Activated Partial Thromboplastin Time (aptt)

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1 Activated Partial Thromboplastin Time (aptt) Order Name: PTT Test Number: REV DATE:12/26/2008 Activated Partial Thromboplastin Time (aptt) CLOT 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 immediately. If testing cannot be started within 4 hours of collection the specimen must be double spun then 1. 5 ml plasma aliquot from each tube into individual plastic aliquot tubes and freeze. Do not pool aliquots together! Specimen Stability: Un-Frozen specimens are only good for 4 hours. If the patient is on Heparin, Un-Frozen specimens are only good 2hrs. Testing Schedule: Daily Expected TAT: 1 Day Clinical Use: This test is most commonly used to monitor heparin therapy. It is also prolonged with deficiencies of clotting factors of the intrinsic system and the common pathway. Presence of antifactor antibodies, and other inhibitors may also be detected with this test. Cpt Code(s): 85730

2 Apolipoprotein E Order Name: APO E Test Number: REV DATE:12/8/2008 Apolipoprotein E PCR Preferred 5mL (3) EDTA Whole Blood EDTA (Lavender Top) Refrigerated Special This purple EDTA tube can not be shared with any other tests since it could lead to DNA contamination of the Instructions: sample. Keep specimen Refrigerated. Stability: Ambient: 3 days; Refrigerated: 1 week; Frozen: Unacceptable. Testing Schedule: Mon, Thr Expected TAT: 3-7 Days Clinical Use: This test is for cardiovascular risk assessment only. This test is not recommended for nonsymptomatic patients under 18 years of age. Cpt Code(s): 83890, 83898, 83896x2, 83912

3 Comprehensive Metabolic Panel Order Name: CHEM 14 Test Number: REV DATE:12/11/2008 Glucose Urea Nitrogen, Blood (BUN) Creatinine Sodium Potassium Serum/Plasma Chloride Bicarbonate Anion Gap Calculated Calcium Aspartate Transaminase (AST) Alanine Transaminase (ALT) Alkaline Phosphatase Bilirubin Total Albumin Protein Total Glomerular filtration rate Hexokinase Urease/GLDH KAP(Jaffe) ISE ISE ISE Enzymatic Calculation Arsenazo Enzymatic Enzymatic Enzymatic Jendrassik-Grof BCG Biuret Calc Preferred 1 ml (0.5) Plasma Lithium Heparin PST (Light Green Top) Refrigerated Alternate 1 ml (0.5) Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Special Specimen stability: Ambient 2 hours. Refrigerated 7 days. Instructions: Testing Schedule: Daily Expected TAT: 1-2 days Clinical Use: See detail tests. Notes: Reference range for GFR African American and non-african American Normal GFR: >60 ml/min. Moderately decreased GFR: ml/min. Severely decreased GFR: ml/min. Kidney failure (or Dialysis): <15 ml/min. Cpt Code(s): 80053

4 Creatinine Order Name: CREATININE Test Number: REV DATE:12/11/2008 Creatinine KAP(Jaffe) Preferred 1 ml (0.5) Plasma Lithium Heparin PST (Light Green Top) Refrigerated Alternate 1 ml (0.5) Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Special Specimen stability: Ambient 8 hours. Refrigerated 7 days. Instructions: Testing Schedule: Daily Expected TAT: 1-2 days Clinical Use: Useful for sensitive and quantitative measurement of renal function. A Glomerular Filtration Rate (GFR) is also provided. Notes: Reference range for GFR African American and non-african American Normal GFR: >60 ml/min. Moderately decreased GFR: ml/min. Severely decreased GFR: ml/min. Kidney failure (or Dialysis): ml/min. Cpt Code(s): 82565

5 Cryofibrinogen Order Name: CRYOFIBRIN Test Number: REV DATE:12/18/2008 Cryofibrinogen PRECIP Preferred 3mL (1mL) Plasma Sodium Citrate 3.2% (Blue Top) See Instructions Special Collect: Whole blood must be drawn in a pre-warmed (37 C) syringe and kept at 37 C. Immediately after Instructions: blood has been obtained, transfer specimen to a pre-warmed (37 C) 5 ml lt. blue (sodium citrate) tube and keep sample at 37 C. Specimen may be drawn directly into a pre-warmed collection tube and maintained at 37 C until centrifugation. Separate plasma from cells using a 37 C centrifuge, if possible. Stability: After separation from cells: Ambient: 1 week; Refrigerated: Unacceptable; Frozen: Unacceptable Remarks: Fasting specimen recommended. Do not refrigerate or freeze at any time. Proper collection and transport of specimen is critical to the outcome of the assay. Quantities less than 3 ml may affect the sensitivity of the assay. Testing Schedule: Sun-Sat Expected TAT: 4-5 days Cpt Code(s): 82585

6 D-Dimer, Quantitative Order Name: DDIMR QUAN Test Number: REV DATE:12/26/2008 D-Dimer, Quantitative LIA 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 immediately. If testing cannot be started within 4 hours of collection the specimen must be double spun then 1. 5 ml plasma aliquot from each tube into individual plastic aliquot tubes and freeze. Do not pool aliquots together! Testing Schedule: Daily Expected TAT: 1 Day Clinical Use: The D-Dimer test may be useful in the diagnosis of thrombosis, DIC, hyperfibrinolytic coagulopathies, and monitoring fibrinolytic therapy. The D-Dimer test is not subject to false positive results in the presence of heparin like the fibrin split products test. The D-Dimer may be decreased in patient on anticoagulant therapy. Cpt Code(s): 85379

7 Entamoeba histolytica Antibody (IgG), EIA Order Name: E HISTO AB Test Number: REV DATE:12/8/2008 Entamoeba histolytica Antibody (IgG), EIA ELISA Preferred 1 ml (0.2) Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated Special Allow specimen to clot at room temperature and then centrifuge. Separate serum from cells as soon as possible Instructions: and Freeze. (Stability: Room Temperature= 8 hours, Refrigerated= 5 days, Frozen= 1 month. ) Testing Schedule: Tues, Fri Expected TAT: 2-3 Days following set up Cpt Code(s): 86753

8 Estradiol, Serum (17 Beta-Estradiol, E2) Order Name: ULTR ESTRD Test Number: REV DATE:12/31/2008 Estradiol, Serum (17 Beta-Estradiol, E2) LC/MS/MS Preferred 2.5 ml (0.2) Serum Clot Activator (Red Top, No-Gel) Refrigerated Special Specify age and sex on test request form. Serum samples collected in SST clot tubes are not acceptable Instructions: specimen types. Testing Schedule: Mon - Sat Expected TAT: 3 Days Cpt Code(s): 82670

9 Fentanyl and Metabolite Quant, Urine Order Name: FENTANYL U Test Number: REV DATE:12/18/2008 Fentanyl and Metabolite Quant, Urine LC/MS/MS Preferred 4 ml (2) Urine, Random Sterile Screwtop Container Refrigerated Special Do not use any preservatives or additives. Instructions: Testing Schedule: Wed, Fri Expected TAT: 3-4 Days Clinical Use: Fentanyls are extensively used for anesthesia and analgesia. There are fentanyl transdermal patches available that are used in chronic pain management. Notes: This assay detects the quantity of Fentanyl and Norfentanyl. Cpt Code(s): 83925

10 Fibrinogen Order Name: FIBRINOGEN Test Number: REV DATE:12/26/2008 Fibrinogen CLOT 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 immediately. If testing cannot be started within 4 hours of collection the specimen must be double spun then 1. 5 ml plasma aliquot from each tube into individual plastic aliquot tubes and freeze. Do not pool aliquots together! Specimen Stability: Un-Frozen specimens are only good for 4 hours. Testing Schedule: Daily Expected TAT: 1 Day Clinical Use: Fibrinogen is increased in diabetes, pregnancy, and inflammatory states. It is decreased in DIC, fibrinolysis, and hereditary disease. Cpt Code(s): 85384

11 Hypercoagulation Analyzer Order Name: HYPRCOAGAN Test Number: REV DATE:12/17/2008 Hypercoagulation Analyzer Preferred 65 ml Whole Blood See Instructions See Instructions Special Please list the patient's anticoagulant. Instructions: Please Collect the following tubes: Fifteen (2. 7mL) 3. 2% Sodium Citrate (Blue Top) tubes, Two (4. 7mL) EDTA (Lavender Top) tubes, One (7mL) lithium heparin (green top) tube (on ice or frozen pour off aliquot) and One (10mL) Clot Activator SST (Red/Gray Top) tube. Tubes must be filled to the proper level, no hemolysis. Improperly filled tubes can give erroneous results. Whole blood must be transported to lab immediately. If submitting only Citrated plasma, plasma must be double spun and frozen in 1. 5 ml aliquots. Do not pool plasma from multiple tubes! Testing Schedule: Mon - Fri Expected TAT: Testing dependent Clinical Use: A comprehensive algorithm used to assess the cause of hypercoagulability. Notes: Algorithm begins with an Activated Protein C Resistance, Homocysteine, Lupus sensitive PTT, Prothrombin time (PT), Prothrombin Gene Mutation, and a Partical Thromboplastin Time (PTT). Further testing is generated based on the results of these tests. A pathology interpretation is included with all orders. 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.

12 Immature Platelet Fraction Order Name: IPF LEVEL Test Number: REV DATE:12/8/2008 Immature Platelet Fraction FC Preferred 4 ml (1) Whole Blood EDTA (Lavender Top) Room Temperature Testing Schedule: Daily Expected TAT: 1 Day Clinical Use: Measures immature platelet fraction (IPF) assisting with the diagnosis and treatment of altered platelet and red cell production. Cpt Code(s): 85055

13 Narcolepsy - HLA Typing Order Name: HLA NARCO Test Number: REV DATE:12/8/2008 Narcolepsy - HLA Typing Mol-HLA Preferred 5 ml (3) Whole Blood EDTA (Lavender Top) Room Temperature Special Specimen Stability: Instructions: Room temperature: 1 Week Refrigerated: 1 Week Frozen: Unacceptable Testing Schedule: Mon-Fri Expected TAT: Days Cpt Code(s): 83891, 83896x30, 83900, 83901x2, 83912

14 Neuron Specific Enolase (NSE) Order Name: NEUR ENOLS Test Number: REV DATE:12/12/2008 Neuron Specific Enolase (NSE) ELISA Preferred 1 ml (0.2) Serum Clot Activator (Red Top, No-Gel) Refrigerated Special NSE is high in platelets and RBC. Therefore, plasma and hemolyzed specimens are not acceptable. Serum Instructions: should be separated from cells immediately. Allow specimen to clot completely at room temperature. Separate serum from cells ASAP. Serum should be separated from cells immediately to avoid release of NSE from blood cells. Avoid repeated freeze/thaw cycles. Stability: Ambient: Unacceptable; Refrigerated: 24 hours; Frozen: 1 year Testing Schedule: Mon, Wed, Fri Expected TAT: 2-4 Days Cpt Code(s): 86316

15 Parasite Screen - Stool (Giardia, Cryptosporidium) Order Name: C PARA SC Test Number: REV DATE:12/4/2008 Parasite Screen - Stool (Giardia, Cryptosporidium) EIA Preferred 3 grams Stool, Random Formalin in Screwtop Container Room Temperature Special Stool in formalin screwtop container. Instructions: Testing Schedule: Sun-Sat Expected TAT: 1-3 Days Clinical Use: Testing includes specific antigen testing for for Giardia lamblia and Cryptosporidium sp. Cpt Code(s): 87328, 87329

16 Platelet Aggregation Profile Order Name: PLT AGG Test Number: REV DATE:12/10/2008 Platelet Aggregation, ADP Platelet Aggregation, Epinephrine Platelet Aggregation, Ristocetin AGG AGG AGG Preferred 9 ml Whole Blood Sodium Citrate 3.2% (Blue Top) Room Temperature Special Call RML Hematology Before Collection: (918) x Instructions: Specimens must reach RML main lab within 1 hour of collection and before 1pm. If you cannot arrange for specimens to arrive in this time frame Do Not Collect Specimen. It is preferred for a collection to be scheduled at the RML Main Laboratory Patient Service Center. Specimen should be unspun and kept at room temperature. Three 2. 7mL blue top tubes, must be filled to the proper level, no hemolysis. Improperly filled tubes can give erroneous results. Patient should refrain from aspirin, phenylbutazone, phenothiazines or antihistamines for 10 days prior to the test. Patient should have PLT count >75,000 for accuracy. Testing Schedule: Mon - Fri (First Shift Only) Expected TAT: 1 Day Clinical Use: Platelet aggregation studies are done to evaluate platelet function. This is a specialized test and would normally be performed in patients with some indicator of a qualitative platelet disorder. Cpt Code(s): 85576x3, 80500

17 Platelet Aggregation, Epinephrine Order Name: PLT AG EPI Test Number: REV DATE:12/2/2008 Platelet Aggregation, Epinephrine AGG Preferred 6 ml Whole Blood Sodium Citrate 3.2% (Blue Top) Room Temperature Special Tubes must reach RML main lab within 2 hours of collection and before 1pm. Instructions: Specimen should be unspun and kept at room temperature. Two 2. 7mL blue top tubes, must be filled to the proper level, no hemolysis. Improperly filled tubes can give erroneous results. Patient should refrain from aspirin, phenylbutazone, phenothiazines or antihistamines for 10 days prior to the test. Testing Schedule: Mon - Fri (First Shift Only) Expected TAT: 1 Day Clinical Use: Platelet aggregation studies are done to evaluate platelet function. This is a specialized test and would normally be performed in patients with some indicator of a qualitative platelet disorder. Cpt Code(s): 85576

18 Platelet Aggregation, Ristocetin Order Name: PLT AG RIS Test Number: REV DATE:12/2/2008 Platelet Aggregation, Ristocetin AGG Preferred 6 ml Whole Blood Sodium Citrate 3.2% (Blue Top) Room Temperature Special Tubes must reach RML main lab within 2 hours of collection and before 1pm. Instructions: Specimen should be unspun and kept at room temperature. Two 2. 7mL blue top tubes, must be filled to the proper level, no hemolysis. Improperly filled tubes can give erroneous results. Patient should refrain from aspirin, phenylbutazone, phenothiazines or antihistamines for 10 days prior to the test. Testing Schedule: Mon - Fri (First Shift Only) Expected TAT: 1 Day Clinical Use: Platelet aggregation studies are done to evaluate platelet function. This is a specialized test and would normally be performed in patients with some indicator of a qualitative platelet disorder. Cpt Code(s): 85576

19 Platelet Function Studies Order Name: PLT FUN Test Number: REV DATE:12/10/2008 Platelet Function, ADP Platelet Function, Epinephrine PFA PFA Preferred 6 ml Whole Blood Sodium Citrate 3.2% (Blue Top) Room Temperature Special Please write on request if patient is receiving aspirin. Two 2. 7 ml blue top. Specimen must be tested within 4 Instructions: hrs. of collection. Do not refrigerate! NOTE: If collected at a location other than the main lab, DO NOT Spin, Filter or Freeze specimens! Patient should have PLT > 150,000 and HCT > 35% for accuracy. Testing Schedule: Daily Expected TAT: 1 Day Clinical Use: Platelet function studies are done to evaluate platelet function. This is a specialized test and would normally be performed in patients with some indicator of a qualitative platelet disorder. Cpt Code(s): 85576x2

20 Prothrombin Time (PT) and INR Order Name: PT Test Number: REV DATE:12/26/2008 International Normalized Ratio (INR) Prothrombin Time CLOT CLOT 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 immediately. If testing cannot be started within 4 hours of collection the specimen must be double spun then 1. 5 ml plasma aliquot from each tube into individual plastic aliquot tubes and freeze. Do not pool aliquots together! Testing Schedule: Daily Expected TAT: 1 Day Clinical Use: This test is often used to monitor warfarin (coumadin) effect. It may also be used to screen for hemostatic dysfunction involving the extrinsic system as a result of liver disease, vitamin K deficiency, factor deficiency or DIC. Cpt Code(s): 85610

Basic Metabolic Panel

Basic Metabolic Panel Order Name: CHEM 8 Test Number: 2028100 REV DATE:2/5/2008 Glucose Urea Nitrogen, Blood (BUN) Creatinine Sodium Potassium Serum/Plasma Chloride Bicarbonate Calcium Anion Gap Calculated