Anti-FceR (CU Index) Antibody

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1 Anti-FceR (CU Index) Antibody Order Name: ANTI-FCER Test Number: REV DATE:5/31/2007 Anti-FceR (CU Index) Antibody CU Index Preferred 2 ml (1mL) Serum Clot Activator SST (Red/Gray or Tiger Top) Room Temperature Special Patients taking calcineurin inhibitors should stop their medication for 72hrs prior to collection. Instructions: Testing Schedule: Mon-Fri Expected TAT: 2-3 Days Clinical Use: To aid in the evaluation of Chronic Urticaria (CU). Patients with a chronic form of urticaria who are positive (>10) with the CU Index (Functional Anti-FceR test) have an autoimmune basis for their disease. A positive result does not indicate which autoantibody (anti-ige, anti-fceri or anti-fcerii) is present. Cpt Code(s): 86343; 83088; 86021

2 CA 125 Assay Order Name: CA125 Test Number: REV DATE:5/8/2007 CA 125 Assay CIA Preferred 1 ml (0.5) Serum Clot Activator SST (Red/Gray or Tiger Top) See Instructions Special Specimen stability: Ambient 8 hours. Refrigerated 24 hours. Freeze if > 24 hours. If testing is delayed >24 Instructions: hours, freeze serum. Testing Schedule: Mon - Fri Expected TAT: 1-3 days Clinical Use: Useful in the follow-up management of patients undergoing cancer therapy, especially for ovarian carcinoma. Cpt Code(s): 86304

3 CMV Antigenemia Order Name: CMV EARLY Test Number: REV DATE:5/1/2007 CMV antigenemia IFA Preferred 4.5 ml Whole Blood EDTA (Lavender Top) Room Temperature Special Clean venipuncture site thoroughly. Collect seperate full EDTA tube and do not share specimen with other Instructions: testing. Send to RML Main Lab Mirobiology department ASAP, Testing must begin within 18 hours of collection. Testing Schedule: Mon, Wed, Fri Expected TAT: 3 Days Clinical Use: This test detects reactivations of previous infections in immunocompromised patients. The CMV antigen is present in the neutorphils if rectivation antigenemia is present. Notes: Not designed for assessing new infections. If new infections are suspected suggest viral culture(s) or CMV G/M AB. Cpt Code(s): 87271

4 Collagen Type I C-Telopeptide(CTx) Order Name: C TELOPEP Test Number: REV DATE:5/31/2007 Collagen Type I C-Telopeptide(CTx) CIA Preferred 1 ml (0.5) Serum Clot Activator (Red Top, No-Gel) Frozen Special Fasting is required! Non-Fasting specimens are unacceptable. Fasting morning collection 8-10 am. (Diurnal Instructions: variations cause elevated levels at night). Allow blood to clot (10-15 minutes) at room temperature. Centrifuge and separate the serum from the cells and place into plastic aliquot tube. Label aliquot tube as Serum and Freeze as soon as possible. Testing Schedule: Tue, Thr, Sat. Expected TAT: 2-4 Days Clinical Use: CTx is useful to asses bone resorption in patients with metabolic bone disease. The test is also useful in monitoring therapy to slow or halt osteoporotic bone loss. Notes: Specimen Stability: Room temperature= 16hr; Refrigerated= 3day; Frozen= 3mo. Cpt Code(s): 82397

5 Cryptosporidium Prep Exam Order Name: C CRYPTOSP Test Number: REV DATE:5/31/2007 Cryptosporidium Prep Exam DFA Preferred Fecal/Stool Parapak Refrigerated Special Place stool in formalin container found with ova and parasite kits. This is usually performed ordered in Instructions: conjunction with an ova and parasite exam. Testing Schedule: Daily Expected TAT: 2 Days Clinical Use: Detects Cryptosporidium sp. infections Cpt Code(s): 87272

6 Factor 10a (Xa) Inhibition, Low Molecular Weight Heparin (LMWH) Test Number: Order Name: LMWHEPARIN REV DATE:5/8/2007 Factor 10a (Xa) Inhibition, Low Molecular Weight Heparin (LMWH) Chrom Preferred 2.7 ml Whole Blood Sodium Citrate 3.2% (Blue Top) Ambient whole blood or frozen aliquots Alternate 2.7 ml Double Spun Sterile, Capped Plastic Tube Ambient whole blood Plasma or frozen aliquots Special Please indicate anticoagulant therapy. Should collect at 4 hours post subcutaneous injection. Tube must be Instructions: filled to the proper level, no hemolysis. Improperly filled tubes can give erroneous results. Whole blood must be transported to lab within 1 hour of collection. If sending citrated plasma aliquots, they must be double spun then aliquot 1. 5 ml plasma from each tube into individual plastic aliquot tubes and freeze. Do not pool aliquots together! Testing Schedule: Mon - Fri Expected TAT: 1 Day Clinical Use: The assesment of the anti-xa effect of heparin by this method gives a high sensitivity in detecting Low Molecular Weight Heparin levels. Cpt Code(s): 85520

7 Factor 10a (Xa) Inhibition, Unfractionated Heparin. Order Name: UNFRAC HEP Test Number: REV DATE:5/8/2007 Factor 10a (Xa) Inhibition, Unfractionated Heparin. Chrom Preferred 2.7 ml Whole Blood Sodium Citrate 3.2% (Blue Top) Ambient whole blood or frozen aliquots Alternate 2.7 ml Double Spun Sterile, Capped Plastic Tube Ambient whole blood Plasma or frozen aliquots Special Please indicate anticoagulant therapy. Tubes must be filled to the proper level, no hemolysis. Improperly Instructions: filled tubes can give erroneous results. Whole blood must be transported to lab within 2 hours of collection. If sending citrated plasma aliquots, they must be double spun then aliquot 1. 5 ml plasma from each tube into individual plastic aliquot tubes and freeze. Do not pool aliquots together! Testing Schedule: Mon - Fri Expected TAT: 1 Day Clinical Use: The assesment of the anti-xa effect of heparin by this method gives a high sensitivity in detecting Unfractionated Heparin levels. Cpt Code(s): 85520

8 Giardia lamblia, DFA fecal Order Name: GIARD FEC Test Number: REV DATE:5/31/2007 Giardia lamblia, DFA fecal DFA Preferred Fecal/Stool Parapak Room Temperature Special Stool specimen needs to be in formalin. Place stool in PARA-PAK formalin container found with ova and parasite Instructions: kits. Testing Schedule: Daily Expected TAT: 2 Days Clinical Use: Detects Giardia lamblia in stool Cpt Code(s): 87328

9 Glucose Tolerance (1 Hour Only) Glucola Order Name: GLUC 1 HR Test Number: REV DATE:5/4/2007 Glucose Tolerance (1 Hour Only) Glucola Preferred 1 ml (0.5) Plasma Sodium fluoride (gray top) Refrigerated Alternate 1 ml (0.5) Plasma Lithium Heparin PST (Light Green Top) Refrigerated 1 ml (0.5) Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Special Fasting is not necessary. Preferably performed at 28 weeks gestation. Give 50 gms of glucola. For non pregnant Instructions: give 75 gms of glucola. Draw 1 hour after glucola load. Lithium heparin and clot tube must be spun within 2 hours for the integrity of the specimen. Specimen stability: Ambient 8 hours. Refrigerated 7 days. Testing Schedule: Daily Expected TAT: 1-2 days Clinical Use: This is the screening test for gestational diabetes. It should only be performed on pregnant females. The reference ranges and interpretive data contain the established reference ranges, interpretive data, and criteria for confirming diagnosis of gestational diabetes. The glucola dosing is 50g. Cpt Code(s): 82950

10 Glucose Tolerance (2 Hour Only) Glucola Order Name: GLUC 2 HR Test Number: REV DATE:5/4/2007 Glucose Tolerance (2 Hour Only) Glucola Preferred 1 ml (0.5) Plasma Sodium Floride (Gray) Refrigerated Alternate 1 ml (0.5) Plasma Lithium Heparin PST (Light Green Top) Refrigerated 1 ml (0.5) Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Special According to the American Diabetes Association, Collect specimen 2 hours after the patient ingests 75g of Instructions: Glucola. Lithium heparin and clot tube must be spun within 2 hours for the integrity of the specimen. If doctor instructs the patient to ingest a Normal Meal, then order GLUC 2HRPC Glucose Tolerance (2 Hour Only) Post Prandial. Specimen stability: Ambient 8 hours. Refrigerated 7 days. Testing Schedule: Mon - Fri Expected TAT: 1-2 days Clinical Use: Criteria for Diagnosis of Diabetes from the American Diabetes Association recommends Random plasma glucose >200 mg/dl with symptoms (polyuria, polydypsia, and unexplained weight loss) repeated to confirm on subsequent day, or Fasting plasma glucose >126 mg/dl repeated to confirm, or 2-hr plasma glucose >200 mg/dl post 75g glucose challenge repeated to confirm. Notes: Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders including diabetes mellitus, neonatal hypoglycemia and idiopathic hypoglycemia and pancreatic islet cell carcinoma. Cpt Code(s): 82950

11 Glucose Tolerance (2 Hour Only) Post Prandial Order Name: GLUC 2HRPC Test Number: REV DATE:5/4/2007 Glucose Tolerance (2 Hour Only) Post Prandial Preferred 1 ml (0.5) Plasma Sodium Floride (Gray) Refrigerated Alternate 1 ml (0.5) Plasma Lithium Heparin PST (Light Green Top) Refrigerated 1 ml (0.5) Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Special This test should only be used if the patient has been instructed by their physician to have glucose testing 2 Instructions: hours after patient has ingested a normal meal. If doctor instructs the patient to ingest Glucola, then order GLUC 2 HR Glucose 2 Hour Only. Lithium heparin and clot tube must be spun within 2 hours for the integrity of the specimen. Specimen stability: Ambient 8 hours. Refrigerated 7 days. Testing Schedule: Daily Expected TAT: 1-2 days Clinical Use: Criteria for Diagnosis of Diabetes from the American Diabetes Association recommends Random plasma glucose >200 mg/dl with symptoms (polyuria, polydypsia, and unexplained weight loss) repeated to confirm on subsequent day, or Fasting plasma glucose >126 mg/dl repeated to confirm, or 2-hr plasma glucose >200 mg/dl post 75g glucose challenge repeated to confirm. Notes: Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders including diabetes mellitus, neonatal hypoglycemia and idiopathic hypoglycemia and pancreatic islet cell carcinoma. Cpt Code(s): 82947

12 Glucose Tolerance (3 Hour) Gestational Diabetes Order Name: GTT PREG Panel Test Number: REV DATE:5/4/2007 Gestational Fasting Glucose Gestational 1hr Glucose Gestational 2hr Glucose Gestational 3hr Glucose Preferred 2 ml (0.5) Plasma Sodium fluoride (gray top) Refrigerated Alternate 2 ml (0.5) Plasma Lithium Heparin PST (Light Green Top) Refrigerated 2 ml (0.5) Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Special Must schedule collection Monday thru Friday from 8am to 12pm. Overnight fasting required. Nothing by mouth Instructions: except water during testing. Collect a full Sodium fluoride (gray top) tube to for each time interval. 2mL (0. 5) of Plasma is required for each glucose interval. Collect and label a baseline gray top tube for the Fasting Glucose. Then give the patient 100 mg Glucola. Collect and label a gray top for 1 hour, 2 hours and 3 hour interals after the ingestion of the Glucola. Performed only on pregnant women. If not pregnant, order GLUC 2 HR. Specimen stability: Ambient 8 hours. Refrigerated 7 days. Testing Schedule: Mon - Fri Expected TAT: 1-2 days Clinical Use: Used in diagnosing gestational diabetes, and to predict perinatal morbidity, risk of fetal abnormality and perinatal mortality. Notes: For more information on this test, access our "Specialized Tests" section. Cpt Code(s): 82951; 82952x2

13 Glucose Tolerance (3 Hour) w/o Urine Order Name: GTT 3 HR Test Number: REV DATE:5/4/2007 Glucose Fasting Glucose 0.5 Hour Tolerance Glucose 1 Hour Tolerance Glucose 2 Hour Tolerance Glucose 3 Hour Tolerance Preferred 1 ml (0.5) Plasma Sodium fluoride (gray top) Refrigerated Alternate 1 ml (0.5) Plasma Lithium Heparin PST (Light Green Top) Refrigerated 1 ml (0.5) Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Special Fasting overnight and during test. Patient may have water. Draw fasting specimen. Adults: Give 75 gm of Instructions: glucola. Children: Adjusted amount of glucola to be calculated by lab. Call (918) Specimen stability: Ambient 8 hours. Refrigerated 7 days. Testing Schedule: Mon - Fri Expected TAT: 1-2 days Clinical Use: There are no established guidelines, reference ranges or criteria, for the evaluation of a three hour specimen following a three hour glucose challenge. Notes: This test should no longer be used to diagnose diabetes. The current ADA criteria for diagnosis of diabetes will be listed in the interpretive data on this test. Cpt Code(s): 82951; 82952x2

14 Hepatitis B Virus DNA UltraQuant Order Name: HEP B PCR Test Number: REV DATE:5/17/2007 Hepatitis B Virus DNA UltraQuant PCR Preferred 2 ml (1) Plasma EDTA (Lavender Top) Frozen Alternate 2 ml (1) Serum Clot Activator SST (Red/Gray or Tiger Top) Frozen Special Centrifuge specimen and separate plasma from cells, then transfer plasma to capped sterile, plastic, aliquot Instructions: tubes. Freeze plasma within 2 hours of collection! Testing Schedule: Tues - Sat Expected TAT: 3-6 Days Clinical Use: Quantitates Hepatitis B Virus DNA down to pg/ml for establishment of a baseline and to monitor viral load. The most important test for determining the efficacy of antiviral treatment is quantitative HBV DNA monitoring. HBV DNA testing is useful in detecting potential disease transmission from prospective donors and for post-transplantation monitoring. Although HBeAg is considered an indirect monitor of viral replication, high viral replication may occur without circulating HBeAg, due to mutations of the virus preventing the production of HBeAg. Cpt Code(s): 87517

15 Hepatitis C Antibody, Confirmatory Test, RIBA Order Name: HCV IMMUNO Test Number: REV DATE:5/31/2007 Hepatitis C Antibody, Confirmatory Test, RIBA RIBA/SIA Preferred 1 ml (0.1) Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Alternate 1 ml (0.1) Plasma EDTA (Lavender Top) Refrigerated Special STABILITY: Room temperature= 1 Week; Refrigerated= 2 Weeks; Frozen= 1 Month. Instructions: Testing Schedule: Tues - Sat Expected TAT: 2-3 Days Cpt Code(s): 86804X5

16 Lyme Antibody (Polyvalent) Order Name: LYME EIA Test Number: REV DATE:5/11/2007 Lyme Antibody (Polyvalent) EIA Preferred 1 ml Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Testing Schedule: Seasonal and Volume Dependant Expected TAT: 5-7 Days Clinical Use: All positives or borderline results are confirmed with western blot. Serology may not be positive until 2-4 weeks after onset of erythema migrans. Cpt Code(s): 86618

17 Myasthenia Gravis Panel 1 Order Name: MYAS GRAV1 Test Number: REV DATE:5/21/2007 Acetylcholine Receptor Binding Antibody Striated Muscle Antibody RIA IFA Preferred 2 (0.4) ml Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Testing Schedule: Mon - Sat Expected TAT: 4-5 Days Clinical Use: Myasthenia Gravis is a neurological disorder characterized by a decrease in acetylcholine receptors. Patients exhibit skeletal muscle weakness and fatigability. Cpt Code(s): 86255; 83519

18 Protein Electrophoresis Analyzer, Serum Order Name: PEP AN Test Number: REV DATE:5/31/2007 Protein Electrophoresis Analyzer, Serum EP Preferred 3 ml (1) Serum Clot Activator SST (Red/Gray or Tiger Top) Room Temperature Testing Schedule: Mon - Sat Expected TAT: 1-3 Days Clinical Use: Initial testing: Protein Electrophoresis; Total Protein; Serum Free Light Chains (Kappa/Lambda); Pathologist Interpretation Notes: For more information on this Analyzer, access our "Specialized Tests" section of this guide for a complete listing of tests and CPT codes. Cpt Code(s): See the Test Notes Section of this test.

19 Protein Electrophoresis Analyzer, Urine Order Name: PEPU AN Test Number: REV DATE:5/31/2007 Protein Electrophoresis Analyzer, Urine EP Preferred 10mL Urine, Random Sterile Urine container Refrigerated Alternate 10mL Urine, 24-hour 24 hour Urine Container Refrigerated Special Urine random or 24 hour collection no preservatives 24 hour urine - no preservatives. Instructions: Testing Schedule: Mon - Sat Expected TAT: 1-3 Days Clinical Use: Initial testing: Protein Electrophoresis; Total Protein; Pathologist Interpretation. Notes: For more information on this Analyzer, access our "Specialized Tests" section of this guide for a complete listing of tests and CPT codes. Cpt Code(s): See the Test Notes Section of this test.

20 RPR (Rapid Plasma Reagin) Order Name: RPR Test Number: REV DATE:5/4/2007 RPR (Rapid Plasma Reagin) CF Preferred 1 ml Serum Clot Activator SST (Red/Gray or Tiger Top) Special Must be submitted in original container Instructions: Testing Schedule: Mon - Fri Expected TAT: 3 Days Clinical Use: A non-treponemal test which screens for syphilis. A positive is always confirmed by a treponemal tests (e. g. FTA). Cpt Code(s): 86592

21 Tickborne Disease Panel Order Name: TICK PANEL Test Number: REV DATE:5/11/2007 Ehrlichia chaffeensis Antibody, IgM, IgG Rocky Mountain Spotted Fever (RMSF) Tularemia Antibody IFA IFA LA Preferred 3 ml Serum Clot Activator SST (Red/Gray or Tiger Top) See Instructions Special Allow minutes for specimen to clot. Keep serum refrigerated until processed. However due to the Instructions: shortened stability for the Tularemia Antibody, it is preferred if a 1mL aliquot of serum is placed into a plastic pour off tube and frozen for this test. Please see Tularemia Antibody test for details. Tularemia Specimen Stability: Room temperature= Unacceptable; Refrigerated= 48 Hours; Frozen= 7 Days. Testing Schedule: Assay Dependant Expected TAT: 3-5 Days Clinical Use: E. chaffeensis - A tick-borne disease common to the OK/ARK/MO/KS area. Peak titers will occur at 6 weeks after onset. Only 22% will be positive after 1 week, 68% after 2 weeks and 100% after 4 weeks. Rocky Mountain Spotted Fever - To assist in the diagnosis of RMSF. Patients may not seroconvert until 10 days after onset of illness. Tularemia Antibody - Diagnosis of exposure to Francisella tularensis. Cpt Code(s): See Individual components

22 Tickborne Disease Panel (with Lyme Antibody) Order Name: TICK/LYME Test Number: REV DATE:5/11/2007 Ehrlichia chaffeensis Antibody, IgM, IgG Rocky Mountain Spotted Fever (RMSF) Tularemia Antibody Lyme Antibody (Polyvalent) IFA IFA LA EIA Preferred 4 ml Serum Clot Activator SST (Red/Gray or Tiger Top) See Instructions Special Allow minutes for specimen to clot. Keep serum refrigerated until processed. However due to the Instructions: shortened stability for the Tularemia Antibody, it is preferred if a 1mL aliquot of serum is placed into a plastic pour off tube and frozen for this test. Please see Tularemia Antibody test for details. Tularemia Specimen Stability: Room temperature= Unacceptable; Refrigerated= 48 Hours; Frozen= 7 Days. Testing Schedule: Assay Dependant Expected TAT: 3-5 Days Clinical Use: E. chaffeensis - A tick-borne disease common to the OK/ARK/MO/KS area. Peak titers will occur at 6 weeks after onset. Only 22% will be positive after 1 week, 68% after 2 weeks and 100% after 4 weeks. Rocky Mountain Spotted Fever - To assist in the diagnosis of RMSF. Patients may not seroconvert until 10 days after onset of illness. Tularemia Antibody - Diagnosis of exposure to Francisella tularensis. Lyme Antibody - All positives or borderline results are confirmed with western blot. Serology may not be positive until 2-4 weeks after onset of erythema migrans. Cpt Code(s): See Individual Components

23 Tularemia Antibody Order Name: TULAREM AB Test Number: REV DATE:5/11/2007 Tularemia Antibody LA Preferred 1 ml (0.5) Serum Clot Activator SST (Red/Gray or Tiger Top) Frozen Special Allow minutes for specimen to clot. Centrifuge and aliquot 1mL serum into plastic pour off tube and Instructions: freeze. Specimen Stability: Room temperature= Unacceptable; Refrigerated= 48 Hours; Frozen= 7 Days. Testing Schedule: Mon - Fri Expected TAT: 3 Days Clinical Use: Diagnosis of exposure to Francisella tularensis. Cpt Code(s): 86668

Acetylcholine Receptor Binding Antibody

Acetylcholine Receptor Binding Antibody Order Name: ACETY BND Test Number: 5500010 REV DATE:9/17/2008 Acetylcholine Receptor Binding Antibody RIA Preferred 1 ml (0.5) Serum Clot Activator (Red Top, No-Gel)