HISTOPATHOLOGY

Specimen Collection and Handling

Routine Tissue Specimens for Pathology

1. Label the specimen container with the patient’s name and specimen source.

2. Once the specimen has been collected, immediately place the tissue into 10% buffered formalin.

3. Secure the lid and make sure the specimen is completely covered by the formalin.

4. Completely fill out the pathology request.

5. Place the specimen and the request in a biohazard bag.

6. Submit the specimen to the Histology Department.
    

Testicular Biopsies

1. Label a container of Bouin’s fixative with the patient’s name and specimen source.

2. Once the biopsy is taken, immediately place the tissue into the container of Bouin’s fixative.

3. Secure the lid and make sure the specimen is completely covered by the formalin.

4. Completely fill out the pathology request.

5. Place the specimen and the request in a biohazard bag.

6. Submit the specimen to the Histology Department immediately for processing.
   Note: Testicular biopsy procedures should be scheduled before 1 PM.
   
    

Tissues for Special Procedures ( flow cytometry, cytogenetic studies, immunoflourescence, electron microscopy)

1. Label the container with the patient’s name and specimen source.

2. Submit the specimen in a sterile container in the fresh state (no fixative).

3. Place the specimen and the request in a biohazard bag.

4. Immediately transport the specimen to the Histology department.

Pathology Request Form

A. Patient/Physician Information

1. Enter the institution’s code, requesting physician’s name.

2. Check the block to indicate how this is to be billed: Bill patient, Bill Medicare/Medicaid (provide further information), Bill insurance .

3. Enter patient demographics. It is very important to include all requested information for correct billing and correct patient identification.

4. Always give date of birth.

5. Enter the patient’s social security number.
    

B. Insurance/diagnosis Code

1. For insurance billing, complete the gray area labeled, “Insurance Information”.

2. Provide an appropriate diagnosis/ICD9 to indicate medical necessity. A written description is accepted but and ICD9 is preferred.

C. Specimen information

1. List source of specimen. Area # 8A is for tissue specimens and area # 8B is for cytology specimens. BE SURE TO INCLUDE COLLECTION DATE.

2. Enter clinical history. Include information regarding any previous specimens. Please enter as much information as possible so that a proper evaluation can be performed.
    

D. Medicare Patient’s Pap Smear Ordering Guidance
Check one of the boxes according to the reason for ordering the pap. Be sure to order the reflex HPV (low or high risk) if needed.
All Medicare patients must be advised of the current screening limitations. If the patient has exceeded the limitation of one pap per every three years, yet wants an additional pap performed, then the patient must sign the Advanced Beneficiary Notice.

Note: Only one request per patient is necessary. For multiple specimens per patient, list all specimen sources.