Cytopathology Specimens Acceptance and Rejection
In order to provide quality patient care and to reduce
chances of potential misidentification of specimens and slides we require that
the guidelines outlined below be followed when submitting specimens or slides
for cytologic evaluation.
The requisition form must contain:
- The patient's first and last name.
- The patient's unique identification number (eg. Unit
History #, Social Security #)
- The patient's date of birth
- The requesting physician's full name - UTMB physicians
also required to submit the physician billing ID number.
- The source of the specimen (eg. cervix, vagina,
- The date the specimen was collected
- The reason for the test – submitted as an ICD-9 code
or as a descriptive diagnosis.
- Please provide any other pertinent clinical
information/history that is available and if pap smear is submitted, last
menstrual period (LMP) should be provided.
- When submitting a screening pap smear on a Medicare
patient, please provide the ICD-9 code for either a low risk patient (V76.2) or
a high risk patient (V15.89)
- When submitting a diagnostic pap smear on a Medicare
patient, please provide the appropriate ICD-9 code for the sign/symptom or
reason it is diagnostic
Slides submitted must be clearly labeled in pencil
with the patient's full name, including first and last name. No initials,
A unique patient identification number must be
provided, either written in pencil on the slide; written on the specimen
container, or provided as a requisition adhesive label placed on the slide
Pap smears with no identification written on the
slide will not be accepted for evaluation.
One patient's pap smear slide should be submitted
per specimen carton.
Slides broken beyond repair will not be accepted.
Those with the label end intact (patient name readable) and with the remaining
slide large enough to fit in the staining machine will be accepted.
If the patient's name/identification number written
on the requisition form does not match the name/identification number on the
specimen container/slide, the specimen will be rejected, and a new specimen will
Depending upon contract agreements, additional
patient information may be required.
Questions concerning these guidelines may be addressed to the laboratory supervisor at
409-772-2872 or 409-772-2873.
Reviewed 6/22/12 by Robert Stewart