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 |
Glucose, Blood (no charge) |
| ANA for Reflex |
Positive, >80 |
Centromere, dsDNA, SSDNA, SSA, SSB, RNP, SM, Scleroderma, Histone |
| 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 |
| Drug Screen-Chain of Custody |
Positive |
Confirmation Test |
| Hepatitis C Virus Antibody |
Reactive |
HCV-RIBA |
| HER2NEU |
2+ |
FISH |
| HCV RNA Reflex (Qual) |
Detected |
HCV RNA Quantitative |
| HGB Electrophoresis |
Band in S position |
Sickle Prep |
| HIV Antibody |
Reactive |
HIV Western Blot |
| HPV Detect |
Positive |
HPV Identification |
| HSV, IgM Screen |
Positive |
HSV, IgM Titer |
| Islet Cell Ab |
Positive |
Islet Cell Titer |
| 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 |
Free T4 |
| Rickettsial Antibodies |
Positive |
IgG or IgM Titer |
| Rocky Mtn Spot Fever |
Positive |
IgG or IgM Titer |
| RPR |
Reactive |
RPR Titer |
| Sickle Prep |
Positive |
HGB Electrophoresis |
| 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.
Current supplementary testing
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 |
Hemoglobin Electrophoresis |
Peripheral Smear Review by Pathologist |
| Cryptococcal Antigen, CSF |
CSF Culture |
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