2025
Blood Culture Collection: Procedure Change
August 4, 2025
Alverno Laboratories is instituting a procedure change for Blood Culture collection to align with Clinical and Laboratory Standards Institute (CLSI) recommendations regarding the timing of specimen collections for Blood Culture.
If more than one Blood Culture is ordered concurrently by the provider, please ensure that:
Both sets of Blood Cultures are drawn at the same time from two separate venipunctures performed at two different anatomical sites, using two separate needles.
Do NOT collect two sets of Blood Cultures from one venipuncture.
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July 2025 Test Bulletin
July 14, 2025
The July 2025 Alverno Laboratories Test Bulletin outlines several key updates. The Soft code for *Mycoplasma hominis/Ureaplasma* Culture has changed from URMHC to MHURC, with no alterations to specimen requirements. Multiple Quest Diagnostics tests have been discontinued and replaced with uncoded Quest referred alternatives, including those related to HLA-B 1502, Narcolepsy HLA-QDB1, and Oxalate testing. Additionally, due to a reagent discontinuation, Alverno will now refer all T3 Uptake testing to Quest Diagnostics, though specimen handling remains unchanged. Lastly, beginning July 21, 2025, Alverno will transition HPV PCR testing to the Abbott Alinity m platform, which will identify 14 high-risk HPV genotypes and provide enhanced differentiation for HPV16, HPV18, HPV45, and others, while maintaining current collection and transport procedures.
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July 2025 Test Bulletin
July 11, 2025
The July 2025 edition of the Alverno Laboratories Test Bulletin includes several important updates. The soft code for Mycoplasma hominis/Ureaplasma Culture has changed from URMHC to MHURC, effective June 30, 2025, with no changes to specimen type, source, or transport requirements. Several Quest Diagnostics tests have been discontinued, including HLA-B 1502, Narcolepsy HLA-QDB1, and Oxalate Serum/Plasma tests; replacements must now be ordered as UNCMS and include updated specimen collection guidelines.
T3 Uptake testing will now be permanently referred to Quest Diagnostics due to the manufacturer discontinuing the reagent. While the performing lab has changed, the Soft code, specimen type, and transport temperature remain the same.
Finally, Alverno Laboratories is transitioning HPV PCR testing to the Abbott Alinity m platform effective July 21, 2025. This new qualitative assay will differentiate HPV16, HPV18, and HPV45, and group additional high-risk genotypes into “Other A” and “Other B.” Specimen collection and transport procedures are unchanged.
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May 2025 Test Bulletin
May 12, 2025
Alverno Laboratories announces important updates effective May 2025. Beta-2 Transferrin body fluid testing is now available under Soft code BETT. Hepatitis C genotype testing will require a minimum concurrent viral load of ≥ 2,000 IU/mL starting May 19, 2025. Allergen panels that include Total IgE no longer require a separate IgE order. The Hepatitis Acute Panel (FRHEP) will be discontinued; providers should instead order HEPAC and HBSAB together. Additionally, HPV PCR testing will transition to the Abbott Alinity m platform in June 2025, enhancing genotype differentiation.
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April 2025 Test Bulletin
April 9, 2025
Alverno Laboratories has announced key test updates for April 2025. Quest Diagnostics has discontinued four tests—Adenovirus Antibody, Influenza A and B Antibodies, Influenza Type B Antibody, and the Myocarditis/Pericarditis Panel—with no alternatives available. Effective April 14, BK Virus and Epstein-Barr Virus PCR testing will change units from copies/mL to IU/mL, and specimen requirements will be updated. Complement, Total (CH50) frozen stability will decrease from 30 to 7 days. Yeast susceptibility testing will now be done in-house at Alverno, improving turnaround time to 48 hours. Starting April 21, Quest will no longer accept unpreserved specimens for CMV Rapid Culture; non-bone marrow samples must be collected in VCM.
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Q1 2025 Alverno Test Bulletin
March 6, 2025
Alverno Laboratories has announced several important updates in Q1 2025 concerning tests performed by Quest Diagnostics. Effective December 23, 2024, Myoglobin, Urine now requires specimens to be submitted in specialized myoglobin urine transport tubes, available through the Supply Request Form on AlvernoLabs.com. For Soluble Transferrin Receptor, plasma collected in EDTA (lavender-top) tubes is no longer accepted; instead, serum in SST tubes or plasma in sodium/lithium heparin (green-top) tubes should be used. Additionally, as of January 13, 2025, Quest Diagnostics will discontinue individual anti-fungal susceptibility tests for yeast, recommending a comprehensive yeast susceptibility panel as the alternative. In February 2025, further updates include the discontinuation of the Toxicology Urine Drug Testing (Quest 91359) in favor of Quest test 11877, a change in specimen requirements for Lead, Whole Blood to a 3 mL Royal Blue Trace Element K2 EDTA tube, and modifications to the Influenza A and B Culture, Rapid Method and Viral Respiratory, Rapid Culture with Reflex tests regarding ordering and specimen collection.
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March 2025 Test Bulletin
March 6, 2025
Alverno Laboratories has issued important updates in March 2025 regarding several tests. The BIOFIRE FILMARRAY Gastrointestinal Panel now shows an increased incidence of false positive Norovirus GI/GII results; providers should verify suspected cases using the Norovirus 1 & 2 PCR test. Additionally, the HIV-1 Viral Load by PCR test carries extended limitations for patients who have received gene therapies using HIV-1 based lentiviral vectors, and it should not be used for screening. The Legionella Antigen Urine test is now restricted to patients 21 years and older, and for Type & Screen Follow-Up Testing, patients with a positive antibody screen should be referred directly to their local hospital. Finally, online supply ordering will be available via the Client Community portal beginning in early March.
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Serum Nicotine Temporary Test Change
February 19, 2025
Effective immediately, Alverno Laboratories will temporarily refer all serum Nicotine testing to our
reference lab, Quest Diagnostics. Importantly, gold-top SST tubes are not acceptable. The Quest
test should be ordered using the UNCMS code. Please note the specimen and ordering changes
below.
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February 2025 Test Bulletin
January 30, 2025
Alverno Laboratories has issued important updates regarding several Quest Diagnostics tests, effective February 2025. The Toxicology Urine Drug Testing test (Quest 91359) has been discontinued as of January 6, 2025, with Quest test 11877 serving as its recommended replacement. Similarly, the Lead, Whole Blood testing process has been updated due to the discontinuation of tan top EDTA tubes, now requiring a 3 mL Royal Blue Trace Element K2 EDTA tube. Additionally, the Influenza A and B Culture, Rapid Method test is no longer interfaced with Alverno Laboratories’ SoftLab LIS and must be ordered as "UNCMS." Lastly, specimen requirements have changed for the Viral Respiratory, Rapid Culture with Reflex test—only samples collected in an approved viral transport medium will be accepted. Providers are encouraged to review these changes to ensure proper testing procedures and specimen handling.
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January 2025 Test Bulletin
January 9, 2025
In January 2025, Alverno Laboratories announced important updates regarding specimen requirements and testing procedures by Quest Diagnostics. For Myoglobin, Urine, effective December 23, 2024, specimens must now be submitted in specialized myoglobin urine transport tubes, available through the Supply Request Form on AlvernoLabs.com. For Soluble Transferrin Receptor, plasma collected in EDTA (lavender-top) tubes will no longer be accepted; instead, serum in SST tubes or plasma in sodium/lithium heparin (green-top) tubes must be used. Additionally, as of January 13, 2025, Quest Diagnostics will discontinue individual anti-fungal susceptibility tests for yeast, recommending a comprehensive yeast susceptibility panel as the alternative. For more details, including test codes and ordering information, visit AlvernoLabs.com.
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2024
Q4 2024 Alverno Test Bulletin
December 10, 2024
In Q4 2024, Alverno Laboratories announced several important updates. They validated new CLSI tobramycin MIC breakpoints for Pseudomonas aeruginosa, which will be implemented using Etest MIC methodology upon request, and Quest Diagnostics discontinued Listeria Antibody by Complement Fixation testing with no replacement offered. Additional changes include a newly available urine drug monitoring test for novel psychoactive substances, a plastic alternative for AFB collection bottles, a new cystic fibrosis sputum culture, the reactivation of certain Streptococcus pneumoniae antibody tests, an updated thyroglobulin assay addressing biotin interference, and the upcoming implementation of 2025 CPT code revisions. These developments may affect diagnostic workflows, test ordering, and patient care strategies at healthcare facilities.
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December 2024 Test Bulletin
December 10, 2024
In December 2024, Alverno Laboratories announced several important updates. They include the introduction of a new Quest Diagnostics urine drug monitoring test featuring additional novel psychoactive substances, the availability of a plastic collection bottle option for AFB cultures, and the launch of a new cystic fibrosis sputum culture. In addition, select Streptococcus pneumoniae antibody tests have been reactivated, a new assay formulation has remediated biotin interference in thyroglobulin testing, and 2025 CPT code changes will be implemented as of January 1, 2025. These developments may affect diagnostic workflows and ordering practices at healthcare facilities.
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October 2024 Test Bulletin
October 2, 2024
In October 2024, Alverno Laboratories announced two important updates. First, they are validating new CLSI tobramycin MIC breakpoints for Pseudomonas aeruginosa, which lower the susceptibility thresholds. This change will be implemented using Etest MIC methodology upon request. Second, effective November 14, 2024, Quest Diagnostics will discontinue the Listeria Antibody by Complement Fixation test, with no replacement offering available. These updates may impact diagnostic procedures in healthcare practices.
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Q3 2024 Test Bulletin
September 17, 2024
This document from Alverno Laboratories outlines several key updates for healthcare providers in Q3 2024. Changes include the discontinuation of two COVID antibody tests by Quest Diagnostics effective July 15, 2024, with new replacement tests provided. Specimen requirements for certain tests have been updated, such as the Microsporidia exam and Borrelia species by RT-PCR, which now have specific acceptable specimens. Alverno has introduced standardized procedures for creatinine clearance and 24-hour urine testing, while clarifying that manual differentials and pathology reviews are rarely necessary. For HPV rectal testing, the orderable test HPVRE replaces HPVAR, though HPVAR will auto-reflex if HPVRE is positive. Additional updates include in-house testing for bile acids to screen for obstetric cholestasis, discontinuation of duplicate test codes for fecal cultures, and changes to testing for Herpes Simplex Virus by PCR and Fetal Fibronectin. Further details on each update, including specimen requirements and methodology, are provided within the document.
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September 2024 Test Bulletin
September 17, 2024
This document from Alverno Laboratories provides key updates on laboratory testing procedures for healthcare providers. Effective August 26, 2024, Quest Diagnostics will no longer accept serum specimens for amylase isoenzyme testing, now requiring plasma collected in lithium heparin tubes. Alverno also announces a change in rectal HPV molecular testing, replacing the current test (HPVAR) with a more comprehensive one (HPVRE), with an automatic reflex to HPVAR if HPVRE is positive. Additionally, the document clarifies bile acid testing options, offering three distinct tests for various clinical scenarios, including a specific screening for pregnant women at risk of obstetric cholestasis.
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August 2024 Test Bulletin
August 13, 2024
The August 2024 Test Bulletin from Alverno Laboratories includes several updates to testing procedures with emphasis that manual differentials and pathology reviews for peripheral blood smears are rarely necessary, as the standard CBC process is sufficient in most cases. A duplicate test code for fecal culture will be discontinued on August 30, 2024.
The lab will also enhance the rectal HPV molecular testing to provide a more comprehensive assessment, with the new test code HPVRE replacing HPVAR. Additionally, Quest Diagnostics will offer in-house testing for Bile Acids, Total (Enzymatic), improving turnaround times.
Lastly, Quest has discontinued Fetal Fibronectin testing, prompting clinics to refer patients to designated hospitals for this service.
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July 2024 Test Bulletin
July 7, 2024
The July 2024 Test Bulletin from Alverno Laboratories includes several significant updates to testing protocols that are crucial for healthcare providers:
COVID Antibody Testing Updates: Effective July 15, 2024, Quest Diagnostics will discontinue two COVID antibody tests. Replacement tests with updated codes and specifications have been introduced, ensuring continued support for COVID-19 diagnostics with enhanced accuracy and reliability.
Microsporidia Exam Specification Changes: Starting July 22, 2024, Quest will restrict specimen types acceptable for microsporidia exams to stool and duodenal aspirates only, excluding urine, CSF, bronchoalveolar lavage, or corneal scrapings. This change aims to improve diagnostic precision for microsporidia infections.
Borrelia Species Testing Modification: Effective July 29, 2024, the specimen requirements for qualitative assessment of Borrelia species by RT-PCR will change. Whole blood collected in ACD (yellow-top) tubes will no longer be accepted, with EDTA (lavender-top) tubes, synovial fluid, or CSF in sterile containers recommended instead.
Pre-Analytical Test Information for Creatinine Clearance and 24h Urine Testing: Detailed instructions have been provided to ensure accurate entry of pre-analytical variables for creatinine clearance and 24-hour urine tests. This update emphasizes the need for precision in test ordering to avoid incorrect results.
These updates are part of Alverno Laboratories' ongoing efforts to enhance test accuracy, streamline processes, and adapt to evolving medical standards.
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June 2024 Test Bulletin
June 5, 2024
The June 2024 Test Bulletin from Alverno Laboratories includes several important updates. Quest will discontinue Streptococcus pneumoniae Antibody IgG tests for 12, 14, and 23 serotypes, as well as the Myoglobin, Urine test, effective May 28, 2024. Detailed information on the replacements is available on page 2.
Additionally, guidelines for collecting STI specimens to minimize PCR reaction inhibitors are outlined on page 3. For Vitamin B1 (thiamine) testing, two distinct tests are offered with specific specimen requirements, both needing protection from light. Details are on page 4.
Effective July 1, 2024, Herpes Simplex Virus (HSV) IgM antibody testing will be discontinued in accordance with CDC recommendations. Further information is provided on page 5.
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May 2024 Test Bulletin
May 13, 2024
The May 2024 Test Bulletin from Alverno Laboratories includes several important updates. The Extended Urine Drug Confirmation Panel has been updated, and detailed information is available on page 2. Alverno Laboratories is also excited to announce the launch of a new and improved website designed for ease of use and navigation, with features like a 'fast topic' menu, a 'super' menu dropdown for healthcare professionals, and an emergency alert section.
Additionally, a new test for Prion Disease, 14-3-3 Protein, CSF, is now available in Soft Lab and Atlas LIS systems. At the same time, certain COVID-related tests will be discontinued, replaced by more specific tests for SARS-CoV-2 antibodies. There is also an update to the reference range for Methylmalonic Acid testing effective June 24, 2024, and changes to acceptable specimen types for several tests, ensuring greater flexibility and accuracy in diagnostic procedures.
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April 2024 Test Bulletin
April 5, 2024
We have introduced new tests such as the Encephalitis Antibody Panel and the Comprehensive Chronic Urticaria Panel, while discontinuing certain offerings like the Fetal Fibronectin test, directing clinicians to local hospital resources instead. Additionally, updates include the transition of molecular testing for STIs to new platforms and the discontinuation of the JAK2 V617F Cascading Reflex test, replaced by a more comprehensive myeloproliferative neoplasms diagnostic panel.
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2023
Midazolam & Doxepin Metabolite Reporting Immediate Update 12/12/2023
December 12, 2023
In December 2023, Alverno Laboratories announced the suspension of reporting quantitative values for alphahydroxymidazolam and desmethyldoxepin due to a technical issue with the assay. While the vendor works to resolve this, only qualitative reporting will be available. Despite this change, samples from patients taking Midazolam or Doxepin as prescribed will still be interpreted as "consistent." Healthcare providers with questions or concerns are encouraged to contact Alverno Central Laboratory for assistance from their Toxicologist.
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December 2023 Test Bulletin
November 29, 2023
In December 2023, Alverno Laboratories announced significant updates: they're transitioning fecal occult blood analysis to the Polymedco OC-Auto® SENSOR io, an automated analyzer endorsed by USPSTF and ACG for its effectiveness in colorectal cancer screening. They emphasized the importance of using acid-washed metal-free containers for accurate urine heavy metal assays, with specific collection devices required for different tests. Additionally, starting January 2024, Alverno will discontinue offering certain COVID-19 PCR tests and refer COVID-19 Anti-Nucleocapsid IgG testing to Quest Diagnostics, with interim ordering procedures in place.
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September 2023 Test Bulletin
September 18, 2023
In September 2023, updates were made to several testing protocols. For HIV 1&2 Antibody/Antigen Screening, 5th generation, a full 7 mL, gold-top SST tube is now required for testing. Quest Diagnostics discontinued Complement C5 testing, effective August 14, 2023, with replacement assays to be ordered using the Uncoded Miscellaneous test code. Additionally, the room temperature stability for Androstenedione testing was shortened from 14 days to 72 hours, effective September 25, 2023. Moreover, Alverno Laboratories will now conduct molecular PCR testing for M. tuberculosis and rifampin resistance in-house using the Cepheid GeneXpert, aiming to improve turnaround time for positive acid-fast smear staining specimens.
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October 2023 Test Bulletin
September 11, 2023
In September 2023, the Extensive Urine Drug Confirmation Panel updated its reporting approach for Noroxymorphone in the presence of protein interferences, now reporting qualitatively when quantitation is hindered. Additionally, Quest Diagnostics discontinued the NK Cells, LGLs (CD57) test in October 2023, with the recommended replacement being the Lyme Antibodies IgG & IgM assay. These changes aim to maintain accuracy and reliability in patient testing.
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August 2023 Test Bulletin
August 15, 2023
The August 2023 test bulletin provides updates on various testing protocols. Notably, Quest Diagnostics will no longer accept Sodium Heparin tan-top tubes for Zinc Protoporphyrin (ZPP) testing, while tan-top EDTA tubes remain acceptable. Additionally, SRP Autoantibodies testing will be discontinued by Quest, with replacement assays ordered using the Uncoded Miscellaneous test code. Alverno Laboratories has ceased accepting plasma specimens for qualitative CMV measurement by PCR and requests switching to pierceable caps for respiratory virus testing. Lastly, there's a transition to Quest Diagnostics for non-respiratory viral culture testing, with detailed instructions on acceptable specimen types and alternative tests provided.
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July 2023 Test Bulletin
July 13, 2023
The July 2023 test bulletin highlights several updates in testing procedures and specimen requirements. Alverno Laboratories has started performing the urea breath test, BreathID® IDkit Hp® Two, in their Microbiology Department. Quest Diagnostics has discontinued several tests, including PETWB, EAPCS, HSVIF, TORAP, and DPDMA, with replacement assays ordered using the Uncoded Miscellaneous test code. Alverno Laboratories has resumed in-house nicotine testing, now accepting gold-top SST samples again, and has updated specimen requirements for Zinc Protoporphyrin (ZPP) testing. Additionally, there are updates on chromosomal analysis for hematological malignancies, TSH receptor antibody testing, and E. coli O157 testing methods.
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June 2023 Test Bulletin
June 22, 2023
The June 2023 test bulletin brings several updates. Alverno Laboratories has revised their Precision Medicine and Hematopathology forms on their website. UroVysion FISH testing will now be outsourced to Quest Diagnostics. Quantitative PCR measurements for CMV will transition to the Abbott Alinity m platform. Omadacycline susceptibility testing is now available. Additionally, E. coli O157 microbiological culture identification will be discontinued in favor of Shiga toxin detection methods. Prenatal testing submissions to Quest Diagnostics require the Maternal Screening Form. Lastly, there are changes in specimen requirements for Non-Respiratory Viral Culture testing sent to Quest Diagnostics.
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May 2023 Test Bulletin
May 4, 2023
Starting May 17, 2023, Alverno Laboratories will switch to Quest Laboratories for reference testing, leading to changes in specimen requirements and testing methodologies. Notably, for HITRS testing, both frozen plasma from a sodium citrate blue-top tube and frozen serum, denoted before submission, are necessary. Additionally, serum nicotine testing will be temporarily referred to the reference lab. The updated Collection Manual provides detailed information on these changes, including altered specimen types, transport temperatures, and reference ranges.
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March 2023 Test Bulletin
April 4, 2023
Alverno Laboratories recently issued a bulletin outlining three significant updates. First, effective immediately, changes have been made to the specimen requirements for quantitative EBV and BK Virus testing, detailed on page 2 of the bulletin. Second, the BreathTek® UBT for H. pylori test is being replaced by the BreathID® IDkit Hp® One test, with associated changes in collection kit and test codes, as of April 3, 2023, described on page 3. Lastly, starting April 29, 2023, Alverno Laboratories will transition molecular testing for several causative agents of Sexually Transmitted Infections (STIs) to the Abbott Alinity m instruments. The bulletin provides instructions for updating EMRs and ordering new kits on pages 4-5, emphasizing the need for healthcare providers to adhere to these changes for accurate testing procedures.
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April 2023 Test Bulletin
April 4, 2023
Alverno Laboratories has updated critical alert values for testing performed at their Central Lab, with details provided on pages 2-4 of their communication. They will transition to an updated version of their SOFT Laboratory Information System on April 29, 2023, along with adopting Atlas as the main middleware for communication with client EMRs, resulting in potential changes in report formatting (detailed on page 5). Effective the same date, Alverno Laboratories will switch to Quest Laboratories for reference testing, leading to changes in specimen types, transport temperatures, and testing methodologies, outlined on pages 6-18. It's advised to consult the Alverno Collection Manual for comprehensive information.
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2022
December 2022 Test Bulletin
December 14, 2022
The bulletin from Alverno Laboratories informs healthcare providers of two important updates. Firstly, there's a THC Drug Confirmation/Quantitation Reporting Range Update effective December 2022, which increases the reporting range for Marijuana Metabolite (THC) from 200 ng/mL to 10,000 ng/mL. Secondly, there's an update regarding STI by PCR Test Code & Collection Guidelines effective February 4, 2023. Alverno Laboratories will transition molecular testing for several causative agents of Sexually Transmitted Infections (STIs) to the Abbott Alinity m instruments, enabling the detection and differentiation of up to 3 STIs in one sample. The bulletin includes timelines for these changes and provides detailed instructions on specimen collection and processing guidelines, ensuring healthcare providers are well-informed.
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November 2022 Test Bulletin
November 15, 2022
The bulletin from Alverno Laboratories contains three important updates for healthcare providers. Firstly, effective November 2, 2022, deamidated gliadin and tissue transglutaminase testing will be performed using a new chemiluminescent methodology, maintaining the reference cutoff for negative results at <20 Units. Secondly, there's a notice regarding the "Preventing Harm Test Code," emphasizing the clinician's responsibility in determining the release of lab results in compliance with applicable laws, with Alverno not responsible for such determinations. Finally, starting January 1, 2023, the Internet Explorer browser will no longer be supported for clients using the electronic system on the Alverno website, urging them to switch to supported browsers like Google Chrome or Microsoft Edge to ensure add-on testing requests are received and processed.
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September 2022 Test Bulletin
September 8, 2022
The bulletin from Alverno Laboratories contains two important updates for healthcare providers. Firstly, effective August 2022, Alverno Central Lab will discontinue performing blood bank antibody identification and antibody titer testing. Any positive blood bank antibody screens will be accompanied by a comment advising follow-up testing at the local hospital for further identification and necessary testing. Secondly, effective September 27, 2022, HCV Genotyping testing will no longer be performed in-house and will instead be sent to ARUP Laboratories. Healthcare providers should use the new order, UNCMS – Uncoded ARUP Referred, for this testing, and the current test code, HCVGP, will be inactivated. Further ordering details are provided in the bulletin.
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August 2022 Test Bulletin
August 16, 2022
The latest bulletin from Alverno Laboratories brings two significant updates for healthcare providers. First, as of August 2022, Alverno Central Lab will discontinue performing antibody identification and antibody titer testing. Any positive antibody screens will be accompanied by a comment advising follow-up testing at the local hospital, especially for prenatal cases. Secondly, effective August 23, 2022, testing for suspected cases of monkeypox can now be directly ordered. Quest Diagnostics will conduct the testing via a Qualitative Real-Time PCR assay capable of detecting both non-variola Orthopoxviruses and the monkeypox virus. Detailed test ordering information, including specimen requirements and stability, is provided for healthcare providers' reference.
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June 2022 Test Bulletin
June 7, 2022
In a recent bulletin, Alverno Laboratories issued several updates for healthcare providers. They have transitioned viral load testing to the Alinity m instruments, discontinuing several test codes and introducing new quantitative viral load test codes along with specimen collection guidelines. Additionally, they suspended quantitative reporting for N-desmethyltramadol due to jurisdiction changes, seeking special licensing, and will now only provide qualitative reporting during this period. The reference ranges for Anti-Streptolysin-O have been updated, especially for patients aged up to 2 years and from 3 years to adult. Furthermore, reporting of cell counts for broncho-alveolar lavage (BAL) specimens will cease, while lead critical values for pediatric lead testing will be updated to ≥ 3.5 ug/dL for children aged 0 to 15 years, aligning with CDC guidelines. These updates offer crucial information for healthcare providers regarding changes in testing procedures, reporting standards, and reference ranges at Alverno Laboratories.
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June 2022 Test Bulletin
June 7, 2022
In a recent bulletin, Alverno Laboratories issued several updates for healthcare providers. They have transitioned viral load testing to the Alinity m instruments, discontinuing several test codes and introducing new quantitative viral load test codes along with specimen collection guidelines. Additionally, they suspended quantitative reporting for N-desmethyltramadol due to jurisdiction changes, seeking special licensing, and will now only provide qualitative reporting during this period. The reference ranges for Anti-Streptolysin-O have been updated, especially for patients aged up to 2 years and from 3 years to adult. Furthermore, reporting of cell counts for broncho-alveolar lavage (BAL) specimens will cease, while lead critical values for pediatric lead testing will be updated to ≥ 3.5 ug/dL for children aged 0 to 15 years, aligning with CDC guidelines. These updates offer crucial information for healthcare providers regarding changes in testing procedures, reporting standards, and reference ranges at Alverno Laboratories.
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May 2022 Test Bulletin
May 12, 2022
In their recent bulletin, Alverno Laboratories provided updates relevant to healthcare providers. They outlined a Hepatitis C testing algorithm covering diagnosis and monitoring, where initial screening involves antibody testing, with reactive or equivocal results automatically confirmed via PCR assay. Additionally, they introduced a new testing algorithm for hospital inpatients with gastrointestinal symptoms, involving reflex testing for Clostridium difficile toxin A/B if detected on the BioFire® FilmArray® Gastrointestinal Panel. The bulletin offers guidance on test ordering to streamline the diagnostic process and ensure appropriate testing based on clinical indications.
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April 2022 Test Bulletin
April 8, 2022
In their recent bulletin, Alverno Laboratories provided updates pertinent to healthcare providers. They implemented new FDA/CLSI MIC breakpoints for Piperacillin-Tazobactam (P/T) regarding Pseudomonas aeruginosa, enhancing precision in interpretation. Additionally, they introduced rapid PCR testing for positive blood cultures, utilizing the GenMark ePlex assay to expedite organism identification and resistance marker detection. These advancements aim to improve turnaround times and streamline diagnostic processes for better patient care. Furthermore, Alverno Laboratories announced a standardization effort for CBC test builds, discontinuing several test codes to enhance workflow efficiency. These updates reflect a commitment to providing high-quality laboratory services and staying at the forefront of diagnostic technologies.
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February 2022 Test Bulletin
February 10, 2022
In this bulletin, Alverno Laboratories provided several updates for healthcare providers. Firstly, they postponed the implementation of the Extensive Urine Drug Confirmation Panel to February 23, 2022, discontinuing the Pain Management Panel and introducing a more comprehensive replacement. Secondly, effective April 5, 2022, they updated the calculation of estimated glomerular filtration rate (eGFR) to the new CKD-EPI 2021 equation, removing the race coefficient to improve accuracy and avoid potential biases. Additionally, they emphasized the availability of weekly data on respiratory pathogen positivity trends on their website, collected from multi-target assays. These updates aim to enhance diagnostic precision, streamline testing processes, and provide valuable insights for patient care.
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January 2022 Test Bulletin
January 14, 2022
In this bulletin, Alverno Laboratories provided important updates for healthcare providers. Firstly, they highlighted the potential for false reactive results on the RPR non-Treponemal Syphilis screen within 5 months of mRNA COVID-19 vaccination, advising careful interpretation in conjunction with patient history and risk factors. They also outlined two testing algorithms for Syphilis screening: the traditional RPR first approach and the reverse Treponemal antibody first strategy, with confirmatory testing following the initial screen assay. Secondly, they noted a correction regarding the postponement of updates for CBC pediatric ranges and manual differential reference range to April 2022, previously mentioned in a client bulletin. These updates aim to ensure accurate testing and interpretation, particularly in light of evolving clinical contexts.
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2021
December 2021 Test Bulletin
December 15, 2021
Alverno Laboratories has issued important updates for healthcare providers. Firstly, tissue culture processing protocols have changed, with E-swabs no longer accepted for solid tissue specimens due to processing limitations; instead, tissue cultures must be sent in sterile containers with saline. Secondly, there are updated CBC reference ranges for pediatric patients, categorized by age and gender. Lastly, Alverno is replacing the Pain Management Panel with a more extensive Extensive Urine Drug Confirmation Panel, offering lower reporting limits and additional analytes tested via Liquid Chromatography Mass Spectrometry, useful for both pain management and behavioral health analysis. These updates aim to improve testing accuracy and provide comprehensive information for patient care.
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November 2021 Test Bulletin
November 5, 2021
Alverno Laboratories issued important updates for healthcare providers, including a transition of Cystic Fibrosis genetic testing to ARUP due to a vendor discontinuation, Streptococcus pneumoniae MIC breakpoints for Tetracycline aligned with FDA/CLSI standards, a C-peptide reference range update reflecting a new platform, and a protocol change for Thyroglobulin testing, now screening for antibodies and using LC-MS/MS technology. Additionally, quantitative viral load testing for Hepatitis B, Hepatitis C, and HIV will shift to Abbott Alinity m instrumentation, IgE allergen reporting will include a new "0/1" class, and PFA analysis reference ranges for Collagen Epinephrine and Collagen ADP assays have been updated. Each update aims to enhance testing accuracy and patient care.
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September 2021 Test Bulletin
September 16, 2021
Alverno Laboratories issued several updates for healthcare providers, including ARUP's consolidation of HIV genotyping and resistance testing into a single Next Generation Sequencing assay, the introduction of the BioFire FilmArray Meningitis/Encephalitis Panel for rapid detection of multiple pathogens in cerebrospinal fluid, and the implementation of a Respiratory Multiplex Panel on the Abbott Alinity m analyzer for simultaneous testing of COVID-19, Influenza A and B, and Respiratory Syncytial Virus. Additionally, Alverno launched an automated Client Community for convenient electronic submission of add-on testing requests. Each update aims to enhance diagnostic capabilities and streamline processes for improved patient care.
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August 2021 Test Bulletin
August 9, 2021
Alverno Laboratories issued updates relevant to healthcare providers, including an NT proBNP assay update for monitoring congestive heart failure patients taking Entresto®, reflecting variations in values and emphasizing clinical correlation, a reflexive lung cancer panel replacing the current ARUP Lung Cancer with KRAS, now including reflex testing to ALK and ROS1 if EGFR and KRAS testing show wildtype status, and an update to Drugs of Abuse panels, lowering the Opiates assay cutoff level to 300ng/mL for improved clinical testing suitability. These updates aim to enhance diagnostic accuracy and clinical utility, ensuring optimal patient care.
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July 2021 Test Bulletin
July 8, 2021
Alverno Laboratories has made updates regarding Prostate Health Index (PHI) testing, now sending all samples to ARUP Laboratories, with testing protocols remaining unchanged but requiring serum specimens to be separated and frozen prior to submission. Additionally, Alverno Laboratories is updating its LCMS drug confirmation testing to provide lower levels of detection and detect additional analytes, improving diagnostic accuracy. These updates aim to enhance testing efficiency and accuracy, ensuring optimal patient care.
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May 2021 Test Bulletin
May 18, 2021
Alverno Laboratories is expanding malaria testing options to include a rapid antigen screen with smear confirmation, providing quicker initial screening results within 24 hours and confirming results with a smear test. In cases of discordant results, samples will be sent to ARUP for PCR detection and speciation. Additionally, Alverno Laboratories has received notification of potential interference affecting estradiol results due to estradiol supplements, with impacted results from October 22, 2019, to April 2021. Clinicians are advised not to use these results to monitor the effectiveness of estradiol supplements and to consider the patient's total clinical presentation when interpreting results, with alternate tests recommended if necessary.
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March 2021 Test Bulletin
March 8, 2021
Alverno Laboratories has updated the naming conventions for COVID antibody detection assays to provide clarity, incorporating the target of the antibody (nucleocapsid or spike) and the test utility (post-vaccination, infection) in addition to the class (IgG or IgM). Additionally, the Molecular Biology Department will introduce viral Hepatitis C Genotyping to the Central Lab, recommended following confirmation of an active infection using the quantitative viral load assay to guide therapy decisions. The Positive Blood Culture Reporting process is being updated to include listing the isolate for all positive blood cultures along with organisms observed in the gram stain, improving abnormal flagging capabilities.
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February 2021 Test Bulletin
February 5, 2021
Alverno Laboratories has made significant updates and announcements affecting practice, including a potassium reference range update to accommodate serum and plasma sample collections, the introduction of a specialized hepatitis panel for immunosuppressive therapy candidates and recipients, and awareness of coagulation therapy effects on aPTT assays, particularly with the influence of emicizumab and other therapeutics. Additionally, the Microbiology Department is adopting new MIC breakpoints for Meropenem, Daptomycin, Aztreonam, and Cephalosporins, alongside automated yeast susceptibility testing for Candida species, aimed at reducing turnaround time by 24 hours. These changes are crucial for ensuring accurate testing and appropriate patient management.
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2020
December 2020 Test Bulletin
February 5, 2021
Alverno Laboratories has announced changes regarding prenatal risk assessment testing, specifically QUAD screens and Maternal Serum AFP, effective January 4, 2021. These tests will now be sent to ARUP Laboratories due to the need for robust statistical data that Alverno Laboratories cannot sustain independently. To ensure accurate analysis, detailed patient history information is required, and a Prenatal Risk Assessment Form is provided on page 2 of the document and available on the Alverno website under the "Provider Forms" tab. It's emphasized that all questions on the form must be answered for timely and accurate risk analysis, as unanswered questions will cause testing delays.
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November 2020 Test Bulletin
November 6, 2020
We're updating our COVID-19 testing services. Now, we offer COVID-19 IgM antibody testing, indicating exposure to the virus. However, early specimen collection may yield false negatives, and IgM status shouldn't determine infectiousness. Additionally, we're soon introducing an RT-PCR mini-respiratory panel detecting COVID-19, Influenza A/B, and RSV, aiding rapid differentiation due to their similar symptoms. See page 2 for details on specimen requirements and stability guidelines. Thank you.
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September 2020 Test Bulletin
September 11, 2020
Alverno Laboratories has introduced new Antinuclear Antibody testing panels and updated report formatting, offering two methodologies: Multiplex Flow Immunoassay or Immunofluorescence Assay, with ANA testing intended for diagnostic use only. They've also changed the urine culture organism identification protocol, no longer differentiating E. coli from Shigella species in urinary isolates unless clinically indicated, aligning with CAP recommendations. Additionally, they now require plasma only for BTNP specimens due to analyte stability concerns and have discontinued accepting whole blood specimens. Moreover, effective October 1, 2020, Alverno has ceased offering a printable order form for supply ordering on their website, transitioning to the use of the online order form exclusively.
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August 2020 Test Bulletin
August 1, 2020
The recent updates from Alverno Laboratories include discontinuation of the Vaginal Panel by PCR due to a national reagent shortage, with a recommendation to replace it with the Vaginitis DNA Probe Panel. There's also a change in collection device between the two tests, requiring samples to be collected using the BD Affirm collection kit instead of the BD Max collection kit, as samples sent in the latter will be rejected. Additionally, there's an update on the reflex criteria for urine culture testing, which now includes positive Leukoesterase indications and/or positive Nitrite indications with a WBC count >10, effective August 4, 2020.
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May 2020 Test Bulletin
May 8, 2020
Alverno Laboratories presents two significant updates: the addition of qualitative COVID-19 IgG antibody testing conducted by ARUP Laboratories and an update to its pain management panel, now comprising 78 different drugs and metabolites. The COVID-19 IgG antibody test can detect antibodies typically present around two weeks post-symptom onset, aiding in indicating exposure to SARS-CoV2; however, it does not establish definitive immunity. Alverno now performs Fentanyl and Buprenorphine screenings in-house, with reflex quantitation if positive, offering faster turnaround times. The pain management panel, effective since May 5, 2020, requires a urine sample and includes a comprehensive list of drugs and metabolites, with results available within a day after sample receipt. More information on specimen requirements and testing availability can be found on Alverno's website or by contacting Client Services.
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March 2020 Test Bulletin
March 13, 2020
Alverno Laboratories provides essential updates on COVID-19 testing and pain management panel procedures. They offer COVID-19 testing through LabCorp for faster results, adhering to CDC guidelines for patient selection. Additionally, the Pain Management Panel, effective April 21, 2020, will be conducted in-house, enhancing turnaround times and comprehensiveness. Alverno emphasizes compliance with Medicare regulations, issuing an annual physician compliance letter outlining diagnostic documentation requirements for Medicare reimbursement. Physicians are urged to ensure proper documentation to avoid billing issues and to utilize internet-based PECOS for Medicare enrollment. For inquiries, contact Alverno's Compliance Manager or Billing Services.
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January 2020 Test Bulletin
January 29, 2020
Alverno Laboratories introduces significant updates in February 2020, including the consolidation of Drug of Abuse screening panels, resuming Lupus Anticoagulant Reflexive Panel testing, and offering an additional Anti-Phospholipid Syndrome Panel. Moreover, the Pain Management Panel testing transitions in-house, enhancing turnaround time and comprehensiveness. The Drug Screen Panel Updates feature consolidated panels with or without confirmation, with propoxyphene available as an individual screening test if needed. Additionally, the Lupus Anticoagulant and Anti-Phospholipid Syndrome Panels emphasize adherence to CLSI guidelines, incorporating prescreening tests and mixing studies. Lastly, the Pain Management Panel Update outlines comprehensive analytes and cutoffs, with improved specimen validity evaluation and a revised report template for enhanced usability.
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2019
December 2019 Test Bulletin
December 20, 2019
Alverno Laboratories has updated the Anion Gap reference range based on recent wellness patient data, effective January 7, 2019. Additionally, they extend warm holiday wishes for a happy and healthy season to healthcare providers.
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November 2019 Test Bulletin
November 13, 2019
Alverno Laboratories introduces in-house Anti-Mullerian Hormone testing, providing a faster turnaround time for assessing reproductive health in women. This hormone's levels diminish with age, reflecting the decline in ovarian reserve, and can aid in fertility evaluations and predicting menopause onset. Additionally, starting December 1, 2019, ARUP, the reference laboratory, mandates trace element specimens like aluminum and zinc be transported in certified metals-free tubes to maintain accuracy, emphasizing meticulous handling and processing protocols to prevent contamination.
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September 2019 Test Bulletin
September 12, 2019
Alverno Laboratories announces updates regarding Lupus Anticoagulant Testing, redirecting all testing to ARUP Laboratories as of September 5, 2019. The new Lupus Anticoagulant Reflexive Panel by ARUP employs ISTH criteria, including prescreening tests and mixing studies, enhancing the detection of various inhibitors affecting coagulation. Additionally, starting September 18, 2019, Alverno will adopt revised critical values for lead testing in compliance with CDC guidelines and OSHA Lead Standards, ensuring adherence to updated medical management recommendations for lead exposure.
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August 2019 Test Bulletin
August 7, 2019
Alverno Laboratories introduces the Prostate Health Index (PHI) calculation, enhancing prostate cancer detection during Prostate Health month. The PHI calculation, incorporating PSA, free PSA, and p2PSA values, offers improved specificity, reducing unnecessary biopsies. Additionally, Alverno addresses Biotin interference in immunoassays, providing insights into affected assays and FDA recommendations for healthcare providers to mitigate potential errors.
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June/July 2019 Test Bulletin
July 1, 2019
Alverno Laboratories announces updates to Group A Strep and blood lead testing, aiming to enhance turnaround times. Additionally, PCR methodology is introduced for pre-surgical Staph. aureus screening, aiding in infection control measures and reducing surgical site infection risks.
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April 2019 Test Bulletin
April 11, 2019
Cigna has implemented a billing policy change effective May 18, 2019, requiring the entity performing lab services to bill for them directly. Alverno Laboratories announces updates to its Thyroid Cascade and Heparin-Induced Thrombocytopenia (HIT) antibody testing procedures, aiming to enhance diagnostic accuracy and efficiency.
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March 2019 Test Bulletin
March 18, 2019
The collection process for Group A Streptococcus specimens has been standardized with the implementation of Copan dual swabs, allowing for one-time collection for both rapid testing and reflex culture. Alverno Laboratories introduces a platform switch for Heparin-Induced Thrombocytopenia (HIT) antibody testing, aiming to enhance on-demand testing capability with qualitative reporting and optional confirmation testing.
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February 2019 Test Bulletin
February 18, 2019
The January C. difficile test algorithm bulletin corrected the CPT codes for the rapid EIA assay to 87324 and 87449. Additionally, due to a manufacturing backorder, the go-live date for the NT proBNP assay at the Central Laboratory has been postponed to February 26, 2019. Furthermore, the utilization guidelines for the Solid Tumor Panel Next Generation Sequencing were outlined, indicating its clinical use in detecting targeted somatic mutations for prognosis and treatment of solid tumors, with specimen requirements including formalin-fixed paraffin-embedded tissue. Finally, a specimen update for HIV-1 RNA Quantitative Viral Load testing emphasized the discontinuation of accepting Pearl Top Tubes and the necessity of collecting EDTA Plasma for accurate results.
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January 2019 Test Bulletin
January 17, 2019
Effective January 21, 2019, the Soft code for the PSA Screening test has changed to PSAS to distinguish it from the Free PSA test. Alverno Laboratories has undergone a name change to Alverno Laboratories, aiming for easier recognition. Additionally, starting January 3, 2019, a two-step algorithm for C. difficile testing will be adopted, following 2018 IDSA and SHEA guidelines, with an initial rapid EIA assay followed by PCR confirmation if necessary. Finally, starting February 5, 2019, an NT proBNP assay will be available for monitoring congestive heart failure patients, particularly those on Entresto™, with detailed reference ranges and specimen requirements provided.
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2024
May 2024 Test Bulletin
May 13, 2024
The May 2024 Test Bulletin from Alverno Laboratories includes several important updates. The Extended Urine Drug Confirmation Panel has been updated, and detailed information is available on page 2. Alverno Laboratories is also excited to announce the launch of a new and improved website designed for ease of use and navigation, with features like a 'fast topic' menu, a 'super' menu dropdown for healthcare professionals, and an emergency alert section.
Additionally, a new test for Prion Disease, 14-3-3 Protein, CSF, is now available in Soft Lab and Atlas LIS systems. At the same time, certain COVID-related tests will be discontinued, replaced by more specific tests for SARS-CoV-2 antibodies. There is also an update to the reference range for Methylmalonic Acid testing effective June 24, 2024, and changes to acceptable specimen types for several tests, ensuring greater flexibility and accuracy in diagnostic procedures.
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April 2024 Test Bulletin
April 5, 2024
We have introduced new tests such as the Encephalitis Antibody Panel and the Comprehensive Chronic Urticaria Panel, while discontinuing certain offerings like the Fetal Fibronectin test, directing clinicians to local hospital resources instead. Additionally, updates include the transition of molecular testing for STIs to new platforms and the discontinuation of the JAK2 V617F Cascading Reflex test, replaced by a more comprehensive myeloproliferative neoplasms diagnostic panel.
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March 2024 Test Bulletin
March 1, 2024
Alverno's March 2024 Test Bulletin highlights crucial updates for healthcare providers. Included are new STI specimen collection guidelines, Quest test offerings, MIC breakpoints updates, and Hemoglobin A1C testing frequency adjustments. These updates aim to enhance testing efficiency and align with recent CMS coverage expansions for better patient care and management.
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February 2024 Test Bulletin
February 21, 2024
Alverno's February 2024 Test Bulletin delivers essential updates for healthcare providers. Included are enhancements to the Client Community interface, an automated process for Cyclic Citrullinated Peptide Antibody testing, updates to Catecholamines Plasma testing, and discontinuation of certain Quest tests. Additionally, Alverno introduces Polymedco’s FIT, an automated CRC screening tool, aiming to increase screening rates via targeted patient outreach and partnerships with healthcare organizations like Ascension Health Medical Group and BCBS.
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January 2024 Test Bulletin
January 16, 2024
Alverno's January 2024 Test Bulletin provides crucial updates for healthcare providers. It announces the suspension of quantitative reporting for Midazolam and Doxepin metabolites, issues with the Platelet Antibody IgG test, discontinuation of certain Quest tests, transition of STI testing to the Abbott Alinity m platform, and updates to Quest specimen stability. These changes aim to ensure testing accuracy, improve specimen collection, and maintain quality standards for patient care.
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2023
Midazolam & Doxepin Metabolite Reporting Immediate Update 12/12/2023
December 12, 2023
In December 2023, Alverno Laboratories announced the suspension of reporting quantitative values for alphahydroxymidazolam and desmethyldoxepin due to a technical issue with the assay. While the vendor works to resolve this, only qualitative reporting will be available. Despite this change, samples from patients taking Midazolam or Doxepin as prescribed will still be interpreted as "consistent." Healthcare providers with questions or concerns are encouraged to contact Alverno Central Laboratory for assistance from their Toxicologist.
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December 2023 Test Bulletin
November 29, 2023
In December 2023, Alverno Laboratories announced significant updates: they're transitioning fecal occult blood analysis to the Polymedco OC-Auto® SENSOR io, an automated analyzer endorsed by USPSTF and ACG for its effectiveness in colorectal cancer screening. They emphasized the importance of using acid-washed metal-free containers for accurate urine heavy metal assays, with specific collection devices required for different tests. Additionally, starting January 2024, Alverno will discontinue offering certain COVID-19 PCR tests and refer COVID-19 Anti-Nucleocapsid IgG testing to Quest Diagnostics, with interim ordering procedures in place.
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September 2023 Test Bulletin
September 18, 2023
In September 2023, updates were made to several testing protocols. For HIV 1&2 Antibody/Antigen Screening, 5th generation, a full 7 mL, gold-top SST tube is now required for testing. Quest Diagnostics discontinued Complement C5 testing, effective August 14, 2023, with replacement assays to be ordered using the Uncoded Miscellaneous test code. Additionally, the room temperature stability for Androstenedione testing was shortened from 14 days to 72 hours, effective September 25, 2023. Moreover, Alverno Laboratories will now conduct molecular PCR testing for M. tuberculosis and rifampin resistance in-house using the Cepheid GeneXpert, aiming to improve turnaround time for positive acid-fast smear staining specimens.
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October 2023 Test Bulletin
September 11, 2023
In September 2023, the Extensive Urine Drug Confirmation Panel updated its reporting approach for Noroxymorphone in the presence of protein interferences, now reporting qualitatively when quantitation is hindered. Additionally, Quest Diagnostics discontinued the NK Cells, LGLs (CD57) test in October 2023, with the recommended replacement being the Lyme Antibodies IgG & IgM assay. These changes aim to maintain accuracy and reliability in patient testing.
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August 2023 Test Bulletin
August 15, 2023
The August 2023 test bulletin provides updates on various testing protocols. Notably, Quest Diagnostics will no longer accept Sodium Heparin tan-top tubes for Zinc Protoporphyrin (ZPP) testing, while tan-top EDTA tubes remain acceptable. Additionally, SRP Autoantibodies testing will be discontinued by Quest, with replacement assays ordered using the Uncoded Miscellaneous test code. Alverno Laboratories has ceased accepting plasma specimens for qualitative CMV measurement by PCR and requests switching to pierceable caps for respiratory virus testing. Lastly, there's a transition to Quest Diagnostics for non-respiratory viral culture testing, with detailed instructions on acceptable specimen types and alternative tests provided.
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July 2023 Test Bulletin
July 13, 2023
The July 2023 test bulletin highlights several updates in testing procedures and specimen requirements. Alverno Laboratories has started performing the urea breath test, BreathID® IDkit Hp® Two, in their Microbiology Department. Quest Diagnostics has discontinued several tests, including PETWB, EAPCS, HSVIF, TORAP, and DPDMA, with replacement assays ordered using the Uncoded Miscellaneous test code. Alverno Laboratories has resumed in-house nicotine testing, now accepting gold-top SST samples again, and has updated specimen requirements for Zinc Protoporphyrin (ZPP) testing. Additionally, there are updates on chromosomal analysis for hematological malignancies, TSH receptor antibody testing, and E. coli O157 testing methods.
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June 2023 Test Bulletin
June 22, 2023
The June 2023 test bulletin brings several updates. Alverno Laboratories has revised their Precision Medicine and Hematopathology forms on their website. UroVysion FISH testing will now be outsourced to Quest Diagnostics. Quantitative PCR measurements for CMV will transition to the Abbott Alinity m platform. Omadacycline susceptibility testing is now available. Additionally, E. coli O157 microbiological culture identification will be discontinued in favor of Shiga toxin detection methods. Prenatal testing submissions to Quest Diagnostics require the Maternal Screening Form. Lastly, there are changes in specimen requirements for Non-Respiratory Viral Culture testing sent to Quest Diagnostics.
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May 2023 Test Bulletin
May 4, 2023
Starting May 17, 2023, Alverno Laboratories will switch to Quest Laboratories for reference testing, leading to changes in specimen requirements and testing methodologies. Notably, for HITRS testing, both frozen plasma from a sodium citrate blue-top tube and frozen serum, denoted before submission, are necessary. Additionally, serum nicotine testing will be temporarily referred to the reference lab. The updated Collection Manual provides detailed information on these changes, including altered specimen types, transport temperatures, and reference ranges.
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March 2023 Test Bulletin
April 4, 2023
Alverno Laboratories recently issued a bulletin outlining three significant updates. First, effective immediately, changes have been made to the specimen requirements for quantitative EBV and BK Virus testing, detailed on page 2 of the bulletin. Second, the BreathTek® UBT for H. pylori test is being replaced by the BreathID® IDkit Hp® One test, with associated changes in collection kit and test codes, as of April 3, 2023, described on page 3. Lastly, starting April 29, 2023, Alverno Laboratories will transition molecular testing for several causative agents of Sexually Transmitted Infections (STIs) to the Abbott Alinity m instruments. The bulletin provides instructions for updating EMRs and ordering new kits on pages 4-5, emphasizing the need for healthcare providers to adhere to these changes for accurate testing procedures.
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April 2023 Test Bulletin
April 4, 2023
Alverno Laboratories has updated critical alert values for testing performed at their Central Lab, with details provided on pages 2-4 of their communication. They will transition to an updated version of their SOFT Laboratory Information System on April 29, 2023, along with adopting Atlas as the main middleware for communication with client EMRs, resulting in potential changes in report formatting (detailed on page 5). Effective the same date, Alverno Laboratories will switch to Quest Laboratories for reference testing, leading to changes in specimen types, transport temperatures, and testing methodologies, outlined on pages 6-18. It's advised to consult the Alverno Collection Manual for comprehensive information.
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2022
December 2022 Test Bulletin
December 14, 2022
The bulletin from Alverno Laboratories informs healthcare providers of two important updates. Firstly, there's a THC Drug Confirmation/Quantitation Reporting Range Update effective December 2022, which increases the reporting range for Marijuana Metabolite (THC) from 200 ng/mL to 10,000 ng/mL. Secondly, there's an update regarding STI by PCR Test Code & Collection Guidelines effective February 4, 2023. Alverno Laboratories will transition molecular testing for several causative agents of Sexually Transmitted Infections (STIs) to the Abbott Alinity m instruments, enabling the detection and differentiation of up to 3 STIs in one sample. The bulletin includes timelines for these changes and provides detailed instructions on specimen collection and processing guidelines, ensuring healthcare providers are well-informed.
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November 2022 Test Bulletin
November 15, 2022
The bulletin from Alverno Laboratories contains three important updates for healthcare providers. Firstly, effective November 2, 2022, deamidated gliadin and tissue transglutaminase testing will be performed using a new chemiluminescent methodology, maintaining the reference cutoff for negative results at <20 Units. Secondly, there's a notice regarding the "Preventing Harm Test Code," emphasizing the clinician's responsibility in determining the release of lab results in compliance with applicable laws, with Alverno not responsible for such determinations. Finally, starting January 1, 2023, the Internet Explorer browser will no longer be supported for clients using the electronic system on the Alverno website, urging them to switch to supported browsers like Google Chrome or Microsoft Edge to ensure add-on testing requests are received and processed.
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September 2022 Test Bulletin
September 8, 2022
The bulletin from Alverno Laboratories contains two important updates for healthcare providers. Firstly, effective August 2022, Alverno Central Lab will discontinue performing blood bank antibody identification and antibody titer testing. Any positive blood bank antibody screens will be accompanied by a comment advising follow-up testing at the local hospital for further identification and necessary testing. Secondly, effective September 27, 2022, HCV Genotyping testing will no longer be performed in-house and will instead be sent to ARUP Laboratories. Healthcare providers should use the new order, UNCMS – Uncoded ARUP Referred, for this testing, and the current test code, HCVGP, will be inactivated. Further ordering details are provided in the bulletin.
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August 2022 Test Bulletin
August 16, 2022
The latest bulletin from Alverno Laboratories brings two significant updates for healthcare providers. First, as of August 2022, Alverno Central Lab will discontinue performing antibody identification and antibody titer testing. Any positive antibody screens will be accompanied by a comment advising follow-up testing at the local hospital, especially for prenatal cases. Secondly, effective August 23, 2022, testing for suspected cases of monkeypox can now be directly ordered. Quest Diagnostics will conduct the testing via a Qualitative Real-Time PCR assay capable of detecting both non-variola Orthopoxviruses and the monkeypox virus. Detailed test ordering information, including specimen requirements and stability, is provided for healthcare providers' reference.
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June 2022 Test Bulletin
June 7, 2022
In a recent bulletin, Alverno Laboratories issued several updates for healthcare providers. They have transitioned viral load testing to the Alinity m instruments, discontinuing several test codes and introducing new quantitative viral load test codes along with specimen collection guidelines. Additionally, they suspended quantitative reporting for N-desmethyltramadol due to jurisdiction changes, seeking special licensing, and will now only provide qualitative reporting during this period. The reference ranges for Anti-Streptolysin-O have been updated, especially for patients aged up to 2 years and from 3 years to adult. Furthermore, reporting of cell counts for broncho-alveolar lavage (BAL) specimens will cease, while lead critical values for pediatric lead testing will be updated to ≥ 3.5 ug/dL for children aged 0 to 15 years, aligning with CDC guidelines. These updates offer crucial information for healthcare providers regarding changes in testing procedures, reporting standards, and reference ranges at Alverno Laboratories.
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June 2022 Test Bulletin
June 7, 2022
In a recent bulletin, Alverno Laboratories issued several updates for healthcare providers. They have transitioned viral load testing to the Alinity m instruments, discontinuing several test codes and introducing new quantitative viral load test codes along with specimen collection guidelines. Additionally, they suspended quantitative reporting for N-desmethyltramadol due to jurisdiction changes, seeking special licensing, and will now only provide qualitative reporting during this period. The reference ranges for Anti-Streptolysin-O have been updated, especially for patients aged up to 2 years and from 3 years to adult. Furthermore, reporting of cell counts for broncho-alveolar lavage (BAL) specimens will cease, while lead critical values for pediatric lead testing will be updated to ≥ 3.5 ug/dL for children aged 0 to 15 years, aligning with CDC guidelines. These updates offer crucial information for healthcare providers regarding changes in testing procedures, reporting standards, and reference ranges at Alverno Laboratories.
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May 2022 Test Bulletin
May 12, 2022
In their recent bulletin, Alverno Laboratories provided updates relevant to healthcare providers. They outlined a Hepatitis C testing algorithm covering diagnosis and monitoring, where initial screening involves antibody testing, with reactive or equivocal results automatically confirmed via PCR assay. Additionally, they introduced a new testing algorithm for hospital inpatients with gastrointestinal symptoms, involving reflex testing for Clostridium difficile toxin A/B if detected on the BioFire® FilmArray® Gastrointestinal Panel. The bulletin offers guidance on test ordering to streamline the diagnostic process and ensure appropriate testing based on clinical indications.
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April 2022 Test Bulletin
April 8, 2022
In their recent bulletin, Alverno Laboratories provided updates pertinent to healthcare providers. They implemented new FDA/CLSI MIC breakpoints for Piperacillin-Tazobactam (P/T) regarding Pseudomonas aeruginosa, enhancing precision in interpretation. Additionally, they introduced rapid PCR testing for positive blood cultures, utilizing the GenMark ePlex assay to expedite organism identification and resistance marker detection. These advancements aim to improve turnaround times and streamline diagnostic processes for better patient care. Furthermore, Alverno Laboratories announced a standardization effort for CBC test builds, discontinuing several test codes to enhance workflow efficiency. These updates reflect a commitment to providing high-quality laboratory services and staying at the forefront of diagnostic technologies.
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February 2022 Test Bulletin
February 10, 2022
In this bulletin, Alverno Laboratories provided several updates for healthcare providers. Firstly, they postponed the implementation of the Extensive Urine Drug Confirmation Panel to February 23, 2022, discontinuing the Pain Management Panel and introducing a more comprehensive replacement. Secondly, effective April 5, 2022, they updated the calculation of estimated glomerular filtration rate (eGFR) to the new CKD-EPI 2021 equation, removing the race coefficient to improve accuracy and avoid potential biases. Additionally, they emphasized the availability of weekly data on respiratory pathogen positivity trends on their website, collected from multi-target assays. These updates aim to enhance diagnostic precision, streamline testing processes, and provide valuable insights for patient care.
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January 2022 Test Bulletin
January 14, 2022
In this bulletin, Alverno Laboratories provided important updates for healthcare providers. Firstly, they highlighted the potential for false reactive results on the RPR non-Treponemal Syphilis screen within 5 months of mRNA COVID-19 vaccination, advising careful interpretation in conjunction with patient history and risk factors. They also outlined two testing algorithms for Syphilis screening: the traditional RPR first approach and the reverse Treponemal antibody first strategy, with confirmatory testing following the initial screen assay. Secondly, they noted a correction regarding the postponement of updates for CBC pediatric ranges and manual differential reference range to April 2022, previously mentioned in a client bulletin. These updates aim to ensure accurate testing and interpretation, particularly in light of evolving clinical contexts.
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2021
December 2021 Test Bulletin
December 15, 2021
Alverno Laboratories has issued important updates for healthcare providers. Firstly, tissue culture processing protocols have changed, with E-swabs no longer accepted for solid tissue specimens due to processing limitations; instead, tissue cultures must be sent in sterile containers with saline. Secondly, there are updated CBC reference ranges for pediatric patients, categorized by age and gender. Lastly, Alverno is replacing the Pain Management Panel with a more extensive Extensive Urine Drug Confirmation Panel, offering lower reporting limits and additional analytes tested via Liquid Chromatography Mass Spectrometry, useful for both pain management and behavioral health analysis. These updates aim to improve testing accuracy and provide comprehensive information for patient care.
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November 2021 Test Bulletin
November 5, 2021
Alverno Laboratories issued important updates for healthcare providers, including a transition of Cystic Fibrosis genetic testing to ARUP due to a vendor discontinuation, Streptococcus pneumoniae MIC breakpoints for Tetracycline aligned with FDA/CLSI standards, a C-peptide reference range update reflecting a new platform, and a protocol change for Thyroglobulin testing, now screening for antibodies and using LC-MS/MS technology. Additionally, quantitative viral load testing for Hepatitis B, Hepatitis C, and HIV will shift to Abbott Alinity m instrumentation, IgE allergen reporting will include a new "0/1" class, and PFA analysis reference ranges for Collagen Epinephrine and Collagen ADP assays have been updated. Each update aims to enhance testing accuracy and patient care.
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September 2021 Test Bulletin
September 16, 2021
Alverno Laboratories issued several updates for healthcare providers, including ARUP's consolidation of HIV genotyping and resistance testing into a single Next Generation Sequencing assay, the introduction of the BioFire FilmArray Meningitis/Encephalitis Panel for rapid detection of multiple pathogens in cerebrospinal fluid, and the implementation of a Respiratory Multiplex Panel on the Abbott Alinity m analyzer for simultaneous testing of COVID-19, Influenza A and B, and Respiratory Syncytial Virus. Additionally, Alverno launched an automated Client Community for convenient electronic submission of add-on testing requests. Each update aims to enhance diagnostic capabilities and streamline processes for improved patient care.
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August 2021 Test Bulletin
August 9, 2021
Alverno Laboratories issued updates relevant to healthcare providers, including an NT proBNP assay update for monitoring congestive heart failure patients taking Entresto®, reflecting variations in values and emphasizing clinical correlation, a reflexive lung cancer panel replacing the current ARUP Lung Cancer with KRAS, now including reflex testing to ALK and ROS1 if EGFR and KRAS testing show wildtype status, and an update to Drugs of Abuse panels, lowering the Opiates assay cutoff level to 300ng/mL for improved clinical testing suitability. These updates aim to enhance diagnostic accuracy and clinical utility, ensuring optimal patient care.
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July 2021 Test Bulletin
July 8, 2021
Alverno Laboratories has made updates regarding Prostate Health Index (PHI) testing, now sending all samples to ARUP Laboratories, with testing protocols remaining unchanged but requiring serum specimens to be separated and frozen prior to submission. Additionally, Alverno Laboratories is updating its LCMS drug confirmation testing to provide lower levels of detection and detect additional analytes, improving diagnostic accuracy. These updates aim to enhance testing efficiency and accuracy, ensuring optimal patient care.
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May 2021 Test Bulletin
May 18, 2021
Alverno Laboratories is expanding malaria testing options to include a rapid antigen screen with smear confirmation, providing quicker initial screening results within 24 hours and confirming results with a smear test. In cases of discordant results, samples will be sent to ARUP for PCR detection and speciation. Additionally, Alverno Laboratories has received notification of potential interference affecting estradiol results due to estradiol supplements, with impacted results from October 22, 2019, to April 2021. Clinicians are advised not to use these results to monitor the effectiveness of estradiol supplements and to consider the patient's total clinical presentation when interpreting results, with alternate tests recommended if necessary.
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March 2021 Test Bulletin
March 8, 2021
Alverno Laboratories has updated the naming conventions for COVID antibody detection assays to provide clarity, incorporating the target of the antibody (nucleocapsid or spike) and the test utility (post-vaccination, infection) in addition to the class (IgG or IgM). Additionally, the Molecular Biology Department will introduce viral Hepatitis C Genotyping to the Central Lab, recommended following confirmation of an active infection using the quantitative viral load assay to guide therapy decisions. The Positive Blood Culture Reporting process is being updated to include listing the isolate for all positive blood cultures along with organisms observed in the gram stain, improving abnormal flagging capabilities.
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February 2021 Test Bulletin
February 5, 2021
Alverno Laboratories has made significant updates and announcements affecting practice, including a potassium reference range update to accommodate serum and plasma sample collections, the introduction of a specialized hepatitis panel for immunosuppressive therapy candidates and recipients, and awareness of coagulation therapy effects on aPTT assays, particularly with the influence of emicizumab and other therapeutics. Additionally, the Microbiology Department is adopting new MIC breakpoints for Meropenem, Daptomycin, Aztreonam, and Cephalosporins, alongside automated yeast susceptibility testing for Candida species, aimed at reducing turnaround time by 24 hours. These changes are crucial for ensuring accurate testing and appropriate patient management.
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2020
December 2020 Test Bulletin
February 5, 2021
Alverno Laboratories has announced changes regarding prenatal risk assessment testing, specifically QUAD screens and Maternal Serum AFP, effective January 4, 2021. These tests will now be sent to ARUP Laboratories due to the need for robust statistical data that Alverno Laboratories cannot sustain independently. To ensure accurate analysis, detailed patient history information is required, and a Prenatal Risk Assessment Form is provided on page 2 of the document and available on the Alverno website under the "Provider Forms" tab. It's emphasized that all questions on the form must be answered for timely and accurate risk analysis, as unanswered questions will cause testing delays.
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November 2020 Test Bulletin
November 6, 2020
We're updating our COVID-19 testing services. Now, we offer COVID-19 IgM antibody testing, indicating exposure to the virus. However, early specimen collection may yield false negatives, and IgM status shouldn't determine infectiousness. Additionally, we're soon introducing an RT-PCR mini-respiratory panel detecting COVID-19, Influenza A/B, and RSV, aiding rapid differentiation due to their similar symptoms. See page 2 for details on specimen requirements and stability guidelines. Thank you.
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September 2020 Test Bulletin
September 11, 2020
Alverno Laboratories has introduced new Antinuclear Antibody testing panels and updated report formatting, offering two methodologies: Multiplex Flow Immunoassay or Immunofluorescence Assay, with ANA testing intended for diagnostic use only. They've also changed the urine culture organism identification protocol, no longer differentiating E. coli from Shigella species in urinary isolates unless clinically indicated, aligning with CAP recommendations. Additionally, they now require plasma only for BTNP specimens due to analyte stability concerns and have discontinued accepting whole blood specimens. Moreover, effective October 1, 2020, Alverno has ceased offering a printable order form for supply ordering on their website, transitioning to the use of the online order form exclusively.
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August 2020 Test Bulletin
August 1, 2020
The recent updates from Alverno Laboratories include discontinuation of the Vaginal Panel by PCR due to a national reagent shortage, with a recommendation to replace it with the Vaginitis DNA Probe Panel. There's also a change in collection device between the two tests, requiring samples to be collected using the BD Affirm collection kit instead of the BD Max collection kit, as samples sent in the latter will be rejected. Additionally, there's an update on the reflex criteria for urine culture testing, which now includes positive Leukoesterase indications and/or positive Nitrite indications with a WBC count >10, effective August 4, 2020.
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May 2020 Test Bulletin
May 8, 2020
Alverno Laboratories presents two significant updates: the addition of qualitative COVID-19 IgG antibody testing conducted by ARUP Laboratories and an update to its pain management panel, now comprising 78 different drugs and metabolites. The COVID-19 IgG antibody test can detect antibodies typically present around two weeks post-symptom onset, aiding in indicating exposure to SARS-CoV2; however, it does not establish definitive immunity. Alverno now performs Fentanyl and Buprenorphine screenings in-house, with reflex quantitation if positive, offering faster turnaround times. The pain management panel, effective since May 5, 2020, requires a urine sample and includes a comprehensive list of drugs and metabolites, with results available within a day after sample receipt. More information on specimen requirements and testing availability can be found on Alverno's website or by contacting Client Services.
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March 2020 Test Bulletin
March 13, 2020
Alverno Laboratories provides essential updates on COVID-19 testing and pain management panel procedures. They offer COVID-19 testing through LabCorp for faster results, adhering to CDC guidelines for patient selection. Additionally, the Pain Management Panel, effective April 21, 2020, will be conducted in-house, enhancing turnaround times and comprehensiveness. Alverno emphasizes compliance with Medicare regulations, issuing an annual physician compliance letter outlining diagnostic documentation requirements for Medicare reimbursement. Physicians are urged to ensure proper documentation to avoid billing issues and to utilize internet-based PECOS for Medicare enrollment. For inquiries, contact Alverno's Compliance Manager or Billing Services.
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January 2020 Test Bulletin
January 29, 2020
Alverno Laboratories introduces significant updates in February 2020, including the consolidation of Drug of Abuse screening panels, resuming Lupus Anticoagulant Reflexive Panel testing, and offering an additional Anti-Phospholipid Syndrome Panel. Moreover, the Pain Management Panel testing transitions in-house, enhancing turnaround time and comprehensiveness. The Drug Screen Panel Updates feature consolidated panels with or without confirmation, with propoxyphene available as an individual screening test if needed. Additionally, the Lupus Anticoagulant and Anti-Phospholipid Syndrome Panels emphasize adherence to CLSI guidelines, incorporating prescreening tests and mixing studies. Lastly, the Pain Management Panel Update outlines comprehensive analytes and cutoffs, with improved specimen validity evaluation and a revised report template for enhanced usability.
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2019
December 2019 Test Bulletin
December 20, 2019
Alverno Laboratories has updated the Anion Gap reference range based on recent wellness patient data, effective January 7, 2019. Additionally, they extend warm holiday wishes for a happy and healthy season to healthcare providers.
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November 2019 Test Bulletin
November 13, 2019
Alverno Laboratories introduces in-house Anti-Mullerian Hormone testing, providing a faster turnaround time for assessing reproductive health in women. This hormone's levels diminish with age, reflecting the decline in ovarian reserve, and can aid in fertility evaluations and predicting menopause onset. Additionally, starting December 1, 2019, ARUP, the reference laboratory, mandates trace element specimens like aluminum and zinc be transported in certified metals-free tubes to maintain accuracy, emphasizing meticulous handling and processing protocols to prevent contamination.
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September 2019 Test Bulletin
September 12, 2019
Alverno Laboratories announces updates regarding Lupus Anticoagulant Testing, redirecting all testing to ARUP Laboratories as of September 5, 2019. The new Lupus Anticoagulant Reflexive Panel by ARUP employs ISTH criteria, including prescreening tests and mixing studies, enhancing the detection of various inhibitors affecting coagulation. Additionally, starting September 18, 2019, Alverno will adopt revised critical values for lead testing in compliance with CDC guidelines and OSHA Lead Standards, ensuring adherence to updated medical management recommendations for lead exposure.
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August 2019 Test Bulletin
August 7, 2019
Alverno Laboratories introduces the Prostate Health Index (PHI) calculation, enhancing prostate cancer detection during Prostate Health month. The PHI calculation, incorporating PSA, free PSA, and p2PSA values, offers improved specificity, reducing unnecessary biopsies. Additionally, Alverno addresses Biotin interference in immunoassays, providing insights into affected assays and FDA recommendations for healthcare providers to mitigate potential errors.
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June/July 2019 Test Bulletin
July 1, 2019
Alverno Laboratories announces updates to Group A Strep and blood lead testing, aiming to enhance turnaround times. Additionally, PCR methodology is introduced for pre-surgical Staph. aureus screening, aiding in infection control measures and reducing surgical site infection risks.
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April 2019 Test Bulletin
April 11, 2019
Cigna has implemented a billing policy change effective May 18, 2019, requiring the entity performing lab services to bill for them directly. Alverno Laboratories announces updates to its Thyroid Cascade and Heparin-Induced Thrombocytopenia (HIT) antibody testing procedures, aiming to enhance diagnostic accuracy and efficiency.
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March 2019 Test Bulletin
March 18, 2019
The collection process for Group A Streptococcus specimens has been standardized with the implementation of Copan dual swabs, allowing for one-time collection for both rapid testing and reflex culture. Alverno Laboratories introduces a platform switch for Heparin-Induced Thrombocytopenia (HIT) antibody testing, aiming to enhance on-demand testing capability with qualitative reporting and optional confirmation testing.
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February 2019 Test Bulletin
February 18, 2019
The January C. difficile test algorithm bulletin corrected the CPT codes for the rapid EIA assay to 87324 and 87449. Additionally, due to a manufacturing backorder, the go-live date for the NT proBNP assay at the Central Laboratory has been postponed to February 26, 2019. Furthermore, the utilization guidelines for the Solid Tumor Panel Next Generation Sequencing were outlined, indicating its clinical use in detecting targeted somatic mutations for prognosis and treatment of solid tumors, with specimen requirements including formalin-fixed paraffin-embedded tissue. Finally, a specimen update for HIV-1 RNA Quantitative Viral Load testing emphasized the discontinuation of accepting Pearl Top Tubes and the necessity of collecting EDTA Plasma for accurate results.
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January 2019 Test Bulletin
January 17, 2019
Effective January 21, 2019, the Soft code for the PSA Screening test has changed to PSAS to distinguish it from the Free PSA test. Alverno Laboratories has undergone a name change to Alverno Laboratories, aiming for easier recognition. Additionally, starting January 3, 2019, a two-step algorithm for C. difficile testing will be adopted, following 2018 IDSA and SHEA guidelines, with an initial rapid EIA assay followed by PCR confirmation if necessary. Finally, starting February 5, 2019, an NT proBNP assay will be available for monitoring congestive heart failure patients, particularly those on Entresto™, with detailed reference ranges and specimen requirements provided.
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