Allina Laboratories

&nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp;

BREAST FLUID/SMEAR for CYTOLOGY=

(<= span style=3D'font-size:11.0pt'>NonGyn Cytology)

Breast FLUID Epic CYTOLOGY/LAB6301C St= ar 6301

Nipple Secretion SMEAR&nbs= p; Epic<= /span> CYTOLOGY/LAB6301 St= ar 6301

Breast Fluid/Nipple Secretion for = FAT STAIN<= /b>

EpicCYTOLOGY/LAB6301   Star 6301

Specify Source

        &= nbsp;

DEPARTMENT:    =             &nb= sp;        Cytology

&n= bsp;

CONTAINER:    &= nbsp;           &nbs= p;            For fluid: Clean, dry tube la= beled with two patient identifiers and source.

    &n= bsp; For smear: Frosted-end glass = slide labeled with patient’s name, DOB, and source (i.e. L. Breast or Rt. Breast Fat Stain).

INSTRUCTIONS:  &= nbsp;           &nbs= p;        Breast fluid:

1.       Place aspirated fluid into l= abeled clean, dry tube.

            =             &nb= sp;            =             &nb= sp;    2.       Bring= to lab immediately or refrigerate for transport.

<= /p>
    = ;            &n= bsp;            = ;            &n= bsp;            Breast smear: Have sp= ray fixative available prior to exam.

1.       Place slide against nipple and press breast area to express fluid    onto slide. Spread across labeled slide.<= /o:p>

2.       Spray fix immediately.* Indicate “fix” = on slide.

If adequa= te specimen is available, also submit labeled air-dried smear; indicate "air" on slide.

*EXCEPTION: For FA= T STAIN DO NOT SPRAY FIX.   Indicate “Breast Smear= for Fat Stain” and write “air” on labeled slide.

3.  &n= bsp;    Place slide/s in slide container for transport to lab.

Indicate pertinent clinical history/previous malignancy.

REPORTING

INTERVAL:            =             &nb= sp;        Within 48 hours of receipt.

REFERENCE

VALUES:           &nb= sp;            =              See pathology report.

SPECIMEN

REJECTION:            =             &nb= sp;      Unlabeled specimen.

=

CPT 88173 Fluid       CPT = 88160 Smear

CPT 88173 and = 88313 Fluid for Fat Stain

CPT 88160 and = 88313 Smear for Fat Stain

Reviewed:  &= nbsp;           &nbs= p;            &= nbsp;

10/99: &nbs= p;    Linda Wennerstrom, CT (ASCP)            =            6/06 Revised: Linda Wennerstrom, CT (ASCP)

2/00         = Linda Wennerstrom, CT (ASCP)        &= nbsp;        10/07 Revised: Li= nda Wennerstrom, CT (ASCP)

2/01         = Linda Wennerstrom, CT (ASCP)   &nb= sp;

2/02         = Linda Wennerstrom, CT (ASCP)   &nb= sp;

2003        Linda Wennerstrom, CT (ASCP)   &nb= sp;

2/04         = Linda Wennerstrom, CT (ASCP)   &nb= sp;

2/05         = Linda Wennerstrom, CT (ASCP)

6/05 Revised: Linda Wenners= trom, CT (ASCP)

DEPARTMENT: = &nb= sp; Cytology

CONTAINER: &= nbsp; &nbs= p; For fluid: Clean, dry tube la= beled with two patient identifiers and source.