December Metanephrines, Fractionated, Free, Plasma Plasminogen Activator Inhibitor Type 1 Stool Cultures and Sensitivities
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1 University of Washington December 2012 TEST change 1,25 Dihydroxy Vitamin D Frequency AFB Blood Cultures Alcohol Screen Anti Deaminated Gliadin, IgG Anti Gliadin Package Anti Mullerian Hormone Package Antiviral Sensitivity, Acyclovir and/or Foscarnet ASO Titer, SRM Calcium, Ionized, Reflexive Panel CBC, Differential & Smear Evaluation Celiac Package CMV, Quantitative by PCR Electrophoresis Tests, with and without Consult Gene Specific Colaris Hemoglobin A2 Quantification by HPLC Immunofixation Tests, with and without Consult Metabolic Panels Collection Reminder CPT New Offline Offline Test, CPT Units, Reference Range, Order Note Stability Test Unit Note New/Changes Send Out In House Reference Range New/Changes Unacceptable Metanephrines, Fractionated, Free, Plasma Plasminogen Activator Inhibitor Type 1 Stool Cultures and Sensitivities Toxic Alcohol Panel Urine Drug Screen Send Out In House Offline, Note Offline New Package Added tests NOTE: NO COURIER SERVICE There will be no courier service and our Reference Lab Services technical support will be closed on Christmas day (Tuesday, December 25th) and New Year s Day (Tuesday, January 1st).
2 1,25 Dihydroxy Vitamin D Weekly on Tuesdays; results next day. VTD125 AFB Culture, Blood Specimen Collection: Blood: Collect in Wampole Isolator 10 tube (call Reference Services at (206) for tube). Disinfect draw site AND tube top with iodine. Do not allow the iodine to pool in the stopper. Allow to dry. Do not overfill or under fill. Whenever possible, inoculate the maximum volume (10 ml) for optimal sensitivity of culture. Unacceptable: Any anticoagulant other than Isolator. Stability: Transport at room temperature to Microbiology Laboratory ASAP. Isolator tube specimens older than 12 hours will be rejected. Specimens must be received in Microbiology laboratory before 10 pm. Specimen Transport: 10 ml (min. 6 ml) blood in Isolator. Daily: 7:00 22:00 [Specimens must be received in Microbiology laboratory before 10 pm.] AFBBC Alcohol Screen Quant. Old CPT: New CPT: 82010, 82055, 84600x2 AS Anti Deaminated Gliadin, IgG On December 1, 2012 celiac testing for Anti Gliadin IgG will be replaced by a superior test, Anti Deaminated Gliadin, IgG. Old AGLIAG New ADGPG Specimen Collection: 3 ml blood in plain (red top) or SST tube. Centrifuge and separate serum. Specimen Transport: 1.0 ml (min 0.5 ml) serum. Freeze. Mon, Wed, Fri Reference Range: 0 19 Units CPT s: Price: $45.76 Anti Gliadin Package On December 1, 2012 the Anti Gliadin order package will go offline. This package ordered two tests which may be ordered separately: Anti Gliadin, IgA; and Anti Gliadin, IgG, which has been replaced by Anti Deaminated Gliadin, IgG. Offline Order : Order Separately: GLIAD AGLIAA, ADGPG Anti Mullerian Hormone Package Extra specimen collection for an Anti Mullerian Hormone study is now discontinued. Package order code RAMHGG will be taken offline. Place orders for this test using RAMHG, instead. Old RAMHGG New RAMHG Antiviral Sensitivity, Acyclovir and/or Foscarnet Testing steps for HSV antiviral sensitivities send out testing have changed and CPTs have been updated. Also, sensitivity testing to Gancyclovir, Pancyclovir and Vidarabine are no longer performed. RVCAV1 (1 st Drug) CPT: 87252, RVCAV2 (2 nd Drug) CPT: 87252, ASO Titer, SRM Old Reporting Units: Todd Units New Reporting Units: IU/mL Old Reference Ranges: 0 5 yrs: <100 Todd Units 6 16 yrs: <200 Todd Units 16 yrs: <100 Todd Units New Reference Ranges: 0 5 yrs: <100 IU/mL 6 16 yrs: <200 IU/mL 16 yrs: <100 IU/mL Old ASO New ASOS 2 UW Laboratory Medicine December 2012
3 Calcium, Ionized, Reflexive Panels Notes: For more information on direct vs. reflexive ionized calcium as well as how to order a direct ionized calcium, see the following website: tests/chemistry/plic Basic Metabolic Panel with Reflexive Ionized Calcium BMPICR Calcium, Ionized, Plasma PLIC Calcium, Ionized, Whole Blood WIC Calcium, Reflexive Ionized ICAR CBC, Differential & Smear Evaluation Stability: The UWMC Laboratory must receive and process specimen within 12 hours of collection. CBD Celiac Package New test Anti Deaminated Gliadin, IgG will replace Anti Gliadin, IgG within the Celiac Package. Old CELIAC New CELAC2 CMV, Quantitative by PCR In an effort to standardize test results for the detection of CMV DNA, the WHO has recently released the 1st International Standard for CMV PCR testing. Our assay had now been standardized with this material and will as of 1 Nov 2012 be resulted in IU/ml instead of the previous copies/ml. This will allow a more accurate comparison of results between laboratories. After this adjustment, the assay has a 95% sensitivity cut-off limit of 20 IU/ml. A conversion factor of 4 copies per 1 IU can be used to relate previous results to the new values. This conversion factor is specific to the method performed in our laboratory, and cannot be applied to methods performed in other laboratories. If you are currently caring for a CMV DNA PCR-positive patient, and have any difficulty with this conversion for serial samples, please let us know. For any additional questions, please call or Keith Jerome (kjerome@u.washington.edu, or Linda Cook, lincook@u.washington.edu, ) Test Order s: CMVQN, CMVLTC, CMVRFX Electrophoresis Tests, with and without Consult As of December 1, 2012, additional billing will be added to all existing electrophoresis panels to reflect pathologist consult, previously included in all panels, which will now be charged. New test order codes have been created to give providers an option to order these panels without consult. Existing Tests with new Pathologist Consult fees added Test Order ELP ELPMCP ELPP UELPG UELPP Name Protein Electrophoresis, Serum Monoclonal Protein Panel, Serum Protein Electrophoresis Reflexive Panel, Serum Protein electrophoresis, Urine Protein Electrophoresis Reflexive Panel, Urine Consult CPT Consult Price $ $ $ $ $28.00 New Tests without Pathologist Consult* * If technologists believe that the interpretation of a specific test result is beyond their scope of practice, the test result will be reported without an interpretation, but with a recommendation to obtain professional consultation. Test Order Name Test Details ELPNR SPEP, No MD Review Same as ELP UELPNR UPEP, No MD Review Same as UELPG Gene Specific Colaris As of December 1, 2012 the Department of Laboratory Medicine will no longer send out testing for Gene Specific Colaris. We now offer ColoSeq Single Gene testing in house. Offline Order : In house Order : RGSCOL CAGENE Hemoglobin A2 Quantification by HPLC Old Reference Ranges: 0 6 mo.: <3.4% >=7mo: % New Reference Ranges: 0 6 mo.: <3.5% >=7mo: % Test Order s: HBA2, THLR5 3
4 Immunofixation Tests, with and without Consult On December 1, 2012, additional billing will also be added to all existing immunofixation tests and panels to reflect pathologist consult, previously included in all panels, which will now be charged. New test order codes have been created to give providers an option to order these panels without consult. Existing Tests with new Pathologist Consult fees added Test Order Name Consult CPT Consult Price CIFIX Immunofixation, CSF $28.00 IFIX Immunofixation, $28.00 Serum UIFIXG Immunofixation, Urine $28.00 New Tests without Pathologist Consult* * If technologists believe that the interpretation of a specific test result is beyond their scope of practice, the test result will be reported without an interpretation, but with a recommendation to obtain professional consultation. Test Order CIFXNR IFIXNR UIFXNR Name Immunofixation, CSF, No MD Review Immunofixation, Serum, No MD Review Immunofixation, Urine, No MD Review Test Details Same as CIFIX Same as IFIX Same as UIFIXG Metabolic Panels Unacceptable: Gray top tube or green top with sodium heparin. Note: Green top with lithium heparin is acceptable. Basic Metabolic Panel BMP Basic Metabolic Panel with Reflexive Ionized Calcium BMPICR Comprehensive Metabolic Panel COMP Comprehensive and Hepatic Panel COMPHF Metanephrines, Fractionated, Free, Plasma As of December 1, 2012 the Department of Laboratory Medicine will no longer send out testing for Plasma Free Fractionated Metanephrines. We now offer this testing in house. Offline Order : In house Order : RPLMET PLMET Specimen Collection: 9 ml blood in EDTA (lavender top) tube. Specimen Transport: 2.5 ml (min 0.5 ml) EDTA plasma. Freeze. Weekly Reference Range: Metanephrine: nmol/l Normetanephrine: nmol/l CPT s: Price: $65.52 Plasminogen Activator Inhibitor Type 1 Due to an unavailability of testing reagents and decreased requests from physicians the Coagulation Section of the Department of Laboratory Medicine at the University of Washington Medical Center is moving PAI 1 Activity (Plasminogen Activator Inhibitor Type 1) testing offline immediately. Tests affected are PAI and PAIPAN and FIBSC1. As of October 31st 2012, there are no known laboratories within the US performing this test. However, this may change, as testing reagents become available to the US market at some point in the future. The Coagulation Section of the Department of Laboratory Medicine at the University of Washington Medical Center does offer PAI Antigen testing and recommends using this test as a substitute or screen for abnormal PAI 1 Activity. Test Order s Offline: PAI, PAIPAN, FIBSC1 Stool Cultures and Sensitivities As of November 1, 2012, the Department of Laboratory Medicine will no longer perform individual stool culture testing for Campylobacter, E. coli O157, Yersinia, or the Salmonella, Shigella, Campylobacter and E. coli O157 battery. It is recommended that providers choose the more inclusive stool culture order; Stool C/S and Enteric Battery. Test Order s Offline: STOCC, STOEC, STOYC, STOCEC Test Order Recommended: STOEPC 4
5 Toxic Alcohol Panel Toxic Alcohol Panel is a new test order package that combines Alcohol Screen and Ethylene Glycol testing. Specimen Collection: 6 ml blood in PST (lime green top), EDTA (lavender top), heparin (green top), fluoride/oxalate (grey top), plain (red top) or SST tube. Centrifuge with stopper on, make aliquot quickly as possible and recap aliquot tube immediately. Refrigerate serum/plasma. Specimen Transport: All available (min 3.0 ml) serum/ plasma. Daily Reference Range: Ethyl Alcohol: Negative Methyl Alcohol: Negative Acetone: Negative Isopropanol: Negative Ethylene Glycol: Negative TOXALC CPT: 82010, 82055, 84600x2 Price: $ Urine Drug Screen As of November 1, 2012, additional drugs will be added to the library of drugs detected by the urine drug screen by GCMS method. An updated list of all drugs detected may be viewed at website: web.labmed.washington.edu/tests/chemistry/udd. UDRSCG 5
6 Online Test Guide: Fee Schedule: Call Reference Lab Services at Virology Newsletter: CONTACT US: Tel: web: December 2012 Reference Lab Services University of Washington PO Box Seattle, WA Non-Profit Org. U.S. Postage PAID Seattle, WA Permit No. 62 address service requested
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October Monthly Update, Quest Diagnostics Nichols Institute, Valencia
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