Frequently Asked Questions
Q: Why should I order immune testing?
A: An in-depth evaluation of the immune system is useful to shed light on underlying dysfunction that can be difficult to identify. The information gained from immune phenotyping will supplement your knowledge and can lead to improved patient outcomes. Often there are subtle shifts in cellular competency that are not discoverable through standard testing.
A quick check of your patients’ immune system, especially in these days of uncertainty post-pandemic, will assess if they are at higher risk of more serious complications post-pandemic, and enable you to empower your patients with the knowledge they need to make the best health and safety decisions.
Amerimmune now offers a post-COVID immune evaluation to assess the immune system, serving as a baseline for comparison in the event of infection, and monitoring post-infection.
Q: Can this be done through Quest or LabCorp?
A: No, the panels Amerimmune offers are unique. We exceed standard lymphocyte phenotyping, and offer tests that are not currently available anywhere else (COVID impact, Basophil, and Eosinophil progenitor panels). Moreover, all results include expert interpretation and recommendations to personalize the report. That said, we have a partnership with Quest Diagnostics for them to be our preferred sample collection center. Patient can walk into any Quest diagnostics in the USA with their Amerimmune kit and have their sample shipped to us.
Q: Is Amerimmune a reference lab?
A: No. We are a private practice with a very robust immune lab. Your request is taken as a consult. We run the lab test requested and provide feedback on the patient(s)’ conditions.
Q: Does insurance pay for flow cytometry?
A: Yes. In our experience, most PPO plans cover flow cytometry (CPT codes 88184, 88185, 88189), while most HMO plans do not. Since plans and coverage are variable, we advise patients to contact their carrier to determine coverage and remaining deductible. In the case of limited benefits, poor coverage, or financial hardship, Amerimmune’s assistance solution helps patients overcome financial barriers to testing. Please contact our billing specialist with questions at clinic.billing@amerimmune.com.
Q: Where can my patients have their blood drawn for the test?
A: Blood collection can either be in a physician office or any Quest Patient Service Center. Test packages are assembled according to your need, so that once collected, blood can easily be shipped overnight in pre-paid safe packaging to our laboratory. Patients MUST use an Amerimmune test package when going to Quest. All blood collection must be done on Mondays - Thursdays for receipt in the lab on a weekday, and not before a holiday. Request Kits.
Q: How soon will I receive results?
A: Your patient’s results will be faxed to you within 3-5 days of receipt of supporting labs (CBC with differential). If you or your group submit 5 or more samples a week, you will be set up with direct access to results through our Lab Information System (SLIMS).
Q: I’m not proficient in lymphocyte phenotyping, so how will I know what the results mean?
A: You will receive a cover page with the patient’s clinical presentation, expert analysis and interpretation of the requested flow cytometry test and any concurrently ordered supporting labs, as well as personalized recommendations in the context of patient clinical information provided at the time of testing. The Amerimmune diagnostic tool is designed to meet the needs of non-immunologists, with clinically-driven, relevant testing that adds value and meaning to your patient management.
Q. What is basophil activation (BAT), or Basophil and Lymphocyte Immune Phenotyping?
A. Food allergens can activate as well as cause histamine release from basophils in patients with food allergies. This can be replicated in the test tube when patients’ basophils come in contact with the food allergen. Activation as well as histamine release from basophils creates changes in the cells that can be detected by flow cytometry.
Basophil testing was initially discovered in 1994 and has been used in research and clinical care since then. It is only now available as a clinically validated test for use in patient management.
Q. How can the Basophil and lymphocyte phenotyping (BAT) help me with my food-allergic patients?
A. Amerimmune’s Basophil testing (more commonly referred to as BAT, or basophil activation testing) is a a test that compliments other allergy tests and patient clinical history so practitioners can make better decisions on patient care.
Peer review publications have suggested that basophil testing can show stronger correlation with clinical reactions compared to other methods such as skin testing or serum allergen specific IgE levels. Investigating basophil reactions can help direct the next step(s) in allergy management, such as whether an oral food challenge is appropriate or oral immunotherapy is an option. These decisions will need to be made by the treating physician, after taking into consideration the patient’s history and other test results.
At present time, the gold standard for food allergy diagnosis remains to be the oral food challenge.
Q. I’ve heard that basophil activation assays need to be run within 4 hours. Have you been able to extend the stability time?
A. Yes. The difficulties in accessing validated and commercially available functional basophil assays and the mistaken belief that blood samples need to be processed very quickly for an accurate result has been a major barrier to the widespread use of basophil activation test in the United States and several other countries. In our study we show that the post-collection stability of basophils can be extended to 1 day at room temperature, defined as 18-25C without compromising the quality of the results. This also applies to samples that are shipped overnight at ambient conditions as long as the temperature is within 2-37C.
Q. When should I consider ordering BLIP?
A. BLIP is a recommended tool to monitor clinical allergy and target therapy. Consider testing in the following instances:
When there is uncertain diagnosis of food allergy (particularly equivocal findings with major allergens)
Prior to an oral food challenge
Prior to sustained unresponsiveness challenge
Prior to initiating oral food immunotherapy
Monitoring OIT
Q. How many allergens can be tested at a given time?
A.Up to two allergens can be tested. Currently our focus is on more common foods.
Q: How do I order the test?
A: We have made it very easy. Please go to the link below and fill out all the requested information. Amerimmune and the ordering provider will get an electronic version of the form. Please call us if you have any questions. Order Test
Q. Do I need to create an account to order tests?
A. An account is not necessary, but useful for ordering kits for your patients, if you anticipate requesting fewer than 10 tests in a month. If your volume is higher we recommend creating an account so that you will have direct access to reports.
Q. What if I want to order a higher volume of tests?
A. Amerimmune will continue to supply test packages to submit patient samples; however we would love to show you how you can keep the revenue from testing in your own practice. Amerimmune partners with private practices to establish privately-owned labs to meet the needs of their patient population. Read about our lab operation options.
Q. Can blood samples for immune testing be shipped from any state to any of your labs?
A. 2020 guidelines currently restrict New York and California. We invite you to contact us directly to investigate options.
Q. I want to order urgently — can I order the test without a kit?
A. Yes, however Amerimmune has simplified the process for your practice and patient by providing free supplies, instructions and shipping in our test packages. We encourage you to take advantage of the supplies. Order test packages for phlebotomy services in your office or through Quest.
If you have lavender (EDTA) and green-top (Sodium Heparin) tubes, you may draw the blood sample on a Monday - Thursday and ship it PRIORITY OVERNIGHT to Amerimmune. Package to protect the specimen from breakage and leakage, at room temperature. Include a copy of the order form. You may use your own shipping label, provided it is sent Priority Overnight, and email or call with a tracking number. You may send us this information or request a shipping label by emailing info@amerimmune.com.
Q. What is the standard procedure to collect blood and ship it to Amerimmune?
A. We will provide kits for you to collect blood in your office. While this is the preferred method, we do offer an alternative to send patients to any convenient Quest Patient Service Center. Patients MUST use an Amerimmune package when going to Quest. Please request kits for blood collection prior to ordering the test.
Q: Does the patient need to sign a form?
A: Yes. Once physicians place an order online, patients will automatically get a release form requesting insurance information and their signature. Amerimmune and the ordering provider will get an electronic version of the form.