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

> or = 1.0

Centromere, dsDNA, SSA,SSB, RNP, SM, Scleroderma, Histone

Antibody Screen (Blood Bank)

Positive

Antibody Identification (panel)

Anti-Reticulin

Positive

Anti-Reticulin Titer

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

Cryptococcal Antigen

Positive

Cryptococcal Titer

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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