Unique Plan Description: OBGYN Pathology Specimen
Plan Selection Display: OBGYN Pathology Specimen
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2021-03-18 10:09:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2024-03-19 08:36:27
Available at all facilities: Yes

OBGYN Pathology Specimen
Laboratory
Tissue
	Pregnancy Loss Anora
		T;N, Routine, spec type = Tissue/Blood
	Pregnancy Loss UNMC Microarray (PreAuth Req)
		T;N, Routine, spec type = Tissue/Blood
	Tissue Request
		Tissue, Uterus, None, Gross & Micro (Histology)
		Tissue, Uterine Myoma, None, Gross & Micro (Histology)
		Tissue, Uterine Fibroid, None, Gross & Micro (Histology)
		Tissue, Uterus and Cervix, None, Gross & Micro (Histology)
		Tissue, Uterus, Cervix and Bilateral Fallopian Tubes, None, Gross & Micro (Histology)
		Tissue, Uterus, Bilateral Fallopian Tubes, None, Gross & Micro (Histology)
		Tissue, Uterus, Cervix, Bilateral Ovaries/Fallopian Tubes, None, Gross & Micro (Histology)
		Tissue, Uterus, Bilateral Ovaries/Fallopian Tubes, None, Gross & Micro (Histology)
		Tissue, Endometrial Mass, None, Gross & Micro (Histology)
		Tissue, Endometrial/Uterine Polyp, None, Gross & Micro (Histology)
		Tissue, Endometrial/Uterine Fibroid, None, Gross & Micro (Histology)
		Tissue, Endometrial Curetting's and Polyp, None, Gross & Micro (Histology)
		Tissue, Uterine Contents, None, Gross & Micro (Histology)
		Tissue, Bilateral Ovaries, None, Gross & Micro (Histology)
		Tissue, Bilateral Fallopian Tubes, None, Gross & Micro (Histology)
		Tissue, Bilateral Fallopian Tube Segments, None, Gross & Micro (Histology)
		Tissue, Bilateral Ovaries and Tubes, None, Gross & Micro (Histology)
		Tissue, Bilateral Ovaries and Tube Segments, None, Gross & Micro (Histology)
		Tissue, Cervix, None, Gross & Micro (Histology)
		Tissue, Cervical Polyp, None, Gross & Micro (Histology)
		Tissue, Cervical Fibroid, None, Gross & Micro (Histology)
		Tissue, Endocervical Polyp, None, Gross & Micro (Histology)
		Tissue, Endocervical Curetting's, None, Gross & Micro (Histology)
		Tissue, Vagina, None, Gross & Micro (Histology)
		Tissue, Bladder, None, Gross & Micro (Histology)
		Tissue, Peritoneal Cyst, None, Gross & Micro (Histology)
		Tissue, Periurethral Cyst, None, Gross & Micro (Histology)
		Tissue, Hymen, None, Gross & Micro (Histology)
		Tissue, Bartholin Cyst, None, Gross & Micro (Histology)
		Tissue, Abdominal Tissue, None, Gross & Micro (Histology)
		Tissue, Abdominal Scar, None, Gross & Micro (Histology)
		Tissue, Abdominal Lesion/Wound, None, Gross & Micro (Histology)
		Tissue, Abdominal Mole/Skin Tag, None, Gross & Micro (Histology)
	Tissue Request Placenta
		Placenta, Gross & Micro (Histology)
		Placenta Twin, Gross & Micro (Histology)
		Placenta Triplet, Gross & Micro (Histology)
		Placenta To Family Or Donation, Gross & Micro (Histology)
	Tissue Request
		Tissue, Products Of Conception, None, Gross & Micro (Histology)
		Tissue, Products Of Conception With Chromosome Studies, Cytogenentics, Gross & Micro (Histology)
		Tissue-Additional, None, Gross & Micro (Histology)
		Tissue-Additional, None, Gross & Micro (Histology)
		Tissue-Additional, None, Gross & Micro (Histology)
		Tissue-Additional, None, Gross & Micro (Histology)
		                                        Left(NOTE)*
		Tissue, Left Ovary, None, Gross & Micro (Histology)
		Tissue, Left Ovary and FallopianTube, None, Gross & Micro (Histology)
		Tissue, Left Fallopian Tube, None, Gross & Micro (Histology)
		Tissue, Left Fallopian Tube Segment, None, Gross & Micro (Histology)
		Tissue, Left Ectopic Fallopian Tube, None, Gross & Micro (Histology)
		Tissue, Left Ovarian Cyst, None, Gross & Micro (Histology)
		                                       Right(NOTE)*
		Tissue, Right Ovary, None, Gross & Micro (Histology)
		Tissue, Right Ovary and Fallopian Tube, None, Gross & Micro (Histology)
		Tissue, Right Fallopian Tube, None, Gross & Micro (Histology)
		Tissue, Right Fallopian Tube Segment, None, Gross & Micro (Histology)
		Tissue, Right Ectopic Fallopian Tube, None, Gross & Micro (Histology)
		Tissue, Right Ovarian Cyst, None, Gross & Micro (Histology)
Lymph Node
	Tissue Request
		Lymph Nodes-Additional, None, Gross & Micro (Histology)
		Lymph Nodes-Additional, None, Gross & Micro (Histology)
Biopsies
	Tissue Request
		Biopsy, Endometrial Biopsy, None, Gross & Micro (Histology)
		Biopsy, Endometrial Curetting's, None, Gross & Micro (Histology)
		Biopsy, Endocervix Curetting's, None, Gross & Micro (Histology)
		Biopsy, Anterior Uterine Wall, None, Gross & Micro (Histology)
		Biopsy, Posterior Uterine Wall, None, Gross & Micro (Histology)
		Biopsy, Bladder, None, Gross & Micro (Histology)
		Biopsy, Anterior Cervical, None, Gross & Micro (Histology)
		Biopsy, Posterior Cervical, None, Gross & Micro (Histology)
		Biopsy, Cervical Cone, None, Gross & Micro (Histology)
		Biopsy, Cervical Leep/Leetz, None, Gross & Micro (Histology)
		Biopsy, Peritoneal, None, Gross & Micro (Histology)
		Biopsy, Anterior Perineum, None, Gross & Micro (Histology)
		Biopsy, Posterior Perineum, None, Gross & Micro (Histology)
		Biopsy, Anterior Vaginal Wall, None, Gross & Micro (Histology)
		Biopsy, Posterior Vaginal  Wall, None, Gross & Micro (Histology)
		Biopsy, Anterior Abdominal Wall, None, Gross & Micro (Histology)
		Biopsy, Posterior Abdominal Wall, None, Gross & Micro (Histology)
		Biopsy-Additional, None, Gross & Micro (Histology)
		Biopsy-Additional, None, Gross & Micro (Histology)
		Biopsy-Additional, None, Gross & Micro (Histology)
		Biopsy-Additional, None, Gross & Micro (Histology)
		                                        Left(NOTE)*
		Biopsy, Left Uterine Wall, None, Gross & Micro (Histology)
		Biopsy, Left Ovarian Cyst, None, Gross & Micro (Histology)
		Biopsy, Left Cervical, None, Gross & Micro (Histology)
		Biopsy, Left Perineum, None, Gross & Micro (Histology)
		Biopsy, Left Labia Minora, None, Gross & Micro (Histology)
		Biopsy, Left Labia Majoria, None, Gross & Micro (Histology)
		Biopsy, Left Vaginal Wall, None, Gross & Micro (Histology)
		Biopsy, Left Breast Lumpectomy, None, Gross & Micro (Histology), Send Directly to Lab
		Biopsy, Left Breast Skin, None, Gross & Micro (Histology)
		                                       Right(NOTE)*
		Biopsy, Right Uterine Wall, None, Gross & Micro (Histology)
		Biopsy, Right Ovarian Cyst, None, Gross & Micro (Histology)
		Biopsy, Right Cervical, None, Gross & Micro (Histology)
		Biopsy, Right Perineum, None, Gross & Micro (Histology)
		Biopsy, Right Labia Minora, None, Gross & Micro (Histology)
		Biopsy, Right Labia Majoria, None, Gross & Micro (Histology)
		Biopsy, Right Vaginal Wall, None, Gross & Micro (Histology)
		Biopsy, Right Breast Lumpectomy, None, Gross & Micro (Histology), Send Directly to Lab
		Biopsy, Right Breast Skin, None, Gross & Micro (Histology)
Cytology
	Non Gyn Cytology Request
		Cytology, Peritoneal Washing, None
		Cytology, Pelvic Washings, None
		Cytology, Cyst Fluid, None
		Cytology-Additional, None
		Cytology-Additional, None
	GYN Request (PAP)
		T;N, Routine TL PAP CERVICAL, Routine
		T;N, Routine TL PAP CV & VAG, Routine
		T;N, Routine TL PAP VAGINAL, Routine
	GYN Pap with HPV High Risk Co-Test
		T;N, Routine TL PAP CERVICAL, Routine
		T;N, Routine TL PAP CV & VAG, Routine
		T;N, TL PAP VAGINAL
	GYN Pap with Reflex to HPV High Risk
		T;N, Routine TL PAP CERVICAL, Routine
		T;N, Routine TL PAP CV & VAG, Routine
		T;N, Routine TL PAP VAGINAL, Routine
Margins
	Tissue Request
		Margins-Additional, None, Gross & Micro (Histology)
		Margins-Additional, None, Gross & Micro (Histology)
		Margins-Additional, None, Gross & Micro (Histology)
		                                       Left(NOTE)*
		Margins, Left 12-3 Margin Breast, None, Gross & Micro (Histology)
		Margins, Left 3-6 Margin, Breast, None, Gross & Micro (Histology)
		Margins, Left 6-9 Margin, Breast, None, Gross & Micro (Histology)
		Margins, Left 9-12 Margin, Breast, None, Gross & Micro (Histology)
		Margins, Left Base Margin, Breast, None, Gross & Micro (Histology)
		                                        Right(NOTE)*
		Margins, Right 12-3 Margin Breast, None, Gross & Micro (Histology)
		Margins, Right 3-6 Margin, Breast, None, Gross & Micro (Histology)
		Margins, Right 6-9 Margin, Breast, None, Gross & Micro (Histology)
		Margins, Right 9-12 Margin, Breast, None, Gross & Micro (Histology)
		Margins, Right Base Margin, Breast, None, Gross & Micro (Histology)
Device
	Tissue Request
		Device, Intrauterine Device (IUD), None, Disposal Only
		Device, Venous Ports, None, Gross Only
		Device, Birth Control Device, None, Disposal Only
		Device, Interstim, None, Gross Only
		Device, Interstim Leads, None, Disposal Only
		Device, Interstim Leads and Battery, None, Gross Only
		Device, Generator Battery, None, Gross Only
		Device-Additional, None, Gross Only
		Device-Additional, None, Gross Only
Specimen for Culture Only
		                                       Tissue #1(NOTE)*
	Bacterial Culture-Surgery
		T;N, Routine, spec type = Tissue
	Fungus Culture-Surgery
		T;N, Routine, spec type = Tissue
	AFB Culture-Surgery
		T;N, Routine, spec type = Tissue
		                                       Tissue #2(NOTE)*
	Bacterial Culture-Surgery
		T;N, Routine, spec type = Tissue
	Fungus Culture-Surgery
		T;N, Routine, spec type = Tissue
	AFB Culture-Surgery
		T;N, Routine, spec type = Tissue
		                                       Tissue #3(NOTE)*
	Bacterial Culture-Surgery
		T;N, Routine, spec type = Tissue
	Fungus Culture-Surgery
		T;N, Routine, spec type = Tissue
	AFB Culture-Surgery
		T;N, Routine, spec type = Tissue
		                                       Fluid #1(NOTE)*
	Bacterial Culture-Surgery
		T;N, Routine, spec type = Body Fluid
	Fungus Culture-Surgery
		T;N, Routine, spec type = Body Fluid
	AFB Culture-Surgery
		T;N, Routine, spec type = Body Fluid
		                                       Fluid #2(NOTE)*
	Bacterial Culture-Surgery
		T;N, Routine, spec type = Body Fluid
	Fungus Culture-Surgery
		T;N, Routine, spec type = Body Fluid
	AFB Culture-Surgery
		T;N, Routine, spec type = Body Fluid
		                                       Fluid #3(NOTE)*
	Bacterial Culture-Surgery
		T;N, Routine, spec type = Body Fluid
	Fungus Culture-Surgery
		T;N, Routine, spec type = Body Fluid
	AFB Culture-Surgery
		T;N, Routine, spec type = Body Fluid

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase