Pap Test/ Gynecologic Cytology Request  PAP TEST

Synonyms

Pap Smear, Pap Test, ThinPrep

Allscripts (AEHR) Order Name

Not Orderable

Sunrise Clinical Manager (SCM) Order Name

Not Orderable

EPIC Order Name

Clinical Info

PDM # 5915331 
The Cytopathology requisition form must be completed with the following information:
- Name and location of the referring clinician
- Source of specimen: Cervical, Endocervical or Vaginal
- Test(s) ordered
- Specimen collection date.
- Patient demographics: name, address, gender, and date of birth
- Last menstrual period.
- ICD-10 code (reason for test)
- Significant patient history or, if none, “Routine” should be included.

Specimen Type

Swab, Cervical, Vaginal

Specimen Volume

Container

ThinPrep PreservCyt® Solution vial. (White Cap Container)

Collection Instructions

- The patient’s name and date of birth are required on the vial.
- Plastic Spatula: Insert the notched end of the spatula in the cervical os and rotate
360 degrees while maintaining firm contact with the epithelial surface. Rinse
the spatula directly into the PreservCyt® Solution vial.
- Broom: Insert the long central bristles into the cervical os until the lateral
bristles bend against the ectocervix and rotate three to five time in a
clockwise direction while maintaining gentle pressure. Transfer the material
directly into the PreservCyt® Solution vial rinsing it vigorously.
- Brush: Insert brush into the endocervical canal until only the bristle closest to the
handle are visible; rotate the brush only 180 degrees to minimize bleeding.
Transfer the material directly into the PreservCyt® Solution vial rinsing it
vigorously.
- Do not leave any collection device inside the PreservCyt® Solution vial.

Transport Instructions

Specimen Stability

3 Weeks Room Temperature
3 Weeks Refrigerated
Unacceptable frozen

Methodology

Thinprep pap test with imaging, Thinprep pap test without imaging, Papanicolaou staining  

Days Performed

Monday through Friday

Performing Laboratories

Northwell Health Laboratories

CPT

88175/88141/88142

PDM

5915331

Result Interpretation

The Bethesda System for Reporting Cervical Cytology

Forms

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