirely and accompany the specimen to the lab. 
  • Biopsies should not be scheduled on Friday or before holidays

Specimen Required

 

 

  Collection Container  

 
Preferred

Muscle - Specimen jar

Nerve -Specimen jar

Muscle - Wrap in wrung saline-moistened gauze

Nerve - glutaraldehyde

 Fresh

 

Instructions for Collection and Transport

  • Muscle:
    • Harvest a 2-3 cm in length x 1 cm in diameter along the longitudinal fiber axis segment of the tissue from the belly of the target mucle but not end-stage. Avoid areas of myotendinous insertion. Choose a mucle that has not been recently subjected to EMG/NCS or other invasive procedures. Multiple small fragments are not acceptable as they are extremely difficult to orient correctly and introduce handling/cutting/crush artifact.
      • The muscle may be harvested with sutures.
      • Handle the muscle gently and avoid overstretching. 
      • Avoid injecting the target muscle with anesthetic.
      • Avoid electrocautery in the region of the target muscle.
    • Wrap the muscle in wrung saline-moistened/wet gauze. Place it in the specimen container and tightly close the lid. Ensure the tissue is not submersed in saline. Place the specimen container in the styrofoam box on wet ice. Fill container with wet ice. The gauze/pad must NOT be soaking wet: wring out fully before letting it touch the tissue, and NEVER immerse fresh muscle in liquid of any kind: we may be unable to make a diagnosis because of swelling artifact. Do not let the tissue dry or enzyme activity will be lost.
  • Nerve:
    • At surgery the nerve is to be exposed gently.
    • If a local anesthetic is used, avoid injecting the nerve itself and do not manipulate the segment to be submitted.
    • Avoid electrocautery in the region of the nerve.
    • An optimal specimen should be at least 3 cm long.
  • Community sites must notify the on-site laboratory thta there is a scheduled Muscle or Nerve biopsy at least 1 day prior to the procedure to allow for obtaining needed supplies for processing.  
  • Submit according to the reference lab specific collection guidelines and include the requisition filled out fully and completely.
  • The specimen must be walked ASAP to the pathology laboratory
    • Ochsner main campus: Benson Cancer Center, 4th Floor
    • Ochsner community sites: Refer to your local laboratory for routing instructions
    • All specimens must be logged in at their proper destination
    • All specimens must be logged into logbook.

 

Aliquot Requirements:

Muscle - 2-3 cm in lenght x 1 cm in diameter

Nerve - 3 cm in lenght

Performing Lab

OMC Anatomic Pathology Lab

Assay Frequency

Monday – Friday (8AM – 5PM)

Routine Turnaround Time

Dependent on sendout laboratory, weekends and holidays. 

CSR Storage Requirements

Fresh - refrigerator

Saline - refrigerator

35 glutaraldehyde -refrigerator

 

CPT Code (s):

88305, 88313,88314, 88348