October Courier Service on Holidays There will be no courier service Thursday, Dec. 24th, 2011.

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Phoebe Reynolds
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University of Washington October 2011 TEST CHANGE ACTH Aldosterone BCR/ABL by PCR, Qualitative Chlamydia trachomatis & N.gonorrhoeae, Amp.

Imipramine and Desipramine Iron, Liver, Tissue Neisseria gonorrhoeae, Amplified NA Potassium, Stool Quantiferon TB test Sodium, Stool Order Code Order Code CPT code Price Frequency Result comments

Hematopathology/Cytogenetics Requisitions: The Hematopathology requisition has been revised to allow ordering of comprehensive hematopathology testing on a single requisition, which now includes

Separate requisitions for cytogenetic testing or morphology are no longer required and are to be discouraged.

1 University of Washington October 2011 TEST CHANGE ACTH Aldosterone BCR/ABL by PCR, Qualitative Chlamydia trachomatis & N.gonorrhoeae, Amp. NA Creutzfeldt-Jakob, CSF Desipramine Doxepine and Nordoxepine, Serum Fluorescence Polarization, Amniotic Fluid Hemochromatosis DNA Screen Hepatitis C PCR Quantitative HIV-Type 2 RNA, Quantitative Imipramine and Desipramine Iron, Liver, Tissue Neisseria gonorrhoeae, Amplified NA Potassium, Stool Quantiferon TB test Sodium, Stool Order Code Order Code CPT code Price Frequency Result comments Ordering, Handling Ordering Courier Service on Holidays There will be no courier service Thursday, Dec. 24th, Hematopathology/Cytogenetics Requisitions: The Hematopathology requisition has been revised to allow ordering of comprehensive hematopathology testing on a single requisition, which now includes ordering information for morphology, flow cytometry, molecular hematopathogy, and cytogenetic testing. Separate requisitions for cytogenetic testing or morphology are no longer required and are to be discouraged. The hope is that the new unified requisition will reduce work for clients ordering testing and allow better coordination of testing once the laboratory receives the samples. To this end, processes are in place to facilitate accessioning, tracking and transport of materials between laboratories where testing is being performed to reduce errors and improve the quality of service. Test menus for each section have also been updated to incorporate a few new tests including a B-cell lymphoma panel by cytogenetics and MPL Exon 10 and KIT D816V mutation testing in molecular hematopathology. Specimen type has been included next to orderable tests for clarification of specimen requirements. The Hematopathology (morphology, flow, molecular, and cytogenetic) requisition can be accessed using the following link Requisition form for outside clients or found on the Laboratory Medicine website at: edu/labweb/divisions/hema/testforms.htm. Please feel free to contact Julie Sako, manager of the Hematopathology Laboratory with any comments or suggestions for continued improvement.

2 ACTH Old Test Order Code: Test Order Code: Aldosterone Old Test Order Code: Test Order Code: ACTH ACTHG1 RDOST RDOSTG BCR/ABL by PCR, Qualitative This test is recommended for initial diagnosis of chronic myelogenous leukemia (CML) and Ph+ acute lymphoblastic leukemia (ALL). The test detects the most common BCR/ABL breakpoints associated with the t(9;22)/philadelphia (Ph) chromosome and can distinguish between the p210 fusion(b3:a2, b2:a2 breakpoints) and the p190 fusion (e1:a2 breakpoint). RNA quality is verified by amplification of the normal beta-2 microglobulin (B2M) gene. For quantitative BCR-ABL testing, see CPHDQ (p210 breakpoints) and CMLQR (p190 breakpoint). We are changing our methodology for detection of the PCR product for our BCR/ABL, Qualitative test (CMLRNA). We are now using the new method capillary electrophoresis rather than gel electrophoresis. There is one CPT code change. CPT codes: 83891, 84311, 83898, 83902, 83900, 83901, 83909, Price: $ Test Order Code: CMLRNA Chlamydia trachomatis & Neisseria gonorrhoeae, Amplified NA Specimen Endocervical or urethral specimen: Collect : using the APTIMA Unisex Swab kit. Collect specimen with narrow-tipped APTIMA swab (labeled APTIMA Unisex Swab); place swab in APTIMA Swab transport tube. (Large swab labeled APTIMA Cleaning Swab is used only to remove excess cervical mucus before collecting specimen with small swab. Discard large swab after cleaning cervix.) Vagina: Collect vaginal specimen using the APTIMA Vaginal Swab Specimen Kit. NOTE: The test performance of vaginal swab specimens has not been evaluated in pregnant women or women less than 16 years of age. Throat: Collect throat/pharynx specimens using the APTIMA Vaginal Swab Specimen Kit. Anal: Collect anal/rectal specimens using the APTIMA Vaginal Swab Specimen Kit. Avoid collecting stool on the swab Urine: Collect first stream of first morning void. (The first portion contains the highest concentration of organisms.) Use disposable pipet in APTIMA urine collection kit to transfer 2 ml to the APTIMA tube, or submit 10 to 30 ml unpreserved urine in urine cup. Also acceptable: Wait at least 1 hour after last void, then collect first stream urine in urine cup. Unacceptable specimens: Frozen urine, unpreserved urine received >24 hours after collection, gel-based culture swab. Note: This testing is not intended for the evaluation of suspected sexual abuse or for other medico-legal indications. Test Order Codes: CHLAD, GCCAD, GCCTAD Creutzfeldt-Jakob, CSF Price: $85.88 Test Order Code: RCCJD 2 UW Laboratory Medicine October 2011

3 Desipramine Specimen : Specimen Transport: Unacceptable: Reference Range: 10 ml of blood in a red top tube. Spin and separate serum from cells within 2 hours of draw. Draw specimen immediately before next scheduled dose (min. 12 hours after last dose). 3 ml serum (min. 1.1 ml); Refrigerate. Gel separator tubes. M-Sat., results in 2 days. Therapeutic concentration: ng/ml Toxic concentration: > 500 ng/ml Note: Therapeutic ranges are for specimens drawn at trough (ie, immediately before next scheduled dose). Levels may be elevated in non-trough specimens. Test Order Code: RDESIG CPT Code: Price: $42.40 Doxepine and Nordoxepine, Serum Specimen : 10 ml of blood in a red top tube. Spin and separate serum from cells within 2 hours of draw. Draw specimen immediately before next scheduled dose (min. 12 hours after last dose). Specimen Transport: 3 ml serum (min. 1.1 ml); Refrigerate. Unacceptable: Gel separator tubes. M-Sat., results in 2 days. Reference Range: Therapeutic concentration: ng/ml Toxic concentration: > 500 ng/ml Note: Therapeutic ranges are for specimens drawn at trough (i.e., immediately before next scheduled dose). Levels may be elevated in non-trough specimens. Test Order Code: RDOXPG CPT Code: 80166, Price: $52.24 Fluorescence Polarization, Amniotic Fluid Daily, results same day Test Order Code: APOL Hemochromatosis DNA Screen Specimen : NOTE: Formalin-fixed paraffin-embedded tissues are not an acceptable specimen. For other specimen types contact the Genetics lab ( ) or the laboratory medicine resident on call. Test Order Code: HEMDNA Hepatitis C PCR Quantitative Reference Range: For all results reported as <12 (Very Low Positives) there is a new appended comment that reads: VERY LOW POSITIVE. HCV detected by the Abbott Real Time HCV PCR assay using primers specific for the 5 UTR. The quantity of virus is below the limit of detection (the minimum virus level that gives a positive result in 95% of replicates) is 12 IU/mL. The clinical significance of very low HCV level is uncertain and should be individualized. Test Order Code: HCVQNT HIV- Type 2 RNA, Quantitative Specimen : 10 ml blood in an EDTA tube. Specimen needs to be processed within 6 hours of draw. Centrifuge and transfer 3-4 ml plasma to a polypropylene tube. -70oC or colder. Specimen Transport: 3-4 ml plasma (min. 2 ml); Frozen. Weekly Reference Range: Not detected. Quantitative range of assay is ,000 HIV-2 RNA copies/ml plasma. Test Order Code: HIV2VL CPT Code: Price: $

4 Imipramine and Desipramine Specimen : 10 ml of blood in a red top tube. Spin and separate serum from cells within 2 hours of draw. Draw specimen immediately before next scheduled dose (min. 12 hours after last dose). Specimen Transport: 3 ml serum (min. 1.1 ml); Refrigerate. Unacceptable: Gel separator tubes. M-Sat., results in 2 days. Reference Range: Imipramine & Desipramine Total therapeutic concentration: ng/ml Total toxic concentration: > 1,00ng/mL Desipramine Only Therapeutic concentration: ng/ml Toxic concentration: > 500 ng/ml Note: Therapeutic ranges are for specimens drawn at trough (i.e., immediately before next scheduled dose). Levels may be elevated in non-trough specimens. Test Order Code: RIMRPG CPT Code: 80160, Price: $51.50 Iron, Liver, Tissue Note: This test measure liver iron stores. For hemochromatosis mutation testing see Hemochromatosis DNA Screen (HEMDNA). Test Order Code: RLTFE Potassium, Stool Specimen : 10 ml Random, fresh, liquid stool. Centrifuge and analyze liquid specimen within 2h. Otherwise, refrigerate up to 48 h. If specimen cannot be analyzed within 48 h, freeze at -20 o C. Testing can only be performed on stools sufficiently liquid to yield a fully aqueous supernatant after centrifugation. Specimen Transport: 10 ml liquid stool; Frozen. Unacceptable: Solid stool or 24 hour stool collections. Daily, STAT, 24 hours. Test Order Code: SK CPT Code: Price: $18.10 Quantiferon TB test Specimen : Use Quantiferon TB blood tubes and collect 1 ml blood in each tube: [one NIL (Grey cap), one TB Ag (Red cap), one MIT (Lavender cap)]. The black mark on the side of tubes indicates the 1 ml fill volume. Do not under or over-fill. Immediately after filling tubes, shake them 10 times to ensure that the entire inner surface of the tube has been coated with the blood. Attach labels so that volume of blood in the tube is visible to the receiving laboratory. Specimen Transport: 1 ml blood/each tube (min. 1 ml). Specimen must be incubated within 16 hours of blood draw. Specimen must arrive at Virology lab within this window. Call Laboratory Reference Services at to order supplies and coordinate specimen transport. The sample may have to be sent by courier directly to the Virology lab depending on collection time/ day of the week to arrive within 16 hours. An alternative method for outside labs is to place all 3 tubes upright in a 37 C incubator for hours at your site. After incubation, mark the tubes as INCUBATED and centrifuge at g for 15 min. Hold at 2-27 C. Incubated tubes must arrive at the Virology lab within 3 days after removing them from the incubator. Please provide clear documentation of incubation time period on both the blood tubes and requisition. Store blood collection tubes at 4 C to 25 C. Test Order Code: QFTB 4 UW Laboratory Medicine October 2011

Sodium, Stool Specimen : Specimen Transport: Unacceptable: Test Order Code: CPT Code: 84302 Price: $22.78 10 ml Random, fresh, liquid stool. Centrifuge and analyze liquid specimen within 2h.

5 Sodium, Stool Specimen : Specimen Transport: Unacceptable: Test Order Code: CPT Code: Price: $ ml Random, fresh, liquid stool. Centrifuge and analyze liquid specimen within 2h. Otherwise, refrigerate up to 48 h. If specimen cannot be analyzed within 48 h, freeze at -20 o C. Testing can only be performed on stools sufficiently liquid to yield a fully aqueous supernatant after centrifugation. 10 ml liquid stool; Frozen. Solid stool or 24 hour stool collections. Daily, STAT, 24 hours. SNA 5

Online Test Guide: http://byblos.labmed.washington.edu/bcard/search.

9198 Virology sletter: www.depts.washington.

6 Online Test Guide: Fee Schedule: Call Reference Lab Services at Virology sletter: CONTACT US: Tel: web: October 2011 Reference Lab Services University of Washington PO Box Seattle, WA Non-Profit Org. U.S. Postage PAID Seattle, WA Permit No. 62 address service requested

March Immunoglobulins, Total (IgA, IgE, IgG, IgM) Interleukin-6 (IL6) Protein Electrophoresis, CSF. Thyrotropin Receptor Antibody

March Immunoglobulins, Total (IgA, IgE, IgG, IgM) Interleukin-6 (IL6) Protein Electrophoresis, CSF. Thyrotropin Receptor Antibody University of Washington March 2012 TEST CHANGE Alpha 1-Antitrypsin Anti-IgE Receptor Antibody Anti-Mullerian Hormone Aquaporin-4 Receptor Antibody ColoSeq - Polyposis Complement testing, C3, C4 Everolimus