RE: [Histonet] Training for gross

From:"Carlos Stolk"

This is getting a little bit complicated. We should talk about this over
a nice steak dinner.

Have a splendid weekend

Carlos Stolk
Account Representative
Georgia | New Mexico 
South Carolina| Texas
Phone: 800-875-8999 ext. 258
Fax: 561-367-0884
Club Staffing, Inc.                   
5901 Broken Sound Pkwy, Ste 500 
Boca Raton, FL 33487 

-----Original Message-----
[] On Behalf Of
Caldwell, Lia
Sent: Friday, August 22, 2008 5:54 PM
To: Sharon.Davis-Devine
Subject: RE: [Histonet] Training for gross

This came up during a recent CAP inspection of a lab we inspected in
Maricopa so I have taken the liberty of copying the information from the
CAP guidelines regarding this issue for you.  The first question defines
high complexity testing and the second question addresses requirements
for individuals performing these tasks.
Hope this helps, have a great weekend! 
According to CAP guidelines 
"Are all macroscopic tissue examinations performed by a pathologist or
pathology resident, or under supervision of a qualified pathologist?
Note:  Two levels of complexity of macroscopic tissue examination are
defined, as follows:
1.  Processing is defined as a tissue examination limited to
description, inking and cutting of the specimen (if applicable), and
submission of the entire specimen to histology.  Tissue processing can
be performed accroding to standardized protocols.  Processing is
generally limited to small specimens (skin ellipses, small biopsies,
curettings, etc.) and does not require knowledge of anatomy.
2.  Grossing (or gross examination) is defined as a tissue examination
requiring a greater exercise of judgement and a knowledge of anatomy.
Dissection of the specimen and selection of tissue samples for
submission to histology are generally required.  The specimen
description is not necessarily stadardized.  
"If individuals other than a pathologist or pathology resident assist in
gross examinations, do such individuals qualify as high complexity
testing personnel under CLIA-88 regulations?
NOTE:  The laboratory director may delegate the dissection of specimens
to non-pathologist individuals;  these individuals must be qualified as
high complexity testing personnel under CLIA-88 regulations.  The
minimum training/experience required of such personnel is:
1.  An earned associate degree in a laboratory science or medical
laboratory technology, obtained from an accredited institution, OR
2.  Education/training equivalent to the above that includes at least 60
semester hours or equivalent from an accredited institution.  This
education must include 24 semester hours of medical laboratory
technology courses, OR 24 semester hours of science courses that
includes 6 semester hours of chemistry, 6 semester hours of biology, and
12 semester hours of chemistry, biology or medical laboratory technology
in any combination. In addition, the individual must have laboratory
training including either completion of a clinical laboratory training
program approved or accredited by the ABHES, the CAHEA, or other
organization approved by HHS (note that this training may be included in
the 60 semester hours listed above), OR at least 3 months documented
laboratory training in each specialty in which the individual performs
high complexity testing.  
In addition, the CLIA-88 regulations include exceptions for
grandfathered individuals; these regulations (42CFR493.1489 and 1491)
may be found at
It is the responsibility of the laboratory director to determine whether
an individual's education, training and experience satisfies the
requirements of this checklist question.
This checklist question applies only to laboratories subject to CLIA-88
Lia M. Caldwell HT (ASCP)
Histology Supervisor
Oro Valley Pathology Dept.
phone: (520) 901-3914
"be yourself - everyone else is already taken." -unknown


From: on behalf of
Sent: Fri 8/22/2008 10:23 AM
Subject: [Histonet] Training for gross

For all of you Histonetters out there I have a question about training
individuals to gross in small specimens.  Can a person with a degree and
being a Cytotechnologist, Medical Technologist or a Histotechnologist
gross in small biopsy samples?  And if they can, what kind of training
is required and for how long?  We are losing one of our PA's and are
contemplating replacing that person with a person with a degree. Thanks
for the info.

Sharon Davis-Devine, CT (ASCP)

Cytology Supervisor

Carle Clinic

602 West University

Urbana, Illinois 61801

Phone:  217-383-3572


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