Acid Fast Bacilli (AFB) Culture and Smear

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Acid Fast Bacilli (AFB) and Smear Order Name: C AFB Test Number: 6000100 Acid Fast Bacilli (AFB) and Smear Preferred 5 ml (3) Sputum Sterile Screwtop Container Room Temperature Alternate 1 5 ml (3)

1 Acid Fast Bacilli (AFB) and Smear Order Name: C AFB Test Number: Acid Fast Bacilli (AFB) and Smear Preferred 5 ml (3) Sputum Sterile Screwtop Container Room Temperature Alternate 1 5 ml (3) Tissue Sterile Screwtop Container Room Temperature Alternate 2 5 ml (3) Fluid Sterile Screwtop Container Room Temperature Encourage deep cough to minimize saliva contaminants. Minimum 3 ml in screw top container. May be collected with routine or fungal culture if quantity is sufficient. For respiratory, 3 consecutive days' early morning specimens are recommended. Also acceptable is: Regular size applicator Copan eswab - White 8 Weeks Determines Mycobacteria sp. infections CPT Code(s) 87116, 87015, 87206

2 Aerobic Wound and Stain Order Name: C WOUN RTS Test Number: Aerobic Wound and Stain Preferred 1 ml Tissue Sterile Screwtop Container Room Temperature Alternate 1 1 ml Fluid Sterile Screwtop Container Room Temperature Alternate 2 Swab Swab Anaerobic Gel Swab (Blue Cap) Room Temperature Place swab in sterile transport (tte or Port-a-Cul). Send fluids or tissues in sterile container. Also acceptable is: Regular size applicator Copan eswab - White Notes 3 Days Aerobic culture for determining bacterial pathogens from wound, tissue and sterile fluid sites. Sensitivities done on isolates considered pathogens. CPT Code(s) 87070, 87205

3 Anaerobic and Stain Order Name: C WOUN AN Test Number: LOINC Code: Anaerobic and Stain Preferred 2 ml (1) Tissue Sterile Screwtop Container Room Temperature Alternate 1 2 ml (1) Fluid Sterile Screwtop Container Room Temperature Alternate 2 Swab Swab Anaerobic Gel Swab (Blue Cap) Room Temperature Avoid skin surfaces, mouth, oral, anal, and vaginal areas which have normal anaerobic flora. Clean surface of lesions with alcohol. Also acceptable is: Regular size applicator Copan eswab - White 4 Days Determines presence or absence of anerobic bacteria in culture. CPT Code(s) 87075, 87205

4 Atypical Pneumonia Antibodies Order Name: ATYP PNEUM Test Number: LOINC CODE Adenovirus IgG and IgM Antibodies Chlamydia pneumoniae IgM Antibody Indirect Fluorescent Antibody Chlamydia pneumoniae IgG Antibody Indirect Fluorescent Antibody Influenza A/B IgG and IgM Antibodies Legionella pneumophila 1-7 Antibody Indirect Fluorescent Antibody Mycoplasma IgG IgM RSV IgG and IgM Antibodies Preferred 1 ml Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Mon - Fri 3 Days Atypical pneumonia Notes CPT codes; 86713; 86603X2; 86632; 86631; 86710X4; 86756X2; 86738X2. CPT Code(s) Multiple

5 Copper, 24-Hour Urine Copper, 24-Hour Urine Order Name: COPPER 24 Test Number: Revision Date: 12/16/2014 Inductively-Coupled Plasma/Mass Spectrometry Preferred 7 ml (3) Urine, 24-hour Acid Washed, Trace Element Free 24 hour Urine Container Ambient / Refrigerated Collect 24-hour urine in a 24-hour Trace Elements Free Urine container (Random urine is not acceptable). No Preservatives needed. Record total volume on specimen container and on test requisition. If making Aliquot it must be in a Trace Elements Free aliquot tube. Specimen Stability: Room temperature 5 days, Refrigerated 14 days, Frozen, 30 days Sun-Thu (Reports 4-5 days following set up) 7-12 Days CPT Code(s) Lab Section Reference Lab

6 Cystic Fibrosis, DNA Analysis Order Name: CYSTIC GEN Test Number: Cystic Fibrosis, DNA Analysis INVADER Preferred 5 ml (3 ml) Whole Blood EDTA (Lavender Top) Room Temperature Include clinical indication for testing on the test request form. Please indicate the ethnicity of the patient. Room temperature or Refrigerated is acceptable. Stability: Room Temp 8 Days, Frozen Not Acceptable. Do not centrifuge. Specimen cannot be shared with other testing for risk of DNA contamination. Set up Monday and Thursday, Reports Tuesday and Friday 7-10 Days Recommended Core Mutation Panel for General Population Cystic Fibrosis Carrier Screening. The CF (cystic fibrosis) transmembrane conductance regulator (CFTR) gene was tested for the presence of 46 specific mutations, including the 25 mutations recommended by the American College of Obstetricians and Gynecologists (ACOG) and the American College of Medical Genetics (ACMG), by genotyping to determine if they are negative, heterozygous, or homozygous for the mutation. This test will detect the F508C MUTATION, a non-cystic fibrosis (CF)-causing variant. When the F508C mutation is paired with a CF-causing mutation, it has been associated with congenital bilateral absence or atresia of the vas deferens (CBAVD). Notes Note: Turnaround time may vary with reflex testing for specific gene identification. CPT Code(s) 81220

7 Ear and Stain Order Name: C EAR RTS Test Number: Ear and Stain Preferred Swab Copan eswab - White (Regular size) Room Temperature Alternate 1 Swab PNP Swab (Green Cap) Room Temperature 3 Days Used to identify bacterial pathogens of the ear. CPT Code(s) 87070

8 Eye and Stain Order Name: C EYE RTS Test Number: Eye and Stain Preferred Swab Copan eswab - White (Regular size) Room Temperature Alternate 1 Swab PNP Swab (Green Cap) Room Temperature 3 Days Eye cultures help determine bacterial and fungal infections in and around the eye. Swab specimens should be carefully collected to maintain sterility. CPT Code(s) 87070

9 Factor 2 (II) Mutation Analysis ( Prothrombin Gene Mutation Analysis ) Order Name: FAC II MUT Test Number: Factor 2 (II) Mutation Analysis ( Prothrombin Gene Mutation Analysis ) INVADER Preferred 5 ml (1) Whole Blood EDTA (Lavender Top) Room Temperature Room temperature or Refrigerated is acceptable. Stability: Room Temp 8 Days, Frozen Not Acceptable. Do Not Centrifuge. Specimen cannot be shared with other testing for risk of DNA contamination. Dayshift- Tue, Fri 2-4 Days CPT Code(s) 81240

10 Fungus Order Name: C FUNGUS Test Number: LOINC Code: Fungus Preferred Sputum Sterile Screwtop Container Room Temperature Alternate 1 Tissue Sterile Screwtop Container Room Temperature Alternate 2 Fluid Sterile Screwtop Container Room Temperature Collect sputum, tissues, or fluids in sterile container; lesions in culturette Also acceptable is: Regular size applicator Copan eswab - White 28 Days Determines yeast or fungal infections CPT Code(s) 87102

11 Glomerular Basement Membrane Antibody (GBM Ab) Order Name: GBM AB Test Number: LOINC Code: Glomerular Basement Membrane Antibody (GBM Ab) Enzyme Immunoassay Preferred 1 ml Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Mon - Fri 3 Days Antibodies to GBM occur in patients with glomerulonephritis and/or pulmonary hemorrhage (Goodpasture's syndrome). CPT Code(s) 83520

12 Gonococcus Screen Order Name: C GC Test Number: Gonococcus Screen Preferred See Swab Copan eswab - White (Regular size) Room Temperature Alternate 1 See Swab Aerobic Swab (White Cap) Room Temperature Obtain culture from mucosal surface with aerobic white swab or green cap minitip swab. Transport at Room Temperature. 3 Days Determines Neisseria gonorrhoeae infections CPT Code(s) 87081

13 Group A Streptococcus Order Name: C STREP A Test Number: Group A Streptococcus Preferred Swab Copan eswab - White (Regular size) Alternate 1 Swab Double Tipped Aerobic Swab (Red) Room Temperature Room Temperature Swab tonsils or affected area thoroughly. Avoid the tongue. Do not crush ampule of culturette. 2 Days Detects Group A Streptococcus by culture. CPT Code(s) 87081

14 Group B Streptococcus Order Name: C STREP B Test Number: Group B Streptococcus Preferred Swab Copan eswab - White (Regular size) Room Temperature Alternate 1 Swab Aerobic Swab (White Cap) Room Temperature Swab vagina, cervix, and/or rectum. 2 Days Detects Group B Streptococcus (GBS) CPT Code(s) 87081

15 Hepatitis, Viral Profile Order Name: HEP PROF Test Number: Revision Date: 12/04/2014 LOINC CODE Hepatitis A Antibody (HAV), IgM Chemiluminescence Assays Hepatitis B Core IgM Chemiluminescence Assays Hepatitis B Surface Antigen Chemiluminescence Assays Hepatitis C Antibody (HCV Ab) Chemiluminescence Assays Preferred 3 ml Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Specimen stability: Room Temp = 8 hours; Refrigerated = 7 days. Sun-Fri 1-2 Days CPT Code(s) 80074

16 Influenza A and B Screen Influenza A Screen Influenza B Screen Order Name: C A/B FLU Test Number: Enzyme Immunoassay Enzyme Immunoassay Preferred See Swab Flocked Flexible Mini-Tip Nasopharyngeal Swab Refrigerated Alternate 1 See Saline nasal wash Sterile Screwtop Container Refrigerated The preferred specimen is Universal Transport Media (UTM) with mini-flocked Swab (Comes as a kit: RML Supply# 50775), BD Viral Transport Media (VTM) or M5. Swabs in saline are only acceptable for up to 8 hours. Keep swabs refrigerated (room temperature stability is only 24hrs). For Saline nasal wash: Use bulbous syringe to dispense 2 ml saline into nasal passages. Aspirate at least 1mL back into syringe and transfer to sterile container. Note: Green cap minitip Swab is No Longer Acceptable. Also not acceptable are swabs in M4, M4-RT, Liquid Amies-D, Amies Clear, Modified or Liquid Stuart s and Remel M6 transport media. (the green cap minitip swab has liquid stuart s) Also acceptable is: Mini-tip size applicator Copan eswab - Green CPT Code(s) 1 Day 87804x2

17 MRSA (Methicillin Resistant Staphylococcus aureus) Order Name: C MRSA Test Number: MRSA (Methicillin Resistant Staphylococcus aureus) Preferred Swab Copan eswab - Green (Mini-tip) Room Temperature Alternate 1 Swab Aerobic Swab (White Cap) Room Temperature Swab anterior nares, perineal region or directly from suspected area. other skin sources or throat are also acceptable. Other swabs are acceptable, including Aimes Gel Swab. Notes 3 Days Confirms presence or absence of methicillan resistant Staph aureus Set up on Chromogenic Agar to facilitate identification. CPT Code(s) 87081

18 MTHFR, DNA Mutation Analysis (C677T & A1298C) [methylenetetrahydrofolate reductase] Order Name: MTHFR Test Number: MTHFR, DNA Mutation Analysis (C677T & A1298C) [methylenetetrahydrofolate reductase] INVADER Preferred 6mL (3mL) Whole Blood EDTA (Lavender Top) Room Temperature Room temperature or Refrigerated is acceptable. Stability: Room Temp 8 Days, Frozen Not Acceptable. Do Not Centrifuge. Specimen cannot be shared with other testing for risk of DNA contamination. Dayshift- Thursday 2-8 Days The Methylenetetrahydrofolate Reductase (MTHFR) enzyme plays a major role in homocysteine metabolism and contains several known polymorphisms(c677t and A1298C). This mutation is reported to reduce MTHFR activity, resulting in hyperhomocysteinemia. This condition is a risk factor for cardiovascular disease, increased risk for arterial and venous thrombosis, and an increased risk for obstetrical complications. CPT Code(s) 81291

19 Myositis Profile Order Name: MYOSI PROF Test Number: Revision Date: 12/10/2014 LOINC CODE PL-7 Autoantibodies Radioimmunoprecipitation assay PL-12 Autoantibodies Radioimmunoprecipitation assay Mi-2 Autoantibodies Radioimmunoprecipitation assay Ku Autoantibodies Radioimmunoprecipitation assay EJ Autoantibodies Radioimmunoprecipitation assay OJ Autoantibodies Radioimmunoprecipitation assay SRP Autoantibodies Radioimmunoprecipitation assay Jo-1 Autoantibodies Enzyme Immunoassay Preferred 6 ml (2) Serum No Additive Clot (Red Top, No-Gel, Plastic) Refrigerated 6mL Serum from Non-Gel Clot tube separated into Two 3mL aliquots. Keep specimen refrigerated. Stability: Ambient= 4 Day(s), Refrigerated= 7 Day(s), Frozen= 30 Day(s). CPT Code(s) Lab Section Tuedays Days 83516x5, 86235x3 Reference Lab

20 Nasal Order Name: C NASAL RT Test Number: LOINC Code: Nasal Preferred Nasal swab Copan eswab - White (Regular size) Room Temperature Alternate 1 Nasal swab Aerobic Swab (White Cap) Room Temperature Alternate 2 Nasal swab PNP Swab (Green Cap) Room Temperature 3 Days Identifies upper respiratory pathogens CPT Code(s) 87070

21 Rapid Strep A screen (Strep Throat) Rapid Strep A screen (Strep Throat) Order Name: C RAP A SC Test Number: Enzyme Immunoassay Preferred Swab Copan eswab - Green (Mini-tip) Room Temperature Alternate 1 Swab Aerobic Swab (White Cap) Room Temperature Alternate 2 Swab Double Tipped Aerobic Swab (Red) Room Temperature Rinse mouth with tap water before collection. Avoid throat lozenges and mouthwashes. Swab back of throat on tonsils, avoid the tongue. Notes CPT Code(s) 1 Day Detection of Group A Streptococcus antigen. If rapid strep A screen is negative, a culture will automatically be set up QW

22 Respiratory Syncytial Virus Detection Respiratory Syncytial Virus Detection Order Name: C RSV SC Test Number: Enzyme Immunoassay Preferred 3 ml (1) Swab Flocked Flexible Mini-Tip Nasopharyngeal Swab Refrigerated Alternate 1 3 ml (1) Nasal Wash Sterile Screwtop Container Refrigerated Alternate 2 3 ml (1) Bronchial lavage/wash Sterile Screwtop Container Refrigerated The preferred specimen is Universal Transport Media (UTM) with mini-flocked Swab (Comes as a kit: RML Supply# 50775), BD Viral Transport Media (VTM) or M5. Keep swabs Refrigerated (2-8'C) or Frozen in UTM or other viral transport if a delay in reaching the lab is anticipated (Room Temperature is Not Recommended). For Saline nasal wash: Use bulbous syringe to dispense 2 ml saline into nasal passages. Aspirate at least 1mL back into syringe and transfer to sterile container. Also acceptable is: Mini-tip size applicator Copan eswab - Green 1 Day Detects presence of Respiratory Syncitial virus CPT Code(s) 87807

23 Testosterone Total, Free, SHBG, Biovailable, Males (Adult) Order Name: TEST FTSBM Test Number: Revision Date: 12/15/2014 LOINC CODE Testosterone, Total, Males (Adult) Chemiluminescence Assays Testosterone Free (Males) Sex Hormone Binding Globulin Testosterone Biovailable Male Calculation Chemiluminescence Assays Calculation Preferred 1 ml (0.5 ml) Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Alternate 1 1 ml (0.5 ml) Serum Clot Activator (Red Top, No-Gel) Refrigerated Not Recommended for Females and Children 13 years and under Preferred to separate serum from cells ASAP or within 2 hours of collection. Stability After separation from cells: Ambient: 8 hours; Refrigerated: 1 week; Frozen: 30 days. Notes Mon-Fri 1-2 Days For Females and Children 13 years and under use the following test code: TEST FTSBF [ ] Testosterone Total, Free, SHBG, Biovailable, Females and Children CPT Code(s) 84403, 84270

24 Thorazine (Chlorpromazine) Serum Thorazine (Chlorpromazine) Serum Order Name: THORAZINE Test Number: Revision Date: 01/09/2015 Liquid Chromatography/Tandem Mass Spectrometry Preferred 4 ml (2) Serum Clot Activator (Red Top, No-Gel) Frozen Do not use gel barrier tubes. Draw sample 1/2 to 1 hour before next dose. Wed, Sat 3-4 Days CPT Code(s) Lab Section Reference Lab

25 Throat Order Name: C THROAT RT Test Number: Throat Preferred See Swab Copan eswab - White (Regular size) Room Temperature For Aerobic s Only. Swab the tonsil area thoroughly and behind the uvula. Other Acceptable Swabs: Double Tipped Aerobic Swab (Red), Aerobic Swab (White Cap), Anaerobic Gel Swab (Blue Cap). 2 Days Identifies oral pathogens that cause pharyngitis. CPT Code(s) 87070

26 Urogenital Order Name: C UROG RTS Test Number: LOINC Code: Urogenital Preferred Swab Copan eswab - White (Regular size) Room Temperature Alternate 1 Swab Aerobic Swab (White Cap) Room Temperature 4 Days Identifies urogenital bacterial pathogens CPT Code(s) 87070

27 Vancomyocin-Resistant Enterococcus Screen (VRE) Order Name: C VRE SCR Test Number: Vancomyocin-Resistant Enterococcus Screen (VRE) Preferred Swab Rectal swab Copan eswab - Green (Mini-tip) Ambient / Refrigerated Alternate 1 Swab Rectal swab Aerobic Swab (White Cap) Ambient / Refrigerated Alternate 2 Swab Rectal swab Anaerobic Gel Swab (Blue Cap) Ambient / Refrigerated 1cc of stool in a sterile tight container is also acceptable. Specimen should be kept refrigerated until sent to lab. 3 Days Confirms presence or absence of vancomycin resistant Enterococcus sp. CPT Code(s) 87081

28 Vitamin B 12 / Folic Acid Order Name: B12 FOLAT Test Number: Revision Date: 12/01/2014 LOINC CODE Folic Acid (Folate) Chemiluminescence Assays Vitamin B 12 Chemiluminescence Assays Preferred 1 ml (0.5) Serum Clot Activator SST (Red/Gray or Tiger Top) See Non hemolyzed serum. Specimen stability: Ambient 8 hours. Refrigerated 72 hours. Sun - Fri 1-3 days CPT Code(s) 82607; 82746

29 Yeast Order Name: C YEAST Test Number: Yeast Preferred See Swab Copan eswab - Green (Mini-tip) See Alternate 1 See Stool, Random Sterile Screwtop Container See Alternate 2 See Urine, Random Sterile Urine container See Specimen Source needs to be indicated. Acceptable Sources include genital, fecal, urine and oral cavity specimens (mouth, gums, throat, esophagus, tongue, teeth, etc.) Sources of foley catheter tips, in viral transport, parasite parapaks are Not Acceptable. Any color BBL swabs in bacterial transport media, ETM or Raw stool, Urine in or Monovettes are acceptable. Specimen Stability: 24hrs Room Temperature or 36hrs Refrigerated (Do Not Freeze). Notes Sun-Sat 8 Days This test was developed as an alternative to the traditional fungal culture (C FUNGUS) which has turn around time approaching 4 weeks. Specimens are plated on chromogenic agar for ease of early identification and final reports are issued within 8 days. Susceptibilities will not be routine performed but would be available upon request. CPT Code(s) 87106

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