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Test ID: PATHC Pathology Consultation

Reporting Name

Pathology Consult

Useful For

A subspecialty second opinion for a specific pathology question referred by a primary pathologist

Note: A consultative opinion is not a full rendering of a primary diagnostic report (eg, multiple parts, margin status, CAP synoptics)

 

Obtaining special studies not available locally

 

This test is not intended to be used to obtain a primary diagnosis.

Clinical Information

Mayo Clinic in Rochester, MN is staffed by pathologists whose expertise and special interests cover the entirety of pathology-from surgical pathology with all of its respective subspecialty areas, to Hematopathology, Renal Pathology, and Dermatopathology.

 

Consultation services are provided for difficult diagnostic problems. Consultation cases may be sent by a referring pathologist and directed to one of the pathologists who is an expert in the given area or directed more broadly to the subspecialty group. Cases are frequently shared and, sometimes, transferred between the pathologists, as deemed appropriate for the type of case or diagnostic problem encountered. Emphasis is placed on prompt and accurate results. Stained slides and paraffin blocks received are reviewed in conjunction with the clinical history provided, laboratory findings, radiographic findings (if applicable), and sending pathologist's report or letter. If additional special stains or studies are needed, the results are included in the final interpretive report. In some cases, electron microscopy and other special procedures are utilized as required.

 

A variety of ancillary studies are available (eg, cytochemistry, immunohistochemistry, immunofluorescence, electron microscopy, mass spectrometry, cytogenetics, and molecular genetics) to aid in establishing a diagnosis. These ancillary studies are often expensive, labor intensive, and most efficiently utilized and interpreted in the context of the morphologic features.

 

The goal is to provide the highest possible level of diagnostic consultative service, while balancing optimal patient care with a cost-conscious approach to solving difficult diagnostic problems.

Interpretation

Results of the consultation are reported in a formal pathology report that includes a description of ancillary test results (if applicable) and an interpretive comment.

Testing Algorithm

This request will be processed as a consultation case. An interpretation, which includes an evaluation of the specimen and determination of a diagnosis, will be provided within a formal pathology report. Second opinion regarding diagnosis will be rendered by staff pathologists, often in consultation with colleagues who have expertise in the appropriate subspecialty areas. Appropriate additional stains and other ancillary testing may be performed in order to render comprehensive assessment. These additional stains/tests ordered will have the results included within the final pathology report and will be at an additional charge.

 

Note: Special stains and studies performed on the case should be sent with the case for review. In order to determine an accurate diagnosis, some of these stains or studies may be deemed to warrant being repeated, at an additional charge, at the reviewing Mayo Clinic pathologist's discretion. In addition, testing requested by the referring physician (immunostains, molecular studies, etc) may not be performed if deemed unnecessary by the reviewing Mayo Clinic pathologist. For all pathology consultations, ancillary testing necessary to determine a diagnosis is ordered at the discretion of the Mayo Clinic pathologist.

 

For more information see Pathology Consultation Ordering Algorithm.

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
COSPC Consult, Outside Slide No, (Bill Only) No
CRHPC Consult, w/Comp Rvw of His No, (Bill Only) No
CSPPC Consult, w/Slide Prep No, (Bill Only) No
CUPPC Consult, w/USS Prof No, (Bill Only) No

Report Available

4 to 8 days; The final pathology report may be delayed if additional materials are required, or if ancillary testing (up to 21 days) is indicated.

Day(s) Performed

Monday through Friday

Clinical Reference

Renshaw AA, Gould EW. Measuring the value of review of pathology material by a second pathologist. Am J Clin Pathol. 2006 May;125(5):737-9. doi: 10.1309/6A0R-AX9K-CR8V-WCG4

Specimen Type

MMLDRY


Ordering Guidance


This test is intended for use with dry tissue - blocks and/or slides - only. For test ordering guidance for other specimen types, see Pathology Consultation Ordering Algorithm.

 

If requesting only a peripheral blood smear evaluation, order SPSM / Morphology Evaluation (Special Smear), Blood.

Note: Send only those case specimens for which a Mayo pathologist interpretation is needed.



Shipping Instructions


Attach the green "Attention Pathology" address label included in the kit to the outside of the transport container.



Necessary Information


The following information is required:

 

1. All requisitions must be labeled with:

-Patient name, date of birth, and medical record number

-Name and phone number of the referring pathologist or ordering physician

-Anatomic site and collection date

 

2. All specimens must be labeled with:

-Two patient identifiers (first and last name, date of birth, or medical record number)

-Specimen type and anatomic site

 

3. A preliminary or final pathology report and brief patient history is essential to achieve a consultation fully relevant to the ordering pathologist's needs. If a report is not available, submit the Pathology Consultation Request (T246) with the specimen.

 

4. A specific diagnostic question is required for each specimen/part submitted. Include question in a cover letter or in the requisition notes/comments.

 

5. Additional requirements by case type:

-For Bone consults, pre-operative imaging studies are often required. Either submit on CD or thumb drive with the request.

-For Neuro Pathology consults, clinical and/or radiology imaging should be included if available. Either submit on CD or thumb drive with the request.

-For Bone Marrow consults, include:

1. Recent peripheral blood smear with complete blood cell count (CBC) report

2. Bone marrow biopsy/clot (block and stained slides)

3. Bone marrow aspirate (stained and unstained slides)

4. All pending and final reports for ancillary testing on above specimens

 

All requisition and supporting information must be submitted in English.



Specimen Required


Supplies: Pathology Packaging Kit (T554)

Specimen Type: Tissue: Formalin Fixed Paraffin-embedded blocks, stained slides and/or unstained slides

Note: Submit only pertinent hematoxylin and eosin (H and E) and all special stains relevant to the diagnostic questions for the case. Include positively charged unstained slides and/or a formalin-fixed, paraffin-embedded tissue block if it is anticipated that additional stains or ancillary testing may be necessary.


Specimen Stability Information

Specimen Type Temperature Time Special Container
MMLDRY Ambient

Reference Values

An interpretive report will be provided.

Test Classification

Not Applicable

CPT Code Information

88321 (if appropriate)

88323 (if appropriate)

88325 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PATHC Pathology Consult 60570-9

 

Result ID Test Result Name Result LOINC Value
71038 Interpretation 60570-9
71039 Participated in the Interpretation No LOINC Needed
71040 Report electronically signed by 19139-5
71041 Addendum 35265-8
71042 Material Received 22633-2
71583 Disclaimer 62364-5
71789 Case Number 80398-1

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-Pathology Consultation Request (T246)

-Hematopathology/Cytogenetics Test Request (T726)

-Gastroenterology and Hepatology Client Test Request (T728)

-Benign Hematology Test Request (T755)

-Oncology Test Request (T729)