Reflex or Supplementary Testing
For some laboratory tests, when certain criteria are met additional testing will be generated to provide more conclusive laboratory information for diagnosis and treatment.
Reflex testing:
Test |
Reflex Criteria |
Additional Tests |
Accucheck Glucose |
< 60 or > 450 mg/dl |
Glucose, Blood (no charge) |
ANA for Reflex |
80 or greater |
Centromere, dsDNA, SSA,SSB, RNP, SM, Scleroderma, Histone |
Antibody Screen (Blood Bank) |
Positive |
Antibody Identification (panel) |
Anti-Reticulin |
Positive |
Anti-Reticulin Titer |
Cardiolipin Screen |
Positive |
Cardiolipin IgG &IgM |
Cat Scratch Disease Abs |
Positive |
Cat Scratch Dis. Ab Titers |
CBC with Diff |
Abnormal Automated Diff
(Flags Generated by Analyzer)
|
Manual Diff & Peripheral Smear Review by Pathologist (as needed) |
Cold Agglutinin Screen |
Positive |
Cold Agglutinin Titer |
Cryoglobulin Screen |
Positive |
Cryocrit |
Cryptococcal Antigen |
Positive |
Cryptococcal Titer |
ER Urine Dipstick for Blood
(Point-of-Care) |
> or = Trace |
UA |
Fetal Screen (Blood Bank) |
Positive |
Fetal Hemoglobin Stain |
Hepatitis C Virus Antibody |
Reactive |
HCV Antibody by RIBA |
HER2NEU |
2+ |
FISH |
HCV RNA Reflex (Qual) |
Detected |
HCV RNA Quantitative |
HGB Electrophoresis |
Band in S position |
Sickle Prep (If not previously performed) |
HIV Antibody I/II |
Reactive |
HIV I Western Blot |
HSV, IgM Screen |
Positive |
HSV, IgM Titer |
HPV Detection |
Positive |
HPV ID |
IFE |
Abnormal electrophoresis panel
suggestive of monoclonal protein |
SPE |
Islet Cell Ab |
Positive |
Islet Cell Titer |
Lupus AntiCoagulant Panel • dRVVT Screen • aPTT |
• Positive • Abnormal |
• dRVVT Confirmatory & Ratio aPPT • aPTT Normal Pool Mix & aPPT Saline Mix |
Lyme Antibody |
Positive |
Lyme Western Blot |
Myoglobin Screen (Urine) |
Positive |
Myoglobin, Quantitative |
Platelet Function Test |
Collagen EPI >201 |
Collagen/ADP (CADP) |
TSH, Reflexive |
<0.27 or >4.20 µIU/mL |
Free T4 |
Rickettsial Antibodies |
Positive |
IgG or IgM Titer |
Rocky Mountain Spotted Fever |
Positive |
IgG or IgM Titer |
RPR |
Reactive |
RPR Titer |
Sickle Prep |
Positive |
HGB Electrophoresis |
SPE |
Abnormal electrophoresis panel
suggestive of monoclonal protein |
IFE |
Streptozyme |
Positive |
Anti-Streptolysin O |
Urine Glucose <10 yrs |
Negative |
Reducing Substances |
VDRL, CSF |
Reactive |
Titer |
Supplementary Testing
Supplementary testing will automatically be performed for the tests below which may be billed separately.
Initial Test |
Supplementary Test(s) |
Anaerobic Culture |
Aerobic Culture |
Directogen CSF |
CSF Culture |
Stool Culture |
Campylobacter |
E. Coli 0157 |
Stool Culture, Campylobacter |
Respiratory Culture |
Gram Stain |
External Culture |
Gram Stain |
Genital Culture |
Gram Stain |
Body Fluid Culture |
Gram Stain |
Eye Culture |
Gram Stain |
Surgical Specimen Cultures |
Gram Stain |
AFB Culture |
AFB Smear |
Fungus Culture |
KOH and/or Wright Stain |
Coagulogram |
Peripheral Smear Review by Pathologist plus indicated Factor Assays |
Hemoglobin Electrophoresis |
Peripheral Smear Review by Pathologist |
Cryptococcal Antigen, CSF |
CSF Culture |
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