Our mission as a department is to deliver patient-centered, physician friendly services in a fiscally responsible manner. This REFERENCE MANUAL is intended to simplify access to the full range of pathology and laboratory medicine services offered at Westchester Medical Center. It includes an updated testing compendium and appendices, current specimen requirements, and updated leadership and contact information.
We hope that you find this REFERENCE MANUAL helpful. We welcome your comments and suggestions regarding this manual and our other services.
The laboratory is backed by the unique and substantial resources of Westchester Medical Center and serves healthcare providers throughout the medical community. Since roughly 100% of the laboratory testing is performed on site, we are able to optimize our testing schedules and provide excellent turnaround times for your patients’ results. This broad in-house capability, coupled with extensive and advanced instrumentation, electronic communication and a skilled team of laboratory professionals, enables Westchester Medical Center’s laboratory to deliver the highest level of quality and service, around the clock, seven days a week. Westchester Medical Center’s hospital-based board certified clinical and anatomic laboratory offers a broad menu of routine and esoteric procedures.
Our laboratories offer testing in the following areas:
Anatomic Pathology
Anatomic Pathology has a State of the art Histology Lab with 24 hour turnaround time for biopsies and surgical specimens. Specialty IHC Diagnostic testing for breast, colon, liver and lymphoma cancer markers. In addition Molecular assay for diagnosing HPV, HPV GT 16 18/45, Chlamydia trachomatis, Neisseria gonorrhea, and Trichomonas vaginalis from Thin prep pap vial, Urethral and vaginal swabs are available
Biochemical Genetics
Biochemical Genetics Laboratory is a newly established laboratory at WMC. We offer a variety of genetic testing for inherited metabolic disorders, also known as inborn errors of metabolism.
Assays performed in Biochemical Genetics Laboratory:
- Phenylketonuria (PKU) diagnostic and follow-up;
- Maple Syrup Urine Disease (MSUD) diagnostic and follow-up;
- Tyrosinemia diagnostic and follow-up;
- Plasma Amino Acids diagnostic and follow-up;
- Urine Organic Acid analysis;
- Total Homocysteine in plasma.
Blood Bank
Coming Soon
Call Center
The call center increases laboratory productivity by allowing the Medical Technologist time to focus on testing. The four man call center receives phone calls from Physician, Nurses, patient’s family members and law enforcement agencies seeking information on patient results, test requirements and specimen storage. The staff’s expertise allows them to filter calls and forward only the calls requiring the Medical Technologist’s attention. The Call center also makes calls to caregivers. When tests are complete, the laboratory is required to call the Physician with abnormal values. Abnormal values are automatically sent to the call center where they are called and the call is documented in accordance with New York State regulations. The Call center accomplishes all of this without utilizing limited laboratory space. The Call center is located off campus at 244 Westchester Avenue in Harrison New York.
Chemistry
“WMC Chemistry laboratory plays an essential part in the delivery of quality health care accurately and quickly as possible. We offer over 196 diagnostic tests and test combinations. They are ordered to diagnose, treat, manage or monitor patient’s condition. Some tests are manually evaluated, while most are performed using technically advanced instrumentation by highly skilled medical laboratory scientists specially trained to perform the requested analyses. Our test menu guide more than 70 % of medical decisions. We perform and interpret about 4 million tests annually”
CTEL
CTEL (the Cell and Tissue Engineering Laboratory) is a laboratory which processes, cryopreserves and prepare cells for infusion or blood and stem cell transplantation. The lab also manufactures varying cell types such as ADV, EBV, BKV and CMV CTLS (cytotoxic T lymphocytes), which is a 2-day process.
CTEL supports and collaborates with both the Pediatric and Adult cell transplantation and cell therapy programs. Its goal is to support other translational programs with a focus on oncology, hematology, neurology hematology, genetics and cardiovascular programs. The CTEL Medical Director, Dr Cairo, has FDA approval for several clinical trials such as the one to treat diseases such as Sickle cell disease using the patient’s mother as a donor while using peripheral blood as a stem cell source. In the sickle cell disease patients, after transplant, the recipients no longer have sickle disease but have sickle cell trait at the same percentage as the donor.
The cGMP(current good manufacturing practice ) lab is comprised of 7 processing suites. Procedures such as CD34 enrichment (which takes 6-8 hrs.) is utilized to remove T cells in HPC (hematopoietic progenitor cell) products to ameliorate graft versus host disease. CD34 cell enrichment is also used for patients receiving partially matched family or matched unrelated adult or pediatric donor allogenic stem cell transplantation for malignant (Hodgkin’s disease or leukemia) and nonmalignant diseases (such as aplastic anemia, thalassemia or Wiskott-Aldrich syndrome). CTEL also prepares cord blood products for transplant. CTEL is FACT (Foundation for the Accreditation of Cellular Therapy) accredited, and NYS and FDA licensed.
Cytogenetic Lab
The Cytogenetics laboratory at Westchester Medical Center provides chromosome analysis of peripheral blood, products of conception and skin fibroblasts. Chromosome analysis is appropriate for individuals with clinical features including infertility, multiple miscarriages, delayed puberty, ambiguous genitalia, amenorrhea, or individuals with clinical features suggestive of an aneuploidy syndrome, including Down syndrome, Turner syndrome, Klinefelter syndrome, trisomy 13 syndrome, and trisomy 18 syndrome. Our laboratory also provides chromosome analysis to detect the acquired chromosomal abnormalities associated with hematological malignancies and solid tumors. Chromosomal abnormalities play a central role in the pathogenesis, diagnosis, and treatment monitoring of many hematologic disorders. Cytogenetic studies on bone marrow may be helpful in many malignant hematologic disorders as the observation of a chromosomally abnormal clone may be consistent with a neoplastic process. Cytogenetic studies are used to monitor patients with hematologic neoplasia and may identify disease progression, such as the onset of blast crisis in CML.
Diagnostic Immunology
The Diagnostic Immunology is involved in work related to the identification of antibodies found in auto-immune disorders such as S.L.E., and other connective tissue disorders. We also screen for antibodies to Mumps, Measles, Rubella, and Varicella zoster. Our department in involved in the diagnostic of Lyme disease using two complimentary methodologies (ELISA, and Western Blot). The section runs testing that is useful in the identification of allergy-related antibodies.
Flow Cytometry
The Flow Cytometry Dept is located within the Clinical Pathology Laboratories.
We offer rapid testing for leukemias, lymphomas and myelomas; utilizing 6 color immunofluorescence techniques to identify, separate and characterize various leukocyte subtypes.
In addition, we perform CD34 stem cell enumerations and immune profile testing such as lymphocyte subsets and TBNK analysis.
Hematology
The Hematology Laboratory is open 24 hours a day, seven days a week. Inpatient and outpatient bloods are processed. Stat specimens are reported within 1 hour after receiving the specimen and routine specimens within 4 hours. Tests performed are CBC, platelet count, differential, ESR, reticulocyte, IPF, and sickle screen. CSF, Ascitic fluid, synovial fluid, peritoneal fluid, urine eosinophils, pleural fluid and amniotic fluid.
Microbiology - The Microbiology laboratory provides diagnostic services covering bacteriology, mycology, limited parasitology and diagnostic immunology, as well as surveillance culture and NGS-based molecular typing to support the hospital Infection Control and Antimicrobial Stewardship Program. Various methods such as rapid antigen detection, culture, Immunoserology, nucleic acid amplification tests and DNA sequencing are employed in this laboratory for clinical diagnostics and public health. Of these, the bacteriology and mycology sections offer full services for culture, identification and antimicrobial susceptibility testing of medically important aerobic & anaerobic bacterial and fungal isolates from all body sites. Limited parasitology and diagnostic immunology services include, but are not limited to, detection of blood parasites, pinworm, helminths, identification of arthropod, as well as screening tests for infectious mononucleosis, group A Streptococcus, RSV, and Influenza A & B viruses. Additional microbiology tests such as viral culture, viral load and multiplex PCR are performed in the Clinical Virology and Molecular Diagnostics Laboratory.
Molecular Diagnostics
The Molecular Diagnostics Laboratory uses cutting-edge technologies that include real-time PCR, Sanger DNA sequencing and next-generation sequencing (NGS) to provide laboratory services for diagnosis of infectious diseases, genetic diseases and cancers. Currently the laboratory offers a variety of FDA-cleared and laboratory developed high complexity tests, covering molecular microbiology [i.e., viral loads for HIV-1, HBV, HCV and CMV, as well as Epstein-Barr virus (EBV) and BK virus; real-time PCR for toxigenic C. difficile and Babesia microti], molecular genetics (i.e., prothrombin and Factor V Leiden mutation, cystic fibrosis 139-variant by NGS), and molecular oncology (i.e., NGS AmpliSeq Focus panel for solid tumor). Among these, various viral load assays are performed and utilized for daily management of patients with transplantation and infectious diseases; the Babesia microti DNA PCR is a WMC-patented assay and one of a few in the US has approval by the New York State Department of Health for diagnosis of human babesiosis; the NGS-based cystic fibrosis 139-variant assay is the first FDA-cleared in vitro diagnostic test using NGS technology that detects 139 functionally validated and clinically relevant cystic fibrosis variants with improved detection rates of cystic fibrosis-causing variants and reduced residual risk of a false negative result and need for additional testing. The NGS Focus AmpliSeq panel detects multiple types of variants that are frequently mutated in 52 genes with known relevance to solid tumors, including single nucleotide variants (SNVs), insertion/deletions (indels), and copy number variants (CNVs) in DNA samples, and gene fusions in RNA samples, supporting individualized and precision medicine in diagnosis, prognosis, treatment response prediction and therapeutic drug selection of patients with solid tumor.
Point-of-Care
The Point of Care Department is located in and operates under, the license and guidelines of the Clinical Laboratory. POC is responsible for 185 instruments and devices, as well as offering 20 different rapid “bedside” assays throughout the whole WMC campus. We perform ongoing training & competency for Drs, Nurses, & Patient Care Techs as well as maintaining and troubleshooting the POC instruments.
Special Hematology - The department of Special Hematology offers a variety of specialty testing including factors assays, Low Molecular Weight Heparin, Protein C, Protein S activity, Anti-thrombin III, Lupus anticoagulant, Factor VIII Inhibitor, Vonwillebrand Ristocetin cofactor (platelet agglutination), and VWFR:Ag (immune-turbidimetric ), Platelet function studies (platelet rich plasma), Serum Cryoglobulins as well as Hemoglobin separation by HPLC. The following tests are performed manually: Procalcitonin plasma, Serum and urine Osmolality, Fetal Fibronectin, Urine pregnancy, PH fluids, Chloride Testing for Cystic fibrosis (sweat test), ionized calcium and potassium
Special Hematology
The department of Special Hematology offers a variety of specialty testing including factors assays, Low Molecular Weight Heparin, Protein C, Protein S activity, Anti-thrombin III, Lupus anticoagulant, Factor VIII Inhibitor, Vonwillebrand Ristocetin cofactor (platelet agglutination), and VWFR:Ag (immune-turbidimetric ), Platelet function studies (platelet rich plasma), Serum Cryoglobulins as well as Hemoglobin separation by HPLC. The following tests are performed manually: Procalcitonin plasma, Serum and urine Osmolality, Fetal Fibronectin, Urine pregnancy, PH fluids, Chloride Testing for Cystic fibrosis (sweat test), ionized calcium and potassium
Stat Lab
The STAT lab performs many of the chemistry tests that are not handled by the automated chemistry department. These tests include Procalcitonin, ionized calcium, osmolarity, RSV, Influenza, Strep, HCG, Plavix, whole blood potassium, pH, gastric and stool occult blood testing. Sweat collected by our Phlebotomist are also tested in this department for Cystic Fibrosis screening. The coagulation section of the STAT lab performs over 300,000 tests per year. These tests include PT, aPTT, PT/PTT corrections, Fibrinogen, Thrombin Time, D-Dimer and Fibrinogen degradation product testing. The STAT lab also performs urinalysis on over 80,000 samples per year
Transplant Immunogenetics
The Transplant Immunogenetics Laboratory (TIL) provides histocompatibility services to support the Kidney, Liver, Heart, and Pancreas Transplant Programs at Westchester Medical Center. The TIL does testing for the identification of Class I and Class II IgG antibody directed against HLA molecules using a sensitive Luminex micro-array platform. Preformed HLA antibody directed at mismatched HLA on transplanted organ increases the probability for early antibody-mediated rejection and graft failure. Antibody directed at HLA Class I (HLA-A*, HLA-B*, HLA-C*) is the major cause of the allo-immune destruction of transfused platelets. Monitoring for post-transplant HLA antibody aids in the diagnosis of antibody-mediated rejection. A three-color flow cytometry crossmatch is used to test for IgG class antibody reacting with T-Cells and B-Cells from a potential donor as a surrogate for transplant compatibility. The presence or absence of HLA-B27 in a blood sample is determined using a complement dependent cytotoxicity test. HLA typing for other purposes is currently a send out test.
Virology
The Clinical Virology Laboratory employs both classic viral culture and the cutting-edge multiplex PCR approach for diagnosis of a variety of viral, bacterial, fungal and parasitic diseases. The viral cultures currently offered include the isolation and identification of Adenovirus, Influenza Virus A and B, Parainfluenza 1 to 3, Human metapneumonvirus, Respiratory syncytial virus (RSV), Varicella-Zoster Virus (VZV), Herpes Simplex Virus (HSV) 1 &2, Cytomegalovirus (CMV) and Enterovirus. There are also 3 multiplex PCR tests performed in the Clinical Virology Lab: The respiratory multiplex PCR which screens for 17 different viral and 3 bacterial targets in nasopharyngeal swab/aspirate; the meningitis/encephalitis multiplex PCR which screens for 14 bacterial, viral and fungal targets in CSF specimens; and the gastrointestinal multiplex PCR which screens for 22 different bacterial, viral and parasitic targets in stool samples.
Client Services
The laboratory is available 24 hours a day, seven days a week to respond to your inquiries and requests. The client service specialists at (914) 493-7384 are HIPAA trained and extremely knowledgeable about the laboratory and its suite of services. We are committed to providing prompt, courteous service with the highest standards.
INFORMATION PROVIDED BY CLIENT SERVICE SPECIALISTS:
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Status of tests
- Test menu
- Test results
- Specimen requirements
- Add-on tests
- Pathologist referrals
- Specimen collection supplies
- Scheduling a stat courier pick-up
Courier services
Regularly scheduled courier pick-up services are provided by the Westchester Medical Center laboratory. A courier will provide direct specimen pick-up, a temperature controlled environment for specimens in transit, and delivery of patient reports and specimen collection supplies.
FOR STAT PICK-UPS CALL (914) 493-7979
Advanced Laboratory Patient Service Center
Westchester Medical Center's Advanced Laboratory Services Patient Service Center (PSC) is open Monday - Friday, 8am to 5:30pm.
The Patient Service Center is located at
19 Bradhurst Avenue, Suite 2600.
Hawthorne, NY 10532
Services include a dedicated courier for pickup of any specimens in the Westchester area.
Call (914) 493-2213 to learn more.
Patient Billing
For most procedures requested, Westchester Medical Center Advanced Laboratory Services will bill patients or third party insurance directly. The test requisition form must include the patient name, address, telephone number, and guarantor information.
Third Party Billing
Westchester Medical Center Advanced Laboratory Services will bill third party, Medicare, and Medicaid directly. For these billing types the following information is required:
- Date of phlebotomy
- Patient’s date of birth, sex, age, and marital status
- Relationship to insured
- Patient’s telephone number
- Responsible party’s name if different than insured
- Insured’s mailing address
- Referring physician’s name (please include middle initial), address, NPI and UPIN #
- Applicable ICD-9 codes
- Complete name, address and telephone number of the primary insurance
- Complete name, address and telephone number of the secondary insurance company
- Group and policy numbers
- Insurance identification numbers for Medicare, Medicaid and third party payers patient’s signature
- Patient’s signature
- Physician’s signature required for all testing ordered
Medical Necessity
The Health Care Financing Administration (HCFA) is responsible for administering the Medicare Program throughout the United States. Medicare does not cover routine screening tests and will only pay for tests that meet Medicare coverage criteria. Medicare will only pay for those tests which it considers reasonable and necessary, and supported by the patient’s medical record. To document medical necessity of the ordered tests, physicians must provide ICD-9 codes specific to the patient’s condition on the specific date of service.
Advanced Beneficiary Notices
If reimbursement is denied for improper documentation of medical necessity, Medicare prohibits the laboratory from billing the patient unless an Advanced Beneficiary Notice (ABN) has been signed and dated by the patient PRIOR to the provision of service. The ABN insures the patient is informed of Medicare’s medical necessity policy, reviews why payment may be denied on the specific tests being ordered, and requires both the patient’s and physician’s signature. A copy of the Westchester Medical Center Advanced Laboratory Services ABN may be found on the back of the laboratory test requisition, and is required for Medicare patients anytime a test highlighted is ordered. The ABN should be signed and dated after the requisition has been completed. To insure complete compliance on both the laboratory’s and the physician’s part, the physician must enter the appropriate ICD-9 codes to document the medical necessity of the tests being ordered.
Please CLICK HERE to download the Advanced Beneficiary Notice form.