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HelpTest Code LAB900 Surgical Pathology, Routine with Frozen Section
Additional Codes
| Test Name in EPIC | EPIC Test Code | Mnemonic |
|---|---|---|
| SURGICAL PATH | LAB900 | SUR |
Useful For
Utilized to aid in the diagnosis of pathological disease and provide information that may help guide the surgeon during the surgical procedure.
Methodology
Macroscopic and microscopic evaluation is performed.
Clinical Information
A frozen section refers to a section of tissue that has been rapidly cooled, cut into thin sections, and stained for microscopic evaluation leading to a preliminary diagnosis. There are many reasons a surgeon may request a frozen section, including: determining if a lesion is malignant or benign, assessing if a tumor has invaded lymph nodes, verify if margins are clear, etc. Ancillary studies and additional testing cannot be performed at the time of the frozen section because the tissue has not been preserved in formalin.
Once the frozen section is complete, the remaining specimen is submitted for routine testing. Routine testing includes a gross examination, a macroscopic evaluation of tissue specimens, and preparation of permanent sections to be microscopically examined. Pathologists will provide a final diagnosis following the microscopic evaluation of the permanent section(s) or determine if further testing is needed.
It is important to note that frozen sections are considered preliminary and may be adjusted following the evaluation of the permanent sections.
Specimen Requirements
Specimen must arrive as soon as possible after collection.
Specimen source is required.
Specimen Type: Tissue
Container/Tube: Sterile container
Specimen Volume: Entire Collection
Fixative: Fresh, no fixative. Note: No fixative means not to place any specimen in any solution; however, saline dampened gauze may be used to prevent drying out of specimen if it is small and drying is a concern.
Amount of Fixative: N/A
Preparation of Specimen: All primary specimen containers must be labeled with at least two patient identifiers, date and time of collection, collector’s name and specimen source. An Epic generated label is preferred. Identifiers that are considered acceptable are as follows: patient name (first and last), date of birth, MRN. Once the specimen is collected, confirm that the specimen is present in the container. Specimen labels should always be placed on the side of the container, never on top of the lid. Ensure the correct label is on each type of specimen if there are multiple specimens. Prior to transport, ensure caps are secure and not leaking.
Note: The order should be complete and contain the following information: collection date, collection time, time in formalin (for breast specimens), ordering provider’s first and last name, copy to provider’s first and last name (if applicable), specimen source, and clinical history.
(AFTER HOURS) Prior to collection, perform the following:
-West Region: Fargo, contact the House Supervisor and request they page the pathologist on call as soon as you know a frozen section is desired. Please allow for pathologist travel time to facility.
-East Region: SMDC, notify the pathologist on call immediately. Please allow for pathologist travel time to facility.
Note: Be certain to mark the EPIC order "Frozen" checkbox.
Hand deliver specimen to lab immediately. Do NOT use pneumatic tube.
Delivery Notes
West Region
Fargo, call 4335 to notify team the frozen is to start and when the specimen is on the way. If no answer, page the pathologist on call. Please deliver to LS431.
Fosston, deliver to general lab.
Detroit Lakes, deliver to general lab.
East Region
Duluth, deliver to SMDC Clinical Laboratory Specimen Processing.
Virginia, deliver to general lab.
Central Region
Brainerd, deliver to Histology.
Specimen Transport
Ambient: Yes
Refrigerate: No
Frozen: No
Day(s) Test Set Up
Monday through Friday
Reference Values
A narrative report will be issued by pathologist.
Performing Laboratory
Anatomic Pathology-
Central Region: SJMC Lab
East Region: SMDC Clinical Lab and *Virginia Hospital Lab
West Region: Fargo Hospital Lab, *Fosston Hospital Lab, and *St. Mary’s- Detroit Lakes Hospital Lab
*See ‘Important Note’ for locations that have an asterisk
Test Classification and CPT Coding
88331-Pathology consultation
88332-Each additional specimen