Our mission as a department is to deliver patient-centered, physician friendly services in a fiscally responsible manner. This ADVANCED LABORATORY SERVICES 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 ADVANCED LABORATORY SERVICES 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.
Services Offered
Our laboratories offer services and testing in the following areas:
Other Services Offered:
- Call Center
- Laboratory Information System Support
- Reference Laboratory Testing
- Research Studies
Anatomic Pathology
The department of Anatomic Pathology is comprised of a team of board-certified pathologists with expertise in several subspecialties. We offer a comprehensive diagnostic and consultation services supporting the need of our clinical colleagues and the patients we care for.
The department processes a wide variety of cases each year from routine biopsies to complex multi-organ resections with a state of the art histology laboratory that operates round-the-clock. We provide timely and accurate routine diagnostic reports for biopsies and surgical specimens within nationally accepted turn around time. Our Subdisciplines include Cytopathology, Autopsy Pathology and various areas of Surgical Pathology including GYN Pathology, Neuropathology, Hematopathology, Pediatric Pathology, Renal Pathology, GI & Liver Pathology, Breast Pathology, Pulmonary Pathology, and GU pathology among others.
Our Laboratory provides variety of specialized ancillary testing to support the Pathologist to make accurate diagnosis, including molecular, immunohistochemical, electron microscopy and immunofluorescence. Our immunohistochemistry lab for example have a wide range of antibody markers for diagnostic and prognostic workup of cases. Cytology lab provides Molecular assay for diagnosing HPV, HPV 16 18/45, Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis. Our department also works in collaboration of various nationally reputed reference labs to provide modern molecular, FISH & NGS gene sequencing.
We also provide intraoperative consultations with frozen sections, and ROSE (rapid on site evaluation for FNA adequacy. Our Pathologist attends and support various interdisciplinary tumor board conferences and clinical trial programs.
We have a strong commitment to providing the highest-quality diagnostic services. We have a robust Quality Assurance and control program which includes prospective second readings on malignant and complicated high-risk cases. Our subspecialty trained pathologist provides consultations services to other practitioners for difficult cases. We also provide second-opinion diagnostic reviews for outside cases.
Biochemical Genetics
The Biochemical Genetics Laboratory offers 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 and Transfusion Services
The Blood Bank & Transfusion services department at Westchester Medical Center supports an adult and pediatric Level I trauma academic hospital of over 600 beds. Laboratory testing of donated blood prior to transfusion is performed in order to ensure that recipients receive the safest possible blood products.
Chemistry
The Westchester Medical Center Chemistry laboratory plays an essential part in the delivery of quality diagnostic results accurately and as quickly as possible. We offer over 196 diagnostic tests and test combinations. They are ordered to diagnose, treat, manage or monitor a 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 percent of medical decisions. We perform and interpret approximately 5 million diagnostics tests annually.
Cytogenetic Lab
The Cytogenetics laboratory at Westchester Medical Center provides chromosome analysis of peripheral blood, products of conception and skin fibroblasts. Our laboratory 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.
Diagnostic Immunology
The Diagnostic Immunology laboratory is involved in work related to the identification of antibodies found in autoimmune disorders such as S.L.E., and other connective tissue disorders. Our department is involved in the diagnostic of Lyme disease using two complementary methodologies (ELISA, and Western Blot). This section also performs testing that would be useful in the identification of allergy-related antibodies.
Flow Cytometry
The Flow Cytometry Department 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 provides testing services 24 hours a day, seven days a week. Testing includes but is not limited to: CBC, platelet count, differential, ESR, reticulocyte, and IPF; from various body fluids. This laboratory utilizes the latest technologies to provide the most accurate results.
The Microbiology laboratory provides diagnostic services covering bacteriology, mycology, virology, 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.
Molecular and Virology Diagnostics
The Molecular Diagnostics Laboratory uses cutting-edge technologies that includes real-time PCR, 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].
The Clinical Virology section employs 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.
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 over 200 instruments and devices, as well as offering 20 different rapid “bedside” assays throughout the WMC campus. We perform ongoing training & competency for doctors, 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, 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: Serum and urine Osmolality, Fetal Fibronectin, Urine pregnancy, PH fluids, Chloride Testing for Cystic fibrosis (sweat test), ionized calcium and potassium.
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.
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 Critical values. Critical values are automatically sent to the call center where they are called and the call is documented in accordance with New York State regulations.
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, 8 a.m. to 5:30 p.m.
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.
PDF Forms
Click to download:
Biochemical Genetics Laboratory Requisition
Biochemical Genetics Laboratory Consent
Hematopathology Requisition
Cytology and FNA Requisition
Frozen Section, Operating Room at Westchester Medical Center
GYN Cytology Requisition
Informed Consent for Cystic Fibrosis Mutation Testing
Informed Consent for Thrombophilia Genetic Testing
Informed Consent for Genetic Testing
Molecular Genetics – Congenital Inherited Diseases Patient Information Sheet
New York State Non-Permitted Laboratory Test Request Approval Form
Infectious Diseases Requisition
Order for Blood Products
Order for Emergency Release Blood/Massive Transfusion Protocol
Requirements and Instructions for Submitting Pediatric Specimens to the Wadsworth Center for Diagnostic HIV Testing
Release Form for Blood and Blood Products
Request for Blood Bank Laboratory Tests
Routine Test Requisition
Surgical Pathology Requisition
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.