NOTICE: Specimen must be labeled on both specimen bag and container/tube.
Aculabs has aggressively worked with both state authorities and our industry peers to tackle the unique ways COVID-19 has impacted post-acute care and the wellness of the residents who our clients serve daily. Our laboratory understands and believes that such urgency is demanded given that the residents of long term care homes and assisted living facilities are considered high-risk under the criteria put forth by the Centers for Disease Control and Prevention (CDC). The Aculabs - COVID-19 Information Hub is an online source meant to assist current and potential clients in assessing the testing needs of their facility's residents and remain up-to-date with information regarding ongoing state-level regulations and compliance standards. We ask that clients continually check for new updates as they continue to develop.
Aculabs recommends the use of 0.85%-0.9% sterile saline screw-cap containers that are at least 0.8 ml but no more than 3 ml as the preferred transport medium for nasal and throat swabs to be used for #3991 SARS-CoV-2 RT-PCR molecular testing. Examples of such saline containers are included in the guide below, but exact manufacturer may vary due to the supply chain at the time. Additionally, Aculabs will also accept the following swabs for #3991 SARS-CoV-2 RT-PCR molecular testing::
  • Viral Transport Media: BD® Universal Viral Transport (UVT), Copan® (UTM), Hardy Diagnostics Healthlink UTM, Puritan® UniTranz Media, Starplex Scientific Multitrans, and Thermofisher® M4/M5/M6
  • ESwab™: BD, Copan
SARS-CoV-2 antibody testing is done via a blood draw that is collected in a serum-separating tube (SST) by our mobile technicians. We also ask that all facilities' nursing staff do not freeze any swabs. Swabs that will not be collected and picked-up the same-day may be refrigerated, but respiratory swabs should never be frozen. Aculabs also may recommend client facilities preserve other types of transport media for testing unrelated to COVID-19. Please see the below specimen collection guides for more info:
  • INCORRECT SWAB* - Aculabs provides clients with swabs for COVID-19 testing that are appropriate for the testing we perform and laboratory equipment used. Sometimes, facilities may take it upon themselves to acquire swabs from outside sources. We ask facilities to not use swabs with calcium alginate tips, preservatives, or wooden shafts.
  • NOT LABELED*† - Our Accessioning team works to ensure all specimens are appropriately identified and matched to coordinating test requisitions forms. Due to the influx of testing, though, we must ask all nursing staff to help reduce the chance of error and ensure all specimens and specimen bags are appropriately labeled with patient information.
  • SENT ON ICE* - We ask all client facilities to not send COVID-19 specimens on ice, with ice packs, or with anything that can melt. Ice that melts makes it difficult to discern melted ice from a specimen that has leaked.
  • SPECIMEN LEAKED* - Aculabs must ask all nursing staff to ensure caps to COVID-19 specimen are secured tightly to prevent the transport media from opening and leaking. Leaked specimen often are no longer sufficient to run and pose a potential danger to laboratory staff.

* - RT-PCR Testing  |  † - Antibody Testing

Employee Testing and Payment

Long term care facilities who desire to have COVID-19 testing ran on their staff by Aculabs must accept full financial responsibility for the cost of all employee testing requested. To ensure completion of payment, Aculabs may require a facility to present a credit card to be kept on file. Facilities using Aculabs' diagnostic services for COVID-19 testing are encouraged to use our Pay Bill portal to make payment easier and more convenient. To order testing for your employees, you must contact your customer service representative for your employee account log-in information to our online web portal. Such ordering structure is done so in order to protect confidentially of those tested in accordance with HIPAA. Our Billing Department must ask all client facilities ordering employee testing to ensure they select the "Employee" unit and "Facility" as the 'bill to' type.

Reimbursement and ICD-10 Codes

The following codes are acceptable diagnoses for reimbursement for COVID-19 testing: J12.89, J20.8, J22, J40, J80, J98.8, Z03.818, Z20.828. The most commonly used codes are R05, R06.02, R50.9, B34.2. The code B97.29 can only be used in conjunction with the first 6 diagnoses listed. All COVID-19 test orders require a proper diagnosis in order to be processed and run.
Facilities wishing to acquire COVID-19 testing services from Aculabs should reach out to our Customer Service team. In accordance with Section 3202(b) of the CARES Act, Aculabs makes the cash price of all COVID-19 diagnostic testing offered publicly available. Pricing for COVID-19 testing can be found in the table below:
Test: #3991 SARS-CoV-2 Molecular TestingPrice: $100.00
Test: #740 - Anti-SARS-CoV-2 Total Antibody TestPrice: $50.00
Test: #6034 - SARS-CoV-2 IgG AssayPrice: $50.00
Test: #6055 - SARS-CoV-2 IgM AssayPrice: $50.00
All Aculabs employees have been trained to follow our Standard Operating Procedures and Infection Control Plan, which outlines in detail the appropriate measures to take when handling any potentially infectious specimen. Additionally, all employees who experience direct patient contact must follow protocol to wear all necessary personal protective equipment (PPE) to reduce the risk of exposure to and transmitting COVID-19. This includes the usage of a respirator mask for the entirety of their time in a facility. Employees must also check their temperature twice a day - once at the start of their shift and once again several hours later, in accordance with guidance by the Centers for Disease Control and Prevention (CDC). To comply with state-based healthcare personnel testing standards, Aculabs has rolled out testing for its employees and will continue to test all employees who enter facilities within states currently requiring a standard of baseline testing.
Aculabs offers SARS-CoV-2 RT-PCR testing - molecular testing meant to aid in the diagnosis of an active infection of SARS-CoV-2, the virus which causes COVID-19. Aculabs uses the BioGX SARS-CoV-2 Reagents for BD MAX™ System, a real-time RT-PCR intended for the qualitative detection of nucleic acid from SARS-CoV-2 in nasopharyngeal and oropharyngeal swab samples. The test is authorized for use by the U.S. Food and Drug Administration (FDA) via an emergency use authorization (EUA).
Aculabs offers SARS-CoV-2 antibody testing - serological testing meant to detect different types of antibodies that develop via the immune response that occurs from exposure to SARS-CoV-2, the virus which causes COVID-19. The test is done via blood draw. Antibody testing is used at present to track those who may have been previously exposed to the virus yet often were asymptomatic. Aculabs offers testing from various manufacturers, which currently includes SARS-CoV-2 antibody testing developed by Abbott and Roche. The test is authorized for use by the U.S. Food and Drug Administration (FDA) via an emergency use authorization (EUA).
Aculabs offers SARS-CoV-2 antibody testing - serological testing meant to detect different types of antibodies that develop via the immune response that occurs from exposure to SARS-CoV-2, the virus which causes COVID-19. The test is done via blood draw. Antibody testing is used at present to track those who may have been previously exposed to the virus yet often were asymptomatic. Aculabs offers testing from various manufacturers, which currently includes SARS-CoV-2 antibody testing developed by Abbott and Roche. The test is authorized for use by the U.S. Food and Drug Administration (FDA) via an emergency use authorization (EUA).
CDC - COVID-19 Testing Guidelines for Nursing Home Residents & HCPRead
CDC - Key Strategies to Prepare for COVID-19 in Long-Term Care FacilitiesRead
CDC - Considerations When Preparing for COVID-19 in Assisted Living FacilitiesRead
CDC - Interim U.S. Guidance for Management of HCP with Potential Exposure to COVID-19Read
FDA - Surgical Mask and Gown Conservation Strategies for Healthcare ProvidersRead
FEMA - Coronavirus Rumor Control PortalRead

Specimen Collection Resources:

Nasopharyngeal Swab Collection

— COPANusa

Nasopharyngeal & Oropharyngeal Swab Collection

Pan American Health Organization

ACULABS COVID-19 UPDATES & NOTICES

— NOTICE PUBLISHED APRIL 7, 2020 —

Aculabs Begins Implementing SARS-CoV-2 Testing for COVID-19:

Aculabs will immediately begin performing COVID-19 screenings via the BioGX SARS-CoV-2 Reagents for BD MAX™ System, a real-time RT-PCR test intended for the qualitative detection of nucleic acid from SARS-CoV-2. The ability to perform screenings will allow for result reporting within 24 hours, vital to the high-risk populations Aculabs services as the largest diagnostic service provider to long term care and assisted living facilities across the Mid-Atlantic.

The BD MAX™ System also allows for Aculabs to process 24 samples simultaneously and analyze hundreds of samples per day. All testing is to be done at the Aculabs East Brunswick, New Jersey laboratory, where our team has worked diligently to obtain the latest instrumentation for rapid testing and satisfying all stringent state and federal regulations.

The usage of the BioGX SARS-CoV-2 Reagents for BD MAX™ System became available to CLIA-certified laboratories and hospitals across the country when BD and BioGX announced on April 3rd that they were granted emergency use authorization by the FDA for their new diagnostic test for screening for COVID-19.

— NOTICE PUBLISHED APRIL 2, 2020 —

Result TAT & Reporting of SARS-CoV-2/COVID-19:

During the ongoing COVID-19 outbreak, Aculabs understands the stresses placed on healthcare providers and their staff, especially our clients who uniquely deal with geriatric populations that are the most vulnerable to the virus.

All healthcare personnel, especially those on the frontlines, are especially aware of their patients’ conditions during the ongoing pandemic. With this in mind, Aculabs has outlined the expected procedure for our result-reporting for the COVID-19 testing provided through our reference laboratory LabCorp below:

  1. If a facility receives a call from either the Department of Health or LabCorp regarding a positive, they should consider it positive. LabCorp has developed a live transfer system with the Department of Health to let them know of known positives. This happens prior to Aculabs getting the result.
  2. The best place to get the most up-to-date information is via our website and web portal. Generation information is on the website, such as collection guides, employee testing forms, latest info regarding tests, etc. Our Aculabs web portal is as up-to-date as possible. Results from our send-out testing are delivered via a live feed from LabCorp’s reporting platform directly to our system.
  3. LabCorp’s expected turnaround time remains 3-4 days for COVID-19 testing. We ask that facilities please ensure all specimen are appropriately labeled to ensure no delays in result reporting. Aculabs will report any updates or information on TAT directly from LabCorp if changed.

Aculabs is currently in the process of setting up our own Molecular Laboratory while we wait for Boston Dickinson to get final EUA approval for the test we anticipate using.  The assay is currently programmed onto the appropriate instrument and will begin validation as soon as possible. Aculabs has already taken the proactive measure to ensure our laboratory can accommodate the appropriate additional equipment needed at this time.

— NOTICE PUBLISHED MARCH 20, 2020 —

HCANJ offers new recommendations on reducing risk of transmission for COVID-19:

The Health Care Association of New Jersey on March 18, 2020, released a new set of actionable steps long term care staff are highly encouraged to take to reduce the risk of transmission and exposure of COVID-19. In addition to the guidance, the HCANJ also encourages staff to follow all current NJ Department of Health and CMS guidance regarding restriction of visitors and non-essential healthcare personnel except in compassionate-care situations.

The HCANJ offers the following guidance:

  • Adhere to internal environmental cleaning protocols to ensure appropriate measures are being taken to clean and disinfect where appropriate including high-touch surfaces and all shared medical equipment (e.g., lifts, blood pressure cuffs, medication carts).
  • Close the unit to new admissions except as needed to cohort ill individuals or staff
  • Consider closure of the facility to new admissions
  • Consider implementing universal use of facemask for HCP while in the facility
  • Encourage residents to remain in their room. If multiple cases are present restrict residents (to the extent possible) to their rooms except for medically necessary purposes
  • Implement active screening of residents and staff for fever and respiratory symptoms.
  • Mask all residents (who can tolerate masks) who are symptomatic when providing direct care; if masks are limited or not tolerated use of a tissue to cover the nose and mouth is appropriate.
  • Quarantine and monitor exposed contacts including healthcare workers and roommates.
  • Stop current communal dining and all group activities such as internal and external group activities

Facilities are also encouraged to continue good hygiene practices and increase the frequency at which they clean their buildings. Read the guidance in full here.

It is also reiterated to healthcare personnel that symptoms of infection may manifest differently in older patients and that other symptomology should also be assessed at minimum, daily. Vital signs should include heart rate, blood pressure, temperature, pain and pulse oximetry. The facility staff should have a heightened awareness for any change in baseline in their residents.

Any new cases or persons suspected of COVID-19 should be reported to NJDOH and LHD.

— NOTICE PUBLISHED MARCH 13, 2020 —

Aculabs to Follow CDC Guidelines at Nursing Homes and Assisted Living Facilities:

In their recommendations for handling the COVID-19 outbreak, the CDC recommends the wearing of a face mask as one of the most effective measures to reduce the exposure one faces when coming in contact with those who potentially have the virus.

According to the CDC, those with prolonged close contact to a patient can ensure they are at “Low-Risk” for exposure by wearing all the appropriately delegated personal protective equipment, including that of a mask worn colored-side out.

Those who remain at a “Low-Risk” level for exposure can continue to work as normal in their assigned tasks and do not have to consider quarantining themselves. Aculabs is routinely surveying all mobile technicians and maintaining that those who experience flu-like symptoms, have recently traveled, or have come into contact with someone diagnosed with the disease are not out in the field in any capacity, but instesad are quarantined at home.

In light of these guidelines, Aculabs is instructing that all mobile technicians who come into contact with nursing home residents must ensure that they wear a face mask the entire time they are in a facility, per CDC guidelines, in addition to other necessary personal protective equipment, to remain at a “Low-Risk” level of exposure. Facilities who may have their own standard procedures and precuations set-up can communicate these to their Customer Service Representative who will communicate such standards to our Phlebotomy Department.

— NOTICE PUBLISHED MARCH 4, 2020 —

Medicare Guidance for Limiting the Transmission of COVID-19 for Nursing Homes:

Click here to read the full March 4, 2020, guidance from the Centers for Medicare & Medicaid Services.

CMS advises nursing homes and other long term care facilities to monitor and limit visitors through the following criteria:

  1. International travel within the last 14 days to restricted countries. For updated information on restricted countries, visit: https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html
  2. Signs or symptons of a respiratory infection, such as a fever, cough, or sore throat.
  3. Has had contact with someone with or under investigation for COVID-19.

Administrative staff of nursing homes should refer to the CMS guidance to ensure the limiting of transmission to elderly populations. If visitors meet the above criteria, facilities may restrict their entry to the facility. Regulations and guidance related to restricting a resident’s right to visitors can be found at 42 CFR §483.10(f)(4), and at F-tag 563 of Appendix PP of the State Operations Manual.

— NOTICE PUBLISHED MARCH 3, 2020 —

CMS Announces New Codes to Bill for COVID-19:

March 3, 2020 – CMS has announced new HCPCS U codes to bill Medicare for COVID-19.

HCPCS is a standardized coding system that Medicare and other health insurers use to submit claims for services provided to patients. Laboratories may usee the code U0001 to bill Medicare for COVID-19 lab tests that use the CDC kit, as this code is specifically for CDC testing laboratories to who patients for SARS-CoV-2; the code U0002 is for non-CDC laboratories testing for SARS-CoV-2/2019-nCoV (COVID-19) using any technique, multiple types or subtypes (including all targets).

The Medicare claims processing system will be able to accept these codes on April 1, 2020 for dates of service on or after February 4, 2020. Click here to read the full news release from CMS.