Laboratory Reflex Testing
Tests can be reflexive to confirmation tests at the request of
provider. A reflex testing agreement must be signed yearly.
Common Reflex Testing Requests
• Blood Bank
— Fetal Screen: If fetal screen is positive, KleihauerBetke is performed.
— Antibody identification is performed on all
antibody screens that are positive.
• Chemistry
— Diabetic Urine Screen: If urine protein is negative,
random microalbumin is performed.
• Cytology
— Human Papillomavirus (HPV) testing: If, on liquid
specimen (ThinPrep®), atypical squamous cells of
undetermined significance (ASC-US) is reported,
HPV typing is performed.
• Immunology
— ReflexAntinuclear Antibodies (ANARX): ANA
screen and dsDNA performed. Positive samples
referred for six Extractable Nuclear Antigens and
Centromere Antibody Panel.
— AlllHepatitis testing: If positive, referred
for confirmation as indicated per
instrument guidelines.
— HIV Screen: If positive, refer for confirmation per
Instrument guidelines.
• Microbiology
— Cryptococcus Antigen: If positive, titer is
performed.
— For pediatric patients seen during the “flu” season,
if (nasopharyngeal) rapid influenza and/or rapid
respiratory syncical virus (RSV) tests are positive,
viral culture is not performed.
• Urinalysis
— Culture is performed for the following results:
• Positive leukocyte esterase
• Positive nitrites
• 10 WBC/hpf