Q&A column
June 2025
Q. Our institution performs rapid onsite evaluation (ROSE). In cases in which multiple passes are done, we frequently encounter unsatisfactory specimens (debris, neutrophils, bronchial cells, etc.). These cases are rescreened by a cytotechnologist and pathologist. If the case goes to a different pathologist, those unsatisfactory slides are unnecessarily screened three times. They’re also included in the daily slide workload of the cytotechnologist. Can the onsite pathologist dispose of unsatisfactory Diff-Quik slides and keep just the counter formalin-fixed slides? Since ROSE is provided for that episode, can you comment on billing? Read answer.
Q. Many times a platelet count on an automated hematology system indicates some degree of thrombocytopenia or the analyzer reports a high mean platelet volume or platelet large cell ratio, while a blood smear shows large platelets and/or giant platelets. Is it OK to include a comment in the report that the platelets are adequate or that the count could be due to large platelets, especially with values that indicate marked thrombocytopenia? Read answer.