Tissue Request

Test Code
Tissue Request


Preferred Specimen
Tissue


Other Acceptable Specimens
Direct immunofluroresence (DIF)- in appropriate fixative


Instructions
Patient's identity must be verified on specimen container using 2 unique identifiers (patient name and 
date of birth are the preferred identifiers).

Specimen removal time/ formalin time is required either on container or requistion.


Transport Container
Routine specimens must be placed in labeled leak proof container which allows an appropriate amount of formalin to be added (15-20:1 ratio is desired but not always achievable) and placed in a sealed biohazard bag.


Transport Temperature
Room temperature for formalin fixed specimens.
Refrigerated for fresh tissue and tissue shared with microbiology.


Specimen Stability
If in question, refrigerate.


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Specimen container or requistion is received  unlabeled or mislabeled. Specimen missing information or identification on container or requisition. Specimens with only one patient identifier.


Report Available
Reports are verified after pathologist reviews and approves dictation after transcription is complete. Verified reports are transmitted to EMR immediately on MMC patients. Verified DML reports are transmitted via fax or into EMR immediately. Providers without fax or EMR access receive printed report delivered to physician offices daily. 


Performing Laboratory
This test is performed at the following locations:
  1. MercyOne Siouxland Medical Laboratory
  2. MercyOne Dakota Dunes Medical Laboratory



Last Updated: September 27, 2022


The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.