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Direct Immunofluorescent biopsy (DIF)

Message
For Direct Immunofluorescent studies
Consult a Pathologist and the special studies Histotechnologist before performing the procedure.
Skin or mucosal biopsies obtained for Direct Immunofluorescent (DIF) studies are mailed to a reference laboratory for processing and evaluation. These biopsies require special fixative and should not be placed in formalin.  In addition to submitting a biopsy for DIF, a routine skin biopsy collected in formalin must also be submitted.

Requirements:
  1. Request on Tissue Examination Report.
  2. Pick up the request form and required fixative (Michel’s solution) from histology prior to collection the specimen.
  3. A completely filled out reference laboratory request and SF15 or printed CHCS order must accompany the specimen.
  4. Place the biopsy in the tube of fixative and label it with the patient information and specimen source.
  5. Deliver the completed request and the specimen to the lab. Call Ext. 3-1524 for further information.

  
  


Test Code
Direct Immunofluorescent biopsy


Instructions
All specimens will be submitted with either a CHCS order entry document or a Tissue Examination Request
[NAVHOSPPTSVA 6510/44 series
It must be completely filled out with:

1. The provider’s full name.
2. The patient’s first and last name.
3. Social security number with FMP.
4. Age.
5. Ward/clinic/MOR.
6. Specimens anatomic site.
7. Two submitting staff initials.
8. Specimen identifier (A, B, C, etc) if more than one container / specimen is to be submitted.
9. Duty station with phone number for active duty personnel.
In addition, pre-operative diagnosis should be included with pertinent clinical data.

Note: All tissue specimens submitted to Histology from internal NMCP sources must have 2 verifying initials on the specimen containers. If they don’t, the specimen will not be accepted. This is command policy. In addition, all patient and specimen source information must be on the specimen container and exactly match the specimen source indicated in the order.

When placing the order in CHCS, the ordering provider must verify that the Patient’s name, FMP, social security number, date of birth and specimen source on the specimen container are correct. Specimens from different body sites must be placed in separate, completely labeled, containers.Surgical Pathology specimens must be labeled and requisitions prepared in the room where the surgical procedure is performed. The ordering provider must ensure that the specimen container(s) are correctly labeled with complete and correct patient information, including full name, FMP, SSN, and date of birth, and with the correct specimen identifier (A, B, C, etc) and specimen source (body site). The provider should verify that the specimen identifier(s) (A, B, C, etc) and body sites in the orders correspond to the identifier(s) and body sites on the specimen container(saAll specimens will be submitted with either a CHCS order entry document or a Tissue Examination Request
[NAVHOSPPTSVA 6510/44 series
It must be completely filled out with:

1. The provider’s full name.
2. The patient’s first and last name.
3. Social security number with FMP.
4. Age.
5. Ward/clinic/MOR.
6. Specimens anatomic site.
7. Two submitting staff initials.
8. Specimen identifier (A, B, C, etc) if more than one container / specimen is to be submitted.
9. Duty station with phone number for active duty personnel.
In addition, pre-operative diagnosis should be included with pertinent clinical data.

Note: All tissue specimens submitted to Histology from internal NMCP sources must have 2 verifying initials on the specimen containers. If they don’t, the specimen will not be accepted. This is command policy. In addition, all patient and specimen source information must be on the specimen container and exactly match the specimen source indicated in the order.
 

  1. When placing the order in CHCS, the ordering provider must verify that the Patient’s name, FMP, social security number, date of birth and specimen source on the specimen container are correct. Specimens from different body sites must be placed in separate, completely labeled, containers.
  2. Surgical Pathology specimens must be labeled and requisitions prepared in the room where the surgical procedure is performed. The ordering provider must ensure that the specimen container(s) are correctly labeled with complete and correct patient information, including full name, FMP, SSN, and date of birth, and with the correct specimen identifier (A, B, C, etc) and specimen source (body site). The provider should verify that the specimen identifier(s) (A, B, C, etc) and body sites in the orders correspond to the identifier(s) and body sites on the specimen container(s.)
 


Transport Container
 These biopsies require special fixative (Michael's solution) and should not be placed in formalin. 
Michael's solution and the appropriate mailout form must be p


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Missing or incomplete patient name on container or lab order form.
Missing or incomplete patient FMP and/or social security number on container or lab order form.
Missing or incomplete anatomic site on container or lab order form.
No double initials on container (two staff members from the submitting clinic must initial the specimen container).
Illegible container label or lab order form.
Patient information on container different from patient information on lab order form.
No lab order form submitted with specimen.
No specimen submitted with lab order form.




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.