The “Surgical Pathology Consult Referral; Incoming” protocol provides instructions for handling of slides sent to Pathology Associates for a pathologist consultation.
Note: Slides and or blocks from outside institutions can arrive by mail, courier or direct delivery from a physician office.
1. Log the case into CoPath under the appropriate patient identifier (medical record number (MRN), patient ID number (PID) or CLICS ‘X-number’). If an identifying number is not sent with the slides call the referring provider for the MRN or PID. Assign a new ‘X-number’ for the patient if appropriate from the CLICS system.
2. Enter the Specimen Class as “R” (referral) in CoPath; the part type on the source card is assigned as “RESB” for Referral Slides/Blocks. There is no protocol loaded; enter the description including quantity of slides, original case number and referring institution or office. Assign the case to the Pathologist who has bench duties for the day
3. Insurance information should accompany all referrals; if not included, call the referring institution or office to obtain it.
4. When a case is received in the lab, all of the information is entered in the Slide Send Out (SSO) function by the person secondary accessioning the case. The “Requested by” is the physician to whom the report is sent and the “Recipient” is the facility that sent the slides. Slide information is entered in “Comments” and the “Specimen” tab.
5. Record the referral (RE) number on all paperwork received; record the assigned pathologist’s initials on the paperwork only.
A. A copy is made and kept with the material until returned to the reference lab.
B. The orginal is reviewed by a pathologist and then is scanned into the image gallery of CoPath. (Scan the report to either the image gallery or to report at the discretion of the pathologist on the case.) When scanning has been reviewed and completed the original is filed in the paperwork office.
C. When the material is returned to the reference lab, check to see that the original req is filed and submit the copies with the slides, material and PA CoPath report to the reference lab.
D. Document the return date and shipping information in the SSO of CoPath
6. Upon completion of the case, copies of the report are distributed as follows:
A. Ordering physician (upon completion)
B. Referring institution
Note: Slides/blocks are held for one month after completion and then returned to the referring institution along with a copy of the Pathology Associates report.
C. Outside Slide Reports Log, along with all accompanying paperwork originally shipped with the slides.
7. After 30 days return the case to the original lab using FedEx. Record the returned/completed date in the SSO of CoPath, along with the FedEx tracking number.
i. May 2003 N. Schmitt/D. Willis
ii. September 2011 B. Wederquist (Revised: II.1-2., 4-5., 7.)