Specimen Type Specimen Container Transport Environment Preferred 2mL(0.5) Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated

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1 Aldolase Order Name: ALDOLASE Test Number: Aldolase Enz Preferred 2mL(0.5) Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Special Hemolyzed specimens are not acceptable. Allow specimen to clot completely at room temperature. Serum is the only acceptable Instructions: specimen type for this assay. Stability Room temperature: 8 hours, Refrigerated: 10 days, Frozen: 6 months. Testing Schedule: Mon-Fri Expected TAT: 2-4 Days Clinical Use: Useful in the evaluation of muscle wasting diseases, such as Duchenne's muscular dystrophy. Cpt Code(s): 82085

2 Aldosterone, Serum Order Name: ALDOS SER Test Number: TEST COMPONENTS REV DATE: 11/20/2012 Aldosterone, Serum LC/MS/MS Preferred 2mL(0.5) Serum Clot Activator (Red Top, No-Gel) Refrigerated Alternate 2mL(0.5) Plasma EDTA (Lavender Top) Refrigerated 2mL(0.5) Plasma Lithium Heparin (Dark Green Top / No-GEL) Refrigerated Special If an upright specimen is collected, patient should be upright (seated or standing) for at least two hours. Non-ambulatory patients can Instructions: be drawn and specimen marked as Supine. Gel Separation tubes are unacceptable. Draw blood in a red-top tube (NO-Gel). Separate serum after clotting. Ship serum/plasma specimens refrigerated or frozen. Do not submit glass tubes. Stability (Serum or Plasma): Room temperature: 4 Days, Refrigerated: 7 Days, Frozen: 28 Days. Testing Schedule: Sun-Fri Expected TAT: 5-7 Days Cpt Code(s): 82088

3 Androstenedione Order Name: ANDROSTEN Test Number: TEST COMPONENTS REV DATE: 11/20/2012 Androstenedione LC/MS/MS Preferred 1mL(0.3) Serum No Additive Clot (Red Top, No-Gel, Plastic) Refrigerated Alternate 1mL(0.3) Plasma EDTA (Lavender Top) Refrigerated 1mL(0.3) Plasma Lithium Heparin (Dark Green Top / No-GEL) Refrigerated Special should be collected between 6-10 a.m. Instructions: Gel Separation tubes are unacceptable. Draw blood in a red-top tube (NO-Gel). Separate serum after clotting. Stability (Serum or Plasma): Room temperature: 14 Days, Refrigerated: 28 Days, Frozen: 2 Years. Testing Schedule: Sun-Fri Expected TAT: 5-7 Days Clinical Use: Androstenedione is useful when evaluating patients with androgen excess and managing patients with Congenital Adrenal Hyperplasia (CAH). Cpt Code(s): 82157

4 Calcitonin Order Name: CALCITONI Test Number: Calcitonin Imm Preferred 1mL(0.5) Serum Clot Activator SST (Red/Gray or Tiger Top) Frozen Special Overnight fasting is preferred. Separate specimens must be submitted when multiple tests are ordered. Separate serum or plasma Instructions: from cells ASAP and refrigerate or freeze. Stability: Room temperature: Unacceptable, Refrigerated: 24 hours, Frozen: 28 days. EDTA plasma, Room temperature and grossly hemolyzed or lipemic specimens are not acceptable. Testing Schedule: Mon, Wed, Fri Expected TAT: 2-4 Days Cpt Code(s): 82308

5 Calprotectin, Fecal Order Name: CALPRO FEC Test Number: Calprotectin, Fecal Imm Preferred 1g(0.3g) Stool, Raw Sterile Screwtop Container Refrigerated Special 1 g Stool unpreserved collected in a Sterile leak-proof container. Instructions: Alternative (s) 1 g Random liquid stool collected in a Sterile leak-proof container. Collect undiluted feces in clean, dry sterile leak proof container. Do not add fixative or preservative. Stability: Room temperature: 11 days, Refrigerated: 11 days, Frozen: 1 year Testing Schedule: Mon, Fri Expected TAT: 2-6 Days Clinical Use: Diagnose inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis. Differentiate IBD from irritable bowel syndrome (IBS). Cpt Code(s): 83993

6 Clozapine (Clozaril) Order Name: CLOZAPINE Test Number: TEST COMPONENTS REV DATE: 11/20/2012 Clozapine (Clozaril) LC/MS/MS Preferred 1mL(0.5) Plasma EDTA (Lavender Top) Refrigerated Alternate 1mL(0.5) Serum Clot Activator (Red Top, No-Gel) Refrigerated 1mL(0.5) Plasma Lithium Heparin (Dark Green Top / No-GEL) Refrigerated Special Do not use gel barrier/serum Separator tubes. Instructions: Optimal time to collect sample: Best to Draw 30min - 1hr before next oral dose at steady state. (Time to steady state: 3-5 days). Separate Plasma or Serum from cells within 2 hours of collection, Keep Refrigerated. Testing Schedule: Mon, Tue, Thr, Fri Expected TAT: 3-5 Days Clinical Use: Clozapine is an atypical antipsychotic agent. Norclozapine has minimal therapeutic activity. Notes: (Change CPT from to on 11/19/2012). Cpt Code(s): 83789

7 Cyanide Whole Blood Order Name: CYANIDE Test Number: Cyanide Whole Blood COLO Preferred 10mL(6mL) Whole Blood Sodium Heparin (Green Top) Room Temperature Alternate 10mL(6mL) Whole Blood Lithium Heparin (Dark Green Top / No-GEL) Room Temperature Special 10 ml Whole blood collected in sodium heparin (green-top) No-Gel tube. Instructions: Stability: Room temperature: 14 Days, Refrigerated: 14 Days, Frozen: 30 Days Testing Schedule: Mon,Wed,Fri Expected TAT: 2-3 Days Cpt Code(s): 82600

8 Dihydrotestosterone Order Name: DIHYDTEST Test Number: Dihydrotestosterone LC/MS/MS Preferred 0.6mL(0.3) Serum No Additive Clot (Red Top, No-Gel, Plastic) Frozen Special Preferred : Collect 0.6 ml serum collected in a Red-top (No-GEL) clot tube. Instructions: Reject Criteria : Moderate hemolysis, Gross hemolysis, Lipemia, SST tubes. Stability: Room temperature: 7 days, Refrigerated: 7 days, Frozen: 2 years Testing Schedule: Sun-Thr Expected TAT: 4-6 Days Clinical Use: DHT is a potent androgen derived from testosterone via 5-alpha-reductase activity. 5-alpha-reductase deficiency results in incompletely virilized males (phenotypic females). This diagnosis is supported by an elevated ratio of testosterone to DHT. Notes: (AKA: 5-a-Dihydrotestosterone) Cpt Code(s): 82651

9 Lamotrigine Order Name: LAMOTRIGIN Test Number: Lamotrigine LC/MS/MS Preferred 1 ml (0.5) Serum Clot Activator (Red Top, No-Gel) Refrigerated Alternate 1 ml (0.5) Plasma EDTA (Lavender Top) Refrigerated Special Draw 1/2-1 hour before next dose at steady state. Do not use gel barrier tubes. Separate serum, plasma from cells ASAP. Instructions: Reject Criteria : Gross Hemolysis, Lipemia, Gel barrier tube. Stability: Room temperature: 48 hours, Refrigerated: 5 days, Frozen: 14 days. Testing Schedule: Mon-Fri Expected TAT: 2-4 Days Cpt Code(s): 80299

10 Methylmalonic Acid Order Name: METHYLMA S Test Number: Methylmalonic Acid GC/MS/MS Preferred 2mL(0.6) Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Alternate 2mL(0.6) Plasma Lithium Heparin PST (Green/Gray Top) Refrigerated Special Barrier gel separator tube : Centrifuge the specimen as soon as possible after complete clot formation has taken place. Do not place Instructions: barrier tubes in an ice bath as freezing may prevent the barrier gel from adequately separating serum from cells. Transfer the serum to a plastic screw-capped vial and ship it at refrigerated temperature. Red top tube : Centrifuge the specimen as soon as possible after complete clot formation has taken place. Transfer the serum to a plastic screw-capped vial and ship it at refrigerated temperature. Heparin tube : Centrifuge the specimen as soon as possible (within one hour after collection) and transfer the plasma to a plastic screw-capped vial and ship it at refrigerated temperature. Stability (Serum or Plasma: Room temperature: 4 days, Refrigerated: 7 days, Frozen: 10 months Testing Schedule: Mon-Sun Expected TAT: 5-7 Days Cpt Code(s): 83921

11 Mitochondrial M2 Antibody, IgG EIA Order Name: MITOCH M2 Test Number: Mitochondrial M2 Antibody, IgG EIA EIA Preferred 1mL(0.3) Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Special Stability: Room temperature: 7 days, Refrigerated: 14 days, Frozen: 30 days. Instructions: Testing Schedule: Wed Expected TAT: 2-8 Days Clinical Use: Mitochondrial Antibody is present in approximately 95% of patients with primary biliary cirrhosis (PBC). Mitochondrial M2 Antibody has an even higher specificity for PBC. Notes: (CPT changed from to on 11/19/2012.) Cpt Code(s): 83520

12 Pancreatic Elastase, Fecal Order Name: STOOL ELAS Test Number: Pancreatic Elastase, Fecal Imm Preferred 1g (0.3g) Stool, Random Sterile Screwtop Container Frozen Special Preferred Frozen Instructions: Collect undiluted feces in clean, dry, sterile leak proof container. Do not add fixative or preservative. Reject Criteria : stored at room temperature for more than 5 days, (s) collected in Formalin, MF, SAF, PVA or Cary-Blair media. Stability: Room temperature: 5 days, Refrigerated: 7 days, Frozen: 1 year. Testing Schedule: Mon, Wed, Fri Expected TAT: 2-5 days Clinical Use: The Elastase-1 is a quantitative enzyme linked immunosorbent assay for measuring concentrations of elastase-1 in feces as an aid in diagnosis of the exocrine pancreatic function. Cpt Code(s): 82656

13 Primidone (Mysoline) Level Order Name: PRIMID REF Test Number: Primidone (Mysoline) Level Imm Preferred 1mL(0.5) Serum Clot Activator (Red Top, No-Gel) Refrigerated Alternate 1mL(0.5) Plasma EDTA (Lavender Top) Refrigerated Special Collect just prior to next dose. Instructions: Centrifuge and immediately separate plasma or serum specimens from the cells into clean, plastic, screw-capped vial(s) - Keep Refrigerated. Stability (Plasma or Serum): Room temperature: 72 Hours, Refrigerated: 14 Days, Frozen: 30 Days. Testing Schedule: Mon-Sat Expected TAT: 2-3 Days Cpt Code(s): 80188

14 Prograf (FK506) Order Name: PROGRAF Test Number: Prograf (FK506) MEIA Preferred 1 ml (0.5) Whole Blood EDTA (Lavender Top) Refrigerated Special To be drawn 12 hours after dose for 12 hour trough or 24 hour after dose for 24 hour trough. Stability: Ambient 3 days. Refrigerated up Instructions: to 14 days. Frozen greater than 14 days. Testing Schedule: Daily Expected TAT: 24hrs (same day if specimen is in lab by 11am) Clinical Use: Useful for assessing the adequacy of systemic drug delivery since metabolism can exhibit significant variability. Notes: Also known as Tacrolimus Cpt Code(s): 80197

15 Secretin (Gastrin) Order Name: GASTRIN Test Number: Secretin (Gastrin) CIA Preferred 1 ml (0.3) Serum Clot Activator SST (Red/Gray or Tiger Top) Frozen Special CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered. Instructions: Overnight fasting is required, preferably 12 hours or more. Reject Criteria : Hemolysis, Lipemia, Thawed Serum, Received room temperature, Received refrigerated, Plasma. Stability: Room temperature: Unacceptable, Refrigerated: Unacceptable, Frozen: 28 Days. Testing Schedule: Mon, Wed, Fri Expected TAT: 2-4 Days Cpt Code(s): 82941

16 Thyroid Stimulating Immunoglobulin (TSI) Order Name: THY ST IG Test Number: Thyroid Stimulating Immunoglobulin (TSI) Imm Preferred 1 ml (0.7) Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Special Allow Serum to clot 30min. then separate 1mL serum into plastic aliquot tube ASAP. Instructions: Unacceptable : Plasma, hemolyzed, icteric, or lipemic specimens. Stability : Room temperature: Unacceptable, Refrigerated: 21 days, Frozen: 60 days. Testing Schedule: Tue-Sat Expected TAT: 3-5 Days Clinical Use: Graves disease is a classic form of hyperthyroid disease, affecting approximately 0.4 percent of the population in the United States. It is caused by IgG immunoglobulins, collectively known as thyroid stimulating immunoglobulins (TSI). Patients who are candidates for antithyroid drug therapy may not respond to this treatment when TSI levels are markedly elevated. The determination of TSI can also assist in predicting hyperthyroidism in neonates due to placental transmission of the immunoglobulins from mother with a hyperthyroidism. Cpt Code(s): 84445

17 Topiramate Order Name: TOPIRAMATE Test Number: TEST COMPONENTS REV DATE: 11/20/2012 Topiramate LC/MS/MS Preferred 1mL(0.5) Serum Clot Activator (Red Top, No-Gel) Refrigerated Alternate 1mL(0.5) Plasma Sodium Heparin (Green Top) Refrigerated 1mL(0.5) Plasma Lithium Heparin (Dark Green Top / No-GEL) Refrigerated Special Preferred collection in Red No-Gel clot tube. Heparin plasma is acceptable. Instructions: Separate serum or plasma from cells ASAP within 2 hours of draw. Avoid use of separator tubes and gels.draw peak 2-4 hours after dose or trough hour before dose or at steady state. Stability (Serum or Plasma): Room temperature: 7 Days, Refrigerated: 14 Days, Frozen: 30 Days. Testing Schedule: Tue-Sat Expected TAT: 4-6 Days Clinical Use: Topiramate is an anticonvulsant used as an adjunctive treatment of partial-onset epilepsy. Therapeutic drug monitoring is useful to optimize dose and avoid toxicity Notes: Daily dose (mg) Peak Trough 100mg mcg/ml mcg/ml 200mg mcg/ml mcg/ml 400mg mcg/ml mcg/ml Cpt Code(s): 80201

18 Vitamin B1, (Thiamine) Whole Blood Order Name: THIAMINE Test Number: Vitamin B1, (Thiamine) Whole Blood HPLC Preferred 3mL(1mL) Whole Blood EDTA (Lavender Top) Frozen Alternate 3mL(1mL) Whole Blood Sodium Heparin (Green Top) Frozen Special CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered. Protect from light during collection, Instructions: storage, and shipment. Collect and freeze 3mL EDTA Whole Blood. Unacceptable s: Nonfrozen specimens. s not protected from light. (Samples received frozen but not protected from light are acceptable.) Stability (Whole blood): Room temperature: 4 Hours Refrigerated: 24 Hours, Frozen: 30 Days. Testing Schedule: Sets up 6 days a week Expected TAT: 4-6 Days Cpt Code(s): 84425

19 Vitamin D, 1,25-Dihydroxy (Vit D 1-25-DOH) Order Name: VIT D1-25 Test Number: Vitamin D, 1,25-Dihydroxy (Vit D 1-25-DOH) LC/MS/MS Preferred 2mL(1.5mL) Serum Clot Activator (Red Top, No-Gel) Frozen Special Preferred specimen is Serum from Red No-Gel Clot Tube. Allow blood to clot (30 minutes) at room temperature. Centrifuge and Instructions: separate the serum from the cells and Freeze ASAP. Plasma s are No Longer Acceptable. Stability: Room temperature: 28 days, Refrigerated: 28 days, Frozen: 28 days. Note: If a serum sample is submitted with less than 1.1 ml and needs to be repeated, the sample will be canceled with the comment TNP-Initial testing necessitated a repeat, but there was insufficient sample to perform repeat. Blood collected in a SST gel barrier tube should be avoided, but should be processed immediately. Allow to clot (30 minutes) at room temperature, then centrifuge and separate the serum from the cells and Freeze ASAP. Testing Schedule: Sun-Sat Expected TAT: 3-4 Days Clinical Use: Vitamin D originating from dietary and endogenous sources is converted to 25-hydroxyvitamin D in the liver, and subsequently to 1-25 Dihydroxy vitamin D in the kidney. Deficiencies of 1-25 Dihydroxy vitamin D, the most active form, cause hypocalcemia, osteomalacia, and related disorders. Measurement is useful in: differentiating primary hyperparathyroidism from hypercalcemia of cancer; distinguishing between vitamin D dependent and vitamin D resistant rickets; monitoring vitamin D status of patients with chronic renal disease; and, assessing compliance to therapy. Notes: This test is used to measure the bio-active form of Vitamin D. This test is also used in the differential diagnosis of hypocalcemia and to monitor patients with renal osteodystrophy or chronic renal failure. Cpt Code(s): 82652

Alkaline Phosphatase, Bone Specific

Alkaline Phosphatase, Bone Specific Order Name: ALK P BONE Test Number: 3656500 REV DATE:11/5/2010 Alkaline Phosphatase, Bone Specific IMMENZ Preferred 1 ml (0.3) Serum Clot Activator SST (Red/Gray or