Oral and Maxillofacial Diagnostic Services

For routine cases specimens are processed the same evening as received by the UT Oral and Maxillofacial Pathology Laboratory. The following morning the slides are diagnosed by one of three board-certified oral pathologists. Any serious or unusual diagnosis is immediately phoned to the contributing clinician. A request for a faxed histopathologic diagnosis report is also executed at this time. The final histopathologic diagnosis report is included with a new biopsy kit delivered by USPS to the contributor. This report contains specimen and patient information as provided by the contributor; a macroscopic (gross) description of the received specimen(s); a microscopic description of the specimen (if specifically requested); a histopathologic diagnosis; a comment (if applicable); the ICD-9 diagnosis code; the CPT code; and the sign-out oral pathologist's signature and present date. Fee billed is determined by assignment of CPT coding based on surgical or surgical and microscopic examination and resultant histopathologic diagnosis.

The ThinPrep® method, which has been shown to produce better specimens than conventional smears, is used. The Papanicolaou (PAP) stain is utilized for all cytology smears unless a different stain (e.g., periodic acid-Schiff) is appropriate. For routine cases the fixed cytology smears are processed the same evening as received by the UT Oral and Maxillofacial Pathology Laboratory. The following morning the slides are diagnosed by one of three board-certified oral pathologists. Any serious or unusual diagnosis is immediately phoned to the contributing clinician. A request for a faxed cytopathologic diagnosis report is also executed at this time. The final cytopathologic report is delivered by USPS to the contributor and contains specimen and patient information as provided by the contributor; a microscopic description and diagnosis of the specimen; a comment if applicable; the ICD-9 diagnosis code; the CPT code; the attending oral and maxillofacial pathologist's signature, and the date of diagnosis. Also, included is a replacement ThinPrep® cytology kit. Fixed fee billed is based on the CPT code for this procedure.

OMDS also does direct immunofluorescence (DIF) studies for detecting the presence of various inflammatory proteins to confirm or rule out the diagnosis of several mucocutaneous diseases such as pemphigoid and pemphigus. These tests are done on fresh, unfixed biopsy tissue sent to the laboratory in a special transport medium (Michel's solution). A perilesional biopsy is preferred; i. e., a specimen with intact epithelium adjacent to an eroded or ulcerated area. At the laboratory the tissue is sectioned frozen, and sections placed on slides for examination with a fluorescence microscope for the presence of five proteins: IgG, IgM, IgA, C3 and fibrinogen. Also, a frozen section routinely stained with H&E is made. The following day the slides are diagnosed by one of three board-certified oral pathologists. A faxed histopathologic diagnosis report is executed at this time. The final immunofluorescence diagnosis report is delivered by USPS to the contributor. This report contains specimen and patient information as provided by the contributor; a macroscopic (gross) description of the received specimen(s); a microscopic description of the H&E specimen when applicable; a diagnosis; a comment (if applicable); the ICD-9 diagnosis code; the CPT code; and the sign-out oral pathologist's signature and current date. Fee billed is determined by assignment of CPT coding based on microscopic examination of the H&E section, and diagnosis of each of the five immunofluorescence studies.

Radiographs and microscopic glass slides prepared elsewhere may be sent to UT Oral and Maxillofacial Diagnostic Services for radiographic and histologic interpretation, respectively. Generally speaking, the radiographs and slides should be accompanied by a cover letter which describes pertinent clinical and prior pathologic information concerning the case. Original radiographs are preferred but duplicate radiographs with sufficient contrast and void of artifacts are usually acceptable. For microscopic consultations a photocopy of any previous histopathologic diagnoses of the case should be sent. Occasionally, recut sections of the existing tissue block might be necessary to render the consultative diagnosis. Consultations are handled in a high priority, expeditious manner. The consultative diagnosis is usually sent by USPS the day after receiving the consultation unless more information is sought from the submitting clinician or recut tissue sections are necessary. Fixed fee billed is based on the CPT code for these procedures.

For clinicians who prefer to refer patients for clinical evaluations, diagnosis, therapy or management, the OMDS faculty will see referral patients on an appointment basis. To make an appointment please call UT Dental Practice at 901.448.6476. Patients should bring a list of all medications they are currently taking, copies of radiographs (if applicable), proof of insurance (if applicable), and arrive a minimum of 15 minutes prior to their initial appointment. Payment is due at the time professional services are rendered and fees are based on the services rendered and the medical complexity of the case as described in Current Procedures Terminology (CPT).

Patients should go to Room N251, lobby floor of the Dunn Dental Building and check-in at the reception desk. Parking is available at the adjacent parking lot for UT Dental Practice patients. Patients may request a map with directions prior to their initial appointment; the map will be faxed to the clinician's office or mailed to the patient.

Specimens received are usually stained the same evening received and diagnosed the following morning. The report is then faxed and a final report sent by FedEx to the submitting clinician. Fixed fee billed is based on assigned CPT code for this procedure.

Specimens received in the provided microbiology medium are analyzed for aerobic and anaerobic organisms by plating on various media depending on the requests and of the submitting clinician and patient clinical history. Final results may take 7-10 days depending on the media used and organisms involved. Fixed fee billed is based on assignment of the CPT code for this procedure.