CONSULT REQUEST GUIDELINES                                                                        
click on the text below for detailed information
 
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Abnormal LFTs
(hepatitic pattern, AST/ALT >5x upper limit of normal or increased bilirubin)
Suggested Pre-Referral Evaluation and Management Guidelines
1) Test for IgM anti-HAV, HBsAg, IgM anti-HBc, anti-HCV, antinuclear antibody (ANA), smooth muscle antibodies(SMA), SPEP
2) Test for serum protein electrophoresis(SPEP)
3) Test for PT/INR
4) Repeat LFT, PT in 1-2 weeks
Suggested Additional Test/Management Prior to Specialty Visit
1) Refer patient
2) Ask for early appointment if AST/ALT >10x upper limit of normal (ULN), bilirubin >2, or INR >1.2
Patient Education/Information (includes preps)
1) American Association for the Study of Liver Diseases
2) Centers for Disease Control and Prevention
3) National Institutes of Health
4) American Liver Foundation
5) Liver Function Panel
Appointment Timeframe 1-2 weeks, call M-LINE and ask to speak to one of the hepatology faculty if urgent appointment is needed
How to Get Results to Consultant UMHS Patients: See MiChart
External Patients: Hand carry non-UM records, MRI/CT films and biopsy slides to visit unless records sent at least 1 week before clinic visit
Outpatient Consult Request form
Clinic Contact Information Physicians: 800-962-3555 or 844-233-0433
Patients: 844-233-0433
Clinic Location Sites Hepatology Clinic Locations
UM Consulting Physician Hepatology Faculty
Lisa Sylvest, RN -- UMHS Patient Liaison will answer provider questions.
Revised on: 04/15/2015
 
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Abnormal LFTs
(hepatitic pattern, AST/ALT < 5x upper limit of normal, normal bilirubin)
Suggested Pre-Referral Evaluation and Management Guidelines
1) No alcohol
2) Repeat after 2-8 weeks to determine if LFT persistently abnormal
3) Test for HBsAg, anti-HCV
Suggested Additional Test/Management Prior to Specialty Visit
1) Refer if LFT persistently abnormal
2) Test for antinuclear antibody (ANA), smooth muscle antibodies (SMA), ferritin/total iron-binding capacity (Fe/TIBC)
3) Test for ceruloplasmin if patient younger than 40 years
4) RUQ US to assess for fatty infiltration
Patient Education/Information (includes preps)
1) American Association for the Study of Liver Diseases
2) Centers for Disease Control and Prevention
3) National Institutes of Health
4) American Liver Foundation
5) Liver Function Panel
Appointment Timeframe 1-6 weeks
How to Get Results to Consultant UMHS Patients: See MiChart
External Patients: Fax non-UM records to Hepatology Scheduling office. Fax number: 734-998-1453
Outpatient Consult Request form
Clinic Contact Information Physicians: 800-962-3555 or 844-233-0433
Patients: 844-233-0433
Clinic Location Sites Hepatology Clinic Locations
UM Consulting Physician Hepatology Faculty

Lisa Sylvest, RN - UMHS Patient Liaison will answer provider questions.
Revised on: 04/16/2015
 
Print
Abnormal LFTs
(cholestatic pattern, alkaline phosphatase more markedly elevated than AST/ALT)
Suggested Pre-Referral Evaluation and Management Guidelines
1) RUQ US to rule out biliary obstruction
2) ANA, antimitochondrial antibodies (AMA) to rule out PBC
Suggested Additional Test/Management Prior to Specialty Visit
1) Refer if bilirubin increased or alkaline phosphatase >2x upper limit of normal (ULN). Ask for early appointment if patient is overtly jaundiced
2) Repeat LFT if bilirubin normal and alkaline phosphatase <2x upper limit of normal (ULN), refer if LFT persistently abnormal
Patient Education/Information (includes preps) No treatment other than bed rest is recommended for hepatitis C
1) American Association for the Study of Liver Diseases
2) Centers for Disease Control and Prevention
3) National Institutes of Health
4) American Liver Foundation
5) Liver Function Panel
Appointment Timeframe 1-3 months, call M-LINE and ask to speak to one of the hepatology faculty if urgent appointment is needed
How to Get Results to Consultant UMHS Patients: See MiChart
External Patients: Fax non-UM records and MRI films to Hepatology Scheduling office. Fax number: 734-998-1453

Outpatient Consult Request form
Clinic Contact Information Physicians: 800-962-3555 or 844-233-0433
Patients: 844-233-0433
Clinic Location Sites Hepatology Clinic Locations
UM Consulting Physician Hepatology Faculty

Lisa Sylvest, RN - UMHS Patient Liaison will answer provider questions.
Revised on: 04/16/2015
 
 
 

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