Provider-Performed Microscopy: A Review

The examinations of labile specimens under the bright-field or phase contrast microscope are classified as provider-performed microscopy (PPM). With a PPM certificate issued by the Centers for Medicare and Medicaid Services Administration, a physician, nurse practitioner, nurse midwife, physician assistant, or dentist may perform PPM and waived procedures. Provider-performed microscopy procedures use specimens, such as body fluids or skin scrapings. Because quality control material is not available for PPM procedures, quality assurance assessment is complicated. Policies and procedures must be written for each test procedure. Provider-performed microscopy procedures include wet mounts, KOH preparations, pinworm detection, fern test, postcoital test, microscopic urinalysis, fecal leukocytes, semen analysis for presence of sperm and motility, and eosinophils in nasal smears. The quality of PPM is dependent on adequate training and retraining to achieve optimal skills.