Because fern testing and wet mount exam are considered moderately complex tests, CLIA requires that those performing them have current documentation of competency (renewed every 6 months). It was an administrative nightmare for our hospital CLIA-compliant lab to keep up with documentation for some 50 independent OB-Gyns, so they decided to take the microscope away from L&D and have a handful of MedTechs in the lab keep up the certification. So now these exams are done in the lab which arguably makes them more accurate and undoubtedly makes them take 1-2 hours longer and makes them a line-item charge to the patient. In that case, there is little reason to prefer fern test over a biochemical assessment for ROM such as Amnisure or ROM-Plus. In my view, however, all these tests require thoughtful clinical judgement integrating the history, exam findings, ultrasound assessment of AF volume, and test result. Dx of ROM is often not as black-and-white as we'd like.
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C. Andrew Combs
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Original Message:
Sent: 07-23-2019 12:17
From: Christian Pettker
Subject: PPM (Provider Preferred Microscopy)
Does anyone out there have a Best Practice for implementing a program around Provider Preferred Microscopy (fern testing, etc.) to satisfy CLIA and regulatory requirements? Any hospital policies or SOPs? Would love any advice on this...our hospital is looking at PPM across all areas and we are trying to make sure we are along with the best practices out there.
Chris
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Christian Pettker
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