Guide to Getting Started - Excelsior Diagnostics
[Pages:36]guide to
Getting Started
For Providers
Table of Contents
WELCOME TO EXCELSIOR
5
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
34
4
Replacing guesswork with applied
science
GETTING STARTED GUIDE
5
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
6
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
7
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
8
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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