General Laboratory Questions
1. What types of pathogens does your lab find?
Fry Laboratories specializes in testing for and the identification of blood-borne pathogens including (but not limited to) Borrelia spp., Bartonella spp., Ehrlichia spp., Anaplasma spp., Rickettsia spp., Babesia spp., Toxoplasma spp., Malaria, Trypanosomes, infectious Protozoans, biofilm forming pathogens, and new emerging diseases.
2. Is the information I find on the internet accurate?
The best place to find information regarding tick and vector-borne diseases is through your healthcare providers. Unfortunately the internet is full of incomplete, inaccurate, or biased information regarding diagnosis, treatment, and testing; therefore, be wary of information from online sources. There are also websites with information regarding our ongoing research projects. Please note that Fry Laboratories does not support, verify, condone, endorse, or approve of any other website claiming to disseminate information regarding ALS, MS, Fibromyalgia, CFS, chronic illness, or Protomyxzoa research. Fry Laboratories does not maintain any professional relationships with any other websites. Please visit your healthcare provider for appropriate medical care and advice.
Specific Test Questions
1. What are hemobartonella or epierythrozoans?
Many of our tests are direct microscopic examinations of blood smears. The term hemobartonella and, often used interchangeably, epierythrozoan is a physical description of the behavior of the organism(s) observed. Except in a few cases it is generally not possible to determine the species of bacteria observed by microscopy. Upon microscopic examination bacteria generally appear as spherical, rod, or slightly irregular shaped cells that may be differentiated from 'artifact' by the use of selective stains. Organisms that adhere to the surfaces of cells have the physical characteristics consistent with epierythrozoan, or red blood cell adhering, bacteria. It is now known that Bartonella spp. are not the only organism to display this characteristic and the out-dated term "hemobartonella" had been previously used as well. In summary, as new species of blood-borne bacteria have been discovered it is apparent that organisms identified by microscopy that are found inside or adherent to red blood cells are not necessarily Bartonella spp. and as such the general terms 'hemobartonella' and 'epierythrozoan' are used to describe the features of the organism that is observed. Fry Laboratories offers targeted molecular and serologic testing to determine if the detected organisms are of the Bartonella genus or are another related species.
2. What is the difference between IgG and IgM?
IgG and IgM are two types of antibodies that are found in the blood. Antibodies are part of the bodies immune system that is used to identify, neutralize, and destroy foreign objects and organisms, such as bacteria, parasites, and viruses. At a basic level, IgM antibodies usually are associated with the early onset phase of an infection (acute), while IgG is generally associated with long-term immunity or reactivity towards a pathogen (chronic). This is a generalization and in some cases does not hold true.
3. How does your laboratory determine the presence of Bartonella spp.?
Fry Laboratories has developed and use several tests to assist in the detection of Bartonella spp. and related organisms. A common method is by the utilization of immunoflorescent microscopy involving IgG and IgM antibodies. This test is a qualitative measure of the hosts immune reaction to the pathogen. The second method is direct microscopic visualization by special stains on a thin blood smear. Fry Laboratories has heavily invested in producing high quality proprietary staining technologies that aid in detection of rare or difficult to detect organisms such as Bartonella spp. Typically if an infection by Bartonella spp. is present they maybe found adherent to the outside of red blood cells, but in some cases may be inside of the cells as well. Lastly, molecular diagnostics may aid in the detection of Bartonella spp. by detecting the presence of the organisms DNA in a patient sample.
4. Can you see Borrelia burgdorferi (the organism that causes Lyme Disease) or other spirochetes on the stained smear (CPT Code: 88342)?
The spirochetes that cause Lyme Disease can be seen on a stained smear and have been observed by our laboratory. Generally it is considered difficult to detect Borrelia spp. by microscopy. The absence of spirochetes by microscopic examination does not necessarily mean the patient does not have Lyme Disease. Therefore, in addition to the stained smear Fry Laboratories offers a Western Blot and PCR tests designed to detect an infection by Borrelia burgdorferi.
5. Do I need to freeze my blood before sending it?
No. Freezing whole blood will destroy the cells and testing cannot be performed. Simply freeze the small ice pack provided with the kit and place both the cold pack with the blood sample(s) in the Styrofoam box.
6. What are PCR tests?
PCR (or Polymerase Chain Reaction) is a technique used to amplify very small amounts of DNA to detectable levels. This allows extremely sensitive detection of pathogens. At Fry Laboratories if a positive detection is suspected, the organism will be sequenced and the exact species identified as a standard part of our PCR testing protocol. Many laboratories do not perform reflex sequencing from positive sequences. Furthermore, Fry Laboratories PCR tests are designed to not only detect known pathogens, but unknown or rare pathogens that are related to other known pathogens.
7. What PCR tests are available?
Fry Laboratories is working to become a primer PCR testing laboratory in the United States that offers tests for all known blood-borne human pathogens. Please check our requisition for the most up to date list of PCR tests available. The list is updated frequently.
8. What are Advanced Stains?
Advanced Stains are tests based on new a newly developed technology in infection and parasite detection. All samples processed by the Advanced Stains test are subjected to two testing strategies. The first test uses fluorescent DNA stains to visualize pathogens in the patient sample. The second test uses a centrifugation technique to enrich samples for parasitic organisms that may then be visualized using traditional staining techniques.
9. If I am currently taking antibiotics, do I need to discontinue my use?
Many of our tests have indicated warnings about potential interference of results due to medications. Generally, antibiotics are recommended to be discontinued 2 weeks prior to the blood sample draw to allow for the most reliable results. However, as with all treatments please consult your physician or health care professional regarding this as it is a medical decision.
10. How does your test X compare to the other lab's test Y?
There are subtle and sometimes significant differences between similar tests from different testing laboratories. Fry Laboratories does not comment on the performance characteristics of other laboratories' tests. Please check with your healthcare provider when selecting tests as they are best equipped to survey the available test suites and select the most appropriate test for your case, sample type, and suspected organism(s).
Questions Regarding Patient Results
1. How do I get my results?
We email or mail the results to your ordering physician within 10 buisness days from when the sample is received. A faxed copy of the results may be faxed to the ordering physician's office only at the request of the patient or the ordering physician. The physician is expected to contact and follow up with the patient once results have been received.
2. What do my results mean?
The results should be discussed with your ordering physician or health care professional. Fry Laboratories is not permitted to discuss, interpret, or release patient results with anyone other than the ordering physician.
3. How soon can I receive my results after it is sent to Fry Laboratories?
Our processing time for testing is expected to be 10 business days or less for most tests. Extended times may occur if gene sequencing is required. While results may be available earlier than this time, please allow a few extra days if the results are reported by mail. Physicians who use the email reporting system are sent results the day they are released.
4. Can my results be emailed, mailed, or faxed to me?
Unfortunately, laboratory regulations do not allow us to email, mail, or fax results to anyone other than the ordering physician or health care professional. Copies of these results may be obtained from the ordering physician directly.
1. Do you accept insurance?
At this time, Fry Laboratories does not accept insurance assignment. Our patients pay for the testing at the time of service. We then provide a paid invoice within several weeks of processing payment. Included with the receipt we provide tips and suggestions for submitting a claim to the insurance company. To submit claims, patients need to retrieve a claim form from their insurance company, complete the form, and submit it for evaluation along with their paid invoice. Since Fry Laboratories does not accept insurance assignment, we do not fill out these forms for our patients and are not responsible for insurance reimbursements.
2. Do I get insurance claim forms from you?
No. You will need to get all insurance forms and claim instructions directly from your insurance company.
3. Medicare Patients
Fry Laboratories is contracted with Medicare. The Advanced Beneficiary Notice of Noncoverage (ABN) Forms as well as instructions for the ABN are located on the "Forms/Orders" section of the website. Please read the instructions as it has valuable information regarding our billing process for Medicare patients. Please note that if Medicare does not reimburse the full amount for testing then the patient will be responsible for the remaining balance. When mailing in your specimen, please include a signed copy of your ABN form, front and back copies of your Medicare ID card, your requisition (test order form) with a credit care included in the "payment" section. For additional questions please call our billing office at 480.292.8457.
1. Can I get a receipt for my bloodwork?
We mail out paid invoices within several weeks of processing payment. We understand that paying for our testing services at the time of service is an inconvenience. We do our best to process payments and mail reciepts promptly to assist in a claim submission for reimbursement. To improve efficiency and reduce overhead costs our reciepts are mailed in batches. If there is a special circumstance in which a receipt is immediately required, please call our Billing Office at 480.292.8457.