Test Bulletin. Specimen Type. Preferred Volume. PCA3 PCA3TM Urine 2.5 ml KIT Frozen. URCTFR Urine 2.5 ml Urine Refrigerated

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1 Bulletin New Referral ing s Effective March January 1, Description Current New Specimen Type Preferred Volume Tube Type Temperature to Transport Notes/Comments Prostate Cancer Biomarker PCA3 PCA3TM Urine 2.5 ml KIT Frozen Kits are available from ACL Materials Management. Catecholamines Fractionated, Urine UCAT24 and URCAT URCTFR Urine 2.5 ml Urine Refrigerated This test can be performed on a random or 24 hour urine collection. osterone, Bioavailable and SHBG, Adult Male BTESTM TSSHMR Serum 2.0 ml Gold Gel Refrigerated Sample should be collected between 6 am and 10 am. Catecholamines Panel, Plasma PLCAT CTFPR Plasma 4.0 ml Two Green Sodium Heparin Refrigerated Patient should be calm and supine for 30 minutes prior to collection. Aldosterone ALDO ALDSR Serum 1.0 ml Gold Gel Frozen Renin Activity RENIN RENINR Plasma 2.0 ml EDTA Lavender Frozen Aldosterone Renin Activity Ratio ALDRN ALRENR Serum and EDTA Plasma 1.0 ml Serum and 2.0 ml Plasma Gold Gel and EDTA Lavender Frozen Both serum and EDTA plasma specimens must be submitted together. Autoimmune Dysautonomia Evaluation AUDYEV REF763 Serum 4.0 ml Plain Red Top Refrigerated The new test will add a new profile member for interpretation, and replaces NMO test reflexes. Referral Modifications Description Action Benzodiazepines Quantitation BNZCFB CPT code updated from to Propoxyphene Screen UPRPSC Current screen limit 200 ng/ml. New screen limit 300 ng/ml.

2 2017 CPT Changes ACL Description 2016 CPT (s) 2017 CPT (s) DMABUS Drug Abuse Panel Drug Management UEIA1 Drug 5 s w/benzo and Barb UEIA2 Drug Medical 9 s w/methadone UEIA2T Drug Medical 10 Panel UEIA4 Drug Medical 5 Panel UEIA7 Drug Medical 7 Panel UEIA8 10 Drug Medical Panel and Alcohol UDRPAN Sedative Hypnotic Panel TOXSU Drug Screen, Urine Basic DRUGU Drug Screen, Urine UCOMP Drug Screen Complete UDINV Drug Investigation DRUGSP Drug Screen Panel with Reflex MECONR Meconium Drug Panel with Reflex UMBDRG Drug Detection Panel, Umbilical Cord, Qualitative UDRUGC Urine Drug Prescription/OTC DRGED Drug Screen-POC TRICYC Tricyclic Antidepressant Detection UCTHC Cocaine and Cannabinoid Screen, Urine U6AMSC Heroin Metabolite Screen UAMPH Amphetamine Screen UBAR Barbiturates Screen UBNZ Benzodiazepine Screen UCOCA Cocaine Screen UMETH Methadone Screen UOPIA Opiate Screen UPCP Phencyclidine Screen UTHC THC Screen UETH Ethanol Urine (Alcohol) UMQSC Methaqualone Screen UOXY Oxycodone Screen UPRPSC Propoxyphene Screen UTHCSC Marijuana Metabolite Screen with Confirmation UXTCSC Ecstasy Screen UEGLUC Ethyl Glucuronide Screen, Urine

3 ACL Description 2016 CPT (s) 2017 CPT (s) UK2 Synthetic Cannabinoid Urine, Nonforensic ULSD LSD, Urine Screen UNICSC Nicotine Screen Urine GHBSER Gamma-Hydroxybutyric Acid, Serum GHBURN Gamma-Hydroxybutyric Acid, Urine RMEPNL Rapid Meningitis Encephalitis Panel x x Modifications to Alkaline Phosphatase Isoenzymes ( ALKISO) Effective Friday, December 30, 2016, Cleveland Clinic Laboratories made test modifications to Alkaline Phosphatase Isoenzymes ( ALKISO). The following three test components are no longer performed and will be reported as component is no longer available : Alkaline Phosphatase Bone (ALKBN) Alkaline Phosphatase Liver (ALKLVR) Alkaline Phosphatase Intestine (ALKINS) Two new test components are now available: Macrohepatic Isoenzyme Placental Isoenzyme 3

4 Pediatric Reference Ranges, Chemistry Effective Wednesday, January 18, 2017, the second group of chemistry related pediatric reference updates will be implemented. These changes are the result of the extensive review of age specific reference ranges of chemistry analytes that was done using one year of ACL generated data. The data was compared to a study done by Dr. Patti Jones, Director, Children s Medical Center Dallas, TX (who did an extensive pediatric reference range study using the same Siemens methodology, which ACL also uses). Several additional references were also utilized, including those from our vendors (Siemens and Beckman), publications from Clinical Chemistry and Clinical Biochemistry, the National Cholesterol Education Program (NCEP) Expert Panel on Cholesterol Levels in Children, and the Lipid Research Clinics Prevalence Study. Proposed reference ranges were determined and then reviewed by physician specialists within Aurora Health Care and Advocate Health Care. The first round of changes were made December 14, Refer to ACL s December 2016 Bulletin for details. The second round of changes are listed below. The final group of changes will be identified in the February 2017 Bulletin. C3 Name, Complement C3 0 up to 5 days up to 2 months C3 5 days up to 2 months months up to 1 year C3 2 months up to 3 months year up to 19 years C3 3 months up to 4 months years and up C3 4 months up to 5 months C3 5 months up to 6 months C3 6 months up to 10 months C3 10 months up to 1 year C3 1 year up to 2 years C3 2 years up to 3 years C3 3 years up to 6 years C3 6 years up to 9 years C3 9 years up to 10 years C3 10 years and up C4 Complement C4 0 up to 5 days up to 3 months C4 5 days up to 2 months months up to 19 years C4 2 months up to 3 months years and up C4 3 months up to 4 months C4 4 months up to 5 months C4 5 months up to 6 months C4 6 months up to 10 months C4 10 months up to 1 year C4 1 year up to 2 years

5 Name, C4 2 years up to 3 years C4 3 years up to 6 years C4 6 years up to 9 years C4 9 years up to 10 years C4 10 years and up CHOL Cholesterol 0 up to 18 years up to 20 years <170 CHOL 18 years and up years up to 25 years <190 CHOL 25 years and up <200 FT3 Free T3 pg/ml ALL up to 2 years FT3 2 years up to 13 years FT3 13 years up to 21 years FT3 21 years and up FT4 Free T4 ng/dl ALL up to 2 years FT4 2 years up to 13 years FT4 13 years up to 21 years FT4 21 years and up HAPT Haptoglobin ALL up to 1 month <197 HAPT 1 month up to 19 years HAPT 19 years and up HDL HDL Cholesterol ALL >39 0 up to 25 years >45 HDL 25 years and up >59 LDH Lactate Dehydrogenase /L ALL M: F: up to 1 month LDH 1 month up to 1 year LDH 1 year up to 3 years LDH 3 years up to 6 years LDH 6 years up to 14 years LDH 14 years and up M: F: LDL LDL Cholesterol ALL <130 0 up to 20 years <110 LDL 20 years up to 25 years <120 LDL 25 years and up <130 5

6 NH3 Name, Ammonia mcmol/l 0 up to 11 days up to 3 days NH3 11 days up to 2 years days up to 2 months NH3 2 years and up months up to 13 years NH3 13 years and up <34 NONHDL Non-HDL Cholesterol ALL [none] 0 to 20 years <120 NONHDL 20 years to 25 years <150 NONHDL 25 years and up [none] PAB Pre-Albumin 0 up to 45 days up to 1 month PAB 45 days up to 3 months month up to 6 months PAB 3 months up to 6 months months up to 4 years PAB 6 months up to 10 months years up to 6 years PAB 10 months up to 3 years years up to 19 years PAB 3 years up to 4 years years and up PAB 4 years up to 5 years PAB 5 years up to 10 years PAB 10 years up to 12 years PAB 12 years up to 14 years PAB 14 years up to 16 years PAB 16 years up to 18 years PAB 18 years and up PHOS Phosphorus 0 up to 4 months up to 5 days PHOS 4 months up to 1 year days up to 1 month PHOS 1 year up to 2 years month up to 2 months PHOS 2 years up to 16 years months up to 1 year PHOS 16 years and up year up to 4 years PHOS 4 years up to 7 years PHOS 7 years up to 12 years PHOS 12 years up to 14 years PHOS 14 years up to 16 years PHOS 16 years up to 20 years PHOS 20 years and up

7 T4 Name, Total T4 mcg/dl 0 up to 1 day up to 2 years T4 1 day up to 7 days years up to 13 years 6.8 to 12.5 T4 7 days up to 28 days years up to 21 years T4 28 days up to 1 year years and up T4 1 year up to 5 years T4 5 years up to 10 years T4 10 years up to 15 years T4 15 years and up TP Total Protein g/dl 0 up to 3 months up to 7 days TP 3 months up to 15 months days up to 8 months TP 15 months up to 3 years months up to 1 year TP 3 years and up year up to 3 years TP 3 years up to 15 years TP 15 years up to 18 years TP 18 years and up TRIG Triglycerides ALL <150 0 up to 10 years <75 TRIG 10 years up to 20 years <90 TRIG 20 years up to 25 years <115 TRIG 25 years and up <150 TSH Thyroid Stimulating Hormone mc/ml ALL up to 2 years TSH 2 years up to 13 years TSH 13 years up to 21 years TSH 21 years and up TT3 Total T3 ng/ml ALL up to 2 years TT3 2 years up to 13 years TT3 13 years up to 21 years TT3 21 years and up /17 MC 2441