10,11 Epoxide See: Carbamazepine 10,11 Epoxide. 11 Deoxycortisol See: Deoxycortisol Hydroxylase Antibodies See: Listing in H section

Transcription

1 Laboratory Test Menu Revised: TEST NUMBER: , 25 Dihydroxy, Vitamin See: Vitamin D1, 25 Dihydroxy TEST NUMBER: HIAA, Urine (5 Hydroxyindole Acetic Acid) See: 5-Hydroxyindolacetic Acid, Urine 24 Hours (in H section) TEST NUMBER: ,10 Methylenetetrahydrofolate Reductase Mutation See: 5,10 Methylenetetrahydrofolate Reductase Mutation (in M section) TEST NUMBER: ,11 Epoxide See: Carbamazepine 10,11 Epoxide TEST NUMBER: Deoxycortisol See: Deoxycortisol 11 TEST NUMBER: Hydroxyprogesterone See: Hydroxyprogesterone -17 (in H section) TEST NUMBER: Hydroxylase Antibodies See: Listing in H section * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 1

2 TEST NUMBER: 2695 TEST NAME 15q11.2 Duplication, FISH Synonyms FISH 15q11.2 Duplication TEST ALIAS Prader Willi & Angelman Syndrome, FISH Fluorescence In Situ Hybridization (FISH) using DNA Probes 2 weeks Mayo Send one of the following: Unacceptable Conditions: CPT Codes: One 6.0 ml Sodium Heparin green-top (non-gel) whole blood, in original tube. Mix well. 20 ml amniotic fluid in a screw top container Non bloody (14 18 wks gestation is optimal, other weeks are acceptable) Discard the first 2.0 ml of fluid 20 mg chorionic villi in 15 ml transport media. 4 mm diameter skin biopsy in sterile Hank s solution, Ringer s solution, or normal saline. Room Temperature Please call during business hours with questions. Reason for referral is required. Anticoagulants other than Sodium Heparin for blood Frozen Interpretive Report will be provided If appropriate, 88271, 88271x2, 88271x3, 88273, 88274, may be added TEST NUMBER: q11.2 Deletion/Duplication, FISH Synonyms FISH DiGeorge/Catch 22 Fluorescence In Situ Hybridization (FISH) 4 10 Days Mayo Send one of the following: Minimum Unacceptable Conditions CPT Codes: One 6.0 ml Sodium Heparin green-top (non-gel) whole blood, in original tube. Mix well. 20 ml amniotic fluid in a screw top container Non bloody (14 18 wks gestation is optimal, other weeks are acceptable) Discard the first 2.0 ml of fluid 20 mg chorionic villi in 15 ml transport media 4 mm diameter skin biopsy, or Products of conception, in sterile Hank s solution, Ringer s solution, or normal saline. 20 ml Amniotic Fluid; 2 ml Blood Room Temperature Please call during business hours with questions. Reason for referral is required. Anticoagulants other than Sodium Heparin for blood Frozen Interpretive Report will be provided If appropriate, 88271, 88271x2, 88271x3, 88273, 88274, may be added * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 2

3 A TEST NUMBER: 7645 AA Quantitative, Plasma See: Amino Acid, Quantitative TEST NUMBER: 3628 AA Quantitative, Urine See: Amino Acid, Quantitative TEST NUMBER: 7234 ABG See: Blood Gas, Arterial TEST NUMBER: 5973 Abilify See: Aripiprazole TEST NUMBER: 9818 ABO & Rh (Blood Type) Hemagglutination 1 day/stat One 6 ml pink-top EDTA tube. Mix well and send whole blood. Label tube with patient s: 1) name, 2) medical record or Fenwal ID, 3) date/time drawn 4) initials of the person drawing the blood. One EDTA microtainer tube 0.5 ml 2 8 O C if not tested within 2 hours Unacceptable Conditions: Gross hemolysis EDTA specimens stored at 2 8 O C are stable for up to 3 days. CPT Code: 86900; TEST NUMBER: 7359 ACE See: Angiotensin Converting Enzyme TEST NUMBER: 6052 Angiotensin Converting Enzyme, CSF ACE, CSF Quantitative Spectrophotometry 2-6 days Focus Transfer 1.0 ml CSF to a screw-capped plastic transport tube 0.3 ml Frozen Unacceptable Conditions: Specimens other than CSF, Hemolyzed or xanthochromic specimens Stability 1 week okay U/L CPT Code: TEST NUMBER: 7770 * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 3

4 Acetaminophen Tylenol Enzymatic/Colormetric Daily One heparinized plasma separator tube (PST) or serum separator tube (SST). Mix well. Allow SST specimen to clot in an upright position for minutes. Centrifuge and store tube in an upright position. 0.1 ml serum or plasma in an upright position Separate serum or plasma from the cells within 2 hours of collection. Icteric samples may decrease results by as much as 11%. 3 days refrigerated Unacceptable Conditions Grossly hemolyzed samples Therapeutic: mcg/ml Toxic: >150 mcg/ml CPT Code: TEST NUMBER: 7516 Acetylcholine Receptors See: Acetylcholine Receptor (Muscle AChR) Binding Antibody, serum TEST NUMBER: 2613 Acetylcholinesterase, Amniotic Polyacrylamide Electrophoresis 5 7 Days Mayo 1.0 ml amniotic fluid. Do NOT centrifuge. Send specimen in plastic screw-top transport tube. Minimum: 0.3 ml Specimen from the week gestational period of pregnancy is preferred. Amniotic fluid from the week gestational period is acceptable Negative CPT Code: TEST NUMBER: 7117 Acetylcholinesterase RBC Cholinester RBC; Acetylcholinesterase Erythrocytes Spectrophotometric-Thiocholine Production 1 Week Mayo 4.0mL EDTA purple-top whole blood in original tube. 2.5 ml Transport Specimen must arrive within 72 hours of draw. Unacceptable Conditions: Ambient or frozen specimens U/g of hemoglobin CPT Code: TEST NUMBER: 7516 Acetylcholine Receptor (Muscle AChR) Binding Antibody, serum * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 4

5 Acetylcholine Receptor Binding Antibody; AChR Radioimmunoassay (RIA) 3-6 days Mayo One 13 x 100 mm serum separator tube. Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 2.0 ml serum into a plastic transport tube 0.5 ml Ambient: 72 hours Okay Frozen: Okay < 0.02 nmol/l CPT Code: TEST NUMBER: 1806 Acid Fast See: Culture, AFB TEST NUMBER: 7320 Acid Phosphatase, Prostatic See: Prostatic Acid Phosphatase TEST NUMBER: 7544 ACTH, Plasma See: Adrenocorticotropic Hormone, Plasma TEST NUMBER: 7146 ACTH Stimulation Pre-infusion (Baseline) Cosyntropin Chemiluminescence Immunoassay Daily One 13 x 100 mm serum separator tube (SST). Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and store in an upright position. Following the collection of the baseline sample, ACTH (cosyntropin) is administered as per physician instructions. 30 minute and 60 minute samples (serum separator tubes) are collected after injection. 0.5 ml serum Unacceptable Conditions: CPT Code: in an upright position Order test # 7146: ACTH Stimulation Pre-infusion (Baseline) Order test # 7147: ACTH Stimulation 30 minute postinfusion Order test # 7152: ACTH Stimulation 60 minute postinfusion Be sure to label each tube with the time of collection. Do NOT order all three tests at the same time. Plasma is an unacceptable specimen. Up to 48 hours refrigerated. The expected response is a significant increase over the baseline cortisol normal range (a.m.) of 4-22 mcg/dl * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 5

6 TEST NUMBER: 1284 Actinomyces Culture See: Culture, Anaerobic TEST NUMBER: 6983 Acylcarnitines, Quantitative, Plasma Flow Injection Analysis-Tandem Mass Spectrometry (FIA- MS/MS) 3-5 Days Mayo One sodium heparin green-top tube just prior to a scheduled meal or feeding. Mix well. Centrifuge and transfer 0.1 ml plasma into a plastic transport tube 0.04 ml Frozen Include family history, clinical condition (asymptomatic or acute episode), diet and drug therapy information. EDTA also acceptable Interpretive Report will be provided Frozen 92 days 64 days Ambient 8 days CPT Code: TEST NUMBER: 2096 ADAMTS13 Activity and Inhibitor Profile ADAMTS13 Evaluation Fluorescent Resonance Energy Transfer (FRET) Mixing Studies 3-5 Days Mayo Two Sodium Citrate light blue-top tubes. Mix well. Centrifuge and remove plasma. Centrifuge plasma again and transfer 1.0 ml of citrate platelet-poor plasma into two plastic screw-top transport tubes. MUST be drawn prior to plasma exchange or plasma replacement therapy. 1.0 ml FROZEN ADAMTS13 inhibitor Screen and/or ADAMTS13 Bethesda Titer may be added at an additional charge. Ambient Unacceptable Conditions: ADAMTS13 Activity Assay: >=70% ADAMTS13 Inhibitor Screen: Negative ADAMTS13 Bethesda Titer: <0.4 BU CPT Code: ADAMTS13 Activity Assay: ADAMTS13 Inhibitor Screen Assay (if appropriate): ADAMTS13 Bethesda Titer (if appropriate): TEST NUMBER: 6328 Adalimumab Quantitative with reflex to Antibody ADALX ADALX Synonyms: Humira Enzyme-Linked Immunosorbent Assay (ELISA) 2-3 Days Mayo * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 6

7 One 13 x 100 mm serum separator tube (SST). Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 0.5 ml serum into a plastic transport tube ml Stability Refrigerate 7 days Ambient 72 hours Frozen 21 days Adalimumab Antibody: <14.0 AU/mL CPT Code: 80299, (if appropriate) TEST NUMBER: 6176 Adenosine Deaminase, CSF Quantitative Spectrophotometry 3 4 days ARUP Centrifuge and transfer 0.3 ml fluid into a plastic transport tube. Freeze ASAP. Write source on tube. 0.1 ml Frozen Remarks Must remain Frozen until received in ARUP Laboratory Unacceptable Conditions Whole blood, BAL specimens, Turbid specimens Stability Ambient 2 hours 7 days Frozen 1 month U/L CPT Code: TEST NUMBER: 6615 Adenosine Deaminase, Varied Sources Quantitative Spectrophotometry Same day ARUP Collect one of the following: Pericardial Fluid, Peritoneal Fluid, Pleural Fluid Centrifuge and transfer 0.3 ml fluid into a plastic transport tube. Freeze ASAP. Write source on tube. 0.1 ml Frozen Must remain Frozen until received in ARUP Laboratory Unacceptable Conditions: Whole blood, BAL specimens, Turbid specimens Ambient 2 hours 7 days Frozen 1 month Pericardial Fluid: U/L Peritoneal Fluid: U/L Pleural Fluid: U/L CPT Code: * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 7

8 TEST NUMBER: 6176 Adenosine Deaminase, CSF See: CSF Adenosine Deaminase Adenovirus Culture See: Culture, Viral Select appropriate source TEST NUMBER: 7093 ADH Antidiuretic Hormone See: Arginine Vasopressin TEST NUMBER: 5535 Adrenal Antibodies See: 21 Hydroxylase Antibodies (under H section) TEST NUMBER: 7544 Adrenocorticotropic Hormone, Plasma ACTH, Plasma Electrochemiluminescence Immunoassay 3-4 Days Mayo One EDTA purple-top tube. Tube should be placed on ice prior to drawing. Mix well. Immediately centrifuge & transfer 1.0 ml EDTA plasma into a plastic transport tube. 0.5 ml FROZEN Unacceptable Conditions: CPT Code: TEST NUMBER: 1806 AFB Culture See: Culture, AFB TEST NUMBER: 1806 AFB Smear See: Culture, AFB Morning (6 a.m. 10 a.m.) specimens are desirable Specimens other than EDTA plasma Gross hemolysis, lipemia Specimens not frozen Frozen pg/ml (a.m. draws) No established reference values for p.m. draws. Pediatric reference values are the same as adults, as confirmed by peer review literature TEST NUMBER: 6120 AFP Amino AFP 3 Marker Screen See: Alpha Fetoprotein, 3 marker TEST NUMBER: 6120 AFP 3 Screen See: Alpha Fetoprotein, 3 marker TEST NUMBER: 6109 AFP 4 Marker Screen See: Alpha Fetoprotein, 4 marker TEST NUMBER: 7216 * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 8

9 AFP Single Marker Screen See: Alpha Fetoprotein, Single Marker TEST NUMBER: 6102 AFP Tumor Marker Screen See: Alpha Fetoprotein, Tumor Marker TEST NUMBER: 2344 AIDS Profile See: T & B Cell Quantitation TEST NUMBER: 7054 Alanine Aminotransferase See: ALT TEST NUMBER: 7626 Albumin Dye Binding BCP (Bromcresol Purple) Daily One heparinized plasma separator tube (PST) or serum separator tube (SST). Mix well. Allow SST specimen to clot in an upright position for minutes. Centrifuge and store tube in an upright position. 0.1 ml plasma/serum in an upright position Separate serum or plasma from the cells within 2 hours of collection Unacceptable Conditions Grossly hemolyzed samples 3 days refrigerated gm/dl CPT Code: TEST NUMBER: 6611 Albumin Body Fluid See: Body Fluid (in B section) TEST NUMBER: 7121 Albumin / Creat Ratio, Urine See: Microalbumin, Random TEST NUMBER: 6702 Alcohol (Ethyl), Urine Gas Chromatography/Flame Ionization Detection (GC-FID) 3 Days Medtox 20 mls of a random or spot urine in a plastic transport container 5 mls Unacceptable Conditions: Urine with preservatives Ambient <3 days OK Frozen OK Negative CPT Code: TEST NUMBER: 7705 * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 9

10 Alcohol, Blood ETOH Synonyms Ethanol, Ethyl Alcohol Alcohol Dehydrogenase Daily A non-alcohol skin cleansing pad should be used. One heparinized plasma separator tube (PST) or serum separator tube (SST). Mix well. Allow SST specimen to clot in an upright position for minutes. Centrifuge and store tube in an upright position. 0.1 ml plasma or serum in an upright position Separate serum or plasma from the cells within 2 hours of collection. Specimen tube should be completely filled. Specimen should be stored tightly capped. Analysis of ethanol in blood is for medical purposes only. Unacceptable Conditions Grossly hemolyzed samples 3 days refrigerated < 3 mg/dl CPT Code: TEST NUMBER: 7549 Aldolase Ultraviolet, Kinetic 2-3 Days Mayo One 13 x 100 mm plain (no additive) red-top tube. Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 1.0 ml serum into a plastic transport tube. 0.5 ml Unacceptable Conditions: SST tubes Gross hemolysis Gross lipemia Ambient Frozen 14 days Okay 0-16 yrs <14.5 U/L >17 yrs < 7.7 U/L CPT Code: TEST NUMBER: 7176 Aldosterone, Serum Radioimmunoassay (RIA) 3-4 Days Mayo One 13 x 100 mm plain (no additive) red-top tube at 8:00 a.m. Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 1.2 ml serum into a plastic transport tube. 0.6 ml FROZEN * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 10

11 0-30 days ng/dl 31 days -11 months ng/dl 1 10 yrs < 40 ng/dl supine 1 10 yrs < 124 ng/dl upright > 11 yrs < 21 ng/dl AM peripheral vein * Ranges based on upright AM collection from subjects on ad lib sodium intake. CPT Code: TEST NUMBER: 3015 Aldosterone Urine Liquid Chromatography-Tandem Mass Spectrometry (LC- MS/MS) 4-5 Days Mayo 11 ml from a 24 hr. urine collection. Add 25 ml of 50% Acetic Acid at start of collection. Use 15 ml 50% Acetic Acid for children <5 yrs old. Send specimen in a plastic screw-top tube. 6.0 ml Urine collection container may be obtained. Call 763/ during business hours or 763/ off-hours 0-30 days mcg/24 hr 31 Days 11 Months mcg/24 hr > or = 1 year mcg/24 hr CPT Code: Aldosterone/Renin Studies Contact Sendout Department for patient preparation guide. Call TEST NUMBER: 7339 Alk P'tase See: Alkaline Phosphatase * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 11

12 TEST NUMBER: 7366 Alkaline Phosphatase Isoenzymes Heat Inactivation / Enzymatic 2-3 Days ARUP One 13 x 100 mm serum separator tube (SST) from an overnight-fasting patient. Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 2.0 ml serum into a plastic transport tube. 1.0 ml Unacceptable Conditions: Severe Hemolysis - 1 week; Ambient - 1 hour Alkaline Phosphatase Serum or Plasma Male Female 0-30 days U/L U/L 1-11 months U/L U/L 1-3 years U/L U/L 4-6 years U/L U/L 7-9 years U/L U/L years U/L U/L years U/L U/L years U/L U/L years U/L U/L 20 years U/L U/L Bone Activity Male Female 1-6 years U/L 1-6 years U/L 7-9 years U/L 7-9 years U/L years U/L years U/L years U/L years 0-91 U/L 20 years U/L 16 years U/L Liver Activity Male Female 1-6 years U/L 1-9 years U/L 7-11 years U/L years U/L years U/L 16 years U/L years U/L 20 years U/L CPT Codes: 84075; * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 12

13 TEST NUMBER: 7339 Alkaline Phosphatase (Alk P tase) Enzymatic / Bichromatic Rate Daily One heparinized plasma separator tube (PST) or serum separator tube (SST). Mix well. Allow SST specimen to clot in an upright position for minutes. Centrifuge and store tube in an upright position. 0.1 ml plasma or serum Unacceptable Conditions: CPT Code: in an upright position Separate serum or plasma from the cells within 2 hours of collection. Assay calibrated to IFCC standard. Grossly hemolyzed samples 5 days refrigerated Adult : U/L Pediatric (0-4 years): U/L Pediatric (5-10 years): U/L Pediatric (11-17 years): U/L TEST NUMBER: Varied Allergy Testing See: 5290 Respiratory Allergy Profile, 5291 Childhood Allergy Profile or 5292 Food Allergy Profile Or refer to the Allergens section of this User s Guide. TEST NUMBER: 6183 Alpha-1-Antitrypsin Proteotype S/Z by LC-MS/MS A-1-A Phenotype Synonym Includes Alpha-1-Antitrypsin and A-1-A Phenotype if appropriate Liquid Chromatography-Tandem Mass Spectrometry (LC- MS/MS) Nephelometry, Isoelectric Focusing 7-10 Days Mayo One 13 x 100 mm Serum Separator tube (SST). Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 1.25 ml serum into a plastic transport tube. 0.5 ml Stability CPT Code: If the mass spectrometry proteotype and quantitative serum level are discordant, then phenotyping will be added and performed at an additional charge. Ambient/Frozen 28 days Okay Alpla-1-Antitrypsin: mg/dl Alpha-1-Antitrypsin Proteotype: Negative for S and Z phenotype (Non S Non Z) 82103, 82542, (82104 if appropriate) * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 13

14 TEST NUMBER: 7358 Alpha-1-Antitrypsin, Quantitative Rate Nephelometry 1 Day Mayo One 13 x 100 mm serum separator tube (SST). Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 1.0 ml serum in a plastic transport tube 0.5 ml Unacceptable Conditions: Specimens other than serum mg/dl CPT Code: TEST NUMBER: 2239 Alpha-Fetoprotein, Amniotic Fluid TEST Abbreviation: AFPA Immunoenzymatic Assay, Polyacrylamide Electrophoresis 3-5 days Mayo 1.0 ml Amniotic fluid in a screw cap tube. Do not centrifuge. Include: Date ultrasound performed Estimated due date by ultrasound Collection date Gestational age must be between 13 and 24 weeks; 16 to 18 weeks preferred 0.5 ml CPT Code: If alpha-fetoprotein (AFP) is positive, then acetylcholinesterase (AChE) will be performed at an additional charge. <=2.0 multiples of median (MoM) 82106, if appropriate TEST NUMBER: 3217 Alpha-1-Antitrypsin, Random Feces A-1-A Stool Nephelometry 2 3 Days Mayo Random stool specimen (at least 5 grams) collected in a screw-top stool collection container. 1.0 ml homogenized stool FROZEN Stability or Room Temperature < 14 days Okay < 54 mg/dl CPT Code: * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 14

15 TEST NUMBER: 6109 Alpha Fetoprotein, Serum - Four-Marker Screen AFP Quad Screen 2-Site Immunoenzymatic & Enzyme-Linked Immunosorbent Assay (ELISA); Sandwich Assay 2 3 Days Mayo One 13 x 100 mm serum separator tube (SST). Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 1.0 ml serum into a plastic transport tube. Minimum: 1.0 ml Unacceptable Conditions CPT Codes: *AFP questionnaire form available. (See: Special Forms section in this guide) or call 763/ during business hours (763/ off-hours) The following information is required for processing: A. Maternal date of birth (not age), weight, race and number of fetuses. (Note: Clinical interpretation is not possible if 3 or more fetuses are present or in twin pregnancies with an insulin-dependent diabetic mother.) B. Is patient an insulin-dependent diabetic? C. Gestational age calculation (Provide 1 of the following) 1. Date of ultrasound and gestation by ultrasound on the date ultrasound was performed. (Note: Do not extrapolate to draw date. Twin pregnancies must have ultrasound information included.) 2. First day of last menstrual period (LMP) 3. Gestation by physical exam 4. Expected delivery date must specify by LMP or ultrasound. D. In vitro fertilization pregnancy provide donor date of birth as this may have a significant impact on calculated screen risk. Gestational age must be between weeks for neural tube interpretation; weeks is optimal. Down Syndrome and Trisomy 18 risk interpretation is provided between weeks Specimens other than serum; Severe hemolysis Interpretive report will be provided. Neural Tube Defects: An AFP multiple of the median (MoM) <2.5 is reported as screen negative. AFP MoM > 2.5 (singleton pregnancies) and >5.33 (twin gestation) are reported as screen positive. Down Syndrome: Calculated screen risks <1/270 are reported as screen negative, risks 1/270 are reported as screen positive. Trisomy 18: Calculated screen risks <1/100 are reported as screen negative, risks 1/100 are reported as screen positive. * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 15

16 TEST NUMBER: 7216 Alpha Fetoprotein, Single Marker Screen AFP Single Marker Screen Two-site Immunoenzymatic (Sandwich) Assay 2 3 Days Mayo One 13 x 100 mm Serum Separator Tube. Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 1.0 ml serum into a plastic transport tube. Minimum: 1.0 ml For AFP Single Screen forms call 763/ during business hours. (763/ off-hours) Gestational age must be between weeks for neural tube interpretation; weeks is optimal. The following information is required for processing: A. Maternal date of birth (not age), weight, race and number of fetuses. (Note: Clinical interpretation is not possible if 3 or more fetuses are present.) B. Is patient an insulin-dependent diabetic? C. Gestational age calculation (provide one of the following): 1. Date of ultrasound & gestation by ultrasound on the date ultrasound was performed. (Note: Do not extrapolate to draw date. Twin pregnancies must have ultrasound info. included.) 2. First day of last menstrual period (LMP) 3. Gestation by physical exam. 4. Expected date of delivery, must specify by LMP or ultrasound. Unacceptable Conditions: Specimens other than serum; Severe hemolysis. (*MOM = Multiple of Median) AFP MOM < 2.5 Screen negative AFP MOM CPT Code: > 2.5 (singleton) Screen positive > 5.33 (twins) Screen positive TEST NUMBER: 6102 Alpha Fetoprotein, Tumor Marker AFP, Tumor Marker Chemiluminescence Immunoassay Daily One 13 x 100 mm Serum Separator Tube (SST). Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 0.5 ml serum into a plastic transport tube. 0.5 ml If testing cannot be performed within 48 hours of collection, transfer serum to an aliquot tube and FREEZE serum. Unacceptable Specimens other than serum Conditions: Moderate hemolysis Up to 48 hours refrigerated ng/ml. CPT Code: * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 16

17 TEST NUMBER: 3130 Alpha-Globin Gene Analysis TEST Abbreviation: ATHAL Dosage Analysis by Polymerase Chain Reaction (PCR)/Multiplex Ligation-Dependent Probe Amplification (MLPA)/Luminex Technology 2 weeks Mayo 3 ml EDTA purple-top whole blood in original tube. Mix well. 1.0 ml EDTA 10.0 ml Amniotic fluid Ambient EDTA blood Amniotic fluid For prenatal specimens only: If amniotic fluid is received, amniotic fluid culture/genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added. *Must arrive at Mayo within 96 hours of collection An interpretive report will be provided. CPT Code: (AF Culture/Genetic Test Reflex-88235,88240) (Maternal Cell Contamination, B ) * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 17

18 TEST NUMBER: 7764 Alprazolam Xanax Liquid Chromatography/Tandem Mass Spectrometry (LC/MS/MS) 6 Days Medtox One 13 x 100 mm no-additive, plain red-top tube. Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 2.0 ml serum into a plastic transport tube. 0.5 ml Remarks Trough levels are most reproducible CPT Code: Ambient < 3 days Okay 5 25 ng/ml Reporting Limit: 2.0 ng/ml CRITICAL VALUE: 60.0 ng/ml * Some patients respond well to high dose alprazolam therapy with resultant serum concentrations of ng/ml. TEST NUMBER: 7262 effective date: Alprazolam Confirmation, Quantitative, Urine Xanax, Niravam Test Abbreviation Medtox #3008 ALPRZU Liquid Chromatography/Tandem Mass Spectrometry (LC/MS/MS) 6 days Medtox 20 ml urine from a random collection in a plastic transport tube. 10 ml Refigerated Unacceptable Conditions: Urine with preservatives Alprazolam, reporting limit: 2.0 ng/ml Alpha-Hydroxyalprazolam Reference ranges have not been established CPT Code: TEST NUMBER: 7054 Alanine Aminotransferase ALT; SGPT Enzymatic/Bichromatic Rate Daily One heparinized plasma separator tube (PST) or serum separator tube (SST). Mix well. Allow SST specimen to clot in an upright position for minutes. Centrifuge and store tube in an upright position. 0.1 ml plasma or serum Unacceptable Conditions: in an upright position Separate serum or plasma from the cells within 2 hours of collection. Assay is calibrated to IFCC standards. Grossly hemolyzed samples * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 18

19 5 days refrigerated U/L CPT Code: TEST NUMBER: Varied Allergy Testing See: Rast Test (under R section) See: List of Allergens (Found in Allergy Testing in this User s Guide) TEST NUMBER: 6100 Aluminum Serum Dynamic Reaction Cell-Inductively Coupled Plasma-Mass Spectrometry (DRC-ICP-MS) 1 week Mayo One Monoject royal-blue no additive metal-free tube. (Supply T 713). Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge. Transfer 1.2 ml serum into a metal-free plastic transport tube. 0.5 ml Unacceptable Conditions: CPT Code: Specimens other than serum 0-6 ng/ml all ages < 60 ng/ml (dialysis patients all ages) Reference values are for serum and do NOT apply to plasma specimens TEST NUMBER: 6800 Ambien Zolpidem Gas Chromatography/Nitrogen Phosphorus Detection (GC- NPD) 3 4 Days MedTox One 13 x 100 mm no-additive plain red-top tube. Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 3.0 ml serum into a plastic transport tube. 0.6 ml Expected hypnotic zolpidem concentrations in patients taking recommended daily dosages - Up to 250 ng/ml. 2.0 ng/ml. CPT Code: TEST NUMBER: 7711 Toxic range has not been established. * Reporting limit * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 19

20 Amikacin Peak See Amikacin Peak or Trough TEST NUMBER: 7711 Amikacin Peak or Trough Immunoassay 2-3 Days MedTox One 13 x 100 mm no-additive, plain red-top tube. Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 1.0 ml serum into a plastic transport tube. Note: Each Trough or Peak must have a separate order, 0.5 ml Ambient < 3 days Okay mcg/ml * Reporting limit 0.8 mcg/ml CPT Code: TEST NUMBER: 7712 Amikacin Trough Test Deleted TEST NUMBER: 7645 Amino Acid, Quantitative Plasma Liquid Chromatography-Tandem Mass Spectrometry (LC- MS/MS) 3-5 Days Mayo One green-top sodium heparin tube (Not PST) from a fasting patient (4 hours or more in infants). Centrifuge ASAP and transfer 0.5 ml plasma into a plastic transport tube. 0.3 ml and be clearly labeled as Trough or Peak CRITICAL FROZEN Include family history, clinical condition (asymptomatic or acute episode), diet, and drug therapy information. Unacceptable Conditions: Severe hemolysis An interpretive report will be provided. CPT Code: TEST NUMBER: 3628 Amino Acid, Quantitative - Urine Liquid Chromatography-Tandem Mass Spectrometry (LC- MS/MS) 3 5 Days Mayo 2.0 ml urine from a random collection. Transport specimen in a 13 ml urine screw-cap plastic transport tube. 1.0 ml CRITICAL FROZEN Include family history, clinical condition (asymptomatic or acute episode), diet, and drug therapy information. An interpretive report will be provided CPT Code: TEST NUMBER: 3326 Aminolevulinic Acid (ALA), Urine Delta aminolevulinic Acid, Urine; ALA * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 20

21 Liquid Chromatography-Tandem Mass Spectrometry (LC- MS/MS) 6-8 Days Mayo 2.0 ml aliquot from a random urine collection in a plastic transport tube. 1.0 ml Patient should abstain from alcohol for 24 hours prior to and during testing. Unacceptable Conditions: Specimens other than Random urine collection Frozen Okay <1 yr: <=10 nmol/ml 1-17 yr: <=20 nmol/ml >=18 yr: <=15 nmol/ml CPT Code: TEST NUMBER: 7715 Aminophylline See: Theophylline TEST NUMBER: 7763 Amiodarone Cordarone High Turbulence Liquid Chromatography-Tandem Mass Spectrometry (HTLC-MS/MS) 2-3 Days Mayo One 13 x 100 mm plain (no-additive) red-top tube no sooner than 12 hours (trough value) after last dose. Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 0.7 ml serum into a plastic transport tube. 0.5 ml FROZEN. Unacceptable Conditions: SST tube. Refrigeration okay; Ambient < 24 hours Okay Amiodarone: mcg/ml TOXIC: > 2.5 mcg/ml Desethylamiodarone: No therapeutic range established. Activity & serum concentration are similar to parent drug. CPT Code: TEST NUMBER: 7702 Amitriptyline & Nortriptyline Elavil & Pamelor High Pressure Liquid Chromatography (HPLC) 2-3 Days Mayo One 13 x 100 mm plain (No additive) red-top tube. Allow specimen to clot in an upright position for minutes. Centrifuge. Transfer 1.0 ml serum into a plastic transport tube. 0.5 ml Remarks Therapeutic ranges are for specimens drawn at trough * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 21

22 Stability 28 days Okay Ambient 7 days Okay Frozen 28 days Okay Unacceptable Conditions: Serum Separator Tubes Amitriptyline and Nortriptyline combined total: ng/ml Nortriptyline Only, therapeutic concentration: ng/ml Amitriptyline: N/A CPT Code: * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 22

23 TEST NUMBER: 7573 Ammonia, Plasma Ammon; NH3 Enzymatic/Colormetric Daily One completely filled heparinized plasma separator tube (PST), centrifuge without delay and stored tightly capped on ice slurry or refrigerated. 3 ml plasma separator tube Immediately on ice slurry or refrigerated in an upright position Separate plasma from the cells immediately following collection. Any amount of hemolysis significantly increases results. Unacceptable Conditions: Hemolyzed samples. Sample exposed to air. Sample not centrifuged immediately. Partially filled tube. Fingerstick samples. Frozen samples. Separate from cells immediately. Once separated stable for 2 hours at C mmol/l CPT Code: TEST NUMBER: Amniotic Fluid Culture/Genetic Testing 2325 TEST Abbreviation: CULAF Cell Culture Days Mayo 5-10 ml Amniotic fluid in a screw cap tube. Do not use the first tube collected for this test. If the culture will be performed in conjunction with chromosome analysis and alphafetoprotein, a total of approximately ml will be needed for the combined studies. 5 ml Transport (preferred) If the specimen does not grow in culture, you will be notified within 7 days of receipt. Provide a reason for referral and gestational age with each specimen. Optimal timing for specimen collection is during weeks of gestation. Unacceptable Conditions Bloody specimens are undesirable No specimen should be rejected. CPT Code: 88235, * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 23

24 TEST NUMBER: 7252-Lamellar Body Count Amniotic Fluid Fetal Lung Maturity FLM; Fetal Lung Maturity Sysmex;Thin Layer Chromatography Densitometry Same day U/MN 6.0 ml amniotic fluid from a TAP collection, in a screw top plastic transport tube. Call (763) NMMC Laboratory or (763) Maple Grove Laboratory prior to sending sample STAT 1.0 ml Transport STAT Unacceptable Conditions CPT Code: L/S Ratio & PG, DSL are no longer available Clotted specimen or vaginal pool. Frozen or centrifuged. Gross hemolysis, meconium or mucus contamination. Lamellar body counts greater than /L, indicate fetal lung maturity and an absence of RDS in more than 95% of all cases. TEST NUMBER: 7717 Amoxapine Ascendin High Performance Liquid Chromatography with Ultraviolet Detection (HPLC-UV) 2-3 Days MedTox One 13 x 100 mm plain (no-additive) red-top tube. Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 2.0 ml serum into a plastic transport tube. 0.3 ml SST tubes are NOT recommended Ambient < 3 days Okay *Reporting limit: 10 ng/ml Amoxapine & Metabolite ng/ml CRITICAL VALUE 600 ng/ml CPT Code: TEST NUMBER: 6601 Amylase Body Fluid See: Body Fluids (B Section) * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 24

25 TEST NUMBER: 7029 Amylase, Blood Amy Enzymatic/Bichromatic Rage Daily One heparinized plasma separator tube (PST) or serum separator tube (SST). Mix well. Allow SST specimen to clot in an upright position for minutes. Centrifuge and store tube in an upright position ml plasma/serum in an upright position. Separate serum or plasma from the cells within 2 hours of collection. Unacceptable Conditions: Grossly hemolyzed samples 5 Days refrigerated U/L CPT Code: TEST NUMBER: 7434 Amylase, Urine Amylase, Urine Transplant Enzymatic/Bichromatic Rate Daily A timed or 24 hour urine collection in a plastic container without preservatives. Sample must be refrigerated during collection. Send entire collection for processing. Indicate the total time of collection on the container. Secure cap on the container to prevent leakage during transport. The label on the collection container must include: Patient identification, Test requested, Preservative used and Date and time of start and finish of the collection period. in an upright position Useful for assessment of acute rejection of bladderdrained pancreas transplant. Can be used as an aid in the diagnosis of acute pancreatitis. Unacceptable Conditions: Acidified urine not recommended. 5 days refrigerated Timed urine Amylase: 3-17 U/hour 24 hour urine Amylase: U/24 hours CPT Code: * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 25

26 TEST NUMBER: 7052 ANA Cascade Anti-nuclear Antibody Profile Test Abbreviation: ANACAS Multiplex Flow Immunoassay M-F One 13 x 100 mm serum separator tube (SST). Mix well. Allow tube to clot in an upright position for minutes. Centrifuge and store tube in an upright position. 0.5 ml serum A positive ANA reflexes to a series of antibodies at an additional cost The cascade includes quantitative detection of antibody to dsdna, and the semi-quantitative detection of antibodies to Chromatin, Ribosomal P, SS-A, SS-B, Sm, SmRNP, Scl-70, Jo-1, and Centromere B. Useful as an aid in the diagnosis of systemic autoimmune diseases such as Systemic Lupus Erythematosus (SLE), Mixed Connective Tissue Disease (MCTD), Undifferentiated Connective Tissue Disease (UCTD), Sjögren's Syndrome (SS), Scleroderma (Systemic Sclerosis), Dermatomyositis, Polymyositis, Rheumatoid Arthritis (RA), CREST Syndrome, and Raynaud's Phenomenon. EDTA or heparinized plasma are acceptable Unacceptable Conditions: refrigerate 2-8 C for up to 7 days Results for ANA and associated antibodies are reported in antibody index (AI) and as negative or positive Results for dsdna are reported as IU/mL and as negative, indeterminate, or positive dsdna Result ANA and associated antibodies 4 IU/mL negative <1.0 AI negative 5-9 IU/mL indeterminate 1.0 AI positive 10 IU/mL positive CPT Code: (Add additional CPT codes if ANA is Positive: 86235; 86225; X 2; X 8) TEST NUMBER: 5116 ANA Screen Anti-nuclear Antibody Test Abbreviation ANA Multiplex Flow Immunoassay M-F One 13 x 100 mm serum separator tube (SST). Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and store tube in an upright position. Pediatrics: 0.5 ml EDTA or heparinized plasma are acceptable Refrigerate 2-8 C for up to 7 days < 1.0 AI (Antibody Index) Negative CPT Code: * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 26

27 TEST NUMBER: 1284 Anaerobic Culture See: Culture, Anaerobic TEST NUMBER: 1207 Anaerobic Susceptibility See: Susceptibility, Anaerobic TEST NUMBER: 7789 Anafranil See: Clomipramine & Metabolite * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 27

28 TEST NUMBER: 2252 ANCA Vasculitis Panel (Includes MPO / PR3) Cytoplasmic Neutrophil Antibody, Vasculitis Panel Test Abbreviation: VASC Synonym: MPO; PR3 Multiplex Flow Immunoassay Monday - Friday One 13 x 100 mm serum separator tube (SST). Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and store tube in an upright position. 0.5 ml serum Unacceptable Conditions: Contaminated, icteric, lipemic, or hemolyzed serum may cause erroneous results and should be avoided. Serum is the recommended sample type. Patients undergoing steroid or immunosuppressant therapy may have negative test results Stable for 7 days at 2-8 C. For longer storage of samples, freeze at -20 C or colder. Results are expressed as an antibody index (AI Antibody Index Result < 0.4 AI Negative 0.4 AI Positive with Reflex to ANCA CPT Code(s): X 2 * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 28

29 TEST NUMBER: 7370 Androstenedione Liquid Chromatography/Tandem Mass Spectrometry (LC- MS/MS) 1 Day Mayo One 13 x 100 mm plain (No additive) red-top tube. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 0.6 ml serum into a plastic transport tube ml Frozen Okay Unacceptable Conditions: SST tubes are NOT acceptable. Premature Infants weeks, day 4: ng/dl Premature Infants weeks, day 4: ng/dl Full-term Infants 1-7 Days: ng/dl 1 Month - 1 Year: <69 ng/dl * Androstenedione gradually decreases during the first 6 months to prepubertal levels. Adults >= 19 Years Males: ng/dl Females: ng/dl * Reference ranges for children are dependent upon age, sex and Tanner stage. Contact the laboratory for specific ranges. CPT Code(s): TEST NUMBER: 7359 Angiotensin Converting Enzyme ACE Spectrophotometry 2-3 Days Mayo One 13 x 100 mm serum separator tube (SST). Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 1.0 ml serum into a plastic transport tube. 0.5 ml Unacceptable Conditions: Specimens other than serum; Hemolysis CPT Code: Frozen OK >=18 years: 8 53 U/L The reference interval for pediatric patients may be up to 50% higher than that of adults. TEST NUMBER: 9154 Antibody Identification Hemagglutination 1-2 days/stat Memorial Blood Center used for complex workups * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 29

30 One or two 6 ml pink-top EDTA tube. Mix well and send whole blood. Label tube with patient s: 1) name 2) medical record or Fenwal ID 3) date/time drawn 4) initials of the person drawing the blood. 2 8 O C Test is automatically done when the antibody screen is positive at an additional charge. Unacceptable Conditions: Gross hemolysis EDTA specimens stored at 2 8 O C are stable for up to 3 days. CPT Code: TEST NUMBER: 9842 Antibody Screen Indirect Coombs Hemagglutination 1 day/stat One or two 6 ml pink-top EDTA tube. Mix well and send whole blood. Label tube with patient s: 1) name 2) medical record or Fenwal ID 3) date/time drawn 4) initials of the person drawing the blood. One EDTA microtainer tube 0.5 ml 2 8 O C if cannot be tested within 2 hours Unacceptable Conditions: Gross hemolysis EDTA specimens stored at 2 8 O C are stable for up to 3 days. CPT Code: TEST NUMBER: 9418 Antibody Titer 3-5 days Memorial Blood Center One 6 ml pink-top EDTA tube. Mix well and send whole blood. Label tube with patient s: 1) name 2) medical record or Fenwal ID 3) date/time drawn 4) initials of the person drawing the blood. 2 8 O C if cannot be tested within 2 hours This test is performed on pregnant women when a clinically significant antibody is identified; at an additional charge. Unacceptable Conditions: Gross hemolysis EDTA specimens stored at 2 8 O C are stable for up to 3 days CPT Code: * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 30

31 TEST NUMBER: 9016 Antibody Titer Panel Test Abbreviation: ATP Hemagglutination Synonym(s): Antibody Titer 3-5 days Memorial Blood Center (titers) 2 pink EDTA tubes, mixed well, send whole blood Refrigerate 2-8 C For pregnant females with known red cell antibody(ies) Unacceptable Conditions: Hemolyzed, QNS 3 days CPT Code: / / TEST NUMBER: 5497 Anti-Cardiolipin Antibodies See: Phospholipid Antibodies IgG/IgM TEST NUMBER: 5361 Anti-DNase B or DNASE B Antibody See: Streptococcal Antibodies TEST NUMBER: 7093 Anti-diuretic Hormone (ADH) See: Arginine Vasopressin TEST NUMBER: 9040 Antigen Type Hemagglutination 1 day/stat One 6 ml pink-top EDTA tube. Mix well and send whole blood. Label tube with patient s: 1) name 2) medical record or Fenwal ID 3) date/time drawn 4) initials of the person drawing the blood. 2 8 O C This test is automatically done with antibody identification when an antibody screen is positive or when patient needs antigen negative blood for transfusion. There is an additional charge. Unacceptable Conditions: Gross hemolysis EDTA specimens stored at 2 8 O C may be tested up to 14 days. CPT Code: TEST NUMBER: 5502 Anti-Mitochondrial See: Mitochondrial M2 Antibody TEST NUMBER: 7022 Antimüllerian Hormone (AMH), Serum Immunometric Assay 3-5 Days Mayo * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 31

32 One 13 x 100 mm serum separator tube (SST). Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 0.5 ml serum into a plastic transport tube 0.3 ml Unacceptable Conditions: Gross Hemolysis, Lipemia, Icterus Stability Frozen: 90 days Males <24 months: ng/ml 24 months 12 years: ng/ml >12 years: ng/ml Females <24 months: <4.7 ng/ml 24 months 12 years: <8.8 ng/ml years: ng/ml >45 years: <1.0 ng/ml CPT Code: TEST NUMBER: 5504 Anti-Smooth Muscle Antibodies Indirect Immunofluorescence 2-3 Days Mayo One 13 x 100 mm serum separator tube (SST). Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 0.5 ml serum into a plastic transport tube. 0.2 ml Unacceptable Conditions: Specimens other than serum; Severe Hemolysis Lipemia Negative If positive, results are titered. CPT Code: 86255; (titer, if appropriate) TEST NUMBER: 5050 Antistreptolysin O (ASO) Screen See: ASO Screen TEST NUMBER: 5485 Antistreptolysin O (ASO) Titer See: ASO Titer TEST NUMBER: 2484 Antithrombin Activity AT; ATIII; Antithrombin III Chromogenic Assay 7-10 Days One Sodium Citrate light-blue top tube. Mix well. Centrifuge and remove plasma. Centrifuge plasma again and transfer 2.0 ml of citrate platelet-poor plasma into 1 plastic styrene tube and 1 plastic screw-top transport tube, each containing 1.0 ml plasma. FROZEN * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 32

33 1. Double spun specimens are CRITICAL for accurate results, as platelet contamination may cause spurious results. 2. If the patient is being treated with Heparin, please alert laboratory, as Heparin may lower plasma antithrombin. Unacceptable Conditions: Specimens other than Sodium-Citrate plasma Lipemia Severe Hemolysis Specimens not FROZEN Double-centrifuged, separated and frozen at - 20 O C for 2 weeks Or at 70 O C for up to 6 months % CPT Codes: TEST NUMBER: 7181 Anti-Thyroid Antibody See: Thyroid Antibody TEST NUMBER: 7599 Apolipoprotein A1 and B, Plasma Automated Turbidimetric Immunoassay 3 4 Days Mayo Specimen Requirements: One EDTA purple-top tube from fasting (12-14 hours) patient. Mix well. Centrifuge and transfer 1.0 ml plasma into a plastic transport tube. 0.5 ml Patient must NOT consume any alcohol for 24 hours prior to sample collection. Unacceptable Severe hemolysis Conditions: Frozen OK Males:Age Apolipoprotein A (mg/dl) Apolipoprotein B (mg/dl) Apolipoprotein B/A1 ratio <24 months Not established Not established Not established 2-17 years Low: <115 Acceptable: <90 <0.8 Borderline low: Borderline high: Acceptable: >120 High: >=110 >18 years >=120 Desirable: <90 Lower Risk: <0.7 Above Desirable: Average Risk: Borderline high: Higher Risk: >0.9 High: Very High: >=140 Females:Age Apolipoprotein A (mg/dl) Apolipoprotein B (mg/dl) Apolipoprotein B/A1 ratio <24 months Not established Not established Not established 2-17 years Low: <115 Acceptable: <90 <0.8 Borderline low: Borderline high: Acceptable: >120 High: >=110 >18 years >=140 Desirable: <90 Lower Risk: <0.6 Above Desirable: Average Risk: Borderline high: Higher Risk: >0.8 High: Very high: >=140 * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 33

34 CPT Codes: x 2 TEST NUMBER: 2231 APT Test See: Fetal Hemoglobin TEST NUMBER: 5421 Arbovirus IgG /IgM Immunofluorescence Assay (IFA) 3-4 Days Mayo One 13 x 100 mm serum separator tube (SST). Mix well. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 0.5 ml serum in a plastic transport tube ml Includes California (LaCrosse), Eastern & Western Equine and St. Louis Encephalitis. Unacceptable Conditions: Specimens other than serum; Hemolysis or Lipemia Ambient specimen. IgG < 1:10; IgM < 1:10 CPT Codes: x 2; x 2; x 2; x 2 * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 34

35 TEST NUMBER: 2219 Argatroban Level Chromogenic Anti Ila 1 Day Abbott One Sodium Citrate light-blue top tube. Mix well. Centrifuge and remove plasma. Centrifuge plasma again. Transfer 2.0 ml of citrate platelet-poor plasma into a plastic screw-top transport tube. Unacceptable Conditions: CPT Codes: FROZEN Do Not over fill or underfill tube. Greiner Tubes are NOT acceptable Therapeutic: mcg/ml Prophylactic: mcg/ml TEST NUMBER: 7093 Arginine Vasopressin Anti-Diuretic Hormone - ADH Radioimmunoassay 3 Days Mayo 1. Patient should fast and thirst for 6 hours. (No liquids, including water, are allowed.) 2. Draw purple-top EDTA tube. Mix well. Centrifuge specimen in a refrigerated centrifuge. Transfer 2.0 ml plasma into plastic transport tube. Be careful NOT to disturb platelet/buffy coat ml FROZEN Unacceptable Conditions: Specimens other than plasma CPT Code: < 24 hours Okay Adults: <4.3 pg/ml Reference values were determined on platelet-poor EDTA plasma from individuals fasting no longer than overnight TEST NUMBER: 5973 Aripiprazole Abilify LC/MS/MS 2-3 Days MedTox One 13 x 100 mm plain (No additive) red-top tube. Allow specimen to clot in an upright position for minutes. Centrifuge and transfer 2.0 ml serum into a plastic transport tube. 0.6 ml Trough levels are most reproducible. Heparinized plasma also acceptable. Expected steady state plasma levels in patients receiving recommended daily dosages: ng/ml CPT Code: * Refrigerate specimen, unless otherwise noted (frozen or room-temp.) ** Analytic Time upon receipt at reference laboratory. Page 35