For Providers

Our Process

Our expert dermatopathologists adhere to a classical process of making a rapid and accurate diagnosis of the patient’s condition. After the slide is cut and stained with a routine H&E (hematoxylin and eosin) stain, the slide is viewed under a microscope or scanned for digital viewing on a high-resolution computer monitor. The appearance of the cells (morphology) and the arrangement of the cells (architecture) are evaluated and correlated with the provided patient clinical information. In the vast majority of cases (95%+), a definitive morphologic diagnosis is made without any further testing. In a small subset of cases, the dermatopathologist will cut more slides to increase the number of slices of the tissue for evaluation, not infrequently exhausting the entire block of tissue. In another subset of cases, very specific stains—called immunohistochemical stains—may be required in order to further differentiate a malignant from a benign process. In certain routine circumstances, (e.g. nail or rash specimens), special stains are applied to test for the presence of infectious organisms such as ringworm or superficial bacterial infections.

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What makes Spek Diagnostics different from other pathology labs?

There are many great options for labs out there. If you are not satisfied with your current provider of pathology services, we invite you to try us out! Our clients all like us for similar reasons. They like our philosophy of providing cut-and-dry, clear, actionable diagnoses, avoiding gray-zone nomenclature whenever possible. Our melanocytic thresholds are based on world-class training and align with the mainstream diagnosticians. They like our interpretation of rashes. They like our special expertise on cutaneous lymphoma cases. They love our turnaround time and our personal touch on the phone. They appreciate our accommodating underinsured patient billing issues. They love that we treat every patient as a V.I.P.! And clinical staff really likes our requisition forms and label stickers!

How can I send specimens to Spek Diagnostics?

Spek Diagnostics provides all supplies and requisition forms necessary to send specimens to our laboratory. Specimen containers pre-filled with formalin are provided for your practice to collect skin and nail specimens. The specimen bottle must be labeled with two patient identifiers (patient’s name, MRN, birthdate), the body site, and preferably the date of service (collection date). The site is the place on the body that the skin or tissue was collected (left elbow, right upper lip, etc.). Please make sure the cap on the formalin bottle is securely tightened before placing the bottle in the biohazard bag. Copies of the requisition should be placed in the biohazard bag along with the collected specimen.

Specimens are collected by courier pickup for locations in the Treasure Valley / Greater Boise area. FedEx overnight shipping is provided for all other locations.

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How do I send a specimen for direct immunofluorescence?

Follow the same procedure as above, but using a provided Michel’s Solution bottle instead of formalin. If you are out of Michel’s, please contact us before proceeding.

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How can I order more testing supplies?

Please use our Supplies Order page to request more supplies. Just follow the online form, selecting what items and quantities you need, where you need them delivered, and hit submit. If you experience any issues, please contact us!

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How do I ensure you evaluate the margins of my specimen?

We automatically evaluate margins of excisions or frozen sections. However, if you require evaluation of margins with o’clock precision, the specimen must be clearly oriented. Our grossing technicians are trained to look for orientation marks by means of either a notch made with a scalpel at the 12 o’clock mark (or other clearly described o'clock), or a surgical suture or stitch tied at the 12 o’clock mark (or other clearly described o'clock). If no orientation markings are identified, the specimen will be inked one color and only peripheral and deep margins will be reported. Please document any orientation on the requisition.

What is the expected turnaround time?

Our goal is to deliver accurate reports in the most timely manner possible. STAT (emergent) cases are prioritized, and results may be available the same day or within 12-18 hours after receipt. In most cases, pathology reports from a biopsy or an excision will be available to the referring provider the day after we receive the specimen (M-F, excluding holidays). In some more complex cases, our dermatopathologists will need to perform additional testing, staining, or molecular studies on the tissue, or the case may go to a consensus conference where two or more experts will discuss the case together. Each of these extra steps may add up to 24 hours to the original expected turnaround time.

What if I am located outside of the Boise area?

If you are mailing samples to us, we recommend they be sent Priority Overnight via FedEx. Our office will work with you to set up online account access to schedule pickups when needed. The typical turnaround time for specimens received via FedEx is the day after receipt is logged. The specimen will be grossed on the day received, and will be processed in the tissue processor overnight. In the morning, embedding, cutting, and staining of the slide will be complete, followed by expert interpretation.

Does the report integrate with my EMR?

We will try to accommodate your preferred method of receiving reports. Some clients prefer faxed reports, while some like to receive their reports via a shared Box account. For higher volume clients, we can set up an electronic HL7 interface. When an interface is in place, patient data is sent to our Laboratory Information System (LIS), and reports are sent back to your practice’s Electronic Medical Record (EMR) automatically, reducing the rate of data input errors. Please contact us if you are interested in establishing an HL7 interface.

How can I submit a specimen for “slide preparation” (technical only)?

Please contact our staff to inquire about our slide preparation service. These arrangements are made on a case-by-case basis.

How do I submit a consult case?

A provider may submit a slide for a primary read or may request a consultation to assist with the interpretation of a slide. In these cases, the slides are typically sent to our office with a copy of the original clinical information. We prefer any and all additional information about the case, including a clinical photograph and clinical progress notes. Please include recent laboratory testing, if available and relevant. Our board-certified pathologist will evaluate the clinical information and integrate with the histologic findings, ordering any additional testing deemed necessary. In some cases, we may request the original block for obtaining further immunostains. A pathology report will be returned to the provider.

What insurance carriers are accepted by Spek?

Spek Diagnostics is contracted with most major national payers and managed care insurers. We are always working to maintain credentialing and add insurance carriers to minimize out-of-network billing issues. If you have questions about your specific insurance, please contact our billing department or check our list of carriers below.

Will my patient receive surprise bills?

The patient’s insurance plan will dictate how much out-of-pocket expense may be incurred for medical services, including laboratory testing. We may bill your patient if the patient has not met his/her deductible, their plan requires a copay, or if the plan includes coinsurance. We may also bill for services if the patient does not have insurance or if the insurance company denies payment for our services. Please click here for details about surprise medical bills and your right under the No Surprises Act.

We recommend pre-emptive discussions with our billing staff if there is concern about a patient’s ability to pay, extent of insurance coverage, or unusually high expected costs for testing (molecular or esoteric testing).

Do you accommodate self-pay patients, hardship, indigent, and charitable service coverage?

We understand some patients may have special financial considerations. We strive to accommodate those needs by aiming to match the rates charged by the provider’s office. Our goal is to work with our referring providers to ensure each patient’s needs are met and handle specific concerns in the most ethical manner possible.

We recommend pre-emptive discussions with our billing staff if there is concern about a patient’s ability to pay, extent of insurance coverage, or unusually high expected costs for testing (molecular or esoteric testing). Please document this status as clearly as possible on the requisition you provide when submitting the specimen.

Test Menu

Order Code Stain Name Stain Type
ADIP Adipophilin Immunohistochemical
AFB AFB Special
ALCBLU Alcian Blue Special
BCL2 BCL-2 Immunohistochemical
BCL6 BCL-6 Immunohistochemical
BER Ber-EP4 Immunohistochemical
CD10 CD10 Immunohistochemical
CD117 CD117 Immunohistochemical
CD138 CD138 Immunohistochemical
CD15 CD15 Immunohistochemical
CD1A CD1a Immunohistochemical
CD2 CD2 Immunohistochemical
CD20 CD20 Immunohistochemical
CD23 CD23 Immunohistochemical
CD3 CD3 Immunohistochemical
CD30 CD30 Immunohistochemical
CD34 CD34 Immunohistochemical
CD4 CD4 Immunohistochemical
CD45 CD45 Immunohistochemical
CD5 CD5 Immunohistochemical
CD56 CD56 Immunohistochemical
CD68 CD68 Immunohistochemical
CD7 CD7 Immunohistochemical
CD79 CD79a Immunohistochemical
CD8 CD8 Immunohistochemical
CDX2 CDX2 Immunohistochemical
CEA CEAmono Immunohistochemical
CHROM Chromogranin Immunohistochemical
CK20 CK20 Immunohistochemical
CK7 CK7 Immunohistochemical
COLL Colloidal iron Special
CONGO Congo Red Special
DES Desmin Immunohistochemical
DIF DIF Panel (lgG, lgM, lgA, C3) Immunofluorescence
ELAS Elastic Special
EMA EMA Immunohistochemical
ER ER Immunohistochemical
F13A F13a Immunohistochemical
FITE Fite Special
GATA3 GATA3 Immunohistochemical
GIEM Giemsa Special
GMS GMS Special
GRAM Gram Special
HMB HMB45 Immunohistochemical
HPY H.pylori (immuno) Immunohistochemical
HSV HSV 1/2 Immunohistochemical
IRON Iron Special
KAP Kappa Immunohistochemical
KI67 Ki-67 Immunohistochemical
LAM Lambda Immunohistochemical
MELA Melan-A Immunohistochemical
MUC Mucin Special
P16 P16 Immunohistochemical
P53 P53 Immunohistochemical
P63 P63 Immunohistochemical
PANK Pankeratin (CK AE1/AE3) Immunohistochemical
PAS PAS Special
PAX8 PAX-8 Immunohistochemical
PDL1 PDL1 Immunohistochemical
PIN4 PIN4 Immunohistochemical
PR PR Immunohistochemical
RETIC Reticulin Special
S100 S100 Immunohistochemical
SMA SMA Immunohistochemical
SOX10 Sox-10 Immunohistochemical
SYNAPT Synaptophysin Immunohistochemical
TOLBLU Toludine Blue Special
TRICH Trichrome Special
TRYPT Tryptase Immunohistochemical
TTF TTF-1 Immunohistochemical
VIM Vimentin Immunohistochemical
WS Warthin-Starry Special

Insurance Carriers

Blue Cross of Idaho
Blue Cross of Idaho - CarePoint
Idaho Medicaid
Independent Doctors of Idaho (IDID)
Mountain Health Co-op
Pacific Source
Regence Blue Shield of Idaho
SelectHealth Idaho
St. Lukes Health Partners (SLHP)
United Healthcare (UHC)

Get to know us and see what a difference Spek Diagnostics can make for both your practice and your patients.