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Fine Needle Aspiration Cytology With Immediate Assessment

CPT 88172; 88173
Synonyms
  • Adrenals
  • Breast
  • Liver
  • Lung
  • Lymph Node
  • Pancreas
  • Salivary Gland
  • Soft Tissues
  • Thyroid

Test Details

Methodology

The fluid will be centrifuged, supernatant poured off, and diagnostic cells aspirated from the remaining material. Filters, monolayers, and/or cytospins will be made along with a cell block, if applicable. Microscopic examination is performed.

Result Turnaround Time

Within 1 day

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

Test Includes

Rapid Pap stain or Diff-Quick® on collected specimen for evaluation of adequacy of specimen. Determination of adequacy is done while the patient is undergoing the procedure. Allows clinician/radiologist to determine accuracy of sampling as well as determining if continued samplings are necessary.

Use

Diagnose primary or metastatic malignant neoplasms; differential diagnosis of benign versus malignant processes

Special Instructions

Include patient's name, date of birth, sex, Social Security number, previous malignancy, drug therapy, radiation therapy, and all other pertinent clinical information, including history of alcohol abuse, on the request form.

Laboratory personnel must be present for needle aspiration procedures under radiologic guidance if rendering of initial interpretation of quality of the specimen is desired. Call the cytology department manager for time arrangement. Twenty-four hour notification is preferred. Specify body site. Include pertinent clinical data on the request form (ie, age, history of carcinoma or infection, history of smoking, exposure to carcinogenic agents). A minimum of two samplings of the site is suggested.

Specimen Requirements

Specimen

Aspirated material

Container

Slides

Collection Instructions

Smears will be prepared by the cytotechnologist when present. Radiologist collects specimen. If technologist is not present follow this procedure for preparing slides.

• Fill Pap jar with 95% ethyl alcohol

• Using a graphite pencil, label slides with patient's last name and first initial.

• Localize mass.

• Disinfect area.

• Apply local anesthesia on/in area to be needled.

• Introduce needle into mass. Create negative pressure and maintain.

• Sample area vigorously on several planes, maintaining the negative pressure. Note: Sample may be only in barrel of needle not in syringe. If no specimen is seen in syringe it does not mean an adequate sample has not been obtained!

• Release the plunger of the syringe to equalize pressure.

• Withdraw the needle from the mass.

• Place bevel of needle directly on one of the glass slides (in approximately the center of the slide).

• Express one to two drops of material onto this glass slide.

Visible material expressed?

• Place the other glass slide on top of the first, and gently pull the slides apart − dispensing the material on the slides evenly.

Important!! Place the slides back to back, in the jar of fixative immediately!

No material expressed?

• Make a second attempt to express material on slide by first removing the needle from syringe. Pull back on syringe plunger, then place needle back onto syringe. Express one to two drops of material on the slide. If no material is expressed on the slide, rinse the barrel of the needle by aspirating saline into the barrel of the needle by aspirating saline into the syringe and expressing the saline wash into a clean container.

• Add an equal volume of Saccomanno fixative to this fluid.

• Attach the request form and transport the specimen to the laboratory.

Storage Instructions

Slides in 95% ethyl alcohol will maintain well at room temperature. Saline wash of needle with Saccomanno fixative added in equal volume will maintain well at room temperature. Saline wash without fixative must be refrigerated and transported to cytology as soon as possible.

Patient Preparation

To be determined by attending physician(s)

Causes for Rejection

Improper labeling; improper fixation; air-drying artifact; specimen submitted in vial that expired according to manufacturer's label; frozen specimen

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
009365 Needle Aspiration/Stereotactic 191131 Specimen type: 22633-2
009365 Needle Aspiration/Stereotactic 191153 Source: 22633-2
009365 Needle Aspiration/Stereotactic 191160 Clinician provided ICD9: 52797-8
009365 Needle Aspiration/Stereotactic 191174 Clinician provided ICD10: 52797-8
009365 Needle Aspiration/Stereotactic 191136 DIAGNOSIS: 33718-8
009365 Needle Aspiration/Stereotactic 191165 Recommendation: 22638-1
009365 Needle Aspiration/Stereotactic 191142 Comment: 22638-1
009365 Needle Aspiration/Stereotactic 191157 Pathologist provided ICD9: 52797-8
009365 Needle Aspiration/Stereotactic 191175 Pathologist provided ICD10: 52797-8
009365 Needle Aspiration/Stereotactic 191132 Clinical history: 22636-5
009365 Needle Aspiration/Stereotactic 191134 Amended report: N/A
009365 Needle Aspiration/Stereotactic 191135 Addendum: 22639-9
009365 Needle Aspiration/Stereotactic 191150 Diagnosis provided by: N/A
009365 Needle Aspiration/Stereotactic 191137 Signed out by: 19139-5
009365 Needle Aspiration/Stereotactic 191138 Performed by: N/A
009365 Needle Aspiration/Stereotactic 191133 Gross description: 22634-0
009365 Needle Aspiration/Stereotactic 191168 Microscopic description: 22635-7
009365 Needle Aspiration/Stereotactic 191143 Special procedure: N/A
009365 Needle Aspiration/Stereotactic 191179 Previous history: N/A
009365 Needle Aspiration/Stereotactic 191144 QA comment: N/A
009365 Needle Aspiration/Stereotactic 019018 . 11546-9
009365 Needle Aspiration/Stereotactic 000000 NonGyn CPT Code Automation N/A
009365 Needle Aspiration/Stereotactic 191167 Photomicrograph N/A
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191131
Result Code NameSpecimen type:
UofM
Result LOINC22633-2
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191153
Result Code NameSource:
UofM
Result LOINC22633-2
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191160
Result Code NameClinician provided ICD9:
UofM
Result LOINC52797-8
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191174
Result Code NameClinician provided ICD10:
UofM
Result LOINC52797-8
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191136
Result Code NameDIAGNOSIS:
UofM
Result LOINC33718-8
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191165
Result Code NameRecommendation:
UofM
Result LOINC22638-1
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191142
Result Code NameComment:
UofM
Result LOINC22638-1
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191157
Result Code NamePathologist provided ICD9:
UofM
Result LOINC52797-8
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191175
Result Code NamePathologist provided ICD10:
UofM
Result LOINC52797-8
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191132
Result Code NameClinical history:
UofM
Result LOINC22636-5
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191134
Result Code NameAmended report:
UofM
Result LOINCN/A
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191135
Result Code NameAddendum:
UofM
Result LOINC22639-9
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191150
Result Code NameDiagnosis provided by:
UofM
Result LOINCN/A
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191137
Result Code NameSigned out by:
UofM
Result LOINC19139-5
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191138
Result Code NamePerformed by:
UofM
Result LOINCN/A
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191133
Result Code NameGross description:
UofM
Result LOINC22634-0
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191168
Result Code NameMicroscopic description:
UofM
Result LOINC22635-7
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191143
Result Code NameSpecial procedure:
UofM
Result LOINCN/A
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191179
Result Code NamePrevious history:
UofM
Result LOINCN/A
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191144
Result Code NameQA comment:
UofM
Result LOINCN/A
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code019018
Result Code Name.
UofM
Result LOINC11546-9
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code000000
Result Code NameNonGyn CPT Code Automation
UofM
Result LOINCN/A
Order Code009365
Order Code NameNeedle Aspiration/Stereotactic
Order Loinc
Result Code191167
Result Code NamePhotomicrograph
UofM
Result LOINCN/A