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General FAQ
Healthcare
Provider FAQ
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General Information on Newborn Screening
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Question:
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What is the newborn screening program?
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Answer:
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The
Texas Newborn Screening Program is an essential public
health program that includes: - Laboratory bloodspot testing for more than 50
disorders
- Point-of-care screenings for 2 more conditions
- Follow-up, case management, and outreach for
infants with out-of-range test results
Newborn Screening is required by law for any baby born in
Texas (Health and Safety Code, Chapter 33) and identifies babies that may have
a specific disorder or medical condition. Early treatment of these disorders
can help prevent serious complications or even death.
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Question: | Does the current Newborn Screening panel in
Texas include all disorders listed on the Recommended Uniform Screening Panel
(RUSP)? |
Answer: | Texas does not
test for all of the disorders listed on the Recommended Uniform
Screening Panel (RUSP).
The
current Texas
Newborn Screening panel does not include:
- Glycogen Storage Disease Type II (Pompe)
- Mucopolysaccharidosis Type 1 (MPS I)
-
Galactoepimerase deficiency (GALE)
-
Galactokinase deficiency (GALK)
A list of the conditions on the
Texas Newborn Screening Panel can be found here (pdf).
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Question:
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Why is newborn screening important?
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Answer:
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Most children born with these problems appear healthy at
birth and are from healthy families. Parents who already have healthy
children, or who are "silent carriers" of a genetic condition, do
not expect any problems. Because every baby is tested soon after birth,
children who may have one or more of these disorders can be identified early
and get early care. This can make a tremendous difference in health outcomes
for the child
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Question:
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What conditions does the newborn screening program cover?
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Answer:
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Texas law
(Health and Safety Code, Chapter 33) requires that all newborns are screened for certain
genetic disorders or medical conditions recommended by the Advisory Committee on Heritable Disorders in Newborns and
Children (ACHDNC) on the Recommended Uniform Screening Panel (RUSP). Currently
for Texas, this includes screening for 31 core conditions, 24 secondary conditions* and point-of-care screens. A list of the conditions on the Texas Newborn
Screening Panel can be found here (pdf). *Note Although
the primary mission of NBS is to identify newborns at highest risk for the core
conditions, secondary conditions may also be detected during screening for core
conditions. Additional testing may be
needed to determine whether it is the core condition or a secondary condition. |
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Question: | Does the Newborn screen identify
all babies with the disorders on the Texas panel? |
Answer: | The newborn screen may NOT
identify all babies with the disorders on the panel. The newborn screening test identifies babies
at risk of having a disorder on the panel. The number of babies with secondary
conditions that are not identified by screening may be higher than for core
conditions. If there are clinical symptoms or family history of a condition,
the newborn screen results alone should not be used to rule out or confirm a
condition; diagnostic testing should be pursued. The newborn screening results
should be considered by a medical professional in conjunction with family
history and diagnostic testing, when warranted. |
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Question: | What
is a false positive result? |
Answer: | A
false positive test result occurs when a test indicates that a person has a
particular disorder when they actually are not affected by the condition. |
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Question: | What
is a false negative result? |
Answer: | A
false negative test result occurs when a test indicates that a person does not
have the particular condition when in fact they do have it. |
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Question: | How are newborn screening test cutoffs
determined, and why are they different among different states? |
Answer: | Each state develops their
own screening test cutoffs, which are appropriate for their state’s
population. Screening test cutoffs are calculated to allow for
identification of babies with the disorder while minimizing both false positive
and false negative results. In Texas, screening test cutoffs are determined by
performing a study to identify the level of the analyte(s) that is indicative
of the disorder. The study takes into account published data, the test method,
and the type of equipment that will be used. Cutoffs for certain disorders also
require considering infant specific factors such as age of the baby at specimen
collection, birthweight, prematurity and transfusion status. A sufficient
number of specimens representing the Texas newborn population and true positive
specimens, if available, are tested to determine the range where we would
expect results from babies without the disorder to fall. If a baby has results outside this range,
then those results would be considered abnormal and would require additional
testing. Test cutoffs are routinely re-evaluated
by comparison to diagnosed case test values and false negative specimen results. In addition, the cutoff may also be revised
to reduce the number of false positive results. |
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Question:
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Is more testing available?
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Answer:
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DSHS
screens for many but not all diseases your baby may have. More tests can be
done. For more information, ask your baby’s doctor and see www.babysfirsttest.org/find-condition or www.savebabies.org/pregnant_faqs.html.
Note: DSHS
has no affiliation with these sites and the opinions and positions of these
organizations may not reflect the opinions and/or positions of DSHS.
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Question:
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Why are two screens completed in Texas?
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Answer:
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DSHS has
implemented a two-screen system to maximize the effectiveness of testing for all
disorders on the Texas Newborn Screening Panel.
Two screens are completed in
Texas to detect some of the disorders at the earliest possible opportunity. The
first screen should be collected between 24 to 48 hours of age and the second screen
between 1 to 2 weeks of age.
In Texas, the second screen
routinely detects babies at risk for severe medical complications. These babies
sometimes have a normal first screen.
After a baby is born, their
physiology changes rapidly and sometimes it takes a week or more for these
changes to occur. In some cases, a disorder may only be detected on the second
screen due to these physiological changes.
In addition, some disorders (like
cystic fibrosis) rely upon both newborn screens to reduce the number of babies
who would otherwise require additional testing with a specialist to determine
whether they have the condition or not.
The goal of the Texas Newborn
Screening Program is to identify babies who have these devastating diseases
before symptoms arise so that they can receive appropriate treatment and lead
productive and healthy lives. Having a second screen improves medical
providers’ ability to identify children with disorders who would have otherwise
gone undetected.
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Question:
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Who does the screening?
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Answer:
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The healthcare provider collects the blood sample. The
DSHS public health laboratory in Austin performs the laboratory testing.
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Question:
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What happens if the test result is NOT okay?
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Answer:
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An abnormal or “out of range” test result indicates that
the baby may be at higher risk of having one or more of the disorders
included on the newborn screening panel. This does not mean that the baby
definitely has a disorder. In fact, most babies who receive "out of
range" results do not have the condition of concern. If the newborn
screen indicates “out of range” results, parents are contacted by their
child’s healthcare provider. It is important that parents follow their
healthcare provider’s directions for their child’s immediate care and
additional testing.
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Question:
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Can infants with any of these disorders be cured?
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Answer:
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Most of these conditions can be treated but not cured. In
these cases, early and continuous treatment can result in dramatic positive
outcomes for the child and help prevent or control the serious effects of
these disorders. Severe Combined Immunodeficiency (SCID), which was added to
the newborn screening panel in 2012, is the one disorder on the panel that if
identified early in life can be treated and for which most patients can be
cured.
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Question:
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Who pays for the screening?
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Answer:
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Healthcare providers or facilities purchase the specimen
collection kits *(which includes the cost of the testing) for private pay or
insurance covered patients. DSHS provides specimen collection kits at no cost
for patients covered by Medicaid, CHIP, and Title V. DSHS is reimbursed by
Medicaid, CHIP, and Title V for the testing performed on these kits.
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Question:
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Can parents opt out of having their newborn screened?
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Answer:
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Parents can only refuse to have their
child screened if the screening conflicts with a parent’s religious tenets
or practices (see Texas Health & Safety Code Sec. 33.012). In order to
refuse, a parent must sign a form stating he/she has a religious objection
to newborn screening. Points to consider before refusing newborn screening:
- There are important medical benefits of newborn
screening.
- Symptoms of a newborn screening disorder can appear much
later, after a child’s health has already been injured by the disease.
- The screen is mandated by law.
- The only legal reason to refuse newborn screening is if
it conflicts with your religious tenets or practices.
If
parents have concerns, they should talk to their baby’s physician or
contact the NBS Program Staff by phone at (888) 963-7111, ext. 7333 or
email mailto:newbornscreeninglab@dshs.texas.gov
Newborn screening of the blood spot
consists of a series of tests to look for 53 diseases that can cause a baby
to get really sick or die if they are not identified and treated early. The
diseases can cause growth problems, mental or physical delays, deafness,
blindness, seizures, and early death. Most babies with these conditions
look perfectly normal when they are born, and problems may not appear for
several weeks or months. About 1 child out of every 500 screened has one of
these newborn screening conditions.
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Question:
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How do I obtain my/my child's newborn screening results?
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Answer:
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Because an interpretation of the result
report may be necessary, it is recommended that newborn screening results be
released to physicians or medical professionals only.
Individuals (if over 18) or parents (if under 18) may:
1.
Talk
to your healthcare provider. Healthcare providers can request newborn
screening results for their patients by contacting DSHS Laboratory Reporting,
Monday through Friday 8am to 5 pm, by either: Sending a fax request to
512-776-7533 or calling 512-776-7578. OR
2.
Visit http://www.dshs.texas/lab/patientresults.aspx for
information on how to obtain copies of your/your child’s test results.
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Question:
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I am an NCAA college athlete and need to request my
newborn screening results for documentation of my sickle cell trait status.
How do I request these results?
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Answer:
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Because an interpretation of the result
report may be necessary, it is recommended that newborn screening results be
released to physicians or medical professionals only.
Individuals (if over 18) or parents (if under 18) may:
1.
Talk
to your healthcare provider. Healthcare providers can request newborn screening
results for their patients by contacting DSHS Laboratory Reporting, Monday
through Friday 8am to 5 pm, by either: Sending a fax request to 512-776-7533
or calling 512-776-7578.
2.
Fill
out the authorization form linked below to request the newborn screening
results be sent to a specific physician. If requesting that the results be
sent for university records, the school’s physician or nurse information
should be included. Fax the completed form to DSHS Laboratory reporting at
512-776-7533.
Authorization to Disclose
Protected Health Information (or other confidential information) Form (PDF
34kb)
The Texas DSHS Laboratory Reporting Department can provide newborn screening
results from 1991 to present.
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Use and Storage of Dried Blood Spots after
Newborn Screening
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Question:
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What happens to the blood spot card after testing?
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Answer:
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DSHS
keeps the blood spot cards in a secure place. By Texas law (Health
& Safety Code Sec. 33.018), the blood spots may be used until DSHS is
required to destroy them. Uses include:
- DSHS
and external quality assurance to make sure tests, equipment, and supplies
are working right
- Developing
new tests; and/or
- DSHS
studies of diseases that affect public health.
Additionally, if the parent gives their OK,
blood spots collected on or after June 1, 2012 may be used
for public health research outside of DSHS. Blood spots used outside DSHS
will not include any information that can identify the child
or parent, unless the parent provides a separate, specific consent.
DSHS storage of residual blood spots is
governed by Texas law as detailed in the chart below:
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Received
by DSHS prior to May 27, 2009
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Specimen
Collection Date
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May
27, 2009 through
May 31, 2012
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June
1, 2012 or Later
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Blood Spot Storage after Completion
of the Newborn Screening Tests
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Blood spots received by DSHS prior to May
27, 2009, for which written consent to retain was not given, have all been
destroyed.
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To be determined.
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All blood spots are stored for up to 2
years and then destroyed unless the parent submits a completed Parental
Decision form allowing for longer storage.
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Learn more
about potential public health uses for blood spot cards after testing is
completed.
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Question:
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Where can parents or healthcare providers get copies of
forms related to the storage and use of dried blood spots?
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Answer:
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https://www.dshs.texas.gov/lab/nbsbloodspots.shtm
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Question:
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After collection of the first screen, the parent sent in a
form related to the storage and use of dried blood spots. Do they need to
send in another form?
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Answer:
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In most cases, additional forms are not
needed. One form will apply to all blood spots collected from a baby.
In the event that the first blood spot specimen is
collected prior to June 1, 2012 and the second specimen collected after June
1, 2012, it may be necessary to submit separate forms to indicate the
parent’s wishes.
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Question:
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What if the parent changes their mind? Can they submit a
new form?
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Answer:
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Parents can change their mind at any time as
long as the blood spot cards have not been destroyed. DSHS will act upon the
latest valid and applicable use and storage form received. Parents may
contact the Laboratory for assistance if needed.
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Question:
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Our facility only performs second screens, usually when
the baby is around 2 weeks old. Are we required to give a form to the
parents?
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Answer:
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Yes. Forms regarding the use and storage of dried blood
spots must be provided to parents / guardians for each newborn screening
specimen drawn.
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Question:
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Do forms related to the use and storage of dried blood
spots allow the parent / guardian to choose NOT to have their child receive
the newborn screen test?
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Answer:
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No. Newborn screening is required for all newborns born in
Texas. The only reason a parent / guardian may refuse to have the newborn
screen test performed is because it conflicts with their religious beliefs
stemming from an established religion. Use and storage of dried blood spots
forms have nothing to do with accepting or declining the newborn screening
tests.
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Question:
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What happens if the parent does not return a form to DSHS
in any manner?
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Answer:
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For blood spots collected on or after June
1, 2012, parents are encouraged to return a decision form regardless of their
choice. If no form is returned, the blood spots will not be used for external
research purposes and will be destroyed within two years.
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Question:
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If the parent completes and signs a form at the time of
specimen collection, may the form be returned to DSHS with a specimen
shipment from the provider?
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Answer:
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Yes. Healthcare providers are required to return to DSHS
completed forms related to the use and storage of dried blood spots if so
requested by the parent.
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Question:
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Some parents may be unsure at the time the blood spots are
collected what they want DSHS to do with the dried blood spots after testing
is complete. Do they have to decide before leaving the hospital / facility?
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Answer:
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No. The parent / guardian can complete, sign, and mail the
completed form to the DSHS address listed on the form at any time. For blood
spots collected on or after June 1, 2012, the blood spots will be destroyed
within 2 years after receipt of the specimen if no form is received.
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Question:
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How should healthcare providers document that forms
related to the storage and use of dried blood spots have been provided to a
parent?
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Answer:
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Healthcare providers should check the box on the NBS
specimen collection kit demographic form indicating that the use and storage
form was distributed.
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Question:
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What happens if a parent completes and submits a
“Directive to Destroy Newborn Screening Blood Spot Cards” form after June 1,
2012?
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Answer:
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If a “Directive to Destroy” form was
received by the laboratory before June 1, 2012, all blood spots cards for the
child would be destroyed within 60 days as required under House Bill 1672.
If a “Directive to Destroy” form is received
by the laboratory after June 1, 2012, Destruction requests will only be
processed for specimens that were collected prior to June 1, 2012. Blood
spots cards collected on or after June 1, 2012 are stored for up to 2 years and
then destroyed unless the parent submits a completed “Parental Decision for
Storage and Use of Newborn Screening Blood Spot Cards” form that indicates
their consent for storage of up to 25 years.
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Question:
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Can a parent submit a “destruction” (Directive to Destroy
Newborn Screening Blood Spot Cards) form after June 1, 2012 if one or
all newborn screens were collected prior to June 1, 2012?
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Answer:
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Yes. Destruction requests will be processed for all
specimens collected prior to June 1, 2012.
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Specimen Collection and Supply Ordering (for
Healthcare Providers)
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Question:
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How do I order newborn screening
collection kits?
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Answer:
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Download
an Order Form for Newborn Screening Supplies.
Or contact the Container Preparation Group at 1-888-963-7111 ext. 7661
(512-776-7661) or at mailto:ContainerPrepGroup@dshs.state.tx.ustexas.gov to
obtain a copy of the order form.
Complete the order form by specifying the
total number of kits needed by your facility. There are two kinds of Newborn
Screening Kits:
1.
NBS
3 – Medicaid/Charity Care/CHIP
2.
NBS
4 – Insurance/Self-Pay
Return envelopes and submitter labels are
also provided at no charge. Indicate the quantity needed on the order form.
Order a quantity of kits to last 1-3 months.
Fax the completed form to 512-776-7672. Orders
will be processed and shipped within 5 working days from the day your order
is received by the Container Preparation Group. (Note: Normal shipping [in
transit] time is 1-3 days business days.)
Additional Information:
NBS 3 (Newborn screening kits for Medicaid-eligible, Charity Care, or CHIP)
kits are provided at no charge. For NBS 4 (Insurance or Self Pay) kits, an
invoice will be sent later. Payment will be due within 90 days.
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Question:
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How can we update our facility’s contact information
(i.e., new address, phone or fax number or doctor)?
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Answer:
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To update your facility’s contact information, complete
the Submitter Identification Number Request/Update Form.
This form is used for new submitters, as well as established submitters who
need to update their information. When completing the form for an update,
please make sure the “Updating Submitter Information” box is checked at the
top.
Fax the completed form to Laboratory Reporting at (512) 776-7533.
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Question:
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If our facility runs out of newborn screening kits before
our next order arrives, is it ok to borrow newborn screening kits from
another facility?
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Answer:
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SHARING CARDS IS STRONGLY DISCOURAGED. Every
effort should be made to monitor inventory and plan accordingly for ordering.
ONLY share or borrow cards if absolutely necessary.
Please be aware of the potential complications with
sharing/borrowing cards:
1.
The
result reports for the newborn screens will go to the original facility that
purchased the kits UNLESS:
2.
The
borrowing facility information (including submitter ID #) is placed in the
submitter information portion of the demographic form of the newborn screening
kit.
3.
DSHS
is not responsible for billing issues that arise when borrowing/sharing
cards. Any reimbursement arrangements for shared/borrowed cards need to be
made between the facilities involved.
Please see above for information on ordering
Newborn Screening supplies.
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Question:
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When does the screening have to be performed?
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Answer:
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The Texas Newborn Screening Program requests the
collection of blood spots on two separate occasions for each child. The first
screen is collected after 24 hours but before 48 hours of age, or prior to
the newborn's discharge from the hospital. The second screen is collected at
one to two weeks of age.
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Question:
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Is it okay to collect specimens at 23 hours, instead of
24-48 hours, or at 6 days, instead of 7-14 days of age? What are the possible
consequences if collected a little early?
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Answer:
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Reference (normal) ranges are set for a
specific population. The DSHS reference ranges are set for specimens
collected at 24-48 hours of age and a different set for specimens collected
at 7-14 days of age. In the laboratory specimens are categorized by the age
of the baby when the specimen was collected.
Collection of the first screen at 23 hours
may not have a large impact. To accurately detect amino acid disorders, the
infant really needs time to metabolize their first protein feedings. There
may not be much difference in laboratory results between 23 and 24 hours.
However, if a specimen were collected at 6 or 12 or 18 hours that will
probably have some impact on the metabolites that are measured and their
potential to be elevated.
Collection of a second screen at 6
days could have a large impact because it can lead to false negative
results for fatty acid oxidation disorders. Fatty acid markers quickly start
to normalize after the first few days of life. Fatty acid oxidation abnormal
ranges are higher for first screen specimens than for second screen
specimens. A specimen collected at 6 days will be analyzed using first screen
reference values.
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Question:
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What is the maximum age at which a child can be screened?
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Answer:
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The Texas NBS Laboratory does not reject
specimens collected on older children. The recommended collection time
periods and the NBS testing methodologies have been designed to minimize the
number of false negative and false positive results in newborns and
young infants. When the newborn screen specimen is collected before 24
hours of age or on older children, the test may not identify some of these
conditions. If there is a clinical concern, diagnostic testing should be
initiated.
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Question:
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If a baby has two newborn screens and one was
“unsatisfactory,” is it necessary to collect a third newborn screen?
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Answer:
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See table below to determine necessity of a
third screen:
1st screen
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2nd screen
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3rd screen necessary?
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unsatisfactory
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normal
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No, if full term baby with a birth weight ≥2,500g
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Yes, if low birth weight or premature baby with a birth weight
of <2,500g
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normal
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unsatisfactory
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Yes, up to 12 months of age
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unsatisfactory
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abnormal
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Please follow recommendations received from DSHS Newborn
Screening Clinical Care Coordination Team.
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abnormal
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unsatisfactory
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Please follow recommendations received from DSHS Newborn
Screening Clinical Care Coordination Team.
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Newborn Screening Clinical Care Coordination
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Question:
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What do we do if a baby has an unsatisfactory
screen, but we are unable to get the baby back in for another one after
multiple attempts to contact/notify the parent/guardian?
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Answer:
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The healthcare facility should document all attempts made
to the parent/guardian and keep the documentation in the baby’s medical
record.
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Question:
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How do I collect a newborn screen on a baby with casts on
both feet?
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Answer:
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If
the baby’s 1st screen was normal, obtain the
2nd screen when the casts are changed or removed.
If
the baby’s 1st screen was abnormal, follow Newborn Screening
Clinical Care Coordination guidelines.
If
the baby’s 1st screen was unsatisfactory, refer
to Alternative Methods for
Collecting a Newborn Screen.
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Question:
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Is it ever acceptable to collect a newborn screen from an
area other than the heel?
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Answer:
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The
heel-stick is the preferred method for optimal laboratory results for the
newborn screen. However, it is understood that certain circumstances may
warrant alternative collection methods. For more information, please see the Specimen Collection – Special
Circumstances web page, or the Alternative Methods for
Collecting a Newborn Screen page.
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Question:
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Where can I find more information on newborn screening
specimen collection?
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Answer:
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Visit
the DSHS Specimen
Collection Requirements page or the Healthcare
Provider Resources page.
Quick
tip: Save these webpages as favorites for easy access whenever needed.
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Question:
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Can parents opt out of having their newborn screened?
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Answer:
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A parent can refuse the screen for religious
reasons only (Texas Health & Safety Code Sec. 33.012). Make sure
you and your staff are familiar with the benefits of screening and the
consequences of undetected disorders.
Points to consider before refusing newborn screening:
- There
are important medical benefits of newborn screening.
- Symptoms
of a newborn screening disorder can appear much later, after a child’s health
has already been injured by the disease.
- The
screen is mandated by law.
- The
only legal reason to refuse newborn screening is if it conflicts with your
religious tenets or practices.
Provide this information to parents who are
considering refusing the screen. Download the Religious Objection to Newborn
Screening Test form below and provide to parents who are sure they want to
refuse newborn screening for their infant. The refusal of newborn
screening must be signed by the parent/legal guardian/managing conservator
and entered in the infant’s medical record.
English Form: FORM TO REFUSE THE NEWBORN SCREENING BLOOD TEST
Spanish Form: FORMULARIO DE RECHAZO DE LA PRUEBA DE DETECCIÓN
TEMPRANA EN SANGRE A RECIÉN NACIDOS (NBS)
INSTRUCTIONS TO COMPLETE FORM TO REFUSE THE NEWBORN SCREENING BLOOD TEST
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Question:
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Does one specimen collection kit cover the first and
second screening?
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Answer:
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No. One kit is required for each screen. Each child will
require two screening test kits.
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Question:
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Specimens are required to be sent to DSHS as soon as
possible, within 24 hours after collection. However, specimens collected late
on Fridays do not dry in time to ship that day. Should we ship the specimen
wet, or have the baby return the next week to draw an acceptable specimen?
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Answer:
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It is understood that it may not be possible
to send all specimens as soon as possible after collection, especially for
those specimens drawn before weekends or mail holidays. Specimens should be
dried thoroughly and sent to DSHS as soon as possible, preferably by
overnight courier.
Rules emphasize the importance of the timely
collection and mailing of specimens so that children with these disorders can
be identified, diagnosed and treated quickly. However, the first priority is
to provide an acceptable specimen. Do not ask the parent/child to return
later as this will delay the screening. Do not ship specimens wet.
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Question:
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What is the recommended time frame for sending specimens
to the DSHS laboratory?
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Answer:
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New national recommendations state that first screen
specimens should arrive at the DSHS Laboratory within 24 hours after
collection. Ideally, specimens should arrive the day after collection.
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Question:
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How can my facility decrease our specimen transit time?
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Answer:
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- DO
NOT delay shipment of newborn screening specimens. Ship dried specimens as
soon as possible, preferably via overnight courier. If mail or courier
services are unavailable, ship as quickly as possible.
- DO
NOT batch or hold dried specimens for shipping.
- Ship
dried specimens directly from the collection facility to the DSHS Newborn
Screening Laboratory.
Identify
internal processes which may delay shipment and look for possible
improvements.
See Decreasing Time Between
Collection of Newborn Screening Specimens to Receipt in DSHS Laboratory (PDF
861kb)
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Question:
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How do I fill out the “mother information” section on the
Newborn Screening kit if collecting on a child that is adopted, fostered or
is a ward of the court or state?
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Answer:
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The information in the “mother information” section of the
Newborn Screening kit should reflect who the child will be in the care of
upon release from the healthcare facility. This information is required for
multiple laboratory and follow-up purposes. Most importantly, it is necessary
for the Newborn Screening Clinical Care Coordinators to have accurate contact
information of the child’s caregiver in the event that there is an abnormal
newborn screen.
|
|
|
Question:
|
How is “charity care” defined? We are trying to determine
which type of test kit to use for a particular child.
|
Answer:
|
The “charity care” newborn is a patient who
is not insured, has a parent or guardian who is unable to provide payment, AND is
not covered or eligible to be covered for newborn screening services by
Medicaid, CHIP, or any other government program.
|
|
|
Question:
|
We collected the specimen on an Insurance / Self-pay card
and it should have been Medicaid. What do we do?
|
Answer:
|
Please submit the specimen on the kit
collected. DO NOT ALTER THE KIT IN ANY WAY. DSHS performs data analyses to
identify Medicaid eligible specimens collected on Paid / Insurance cards. If
a Medicaid eligible patient has a specimen collected on a Paid / Insurance
card, the facility’s account will be credited for the cost of the kit.
The data analysis and reimbursement process takes 6 - 9 months.
|
|
Question:
|
We collected the specimen on a Medicaid card and it should
have been Insurance / Self-Pay. What do we do?
|
Answer:
|
Please submit the specimen. Note on the
collection kit that the specimen should have been collected on an Insurance /
Self-Pay card. DSHS will bill the facility for the cost of the kit.
|
|
|
Question:
|
If the parent states that they have Medicaid or are in the
process of getting Medicaid but do not have the number available, which
specimen collection card should be used?
|
Answer:
|
Use the Insurance/Self-Pay card. If the child is later
identified as Medicaid, the provider will be reimbursed in 6-9 months for the
cost of the card.
|
|
|
Question:
|
If the patient has both insurance and Medicaid, which
specimen collection card should be used?
|
Answer:
|
In this scenario, the provider should use the Medicaid
card.
|
|
|
Question:
|
May STAR plans use the Medicaid screening kits?
|
Answer:
|
Yes. STAR plans are Medicaid- managed care
plans. Patients seen under these plans are eligible for Medicaid. You will
not be charged for kits for Medicaid-eligible, CHIP, and charity care
newborns.
|
| |
NBS4
(Insurance/Self-Pay) Kit Exchange of Expired Kits
|
Question: | When will DSHS begin to accept requests to exchange
expired NBS4 (Insurance/Self-Pay) kits
for non-expired NBS4 kits? |
Answer: | DSHS will begin to accept exchanges on the date following
kit expiration. (For kits that expired
on September 19, 2017; exchange requests will be accepted starting on September
20, 2017. Kits that have expired prior
to the most recently expiring kits will not be accepted for exchange. |
| |
Question: | Do
expired NBS3 (Medicaid/Chip/Charity) kits need to be returned to DSHS?
|
Answer: | No, NBS3 kits do not need to be returned to DSHS for
exchange. Expired NBS3 kits can be discarded. |
| |
Question: | How
do I dispose of expired NBS Specimen collection kits?
|
Answer: | Expired and unused NBS specimen collection kits can be
discarded in the regular garbage, recycled with paper recycle, or shredded. |
| |
Question: | What
form do I need to fill out to request an exchange? |
Answer: | Complete
the G-6D “Newborn
Screening Supplies” order form. Count the number of
expired NBS4 kits. Write the number of forms to be exchanged in the “Quantity
Requested” box and write “Exchange” in the “Billing – Purchase Order Number” box
section of the form. |
| |
Question: | Where
and how do I send my exchange request and expired kits? |
Answer: | The
completed G-6D form and expired kits should be mailed to:
For
Overnight/Priority Shipping (UPS, DHL, FedEx, etc):
Texas Department of
State Health Services Container Preparation
Group
Laboratory Services
Section, MC 1947
1100 W. 49th Street
Austin, TX 78756-3199
For
regular mail:
Texas Department of
State Health Services
Container Preparation
Group
Laboratory Services
Section, MC 1947
PO Box 149341
Austin, TX 78714-9341 The cost
for shipping is the responsibility of the submitter. |
| |
Question: | How long will it take to process an exchange request? |
Answer: | Allow DSHS 5 business days from receipt of exchange
request to process the request. |
| |
Question: | I ordered additional new kits when I requested an
exchange, why have I not received my additional new order? |
Answer:
| Although the same form is used to both request an exchange of expired forms and to order new kits, a separate form must be filled out for each type of request. If additional new kits are ordered on the same G-6D form as the request for exchange of expired kits, only the exchange request will be processed. Example: 20 expired kits are sent in for exchange and 100 additional kits are requested on the same G-6D form. DSHS will only send out 20 new kits to cover the number returned for exchange. |
| |
Question:
| Can I request an exchange for kits now that are due to expire soon? |
Answer:
| No, DSHS will only accept requests to exchange kits that have
already expired. |
| |
Question: | How
long do I have to request an exchange of expired NBS4 kits?
|
Answer: | You have up to 3 months after the expiration date to
submit a request to have expired NBS4 kits exchanged for non-expired kits. |
| |
Question: | Will
our facility be refunded the amount of the exchanged kits? |
Answer: | No. When an exchange request is received, DSHS will automatically send new kits for the exact number of kits that were returned. |
| |
Question:
| I
would like to return expired kits but do not want new kits, will a refund be
issued?
|
Answer:
| No. Expired NBS4 kits cannot be returned for a refund or credit. DSHS will automatically process the request as an exchange.
|
| |
Accessing Newborn Screening Result Reports
Online (for Healthcare Providers)
|
Question:
|
How do healthcare providers get access to the Texas
Newborn Screening Web Application?
|
Answer:
|
1.
Fill out:
2.
Submit the completed forms:
For
help, call: 888-963-7111, ext. 2484 or ext. 6275.
A
Newborn Screening Submitter ID is required to complete this paperwork. If the
facility does not have a Submitter ID, see the next question and answer
below.
|
|
|
Question:
|
I would like to access newborn screening results for my
patients online, but my facility does not collect newborn screens. Do I have
to collect newborn screening specimens in order to access the results online?
|
Answer:
|
Metabolic
specialists, endocrinologists, pediatricians and other healthcare providers
often need quick access to newborn screening results for their patients. It
is not requirement that a facility submit newborn screening specimens in
order to access newborn screening results online. However, healthcare
providers/facilities are required to have a Submitter ID to access newborn
screening results online.
Healthcare
Providers/Facilities can obtain a Submitter ID or use the Submitter ID for a
facility with which they are associated.
If
you are a healthcare provider that would like to obtain a Submitter ID:
- Complete
the Submitter Identification Number Request/Update Form
- If
your facility will not be submitting newborn screening specimens, in the box
“Type of tests to be submitted,” fill in with “None. Need online access to
NBS results.”
- Fax
to Laboratory Reporting at (512) 776-7533.
Once
you have obtained a Submitter ID, signup for online access by following the
steps outlined in the question & answer above, How do healthcare
providers get access to the Texas Newborn Screening Web Application.
If
you are a healthcare provider that would like to use a Submitter ID for a
facility with which you are associated, call the telephone number below for
help.
For help, call: 888-963-7111, ext. 2645 or
ext. 6030.
|
|
|
Question:
|
What is the Newborn Screening Report Card?
|
Answer:
|
The
Newborn Screening Report Card provides a monthly report on your facility’s
NBS submissions; including number of specimens submitted and specific
information on specimen quality and demographic issues.
Refer
to the Guide
to the Newborn Screening Report Card (PDF 111kb) for more
information on each category.
Access
to the report allows the facility to:
- Identify
strengths and opportunities for improvement.
- Compare
your facility’s performance with others in the state.
To
access your facility’s report card, you must be a registered user of the
Texas Newborn Screening Web Application (Neometrics). If you are not already
a registered user, you can sign up to become a registered user of the Texas Newborn Screening Web Application.
|
|
|
Question:
|
I have forgotten my password or been locked out of my web
account. What do I do?
|
Answer:
|
Send
an email request for a password reset to help@hhsc.state.tx.us. Business hours for
assistance are 8am-5pm Monday through Friday.
|
|
|
Question:
|
When will results be available through the Web
Application?
|
Answer:
|
Results will be available in the web application 4 to 7
working days (Monday - Saturday) after receipt of the specimen, in most
cases.
|
|
|
Question:
|
How long will the results be available on the web?
|
Answer:
|
Results will be available indefinitely. Currently, users
can access results for any specimens reported after mid-February of 2007. To
access result reports for earlier specimens, providers must contact the DSHS
Laboratory Reporting Group (fax 512-776-7533 or call 512-776-7578).
|
|
|
Question:
|
We no longer wish to receive a hard copy of the result
report. How do we opt out?
|
Answer:
|
Call DSHS Laboratory Reporting at 512-776-7578 to request
to opt out of hard copy reports.
|
|
|
Question:
|
When trying to view a result report, I am receiving the
error "The file is damaged and could not be repaired" Why?
|
Answer:
|
To
view result reports, the web application requires Adobe Reader 8.0 or higher.
If you have an older version, this error will occur. Update your version of Adobe Reader.
|
|
|
Question:
|
I am a provider treating a child and a registered user of
the Web Application. Can I access reports on specimens that were sent to DSHS
by a different provider for the child?
|
Answer:
|
Yes. In the Access Result Reports module,
uncheck Submitted Samples Only before performing a search. For additional
security purposes, the user must use a combination of multiple search fields
to access the result report. Recommended search criteria for SRV criteria. (PDF
22kb).
|
|
|
Question:
|
I am having trouble accessing results. Where can I get
help and hints for accessing result reports?
|
Answer:
|
The web application includes features that
maximize patient privacy and ensure compliance with HIPAA Security rules.
If
you are having trouble accessing results for a patient, check out the general SRV search tips (PDF 22kb) or
send an email request for assistance with the website to: mailto:NBSRemoteDataServices@dshs.state.tx.us.
A
few quick reminders:
- Search
with as few fields filled in as possible.
- If
there are any differences between what is searched for and what is in the
system, results will not be retrieved.
- The
search combinations outlined in the Search Tips document (linked above) are
the ONLY combinations allowed when searching for results for
specimens that were not submitted by your facility.
- When
searching for results for specimens submitted by another facility, you must un-check
the “Submitted Samples Only” box.
|
|
|
Accessing and Interpreting Result Reports (for
Healthcare Providers)
|
Question:
|
How do healthcare providers get result reports in addition
to receiving them through the mail?
|
Answer:
|
1.
(Recommended)
Sign up as a registered user of the Texas Newborn Screening Web Application
and access reports online (see FAQs for Accessing Newborn Screening Result
Reports Online (for Healthcare Providers), or
2.
Contact
DSHS Laboratory Reporting Monday - Friday 8am to 5 pm.
- Send
a fax request to 512-776-7533 or
- Call
512-776-7578.
|
|
|
Question:
|
Our facility received an unsatisfactory report on a
specimen, but the baby is no longer in our care. What should we do?
|
Answer:
|
DSHS will ONLY notify the submitting
facility of an unsatisfactory specimen. Facility’s receiving an
unsatisfactory report for a specimen should either recall the patient for a
redraw or coordinate with the patient’s current healthcare provider to ensure
that a satisfactory newborn screening specimen is collected.
|
|
|
Question:
|
Our facility needs to make a correction to a result report
(i.e., medical record number, name or other information is incorrect); what
is the best way to request an update?
|
Answer:
|
To make a correction to demographic information on a
newborn screening result report:
1.
Draw
a line through the incorrect information on the result report.
2.
Write
the correct information above or below the incorrect information.
3.
Initial,
date and fax the result report back to: DSHS Laboratory Reporting,
512-776-7533.
A revised result report will be mailed or faxed to the facility that
submitted the specimen. Corrections to information on a result report can
only be requested by the facility that submitted the specimen.
Please note:
- Corrections
made to the date of birth, date of collection and/or birth weight on a result
report may cause changes in test results. Please be mindful of any updates to
results.
- Any
requested change that calls into question the identity of the specimen (i.e.
name changes or multiple field updates) will be deemed unacceptable and the
results updated to UNSATISFACTORY: PATIENT INFORMATION INCOMPLETE OR INVALID.
If a submitting facility is unsure of the identity of a specimen due to
possible miss-labeling of the newborn screening demographic form, the DSHS
Laboratory should be notified and any infant in question should have their
newborn screen recollected.
|
|
|
Question:
|
What are analytes?
|
Answer:
|
An analyte is the specific enzyme, chemical, or molecule
that is tested for and measured to identify a child at risk for an NBS
disorder. Many of the analytes are listed by name. For example, phenylalanine
is the analyte measured which indicates PKU, thyroxine (T4) is the analyte
measured which indicates hypothyroidism, and immunoreactive trypsinogen (IRT)
is the analyte measured which indicates cystic fibrosis. However, Fatty Acid
and Organic Acid disorder analytes are listed by abbreviations of the
acylcarnitine markers or ratios that identify the disorder (e.g., C8, C6,
C10:1 and C10 are the analytes that are measured and may indicate the MCAD
disorder).
|
|
|
Question:
|
For abnormal test results, are we responsible for ordering
the confirmatory tests, or will the specialist order them? If we have to
order the tests, what laboratory do you suggest we use?
|
Answer:
|
The suggested confirmatory tests are listed in the result
reports so that if you wish to order the tests before the specialist is
consulted, you can do so. Some people prefer to consult with the specialist
first and have the specialist order the tests. The laboratory used will
depend on insurance requirements and local availability.
|
|
|
Question:
|
Why do some abnormal results only require a repeat screen
and others require other additional laboratory tests?
|
Answer:
|
The requested or recommended actions are
based on the concentrations of the abnormal analytes. The majority of
abnormal analyte results only indicate the need for a repeat screen; however,
some results are within a critical range and require immediate action to
identify, prevent or control serious health problems.
|
|
|
Question:
|
What does an Indeterminate Cystic Fibrosis (CF) screen
result mean on the newborn screen result report?
|
Answer:
|
The Texas Newborn Screening Program requests the
collection of blood spots on two separate occasions for each baby. First
screen specimens should be collected after 24 hours but before 48 hours of
age, and the second screen specimens should be collected at one to two weeks
of age. The IRT/IRT/DNA screening model used in Texas will identify babies
with a persistent elevation of IRT. If the IRT level is elevated on the first
screen, the NBS result report will list the CF result as
"indeterminate", pending results from the second newborn screen.
Therefore, please ensure that the second screen is promptly collected for any
baby with an "indeterminate" result on the first screen.
|
|
|
Question:
|
What does an Inconclusive CF screen result mean on the
newborn screen result report?
|
Answer:
|
With the IRT/IRT/DNA model used in Texas, newborn screens
are tested for a panel of 40 DNA mutations when the second screen has an
elevated IRT result or if the first screen is elevated and a second screen is
not received by DSHS. If none of the 40 mutations are detected by the DNA
testing, the newborn screening result report will list the CF result as
Inconclusive. Although the mutation panel tests
for the 40 most common Cystic Fibrosis Transmembrane Reductase (CFTR) gene
mutations, there are more than 1600 known mutations in this gene. Therefore,
even with the absence of these 40 mutations, there is still a minimal risk
for CF. No further testing is recommended unless the child shows clinical
symptoms of cystic fibrosis.
|
|
|
Question:
|
When an abnormal result note states “Possible metabolic
disorder,” what does this mean?
|
Answer:
|
Sometimes, the screen results do not provide
enough information to determine the exact disorder that may be indicated.
Typically, the results do not indicate a critical situation so the action
needed is to collect and submit a repeat screen as soon as possible.
|
|
|
Question:
|
Why does the Screening Result indicate “Abnormal” but some
analytes are listed as “Normal” in the Analyte Result” column?
|
Answer:
|
Multiple analytes are used to determine a patient’s risk
for some disorders. Not all the analytes have to be abnormal to indicate a
problem.
|
|
|
Question:
|
What does it mean when some result notes mention
Non-Specific Elevation(s)?
|
Answer:
|
Non-Specific Elevation(s) or Elevations in a
non-diagnostic pattern refers to abnormal analyte(s) that are not recognized
as a specific pattern associated with one of the screened disorders.
|
|
|
Question:
|
Why does the result report have two or more result notes
with differing instructions? Which directions am I supposed to follow?
|
Answer:
|
Depending upon the specific analytes that
are elevated, multiple disorders may be indicated. Therefore, multiple
screening notes may be printed. NBS Clinical Care Coordination staff will
contact the healthcare provider to provide guidance on necessary actions and
follow-up.
|
|
|
Question:
|
I received a two page abnormal result report but the
second page was blank. Is there information missing?
|
Answer:
|
No information is missing. If all of the information on
the report (including the list of disorders that are screened for) cannot fit
on the first page, a second report page is automatically generated to provide
the information.
|
|
|
Question:
|
What does it mean when the newborn screening report
states, "Possible TPN - Please repeat the Newborn Screen when TPN is
discontinued?”
|
Answer:
|
Some newborns have gastrointestinal systems that are too
immature to absorb nutrients safely, and therefore receive their initial
nutrient (amino acids, sugars and lipids) through intravenous (IV) feeding,
which is called total parenteral nutrition (TPN). TPN may interfere with the
newborn screen by causing elevated results for many of the analytes masking a
true disorder. This is a particular concern with the Amino Acid Disorders.
Please do not collect the newborn screening sample directly off the TPN line.
Please remember to note on the specimen collection card when a child is on
TPN.
|
|
|
Question:
|
Some results state, “DNA Report to follow.” Do I have to
order additional testing?
|
Answer:
|
No. As part of the NBS program, certain DNA
testing is automatically performed on specimens that test positive for
specific disorders. Specimens that will have the DNA testing
performed have the above note on the NBS report. The DNA report will be
mailed separately when the testing is completed. There is no additional
charge associated with this DNA testing.
|
|
|
Demographic Entry through the Texas Newborn
Screening Web Application (for Healthcare Providers)
|
Question:
|
Which label printers can be used with the system?
|
Answer:
|
The following is a list of just some of the
label printers that have been tested with this system. Other similar printers
will likely be configurable as well.
- Zebra
LP2824
- Zebra
TLP 3742
- DYMO
LabelWriter 400 Turbo
- Brother
P-touch QL-5000
- SII
Smart Label Printer
|
|
|
Question:
|
How do I configure the label printer and my web browser to
ensure labels print properly?
|
Answer:
|
For complete instructions for configuring your printer and
web browser, download Lab NBS Provider Web Installation (PDF 834KB) |
|
|
Question:
|
Do we still have to hand-write the demographic information
onto the cards?
|
Answer:
|
No. If you place a web label on the NBS card, you do not
have to complete the form.
|
|
|
Question:
|
I entered the specimen information and clicked “Submit”
but I need to change something. How do I do this?
|
Answer:
|
Through the web system, you may re-access
the submitted specimen using the Search option under the Enter NBS
Demographics module. Choose to edit the demographics for the specimen in
question. Make any necessary changes to the demographic information and
submit the specimen again. You will then be prompted to print a label.
|
|
|
Question:
|
How do I print more than one label?
|
Answer:
|
If your printer is configured to initiate a print dialog
at each print, there will be an option to choose the number of copies within
that dialog. If you will always print multiple labels, the number of copies
can be set in the printer preferences.
|
|
|
Question:
|
Can I print labels on a laser printer?
|
Answer:
|
Although the system is configured to print to a label
printer, if you prefer to print to labels on a laser printer see PDF directions located at: NBS Procedure Print Label Web Application (PDF) |
|
|
Question:
|
Is there a way to set the default printer so that I can
print labels to the label printer, but also print to the regular networked
printer from other applications?
|
Answer:
|
There is not a default setting to automatically print
labels to the label printer and other documents to the networked printer. If
you have the default set to the label printer but want to print documents to
another printer, you will have to either change the default printer to the
laser one you wish to print to, or select the laser printer from the print
dialog box.
|
|
|
Question:
|
I am getting an ActiveX control error when I submit a
specimen or try to print a label. How do I fix this?
|
Answer:
|
Since this is a secure site, the site must be added to a
list of acceptable sites under security settings for your web browser. This
may require setup assistance from your facility’s IT department. The steps
necessary to reconfigure this are also available in the document Lab NBS Provider Web Installation (PDF 834KB)
|
|
Billing (for Healthcare Providers)
|
Question:
|
Who will be billed for newborn screening test kits?
|
Answer:
|
For insurance/self-pay test kits, DSHS will bill the person or facility that orders kits. No bill is sent for Medicaid, CHIP or charity care newborn kits. |
|
|
Question:
|
Wouldn't it be easier for DSHS to bill the patient?
|
Answer:
|
DSHS considered billing patients, but found
that administrative costs would more than double the cost of the service.
Minimizing administrative costs by charging providers for screening kits
represented the most cost-effective approach.
|
|
|
Question:
|
What if the screening test kit is defective?
|
Answer:
|
Each
screening test kit qualifies as a medical device. If a kit does not perform
as it should, please notify the DSHS Laboratory
Quality Assurance group by email. DSHS will investigate, and kits
found to be defective will be replaced free of charge.
|
|
|
Question:
|
If DSHS requests a repeat newborn screen because a
specimen was deemed unsatisfactory, will a screening test kit be provided
free of charge?
|
Answer:
|
For Insurance / Self-pay kits, healthcare providers will
be required to purchase a replacement kit. Healthcare providers are
responsible for ensuring the quality of specimens drawn. All screening kits
for Medicaid-eligible, CHIP, and charity care newborns are provided free of
charge to the healthcare provider.
|
|
|
Question:
|
Is newborn screening covered by insurance?
|
Answer:
|
Yes; however, there are caveats depending on the type of health plan.
Federally recommended newborn screenings are part of the comprehensive preventive health guidelines supported by the Health Resources and Services Administration (HRSA) for infants and children (Section 2713 of the Public Health Service Act). Health plans are required to cover screenings included in the HRSA-supported comprehensive guidelines without charging a co-payment, co-insurance, or deductible for plan years beginning on or after the date that is one year from the Secretary’s adoption of the condition for screening. However, there are many plans that were grandfathered and are not subject to this provision. Grandfathered health plans are typically plans issued before March 23, 2010.
The full list of federally-recommended newborn screening conditions: https://www.hrsa.gov/advisory-committees/heritable-disorders/rusp/index.html.
At the state level, Texas Insurance Code 1367.003 requires Texas regulated health plans to provide certain health coverage for newborn children including newborn screening. This addition to the law became effective September 1, 2019 and only applies to a health benefit plan delivered, issued for delivery, or renewed on or after January 1, 2020.
Doctors and health care facilities should work with health plans to ensure that newborn screening is included as a benefit in their contracts and that the health plans are aware of the cost for newborn screening.
|
|
|
Question: | How
will healthcare facilities be informed of changes to the cost of the Texas PAID
newborn screening specimen collection kit? |
Answer: | DSHS
will post the new cost to the DSHS NBS website and send out electronic
notifications via the newborn screening distribution list, at minimum, 90 days
prior to the effective date. |
| |
Question: | What
steps do providers take for reimbursement of the newborn screening test kit
cost? |
Answer: | 1) Contact
each health plan or insurance company to update your facility contracts.
2) Verify that Healthcare Common Procedure
Coding System (HCPCS) code S3620 is updated to match the current cost for the
screening kit.
3) Submit newborn screening claims using
HCPCS code S3620. Notes:
- HCPCS Code
S3620: Newborn metabolic
screening panel includes test kit and the laboratory tests specified by
the state for inclusion in this panel. The healthcare provider may be
responsible for additional costs not included in the cost of the test kit
such as preparing and shipping the specimen to the DSHS Laboratory.
- CPT code
36416: Collection of
capillary blood specimen, may also be used.
|
| |
Question:
|
What can be done if the correct reimbursement is not received? |
Answer:
|
First, contact the health plan or
insurance company to seek resolution.
If
no resolution is identified:
- For Texas Regulated Health Plans (Fully Insured
and HMOs), contact:
Texas
Department of Insurance.
https://www.tdi.texas.gov/hprovider/providercompl.html or
1-800-252-3439
- Self-Funded
Plans regulated at the federal level (Most people who have health insurance in
Texas have a self-funded plan), contact:
U. S. Department of Labor
Division
of Technical Assistance and Inquiries
PWBA N5619
200 Constitution Ave. NW
Washington DC 20210
1-866-444-3272
- If
insurance is provided by a school district, city, county or state government, a
union, or church, work directly with the health plan.
Note:
DSHS
does not control how insurance companies operate or the reimbursement rates
that are set.
TDI maintains resources for providers
as does TMA and THA. Other Resources:
Texas Department of Insurance: https://www.tdi.texas.gov/hprovider/providercompl.html Texas Medical Association: https://www.texmed.org/newborn/
Texas Hospital Association: https://www.tha.org/newbornscreening
|
| |
Fee Change |
Question: | Why
does the fee for newborn screening change? |
Answer: | DSHS
must evaluate and adjust the fee of the newborn screening kit to recover the
costs of: specimen processing, laboratory testing, and follow-up services. Most
often the cost of these services increase due to adding disorders to the
testing panel. |
Question: | What is included in the fee
and how is it determined? |
Answer: | The fee includes: - Direct costs for testing chemicals, supplies,
labor, specimen collection kits, laboratory information management system
(LIMS) and instrument maintenance
- Indirect costs for quality assurance, safety,
building costs, courier service, administration, IT network and purchasing
- Follow-up
notification and care coordination for babies that have out-of-range laboratory
results
The fee is calculated using a procedure
approved by the DSHS Chief Financial Officer. This method is used to determine
all DSHS laboratory fees. |
Question: | Is it still necessary to collect the second screen? |
Answer: | Yes. Both screens are required as listed in the Texas Administrative Code, Title 25 Section 37.56. Also, some of the disorders screened are more likely to be detected when the baby is more that one week old. |
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Additional
Healthcare Provider Questions |
Question:
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What are the DSHS laboratory’s
recommendations for meeting the College of American Pathologist (CAP) Newborn
Screening Specimen Tracking requirement?
CAP# GEN.40545 Newborn Screening Specimen
Tracking (Phase I)
For specimens being submitted to a remote testing laboratory
for newborn screening for congenital disorders, there is a documented
tracking system to ensure that all specimens are submitted in compliance with
timing requirements and that a result or other appropriate notification is
received indicating that the specimens were actually received.
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Answer:
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DSHS
Recommended Solution:
Use
the Texas Newborn Screening Web
Application (Neometrics). Benefits include:
- Provider
can opt to enter patient demographic information (reduces miss interpretation
of hand written information on the kits) and/or
- Search
and view/print newborn screening result reports 24/7
Two
ways the Texas Newborn Screening Web
Application (Neometrics) helps you meet the new CAP
requirement for NBS tracking:
1.
Electronically
submit the demographic information for each newborn screen (NBS) specimen to
the DSHS Laboratory. Once the specimen is received and scanned into the
Laboratory Information Management System (LIMS), it will appear as “merged”
in the provider’s Texas
Newborn Screening Web Application account.
2.
Search
for any newborn screening specimen submitted and view or print the result
report. The DSHS Laboratory Quality Assurance Group has consulted with CAP
and confirmed that healthcare providers can meet the specimen tracking
requirement by confirming receipt of a result report for each specimen
submitted. (Note: Demographic entry of specimens as described in above option
is NOT needed in order to view/retrieve result reports.)
If
you are not already a registered user of the Texas
Newborn Screening Web Application, access the required forms and
learn more information on the benefits of signing up here:
Alternate
manual method:
NBS
submitters can also opt to maintain a list of each NBS specimen submitted to
the DSHS laboratory in the form of a manifest and reconcile the list upon
receipt of the NBS result report. (A manifest does not need
to be forwarded to the DSHS Laboratory.)
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Question:
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Our facility has multiple locations; can we use one
Submitter ID number for all of them?
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Answer:
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Yes, if necessary, but this practice is highly
discouraged.It is preferred that each site request/receive its own submitter
number.
All supplies, patient results, mailed correspondence, and alerts will be sent
only to a single address for the Submitter ID number given. Separate
submitter IDs for separate locations improves the timeline for submitter
receipt of test result reports and ability to track supply shipments. It will
also help ensure that supplies are received specifically by the site that
ordered them.
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