Cytology - ThinPrep Pap Test
| WSLH Department: | Cytology |
| WSLH Test Code: | 95000 THIN |
| Availability: | Monday-Friday |
| Turn-around Time: | 7 Days |
| Recommended Uses: | Evaluation of cervical-vaginal smear for premalignant, malignant, infectious, and inflammatory changes. |
| Contraindications: | If possible, avoid during the menstrual phase of cycle. Endocervical collection methods not recommended for use on pregnant patients. The test does not sample from the endometrium. Inform patients that there may be some minor painless spotting for a day or two following the Pap test. |
| Additional Tests Performed: |
| Patient Preparations: | Instruct the patient not to douche or use spermicide for 24 hours prior to examination. A warm speculum containing no lubricant is inserted into the vagina. |
| Specimen Requirements: | Collected cellular material is transferred to 20mL ThinPrep Pap test vial. Patient's full legal name, DOB and DOS must be written on the vial. |
| Specimen Handling & Transport: | Tightly seal the ThinPrep Pap test vial and place in biohazard bag. Add one absorbent cloth to the bag. Place requisition form with HPV order in biohazard bag sleeve. Transport via courier or shipping carrier with a tracking option strongly preferred. Store at controlled room temperature. |
| Collection Kit/Container: |
ThinPrep Kit #16 and Mailers
|
| Collection Instructions: | Container identification may be affixed with a label or hand-printed and MUST include: full legal name of patient, DOB and DOS. Speculum should be warmed and rinsed in saline solution; no lubricant should be used. Obtain an adequate sampling from the cervix using one of the following methods: BROOM-LIKE DEVICE--Insert the central bristles of the broom into the endocervical canal deep enough to allow the shorter bristles to fully contact the ectocervix. Push gently, and rotate the broom in a clockwise direction five (5) times. Immediately and vigorously swirl the cell contents into the ThinPrep vial, swirling the brush around the bottom of the vial at least 10 times for at least 10 seconds. This collection device should then be discarded. BRUSH--Insert the central bristles of the brush into the endocervical canal so that the bottom of the brush is visible at base of os. Rotate the brush in a clockwise direction one-fourth to one-half turn. NOTE that over-rotating may cause excessive bleeding leading to an unsatisfactory Pap test. Immediately and with some force, vigorously swirl and twirl the brush against the edges of the vial at least 10 times for at least 10 seconds. This collection device should then be discarded. SPATULA--Using a plastic spatula, insert the small end of the spatula into the ectocervix. Rotate the spatula one full turn in a clockwise direction. Quickly place the spatula into the vial and forcefully swish in the liquid against the vial 10 times for at least 10 seconds. PLEASE NOTE: Make sure vial is properly closed to prevent spilling or leakage. Do not leave collection devices in ThinPrep Vials as it can interfere with slide production. |
| Unacceptable Conditions: | Unlabeled and/or leaking specimens will not be tested. |
| Requisition Form: |
WSLH Cytology Form 141
|
| Required Information: | Laboratory regulations require the following minimum information to be provided on the requisition form for a specimen to be accepted for testing: Patient name or unique identifier; date and time of collection, patient date of birth and sex, specimen type/site of collection, test request(s), clinician name and UPIN, and address for reporting results. Please be certain that name/identifier on the form matches that on the specimen label. |
| Results Include: | Negative for Intraepithelial Lesions or Malignancy (NILM), Unsatisfactory, Atypical Squamous Cells of Undetermined Significance (ASCUS), Atypical Squamous Cells cannot rule out High Grade Lesion (ASC-H), Atypical Glandular Cells (AGC), Low Grade Squamous Intraepithelial Lesion (LSIL), High Grade Squamous Intraepithelial Lesion (HSIL), Endocervical Adenocarcinoma in situ (AIS), Positive for Squamous Carcinoma, Positive for Endocervical Adenocarcinoma, Positive for Endometrial Adenocarcinoma (ADCA), and Positive for Adenocarcinoma, NOS. Results may also include inflammatory, bacterial, and viral findings. |
| Limitations: | Avoid specimen collection during menses, if possible. Specimens that do not meet basic requirements of cell volumes, or that are not well-preserved/or visualized, may be non-diagnostic and rendered unsatisfactory for evaluation. Abnormal findings must be correlated with history and other test results. The Pap smear is a valuable screening test for cervical cancer and its precursors. As with any laboratory test, both false negative and false positive results may occur. Positive results should be confirmed with additional studies as clinically indicated. |
| Additional Tests Recommended: | In the event of a liquid-based Pap smear diagnosis of atypical cells of undetermined significance (ASCUS), a test for high-risk types of human papilloma virus (HPV) may be reflexed depending on clinician's orders, patient's age, and previous HPV testing history. Clinicians may also order HPV testing regardless of Pap diagnosis or as a standalone test. |
| Additional Comments: | Additional tests performed: Cytology-HPV Test (Test code: 95507 HPVCOBAS) Professional Fee for samples forwarded to a doctor may be billed under CPT code 88141 at $21.00 (as of Dec. 2019). |
| Methodology: | Cytologic evaluation of cells from the vaginal/cervical area using liquid-based technology. |
| Includes: | Cervical and vaginal specimens. |
| CPT Code: | 88142 |
| Price: | $35.00 |