HISTOPATHOLOGY
Specimen Collection and Handling
Routine Tissue Specimens for Pathology
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Label the specimen
container with the patient’s name and specimen source.
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Once the specimen has been
collected, immediately place the tissue into 10% buffered formalin.
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Secure the lid and make
sure the specimen is completely covered by the formalin.
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Completely fill out the
pathology request.
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Place the specimen and the
request in a biohazard bag.
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Submit the specimen to the
Histology Department.
Testicular Biopsies
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Label a container of
Bouin’s fixative with the patient’s name and specimen source.
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Once the biopsy is taken,
immediately place the tissue into the container of Bouin’s fixative.
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Secure the lid and make
sure the specimen is completely covered by the formalin.
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Completely fill out the
pathology request.
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Place the specimen and the
request in a biohazard bag.
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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)
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Label the container with
the patient’s name and specimen source.
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Submit the specimen in a
sterile container in the fresh state (no fixative).
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Place the specimen and the
request in a biohazard bag.
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Immediately transport the
specimen to the Histology department.
Pathology Request Form
A. Patient/Physician Information
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Enter the institution’s
code, requesting physician’s name.
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Check the block to indicate
how this is to be billed: Bill patient, Bill Medicare/Medicaid (provide
further information), Bill insurance .
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Enter patient demographics.
It is very important to include all requested information for correct
billing and correct patient identification.
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Always give date of birth.
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Enter the patient’s social
security number.
B. Insurance/diagnosis Code
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For insurance billing,
complete the gray area labeled, “Insurance Information”.
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Provide an appropriate
diagnosis/ICD9 to indicate medical necessity. A written description is
accepted but and ICD9 is preferred.
C. Specimen information
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List source of specimen.
Area # 8A is for tissue specimens and area # 8B is for cytology
specimens. BE SURE TO INCLUDE COLLECTION DATE.
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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.
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