C-1-Q IMMUNE COMPLEX Immune Complex, C-1-Q Binding Assay

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Derek Doyle
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1 C-1-Q IMMUNE COMPLEX Immune Complex, C-1-Q Binding Assay 5 ml blood, gel tube Special Instructions: Avoid hemolysis. Transfer serum to plastic vial immediately after centrifugation and freeze. Less than 4 ug Eq/mL 3-6 days Day(s) Test Set Up: Tuesday and Thursday CPT Code: CA15-3 Cancer Antigen CA ml blood, gel tube <24 U/mL Day(s) Test Set Up: Monday-Friday CPT Code: CA19-9 Carbohydrate Antigen 19-9 CA199 2 ml blood, gel tube <34 U/mL Day(s) Test Set Up: Monday-Friday CPT Code: CA-125 Cancer Antigen 125 CA ml blood, gel tube U/mL Day(s) Test Set Up: Monday - Friday CPT Code: CALCITONIN CALC 2.5 ml blood, gel tube on ice Special Instructions: Transfer serum to plastic vial and freeze Interpretive report with results 2-5 days Day(s) Test Set Up: Tuesday-Saturday CPT Code: Page 1 2/19/2013

2 CALCIUM CA 2.5 ml blood (0.6 ml minimum), gold gel or green tube or 1 full microtainer mg/dl CPT Code: CALCIUM, IONIZED CA, Ionized CAI 2.5 ml blood, green top tube (Na or Li Heparin) NO GEL Special Instructions: Do not uncap vial mmol/l mg/dl CPT Code: CALCIUM - URINE RANDOM CAUR 10 ml urine Undefined for random specimens CPT Code: CALCIUM - URINE 24 HOUR CA24 Total collection, 24 hour urine Special Instructions: Requires 15 ml 6N HCl prior to start of collection. Specify starting date/time and ending date/time mg/24 hr CPT Code: CARDIOLIPIN ANTIBODY See Anti-cardiolipin Antibody CARBAMAZEPINE CARB Special Instructions: 2.5 ml blood (0.6 ml minimum), gold gel or green tube or 1 full microtainer. Peak: draw 6 18 hours after oral injestion. Valley: draw just prior to next dose after 2 6 days of oral dosing µg/ml 4 hours Daily Day(s) Test Set Up: CPT Code: Page 2 2/19/2013

3 CAROTENE CARO 12.5 ml blood, gel tube Special Instructions: Protect from light ug/dl 2-4 days Day(s) Test Set Up: Monday - Friday CPT Code: CAT SCRATCH FEVER ANTIBODIES CAT Special Instructions: Day(s) Test Set Up: CPT Code: Includes: 2.5 ml blood (1.5 ml minimum), red top tube Separate serum from cells within 4 hours of collection. See report 2-4 days Monday - Friday 88611X4 Bartonella Henselae, IgG and IgM; Bartonella Quintana IgG and IgM. CATECHOLAMINES, FRACTIONATED - URINE 24 HOUR CATF Special Instructions: 10mL aliquot of 24 hour urine collection Requires 30 ml 6N HCl added to container prior to collection. See caution regarding urine preservatives in specimen collection section of this manual. Specify starting day and time and ending day and time. Range will be provided with individual tests 2-3 days Monday - Saturday Day(s) Test Set Up: CPT Code: Test Includes: Epinephrine, Norepinephrine, Dopamine CATECHOLAMINES, TOTAL AND FRACTIONATED, PLASMA CATU 4 ml blood, green top tube, on ice Special Instructions: Transfer plasma to plastic vial and freeze. Please indicate whether patient is supine(30 mins), sitting or standing (30 mins) when drawn. Interpretive report with results 2-3 days Day(s) Test Set Up: Monday - Friday CPT Code: Test Includes: Epinephrine, Norepinephrine, Dopamine Page 3 2/19/2013

4 CATH TIP (Intravenous) CULTURE CTIP Short segment near tip, use sterle scissors to cut. Submit in sterile container. Special Instructions: Decontamination of skin and careful asceptic removal mandatory. If culture setup is delayed greater than 30 mins add 1ml sterile saline to prevent drying. Held 72 hrs Day(s) Test Setup: Daily CPT Code: Varies _ CBC Complete Blood Count Test Includes: Hgb, Hct, RBC, WBC, Indices, Platelet Count, Automated Differential. 5 ml blood (min 1.0 ml), lavender top tube or 0.25 ml collected in a microtainer tube. See below CPT Code: yr- adult 12 yr-adult 2mo - 2yr 0-2 mo MALE FEMALE CHILD NEONATE WBC RBC HGB HCT MCV MCH MCHC RDW PLT PERCENTAGE COUNTS ABSOLUTE COUNTS Adults Neutrophils ,266-7,676 Lymphocytes ,140 Monocytes Eosinophils Basophils Male Children(age 5-16yrs) Neutrophils ,420-5,200 Lymphocytes ,500-3,600 Monocytes Eosinophils Basophils Female Children(age 5-16yrs) Neutrophils ,550-6,500 Lymphocytes ,200-3,600 Page 4 2/19/2013

5 Monocytes Eosinophils Basophils Children (age 0-4yrs) Neutrophils ,000-12,000 Lymphocytes ,500-8,500 Monocytes Eosinophils Basophils _ CBC WITHOUT DIFF CBCD Test Includes: Hgb, Hct, WBC, Indices, Platelet Count 5 ml blood (min 1.0 ml), lavender top tube or 0.25 ml collected in a microtainer tube See CBC with DIFF 4 hours Daily Day(s) Test Set Up: CPT Code: C. DIFFICILE TOXIN - STOOL Clostridium Difficile Toxin with GDH antigen, reflex PCR Special Instructions: 5 gm diarheal (liquid or unformed) stool Cannot be performed on specimen submitted on stool transport medium or on transport swabs. Refrigerate after collection. Must be transported to laboratory within 24 hrs. or keep frozen if > 24 hrs. Negative Specimens that test positive for the GDH antigen/negative for toxin screen, will reflex C. diff toxin PCR. 3 days Daily Day(s) Test Set Up: CPT Code: CEA Carcinoembryonic Antigen 2.5 ml blood (0.6 ml minimum), gold gel tube only. 0-3 ng/ml CPT Code: _ CELL COUNT CSF CELLC Test Includes: RBC, WBC, Differential if WBC greater than 5 At least 1 ml CSF Special Instructions: Must be delivered to laboratory immediately; call for STAT courier pickup < 6 total cells Page 5 2/19/2013

6 CPT Code: CELL COUNT - FLUID CELLF Test Includes: RBC, WBC, Differential if WBC greater than 5 At least 1 ml body fluid, transfer to lavender top tube immediately after collection Special Instructions: Specify type of fluid < 6 total cells 1 day CPT Code: CERULOPLASMIN CER 5 ml blood, gel tube Adult Males: 18-42mg/dL Adult Females: 21-53mg/dL 2-3 days Day(s) Test Set Up: Monday - Saturday CPT Code: C-1 ESTERASE INHIBITOR, NON-FUNCTIONAL C-1 Esterase Inhibitor, Quantitative 2.5 ml blood, gel tube 6-25 mg/dl 2-4 days Day(s) Test Set Up: Tuesday,Thursday and Saturday CPT Code: C-1 ESTERASE INHIBITOR, FUNCTIONAL BY ANTI-C1r C1, ESTERASE 2.5 ml blood, plain red top tube Special Instructions: Transfer serum to plastic vial and freeze within 1 hour of time drawn Adequate Functional Activity 2-4 days Day(s) Test Set Up: Monday, Wednesday and Friday CPT Code: CHEM 8 PROFILE Basic Metabolic Profile, BCP, BMP 3.0 ml blood (0.8 ml minimum), gold or green gel tube or 1 full microtainer Special Instructions: Centrifuge. Store upright at room temperature, do not uncap vial. Reference Range : See individual tests Page 6 2/19/2013

7 CPT Code: Test Includes: BUN, Sodium, Potassium, Chloride, CO2, Calcuim Glucose, Creatinine (Calculated: egfr, Anion Gap, Osmolality) CHLAMYDIA CULTURE CHL Specimen Sources: Specimen in M4 Viral Transport Media: Abdomen, Bronchial Alveolar Lavage (BAL), Cervix, Eye, Lymph Node, Nasal Aspirate, Rectum, Throat, Urethra None Detected Monday-Friday: cut off 6:00AM; set-up 10:00 AM exp rel 48 hours Saturday-Sunday: cut off 6:00AM; set-up 10:00 AM exp rel 48 hours Daily Day(s) Test Set Up: CPT Codes: 87110, CHLAMYDIA /GC DNA PROBE GCCHLAM, CHLAMGC Endocervical or urethral swab in M4 Viral Transport Store and transport at 2-8 C. Media. Avoid contact with alcohol. Discard cleaning swab. Place collection swab in media. DO NOT USE POWDERED GLOVES DURING COLLECTION. Endocervical or urethral swab in PCR Transport media, store and transport at room temp. Male Urine in PCR Transport media, store and transport at room temp. Negative 1 day Day(s) Test Set Up: Monday-Friday CPT Code: CHLAMYDIA SEROLOGY Chlamydia Trachomatis Antibody Panel CHLTABS 5 ml blood, gel tube See Report 2-3 days Day(s) Test Set Up: Monday, Wednesday and Friday CPT Code: 86632/86631 x2 CHLORIDE CL Day(s) Test Set Up: 2.5 ml blood (0.6 ml minimum), gold gel or green tube or 1 full microtainer mmol/l 4 hours Daily Page 7 2/19/2013

8 CPT Code: CHLORIDE - URINE RANDOM CLU 10 ml urine mmol/l CPT Code: CHLORIDE - URINE 24 HOUR CL24 Total collection, 24 hour urine Special Instructions: Refrigerate during collection. Provide starting date, time and ending date and time. Must be delivered to the laboratory within 24 hours of end of collection mmol/24 hr CPT Code: CHOLESTEROL CHOL 2.5 ml blood (0.6 ml minimum), gold gel or green tube or 1 full microtainer. Special Instructions: 8 hour fast preferred Adult: less than 200 mg/dl CPT Code: CHOLINESTERASE, PSEUDO CHOLIN 2.5 ml blood, gel tube U/L 3-5 days Day(s) Test Set Up: Monday - Friday CPT Code: CHROMOSOME ANALYSIS Chromosome Analysis, Banded, PHA - Stimulated Special Instructions: Common Indications: 6 ml whole blood, green top tube (10 ml size). Should be Na Heparin, not Li Heparin. Draw Monday - Thursday only. Do not refrigerate or Freeze. Requires patient age, sex and presumptive diagnosis. Previous family history of chromosomal abnormality, children with multiple congenital abnormalities, habitual abortions or infertility, mental retardation of undetermined origin, pre-term indications of Page 8 2/19/2013

9 CPT Code: abnormalities. Interpretive report provided with results 29 days CK-MB CPK MB 5.0 ml blood (1.0 ml minimum), gold gel or green tube or 2 full microtainers. Special Instructions: Centrifuge, remove serum and freeze ng/ml Male ng/ml Female CPT Code: Test Includes: CPK, CKMB, CK-MB Index CMV SEROLOGY Cytomegalovirus 5 ml blood, gel tube Special Instructions: Avoid hemolysis, very important See Report 3-5 days Day(s) Test Set Up: Tuesday-Saturday CPT Code: CMV-IGM SEROLOGY Cytomegalovirus - IGM 2.5 ml blood, gel tube See Report 3-5 days Day(s) Test Set Up: Tuesday-Saturday CPT Code: CO2 Carbon Dioxide 2.5 ml blood (0.6 ml minimum), gold gel or green tube or 1 full microtainer mmol/l CPT Code: COAGULATION FACTOR ASSAYS (see FACTOR) 2 FULL Blue top tubes: 4.5cc in large tube; 2.7cc in small tube See Report 2 days Page 9 2/19/2013

10 Days set up: Monday-Friday COCAINE SCREEN - URINE COCU 50 ml urine Special Instructions: Specimen volume for single test or combined with other drug screens. Special Instructions: Positives sent to reference lab for confirmation Negative if negative CPT Code: COCCIDIOIDES SEROLOGY COCAB 2.5 ml blood, gel tube Negative 2-3 days Day(s) Test Set Up: Tuesday,Thursday and Saturday CPT Code: COLD AGGLUTININS COLD AGG 10 ml blood, 2 small or 1 large lavender top tube Wrap in a heel warmer to deliver to laboratory. Special Instructions: Allow to clot at 37 C for one hour. Spin immediately and separate serum from cells. Pipette serum into plastic vial and store at room temperature. Negative 1 day CPT Code: COLONY COUNT Clean catch or catherized urine specimen collected in a sterile container or a gray-top urine transport tube. Routinely performed on urine cultures when organisms are present. COMPLEMENT, C-2 Special Instructions: Day(s) Test Set Up: 2.5mL ( minimum 1.5 ml)blood in red-top tube Separate serum within one hour of time drawn and refrigerate mg/dl 4-7 days Tuesday and Thursday Page 10 2/19/2013

11 CPT Code: _ COMPLEMENT, C ml (minimum 1.5 ml) blood, gel tube mg/dl Day(s) Test Set Up: Monday -Friday CPT Code: COMPLEMENT, C ml ( 1.5 ml minimum )blood, gel tube mg/dl Day(s) Test Set Up: Monday -Friday CPT Code: COMPLEMENT, TOTAL CH50 C50 5 ml blood (2.0 ml minimum), gel tube Special Instructions: Avoid hemolysis. Allow specimen to clot. Separate serum into a plastic tube and freeze sample within one hour of time drawn CAE Units 1-3 days Day(s) Test Set Up: Monday - Saturday CPT Code: CMP PROFILE Comprehensive Metabolic Profile 3.0 ml blood (0.8 ml minimum), gel tube, gold or green or 2 full microtainers. Special Instructions: Centrifuge. Store upright at room temperature, do not uncap vial. Reference Range : See individual tests CPT Code: Test Includes: BUN, Sodium, Potassium, Chloride, CO2, Calcuim Glucose, Creatinine, Protein, Albumin, Total Bilirubin, SGOT, SGPT, Alkaline Phosphatase (Calcualted: egfr, Anion Gap, Globulin) COOMBS, DIRECT DAT Page 11 2/19/2013

12 1 ml blood, lavender top tube or ½ lavender microtainer tube Negative 1 day CPT Code: COOMBS, INDIRECT IC 5 ml blood, lavender top tube or 1 full lavender microtainer tube. Negative 1 day CPT Code: COPPER COP 5.0mL blood in royal blue top trace metal tube ug/dl 2-3 days Day(s) Test Set Up: Monday - Friday CPT Code: COPPER - URINE 24 HOUR COP24 7ml aliquot of 24 hour urine collection Special Instructions: Preserve with 20 ml 6 N HCl prior to start of collection. See cautions regarding urine preservative in specimen collection section of this manual ug/l 2-5 days Day(s) Test Set Up: Tuesday -Saturday CPT Code: CORONARY RISK PROFILE CORRSK 3 ml, blood (0.8 ml minimum), gel tube, gold or green or 2 full microtainers. Special Instructions: Patient should be fasting 12 hours. See individual tests 4 day Days Test Set Up: Daily CPT Code: Test Includes : Cholesterol, Triglyceride, HDL, (Calculated: LDL, HDL/Total Ratio, Chol/HDL Ratio and VLDL) CORTISOL,SERUM CORTL Page 12 2/19/2013

13 2.5 ml blood, gel tube Special Instructions: AM preferred collection is 07:00 10:00 PM preferred collection is 16:00 20: ug/dl A.M. Draw ug/dl P.M. Draw 8 hours CPT Code: CORTISOL, FREE - URINE 24 HOUR CORTF 20mL aliquot of 24 hour urine collection Special Instructions: Refrigerate during collection See Report 2-3 days Day(s) Test Set Up: Monday - Saturday CPT Code: COXSACKIE B1-6 SEROLOGY COXB 5.0 ml blood, gel tube Less than 8-Serum Less than 2-CSF 2-4 days Day(s) Test Set Up: Monday,Wednesday and Friday CPT Code: x6 C-PEPTIDE REACTIVITY CPEP 2mL serum or heparinized plasma. (Red top, SST, or Green top tube) Special Instructions: 8 hour fast required. Centrifuge and transfer serum or plasma to plastic vial, freeze ng/ml 1-3 days Day(s) Test Set Up: Monday-Saturday CPT Code: CPK CK 2.5 ml blood (0.6 ml minimum), gold gel or green tube or 1 full microtainer IU/L CPT Code: Page 13 2/19/2013

14 CPK ISOENZYMES CKISO Test Includes: CPK, CPK-MM, CPK-MB, CPK-BB 5 ml blood, gel tube Interpretive report provided with results 2-5 days CPT Code: CREATININE CRE 2.5 ml blood (0.6 ml minimum), gold gel or green tube or 1 full microtainer mg/dl CPT Code: CREATININE - URINE RANDOM CREU 10 ml urine mg/dl CPT Code: CREATININE - URINE 24 HOUR CRE24 Total collection, 24 hour urine Special Instructions: Refrigerate during collection. Provide starting date/time and ending date/time. Male: mg/24hr Female: mg/24hr CPT Code: CREATININE CLEARANCE CRCL Test Includes: Special Instructions: Blood creatinine, urine creatinine in mg/dl, 24 hour urine creatinine, Creatinine clearance 2.5 ml blood, gel tube and total collection, 24 hour urine Refrigerate urine during collection. Provide starting date, time and ending date and time ml/min 4 hours Page 14 2/19/2013

15 CPT Code: CRP QUANTITATIVE C-Reactive Protein 2.5 ml blood (0.6 ml minimum), gold gel or green tube or 1 full microtainer mg/dl CPT Code: CRYOGLOBULINS CRYO 20 ml blood, plain red top tube. Wrap specimen in heel warmer until delivery to the laboratory. Special Instructions: Allow to clot at 37C for about one hour. Centrifuge and transfer serum to a plastic vial. Do not refrigerate. 10 ml preferred; 7 ml serum minimum Negative 4-7 Days CPT Code: CRYPTOCOCCAL ANTIGEN 1mL of CSF or 5mL blood,red gel tube Negative CPT Code: CRYSTALS, BODY FLUID CRYSTALS Test Includes: Crystals, Type At least 1 ml; Aspirate into sterile, heparinized syringe transferring to sterile container Special Instructions: Specify type of fluid Negative for Crystals Analytical time: 1 day Day(s) set up: Daily CPT code: CYCLOSPORINE CYC 2.5mL EDTA whole blood (1 ml minimum) ng/mL CPT Code: Page 15 2/19/2013

16 CYTOLOGY - GYN Pap Smear 1 or 2 slides (prefer 1) fixed with cytologic spray fixative or 95% alcohol bottle. Special Instructions: Label frosted end of slide with patient's full name using pencil Within normal limits. 10 days Day(s) Test Set Up: Monday - Friday CPT Code: CYTOLOGY - NON-GYN Fluids - Two 10 ml green top tubes Sputum - 4 oz. cup Urines - 4 oz. cup containing 50% alcohol Special Instructions: Fluids - Invert tubes 6-8 time to prevent clotting. Sputum - Deep cough specimens, avoid saliva. Urines - Add equal volume of urine to alcohol cup Negative for malignant cells 3-5 days Day(s) Test Set Up: Monday - Friday CPT Code: Page 16 2/19/2013

TEST NAME/ PSYCHE CODE COLLECTION GUIDELINES REFERENCE VALUES ROOM TEMP. REFRIGERATED FROZEN

TEST NAME/ PSYCHE CODE COLLECTION GUIDELINES REFERENCE VALUES ROOM TEMP. REFRIGERATED FROZEN Clinical Utility CA19-9 (CA-GI) 8 hours 48 hours UNDETERMINED CA 19-9 may be ordered along with other tests,