Guide to Getting Started - Excelsior Diagnostics

[Pages:36]guide to

Getting Started

For Providers

Table of Contents

WELCOME TO EXCELSIOR

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EXCELSIOR SCREENINGS

6

HOW TO ORDER A TEST

8

COLLECTION INSTRUCTIONS

10

ICD-10 CODES

12

HOW TO READ OUR RESULTS

21

ORDERING TESTS ONLINE 24

ORDERING SUPPLIES ONLINE

30

GETTING STARTED WITH SHIPPING

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Replacing guesswork with applied

science

GETTING STARTED GUIDE

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Welcome to Excelsior

OUR MISSION One of the few molecular diagnostics laboratories specializing in infectious diseases, Excelsior Diagnostics is dedicated to revolutionizing the fight against antibiotic resistance with precision DNA technology. Testing panels are robust and designed to target specific pathogens: bacteria, virus, fungus and parasites with virtually 100% accuracy and are customized to medical specialties.

(GAS), Group B Strep (GBS). Excelsior continues to be unrivaled with product development finding solutions customized to medical specialties.

ANTIBIOTIC RESISTANCE PANELS Excelsior Diagnostics provides Antibiotic Resistance Testing (ABR), a complementary test that gives providers the full ability to treat patient's with the right antibiotic.

COMPREHENSIVE TESTING Panels are designed to guide the clinician's treatment decisions offering comprehensive analysis in Wound, Sinus, Nail, Gastroenterology (GPP), Urinary Tract Infections (UTI), Sexually transmitted infections (STI), Upper and Lower Respiratory (RPP/LRP), Group A Strep

INDUSTRY LEADER The introduction of automation within the laboratory has allowed Excelsior to accomplish true consistency and efficiency in turnaround time for fast, accurate results. Utilizing the highest level of technology poises Excelsior as an industry leader in molecular diagnostics.

EXCELSIOR DIAGNOSTICS

Excelsior Screenings

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SCREENING

TARGETS

Gastrointestinal Pathogen Panel

(GPP)

Bacteria: Salmonella, Shigella, Campylobacter, E. coli 0157, Shiga toxin 1, Shiga toxin 2, Vibrio cholera, E. Coli ST, E. Coli LT, C. difficile toxin A, C. Difficile toxin B.

Viruses: Norovirus GI, Norovirus GII, Rotavirus A, Adenovirus 40/41 Parasites: Giardia Iamblia, Entamoeba histolytica, Cryptosporidium

C. Diff

C. Difficile toxin A, C. Difficile toxin B

A/B Toxin

C. Difficile toxin A, C. Difficile toxin B

Respiratory Pathogen Panel

(RPP)

Bacteria: Chlamydophila pneumoniae, Mycoplasma pneumoniae Viruses: Influenza A, Parainfluenza virus 1, Rhinovirus/ Enterovirus, Influenza A H1, Parainfluenza Virus 2, Adenovirus, Influenza A H3, Parainfluenza virus 3, Coronavirus HKU1, Influenza B, Parainfluenza virus 4, Coronavirus NL63, Respiratory syncytial virus A, Human bocavirus, Coronavirus OC43, Respiratory syncytial virus B, Human metapneumovirus, Coronavirus 229E

Lower Respiratory Panel

Bacteria: Moraxella catarrhalis, Haemophilus influenzae, Streptococcus pneumoniae

Group A Strep

Streptococcus pyogenese

Group B Strep

Streptococcus agalactiae

Wound Panel

Bacteria: Acinetobacter baumannii, Clostridium perfringens, Corynebacterium striatum, Enterobacter aerogenes, Enterobacter cloacae, Enterococcus faecalis, Enterococcus faecium, Escherichia coli, Finegoldia magna, Klebsiella pneumoniae, Morganella morganii, Peptostreptococcus anaerobius, Proteus mirabilis, Pseudomonas aeruginosa, Salmonella enterica, Serratia marcescens, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus agalactiae (Group B), Streptococcus pyogenese (Group A), Streptococcus pneumoniae Fungus: Candida albicans, Candida glabrata, Candida parapsilosis, Candida tropicalis

GETTING STARTED GUIDE

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SCREENING

TARGETS

Nail Panel

Fungus: Acremonium strictum, Alternaria, Aspergillus fumigatus, Aspergillus niger, Aspergillus terreus, Aspergillus versicolor, Curvularia lunata, Epidermophyton floccosum, Fusarium solani, Geotrichum candidum, Neofusicoccum mangiferae, Scopulariopsis brevicaulis, Scytalidium dimidiatum, Candida spp., Microsporum audouinii, Microsporum canis, Microsporum gypseum, Microsporum nanum, Trichophyton interdigitale (T. mentagrophytes), Trichophyton rubrum, Trichophyton soudanense, Trichophyton tonsurans, Trichophyton violaceum, Trichosporon beigelii, Trichosporon mucoides, Zygosaccharomyces spp. (genus level)

Urine Panel

Bacteria: Acinetobacter baumannii, Citrobacter freundii, Enterobacter aerogenes, Enterobacter cloacae, Enterococcus faecalis, Enterococcus faecium, Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Morganella morganii, Proteus mirabilis, Proteus vulgaris, Providencia stuartii, Pseudomonas aeruginosa, Staphylococcus saprophyticus, Streptococcus agalactiae (Group B) Fungus: Candida albicans

Bordetella Pertussis

Bordetella pertussis

HSV 1 & 2

Herpes simplex virus1, Herpes simplex virus 2

Sinus Panel

Bacteria: Acinetobacter baumannii, Corynebacterium striatum, Enterobacter aerogenes, Enterobacter cloacae, Enterococcus faecalis, Enterococcus faecium, Escherichia coli, Klebsiella pneumoniae, Morganella morganii, Peptostreptococcus anaerobius, Proteus mirabilis, Pseudomonas aeruginosa, Serratia marcescens, Staphylococcus aureus, Staphylococcus epidermis, Streptococcus agalactiae (Group B), Streptococcus pyogenese (Group A), Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Fusobacterium nucleatum, Prevotella SPP, Peptostreptococcus SPP, Methicillin-Resistant S. Aureus (MRSA), Mycobacterium kansasii, Helicobacter pylori Fungus: Alternaria, Candida albicans, Candida glabrata, Candida parapsilosis, Candida tropicalis, Aspergillus SPP, Microsporidium, Curvularia lunata

EXCELSIOR DIAGNOSTICS

How to Order a Test

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Paper Lab Requisition Forms - Front

Complete patient lab requisition forms - print or digitally.

Required Information PATIENT INFORMATION

12605 East Freeway, Ste. 365 Houston, TX 77015 T: (713) 571.4270 F: (832) 767.0729 Lab Director: Jonathan Stein, PhD CLIA # 45D2141802

Last Name Sex F M DOB Address City, State, ZIP

First Name Resides

Home

MI Facility

REPRESENTATIVE INFORMATION Name

LAB REQUISITION

Phone

Email

** This completed form must be sent with the specimen **

PROVIDER INFORMATION

Clinic Name Address City, State, ZIP Provider Name(s)

Phone NPI #

FACILITY INFORMATION

Facility Name

Address CONTACT FOR REQUISITION (Contact for missing info or questions) Facility Contact Person:

PAYMENT INFORMATION

BILL: Patient

Insurance

Other

See attached copy of patient demographics/ insurance info

Primary Insured Name:

Relationship to Insured: Self

Spouse

Child

Insurance Company:

Other

Member ID #

Group ID #

City, State, ZIP:

TYPE: Facility City, State, ZIP

Home Health Home Visit Provider

Other

Facility Contact Phone:

SPECIMEN COLLECTION

Date of Collection:

Time:

Collected by: TYPE:

NASAL THROAT SPUTUM NAIL/PARONYCHIA SKIN WOUND/SOFT TISSUE Location Swabbed

STOOL Consistency:

Soft Loose Watery

URINE Type:

Clean Catch

Catheter

AM

PM

URINOGENITAL Vaginal Fluid Genital Ulcer Prostatic Fluid Pelvic Abcess Semen

SCREENINGS AND PANELS

001. GPP gastrointestinal pathogen panel 002. RPP upper respiratory pathogen panel 003. LRP lower respiratory panel 004. SINUS PANEL 005. URINE PANEL 006. NAIL PANEL

007. WOUND PANEL 008. GAS group a streptococcus 009. GBS group b streptococcus 010. HSV 1 & 2 herpes virus infection 011. BORDETELLA whooping cough 012. C-DIFF ONLY 013. COVID-19/ SARS/ RPP

Include ABR

antibiotic resistance panel

Available For

- GPP - RPP (Bacteria only, not viruses) - LRP

- Urine Panel - Wound Panel - Sinus Panel

Include A/B Toxin Available for C-Diff test only, and will be run if C-Diff test is positive

Provider Signature

DIAGNOSTIC INFORMATION

PRIMARY DIAGNOSES ICD-10 SECONDARY DIAGNOSES ICD-10

RESULTS: RESULTS SENT TO: (SELECT ALL THAT APPLY)

Physicians Portal

Email

Fax

BACKUP RESULTS SENT TO:

Email

Fax

Date

CLEARLY include patient's name & DOB Include patient's address for billing CLEARLY include provider's name & NPI

Check panel box AND check "Include ABR" or "Include A/B Toxin" ICD-10 Codes must be included (can be found on page xx)

Include all recipients of test results, or select "Physicians Portal"and a login will be sent for you to begin setup Physicians signature/ date required

GETTING STARTED GUIDE

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