Clinical Laboratory and Outreach Services

Baptist's Clinical Laboratory and Outreach Services are accredited by the College of American Pathology, Clinical Laboratory Improvement Act, and the American Association of Blood Banks. The blood bank is also inspected and licensed by the Food & Drug Administration. The labs are medically supervised by board certified pathologists and staffed by certified medical technologists, cytology technologists, and by laboratory technicians and histology technicians.

Laboratory Outreach Services

In late 1985, Baptist Laboratories established a Clinical Outreach Program with the idea of providing quality lab work to Central Mississippi. Throughout the past decade, Baptist's commitment to the constantly changing needs of the healthcare community has prompted expansion of our services. Currently, the Outreach Program provides:

  • Community-based full service comprehensive laboratory
  • Services of Board-Certified Pathologists
  • 24-hour Client Services Department
  • Leading-edge testing facilities
  • Personalized reporting capabilities and on-line interface capablilities
  • Dedicated Courier Service and STAT specimen pick-up
  • Variety of billing options
  • Ongoing formal education program
  • Optimal turn-around times for laboratory testing.

The Clinical Outreach Program has CAP and CLIA certification, JCAHO accreditation, including AABB and FDA certifications for Blood Bank Services.

Laboratory Procedures

Please use this link for a list of Laboratory Procedures.

Hours, Referral Lab, Courier and Outpatient Services

Availability of Services

The clinical laboratory is open 24 hours a day, 7 days a week. Medical Technologists are on the premises at all times.

Contact Us: 601-968-3070

Referral Laboratory Services

BHS Clinical Laboratory accepts clinical specimens on a referral basis. If a requested test is not available in the BHS Laboratory, the laboratory will arrange for transport of the specimen to another reference lab for testing. Testing performed by off-site reference labs may have increased turn-around times for results of 3 - 10 days.

Courier Service

Courier services for specimen pick up and report delivery may be arranged by contacting the Outreach Department. Courier runs are made on a regular schedule each weekday with limited STAT courier service available upon request. A STAT courier is available on weekends for life-threatening situations only.

Outpatient Services

Outpatient Laboratory services are provided at the Colonnades Laboratory.

Physicians referring a patient to BHS for outpatient work during a weekday should have an order phoned to the scheduling office prior to the patient's arrival. The scheduling office's phone number is 601-968-1400. All tests requiring more than 30 minutes for completion, such as glucose tolerance and coagulograms, must be scheduled at least 24 hours in advance. During regular business hours (6:15 a.m. - 6:00 p.m.) patients should report to the Outpatient Business Office located on the ground floor of the Colonnades Building. The patient will then be called to the Colonnades phlebotomy station or other appropriate drawstation for specimen collection.

Complete reports will be mailed or delivered to the physician's office. If requested, results will be faxed to the physician's office. All critical results are telephoned to the physician or nurse in charge of the patient.

Labeling Specimens

  1. All specimens for laboratory testing should be labeled with the following information:
    • Patient's first and last name
    • Unique patient identifier (Eg. Inpatients, Patient Account #; Outreach Patients, Last four digits of social security number, date of birth, etc.)
    • Date and time of collection
    • Identification of collector (Initials)
  2. All specimens for laboratory testing must be accompanied by a lab requisition slip or electronic order (inpatients). The request slip should contain the following information:
    • Patient's first and last name as it is presented on photo ID/Driver's license
    • Patient's birth date
    • Patient's sex
    • Patient's social security number
    • Patient's home address
    • Date and time of collection and collector's initials
    • Laboratory test(s) to be performed (include valid ICD-10 codes for each test ordered)
    • First and last name of physician requesting test
    • Specimen source
    • Call back/fax information if applicable
    • Name and address of clinic or hospital sending specimen
    • Clinical information when appropriate:
      • Medicare/Medicaid patients - include number and alpha code
      • Insurance company
      • Responsible party/guarantor information if patient is under 18 years of age
      • Group number
      • Policy number
      • Complete address and name of insurance company
      • Name and employer of policy holder
    • Signature of Medicare patient, advanced beneficiary notice, for all tests lacking medical necessity documentation.
  3. Unlabeled or improperly identified specimens should be recollected. Outreach personnel will contact the clinic to request recollection of any unlabeled or improperly identified specimen. If recollection is not feasible and specimen is deemed "precious," the appropriate clinic personnel will be responsible for identifying the specimen.

The Outreach Department will acknowledge verification of the specimen only after being authorized by clinic personnel to do so. A note will be made upon admission that the specimen was received unlabeled, along with the name of the person at the clinic verifying the specimen. This information will be recorded on the appropriate quality assurance form.

Exceptions:

  • All unlabeled or improperly identified specimens for cytology and histology are unacceptable and will be returned to the physician's office.

It is recommended that a copy of the requisition be maintained in the patient's file by the ordering facility.

Medical Necessity

Under section 1862(a)(1) of the Medicare law, claims submitted for service or supplies will only be paid if the service meets Medicare coverage criteria, and is "reasonable and necessary" for the beneficiary (patient), given his/her medical condition. If Medicare determines that a particular service, although it would otherwise be covered, is "not reasonable and necessary" under Medicare program standards, Medicare will deny payment for that service.

MEDICARE will pay only for service or supplies that:

  • Are proper and needed for the diagnosis or treatment of the patient's medical condition according to coverage criteria.
  • Are used for the diagnosis, direct care, and treatment of the patient's medical condition according to coverage criteria.
  • Meet "frequency limitations."
  • Are not for experimental or research use.
  • Are not mainly for the convenience of the patient and his/her doctor.

Physicians are required by Federal law to provide a diagnosis that medically justifies the laboratory test(s) at the time of the request. Prior to furnishing the service, the physician/provider must present to the patient an Advanced Beneficiary Notice (ABN) that Medicare will probably deny payment and that the patient will be personally and fully responsible for payment if Medicare denies payment.

All diagnosis information should be designated in the spaces provided on the Outreach requisition for each requested laboratory test.

National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) are readily available upon request or from CMS website(s).

Order of Draw

Note: When using a winged collection set for venipuncture and a blue top is the first tube to be drawn, a discard tube should be drawn first (do not completely fill). The discard tube should be a non-additive (plain red) or an extra blue top.

To ensure that the chance of carry-over of anticoagulants/additives has a minimal effect on sample integrity, collect samples in this order.

  1. BLOOD CULTURES
  2. BLUE
  3. GOLD
  4. RED (CLOT ACTIVATOR)
  5. LIGHT GREEN
  6. GREEN
  7. PINK
  8. PURPLE
  9. GRAY

Personnel

Director of Laboratories

William Payne, M.D.

Pathologists

Anamaria Andrei, M.D.
Steven Bigler, M.D., FACP
Kathryn B. Brown, M.D.
David Marbury, M.D.
William Payne, M.D.
Nanette B. Pinkard, M.D.

Clinical Laboratory Director

Robert Barham, M.B.A., M.T. (ASCP)

Clinical Laboratory Managers

Carolyn Kent Purvis, M.B.A., M.T. (ASCP) 
Jennifer Knight, M.H.S., M.L.S. (ASCP)

Medical Technology Program

Jennifer Knight, M.H.S., M.L.S. (ASCP)

Compliance Management

Carolyn Kent Purvis, M.B.A., M.T. (ASCP)

Laboratory Marketing Representative

Arthur Wright, M.T. (ASCP)

Laboratory Data Management Technical Specialist

Vicki Edwards, M.T. (ASCP)

Technical Specialists of Laboratory Sections

Accessioning Coordinator: Leighea Triplett, M.B.A., M.T. (ASCP)
Compliance: Theresa L. Pringle, M.T. (ASCP), S.B.B.
Core (Heme, Coag, UA, Chem): Charlene Combest, M.T. (ASCP)
Cytology: Leanne B. Huckaby, B.S., S.C.T. (ASCP)
Histology: Kathy Tedford Hays, H.T. (ASCP)
Immunochemistry: Paul Montgomery, M.H.S., M.T. (ASCP)
Immunohematology: Laresa Swisher, M.H.S., M.T. (ASCP)
Microbiology: Gloria Luckett, M.T. (ASCP)
Outreach Services: Kaye Stuart, M.L.T. (ASCP)
Phlebotomy: Leighea Triplett, M.B.A., M.T. (ASCP)
Point of Care: Lana Strobel, M.T. (ASCP)
Referrals: Rita Embry, M.T. (ASCP)
Serology: Carolyn Campbell, M.T. (ASCP)
Special Hematology: Susan Lackey, M.T. (ASCP)

Shift Coordinators

Second shift: Suzanne Smith-Holmes, M.T. (ASCP) 
Third shift: Jelani Parker, M.T. (ASCP)

Office Coordinator

Dawn Gurley

Transcription Coordinator

Dee Jones

Advances in medical science are transforming the traditional field of surgical pathology. Nevertheless, the time-honored microscopic examination of histologic slides continues to be the mainstay of diagnosis in examining biopsy, cytology, and resected tissue specimens.

When it comes to the diagnosis, assessment, and staging of cancer, the pathologists at Baptist, with their extensive training and experience, are critical members of the patient care team.

In addition, the pathology department at Baptist employs state-of-the-art ancillary techniques whenever indicated, including immunochemistry, molecular pathology, and computer-assisted cytometry. Many of these technologies are available onsite, but all are available through Baptist's network of reference laboratories.

Anatomic Pathology Services at Baptist:

  • Provides a range of sophisticated diagnostic tests in-house, including a full panoply of immunohistochemical testing.
  • Offers responsive turn-around for results, generally 24 hours or less.
  • Is physically located near the operating rooms and radiology department. This proximity allows our pathologists to provide immediate feedback to surgeons and interventional radiologists if more tissue is needed to render a diagnosis. Pathologists at Baptist examine one thousand fine needle aspiration and biopsy specimens from interventional radiological procedures annually.
  • Is highly accessible. Pathologists are available by telephone or e-mail with at least one pathologist on call 24 hours a day.
  • Operates with complete independence. Pathologists on staff at Baptist are unbiased, unstinting advocates for the patient and answerable only to the patient.

 

Our Pathologists

Dr. Anamaria Andrei is originally from Romania and graduated from Carol Davila Medical School in Bucharest. Following her anatomic and clinical pathology residency at Beaumont Hospital in Royal Oak, Michigan, she was a hematopathology fellow at Wayne State University in Detroit, Michigan and joined Baptist in 2007. She is board-certified in anatomic and clinical pathology, and has a special interest in hematopathology and clinical pathology.

Dr. Steven Bigler is originally from Utah and after completing medical school at the University of Utah, went to Seattle, Washington for a residency in anatomic pathology. Following residency and after working 4 years at the Veteran's Administration Medical Center in Seattle, he came to Jackson where he worked for 18 years at University Medical Center. He served as Chair of the Department of Pathology from 2005 to 2011. In January 2012 Dr. Bigler was very happy to join the staff at Baptist. He has a special interest in pathology of the male genitourinary tract, prostate cancer, and renal pathology.

Dr. Kathryn Brown is a native of Jackson who graduated from the University of  Mississippi Medical School. Following her anatomic and clinical pathology residency at UMMC, she completed a fellowship in gastrointestinal pathology at the Cleveland Clinic and joined Baptist in 2015. She is board certified in anatomic and clinical pathology, and has a special interest in gastrointestinal and hepatic pathology.

Dr. David Marbury is a native of Jackson who graduated from the University of  Mississippi School of Medicine in 2014. He completed a residency in AP/CP Pathology at UMMC in 2018 and subsequently completed a surgical pathology fellowship at the University of Alabama at Birmingham Hospital. He joined Baptist in 2019 following his fellowship. He is board certified in anatomic and clinical pathology and has a special interest in head and neck pathology.

Dr. William Payne is a native of Jackson who graduated from the University of  Mississippi Medical School. After completing a residency at the University of Texas Health Science Center in Houston, Texas, he was a surgical pathology fellow at the MD Anderson Cancer Center in Houston, Texas in 2010. In 2014 he joined Baptist. He is board certified in anatomic and clinical pathology, and has a special interest in breast pathology.

Dr. Nanette Pinkard graduated from the University of  Mississippi Medical Center where she also completed a residency in pathology. At the University of Alabama Medical Center at Birmingham she was for several years the principal pulmonary pathologist supporting UAB’s active lung transplant program. At Baptist she retains her interest in lung pathology and serves as medical director of microbiology.

Contact Information

Telephone:

601-968-3070

E-mail:

Dr. Anamaria Andrei: Anamaria.Andrei@BMHCC.org
Dr. Steven Bigler: Steven.Bigler@BMHCC.org
Dr. Kathryn Brown: Kathryn.Brown@BMHCC.org
Dr. David Marbury: David.Marbury@BMHCC.org
Dr. William Payne: William.PayneJr@BMHCC.org
Dr. Nanette Pinkard: Nanette.Pinkard@BMHCC.org

Reflex or Supplementary Testing

Reflex testing

For some laboratory tests, when certain criteria are met, additional testing will be generated to provide more conclusive laboratory information for diagnosis and treatment.

TEST

REFLEX CRITERIA

ADDITIONAL TESTS

Accucheck Glucose

< 50 or > 450 mg/dl

Glucose, Blood (no charge)

ANA Screen for Reflex

> or = 1.0

Centromere, dsDNA, SSA,SSB, RNP, SM, Scleroderma

Antibody Screen (Blood Bank)

Positive

Positive - surgery patient

Antibody Identification (panel)

Antibody Identification (panel) with 2 XM compatible units

C. difficile Toxin Panel
by EIA

Disagreement with the EIA antigen and toxin results or an invalid result

Molecular C. difficile Toxin assay

CBC with Diff

Abnormal Automated Diff
(Flags Generated by Analyzer)

Manual Diff & Peripheral Smear Review/Consult Hematology by Pathologist (as needed)

Celiac Disease
Comprehensive Panel
*   Tissue transglutaminase
IgA

*   IgA



Positive

<10 mg/dl


Endomysial Ab Screen

Tissue transglutaminase IgG

Cryptococcal Antigen

Positive

Cryptococcal Titer

Fetal Screen (Blood Bank)

Positive

Fetal Hemoglobin Stain

Hepatitis C Virus Antibody

Reactive

HCV Quantitative RNA,
(HCV Viral Load)

Hgb Electrophoresis

Band in S position

Sickle Prep (if not previously performed) and citrate agar Hgb electrophoresis for Sickle disease confirmation.

Hgb Electrophoresis

Hgb Electrophoresis

Band in C (or other abnormal) position

Rare Hgb

Citrate agar Hgb electrophoresis

HPLC Hgb electrophoresis

HIV Combo Ab/Ag:
HIV-I and HIV-2 Antibody &
HIV-1 p24 Ag

Reactive

HIV-1 & HIV-2 Differentiation
Negative for both HIV-1 and HIV-2 Ab

HIV-1 & HIV-2 Differentiation

HIV-1 RNA, Viral Load

HSV, IgM Screen

Positive

HSV, IgM Titer

IFE
(Immunofixation Electrophoresis)

Abnormal electrophoresis
suggestive of
monoclonal protein

SPE
(Serum Protein Electrophoresis)

Islet Cell Ab

Positive

Islet Cell Titer

Lupus Anticoagulant Panel

• dRVVT Screen

• PTT La Sensitive

 

• Positive/ Elevated

• Elevated

 

• dRVVT Confirmatory

• Hepzyme Neutralization

• Hexagonal Phase Neutralization (if needed)

Lyme Antibody

Positive

Lyme Western Blot

Myoglobin/Hgb Screen (Urine)

Positive

Myoglobin, Quantitative

Platelet Function Test

Collagen EPI >201

Collagen/ADP

RPR

Reactive

RPR Titer

Sickle Prep

Positive

Hgb Electrophoresis for both C and S Hgb differentiation

SPE
(Serum Protein Electrophoresis)

Abnormal electrophoresis suggestive of monoclonal protein

IFE
(Immunofixation Electrophoresis)

Streptozyme

TSH, Reflexive

VDRL, CSF

Positive

<0.27 or >4.20 uIU/mL

Reactive

Anti-Streptolysin O

Free T4

Titer

SURGICAL PATHOLOGY

 Breast or metastatic

 Breast

Colon resections

Esophagogastric junction
(distal esophagus)

HER2NEU

Glioma (brain)

Lung (initial biopsy)




All stomach biopsies

    REFLEX CRITERIA

 Breast Cancer

Ductal carcinoma in-situ
(DCIS)

 Colon Cancer

Adenocarcinoma


2+

Glioma

Squamous cell/non-small cell/
large cell, adenocarcinoma

Adenocarcinoma

    ADDITIONAL TESTS

ER, PR, HER2, Ki-67

ER

MMR

HER2 by IHC

HER2 by FISH or CISH

MDM2

ALK gene rearrangement by FISH, EGFR and PD-L1, ROS-1


HER2 by IHC

Supplementary Testing

Supplementary testing will automatically be performed for the tests below, which may be billed separately.

Initial Test

Supplementary Test(s)

AFB Culture

Anaerobic Culture

Body Fluid Culture

Coagulogram

Cryptococcal Antigen, CSF

AFB Smear

Aerobic Culture

Gram Stain

Peripheral Smear Review by Pathologist plus indicated Factor Assays/Tests

CSF CUlture

Directogen CSF

CSF Culture

E. Coli 0157

Stool Culture, Campylobacter

External Culture

Gram Stain

Eye Culture

Gram Stain

Fungus Culture

KOH and/or Wright Stain

Genital Culture

Gram Stain

Electrophoresis, Hemoglobin

Peripheral Smear Review by Pathologist

Electrophoresis, Protein

Total Protein

Electrophoresis, Immunofixation (IFE) Serum

Electrophoresis, Immunofixation (IFE) Urine

Microalbumin, Random Urine

Immunoglobulins
(IgA,IgG,IgM)

Urine Creatinine, Urine Protein

Urine Creatinine

Respiratory Culture

Gram Stain

Stool Culture

Campylobacter

Surgical Specimen Culture

Urinalysis with reflex to culture

Gram Stain

Urine Culture if >10 WBC's

Specimen Collection

  • Always identify the patient prior to collecting samples by verifying the patient's full name and other unique identifiers such as the billing (encounter) number.
  • If a sample is drawn from a line, at least 10 ml of blood must be drawn and discarded before the test sample is drawn. If heparin is used to flush the line, an equal amount of blood must be drawn and discarded before the test sample is drawn. It is recommended NOT to draw a PTT from a heparin flushed line.
  • All tubes should be filled to the volume indicated on the label.
  • Follow the correct order of draw when using evacuated blood collection tubes.
  • A waste tube should be used to clear air from butterfly tubing when collecting a blue top first.

All tubes must be inverted gently for at least 8 times at collection. Gold top tubes must be allowed to clot at least 30 minutes prior to centrifugation.

DO NOT COLLECT SAMPLES FOR THERAPEUTIC DRUG MONITORING IN ANY TUBE THAT CONTAINS A GEL SEPARATOR. (I.E. GOLD TOP)

  • Use aseptic technique when collecting blood samples, particularly if you are collecting blood cultures. Always allow the cleansing solution to dry prior to performing the venipuncture.
  • Appropriately label all samples with:
    1. The patient's first and last name.
    2. A unique identifier (last four digits of Social Security Number, Date of Birth, etc.).
    3. Date and time specimen was collected.
  • Do not remove the tops of vacutainer tubes. Do not transfer blood from one tube to another. Do not vigorously shake vacutainer tubes once they are filled with blood.
  • Do not send samples to the laboratory in syringes with needles still attached.
  • Please call the laboratory prior to drawing the blood for any test not included in the Laboratory Procedures List.

Specimen Packaging and Handling

Client specimen should be stored in one of the following three thermal environments depending upon the client, specimen, and test requirements:

  • Ambient or room temperature
  • Refrigerated
  • Frozen

The viability of each specimen depends upon how well the thermal environment is maintained through the specimen transport process. All specimens must be maintained at the proper temperature to prevent the need to recollect due to thermal damage. The thermal environment of each specimen should be clearly defined by the client and the location of the specimen at the account.

Laboratory specimens are packed in primary, secondary, and tertiary containers for transportation.

Primary = tube, cup, or slide
Secondary = biohazard bag
Tertiary = Courier bag

  • The client is responsible for primary and secondary packaging
  • The courier is not to pick up a sample if the specimen container is contaminated or leaking
  • Specimens with needles attached should not be transported
  • The client should label all radioactive materials as such

School of Medical Laboratory Science

The School of Medical Laboratory Science was established in 1946 and is a division of the Department of Pathology at Mississippi Baptist Medical Center. The largest private general hospital in the state, Baptist is accredited by The Joint Commission and is a member in good standing of the Mississippi Hospital Association. The Pathology Department is accredited by the College of American Pathologists and the American Association of Blood Banks.

The School of Medical Laboratory Science offers a 12-month program for qualified applicants in the major disciplines of clinical laboratory medicine including Chemistry, Hematology, Immunohematology and Microbiology as well as special topics such as Education and Management.

Unacceptable Bacteriological Specimens

  • Specimens received without a label or with incorrect label.
  • Specimens received in unsterile container (i.e. ziplock bag) or on a dry swab.
  • Stool specimen for OCP, Wright’s stain or fat stain which contains barium.
    *OCP in any fixative other than the Ecofix Vial (Green Label).*
  • Foley cath tips are unacceptable for culture.
  • Sputum collected in alcohol or fixative. Sputum that is obviously saliva.
  • Pooled sputum collections (such as 24 hour collection for routine, AFB, or fungal cultures).
  • Specimens for anaerobic culture collected in aerobic container.
  • Urines in vacutainer tubes with the red and yellow marbled top.
  • Specimens received in containers visibly contaminated on the outside.
  • Specimens received on diapers, gloves, toilet paper, bed pans, plastic bags or any other inappropriate containers.

Unsuitable for anaerobic cultures

Sputum, Throats, NP, Bronchial washes, Vaginal or cervical swabs, Urines (voided), Stool (except for C. difficile).

Additional Notes for Bacteriology

Sites for lone anaerobic culture are highly unusual. It is recommended that both aerobic and anaerobic cultures be performed from the site being cultured.

The following culture types will include a gram stain automatically when ordered and billed separately from the culture for patient billed accounts:

Respiratory – sputum, gastric, bronchial washings, bronchial brush, etc.
External – wound, abdominal, abscess, etc.
Genital – vaginal, urethral, cervical, etc.
Body fluids – joint, spinal fluid, peritoneal, chest, ascites, etc.
OTHER – eye, surgical specimens, etc.
AFB cultures will include an AFB smear, and fungal cultures will include a KOH or a Wright stain.

ABN (Advanced Beneficiary Notice)

Details on the ABN form, when to use an ABN, and how to complete the form may be found at website:

Centers for Medicare & Medicaid Services

Click here for the current MBHS ABN form.