I agree with Juan.  We do Diff-Quiks on all stomach biopsies (not on stomach
polyps though).  This is not only by the request of our Pathologists, but by
the request of the surgeons.  In fact they usually write "Gastric biopsy,
check for H. pylori" right on the requisition.

Dawn


-----Original Message-----
From: GUTIERREZ, JUAN [mailto:juan.gutierrez@christushealth.org] 
Sent: Wednesday, November 10, 2004 9:50 AM
To: Marshall Terry Dr, Consultant Histopathologist; Horn, Hazel V; Richard
Cartun; histonet@lists.utsouthwestern.edu; PatPatterson@mhd.com;
JWEEMS@sjha.org
Subject: RE: [Histonet] DiffQuik Question again


We do.  Besides, was there not a reason to do the bx in the first place?

Juan C. Gutierrez, HT(ASCP)
Histology Laboratory Supervisor
(210)704-2533

My opinions are my own and do not reflect those of my employer.  Long live
free speech!


-----Original Message-----
From: Marshall Terry Dr, Consultant Histopathologist
[mailto:Terry.Marshall@rothgen.nhs.uk] 
Sent: Wednesday, November 10, 2004 9:31 AM
To: Horn, Hazel V; Richard Cartun; GUTIERREZ, JUAN;
histonet@lists.utsouthwestern.edu; PatPatterson@mhd.com; JWEEMS@sjha.org
Subject: RE: [Histonet] DiffQuik Question again

Really?
You don't do specials on kidney or liver until the H&E is examined?

Dr Terry L Marshall, B.A.(Law), M.B.,Ch.B.,F.R.C.Path  Consultant
Pathologist  Rotherham General Hospital  South Yorkshire  England
        terry.marshall@rothgen.nhs.uk

-----Original Message-----
From: Horn, Hazel V [mailto:HornHV@archildrens.org]
Sent: 10 November 2004 15:11
To: Richard Cartun; juan.gutierrez@christushealth.org;
histonet@lists.utsouthwestern.edu; PatPatterson@mhd.com; JWEEMS@sjha.org
Subject: RE: [Histonet] DiffQuik Question again


There has to be a medical indication for ordering any tests.    You
can't just do a stain because it is a gastric biopsy.    Our hospital
does not allow that.    We wait on all stains until the pathologist has
looked at the H&E.    

Hazel Horn, HT/HTL (ASCP)
Histology Supervisor
Arkansas Children's Hospital

Phone - 501.364.4240
Fax - 501.364.3912 

-----Original Message-----
From: histonet-bounces@lists.utsouthwestern.edu
[mailto:histonet-bounces@lists.utsouthwestern.edu] On Behalf Of Richard
Cartun
Sent: Tuesday, November 09, 2004 3:52 PM
To: juan.gutierrez@christushealth.org;
histonet@lists.utsouthwestern.edu; PatPatterson@mhd.com; JWEEMS@sjha.org
Subject: RE: [Histonet] DiffQuik Question again


Some pathologists would argue that if inflammation is not present, there is
no reason to look for H. pylori.  Also, third party payors may question the
policy of doing a histochemical stain for bugs without first examining the
H&E-stained slide.

Richard

Richard W. Cartun, Ph.D.
Director, Immunopathology & Histology
Assistant Director, Anatomic Pathology
Hartford Hospital
80 Seymour Street
Hartford, CT  06102
(860) 545-1596
(860) 545-0174 Fax

>>> "GUTIERREZ, JUAN"  11/09/04
02:56PM >>>
Who determines when it's not necessary?  If a stain is negative it does not
necessarily mean it was not warranted.  The stain is done to figure out if
the bugs are there or not.  The clinician needs to know either way.  Because
even if it's a tumor, did the bugs have a role in the process?  

Juan C. Gutierrez, HT(ASCP)
Histology Laboratory Supervisor
(210)704-2533

My opinions are my own and do not reflect those of my employer.  Long live
free speech!


-----Original Message-----
From: Weems, Joyce [mailto:JWEEMS@sjha.org] 
Sent: Tuesday, November 09, 2004 1:38 PM
To: Richard Cartun; GUTIERREZ, JUAN; histonet@lists.utsouthwestern.edu;
PatPatterson@mhd.com 
Subject: RE: [Histonet] DiffQuik Question again

We do Genta on all gastric bxs and then if they are not necessary we credit
the charge. 
Joyce 

-----Original Message-----
From: histonet-bounces@lists.utsouthwestern.edu 
[mailto:histonet-bounces@lists.utsouthwestern.edu]On Behalf Of Richard
Cartun
Sent: Tuesday, November 09, 2004 2:17 PM
To: juan.gutierrez@christushealth.org;
histonet@lists.utsouthwestern.edu; PatPatterson@mhd.com 
Subject: RE: [Histonet] DiffQuik Question again


Dear Juan:

Do all these patients get billed for the Giemsa histochemical stain?

Richard

Richard W. Cartun, Ph.D.
Director, Immunopathology & Histology
Assistant Director, Anatomic Pathology
Hartford Hospital
80 Seymour Street
Hartford, CT  06102
(860) 545-1596
(860) 545-0174 Fax

>>> "GUTIERREZ, JUAN"  11/09/04
01:29PM >>>
We do a Giemsa on all gastric bx. And never get questioned.  The pathologist
does not have to review the H&E before it's done.  We usually turn it in
with the H&E.

Juan C. Gutierrez, HT(ASCP)
Histology Laboratory Supervisor
(210)704-2533

My opinions are my own and do not reflect those of my employer.  Long live
free speech!


-----Original Message-----
From: Patterson, Pat [mailto:PatPatterson@mhd.com] 
Sent: Tuesday, November 09, 2004 10:01 AM
To: 'histonet@lists.utsouthwestern.edu' 
Subject: [Histonet] DiffQuik Question again


Hi all -
Thanks for response previously for request for DiffQuik stain protocols.

I'm trying to get a sense from all about prodecure/policy -- do the clinical
sites routinely perform a DiffQuik on all Gastric Bxs? Or do your
Pathologists order after initial review of H&E?  And if done on all Bxs -
have there been any questions from your Billing offices about necessity?

Thanks for any information.

Pat Patterson
Methodist Dallas Medical Center

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