SHORE HEALTH LABORATORIES
TEST DIRECTORY
2015
Client Services
(410) 820-9355
(800) 666-3222
Shore Health Laboratories
219 S. Washington Street
Easton, MD 21601
410-822-1000
Dorchester General Hospital
300 Byrn Street
Cambridge, MD 21613
410-228-5511
Queen Anne Emergency Center Lab
115 Shoreway Drive
Queenstown, MD 21658
410-827-3900
OVERVIEW
Greetings from Easton! Here at Shore Health Laboratories, our technologists, office staff,
administrators, and pathologists are proud to have developed a local laboratory that provides
clinical services to hundreds of Delmarva's doctors and nurse practioners, and to many
insurance plans.
But we're not resting on our laurels. We know that our laboratory has to offer you the
highest quality results at the lowest cost to compete effectively with the national laboratories that
have been moving onto the Eastern Shore. And we want to continue to offer you that special
quality of service and sense of confidence that only a neighbor can provide.
I know that any of our highly trained and motivated staff would be glad to assist you in
any way they can. But I hope that you will also feel free to call on me personally, with any
question or problem you may have. It's no more than any neighbor should do.
Sincerely,
David B. Danner, M.D., Ph.D., F.C.A.P
Medical Director
410-924-2423
[email protected]
1
CONTENTS
PERSONNEL _______________________________________________________________________________ 4
POLICIES __________________________________________________________________________________ 5
SPECIMEN PACKAGING AND COURIER SERVICES ______________________________________________ 8
SPECIMEN COLLECTION AND PREPARATION __________________________________________________ 9
INSTRUCTIONS FOR COMPLETION OF ROUTINE REQUEST FORM _______________________________ 17
INSTRUCTIONS FOR COMPLETION OF CONSENT FORMS _______________________________________ 19
REQUESTS / REPORTING ___________________________________________________________________ 22
Outpatient Instructions for Scotch-Tape Preparation for Pinworms ________________________________ 23
Outpatient Instructions for Semen Collection___________________________________________________ 24
Semen Analysis Questionnaire ______________________________________________________________ 25
Outpatient Instructions for Collection of Sputum _______________________________________________ 26
SUPPLIES ________________________________________________________________________________ 27
CRITICAL VALUES ________________________________________________________________________ 29
Test Panels _______________________________________________________________________________ 31
Alphabetical Test Listing ____________________________________________________________________ 35
SPECIAL INSTRUCTIONS __________________________________________________________________ 240
Allergens ______________________________________________________________________________ 240
Amino Acid Disorders ___________________________________________________________________ 242
Catecholamine Fractionation _____________________________________________________________ 243
Coagulation Studies _____________________________________________________________________ 244
Biopsy Collection and Transport __________________________________________________________ 245
Hepatitis Clinical Interpretation Guide ______________________________________________________ 247
Human Immunodeficiency Virus Clinical Interpretive Guide ____________________________________ 248
IgG Subclasses Reference Values _________________________________________________________ 249
Lipids and Lipoproteins in Blood Plasma (Serum) ____________________________________________ 250
Cholesterol and Triglyceride Values in Serum Lipoprotein Fractions* ___________________________ 253
Metals Analysis — Collection and Transport ________________________________________________ 258
Microbiology Specimen Guide for Viral and Mycoplasma Specimens* ___________________________ 259
Parathyroid Hormone Assays _____________________________________________________________ 260
Pediatric Literature References ___________________________________________________________ 262
Porphyrinogens. Porphyrins, and Porphyrias ________________________________________________ 263
Renin- Aldosterone Studies_______________________________________________________________ 266
Stool Collections _______________________________________________________________________ 268
2
D-Xylose_______________________________________________________________________________ 269
PSA (PROSTATE SPEC AG), SCREEN NORMAL RANGE ______________________________________ 270
INDEX___________________________________________________________________________________ 271
APPENDIX _______________________________________________________________________________ 272
3
PERSONNEL
Consultants, Medical
David B. Danner, M.D., Ph.D.
Medical Director
Reinhardt Sahmel, M.D., Ph.D.
Associate Pathologist
Our consultants are available to
Shore Health Laboratories’ clients by calling 410-820-9355 or 800-666-3222
For Pathology call (410) 820-0019
Administration
Technical Specialists
Gary Shortall, BS, MT (ASCP), SM
Acting Administrative Director
Karen Bitter, BS, MT (ASCP)
Chemistry/Hematology
Gary Shortall, BS, MT (ASCP), SM
Laboratory Manager, MHE
Helen McQuay, BS, MT (ASCP), SM
Microbiology/Immunology
Kathy Davidson, BS, MT (ASCP)
Client Service Specialist
Patricia Schwaninger, MT (HEW)
Blood Bank
Lisa Lyons, BS, MT (ASCP)
Clinical Specialist
Quality Assurance and point of care
Bonnie Niebuhr, CT (ASCP)
Anatomic Pathology
4
POLICIES
Animal Specimens
We do not accept animal specimens for laboratory testing except by special arrangement.
Billing
Patient — If you elect to have Shore Health Laboratories bill your patients, please include the following necessary
billing information: patient birth date, sex, social security number, responsible party, complete address (including
zip code), and home phone number. Providing this information will avoid additional correspondence to your office
at some later date.
Insurance/Third Party — We provide direct third-party billing to the carriers listed below on our “BILLING
INFORMATION — QUICK REFERENCE GUIDE.” Fill in the appropriate insurance information on the requisition
required by that third-party payor on the list. A copy of the insurance card attached to the lab requisition form can
also be provided.
The patient’s birth date, sex, social security number, address, and diagnosis are required in addition to the
insurance information.
BILLING INFORMATION — QUICK REFERENCE GUIDE
AETNA: The employer’s name, subscriber’s name and social security number, group number and diagnosis are
essential.
BLUE CROSS/BLUE SHIELD: The diagnosis and subscriber number and group number are essential. The
subscriber name is needed if other than the patient. If carrier is Blue Cross from out of state, specify which state.
If Federal Blue Cross, give the FEP number. Provide “Plan Code,” if applicable. Subscriber number anything other
than Federal must have 3-letter prefix.
COMMERCIAL: The name of the insurance company, subscriber’s name, social security number, group number,
and relationship to patient are essential. Please include the subscriber’s employer’s name and address. If
applicable, the name of the union, local or teamster should be provided.
Address for insurance company is mandatory.
MEDICAL ASSISTANCE: The membership number (eleven digits) and diagnosis are required. Please verify the
validity of the number by checking the EVS 800-492-2134.
MEDICARE: The membership number is essential and should include a suffix (A, M, D, Cl, T). A UPIN will identify
each physician when we bill Medicare. If the patient has secondary insurance, please provide the insurance name
and policy number. A Medicare secondary payor form should accompany the requisition.
MA/MCO
PRIORITY PARTNERS-patient is insured with own policy number.
5
Cancellation of Tests
Cancellations received prior to test setup will be honored at no charge. Requests received following test setup
cannot be honored. A report will be issued automatically and charged appropriately.
Specimen Labeling
ALL specimens must be labeled with patient's FULL NAME and the lab requisition number. Nicknames are NOT
acceptable. Unlabelled specimens will not be tested.
Rejected Sample
The physician will be notified of any specimen rejection, and a request will be made to submit a new sample. A
written report will be sent with the reason for rejection. See below, “Unacceptable Specimens.”
Supplies
Mailing cartons, specimen vials, special specimen collection containers and kits, sterile vials, stool containers, and
request forms are provided without charge upon request. Other specimen containers are provided by the referring
laboratory. See p. 27, for a complete listing of supplies available.
Test Turnaround Time
This catalog lists the days on which the test is set up and the analytical time as a guide to expected turnaround
times. Repeated tests take additional time.
Unacceptable Specimens
Some specimens cannot be analyzed because of improper collection or degradation in transit. Other specimens
may have prolonged turnaround times because of lack of necessary ancillary specimens or patient information.
You will be notified of rejected or problem specimens upon receipt. To avoid specimen rejection, please use the
following checklist.
Are the following conditions correct? Please check the test catalog.
• Full 24 hours for timed urine collection
• Lack of hemolysis
• Patient information requested
• Patient/specimen properly identified
• pH of urine
• Specimen container (metal-free, separation gel, sterile, etc.)
• Specimen type (plasma, serum, whole blood, etc.)
• Specimen volume
• Temperature (ambient, refrigerated, frozen)
• Transport medium
6
GENERAL LABORATORY POLICY TITLE: IDENTIFICATION OF PATIENTS
Correct identification of the patient is critical for specimen collection. With this is mind, the following procedures
should be adhered to for collecting of samples.
A. Outpatient Samples
When approaching the patient with the appropriate orders, ask the patient to state their name and date
of birth. If name does not match requisition, do not collect sample until problem can be resolved. If patient
(usually small child) is unable to respond concerning name and date of birth, have responsible party
identify the patient before collecting the sample.
ANTIMICROBIAL SUSCEPTIBILITY TESTING POLICY
We routinely report susceptibility results on all organisms that have published interpretive standards for the
indicated source, unless the organism would not routinely be considered a pathogen for that source, or if the
organism is normal flora for the source. Some organisms do not routinely have susceptibilities reported due to
their predictable susceptibility. The standards we use are mandated by the College of American Pathologists and
agencies of the federal and state government, by whom we are accredited and licensed.
We will try to accommodate special cases, if advance notice is given along with the order for culture. When
requesting susceptibility testing on organisms that do not routinely have susceptibility reports, please write the
following on the requisition:
“ATTENTION MICRO – SPECIAL SUSCEPTIBILITY REQUEST”
Additionally, a phone call to the Micro Lab at ext. 5526 will enable us to discuss all of the testing options available.
Some organisms may not be viable in susceptibility test systems. Certain organisms may not have standardized
interpretative criteria and may need to be reported with a disclaimer statement.
7
SPECIMEN PACKAGING AND COURIER SERVICES
Ambient Specimens
Our standard mailing containers are designed to transport serum and urine specimens that do not require special
temperatures or handling. If you have any concerns regarding the effect of extreme weather conditions on routine
or refrigerated specimens, please call Client Services personnel.
Courier Services
It is important to pay particular attention to adequate packaging and handling to ensure constituent stability for the
required tests. Of critical importance are transport conditions that are too hot (summer) or too cold (winter).
If there is a major snowstorm on the Eastern Shore, Shore Health Laboratories will contact each physicians’ office
to check if they are closed, closing early, opened for regular hours, or what altered courier schedule is necessary.
Your patients and their lab studies are very important to us. Our employees are also important. So, in cases where
the safety of our drivers is in jeopardy, Shore Health Laboratories will contact the physicians’ offices with
instructions of what to do with specimens if the courier pickup is unavailable.
Exposure to Light
It is important to avoid exposing blood specimens for photosensitive analytes to artificial light or sunlight for any
length of time. Examples: vitamins A and B6, betacarotene, porphyrins, vitamin Ds, or vitamin B12. These
specimens are to be protected with an aluminum foil wrap or equivalent.
Frozen Specimens
Place specimen in plastic vials (not glass). Send each frozen vial not more than three-fourths full to allow for
expansion when frozen. Store in freezer or on dry ice until picked up by courier.
Please label each vial with the patient’s name, date, and type of specimen (EDTA plasma, serum, urine, etc).
Refrigerated (on coolant) Specimens
Place specimen in the refrigerator for storage before pickup by the courier. When packing for pickup, place
specimen (culture, tube, or urine cup) into ziplock portion of bag and the requisition form in the outer pouch. Place
coolant in transport bag (box) along with any specimens in a way so that there is not direct contact of the
specimens with the coolant. You may use some paper to separate the two.
NOTE: OSHA requires that all shipments containing clinical specimens be marked with a “Biohazard
Label.” Bags and labels for shipments sent to Shore Health Laboratories will be provided.
8
SPECIMEN COLLECTION AND PREPARATION
Laboratory test results are dependent on the quality of the specimen submitted. It is important that all specimens
and request slips be properly labeled with the name of the patient, collection date, and the origin (source) of the
sample, when applicable. Each container submitted must be tightly sealed with no external spillage.
If there is any doubt or question regarding the type of specimen that should be collected, it is imperative that our
Client Services be called to clarify the order and sample requirements.
To help ensure patient identification, every Shore Health Laboratories’ request slip has pre-numbered specimen
labels that provide unique patient identification.
Blood Collection
Most laboratory tests are performed on anticoagulated plasma, serum, or whole blood. In general, specimens
should be refrigerated until placed in the courier box for transport to the laboratory. Please see our individual test
directory section for specific requirements.
•
•
•
Plasma: Draw a sufficient amount of blood with the indicated anticoagulant to yield the necessary plasma
volume. Gently mix the blood collection tube by inverting six to ten times immediately after collection. If
required, separate plasma from cells by centrifugation within 20-30 minutes.
Serum: Draw a sufficient amount of blood to yield the necessary serum volume. Invert tube 5 to 10 times to
activate clotting. Allow blood to clot at room temperature for 30 minutes. Separate serum from clot by
centrifugation for 10 minutes. Caution: avoid hemolysis
Whole Blood: Draw a sufficient amount of blood with the indicated anticoagulant. Gently mix the blood
collection tube by inverting 6 to 10 times immediately after collection. Caution: Do not centrifuge and
separate tubes intended for whole blood analysis.
Centrifugation
Centrifugation should be performed at 1,000-1,300 Gs for 10 minutes. Tubes of plasma, blood, and serum are to
be kept closed at all times. This prevents possible exogenous contamination, evaporation, concentration changes,
or possible spillage and aerosols.
Fasting Specimens
An overnight fast is required for most fasting specimens. Some tests, however, particularly for lipids, triglycerides,
and lipoproteins, require further dietary restriction. For these tests, nothing should be eaten for 14 hours prior to
specimen collection. The evening before the specimen is drawn, the meal should contain no fatty foods or alcohol,
and the meal should be completed before 6 p.m.
Metals Collection
Avoid iodine-containing disinfectants and always cleanse arm with alcohol swab. Use only stainless steel
phlebotomy needles. Use only Monoject® trace element blood collection tubes as follows: product #8881-307006
for specimens that require serum no additive; product #8881-307022 for specimens that require whole blood
EDTA is additive. When multiple blood samples are to be collected from one patient, the trace metal specimens
should be collected first. Once the needle has punctured another stopper, it is contaminated and should not be
used for trace metal specimen collection.
—
•
—
Metal-Free Tubes: Special metal-free tubes are available for tests that indicate their use. They are the navyblue top Monoject® tubes. The standard Vacutainer® tubes contain metals in the stoppers. See p. 257,
“Metals Analysis, Collection and Transport.”
9
Microbiological Collection Containers Available
The following is a list of microbiological collection containers referred to in Shore Health Laboratories’ specimen
requirements:
Blood Collection Bottle Sets: Each set contains two bottles of a special media and atmosphere for culturing blood
specimens. The purple-labeled bottle contains lytic broth, which supplies an anaerobic atmosphere. The bluelabeled bottle contains tryptic soy broth, which supplies an aerobic atmosphere. (See Directions for Blood
Culture Collection on page 14)
Chlamydia trachomatis by Nucleic Acid Amplification (Genprobe® -Aptima®):
Genprobe Aptima Unisex Swab collection kit for female cervical and male urethral specimens. The special
swab provided in the transport package for specimen collection must be used. Follow the instructions on the
package for specimen procurement.
NOTE: Chlamydia trachomatis and Neisseria gonorrhoeae may be detected in cervical or urethral specimens
using a single sample.
Chlamydia/Ureaplasma/Mycoplasma/Viral Culture Transport Media:
This media must be stored in the refrigerator before & after inoculation. Bring Multimicrobe Media to room
temperature before inoculating. Collect the specimen using sterile non-wooden shafted swab.
Clean-Catch Urine Collection Kit: This is used for collection of urine for culture. The kit includes a sterile specimen
container, a container lip protector, a screw cap and protector, three castile soap towelettes, and a patient label
and instructions.
Influenza & Viral Transport Media: This media must be stored in refrigerator before and after inoculation. Inoculate
with specimen on a swab.
Mini-Tip Cultureswab: This is a smaller tip rayon swab on a flexible and extendable aluminum wire
with Amies clear transport medium. The suggested use for this mini-tip Cultureswab® is for culture of
urethral, nasopharyngeal and ocular areas. The directions for use are on the package.
Para-Pak® C&S Kit (Stool for Culture)
Para-Pak® vial contains modified Cary-Blair transport medium to insure survival of bacterial pathogens and
prevent over-growth of commensal organisms.
Gray Specimen Cup: Stool for C. difficile and Rotavirus
Para-Pak® PVA/Formalin (Stool for Ova & Parasites): The Para-Pak® kit consists of one vial containing Formalin
fixative and one vial of PVA fixative, to preserve stool for ova and parasites examination or Giardia and
Cryptosporidium Antigen assays.
Sputum Collection Container: This is a sterile container used for the collection and transport of sputum for culture.
Culture-swab Contains Amies clear transport medium that ensures organism viability. A sterile rayon swab is
included for specimen collection of culture.
Transgrow Media: This is a screw-top bottle containing GC media with trimethoprim. Keep bottle stored in
refrigerator until ready for use. Bring bottle to room temperature before inoculating with patient specimen. After
inoculation, keep specimen at room temperature.
Neisseria gonorrhoeae by Nucleic Acid Amplification (Genprobe®-Aptima®)
For female cervical and male urethral specimens.
See above – Chlamydia trachomatis by Nucleic Acid Amplification (Genprobe® -Aptima®):
NOTE: Chlamydia trachomatis and Neisseria gonorrhoeae may be detected in cervical or urethral specimens
using a single sample.
10
Specimen Collection Tubes Available
The following is a list of tubes referred to in Shore Health Laboratories’ specimen requirements:
Green-Top Tube (Sodium Heparin): This tube contains sodium heparin -used for the collection of heparinized
plasma or whole blood for special tests.
NOTE: After the tube has been filled with blood, immediately invert the tube several times in order to prevent
coagulation.
Grey-Top Tube (Potassium Oxalate/Sodium Fluoride): This tube contains potassium oxalate as an anticoagulant
and sodium fluoride as a preservative -used to preserve glucose in whole blood and for some special chemistry
tests.
NOTE: After the tube has been filled with blood, immediately invert the tube several times in order to prevent
coagulation.
Lavender-Top Tube (K2 EDTA): This tube contains K2 EDTA as an anticoagulant -used for most hematological
procedures.
NOTE: After the tube has been filled with blood, immediately invert the tube several times in order to prevent
coagulation.
Light Blue-Top Tube (Sodium Citrate): This tube contains sodium citrate as an anticoagulant -used for collection of
blood for coagulation studies, such as prothrombin times. 3.2% Na Citrate is preferred for accuracy of results.
NOTE: It is imperative that the tube be completely filled. The ratio of blood to anticoagulant is critical for valid
prothrombin time results. Immediately after draw, invert the tube 6 to 10 times in order to activate the
anticoagulant.
Pink-Top Tube (K2 EDTA): For Blood Bank specimens. This tube contains K2 EDTA as an anticoagulant. After
filling with blood, immediately invert tube several times to prevent clotting.
Royal Blue-Top Tube: There are two types of royal blue-top Monoject® tubes -one with the anticoagulant EDTA
and the other plain. These are used in the collection of whole blood or serum for trace element analysis. Refer to
the individual metals in the individual test listings to determine the tube type necessary.
Red-Top Tube: This tube is a plain Vacutainer® containing no anticoagulant -used for collection of serum for
selected chemistry tests as well as clotted blood for immunohematology.
Serum Separator Tube (SST): This tube contains a clot activator and serum gel separator — used for routine
chemistries.
NOTE: Invert the tube to activate the clotting; let stand for 20-30 minutes before centrifuging for 10 minutes. If
frozen serum is required, pour off serum into plastic vial and freeze. Do not freeze Vacutainer® tubes.
Special Collection Tubes: Some tests require specific tubes for proper analysis. Please contact Shore Health
Laboratories prior to patient draw to obtain the correct tubes for metal analysis or other tests as identified in the
individual test listings.
White or Pearl - Top Tube: PPT (Plasma Preparation tube) contains Potassium EDTA as the anticoagulant. This
tube is used for both HIV and Hepatitis C Viral Loads and phenotyping.
Yellow-Top Tube (ACD): This tube contains ACD Solution A or B—used for the collection of whole blood for
special tests.
11
Stool Specimen Collection Containers Available
24-Hour Stool: Special Metal containers for the collection and processing of fecal specimens are supplied by
Shore Health Laboratories. See p. 267, for further information regarding the use of these containers.
Urine Collection
Random Collections: For routine analysis and microscopic evaluation, have the patient void into a clean container.
The specimen should be capped, labeled, and refrigerated until courier pickup time. A clean-catch or midstream
specimen is preferred. The patient should first void a small amount of urine, which is discarded. Some of the urine
should then be collected in a clean container before voiding is completed.
24-Hour Urine Collections: Shore Health Laboratories provides 24-hour urine collection containers with various
types of preservatives depending on the test requested. Use the following procedure for the correct specimen
collection and preparation.
• Instruct the patient to discard the first morning specimen and to record the time of voiding.
• The patient should collect all subsequent voided urine for the remainder of the day and night.
• Collect the first morning specimen on day two at the same time as noted on day one.
• Send the entire 24-hour specimen to the laboratory. If only an aliquot is submitted, please mix well
before aliquoting and provide the total volume of the 24-hour urine collection. Include the height and weight
of the patient.
12
DIRECTIONS FOR BACTEC BLOOD CULTURE SPECIMEN COLLECTION
NOTE: 2-3 sets of blood cultures are routinely ordered and should be drawn ½ hour apart and from
separate sites unless otherwise specified by the physician.
Successful recovery of bacteria from a blood culture is highly dependent on collection of an adequate
volume of blood without overfilling the Bactec® bottles. Under-filling the bottles may cause bacteremia
to go undetected, and overfilling the bottles causes false positive readings on the Bactec® instrument.
Strictly aseptic technique must be followed throughout the collection procedure to avoid blood culture
contamination. Blood cultures should NEVER be collected through an IV catheter, whether it is a
newly inserted IV catheter or an established IV, unless simultaneous catheter and venous specimens
are being collected to investigate possible established IV line catheter-caused bloodstream infections.
Drawing blood from an IV catheter can significantly increase blood culture contamination with skin
organisms, even if the IV catheter is newly inserted.
SPECIMEN COLLECTION:
Maintain Aseptic Technique During All Aspects of Arm Preparation, Drawing the Blood, and Inoculation of the
Culture Bottles.
Skin Preparation of the Venipuncture Site
1.
Locate the vein to be used.
2.
Remove the ChloraPrep One-Step Frepp from kit and hold by center of handle in a horizontal
position with sponge surface downward. Gently squeeze wings, releasing solution for a
controlled flow. (Do not use Chloraprep
 One-Step FREPP on patients less than 2 months
of age. Substitute a sterile alcohol prep for the Chloraprep
 and follow directions below.)
3.
Press sponge against skin surface to be cleansed once or twice to saturate.
4.
Cleanse area thoroughly, scrubbing vigorously using a back- and- forth friction scrub ensuring the
solution reaches into the cracks and fissures of the skin for a full 30 seconds. Adequate skin
decontamination at the site of the venipuncture is the single most important factor in avoiding skinorganism contaminated blood cultures.
5.
Allow area to dry for approximately 30 seconds.
6.
Avoid touching the site of venipuncture. All site locating should be done prior to cleansing the
site. If it is absolutely necessary to touch the site after it has been cleansed, then your fingers
(gloved) need to be cleansed thoroughly with ANOTHER Frepp and allowed to dry before
touching the site.
13
Two options of Venipuncture methods for blood cultures:
Option 1 – Sterile Safety-Lok™ Blood Collection set (butterfly) with Pre-Attached Holder
(“Direct Draw”)
This method MUST NOT BE USED if…
•
Using a Peds-Plus® bottle for collection
Syringe collection is the only method that is reliable in determining if a sufficient
minimum blood volume is collected in the bottle
or
•
After inspecting the patient’s veins, difficulty in obtaining an adequate volume of blood is
anticipated.
The vacuum in the Bactec® bottles is very strong and may cause collapse of delicate
veins.
NOTES: Option 1 – Sterile Safety-Lok™ Blood Collection set (butterfly) with Pre-Attached Holder
(“Direct Draw”)
•
The vacuum in the bottles may exceed the maximum blood fill volume of the
Bactec® Bottles. The bottles must ALWAYS be marked prior to drawing the sample. The
blood volume being drawn must be closely monitored so that the optimum volume of
blood is drawn without exceeding the maximum fill volume.
•
The bottles must always be remain in an upright position to avoid back-flow of the
contents of the bottle into the patient’s arm
•
Closely observe the flow of the blood into the butterfly tubing and into the bottles when
starting the sample collection
NEVER draw blood directly into Bactec® bottles using a needle and tube holder, as the contents
of the bottle may backflow into the patient’s arm! Bottles must always be sitting upright during
specimen collection by using a Sterile Safety-Lok™ Blood Collection set (butterfly) with PreAttached Holder.
Preparation of Bactec® Bottles When Using Option 1 – Sterile Safety-Lok™ Blood Collection set (butterfly)
with Pre-Attached Holder (“Direct Draw”)
1.
Note the media fluid level of the un-inoculated Bactec® Culture bottles being used.
Mark the bottles at the maximum fill level so when monitoring volume during collection, the optimum
volume can be drawn without exceeding the maximum fill volume.
The optimum fill volume for Standard Aerobic, Lytic, and Plus Aerobic bottles
is 8-10 ml. for each bottle. Do not exceed bottle maximum fill volume of 10 ml. per bottle.
Note: Do not use bottles beyond the expiration date stamped on the bottle label.
2.
Remove the flip-off caps from the bottles and scrub the tops of the blood culture bottles with a sterile
70% Isopropyl alcohol pad and allow to dry. DO NOT USE IODINE TO DISINFECT TOPS OF
BOTTLES! (Iodine compromises the integrity of the rubber septa of the bottles.)
14
Venipuncture – Option 1 – Sterile Safety-Lok™ Blood Collection set (butterfly) with Pre-Attached Holder
(“Direct Draw”)
1.
Peel apart Safety-Lok™ Blood Collection set (butterfly) with Pre-Attached Holder and make sure that
butterfly luer and screw connections to tube holder are tight.
2.
Remove sheath covering needle at wings.
3
Perform venipuncture holding wings. Do not hold by grasping the yellow safety shield.
4.
Fill the aerobic bottle first. Be sure to hold bottle upright.
5.
Push and hold the holder over the top of the bottle to puncture bottle septum.
6.
Carefully observe the flow of the blood into the butterfly tubing and into the bottle when starting the
sample collection to ensure that blood is properly flowing into the bottle.
7.
Carefully monitor the blood volume collected in the bottle by means of the mark you made in bottle
preparation and the 5 ml. graduation marks on the bottle label.
8.
Collect blood to desired fill level.
9.
When desired fill level is achieved in aerobic bottle, remove holder from bottle and
push and hold holder on anaerobic bottle. Fill as directed below in a-d:
a.
immediately
Inoculate both a Standard 10 Aerobic/F Bottle (Blue/Blue Top) and a
Lytic/10 Anaerobic/F Bottle (Purple/Magenta Top) with 8-10 ml. of blood each.
b.
If unable to obtain 16-20 of patient's blood, a minimum of 10 cc may be divided equally
(5cc to each bottle) between the Standard 10 Aerobic/F and the Lytic/10 Anaerobic/F
bottles.
c.
If only 3-9cc of patient's blood can be obtained, place the entire amount in the
Standard 10 Aerobic/F (Blue) Bottle.
d.
(Note: On physician's request for use of Antimicrobial Removal Resins Bottles for Blood
Cultures, the Bactec® Plus Aerobic/F Bottle (Gray/Blue Top) should be substituted for
the Standard 10 Aerobic/F Bottle, and requires 3-10 cc of patient's blood per bottle)
10.
When final bottle is filled, withdraw the needle by grasping the wings (not the yellow safety
and gently pull. Cover the venipuncture site with sterile gauze and apply pressure.
device)
11.
Label bottles with patient name, location, date and time of draw and initials of phlebotomist, being
careful not to obliterate the bar code labels on the media bottles.
12.
The appropriately labeled bottles should then be left at room temperature and forwarded to
Microbiology as soon as possible. DO NOT PLACE BOTTLES IN INCUBATOR!
15
Option 2 - Syringe and Transfer Device
A syringe and transfer device MUST be used for collection if:
Using a Peds-Plus® bottle for collection
Syringe collection is the only method that is reliable in determining if a
minimum blood volume is collected in the bottle
•
•
sufficient
After inspecting the patient’s veins, difficulty in obtaining an adequate volume of blood is
anticipated.
The vacuum in the Bactec® bottles is very strong and may cause collapse of delicate
veins.
NOTES: Option 2-Syringe and Transfer Device
When using a syringe, pull back on plunger before use to break the seal, but DO NOT TOUCH
THE PART OF THE PLUNGER THAT GOES BACK INTO THE SYRINGE.
DO NOT TOUCH THE HUB OF THE SYRINGE OR THE ENDS OF THE LUER ADAPTORS Of The
BUTTERFLY, NEEDLE, or TRANSFER DEVICE.
Preparation of Bactec Bottles When Using Option 2 - Syringe and Transfer Device
1.
Scrub the tops of the blood culture bottles with a sterile 70% Isopropyl alcohol pad,
and allow to dry. DO NOT USE IODINE TO DISINFECT TOPS OF BOTTLES! (Iodine
compromises the integrity of the rubber septa of the bottles.)
Venipuncture – Option 2 – Syringe and Transfer Device
1.
Draw 16 cc to 20 cc of blood into a syringe and inoculate the Bactec® Bottles , using a Blood
Transfer safety device as follows:
Note: Do not use bottles beyond the expiration date stamped on the bottle label.
a.
Equally inoculate both a
Standard 10 Aerobic/F Bottle (Blue/Blue Top) and a
Lytic/10 Anaerobic/F Bottle (Purple/Magenta Top).
Fill the aerobic bottle first!
* Do not exceed bottles maximum fill volume of 10 ml. per bottle.
b.
If unable to obtain 16-20 of patient's blood, a minimum of 10 cc may be divided equally
(5cc to each bottle) between the Standard 10 Aerobic/F and the Lytic/10 Anaerobic/F
bottles.
* Do not exceed bottles' maximum fill volume of 10 cc per bottle.
c.
If only 3-9cc of patient's blood can be obtained, place the entire amount in the Standard
10 Aerobic/F (Blue) Bottle.
Do not exceed Bottle's maximum fill volume of 10 cc!
16
d.
If less than 3cc of patient's blood can be obtained, place a minimum of 0.5cc to 3.0 cc of
patient's blood in a:
_
Bactec® Peds Plus/F Bottle (Pink/Silver Top)
Do not exceed bottle's maximum fill volume of 5 ml.
e.
(Note: On physician's request for use of Antimicrobial Removal Resins Bottles for Blood
Cultures, the Bactec® Plus Aerobic/F Bottle (Gray/Blue Top) should be
substituted for the Standard 10 Aerobic/F Bottle, and requires 3-10 cc of
patient's blood per bottle)
Do not exceed bottle's maximum fill volume of 10 ml.!
2.
Label bottles with patient name, location, date and time of draw and initials of phlebotomist, being
careful not to obliterate the bar code labels on the media bottles.
3.
The appropriately labeled bottles should then be left at room temperature and forwarded to
Microbiology as soon as possible. DO NOT PLACE BOTTLES IN INCUBATOR!
INSTRUCTIONS FOR
COMPLETION OF ROUTINE REQUEST FORM
Please refer to the copy of the Laboratory Request Form, located in the Appendix, for the fields that correspond
to the following explanations.
1. Enter “DATE” and “PHYSICIAN” name.
2. Enter “PATIENT LAST NAME”; “JR, SR, III,” “FIRST NAME”, “MI”
Mark “SEX”-- many tests are sex-related.
Enter “SOCIAL SECURITY NUMBER” and “BIRTHDATE”- for patient identification.
Enter “DIAGNOSIS or ICD-9 CODE”--for billing. THIS IS MANDATORY
Enter “PATIENT ADDRESS”-- for the registration process.
3. Enter patient’s primary insurance in “INSURANCE#1” and enter “POLICY NUMBER, GROUP
NUMBER”. If the patient has secondary insurance, enter the information in “INSURANCE#2”
A COPY OF THE PATIENT’S INSURANCE CARD (FRONT&BACK) CAN BE PROVIDED IN LIEU
OF WRITING THIS INFORMATION.
Enter the Parent/Guarantor and relationship for all minors.
4. To order special handling of results:
a. STAT- Doctor or doctor on-call will be called when results are complete unless otherwise
documented.
b. Faxing- Provide FAX number
c. Call results.
d. Additional copies to other physicians. Please provide first and last name of physician.
5. Mark an “X” in the box preceding test(s) desired.
17
a. PROFILES: For quick reference, reverse side of request form has each defined and includes
specimens required.
b. BLOOD TESTS: Listed in alphabetical order, those not listed may be entered in the space
labeled “OTHER.” Listed tests are followed with a specimen collector code (example: “L” for
lavender tube).
c. CULTURES: Specimen collector and storage temperature are provided. Any culture not listed on
the request may be entered under “Miscellaneous” along with the source. Refer to the test
directory for appropriate collection directions or call Client Services.
6. Ordering a PAP requires a separate form from Chesapeake Pathology Associates. Please provide the
appropriate patient history.
7. After specimen collection, label samples with patient’s name, date, and affix a unique numbered label
from the request form. This number further ensures proper identification of the specimen(s).
8. Mark where specimen was collected along with time drawn. This will assist our Client Service
personnel in contacting the appropriate facility concerning questions about specimens.
18
INSTRUCTIONS FOR COMPLETION OF CONSENT FORMS
Shore Health Laboratories
Informed Consent and Agreement for HIV Testing Form
With my signature below, I acknowledge that I have read (or have had read to me) and understand the following
information.
Facts About HIV Testing
I HAVE BEEN TOLD THAT: (1) my blood will be tested for signs of an infection by the human immunodeficiency
virus, the virus that causes AIDS; (2) my consent to have my blood tested for HIV should be FREELY given; and
(3) every attempt will be made to keep the results of this test confidential, but that confidentiality cannot be
guaranteed.
What a NEGATIVE Result Means
A negative test means that the laboratory has not found evidence of HIV infection in my blood sample.
What a POSITIVE Result Means
A. A positive HIV test means that I have HIV infection and can spread the virus to others by having sex or by
sharing needles.
B. A positive HIV test DOES NOT mean that I have AIDS — other tests are needed.
C. If my test result is positive, I may experience emotional discomfort, and, if my test result becomes known to
the community, I may experience discrimination in work, personal relationships, and insurance.
What will be done for me if My Test is Positive?
A. I will be given a copy of the Department of Health and Mental Hygiene’s publication, “Directory of Counseling
and Referral Resources for HIV Seropositive Persons,” which contains information about medical, social,
psychological, and legal services that will be helpful to me.
B. I will be told how to keep from spreading my HIV infection by: (1) avoiding sexual intercourse, or practicing
SAFER sex; (2) not sharing drug needles — better still, getting off drugs; (3) not donating or selling my blood,
plasma, organs, or sperm; (4) avoiding pregnancy; and (5) not breast-feeding or donating breast milk.
C. Unless my test is performed at a designated anonymous test site approved by the Department of Health and
Mental Hygiene, my unique patient identifying number will be given to the local health department, and if I
have signs or symptoms of HIV infection, my name will be reported to the local health department to assist me
in obtaining services and help the health department understand and control the AIDS problem.
D. I know that my local health department or doctor may assist me in notifying and referring my partners for
medical services — without giving my name to my partners.
E. If I refuse to notify my partners, my doctor may either notify them or have the local health department do so. In
this case, my name will not be used. Maryland law requires that, when a local health department knows of my
partners, it must refer them for care, support, and treatment.
F. I have had a chance to have my questions about this test answered. My counselor has explained to me
about the use of a portion of my Social Security number in the unique patient identifying number and I have
indicated below whether or not a portion of my Social Security number can be used for this purpose.
YES, I allow the use of a portion of my Social Security number.
NO, I DO NOT allow the use of a portion of my Social Security number.
I hereby agree to have my blood drawn for an HIV test.
Name of Person Tested
Date
Signature of Patient or Authorized Substitute
19
Shore Health Laboratories
Consent to Use a Portion of the Social Security Number Form
I have been informed that some diagnostic test results must be reported to the local or state health
department for statistic analysis and/or monitoring.
A unique numbering system has been designated as an anonymous reporting mechanism for CD4
lymphocyte counts <200/mm3 in Maryland. This unique reporting number includes the last four numbers
of my Social Security number.
I understand that in using this number, my identification will be kept anonymous.
Please indicate which of the following statements you agree to by placing your initials on the line before
the statement.
_____ _________________
_______________________
I hereby give my consent for using the last four digits of my Social Security number for
reporting test results to the local or state health department.
I do not give my consent for using the last four numbers of my Social Security number for
reporting test results to the local or state health department.
Name and Date:
Signature:
______________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________
Witness and Date:
_________________________________________________________________________________________________________________________
Name of Physician:
________________________________________________________________________________________________________________________
20
Instructions to Generate a “Unique Identifier” Number
Maryland state law (COMAR 10.52.09) requiring laboratories to report confirmed HIV infections and CD4
3
lymphocyte counts <200/mm by “Unique Identifier” (U.I.) took effect June 1, 1994. Confirmed HIV infection is
indicated by a positive Western blot antibody test, a positive HIV antigen test, or a positive HIV culture confirmed
by either specific HIV antigen test or reverse transcriptase detection.
Each health-care provider is responsible for generating the 12 digits of the patient’s U.l. number as follows:
Example
• FIRST 4 NUMBERS
Last four digits of patient’s social security number
1234
• NEXT 6 NUMBERS
Six digits of patient’s birthdate (month, day, year)
(NOTE: Use 0 before single digit, i.e., if patient’s birthdate is January 12, 1972)
• NEXT-TO-LAST NUMBER
One digit for patient’s racial or ethnic group, i.e., if patient is Hispanic:
White, not Hispanic
African-American
Hispanic
Asian or Pacific Islander
Native American or Alaskan Native
Other
3
Use 1
Use 2
Use 3
Use 4
Use 5
Use 6
• LAST NUMBER
One digit for patient’s gender, i.e., if patient is female:
Male
Female
011272
2
Use 1
Use 2
Therefore, using the above criteria for a Hispanic female born January 12, 1972, the U.l. will be 123401127232.
NOTE: If particular information is unavailable, use 9.
In order to comply with this new state law, please write the U.I. in the “Other” section of the Shore Health
Laboratories’ request form when ordering HIV testing or CD4+ lymphocyte counts. If this information is incomplete
or missing, the laboratory will call for the U.I. number.
As a service to you, we have revised our “Human Immunodeficiency Virus (HIV) Consent Form” (p. 19) so that the
patient can give the physician permission to use his/her social security number to create the U.l. A second
consent form (p. 20) is available for use when CD4 testing is ordered.
21
REQUESTS / REPORTING
CPT Coding
It is your responsibility to determine the correct CPT Codes to use for billing. While this catalog lists CPT Code(s)
in an effort to provide some guidance, the CPT Codes listed only reflect our interpretation of CPT coding
requirements and are not necessarily correct. Particularly, in the case of a test involving several component tests,
this catalog attempts to provide a comprehensive list of the CPT Codes for all of the possible components of the
test. Only a subset of the component tests may be performed on your specimen. You should verify the accuracy of
the codes listed and, where multiple codes are listed, you should select the codes for the tests actually performed
on your specimen. SHORE HEALTH LABORATORIES ASSUMES NO RESPONSIBILITY FOR BILLING
ERRORS DUE TO RELIANCE ON THE CPT CODES LISTED IN THIS CATALOG. For further reference, please
consult the CPT Coding Manual published by the American Medical Association, and if you have any questions
regarding the use of a code, please contact your local Medicare carrier.
Interfering Substances
The most common interfering substances are listed on the specimen requirement column of the test listing. A
more comprehensive listing is available in Young DS: Effects of Drugs on Clinical Laboratory Tests; fourth edition.
Washington DC, AACC Press, 1995.
Request Slips
Specific test request forms are provided for: allergen-specific IgE antibodies, cytogenetics/AFP congenital
disorders, laboratory services, and pathology/dermatology/cytology. Additional clinical information is required on
the cytogenetics/AFP congenital disorders, and pathology/dermatology/cytology forms for diagnostic reasons.
Check () tests desired and provide all required information. Type or clearly print all information, always including
the patient’s age, sex and diagnosis code.
STAT Requests
Selected tests may be ordered on a “STAT” basis. Testing will be done in a timely manner, and results will be
called to the physician. Use the “Call Result Report” to aid in recording data as results are given over the phone.
Written follow-up reports will be sent.
Written Reports
The completed test report will be mailed, returned by courier, or transmitted via a teleprinter. Teleprinters are
provided to high-volume offices.
Critical Values and read-back policy
The physician, or other licensed care-giver, will be called if a critical value result is obtained on testing the patient’s
specimen. Verbal critical value results require confirmation by “readback” by the person receiving the results. The
printed test report will have the critical value results flagged. Critical values are listed on pages 29-30.
Reference Values
All reference values listed are for adult normals unless otherwise indicated.
22
Outpatient Instructions for Scotch-Tape Preparation for Pinworms
Items provided:
1 Slide container
2 Slides with clear cellophane-tape applied.
Instructions:
Avoid using powder or talc around rectal area the night before obtaining the specimen. Specimens should be
taken in the morning before bathing or going to the bathroom.
1. Using the glass slide with the clear cellophane-tape that you have been given, remove the tape from
the slide. With the sticky side of the tape outward, wrap the tape over one finger and touch the
perianal area (area around the rectum) with the tape. Do not touch the sticky side of the tape with
your fingers except on the ends where it is grasped.
2. Replace the tape smoothly and firmly onto the slide with the sticky side down against the slide, making
sure there are no bubbles in the tape.
3. Wash your hands thoroughly; dry.
4. Replace the slides in the slide container. Label with the patient's name and return it to the nearest
Shore Health Laboratories draw site location.
5. These slides are stable and do not need special handling.
Note: Your physician may order this test for three (3) consecutive mornings. DO NOT COLLECT ALL THE
SPECIMENS AT THE SAME TIME. COLLECT ONE EACH MORNING FOR THREE (3) MORNINGS.
23
Outpatient Instructions for Semen Collection
Items provided:
Clean wide-mouth screw-top plastic or glass jar.
NOTE:
•
•
•
•
•
•
•
Semen analysis is performed in the hospital laboratory Monday - Friday from 7 a.m. - 11 a.m. Specimens
are not accepted on weekends or holidays.
The complete analysis involves several hours of work; therefore specimens should be delivered to the lab
early in the morning.
Semen is best collected by masturbation after a three (3) day period of abstinence from intercourse or
masturbation. The sample may be collected at home or in a bathroom close to the laboratory.
Do not abstain more than 4 days because this diminishes the quality of the semen and the motility of the
sperm. However, if your doctor has given you specific instructions in this regard, his orders should be
followed.
Coitus interruptus (early withdrawal during intercourse) is unacceptable. The first ejaculate, that contains
the majority of spermatozoa, may be lost.
The semen must be ejaculated into the clean, dry, wide-mouth jar given to you by the laboratory or your
doctor to avoid introducing trace amounts of detergent or other harmful contaminants into the specimen.
A condom is unacceptable because many contain a spermicide, and it is impossible to retrieve the entire
sample for analysis.
Instructions
1. Do not use any lubricant during collection.
2. After ejaculating the entire specimen into the container, replace the lid and secure it tightly.
3. Wash hands thoroughly, dry.
4. Label the container with your name and the time of collection.
5. If the specimen is collected away from the lab, bring to the lab as quickly as possible and keep
close to body temperature by placing the jar inside your shirt during transport.
6. The specimen must be received in the lab within 30 minutes of collection.
7. Patients collecting semen samples for fertility testing are required to fill out a questionnaire. See
next page.
24
Semen Analysis Questionnaire
DEAR PATIENT:
IN ORDER TO ACCURATELY EVALUATE YOUR SEMEN SAMPLE, WE REQUIRE THE FOLLOWING
INFORMATION: BE TRUTHFUL!!!
ALL INFORMATION OBTAINED IS CONFIDENTIAL.
PLEASE PRINT
NAME:(LAST)______________________(FIRST)________________
DATE OF SPECIMEN COLLECTION:_______________
TIME OF SPECIMEN COLLECTION:_______________
TYPE OF CONTAINER USED:
GLASS
PLASTIC
OTHER ______________
WHERE WAS THE SPECIMEN COLLECTED ?
AT HOSPITAL
AT HOME
IF THE SAMPLE WAS TRANSPORTED TO THE HOSPITAL, WAS IT
KEPT WARM ?
YES
NO
DAYS SINCE LAST EJACULATION:
1
2
3
4
5
GREATER THAN 6
HOW WAS THE SPECIMEN COLLECTED ?
MASTURBATION
OTHER METHOD
WAS THE COMPLETE SAMPLE COLLECTED IN THE CONTAINER?
YES
NO - EXPLAIN BELOW
____________________________________________________________
____________________________________________________________
I
25
Outpatient Instructions for Collection of Sputum
Items provided:
Sterile specimen cup
Instructions:
1. It is preferable that sputum be collected in the morning, shortly after arising and before breakfast.
2. Blow your nose prior to the collection of the sputum.
3. Sputum should be collected by means of a deep chest cough in the container provided. Saliva or "spit"
is not acceptable.
4. Please tighten the specimen lid securely. Label the container with your name and the date and time of
collection. Please place the label on the container NOT the container lid.
5. Deliver the sputum sample to the nearest Shore Health Laboratories draw site location as soon as
possible after collection.
6. Do not expose the specimen to extreme temperatures.
26
SUPPLIES
The following supplies are available through our packaging area. Please use our special supply requisition form
when ordering.
Bags
Small Transport (Individual with Pouch)
Large Transport (Clear)
Blood Collection (Specify Box of 100 each)
Blue (Citrate)
Red (Plain)
Grey (Fluoride)
Royal Blue (EDTA)
Dark Green (Na heparin)
Royal Blue (No Additive)
Light Green (Li Heparin)
Serum Separator Tube (SST)
Lavender (K2 EDTA)
White / Pearl (Potassium EDTA)
Pink (EDTA)
Yellow Jungle (Ascorbic Acid)
Yellow (ACD)
Centrifuge
Provided if Necessary (Back-up Centrifuge and Service as Needed)
Cytology/Histology
Plastic Slide mailers (50)
Cytology Brushes (Bag of 25)
Cytology Fixatives Body fluid & FNA’s
Alcohol filled slide containers
Cyto Scrapers-plastic (Package of 25)
Cytobrooms (bag of 25)
Cytolyte Filled Containers For FNA
Thin Prep Vials for PAP
10% Formalin Jar (20 & 60 ml)
Frosted End Slides (Box)
Rubber Bands (Bunch)
Forms
Allergen (Individual Tests and Panels) Request Form
Call Result Forms
Chesapeake Pathology Request Form
Client Supply Requisition
Cytogenetics/AFP Congenital Disorders Request Form
Laboratory Services Request Form
Instructional Pamphlets for Patients
A series of informational pamphlets are available for patient use and can be ordered on the “Client Supply
Requisition” form. These are intended to aid in patient preparation and in the collection of proper specimens by
giving explanations and instructions. These pamphlets are as follows:
Laboratory Outpatient Instructions for Collection of Clean-Caught Midstream Urine for Culture
Laboratory Outpatient Instructions for Pediatric Urine Collections
Laboratory Outpatient Instructions for Scotch-Tape Preparation for Pinworms
Laboratory Outpatient Instructions for Semen Collection
Laboratory Outpatient Instructions for Sputum Collection
Laboratory Outpatient Instructions for Stool for Ova & Parasites, Stool Culture, Clostridium difficile & Rotavirus
Laboratory Outpatient Instructions for Urine Cytology
Patient Instructions for 24-Hour Urine Collection
Patient Preparation for Glucose Tolerance Test
Understanding Your Laboratory Tests — Bacterial/Viral Serology
27
Kits or Vials for Special Tests
Digene® Specimen Collection Kit
Digene® Specimen Transport Medium
Metal-Free Vacutainer® Tubes (Royal Blue Top) with and without EDTA
ParaPak PVA/Formalin for Ova& Parasites® Kit
ParaPak C&S for stool culture® Kit
ParaPak Triple Pak for Stool culture and Ova & Parasite ordered together
Serotonin Tubes
Microbiology
Blood Culture Bottle (Set of 2)
Chlamydia trachomatis — Genprobe® Aptima® Unisex Swab Collection kits (Each)
Influenza Viral Transport Tube (Each) — Store Refrigerated
Mini-Tip Cultureswab® (Each)
Multi-Microbe (Viral/Ureaplasma/Mycoplasma/Chlamydia/Herpes)
Culture tube (each). Store refrigerated.
Neisseria gonorrhoae - Genprobe® Aptima® Unisex Swab Collection kits (Each)
Pertussis Collection Kit (Each)
Sterile Cup (Each)
Culture swab Plus® (Each)
Transgrow® (Each) — Store Refrigerated
Miscellaneous
Bags, ERA Tissue Specimen
Bags, Refrigerate (6 x 6)
Bags, Routine (6 x 6)
Colcemid
Solution and a Bottle Containing 40 ml of KCI
Solution
Container, Serum Vial (4 ml)
Container, Serum Vial (8 ml)
Container, Sterile Vial
Container, Stool, Random, Small
Container, Stool, Timed, Each
Glucose Tolerance Beverage, 75 mg (Non-Pregnant Adults)
Glucose Tolerance Beverage, 50 mg (OB Glucose Challenge)
Glucose Tolerance Beverage, 100 mg (Pregnant Female)
Interpretive Handbook
Other Items as Requested in Order to Obtain Proper Specimen
Needles
Needle Box, Large (Each)
Needle Box, Medium (Each)
Needle Box, Small (Each)
Syringe, 12 cc (Each)
Syringe Needles, 21 g x 1 1/2” (Each)
Vacutainer®, 21 g x 1” (Box of 100)
Vacutainer® Holder (Each)
Urine Collection
24-Hour Urine Container (Each — Call if Preservative is needed)
Non-Sterile Cups (Package of 20)
Pediatric (Each)
Sterile Clean Catch Kit (Each)
28
CRITICAL
VALUES
CRITICAL VALUE
SHORE HEALTH SYSTEM LABORATORIES
DR. _____________________ DATE: __________
NOTIFICATION
PATIENT’S NAME: __________________________
BIRTHDATE: _________ / _________ / _________
TEST NAME: _____________________________
CALLED TO: ______________________
CALLED BY: ______________________
DATE: _____________ TIME: ________
TECH: _________ COLLECTION TIME: __________
TEST
ACETAMINOPHEN
BILIRUBIN, NEONATAL
BUN
CALCIUM
CALCIUM, IONIZED
CARBAMAZEPINE
CHLORIDE
CO2
CREATININE
DIGOXIN
DILANTIN
FIBRINOGEN
GENTAMICIN,TROUGH
GENTAMICIN, PEAK
GLUCOSE
GLUCOSE, CSF
HEMATOCRIT
HEMOGLOBIN
LACTIC ACID
LIDOCAINE
LITHIUM
AGE
ALL
0 DAYS OLD
2 DAYS OLD
3-6 DAYS OLD
7-21 DAYS OLD
CHILD
20 YRS - ADULT
ALL
ALL
ALL
0 DAYS-17 YRS.
18 YRS. - ADULT
ALL
0 DAYS-18 YRS
19 YRS-ADULT
ALL
ALL
ALL
ALL
ALL
NEWBORN (07DAYS)
CHILD
18 YRS-ADULT
ALL
CHILD
16 YRS OLDADULT
CHILD
16 YRS OLDADULT
CHILD
18 YRS-ADULT
ALL
ALL
PATIENT
RESULT
CRITICAL
LOW
<6.6
<3.3
<77
<75
<11
CRITICAL
HIGH
>150
>8.0
>13.0
>15.0
>20.0
>70
>104
>12.9
>6.2
>20
>121
>126
>40
>3.8
>7.4
>2.5
>30.0
<100
<32
<46
<46
<37
<20
<18.0
<6.9
<6.6
>3.0
>12.0
>328
>445
>484
>20.0
>4.1
>2.9
>7.1
>1.5
29
TEST
MAGNESIUM
OSMOLALITY
PHENOBARBITAL
PHOSPHORUS
PLATELETS
POTASSIUM
PT/INR
PTT
SALICYLATE
SODIUM
THEOPHYLLINE
TROPONIN
URIC ACID
VALPROIC ACID
VANCOMYCIN, TROUGH
VANCOMYCIN, PEAK
WBC
CSF SMEAR OR CULTURE
BLOOD CULTURE
MALARIA SMEAR
INFANT CULTURE
AGE
CHILD
19 YRS-ADULT
0 DAYS-17 YRS
18 YRS-ADULT
ALL
CHILD
16 YRS.-ADULT
0 DAYS-17 YRS.
17 YRS-ADULT
NEWBORN
(<1MONTH)
CHILD
16 YRS -ADULT
ALL
ALL
ALL
CHILD
16 YRS -ADULT
ALL
18 YRS – ADULT
ALL
ALL
ALL
ALL
CHILD
18 YRS OLDADULT
ALL
ALL
ALL
NEWBORN
(UP TO 1 Y/OLD)
PATIENT
RESULT
CRITICAL
LOW
CRITICAL
HIGH
<1.1
<1.0
<253
<250
>4.3
>4.9
>317
>326
>60
>8.9
>8.9
>916,000
<1.3
<1.2
<53,000
<30,000
<2.8
<2.8
<2.8
>7.8
<2,000
<2,000
>6.4
>6.2
>5.0
>90
>30
>156
>158
>25.0
>0.5
>13.0
>200
>20.0
>80.0
>30,000
>40,000
BACTERIA
BACTERIA
SEEN
SEEN
<121
<120
POSITIVE
STAPH
OR GROUP
AUREUS
B STREP
30
TEST PANELS
ARTHRITIS PANEL
No longer available. Please order individual tests as needed.
LIPID PANEL
Cholesterol
HDL
Triglycerides
Cholesterol HDL Ratio
LDL-Calculated, VLDL-Calculated
NOTE: For specific lipoprotein fractionation, see “Lipoprotein Profile, Serum.”
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 2.0 ml of serum) from a fasting patient. Draw specimen following
an overnight (12-14 hour) fast. Patient must not consume any alcohol for 24 hours before
the specimen is drawn. Centrifuge SST 30 minutes after draw. Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See individual test listings.
2 days
Daily
80061
ACUTE HEPATITIS PROFILE
Hepatitis A Antibody, IgM (Anti-HAV IgM)
Hepatitis Bc Antibody, IgM (Anti-HBc lgM)
Hepatitis Bs Antigen (HBsAg)
Hepatitis C Antibody (Anti-HCV)
Test Performed At:
Dorchester General Hospital Lab
Specimen:
1 SST tube (minimum: 3.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
NOTE: 1. If collecting blood for other tests also, obtain a separate tube dedicated for this profile.
2. Collection date is required on request form for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See individual test listings.
2 days
Monday - Friday
80074
LUPUS (SLE) ANALYSIS
Antibodies to Extractable Nuclear antigens, antinuclear antibodies, ANA (Hep-2 Substrate), Double
Stranded (ds-DNA) Antibody, RNP, Smith AB, C4, SCL 70, TPO, Mitochondrial AB, Paratiel Cell AB, Actin,
Striated Muscle AB
Test Performed At:
LabCorp
Specimen:
3 SST tubes (minimum: 5.0 ml of serum). Centrifuge SST 30 minutes after draw.
31
Refrigerate specimen.
NOTE: 1. If collecting blood for other tests also, obtain a separate tube dedicated for this profile.
2. Collection date is required on request form for processing.
Reference Values: See individual test listings.
Analytic Time:
3-5 days
Day(s) Test Set Up: Monday - Saturday
CPT Code(s): 86235x5
86376
86225x2
86038
83516x3
86160
NMR LIPOPROTEIN PROFILE, SERUM (WITH IR MARKERS)
Ultracentrifugation, Electrophoresis, and Quantitation recommended for determining existence and type of
dyslipoproteinemia. Includes total cholesterol, total triglycerides, and quantitation of cholesterol and triglycerides
in VLDL, beta-LDL,, alpha-1 HDL, Lp(a), and any other significant lipoprotein fraction.
Test Performed At:
LabCorp
Specimen:
1 plain, red-top tube or NMR Lipotube (2.0 ml of serum). Draw specimen following
an overnight (12-14 hour) fast. Patient must not consume any alcohol for 24 hours
before the specimen is drawn.
Refrigerate specimen.
NOTE: Patient’s age and sex are required on request form for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See individual test listings.
7 days
Monday - Saturday
80061
83704
HEPATIC FUNCTION PANEL
Total Protein
Albumin
Globulin
A/G Ratio
ALT (SGPT)
AST (SGOT)
Alkaline Phosphatase
Bilirubin, Total & Direct
Test Performed At: Shore Health Laboratories
Specimen:
1 SST tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Globulin: Female 1.8-3.5 g/dl
Male: 1.9-3.5 g/dl
See individual test listings for other reference values.
Analytic time:
1 day
Day(s) Test Set Up: Daily
CPT Code(s):
80076
32
BASIC METABOLIC PANEL
Creatinine
Potassium
BUN
Carbon Dioxide
Glucose
Calcium
Sodium
Chloride
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes after
draw. Refrigerate specimen after collection.
Reference Values:
Analytic time:
Day(s) Test Set Up:
CPT Code(s):
See individual test listings for reference values.
1 day
Daily
80048
COMPREHENSIVE METABOLIC PANEL
Albumin
Creatinine
Alkaline Phosphatase
Glucose
AST (SGOT)
Bilirubin, Total
Potassium
BUN
Protein, Total
Calcium
Sodium
ALT (SGPT)
Carbon Dioxide
Chloride
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum: 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See individual test listings for other reference values.
1 day
Daily
80053
RENAL FUNCTION PANEL
BUN
Glucose
Calcium
Carbon Dioxide
Chloride
Creatinine
Albumin
Phosphorus
Potassium
Sodium
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See individual test listing
1 day
Daily
80069
33
MULTIPLE SCLEROSIS (MS) PANEL
Cerebrospinal Fluid (CSF) IgG Index
Oligoclonal Banding
Test Performed At:
Specimen
Serum:
CSF:
LabCorp
Both serum and CSF are required for this test. Specimens must be drawn at same
time.
1 plain, red-top tube or 1 SST tube (minimum 2.0 ml serum):
2 pouroffs - #1=1.5 ml, #2=0.5 ml)
Centrifuge 30 minutes after draw. Refrigerate.
1 plain red-top tube (minimum 1.5 ml of CSF).
Divide sample: #1=1.0 ml CSF Refrigerate
#2=0.5 ml CSF Freeze.
NOTE: Label specimens appropriately (serum or CSF).
Total of 4 samples to send.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
2-3 days
Monday - Friday
82040 albumin, serum
82042 albumin, CSF
82784 x 2 IgG, serum and CSF
83916 Oligoclonal immunoglobulin, serum & CSF
PRENATAL PANEL
Blood Count
Type and Screen
Hepatitis Bs Antigen (HBsAg)
Rapid Plasma Reagin (RPR)
Rubella Serology, IgG
Test Performed At:
Shore Health Laboratories
Specimen:
Whole Blood and Serum are required for this test. Blood: 1 pink-top blood bank tube and
1 lavender-top (EDTA) tube (minimum 3.0 ml of EDTA whole blood). Refrigerate
specimens. Serum: 2 SST tubes (minimum 3.0 ml of serum), Centrifuge SST 30 minutes
after draw.
Reference Value:
Analytic time:
Day(s) Test Set Up:
CPT Code(s):
See individual test listing.
1 day
Daily
80055
34
ALPHABETICAL TEST LISTING
A
A1 HEMOGLOBIN /A1C
See: “Glycated Hemoglobin, Blood”
A2 HEMOGLOBIN
See: “Hemoglobin A2, Column, Blood”
“Hemoglobin Electrophoresis, Blood”
"Thalassemia and Hemoglobinopathy Evaluation"
ABO AND Rh
See: “Prenatal Profile”
“Type”
“Type and Screen (TS)”
ABSOLUTE CELL COUNT
See: “CBC”
ACETAMINOPHEN, SERUM
Enzymatic
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen. Collect first sample 4 hours after poisoning. Collect second
sample 12 hours later.
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Normal: 10- 30 ug/ml
> 150 ug/ml
1 day
Daily
82003
Liver damage unlikely if <150 4 hour post ingestion
ACETAMINOPHEN (TYLENOL)
See: “Acetaminophen, Serum”
“Drug Screen, Plasma”
“Drug Screen, Plasma and Urine”
35
ACETONE, SERUM
Nitroprusside Tablets, Manual
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Daily
82009 – screen
ACETONE, URINE
See “Ketones, Urine”
ACETYLCHOLINE RECEPTOR (AChR) BINDING ANTIBODIES, SERUM
Radioimmunoassay (RIA). This is the primary diagnostic test for Myasthenia Gravis.
Test Performed At:
LabCorp
Specimen:
1 plain red-top tube or 1 SST tube (minimum 1.0 ml of serum). Centrifuge 30 minutes
after draw. Refrigerate specimen.
Reference Values:
Negative 0.00-0.24 nmol/L
Borderline 0.25-0.40 nmol/L
Positive >0.40 nmol/L
Analytic Time:
1-2 days
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
83519
ACETYLCHOLINESTERASE, ERYTHROCYTES (CHOLINESTERASE, RBC)
Kinetic/Colorimetric
Test Performed At:
Specimen:
Note:
Reference Values:
Analytic Time:
Day(s) Test Set Up:
LabCorp
1 EDTA (lavender) tube. Refrigerate specimen. Do not separate. Send whole blood.
Collect Monday-Thursday only. Stable for 48 hours.
5300-10000 IU/L
1 day
Monday - Friday
CPT Code(s):
82482
ACETYLSALICYLATE (ASPIRIN)
See: “Salicylate, Serum”
36
ACID PHOSPHATASE, PROSTATIC, SERUM
Alpha-naphthylphosphate
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube. Centrifuge SST 30 minutes after draw. Refrigerate. This test cannot
be done as an “add-on” procedure. Do not uncap tube once specimen is collected.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
<2.0 U/L
1 day
Daily
84066
ACTIVATED PARTIAL THROMBOPLASTIN TIME (APTT), PLASMA
Photo Optic Clot Detection
Test Performed At:
Shore Health Laboratories
Specimen:
1 light blue-top (citrate) tube (minimum 2.0 ml of 3.2 sodium citrate whole blood). Fill
light blue-top (citrate) tube to blue band on the label of the tube. Please state whether
patient is on anticoagulant.
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
23-36 seconds
> 90 seconds
1 day
Daily
85730
ADRENOCORTICOTROPIC HORMONE (ACTH), PLASMA
(ICMA)
Test Performed At:
LabCorp
Specimen:
1 ice chilled lavender top (EDTA) tube (minimum 1.0 ml EDTA plasma) from a
fasting patient. Separate plasma in a refrigerated centrifuge. Freeze immediately
in a plastic vial. Due to diurnal variation, draw between 8 and 10 am.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
6-48 pg/ml
1 day
Monday - Friday
82024
37
ADRENOCORTICOTROPIC HORMONE (ACTH) STIMULATION, SERUM
Outpatient must call hospital ext 5919 for appointment
Test Performed At:
Shore Health Laboratories- call scheduling office to set up appointment x2600
Specimen:
3 serum specimens drawn in SST tubes; minimum 1 ml of serum. Draw baseline
nd
specimen prior to ACTH injection (250ug Cosyntropin IM by physician). Draw 2
rd
specimen 30 minutes post injection, and 3 specimen 60 minutes post injection. Label
each specimen with the time of collection. Centrifuge SST 30 minutes after draw;
refrigerate. Cortisol Levels are tested
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Monday - Friday
82533 x 3
ADVIL® (IBUPROFEN)
See: “Drug Screen, Plasma”
“Drug Screen, Plasma and Urine”
“Ibuprofen, Serum”
“Ibuprofen, Urine”
AFB (ACID-FAST BACILLI)
See: “Culture, Acid-Fast Bacillus”
AFP (ALPHA-FETOPROTEIN)
See: “Alpha-Fetoprotein (AFP- MS), Maternal/Initial (MAP1)"
“Alpha-Fetoprotein (AFP), Quad Screen (MAP4)”
“Alpha-Fetoprotein (AFP) Triple Screen, Serum (MAP3)”
“Alpha-Fetoprotein (AFP) Tumor Marker, Serum”
A/G (ALBUMIN/GLOBULIN) RATIO
Cannot be ordered separately
See: “Albumin/Globulin (A/G) Ratio, Serum”
ALANINE AMINOTRANSFERASE (ALT/SGPT)
See: “Alanine Aminotransferase (ALT/SGPT), Serum"
“Hepatic Panel"
38
ALANINE AMINOTRANSFERASE (ALT/SGPT), SERUM
Spectrophotometry
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw. Refrigerate
specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
10-65 U/L
1 day
Daily
84460
ALBUMIN
See: “Albumin/Globulin (A/G) Ratio, Serum”
“Albumin, Serum”
“Hepatic Function Panel”
“Comprehensive Metabolic Panel”
“Microalbuminuria, 24-Hour Collection, Urine”
“Microalbuminuria, Random, Urine”
ALBUMIN/GLOBULIN (A/G) RATIO, SERUM
BCP-Dye Binding. Includes albumin, A/G ratio, globulin, and total protein.
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml serum). Centrifuge SST 30 minutes after draw. Refrigerate
specimen.
Reference Values:
Albumin: 2.9 - 5.0 g/dl
A/G Ratio: 1.0 - 2.5
Globulin: Male: 1.9 - 3.5 g/dl
Protein, Total: 6.0-8.2 g/dl
1 day
Daily
82040 - Albumin
84155 - Protein, total
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Female: 1.8-3.5 g/dl
ALBUMIN, SERUM
BCP-Dye Binding
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
2.9-5.0 g/dl
1 day
Daily
82040
39
ALCOHOL, ETHYL, SERUM
Enzymatic
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate centrifuged tube with top on.
NOTE: 1. A non-alcohol germicide must be used to cleanse the skin.
2. Do not use alcohol wipes for venipuncture.
3. Do not uncap tube once specimen is collected.
4. For diagnostic purposes only.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
< 5 mg/dl
1 day
Daily
82055
ALDOLASE, SERUM
Kinetic, Spectrophotometric (Enzymatic)
Test Performed At:
LabCorp
Specimen:
1 plain, red-top tube or 1 SST tube (minimum 2.0 ml of serum) (pediatric 0.5 ml serum.
Centrifuge 30 minutes after draw. Freeze serum.
NOTE: Hemolyzed specimens are not acceptable.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
1.2 – 7.6 IU/L
1 day
Sunday - Friday
82085
ALDOSTERONE, SERUM
Liquid chromatography/tandem mass spectrometry (LC/MS-MS)
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate serum.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
1 day
Monday - Friday
82088
40
ALDOSTERONE, URINE
Liquid chromatography/tandem mass spectrometry (LC/MS-MS)
Test Performed At:
LabCorp
Specimen:
Submit 20 ml of urine collection in a urine container with 1 gm boric acid
Preservative during collection. Urine Containers are supplied by Shore Health
Laboratories.
NOTE: Follow guidelines in “Patient Instructions for 24-Hour Urine Collection supplied by Shore Health
Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 day
Tuesday - Thursday
82088
ALKALINE PHOSPHATASE
See: “Alkaline Phosphatase lsoenzymes, Serum”
“Alkaline Phosphatase, Serum”
“Leukocyte Alkaline Phosphatase (LAP) Score”
“Hepatic Panel”
“Comprehensive Metabolic Panel”
ALKALINE PHOSPHATASE ISOENZYMES, SERUM
Electrophoresis. Includes total Alkaline Phosphatase
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 2.0 ml of serum) from a fasting patient. Centrifuge SST 30
minutes after draw. Refrigerate specimen after collection.
Reference Values:
Liver 26% - 86%
Bone 11% - 68%
Intestine 0% - 16%
1 day from set up
Monday - Friday
84080, 84075
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
ALKALINE PHOSPHATASE, LEUKOCYTE
See: “Leukocyte Alkaline Phosphatase (LAP) Score”
ALKALINE PHOSPHATASE, SERUM
p-Nitrophenol Phosphate
Test Performed At:
Specimen:
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Shore Health Laboratories
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
30-140 U/L, age related
1 day
Daily
84075
41
ALKALINE PHOSPHATASE STAIN
See: “Leukocyte Alkaline Phosphatase (LAP) Score"
ALPHA-1-ANTITRYPSIN PHENOTYPING, SERUM
Phenotype: isoelectric focusing (IEF); total: immunologic
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
2 days
Monday - Friday
82104
82103
ALPHA-1-ANTITRYPSIN, SERUM
Nephelometry
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
90-200 mg/dl
1 day
Monday, Wednesday, Friday
82103
ALPHA-FETOPROTEIN (AFP-AF), AMNIOTIC FLUID
ICMA. Includes chromosome analysis on Amniotic fluid.
Test Performed At:
LabCorp
Specimen:
1 plain red-top tube (minimum 1.0 ml of amniotic fluid). Do not centrifuge.
Keep the specimen at room temperature. Protect from light.
NOTE: 1. The following information is required for processing:
A. First day of last menstrual period
B. Date ultrasound performed
C. Gestational age by ultrasound
D. Collection Date
2. Gestational age must be between 13 and 23 weeks; 14-18 weeks preferred.
3. If chromosome studies are also requested, see “Chromosome analysis, Amniotic Fluid”. The
specimen for alpha-fetoprotein, amniotic fluid testing when requested cannot be frozen.
4. Please complete a “Cytogenetics/AFP Congenital Disorders Request Form” and forward it with the
specimen. This form is supplied by Shore Health Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
2.0 multiples of median (MOM) for gestational group. Interpretive report will be
provided.
2-3 weeks
Monday - Friday
42
CPT Code(s):
82103
88280
88291
88235
88269
If AFP has a MOM greater than or equal to 2.0, Acetylcholinesterase, AF and HgbF, AF will automatically be
performed.
ALPHA-FETOPROTEIN (AFP-MS), MATERNAL SERUM, INITIAL
Immunometric chemiluminescencs
Test Performed At:
LabCorp
Specimen:
2 SST tubes (minimum 3.0 ml of maternal serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
NOTE: Please fill out an AFP request form. The following information is required for processing:
A. Gestational age, maternal age, weight, and race
B. First day of last menstrual period
C. Is patient an insulin-dependent diabetic?
D. Specify single or twin pregnancy
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Interpretive report will be supplied. Abnormally high values are called back and
discussed with ordering physician.
3-5 weeks
Monday - Friday
82105
ALPHA-FETOPROTEIN (AFP), QUAD (MAP4) (TETRA)
Chemiluminescence; Enzyme Linked Immunoabsorbent Assay
Test Performed At:
LabCorp
Specimen:
2 SST tubes (minimum 5.0 ml of serum). Centrifuge 30 minutes after draw.
Refrigerate. Send original tubes, do not pour off.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Reported with patient results
3-5 days
Monday - Friday
82105, 86336, 84702,82677
ALPHA-FETOPROTEIN (AFP), TRIPLE SCREEN, SERUM (MAP3), AFP X-TRA PROFILE
Chemiluminescence. Includes alpha-fetoprotein, beta-human chorionic gonadotropin, and estriol
Test Performed At:
LabCorp
Specimen:
2 SST tubes (minimum 3.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate. Send original tubes, do not pour off.
NOTE: Please submit Marker Assessment Request Form. The following information is required for processing:
A. Gestational age, maternal age, weight, and race
B. First day of last menstrual period
C. Is patient an insulin-dependent diabetic?
D. Specify single or twin pregnancy
43
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
An interpretive report will be issued. Abnormally high values are called back and
discussed with ordering physician.
3-5 days
Monday - Friday
82105, 84702, 82677
ALPHA-FETOPROTEIN (AFP) TUMOR MARKER, SERUM
Microparticle Enzyme Immunoassay (MEIA)
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen. Amniotic fluid should not be sent because this test is only used as
a tumor marker. Diagnosis should be confirmed by other tests or procedures. We will not
routinely analyze specimens from females of childbearing age unless a suspected tumor
diagnosis is specified.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0-5 IU/ml
2 days
Monday - Friday
82105
ALPHA -hCG (HUMAN CHORIONIC GONADOTROPIN)
See: “Alpha-subunit of Pituitary Glycoprotein Hormones (a-PGH), Serum"
ALPHA 2 MACROGLOBULIN, SERUM
Rate Nephelometry
Test Performed At:
LabCorp
Specimen:
1 plain red-top tube or 1 SST tubes (minimum 1.0 ml of serum).
Centrifuge 30 minutes after draw. Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
110-276 mg/dl
2 days
Monday – Friday
83883
ALPHA-SUBUNIT, SERUM, FREE
Measures the alpha subunit of LH, DSH, TSH, and HCG (Pituitary glycoproteins)
Radioimmunoassay (RIA)
Test Performed At:
LabCorp
Specimen:
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
1 SST tubes. Centrifuge 30 minutes after draw. Separate and f eeze.
See report
1 day
Monday and Thursday
83520
44
ALT/SGPT (ALANINE AMINOTRANSFERASE)
See: “Alanine Aminotransferase (ALT/SGPT), Serum”
AMINOPHYLLINE
See: “Drug Screen, Plasma”
“Drug Screen, Plasma and Urine”
“Theophylline, Serum”
ALUMINUM, SERUM OR PLASMA
Flameless Atomic Absorption Spectrometry
Test Performed At:
LabCorp
Specimen:
1 Royal navy blue-top without EDTA (serum) or 2 Royal navy blue-top with EDTA
(plasma) metal free tubes.
For plasma, send minimum of 7 ml whole blood in unopened tube at room
temperature.
For serum, send minimum of 1 ml serum at room temperature. Serum must be
transferred to plastic tube within 45 minutes of draw.
Reference Values:
0-9 ug/L
Dialysis patients <40 ug/L
Reference values are for serum and do not apply to plasma specimens.
2 days
Tuesday - Saturday
82108
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
AMIKACIN, SERUM
Immunoassay
Test Performed At:
LabCorp
Specimen:
1 plain red-top tube (minimum 1.0 ml of serum). Serum for a peak level should be taken
30 minutes after completion of infusion of an intraveneous dose or 60 minutes after an
intramuscular or oral dose of amikacin. The trough specimen should be collected 30
minutes before dose. Refrigerate specimen.
NOTE:
1. The plain red-top tube should NOT contain gel or silicone.
2. Clearly mark tubes with “TROUGH” or “PEAK”
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Therapeutic ranges
Peak: 20-25 ug/ml
Trough: 1.0-8.0 ug/ml
1 day
Monday - Saturday
80150
45
AMINOLEVULINIC ACID (ALA), URINE (24 HR OR RANDOM)
Colorimetric
Test Performed At:
LabCorp
Specimen:
24 hour urine container with 30 ml of 30% glacial acetic acid.
Random specimen should be collected in container with 0.5 ml of 30% glacial acetic acid.
Submit 10 ml aliquot in AMBER tube and freeze. pH<6
Note:
Random sample should NOT be the first morning void, or after 8pm in the evening
and not after excessive fluid intake.
Reference Values:
24hr sample = 1.5-7.5 mg/24 hour
Random sample = 0.0-5.4 mg/L
2 days
Monday, Wednesday, Friday
82135
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
AMIODARONE, SERUM (CORDARONE)
Includes Desethylamiodarone
High-Pressure Liquid Chromatography (HPLC)
Test Performed At:
LabCorp
Specimen:
1 plain red-top tube (minimum 1.0 ml of serum). DO NOT use gel tube.
Separate and freeze.
Reference Values:
Therapeutic:
Amiodarone 1.0-2.5 ug/ml
3 days
Monday - Friday
82542
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Noramiodarone 1.0-2.5 ug/ml
AMITRIPTYLINE AND NORTRIPTYLINE
High Pressure Liquid Chromatography (LCMS-MS)
Test Performed At:
LabCorp
Specimen:
1 plain red-top tube or 1 LAV EDTA tube (minimum 1.0 ml of serum or plasma).
Do not use barrier gel tubes. Note time of last dose and dosage. Refrigerate.
Reference Values:
Amitriptyline & Nortriptyline
Total therapeutic concentration: 80-250 ug/L
3 days
Monday - Friday
80152 - amitriptyline
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
46
AMMONIA, PLASMA
Enzymatic
Test Performed At:
Shore Health Laboratories
Specimen:
1 green-top (heparin) tube (minimum 0.2 ml of heparinized plasma). Specimen should be
placed on wet ice immediately after drawing and kept refrigerated until centrifugation.
Centrifuge within 15 minutes of draw. Separate plasma into a plastic vial. Place in -70º
C freezer if specimen cannot be delivered immediately to the laboratory.
NOTE: EDTA plasma is not acceptable.
Reference Values:
Analytic time:
Day(s) Test Set Up:
CPT Code(s):
11-35 umol/L
1 day
Daily
82140
AMNISURE (PAMG-1)
Immunochromatographic method
Test Performed At:
Shore Health Laboratories
Specimen:
Amnisure collection swab and vial
Reference Values:
Negative denotes intact fetal membranes
Positive denotes ruptured fetal membranes
Analytic Time:
Day(s) Test Set Up:
CPT Code:
Same day results
Daily
84112
AMOEBA SEROLOGY, SERUM (E.histolytica)
Enzyme Immunoassay [EIA]
Test Performed At:
Maryland State Health Dept
Specimen:
2 SST tubes (minimum 6.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
NOTE: 1. Acute and convalescent specimens are needed to interpret the results. The convalescent
specimen should be obtained 2-3 weeks after onset.
2. Label specimen appropriately (acute or convalescent).
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
3-4 weeks
Monday - Friday
86753
AMPHETAMINES
See: “Drug Screen, Urine”
“Drug Screen, Plasma and Urine”
47
AMPHETAMINES, URINE
Includes gas chromatography/mass spectrometry (GC/MS) confirmation with quantitation
Test Performed At:
LabCorp
Specimen:
20 ml from a random urine collection in a urine sample cup supplied by Shore Health
Laboratories. Store at Room Temperature.
If delay getting to LabCorp more than 7 days, refrigerate.
Reference Values:
None detected. Positive results are quantitated.
Cutoff conc: 500 ng/ml
2-3 days
Daily
82145
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
AMYLASE, BODY FLUIDS
Enzymatic
Test Performed At:
Shore Health Laboratories
Specimen:
NOTE:
1 plain, red-top tube (minimum 0.2 ml of fluid). Refrigerate specimen.
The plain, red-top tube should NOT contain gel or silicone.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
No established reference range
1 day
Daily
82150
AMYLASE, SERUM
Enzymatic
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
25 - 115 U/L
1 day
Daily
82150
AMYLASE, URINE
Enzymatic
Test Performed At:
Shore Health Laboratories
Specimen:
Submit an entire 2-hour timed urine collection in a urine sample cup supplied by Shore
Health Laboratories. Refrigerate specimen. May also be performed on a 24 hour urine
collection.
Reference Values:
5 - 54 U/2 hrs
59 - 401 U/24 hrs
48
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
1 day
Daily
82150
ANA (ANTINUCLEAR ANTIBODIES)
See: “Antinuclear Antibodies (ANA) Screen, Serum”
“LE Package”
“Lupus Comprehensive Panel”
ANACIN-3® (ACETAMINOPHEN)
See: “Acetaminophen, Serum”
“Drug Screen, Plasma”
“Drug Screen, Plasma and Urine"
ANGIOTENSION CONVERTING ENZYME (ACE)
Test Performed At:
LabCorp
Specimen:
1 SST tubes (minimum 2.0 ml of serum). Centrifuge 30 minutes after draw.
Refrigerate specimen.
Reference Values:
>14 years = 12 – 68 U/L
Analytic Time:
2 days
Day(s) Test Set Up: Sunday - Friday
CPT(s) Code:
82164
ANTEPARTUM RhoGAM WORKUP
See:” RhoGAM” – indicate if an Antepartum
ANTIBIOTIC ASSAY
See: “Amikacin, Serum”
“Ganciclovir, Serum”
“Gentamicin, Serum”
“Tobramycin, Serum”
“Vancomycin, Serum”
ANTIBODIES TO EXTRACTABLE NUCLEAR ANTIGENS, SERUM
Enzyme Immunoassay
Includes RNP and Smith Antibodies
Test Performed At:
LabCorp
Specimen:
1 SST tubes (minimum 1.0 ml of serum). Centrifuge 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Monday, Wednesday, Friday
86235 x2
49
ANTIBODY IDENTIFICATION
See: “Antibody Identification, Blood”
“Antibody Screen”
”Prenatal Profile”
ANTIBODY IDENTIFICATION, BLOOD
Solid Phase
Agglutination
(Red cell antigen typing will be performed to verify antibody Identification)
Test Performed At:
Shore Health Laboratories
Specimen:
1 pink-top blood bank tube. Avoid hemolysis.
NOTE:
Include report of diagnosis and history of transfusions, pregnancy, and drug therapy.
Reference Values:
Negative
A consultation service is offered regarding the clinical relevance of red cell antibodies.
Analytic Time:
1 day
Day(s) Test Set Up: Daily
CPT Code(s):
86870 - antibody identification
86905 - each red cell antigen typing
ANTIBODY SCREEN
See: “Antibody Screen, Blood”
“Prenatal Panel”
ANTIBODY SCREEN, BLOOD
Solid Phase
Agglutination
(If positive, antibody identification will be performed at an additional charge)
Test Performed At:
Shore Health Laboratories
Specimen:
1 pink-top blood bank tube. Avoid hemolysis. NOTE: Include report of diagnosis
and history of transfusions, pregnancy, and drug therapy.
Reference Values:
Negative
If positive, antibody identification will be performed.
Analytic Time:
1 day
Day(s) Test Set Up: Daily
CPT Code(s):
86870 - antibody identification
86850 – antibody screen
86905 -each red cell antigen typing
ANTIBODY TO HEPATITIS C VIRUS
See: “Hepatitis C Antibody (Anti-HCV), Serum”
“Hepatitis Profile”
50
ANTIBODY WORKUP
See: “Antibody Identification, Blood”
“Antibody Screen”
“Prenatal Panel”
ANTIDIURETIC HORMONE (VASOPRESSIN), RIA (ADH)
Radioimmunoassay (RIA)
Test Performed At:
LabCorp
Specimen:
Serum and Plasma required
1 SST tubes (minimum 1.0 ml of serum). Centrifuge 30 minutes after draw.
Refrigerate specimen.
1 Lavender-top (EDTA) tube (minimum of 2.0 ml of EDTA plasma).
Pre-chill lavender top tube at 40 degrees C before drawing sample.
Separate plasma from cells immediately after collection and freeze in plastic vial.
Reference Values:
0.0-4.7 pg/ml
Additional interpretive information provided with report.
5 days
Tuesday, Thursday, Saturday
84588 83930
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
ANTI-DNAse B (STREP AB)
Radioimmunoassay (RIA)
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum of 1.0 ml of serum). Store at Room Temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
1 day
Monday - Friday
86215
ANTIGEN IDENTIFICATION, BLOOD
Agglutination
Test Performed At:
Shore Health Laboratories
Specimen:
1 pink top (blood bank) tube. NOTE: Test will not be valid if patient was transfused
within 3 months prior to collection.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Antigen specific
1 day
Daily
86905
51
ANTI-HCV (HEPATITIS C VIRUS)
See: "Hepatitis C Antibody (Anti HCV), Serum"
"Hepatitis Panel"
ANTI-HEPATITIS Bc
See: “Hepatitis Bc Antibody, lgG and IgM (Anti-HBc lgG and IgM), Serum”
“Hepatitis Panel”
ANTI-HEPATITIS Bs
See: “Hepatitis Bs Antibody (Anti-HBs), Serum”
ANTINUCLEAR ANTIBODIES (ANA)
See: “Antinuclear Antibodies (ANA) Screen, Serum”
“LE Package"
“Lupus Comprehensive Panel”
ANTINUCLEAR ANTIBODIES (ANA) SCREEN, SERUM
Indirect Immunofluorescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Negative
(If positive, results are titered).
1-2 days
Monday- Friday
86038 - screen
86039 - titer
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
ANTISTREPTOLYSIN-O ANTIBODIES
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
0-200 IU/ml
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
1-2 days
Monday- Friday
86060
52
ANTI-TPO (THYROID PEROXIDASE ANTIBODIES)
See: “Thyroid Peroxidase Antibodies, FIA”
A-1 -ANTITRYPSIN
See: “Alpha-1-Antitrypsin Phenotyping, Serum”
“Alpha-1-Antitrypsin, Serum”
APOLIPOPROTEIN A&B, SERUM
Nephelometry
Test Performed At:
LabCorp
Specimen:
2 SST tube (minimum 4.0 ml of serum). Patient must not consume any alcohol for 24
hours before the specimen is drawn. Refrigerate specimen.
Note:
Patient should be fasting for 12 to 14 hours.
Reference Values:
See report
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
3 days
Monday, Wednesday, Friday
82172 x2
APT TEST FOR FETAL HGB
Alkali Denaturation
Test Performed at:
Shore Health Laboratories.
Specimen:
Bloody stool or emesis. Bloody vaginal discharge.
Reference Values:
Analytic Time:
Days Test Set Up:
CPT Code(s):
Negative
1day
Daily
83033
ARSENIC, WHOLE BLOOD
Atomic Absorption Spectrometry
Test Performed at:
LabCorp
Specimen:
1 royal-blue top EDTA trace element blood collection tube (2.0 ml whole blood).
It is important the specimen be obtained, processed, and transported according to
instructions on page 257 “Metals Analysis Collection and Transport”.
Store at Room Temperature.
Reference Values:
Analytic Time:
Days Test Set Up:
CPT Code(s):
2-23 ug/L
3 days
Monday, Wednesday, Friday
82175
53
ARSENIC, URINE (24 HOUR)
Inductively Coupled Plasma/Mass Spectrometry (ICP/MS)
Test Performed at:
LabCorp
Specimen:
Submit a 10 ml aliquot of a 24 hour urine collection in a urine container washed with acid.
A random specimen in an acid-washed container is also acceptable. Urine containers
with preservative are supplied by Shore Health Laboratories. It is important that he
specimen be obtained, processed, and transported according to the instructions on page
257, “Metal Analysis Collection and Transport”. Store at Toom Temperature.
NOTE: 1. Patient should not eat seafood for 48 hours prior to start of collection.
2. Follow patient instructiosn for “24 Hour Urine Collections” supplied by Shore Health Laboratories.
Reference Values:
Analytic Time:
Days Test Set Up:
CPT Code(s):
Normal Concentration:
<80 ug/L / 24 hr urine
4 days
Monday, Wednesday, Friday
82175 82570
ASA (ASPIRIN)
See: “Drug Screen, Plasma”
"Drug Screen, Plasma and Urine"
“Salicylate, Serum”
ASCORBIC ACID (VITAMIN C)
HPLC
Test Performed at:
Specimen:
Reference Values:
Analytic Time:
Days Test Set Up:
CPT Code(s):
LabCorp
1 SST tube (minimum 2 ml serum). Separate and Freeze specimen.
Wrap in foil to protect.
Chill tube before collection.
0.4 – 2.0 mg/dl
2 day
Tuesday, Thursday
82180
ASO (ANTISTREPTOLYSIN-O) SLIDE TEST, (QUALITATIVE)
See: “Streptozyme, Serum”
ASOT (Streptozyme)
See: “Streptozyme”
ASPARTATE AMINOTRANSFERASE (AST/SGOT)
See: “Aspartate Aminotransferase (AST/SGOT), Serum"
“Hepatic Panel”
“Comprehensive Metabolic Panel”
54
ASPARTATE AMINOTRANSFERASE (AST/SGOT), SERUM
Enzymatic
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
7 - 40 U/L
1 day
Daily
84450
ASPERGILLUS SEROLOGY
Latex Agglutination
Test Performed At:
Maryland State Health Department
Specimen:
1 SST tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Negative
21-28 days
Monday - Friday
86331 x 3
Reference Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
ASPIRIN (ACETYLSALICYLATE)
See: “Drug Screen, Plasma”
“Drug Screen, Plasma and Urine”
“Salicylate, Serum”
AST/SGOT (ASPARTATE AMINOTRANSFERASE)
See: “Aspartate Aminotransferase (AST/SGOT), Serum"
“Hepatic Function Panel”
“Comprehensive Metabolic Panel”
AUSTRALIA ANTIGEN
See: “Hepatitis Bs Antigen (HBsAg), Serum”
“Acute Hepatitis Profile”
AUSTRALIA Bs ANTIBODY
See: “Hepatitis Bs Antibody (Anti-HBs), Serum”
AUTOANTIBODIES TO Scl 70, Serum
EIA. Useful for evaluation of patients suspected of having scleroderma
Test Performed At:
LabCorp
Specimen:
1 plain red-top tube or 1 SST tube (minimum 1.0 ml of serum).
Centrifuge SST 30 minutes after draw. Store at Room Temperature.
Reference Value:
Negative <1.00
Positive >1.06
2 days
Analytic Time:
55
Day(s) Test Set Up:
CPT Code(s):
Monday - Friday
86235
AUTOANTIBODIES TO Sm, Serum
Enzyme Immunoassay (EIA)
Test Performed At:
LabCorp
Specimen:
1 plain red-top tube or 1 SST tube (minimum 1.0 ml of serum).
Centrifuge SST 30 minutes after draw. Refrigerate Specimen.
Ship at Room Temperature. Can be stored 7 days at refrigerated temperature.
Reference Value:
Expected values
<1.0 Index - Negative
>1.0 Index - Positive
1 day
Monday, Wednesday, Friday
86235
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
AUTOANTIBODIES TO SSA (Ro), Serum
Enzyme Immunoassay (EIA)
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Ship at Room Temperature. Can be stored 7 days at refrigerated temperature.
Reference Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Monday, Wednesday, Friday
86235
AUTOANTIBODIES TO SSB (La), Serum
Enzyme Immunoassay (EIA)
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Ship at Room Temperature. Can be stored 7 days at refrigerated temperature.
Reference Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Monday, Wednesday, Friday
86235
AUTOANTIBODIES TO RNP, Serum
Enzyme Immunoassay (EIA)
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Ship at Room Temperature. Can be stored 7 days at refrigerated temperature.
56
Reference Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Monday, Wednesday, Friday
86235
AUTOANTIBODIES TO SSA(Ro) AND SSB(La), Serum
Enzyme Immunoassay (EIA)
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Ship at Room Temperature. Can be stored 7 days at refrigerated temperature.
Reference Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Monday, Wednesday, Friday
86235 X2
AUTOMATED REAGIN TEST (ART) SEROLOGY
See: “Syphilis Serology”
B
B12 ASSAY
See: “Vitamin B12 and Folate, Serum”
BACILLUS, ACID FAST
See: “Culture, Acid-Fast Bacillus”
BACTERIA CULTURE
See: “Culture, Bacteria (Not Listed)”
BACTERIAL MENINGITIS ANTIGENS
See: “Directigen, Spinal Fluid”
BACTERIAL SEROLOGY, SERUM
Available for Tetanus antitoxins, Tularemia, and Typhoid & Paratyphoid.
Test Performed At:
Maryland State Health Department
Specimen:
NOTE:
1 SST tube (minimum 5.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
1. Acute and convalescent specimens are needed to interpret the results. The convalescent
specimen should be obtained 2-3 weeks after onset.
57
2. Label specimen appropriately (acute or convalescent).
3. Type of bacteria is required on request form for processing.
Reference Values:
Antigen dependent
TETANUS ANTIBODY
0.01 IU/ml: indicates immunity
Analytic Time:
21-28 days
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
86280
BARBITURATES
See: “Drug Screen, Urine”
“Drug Screen, Plasma and Urine”
BART'S HEMOGLOBIN
See: “Hemoglobin Electrophoresis, Blood”
BENZEDRINE® (AMPHETAMINES)
See: “Amphetamines, Urine”
“Drug Screen, Plasma and Urine"
BENZODIAZEPINES
See: “Diazepam and Nordiazepam, Serum”
“Drug Screen, Urine”
“Drug Screen, Plasma and Urine"
BETA-CAROTENE
See: “Carotene, Serum"
BETA-hCG (Human Chorionic Gonadotropin)
See: “Alpha-Fetoprotein (AFP) Triple Screen, Serum”
“Chorionic Gonadotropin, Beta-Subunit (Quantitative), Serum”
BETA-HYDROXYBUTYRATE, SERUM
Photometric
Test Performed At:
LabCorp
Specimen:
1 plain red-top tube or 1 SST tube (minimum 1.0 ml of serum).
Centrifuge SST 30 minutes after draw. Separate and Freeze.
Reference Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
<0.4 mmol/L
1 day
Daily
82010
58
BETA-2-MICROGLOBULIN, SERUM
Microparticle Enzyme Immunoassay (MEIA)
Test Performed At:
LabCorp
Specimen:
1 plain red-top tube or 1 SST tube (minimum 1.0 ml of serum).
Centrifuge SST 30 minutes after draw. Refrigerate.
Reference Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See copy of report
1 day
Monday, Wednesday, Friday
82232
BETA-THALASSEMIA
See: “Hemoglobin Electrophoresis, Blood”
BETA-TOCOPHEROL
See: “Vitamin E, Serum”
BILIRUBIN
See: “Bilirubin, Direct, Serum”
“Bilirubin, Total, Neonatal, Serum”
“Bilirubin, Total, Serum”
“Hepatic Function”
“Comprehensive Metabolic Panel”
BILIRUBIN, DIRECT, SERUM
Spectrophotometry
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml serum; pediatric 0.2 ml serum). Centrifuge SST 30
minutes after draw. Refrigerate specimen. Protect specimen from light.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.0-0.3 mg/dl
1 day
Daily
82251
BILIRUBIN, TOTAL, NEONATAL, SERUM
Spectrophotometry
Note: This assay is performed on infants from birth to 21 days of age only.
Test Performed At:
Shore Health Laboratories
Specimen:
1 full Capiject® — usually from heel. Refrigerate specimen.
NOTE: Protect specimen from light. Specimen should be transported to laboratory as soon as possible.
59
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Age dependent
Age dependent. See page 29.
1 day
Daily
82250
BILIRUBIN, TOTAL, SERUM
Spectrophotomerty
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml; pediatric- 0.2 ml of serum). Centrifuge SST 30 minutes
after draw. Refrigerate specimen after collection. Protect specimen from light.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.1-1.4 mg/dl
1 day
Daily
82250
BLADDER CANCER, DNA (FISH) (UroVysion)
Test Performed At:
LabCorp
Specimen:
TCC monitoring kit to collect urine. Follow instructions provided by LabCorp.
Submit 33-60 ml TCC preserved urine. Refrigerate.
Must be at LabCorp within 72 hours.
See copy of report
Reference Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Determined upon completion of testing.
BLOOD COUNT
See: “Blood Count”
“Prenatal Panel”
BLOOD COUNT
Automated. Includes WBC, RBC, hemoglobin, hematocrit, platelets, MCV, MCH, MCHC, RDW, 5 part differential:
granulocytes, lymphocytes, monocytes, eosinophils, and basophils.
Test Performed At:
Shore Health Laboratories
Specimen:
1 lavender-top (K2 EDTA) tube (minimum: 3.0 ml blood) or 1 pediatric lavender-top
(K2 EDTA) tube (minimum 0.5 ml blood).
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See Report
1 day
Daily
85025 - CBC
60
BLOOD CULTURE
See: “Culture, Blood”
BLOOD FILMS FOR MALARIAL PARASITES
See: “Malaria Smear”
BLOOD SUGAR
See: “Glucose, Plasma or Serum”
“Basic Metabolic Panel”
“Renal Function Panel"
BLOOD UREA NITROGEN (BUN)
See: “Basic Metabolic Panel”
“Renal Function Panel”
“Urea Nitrogen, Serum"
BLOOD TYPE
See: “Type, Blood”
BNP (Brain Natriuretic Peptide)
FIA
Test Performed At:
Shore Health Laboratories
Specimen:
1 large lavender top (EDTA) tube (minimum 3 ml whole blood).
Reference Values:
Analytic Time:
Day(s) Test Set Up:
5-99 pg/ml
1 day
Daily
BODY FLUID CULTURE
See: “Culture, Fluid (Not Spinal Fluid)"
BONE MARROW STUDY
Includes staining and interpretation.
Test Performed At:
Shore Health Laboratories
Specimen:
Call Chesapeake Pathology in Easton at (410) 820-0019. Bone marrow aspirate requires
air-dried smear slides and a peripheral blood smear, if possible. When available, the clot
section of marrow is fixed and sent to the lab in formalin. A bone marrow core biopsy
requires the biopsy to be fixed in Bouin’s fixative for 1-2 hours and transported to the lab.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
The laboratory will provide an interpretive report.
2 days
By appointment
85095 - aspiration
85102 - biopsy
61
BORRELIA BURGDORFERI (LYME DISEASE SPIROCHETE) DETECTION BY POLYMERASE CHAIN
REACTION (PCR)
PCR and DNA Probe Hybridization. Useful for diagnosis of active Lyme disease.
Test Performed At:
LabCorp
Specimen:
Blood: 1 ml lavender-top (EDTA) tube. Maintain at Room Temperature.
CSF or Synovial Fluid: 1 plain red-top tube (minimum 1.0 ml of fluid).
Refrigerate specimen in screw-capped sterile vial after collection.
Maintain sterility and forward promptly.
NOTE: 1. The plain red-top tube should NOT contain gel or silicone.
2. Indicate CSF, synovial fluid, or whole blood on request form.
3. Label tube with type of specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Not detected
3 days
Monday, Thursday
87476 83890
BRUCELLA CULTURE
See: “Culture, Blood, Brucella”
BRUCELLA SEROLOGY, SERUM
IgG Antibody Titers to B.abortus and B.canis
Test Performed At:
Maryland State Health Department
Specimen:
1 SST tube (minimum 5.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
NOTE: 1. Acute and convalescent specimens are needed to interpret the results.
The convalescent specimen should be obtained 2-3 weeks after onset.
2. Label specimen appropriately (acute or convalescent).
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
B.abortus < 1:160
B.canis < 1:80
21 – 28 days
Monday – Friday
86622
BUN (BLOOD UREA NITROGEN)
See: “Basic Metabolic Panel”
“Renal Function Panel”
“Urea Nitrogen, Serum”
BUPRENORPHINE, URINE (SUBOXONE)
Lateral flow chromatographic immunoassay
Test Performed At:
Specimen:
Shore Health Laboratories
10 ml from a random urine collection in a urine sample cup supplied by Shore
Health Laboratories. Minimum volume of 1ml. No preservative. Refrigerate specimen.
62
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Daily
80300
C
C1 ESTERASE INHIBITOR, FUNCTIONAL (SERUM OR PLASMA)
EIA
Test Performed At:
LabCorp
Specimen:
Serum: 1 plain red top tube (minimum 0.5 ml serum). Separate and freeze serum.
Plasma: 1 EDTA lavender tube (minimum 0.5 ml plasma). Separate and freeze.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Normal >67% normal activity.
5-7 days
Tuesday & Thursday
86161
C1 ESTERASE INHIBITOR, SERUM
Immunologic, Quantitative
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml serum) from a fasting patient. Separate from cells within 30
minutes. Store at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
21-39 mg/dl
2 days
Monday, Wednesday, & Friday
86160
C1q (COMPLEMENT COMPONENT C1q), SERUM
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml serum). Separate and store at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
11.8-23.8 mg/dl
5 days
Monday and Friday
86160
63
C2 FUNCTION, SERUM
Radial Immunodiffusion. This test is useful to measure hemolytic activity of Complement C2.
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml serum). Separate and store at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
1.6-4.0 mg/dl
5 days
Wednesday, Friday
86160
C3 (THIRD COMPONENT OF COMPLEMENT)
See: “C3 (Third Component of Complement), Serum"
“Lupus Comprehensive Panel”
C3 (THIRD COMPONENT OF COMPLEMENT), SERUM
Turbidimetric
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
75-135 mg/dl
1 day
Daily
86160
C4 (FOURTH COMPONENT OF COMPLEMENT), SERUM
Turbidimetric
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
16-37 mg/dl
1 day
Daily
86160
C5 (COMPLEMENT FUNCTIONAL), SERUM
Test Performed At:
LabCorp
Specimen:
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
1 plain red-top tube (minimum 0.5 ml serum). Separate and freeze (-70C) serum.
See report
3 days
Monday - Friday
86160
64
C6 COMPLEMENT COMPONENT
Radioimmunoassay (RIA)
Test Performed At:
LabCorp
Specimen:
1 Lavender (EDTA) tube (minimum 1.0 ml plasma). Separate and freeze plasma.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
2 days
Tuesday, Thursday
86160
CA (CALCIUM)
See: “Calcium, Feces”
“Calcium, Ionized, Serum”
“Calcium Load, Urine”
“Calcium, Serum”
“Calcium, Urine”
“Comprehensive & Basic Metabolic Panel”
“Renal Function Panel”
CA 27-29
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.0-38.6 U/ml
3 days
Monday through Friday
86300
CA 15-3 (CANCER ANTIGEN 15-3)
See: “Cancer Antigen 15-3 (CA 15-3), Serum”
CA 125 (CANCER ANTIGEN 125)
See: “Cancer Antigen 125 (CA 125), Serum”
CA 19-9 (CARBOHYDRATE ANTIGEN 19-9)
See: “Carbohydrate Antigen 19-9 (CA 19-9), Serum”
CADMIUM, BLOOD
(ICP/MS)
Test Performed At:
LabCorp
Specimen:
1 royal blue top(EDTA) trace element blood collection tube. Submit original tube. It is
important that the specimen be obtained, processed, and transported according to
65
instructions on page 257 “Metal Analysis – Collection and Transport.” Send at Room
Temperature
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
<5.0 ug/ml
2 days
Monday-Friday
82300
CAFFEINE, SERUM
Immunoassay
Test Performed At:
LabCorp
Specimen:
1 plain red-top tube (minimum 1.0 ml serum). Refrigerate serum.
Reference Values:
Therapeutic concentration:
3-15 ug/ml
Analytic Time:
1 day
Day(s) Test Set Up: Daily
CPT Code(s):
82491
CALCITONIN
(ICMA)
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1 ml serum). Allow blood to clot 1-4 hrs. in refrigerator. Spin and
separate. Freeze immediately.
Reference Values:
ADULT BASAL
Males: <=8.4
Females: <=5.0
Analytic Time:
2 days
Day(s) Test Set Up: Monday, Wednesday, Friday
CPT Code(s):
82308
CALCIUM
See: "Calcium Stool"
"Calcium Ionized, Serum"
"Calcium, Urine"
"Comprehensive & Basic Metabolic Panel"
"Renal Function Panel"
CALCIUM, IONIZED, SERUM
Ion-Selective Electrode (ISE)
Test Performed At:
LabCorp
Specimen:
1 SST tube. Must be kept intact – do not separate or remove stopper. Refrigerate.
NOTE:
If other tests are ordered in conjunction with ionized calcium, a separate
specimen must be drawn just for this test.
66
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
4.5-5.6 mg/dl
1 day
Monday - Friday
82330
CALCIUM, IONZIED, SERUM, CALCULATED
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube Must be kept intact- do not separate or remove stopper. Refrigerate
NOTE: If other tests are ordered in conjunction with ionized calcium, Separate specimens must be drawn.
Reference Values:
Critical Value:
Analytic time:
Day(s) Test Set Up:
CPT Code(s):
4.2 – 5.1 mg/dl
< 3.3 or > 6.2 mg/dl
1 day
Daily
82330
CALCIUM PYROPHOSPHATE CRYSTALS
See: "Crystals, Body Fluids”
CALCIUM PYROPHOSPHATE DIHYDRATED (CPPD)
See: “Crystals, Body Fluids"
CALCIUM, SERUM
Indirect Potentiometry
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate.
Reference Values:
Critical Value:
8.4-10.1 mg/dl
< 6.6 or > 12.9 mg/dl
Note: Patients given a radiological contrast agent can have falsely low or falsely normal
calcium levels.
1 day
Daily
82310
Analytic time:
Day(s) Test Set Up:
CPT Code(s):
CALCIUM, URINE
Indirect Potentiometry
Test Performed At:
Shore Health Laboratories
Specimen:
Submit an entire 24-hour urine collection. Urine containers are supplied by Shore Health
Laboratories. Refrigerate specimen during and after collection.
NOTE: 1. Follow guidelines in “Patient Instructions for 24-Hour Urine Collection” supplied by Shore Health
Laboratories.
2. Urine creatinine must be >500 mg/24 hours for results to be valid.
67
3. Random urine may be submitted for testing. No normal ranges exist for random specimens.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
40-350 mg/24 hours
1 day
Daily
82340 - calcium
81050 - urine timed measurement
CALCULUS, RENAL STONE
Crystallographic Examination
Test Performed At:
LabCorp
Specimen:
Place entire specimen in a snap cap vial or similar vial. Do not tape the specimen to
anything – tape interferes with the analytical procedure. Sample must be completely
dry. Send at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Quantitative report
14-21 days
Monday - Friday
82360
CAMPYLOBACTER PYLORI (HELICOBACTER PYLORI)
See: “Helicobacter pylori lgG Antibody, Serum”
CANCER ANTIGEN 19-9 (CA 19-9)
See: “Carbohydrate Antigen 19-9 (CA 19-9), Serum”
CANCER ANTIGEN 15-3 (CA 15-3), SERUM (BR MONITOR)
Chemiluminescence
Test Performed At:
Specimen:
Shore Health Laboratories
1 plain, red-top tube or 1 SST tube (minimum 3.0 ml of serum). Refrigerate
specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.0 – 31.0 U/ml
1 day
Daily
86316
CANCER ANTIGEN 125 (CA 125), SERUM (OV MONITOR)
Chemiluminescence
Test Performed At: Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values: 0 - 35 U/ml
Analytic Time:
1 day
Day(s) Test Set Up: Daily
CPT Code(s):
86316
68
CANDIDA ANTIGEN/ANTIBODY, SERUM (IgG, IgA, IgM)
EIA
Test Performed At:
LabCorp
Specimen:
2 plain red-top tubes or 2 SST tubes (minimum 3.0 ml serum). Centrifuge SST within 30
minutes of draw. Refrigerate serum.
NOTE:
Positive results are titered.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
3 days
Tuesday, Friday
86628
CARBAMAZEPINE-10,11 EPOXIDE
High-Performance Liquid Chromatography (HPLC)
Useful for monitoring serum concentrations in patients who may be producing significant levels of the active
metabolite epoxide.
Test Performed At:
LabCorp
Specimen:
1 plain red-top tube (minimum 1.0 ml serum). Refrigerate serum.
NOTE:
The plain red top tube should NOT contain gel or silicone.
Reference Values:
Therapeutic concentration:
0.2-2.0 ug/ml
Analytic Time:
3-5 days
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
82542
CARBAMAZEPINE, SERUM
PETINIA Technique
Test Performed At:
Shore Health Laboratories
Specimen:
1 plain red-top tube (minimum 0.5 ml of serum). Refrigerate specimen.
NOTE: 1. The plain, red-top tube should NOT contain gel or silicone.
2. With patient at steady state (chronic oral dosing of 2-6 days), draw trough specimen immediately
before next dose.
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Therapeutic concentration: 4-12 ug/ml
> 20 ug/ml
1 day
Daily
80156
CARBAMAZEPINE (TEGRETOL)
See: “Carbamazepine-10, 11 -Epoxide, Plasma”
“Carbamazepine, Serum”
69
CARBOHYDRATE ANTIGEN 19-9 (CA 19-9) SERUM (GI MONITOR)
Chemiluminescence
Test Performed At:
Shore Health Laboraories
Specimen:
1 plain, red-top tube or 1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30
minutes after draw. Refrigerate specimen.
Reference Values:
0.8 – 35 U/ml
NOTE: This test is for investigational use only. Its analytic performance has been
validated, but the reagents are not FDA approved.
1 day
Monday - Friday
86301
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
CARBOHYDRATE DEFICIENT TRANSFERRIN, SERUM
ESI/MS and Affinity Chromatography
Useful for detecting carbohydrate deficient glycoprotein syndrome.
Test Performed At:
LabCorp
Specimen:
1 SST tubes (minimum 1.0 ml serum).
Centrifuge 30 minutes after collection. Separate and freeze serum.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
3-5 days
Monday and Thursday
82373
CARBON DIOXIDE
See: “Basic & Comprehensive Metabolic Panel”
“Carbon Dioxide”
“Electrolyte Panel”
“Renal Function Panel”
CARBON DIOXIDE
ISE
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml serum). Centrifuge SST 30 minutes after draw. Do not
remove stopper from tube. Refrigerate specimen.
Reference Values:
Critical Value:
Analytic Time:
Days Test Set Up:
CPT Code(s):
24 - 35 meq/L
< 11 or > 40 meq/L
1 day
Daily
82374
70
CARBON MONOXIDE SCREEN
See: “Carboxyhemoglobin"
CARBOXYHEMOGLOBIN
Spectrophotometry. Used for the determination of CO poisoning and toxicity.
Test Performed At:
Respiratory Therapy-SHL
Specimen:
1 green-top (Sodium Heprin) tube or 1 EDTA lavender top tube or 1 gray (sodium fluoride)
tube (minimum 2 ml whole blood). Do NOT transfer to another vial. Place on wet ice for
transport.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Daily
82375
CARCINOEMBRYONIC ANTIGEN (CEA), SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0-3 ng/ml
1 day
Daily
82378
CARISOPRODOL, BLOOD
GC
Test Performed At:
LabCorp
Specimen:
1 plain red-top tube (minimum 2.0 ml serum). Refrigerate serum.
NOTE:
The plain red top tube should NOT contain gel or silicone.
Reference Values:
Therapeutic concentration:
6-12 ug/ml
Analytic Time:
5-7 dayS
Day(s) Test Set Up: Tuesday and Thursday
CPT Code(s):
82491
71
CARNITINE, TOTAL AND FREE
LCMS-MS
Test Performed At:
LabCorp
Specimen:
2 SST tubes(minimum 3.0 ml serum). Separate from cells within 5 hours of
collection and freeze.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
2 days
Monday - Friday
82379
CAROTENE, SERUM
HPLC
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 2.0 ml serum). Draw specimen following an overnight
(12-14 hour) fast. Patient must not consume any vitamin supplements or foods
containing Vitamin A or carotene for 48 hours before specimen is collected.
Freeze specimen. Protect specimen from light.
Reference Values: 10-85 ug/dl
Analytic Time:
2 days
Day(s) Test Set Up: Monday, Wednesday, Friday
CPT Code(s):
82380
CATECHOLAMINE FRACTIONATION, PLASMA, FREE
High Pressure Liquid Chromatography (HPLC)
Includes unconjugated norepinephrine, epinephrine, total catecholamines, and dopamine.
Test Performed At:
LabCorp
Specimen:
Patient should avoid alcohol, coffee, tea, tobacco, and strenuous exercise prior to
collection. Draw 2 green top (Sodium Heparin) tubes. Patients should be at rest for
30 minutes. Draw specimen with patient in the supine position. Patient should then
sit up for 15 minutes. Draw another specimen with patient in an upright position.
Label respective specimens supine and upright. Uses 3 ml plasma from each green top
Sodium heparin tube. Separate and pour off in correctly labeled tubes and freeze as soon
as possible. Serum is not acceptable.
NOTE:
Discontinue epinephrine and epinephrine-like drugs as least 1 week prior to obtaining
sample.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Age related, see report
3 days
Monday - Friday
82384
72
CATECHOLAMINE FRACTIONATION, URINARY, FREE (24 hour or random sample)
High Pressure Liquid Chromatography (HPLC)
Test Performed At:
LabCorp
Specimen:
Submit 30 ml of a 24 hour urine collection in a brown urine container with 30 ml 6N
HCL (pH <=3.0). Refrigerate specimen during and after collection. Urine containers
are supplied by Shore Health Laboratories. This assay is most valuable when the
specimen is collected during an hypertensive episode. Mandelamine interferes with
the test procedure and should be discontinued 48 hours prior to collection of
specimen.
Random urine samples can also be submitted. Send 10 ml of a random collection.
Adjust pH < 3.0 with 6N HCL.
Refrigerate sample.
NOTE:
Follow guidelines in “Patient Instructions for 24 hour Urine Collection” supplied by
Shore Health Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
2 days
Monday - Friday
82384
CBC (COMPLETE BLOOD COUNT)
See: “Blood Count”
CBC / DIFF (COMPLETE BLOOD COUNT / DIFFERENTIAL)
See: "Blood Count"
CEA (CARCINOEMBRYONIC ANTIGEN)
See: “Carcinoembryonic Antigen (CEA), Serum”
CELIAC COMPHRENSIVE AB PANEL (6)
Includes Gliadin IgG + IgA; t-Transgluataminase IgG+ IgA; Endomysial IgA and Total IgA.
EIA; indirect immunofluorescence
Test Performed At:
LabCorp
Specimen:
2 SST tubes (minimum 3.0 ml of serum). Centrifuge 30 minutes after draw.
Refrigerate specimen.
Reference Values: See report
Analytic Time:
2 days
Day(s) Test Set Up: Monday - Friday
CPT(s) Code:
82784, 83516 x 4, 86255
73
CELL COUNT, DIFFERENTIAL
See: “Cell Count, CSF”
“Cell Count, Differential, Peritoneal Dialysate, Body Fluids/ Dialysis Fluid”
CELL COUNT, CSF
Manual Count
NOTE: This cell count does not include spinal fluid chemistries.
Test Performed At:
Shore Health Laboratories
Specimen:
1 plain, red-top tube (minimum 3.0 ml of spinal fluid) divided into 3 plastic tubes
each containing 1.0 ml.
NOTE: 1. The plain, red-top tube should not contain gel or silicone.
2. Label specimens appropriately (1, 2, and 3).
Reference Values:
RBC: 0
3
WBC: 0-5/mm
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
1 day
Daily
89051
CELL COUNT, DIFFERENTIAL, PERITONEAL DIALYSATE, FLUID
Manual Count
Cell count includes a 5-part differential: polys, eosinophils, basophils, lymphocytes, monocytes, and segs.
Test Performed At:
Shore Health Laboratories
Specimen:
1 green-top (heparin) tube (minimum 2.0 ml of heparinized fluid).
Reference Values:
RBC: 0
3
3
WBC: < 100/mm (Culture if WBC is > 100/mm )
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
1 day
Daily
89051
CELL COUNT, BODY FLUID
Manual Count. Includes differential, RBC, and WBC.
Test Performed At:
Shore Health Laboratories
Specimen:
1 green-top (heparin) tube (minimum 2.0 ml of heparinized joint fluid).
Indicate type of fluid.
Reference Values:
RBC: 0
3
WBC: < 500/mm
74
3
(granulocytes:< 25%/mm )
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
1 day
Daily
89051
CENTROMERE B ANTIBODIES, SERUM
Immunofluorescence. If positive, a titer will be performed
Test Performed At:
LabCorp
Specimen:
1 plain red-top tube or 1 SST tube (minimum 1.0 ml serum). Centrifuge SST 30
minutes after draw. Store at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Normal: titer <1:40
1 day
Monday - Friday
86235
CERULOPLASMIN, SERUM
Immunoassay
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml serum) from a fasting specimen. Centrifuge 30 minutes after
draw. Separate and refrigerate serum.
Reference Values:
Adult males: 16.2-35.6 mg/dl
Adult females: 17.9-53.3 mg/dl
Analytic Time:
1 day
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
82390
CG (CHORIONIC GONADOTROPIN)
See: “Alpha-Fetoprotein (AFP) Triple Screen, Serum”
“Alpha-Subunit of Pituitary Glycoprotein Hormones (a-PGH), Serum”
“Chorionic Gonadotropin, Beta-Subunit (Quantitative), Serum”
“Chorionic Gonadotropin, Beta-Subunit (Quantitative), Spinal Fluid”
“hCG (Human Chorionic Gonadotropin), Quantitative (Titer), Serum”
“Pregnancy Test, Qualitative, Serum”
“Pregnancy Test, Urine”
CHLAMYDIA CULTURE
See: "Culture, Chlamydia trachomatis”
75
CHLAMYDIA trachomatis by Nucleic Acid Amplification (Genprobe® - Aptima®)
Useful for detection of Chlamydia trachomatis from female endocervical and male urethral swab specimens.
Note: Chlamydia trachomatis and Neisseria gonorrhoeae may be detected in cervical or urethral specimens using
a single sample.
Test Performed At:
Shore Health Laboratories
Specimen:
Acceptable sites are female endocervix and male urethral. Must use GenprobeAptima® Unisex Swab collection kit. Collect specimen as follows:
Endocervix (Females Only)
1. Remove excess mucus from cervical os and surrounding mucosa using the Aptima® Cleaning Swab
provided in the collection kit. Dispose of the cleaning swab.
2. Insert the Aptima® Unisex Collection Swab (blue shaft) into endocervical canal.
3. Gently rotate swab clockwise for 10-30 seconds in the endocervical canal to ensure adequate sampling.
4. Withdraw swab without touching the vaginal mucosa.
5. Remove the cap from the swab specimen transport tube and immediately place the specimen collection
swab into the the transport tube.
6. Carefully break swab shaft at score marking. Use care to avoid splashing or spilling of the transport media
in the transport tube.
7. Replace cap tightly and transport to the laboratory.
Urethra (Males Only)
Note: The patient should not have urinated for at least 1 hour prior to specimen collection.
1. Insert the Aptima® Unisex Collection Swab (blue shaft) 2-4 cm into urethra.
2. Gently rotate the swab clockwise for 2-3 seconds to ensure adequate sampling.
3. Withdraw the swab carefully.
4. Remove the cap from the swab specimen transport tube and immediately place the specimen collection
swab into the the transport tube.
5. Carefully break swab shaft at score marking. Use care to avoid splashing or spilling of the transport media
in the transport tube.
6. Replace cap tightly and transport to the laboratory.
NOTE: 1. Culture site is required on request form for processing.
2. Vaginal specimens are not acceptable.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Monday, Wednesday, Friday
87491
CHLAMYDIA PNEUMONIAE ANTIBODY PANEL (IGG AND IGM)
Micro Indirect Fluorescent Antibody (IFA)
Test Performed At: LabCorp
Specimen:
Reference Values:
1 SST tube (minimum 1.0 ml serum). Refrigerate serum.
Index <0.91 Negative
Additional interpretive information provided with report.
Analytic Time:
2 days
Day(s) Test Set Up: Monday - Saturday
CPT Code(s):
86632
86631
76
CHLAMYDIA SEROLOGY IgG ANTIBODY, SERUM
EIA
Tests for Chlamydia group IgG antiboby
Test Performed At:
Maryland State Health Department
1 SST tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
NOTE: 1. Acute and convalescent specimens recommended. Convalescent specimen should be obtained
2-3 weeks after onset.
2. Label specimens appropriately (acute or convalescent).
Specimen:
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.01 – 1.09
3-4 weeks
Monday - Friday
86631
CHLAMYDIA TRACHOMATIS
See: “Chlamydia by Nucleic Acid Amplification – Genprobe ®-Aptima®”
“Chlamydia Pneumoniae Antibody Panel, Micro IFA”
“Culture, Chlamydia trachomatis”
CHLORIDE
See: "Basic Metabolic Panel"
“Chloride, Serum”
“Chloride, Urine”
“Comprehensive Metabolic Panel”
“Renal Function Panel”
“Electrolyte Panel”
CHLORIDE, SERUM
Ion specific electrode
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Critical Value:
95 – 108 meq/L
0 days - 17 yrs old: < 77 or > 121 meq/L
18 yrs old - Adult: < 75 or > 126 meq/L
1 day
Daily
82465
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
77
CHLORIDE, URINE
Ion specific electrode
Test Performed At:
Shore Health Laboratories
Specimen:
2.0 ml from a random urine collection in a urine sample cup supplied by Shore Health
Laboratories, or an entire 24-hr urine collection in a urine container with no preservative.
24-hr urine containers are supplied by Shore Health Laboratories. Refrigerate 24-hr
urine specimen during and after collection.
NOTE: Follow guideslines in “Patient instructions for 24-hr urine collection” supplied by Shore Health Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
110-250 meq/24 hrs
1 day
Daily
82465
No normal ranges for random specimens.
CHOLESTEROL
See: “HDL Cholesterol, Serum”
“Lipid Panel"
CHOLESTEROL CRYSTALS
See: “Crystals, Body Fluids or Urine”
CHOLESTEROL, HDL (HIGH DENSITY LIPOPROTEIN)
See:
“Lipid Panel”
“HDL Cholesterol, Serum”
CHOLESTEROL, LDL (LOW DENSITY LIPOPROTEIN)
See: “Lipid Panel”
CHOLESTEROL, SERUM
Spectrophotometry
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum: 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
NOTE: Include patient’s age and sex on request form.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Reference values vary with age and sex.
1 day
Daily
82465
CHOLINESTERASE
See: “Acetylcholinesterase, Erythrocytes”
“Pseudocholinesterase, Total, Serum”
78
CHORIONIC GONADOTROPIN (CG)
See: “Alpha-Fetoprotein (AFP) Triple Screen, Serum”
“Alpha-Subunit of Pituitary Glycoprotein Hormones (a-PGH), Serum”
“hCG (Human Chorionic Gonadotropin), Quantitative (titer), Serum”
“Pregnancy Test, Qualitative, Serum”
“Pregnancy Test, Urine”
CHROMIUM, PLASMA
Flameless Atomic Absorption Spectrometry
Test Performed At:
LabCorp
Specimen:
2 royal blue top (EDTA) trace element tubes (minimum 3.0 ml plasma). It is important
that the specimen be obtained, processed, and transported according to instructions
on page 257 “Metals Analysis – Collection and Transport.” Store at room
temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
<2.1 ug/L
1 day
Tuesday and Thursday
82495
CHROMIUM, URINE
Atomic Absorption Spectrometry
Test Performed At:
LabCorp
Specimen:
Submit 5 ml of random urine collection in an acid washed urine container. It is
important that the specimen be obtained, processed, and transported according to
instructions on page 257 “Metal Analysis – Collection and Transport.” Store at room
temperature.
NOTE:
Patient should refrain from taking vitamins with minerals 1 week prior to collection.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
7 days
Wednesday
82495
82570
79
CHROMOSOME ANALYSIS, AMNIOTIC FLUID
Does not include alpha-fetoprotein.
Test Performed At:
LabCorp (052040)
Specimen:
Obtain specimen durint the 15 -16 week of gestation. Draw 20 ml of amniotic fluid in a
sterile syringe. Remove needle and transfer the specimen to 2 screw-capped, sterile 15 ml
centrifuge tubes. Bloody specimens are undesirable. If the specimen does not grow in
culture, you will be notified within 10 days of receipt. Label container with patient’s name.
Keep specimen at room temperature after collection. SPECIMEN CANNOT BE FROZEN.
NOTE:
Please complete a “Cytogenetics/AFP Congenital Disorders Request Form” and forward it
with the specimen. This form is supplied by Shore Health Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
12-14 days
Daily
88291
88280
88269
88235
88285
th
th
CHROMOSOME ANALYSIS, FOR CONGENITAL & HEMATOLOGIC DISORDERS, BLOOD
Tissue Cultures
Test Performed At:
LabCorp
Specimen:
1 green top (heparin) tube (minimum 5 ml.; pediatric 1-2 ml of sodium heparin whole blood).
Maintain sterility. Invert several times to mix blood. (Clotted blood is not acceptable).
Other anticoagulants may be harmful to the viability of the cells. Label vial with patient’s
name and laboratory control number. ROOM TEMP ONLY. Do not collect on Fridays or
Holidays. May refrigerate if there is a delay.
NOTE:
Patient should refrain from taking vitamins with minerals 1 week prior to collection.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report of the representative karyotype.
2-3 weeks
Monday - Sunday
88262
88291
88230
CHROMOSOME ANALYSIS, FOR HEMATOLOGIC DISORDERS, BONE MARROW
Includes 2-banded karyotypes, analysis of 20 or more metaphases whenever possible, and other banding
techniques when required.
Test Performed At:
LabCorp
Specimen:
2 ml bone marrow aspirate in a green top (sodium heparin) tube. Other anticoagulants may
be harmful to the viability of the cells. Label vial with patient’s name and laboratory control
number. ROOM TEMP ONLY. Bone marrow is the recommended specimen for most
neoplastichematologic disorders, because only about 60% of blood specimens produce
80
adequate metaphases for interpretation. Studies on blood are informative mainly in
advanced myeloproliferative disorders.
NOTE:
Please include diagnosis.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
3-4 weeks
Monday - Friday
88237
88264
88291
88280 x2
CK (CREATINE KINASE
See: “Creatine Kinase (CK) MB Isoenzyme, Serum”
“Creatine Kinase (CK), Serum”
CLINITEST® ON STOOL
See: “Reducing Substance, Feces”
CLONAZEPAM, SERUM
HPLC
Test Performed At:
LabCorp
Specimen:
2 plain, red top tubes (minimum 4.0 ml of serum). Refrigerate specimen.
NOTE:
The plain red top tube should NOT contain gel or silicone.
Reference Values:
Therapeutic concentration:
15-60 ng/ml
Toxic concentration (automatic callback): >=70 ng/ml
Analytic Time:
1 day
Day(s) Test Set Up: Monday, Wednesday, Friday
CPT Code(s):
80154
CLOSTRIDIUM DIFFICILE TOXIN A & B, FECES (NAAT)
Test Performed At:
Specimen:
Shore Health Laboratories
Suitable specimens are unformed stool specimens (liquid or soft stool) of patients
suspected of having Clostridium difficile associated disease (CDAD). Formed stool
specimens will be rejected.
Using a clean, non-sterile or sterile container:
1.
Place a minimum of 1.5 g of liquid or soft stool into the container, taking care not to transfer toilet paper,
urine, water or soap. Refrigerate specimen if transport is delayed. Forward specimen promptly on wet ice.
Reference Values: Negative
Analytic Time:
1 day
Day(s) Test Set Up: Sunday - Friday
CPT Code(s):
87493
81
CLOZAPINE (CLOZARIL), SERUM
LC/TMS
Test Performed At:
LabCorp
Specimen:
NOTE:
1 plain red top tube (minimum 1.0 ml of serum). Refrigerate.
The plain red top tube should NOT contain gel or silicone.
Reference Values:
Peak: 102-771 ng/ml
Trough: 41-343 ng/ml
Analytic Time:
1 day
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
80154
COAGULATION, SPECIFIC FACTOR ASSAYS, PLASMA
Photometric Clot Detection
FACTOR II ACTIVITY – LABCORP 086231
FACTOR V ACTIVITY – LABCORP 086249
FACTOR VII ACTIVITY – LABCORP 800599
FACTOR VIII ACTIVITY—LABCORP 086264
FACTOR IX ACTIVITY – LABCORP 086298
FACTOR X ACTIVITY – LABCORP 086306
FACTOR XI ACTIVITY – LABCORP 086314
FACTOR XII ACTIVITY – LABCORP 086322
FACTOR XIII ACTIVITY—LABCORP 500185
Coagulation testing is highly complex, often requiring the performance of multiple assays and correlation with
clinical information. Factor assays are available individually. Each assay utilizes the same specimen
requirements that are listed once to prevent repetition. Order the specific factor required.
Test Performed At:
LabCorp
Specimen:
Draw blood in a 3.2 sodium citrate (light blue) tube. Centrifuge, remove plasma, spin
plasma again, and FREEZE. Need 3 ml plasma.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
50-150% of Normal for all factors
1 day
Varies
88210 – Factor II
85220 – Factor V
85230 – Factor VII
85240 – Factor VIII
85250 – Factor IX
85260 – Factor X
85270 – Factor XI
85280 – Factor XII
85290 – Factor XIII
COBALAMIN
See: “Vitamin B12 and Folate, Serum”
82
COCAINE
See: “Cocaine Confirmation, Urine”
“Drug Screen, Urine”
“Drug Screen, Whole Blood”
COCAINE CONFIRMATION, URINE
Gas Chromatography/Mass Spectrometry (GC/MS) for Confirmation
Test Performed At:
LabCorp
Specimen:
20 ml from a random urine collection in a urine sample cup supplied by Shore Health
Laboratories. No preservative. Room Temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
None detected
3 days
Monday - Friday
82520
COCCIDIOIDES
See: “Fungus Serology, Serum”
CODEINE, QUANTITATIVE (OPIATE CONFIRMATION, BLOOD)
Gas Chromatography/ MS
Test Performed At:
LabCorp
Specimen:
2 gray top tubes (12 ml). Store at Room Temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
3-5 days
Tuesday and Friday
83925
COLD AGGLUTININ TITER, SERUM
Cold Hemagglutination. Red cell agglutination at 4°C.
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw. Do not
refrigerate prior to separation of serum from red cells. Separate serum from red cells
immediately after blood clots. Refrigerate specimen after separation.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
< 1:32
1 day
Daily
86157
83
COMPLEMENT
See: “Cl Esterase Inhibitor, Serum”
“C2 Function, Serum”
“C1q (Complement Component C1q), Serum”
“C3 (Third Component of Complement), Serum”
“C4 (Fourth Component of Complement), Serum”
“C5 (Fifth Component of Complement), Serum”
“C6 Complement Component”
“Complement, Total, Serum”
COMPLEMENT, C3
See: “C3 (Third Component of Complement), Serum”
“Lupus Comprehensive Panel”
COMPLEMENT, C4
See: “C4 (Fourth Component of Complement), Serum”
“Lupus Comprehensive Panel”
COMPLEMENT, TOTAL SERUM (CH50)
Enzyme Colorimetry
Test Performed At:
LabCorp
Specimen:
1 plain red top tube or 1 SST tube (minimum 1.0 ml of serum). Centrifuge, separate from
clot, and freeze serum immediately in plastic vial. Avoid hemolysis.
Reference Values: 26-58 U/ml
Analytic Time:
1 day
Day(s) Test Set Up: Monday - Saturday
CPT Code(s):
86162
CONJUGATED BILIRUBIN
See: “Bilirubin, Direct, Serum”
COOMBS, DIRECT, BLOOD (DAT)
Anti-Human Globulin
Test Performed At:
Shore Health Laboratories
Specimen:
1 pink-top blood bank tube (minimum 5 ml whole blood). Avoid hemolysis.
NOTE: Include report of diagnosis and history of transfusions, pregnancy, and drug therapy.
Reference Values:
Day(s) Test Set Up:
Analytic time:
CPT Code(s):
Negative (Agglutination or hemolysis indicates a positive test)
Daily
1 day
86880
84
COPPER, SERUM/PLASMA
ICP/MS
Test Performed At:
LabCorp
Specimen:
1 royal blue top trace element collection tube – no additive. Minimum 1.0 ml of serum. It is
important that the specimen be obtained, processed , and transported according to the
instructions on page 257, “Metals Analysis – Collection and Transport.”
Serum – 1 red top tube.
Send at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Environmental exposure – 70-155 ug/dl
2 days
Monday - Friday
82525
COPPER, URINE
Inductively Coupled Plasma (ICP) Spectroscopy/MS
Test Performed At:
LabCorp
Specimen:
Submit 5 ml of random or 24 hour urine collection in plastic urine collection. It is
important that the specimen be obtained, processed, and transported according to
instructions on page 257 “Metal Analysis – Collection and Transport.” Store at room
temperature.
NOTE:
Follow guidelines in “Patient Instructions for 24 hour Urine Collection” supplied by Shore
Health Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
2-30 ug/L
3 days
Monday - Friday
82525
82570
CORD BLOOD WORKUP, BLOOD
Hemoagglutination - Group
Agglutination - Group
Solid Phase - DAT
Anti-Human Globulin - DAT
Test Performed At:
Shore Health Laboratories
Specimen:
1 pink-top Blood Bank Tube (minimum 5.0 ml of whole cord blood)
Reference Values:
Negative Solid Phase - DAT (adherence of Capture-Ready Indicator Red Cells to part or
all of reaction surface indicates a Positive Test)
Negative Coombs - DAT (Agglutination or hemolysis indicates a Positive Test)
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
1 day
Daily
86900 – ABO Type
86901 – Rh Type
86880 – Coombs, Direct
85
CORTICOSTEROIDS
See: “Cortisol, Serum"
CORTISOL, FREE URINE
LC/MS
Useful for patients who are not, or are not suspected to be, taking exogenous glucocorticoids.
recommended routine procedure.
This is the
Test Performed At:
LabCorp
Specimen:
Submit 10-100 ml of a 24 hour urine collection in a 24 hour urine container. 24 hour
containers with no preservative or with 1 gram boric acid or 6N HCl are all acceptable.
Refrigerate container during collection.
NOTE:
Follow guidelines in “Patient Instructions for 24 hour Urine Collection” supplied by Shore
Health Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Age dependant – See report.
2 days
Monday - Friday
82530
CORTISOL, SERUM
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes after
draw. Refrigerate specimen.
Reference Values:
A.M. 5 - 25 ug/dl
P.M. 2.5 -12.5 ug/dl
1 day
Daily
82533
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
CORTISOL STIMULATION, SERUM
See: “Adrenocorticotrophic Hormone (ACTH) Stimulation, Serum”
COXSACKIE VIRUS A ANTIBODY SERUM, IGG (A7, A9, A16, A24)
Complement Fixation
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw. Label
specimen appropriately (acute or convalescent). Refrigerate.
NOTE:
Acute and convalescent specimens are needed to interpret the results. The convalescent
specimen should be obtained 2-3 weeks after onset.
86
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative <1:8
3-5 days
Monday - Friday
86658 x4
COXSACKIE VIRUS A ANTIBODY SERUM, IGM (A7, A9, A16, A24)
Complement Fixation
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw. Label
specimen appropriately (acute or convalescent). Refrigerate.
NOTE:
Acute and convalescent specimens are needed to interpret the results. The convalescent
specimen should be obtained 2-3 weeks after onset.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative <1:8
3-5 days
Monday - Friday
86658 x4
COXSACKIE VIRUS B ANTIBODY (TYPES 1-6), SERUM
Complement Fixation
Test Performed At:
LabCorp
Specimen:
3 ml serum from 2 SST tubes. Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
3 days
Monday - Friday
86658 x6
C-PEPTIDE
Chemiluminescence
Test Performed At:
LabCorp
Specimen:
1 ml serum from a red top or SST tube. Centrifuge, separate serum and refrigerate
specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
1.1-4.4 ng/ml
1 day
Monday - Friday
84681
CPK (CREATINE PHOSPHOKINASE
See: “Creatine Kinase (CK) MB lsoenzyme, Serum”
“Creatine Kinase (CK), Serum"
87
C-REACTIVE PROTEIN (NON-CARDIO)
Turbidimetric Immunoassay
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube supplying 1 ml serum. Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Value:
Analytic time:
Day(s) Test Set Up:
CPT Code(s):
0.0-0.75 mg/dl
1 day
Daily
86140
C-REACTIVE PROTEIN HIGH SENSITIVITY
Turbidimetric Immunoassay
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube supplying 1 ml serum. Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Value:
Analytic time:
Day(s) Test Set Up:
CPT Code(s):
0.0-0.3 mg/dl
1 day
Daily
86141
CREATINE KINASE (CK) MB ISOENZYME, SERUM
Enzyme Immunoassay
Useful for predicting the presence of an acute myocardial infarction.
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
NOTE:
1. Include date and time of collection on request form.
2. Strenuous exercise or intramuscular injections may cause transient elevation of CK isoenzymes.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
MB:
< 5 ng/ml
Relative Index < 4
1 day
Daily
82553 - CK isoenzymes
CREATINE KINASE (CK), SERUM
Spectrophotometry
Test Performed At:
Specimen:
Shore Health Laboratories
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen after collection.
NOTE: 1. Include date and time of collection on request form.
88
2. Strenuous exercise or intramuscular injections may cause transient elevation of CK isoenzymes.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Males: 35-232 U/L
1 day
Daily
82550
Females: 21-215 U/L
CREATINE PHOSPHOKINASE
See: “Creatine Kinase (CK), Serum"
CREATINE, URINE
Enzymatic Colorimetric
Test Performed At:
LabCorp (003475)
Specimen:
Submit 10 ml from 24 hour urine collection in a urine container with no preservative. Urine
containers are supplied by Shore Health Laboratories. Refrigerate specimen during and
after collection. Send aliquot frozen.
NOTE:
Follow guidelines in “Patient Instructions for 24 Hour Urine Collection” supplied by Shore
Health Laboratories.
Reference Values:
Males: 0-40 mg/24 hr.
Females: 0-80 mg/24 hr.
Analytic Time:
1 day
Day(s) Test Set Up: Tuesday, Friday
CPT Code(s):
82540
CREATININE
See: “Creatinine Clearance, Serum and Urine”
“Creatinine, Serum”
“Creatinine, Urine”
“Comprehensive and Basic Metabolic Panel”
“Renal Function Panel"
CREATININE CLEARANCE, SERUM AND URINE
Jaffe Reaction
Test Performed At:
Shore Health Laboratories
Specimen:
Both serum and urine are required for this test. Blood specimen should be obtained
sometime during the 24-hour period of urine collection. Serum: 1 SST tube (minimum
0.5 ml of serum). Centrifuge SST 30 minutes after draw. Refrigerate specimen after
collection. Urine: Submit an entire 24-hour urine collection in a urine container with no
preservative. Urine containers are supplied by Shore Health Laboratories. Refrigerate
specimen during and after collection.
NOTE: 1. Follow guidelines in “Patient Instructions for 24-Hour Urine Collection” supplied by Shore Health
Laboratories.
2. Patient’s height and weight are required on request form for processing.
Reference Values:
70-120 ml/min
89
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
1 day
Daily
82575 - creatinine clearance
81050 - urine timed measurement
CREATININE, SERUM
Jaffe Reaction
Test Performed At:
Specimen:
Shore Health Laboratories
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.6-1.3 mg/dl
Age 0 days-18yrs=>3.8 mg/dl. Age 19yrs-Adult = >7.4 mg/dl.
1 day
Daily
82565
CREATININE, URINE 24 hr
Jaffe Reaction
Test Performed At:
Specimen:
Shore Health Laboratories
Submit an entire 24-hour urine collection in a urine container with no preservative.
Urine containers are supplied by Shore Health Laboratories. Refrigerate specimen
during and after collection. Random specimens also acceptable.
NOTE: Follow guidelines in “Patient Instructions for 24-Hour Urine Collection” supplied by Shore Health
Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
600-2500 mg/24 hr. No normal ranges established for random specimens.
1 day
Daily
82570 - creatinine
81050 - urine timed measurement
CRP (C-REACTIVE PROTEIN)
See: “C-Reactive Protein (CRP), High Sensitivity"
“C-Reactive Protein (Non-Cardio)”
CRYOGLOBULIN, SERUM
Manual, Qualitative
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
NOTE: Keep specimen at room temperature until after centrifugation and separation of cells.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
3 days
Daily
82595
90
CRYPTOCOCCUS ANTIGEN, SERUM
Latex Agglutination
Test Performed At:
LabCorp
Specimen:
1 SST tube or plain red top tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes
after draw. Refrigerate specimen in a screw-capped, sterile vial after collection. Maintain
sterility and forward promptly.
Reference Values:
Negative
If positive, results are titered.
Analytic Time:
1 day
Day(s) Test Set Up: Daily
CPT Code(s):
86406
CRYPTOCOCCUS ANTIGEN, SPINAL FLUID
Complement Fixation
Test Performed At:
LabCorp
Specimen:
0.5 ml CSF in sterile plastic tube. Refrigerate.
Reference Values:
Negative
If positive, results are titered
Analytic Time:
1 day
Day(s) Test Set Up: Daily
CPT Code(s):
87899
CRYPTOSPORIDIUM ANTIGEN, FECES
Immunoassay
Useful for screening for the detection of Cryptosporidium antigen present in stool specimens.
Test Performed At: Shore Health Laboratories
Specimen:
Fresh stool, formalin preserved, or tightly sealed ParaPak PVA/Formalin® specimen.
Refrigerate fresh stool specimen. Formalin preserved or ParaPak PVA/Formalin ® tightly
sealed specimen should be kept at ambient temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Monday-Friday
87328
CRYSTALS
See: “Crystals, Body Fluids”
91
CRYSTALS, BODY FLUIDS
Polarized Microscopy
Test Performed At:
Shore Health Laboratories
Specimen:
Body Fluid: 1 green-top (heparin) tube (minimum 2.0 ml of heparinized fluid).
NOTE: Type of fluid is required on request form for processing.
Reference Values:
AnalyticTime:
Day(s) Test Set Up:
CPT Code(s):
No crystals seen
1 day
Daily
89060
CULTURE, ACID-FAST BACILLUS
Includes acid-fast smear.
Test Performed At:
Shore Health Laboratories
Specimen:
Blood and Body Fluids: 2 green-top (sodium heparin) tube (minimum 4.0 ml). Send
specimen in a tightly screwed, capped sterile vial. Maintain sterility and forward promptly
at ambient temperature.
NOTE: 1. If specimen is used for bacterial culture, keep specimen at ambient temperature only.
2. Culture site is required on request form for processing.
Bronchial Washings, Gastric Contents, Lung Aspirates, or Sputum: Refrigerate
specimen in a tightly screwed, capped sterile container after collection. Maintain sterility
and forward promptly, ideally within 30 minutes of collection, but at least the same day.
NOTE: 1. Sputum must be obtained from first morning specimen. It is recommended to collect 3 firstmorning specimens on 3 separate days.
2 .No more than 1 specimen collection per day will be accepted.
3. If routine bacterial culture is also desired, collect another specimen and forward promptly at
ambient temperature.
4. Culture site is required on request form for processing.
Tissue: 1 g of tissue. Refrigerate specimen in a tightly screwed, capped sterile container.
Maintain sterility and forward promptly.
NOTE: 1. If bacterial culture is also desired, keep specimen at ambient temperature only.
2. Culture site is required on request form for processing.
Urine: Submit entire fully voided, first a.m. specimen. It is recommended to collect 3 first
morning specimens on 3 separate days. Refrigerate specimen in a screw-capped, sterile
container after collection. Maintain sterility and forward promptly.
NOTE: No more than 1 specimen collection per day will be accepted.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Not applicable
Positive cultures are referred to the Maryland State Health Department for identification
and sensitivity. Certain positive cultures may be referred to Lab Corp for susceptibilities.
1 day - acid-fast smear
56 days (8 weeks) - culture
Daily
87206 - acid-fast smear
87117 – culture
92
CULTURE, BACTERIA (NOT LISTED)
Includes both aerobic and anaerobic culture.
Test Performed At:
Shore Health Laboratories
Specimen:
Sample should arrive within 24 hours of collection. Acceptable sources normally are
abscesses, skin, drainages, tissue, catheter tips, and wounds. Collect specimen in a
sterile tightly sealed container or by using a Culture swab® which is supplied by Shore
Health Laboratories. Forward promptly at ambient temperature only
NOTE: Culture site is required on request form for processing.
Reference Values: Not applicable
AnalyticTime:
2-5 days
Day(s) Test Set Up: Daily
CPT Code(s):
87076
CULTURE, BETA STREP, THROAT
Test Performed At:
Shore Health Laboratories
Specimen:
Swab of affected area placed in transport media. NOTE: This is a test for Group A Strep
and Beta Strep, Not Group A only. When physician requests other pathogens isolated,
you must order Culture, Throat
Reference Values:
Analytic Time:
Days(S) Test Set Up:
CPT Code(s):
Not applicable
2-3 days
Daily
87081
CULTURE, BLOOD
Test Performed At:
Shore Health Laboratories
Specimen:
See page 14 for complete collection instructions. 2 blood culture bottles (aerobic [blue]
and anaerobic [purple]). 5 –10 ml of whole blood in each bottle. Forward promptly at
ambient temperature only. NOTE: If 3 -9 ml of blood is collected, place all of the collected
blood in the blue-top bottle. If < 3.0 ml of blood collected put a minimum of 0.5ml to 3.0
ml in the Peds Plus bottle (pink top)
Reference Values:
Not applicable
Positives results will be called upon initial detection.
5 days
Daily
87040
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
93
CULTURE, BLOOD, BRUCELLA
Test Performed At:
Shore Health Laboratories
Specimen:
3 blood culture bottles: 1 standard aerobic (blue), 1 lytic (purple), and 1 Mycolytic (red).
5 - 10 ml of whole blood in each bottle. Forward promptly at ambient temperature only.
See page 14 for sterile technique for arm prep and bottle collection, but use 1 Standard
Aerobic, 1 Lytic and 1 Mycolytic broth bottles.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Not applicable
28 days
Daily
87040
CULTURE, BLOOD, FUNGUS
Test Performed At:
Shore Health Laboratories
Specimen:
2 Mycolytic blood culture bottles (Mycolytic broth). Minimum 5.0 ml of whole blood in
each bottle. Forward promptly at ambient temperature only. See page 14 for sterile
technique for arm prep and bottle collection, but use Mycolytic broth blood culture bottles.
Reference Values:
If positive for molds, isolate will be referred to Lab Corp for identification. Positives for
yeast are identified at Shore Health Laboratories.
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Positives are reported when detected. Negatives are reported in 28 days.
Daily
87103
CULTURE, BODY FLUID
See: “Culture, Fluid (Not Spinal Fluid)”
CULTURE, BONE MARROW
Test Performed At:
Shore Health Laboratories
Specimen:
Bone Marrow aspirate collected in lavender top tube or in aerobic (blue) and anaerobic
(purple) blood culture bottles
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Not applicable
5 days
Daily
87070
94
CULTURE, BORDETELLA PERTUSSIS
Test Performed At:
Maryland State Health Department
Specimen:
2 nasopharyngeal (not throat) swabs collected using a “Pertussis Collection Kit” supplied
by the Maryland State Health Department or Shore Health Laboratories. NOTE: Follow
guidelines in “Pertussis Collection Kit.”
Reference Values:
Analytic Time:
Days(s) Test Set Up:
CPT Code(s):
Negative
14-28 days - culture
Daily
87163 – additional identification methods required
87140 – culture, typing, fluorescent method
CULTURE, CHLAMYDIA TRACHOMATIS
Cell Culture Isolation
Test Performed At:
LabCorp
Specimen: Acceptable Culture Sites: Endocervix, eye, nasopharynx, throat, rectum, urethra, fluid aspirate or
tissue.
Unacceptable Culture Sites: Urine, vagina, any discharges, stool.
1. Use Viral, Chlamydia, or Mycoplasma Culture Transport Medium.
Bring to room temperature before inoculation.
2. Collect specimen using a sterile non-wooden shafted swab.
3. Obtain epithelial cells from infected site (i.e. Insert swab 2-3 cm into male urethral or
endocervix)
4. Place swab in media.
5. Tightly cap the tube and place in a tightly sealed plastic bag.
6. Refrigerate immediately.
NOTE:
Culture site is required on request form for processing.
Reference Values:
Negative (reported as positive or negative). Asymptomatic, sexually active persons may
harbor C. trachomatis in rates ranging from 0-7%. However these apparently asymptomatic
individuals will commonly have pyuria demonstrated by urinalysis.
Analytic Time:
3 days
Day(s) Test Set Up: Monday - Saturday
CPT Code(s):
87110
87140
CULTURE, CYTOMEGALOVIRUS (CMV), URINE
Spin Amplification Culture
Test Performed At:
LabCorp (008201)
Specimen:
4 ml urine from first morning or random collected specimen in a sterile screw capped
container. Maintain sterility and forward promptly. Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
2 weeks
Daily
87252
87254
95
CULTURE, CSF
See: “Culture, Spinal Fluid (with Gram Stain)
CULTURE, DOCTOR’S OFFICE WORKUP
Test Performed At:
Shore Health Laboratories
Specimen:
Culture plate of urine, throat, etc. Forward promptly at ambient temperature only.
NOTE: Culture site is required on request form for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Not applicable
2-4 days
Daily
87070
CULTURE, ENVIRONMENTAL
Test Performed At:
Shore Health Laboratories
Specimen:
Environmental swab collected using a Culture swab Plus® which is supplied by Shore
Health Laboratories. NOTE: Culture site is required on request form for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Not applicable
2-5 days
Daily
87070
CULTURE, FLUID (NOT SPINAL FLUID)
Test Performed At:
Shore Health Laboratories
Specimen:
1 green-top (sodium-heparin) tube (minimum 0.2 ml of heparinized fluid other than spinal
fluid). Forward promptly at ambient temperature only. Do not refrigerate. NOTE: Culture
site is required on request form for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Not applicable
2-5 days
Daily
87070
CULTURE, FUNGUS
Test Performed At:
Shore Health Laboratories
Specimen:
For all specimens- Culture site is required on request form for processing.
Body Fluids: 1 green-top (sodium heparin) tube, minimum: 5.0 ml of heparinized fluid. Refrigerate specimen in
a tightly screw-capped, sterile container. Maintain sterility and forward promptly. NOTE: If specimen is used for
bacterial culture, keep specimen at ambient temperature only.
96
Bronchial Washings, Gastric Contents, Lung Aspirates, or Sputum: Refrigerate specimen in a tightly
screw-capped, sterile container. Maintain sterility and forward promptly. NOTE: Sputum must be obtained from
first a.m. specimen. If specimen is used for bacterial culture, keep specimen at ambient temperature only.
Tissue: 1 g of tissue. Refrigerate specimen in a tightly screw-capped, sterile container. Maintain sterility and
forward promptly. NOTE: If specimen is used for bacterial culture, keep specimen at ambient temperature only.
Urine: Submit entire fully voided, first a.m. specimen. Refrigerate specimen in a tightly screw-capped, sterile
container. Maintain sterility and forward promptly.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative. If positive for molds, isolate will be referred to Lab Corp for identification.
Positives for yeast are identified at Shore Health Laboratories.
Positives are reported when detected, Negatives are reported in 28 days
Daily
87106 - culture, fungus, definitive
871 02 - culture, fungus, isolation, other
CULTURE, GARDNERELLA VAGINALIS
NOTE: This is a test for Gardnerella ONLY. If physician requests other Pathogens isolated, you must order
“Culture, Genital.”
Test Performed At:
Shore Health Laboratories
Specimen:
Sample must arrive within 4 hours of collection. Cervical, urethral, or vaginal swab placed
in transport medium. NOTE: Culture site is required on request form for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
No Gardnerella vaginalis isolated
3 days
Daily
87081
CULTURE, GC
See: “Culture, Transgrow ®”
CULTURE, GENITAL
Acceptable sources: cervix, labia, lochia, penis, urethra, vagina, vaginal wash, and vulva
Test Performed At:
Shore Health Laboratories
Specimen:
Swab of genital area placed in transport medium.
NOTE: For GC culture, refer to “Culture, Transgrow®. Culture site is required on request form for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Not applicable
2-5 days
Daily
87070
97
CULTURE, GENITAL + ANAEROBE
Acceptable Sources: Amniotic fluid, bartholin, endometrium, fallopian tube, perineum, placenta, prostatic fluid,
scrotum, semen, umbilical cord, uterus, uterine curettings
Test Performed At:
Specimen:
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Shore Health Laboratories
Swab of affected area placed in transport medium or specimen in tightly sealed sterile
container. Specimen in sterile container should be received within 1 hour of collection.
Forward promptly at ambient temperature. Culture site is required on requent form for
processing.
Not applicable
3 - 5 days
Daily
87070
CULTURE, GROUP B STREP SCREEN
NOTE: This is a test for Group B Strep ONLY. When Physician requests other pathogens isolated, you must order
“Culture, Genital”
Test Performed At:
Shore Health Laboratories
Specimen:
Vaginal/Rectal swab(s) placed in transport medium.
Reference Values:
AnalyticTime:
Day(s) Test Set Up:
CPT Code(s):
Not applicable
3-5 days
Daily
87081
CULTURE, MRSA (METHICILLIN (OXACILLIN)-RESISTANT STAPH AUREUS) SCREEN
• This test is for Infection Control Surveillance Use only.
• Order Culture, Nose and comment, “R/O MRSA” for clinical cultures
Test Performed at:
Specimen:
Shore Health Laboratories
Use one Culture swab Plus transport and swab both nares of the nose. Swab tip must be
inserted up to 1 inch from edge of nares or until resistance is met at the level of the
turbinates (which may be slightly less than 1 inch in neonates and infants). Roll the swab
5 times in each nares. Forward promptly at ambient temperature.
1. Nose (nares) is the only approved site for MRSA Screen Culture. Do not submit specimens other
than nose for Culture MRSA Screen.
2. This culture is used to look for MRSA colonization. No antimicrobial susceptibilities will be reported.
If physician requests other pathogens isolated, you must order Culture, Nose.
Results from MRSA Screen cultures should be used as an adjunct to infection control efforts to identify
patients needing isolation precautions. The test is not intended to identify patients with
Staphylococcal infection. Results should not be used to guide or monitor treatment for MRSA
infections.
Reference Values:
Analytic Time:
Day(s) Set Up:
CPT Code(s):
No MRSA Isolated
1 day
Daily
87081
98
CULTURE, MYCOBACTERIA
See: “Culture, Acid-Fast Bacillus"
CULTURE, MYCOPLASMA, RESPIRATORY
Triphasic Culture System
Test Performed At:
LabCorp
Specimen:
Respiratory swab placed in special M4 transport media (blue cap). Refrigerate specimen.
DO NOT use wooden shafted swabs. See p. 258 “Microbiology Specimen Guide for
Mycoplasma and Viral Specimens.”
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Not detected
14 days
Monday - Friday
87109
CULTURE, MYCOPLASMA, GENITAL
Triphasic Culture System
Test Performed At:
LabCorp
Specimen:
Urethral, vaginal, or cervical swab placed in special M4 transport media (blue cap).
Refrigerate specimen. DO NOT use wooden shafted swabs.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Not detected
6 days from inoculation
Monday - Saturday
87109
CULTURE, NEISSERIA GONORRHOEAE
See: “Culture, Transgrow"
CULTURE, NOCARDIA
See: “Culture, Fungus”
CULTURE, NOSE
Test Performed At:
Shore Health Laboratories
Specimen:
Swab of affected area placed in transport medium.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Not applicable
2-3 days
Daily
87060
99
CULTURE, PERITONEAL DIALYSATE
Test Performed At:
Shore Health Laboratories
Specimen:
At least 10cc of peritoneal dialysate collected in a sterile non-gel red top tube. Forward
promptly at ambient tempreture.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Not applicable
1 - 5 days
Daily
87070
CULTURE, RESPIRATORY SECRETIONS
Acceptable specimens: sputum (exporated), bronchial brushings, bronchial washings, tracheal aspirate, transtracheal aspirate.
Test Performed At:
Shore Health Laboratories
Specimen:
Submit in a tightly sealed sterile container. Forward promptly at ambient tempreture; do
not refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Not applicable
2 - 4 days
Daily
87070
CULTURE, SPINAL FLUID (WITH GRAM STAIN)
Test Performed At:
Shore Health Laboratories
Specimen:
1 plain (no additives) STERILE tube (tightly sealed). Minimum 1.0 ml of spinal fluid.
Maintain sterility and forward immediately after collection at ambient
temperature only. Do not refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
No growth
Positive results will be called upon initial detection.
5 days
Daily
87070 - Culture
87205 - Gram stain
CULTURE, SPUTUM
See: “Culture, Respiratory Secretions”
CULTURE, STOOL, FORMED
NOTE: Yersinia enterocolitica, Vibrio, Aeromonas, Plesiomonas, and E. coli: 0157 are tested by REQUEST
ONLY. Campylobacter is tested on formed stools by request only.
100
1. No more than two specimens per patient should be submitted for routine bacterial culture without consulting with
the Medical Director of Microbiology or the Infectious Disease Specialist, who may approve testing additional
specimens under special circumstances.
2. Specimens for routine bacterial culture should not be submitted from inpatients after the third hospital day, without
prior consultation with the Medical Director of Microbiology or the Infectious Disease Specialist, who may approve
such testing under special circumstances.
3. Testing stool specimens for Clostridium difficile on patients over six months of age, with significant diarrhea and
a history of exposure to antibiotics should be considered, especially for inpatients.
Test Performed At:
Shore Health Laboratories
Specimen:
4.0 g of formed stool collected in a tightly sealed Para-Pak C&S® vial. Gray specimen
cup for INPATIENT ONLY! Forward promptly at ambient temperature. Gray cups must
be received within 1 hr of collection.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Not applicable
2-4 days
Daily
87045
CULTURE, STOOL, NOT FORMED
NOTE: Yersinia enterocolitica, Vibrio, Aeromonas, Plesiomonas, and E. coli:0157 are tested by REQUEST
ONLY.
1. No more than two specimens per patient should be submitted for routine bacterial culture without consulting with
the Medical Director of Microbiology or the Infectious Disease Specialist, who may approve testing additional
specimens under special circumstances.
2. Specimens for routine bacterial culture should not be submitted from inpatients after the third hospital day, without
prior consultation with the Medical Director of Microbiology or the Infectious Disease Specialist, who may approve
such testing under special circumstances.
3. Testing stool specimens for Clostridium difficile on patients over six months of age, with significant diarrhea and
a history of exposure to antibiotics should be considered, especially for inpatients.
Test Performed At:
Shore Health Laboratories
Specimen:
4.0 g of soft or liquid stool collected in a tightly sealed Para-Pak C&S® vial or on a rectal
swab placed in transport media. Gray specimen cup for INPATIENT ONLY! Forward
promptly at ambient temperature. Gray cups must be received within 1 hr of collection.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Not applicable
2-4 days
Daily
87045
87046
CULTURE, TB (TUBERCULOSIS)
See: “Culture, Acid-Fast Bacillus”
101
CULTURE, THROAT
Test Performed At:
Shore Health Laboratories
Specimen:
Swab of affected area placed in transport medium.
Reference Values:
Analytic time:
Day(s) Test Set Up:
CPT Code(s):
Not applicable
2-4 days
Daily
87060
CULTURE, TRANSGROW®
NOTE: This is the preferred method for transport of specimens for GC culture.
Test Performed At:
Shore Health Laboratories
Specimen:
Transgrow® bottle inoculated with swab. Do not expose to extreme temperatures.
Forward promptly at ambient temperature only. NOTE: Hold Transgrow® bottle vertically
while inoculating. Culture site is required on request form for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Not applicable
3-5 days
Daily
87081
CULTURE, UREAPLASMA UREALYTICUM
See: “Culture Mycoplasma, Genital”
CULTURE, URINE
Test Performed At:
Shore Health Laboratories
Specimen:
Collect specimen from a clean-catch urine or from a catheterized patient. Refrigerate
specimen in a tightly screwed capped, sterile container. Maintain sterility and forward
promptly.
NOTE: 1. Indicate if specimen is from a catheterized patient.
2. For adult urine collections, follow guidelines in “Laboratory Outpatient Instructions for Collection of
Clean-Caught Midstream Urine for Culture” supplied by Shore Health Laboratories.
3. For pediatric urine collections, follow guidelines in “Laboratory Outpatient Instructions for Pediatric
Urine Collections” supplied by Shore Health Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
No growth or no significant growth
2-4 days
Daily
87086
102
CULTURE, URINE (CYSTO-BLADDER)
Test Performed At:
Shore Health Laboratories
Specimen:
Collect specimen from a cystoscopic procedure in a sterile urine cup. Maintain sterility,
refrigerate and forward promptly. NOTE: Indicate if specimen is cystoscopic, bladder or
kidney urine.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
No growth
2-4 days
Daily
87086
CULTURE, VIRAL
Test Performed At:
Maryland State Health Laboratory
Specimen:
Variable; depends on virus. See page 258, “Microbiology Specimen Guide for
Mycoplasma and Viral Specimens.” Refrigerate specimen after collection and forward
promptly.
NOTE: Specific virus desired and culture site are required on request form for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
No virus isolated
21-28 days
Monday - Friday
87253
CULTURE, WATER-DIALYSIS UNIT
Test Performed At:
Specimen:
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Shore Health Laboratories
Refrigerate water in a screw-capped, sterile vial after collection. Maintain sterility and
forward promptly.
No growth
2-4 days
Daily
87070
CULTURE, YEAST
See: “Culture, Fungus”
“Culture, Fungus, Blood”
CYANIDE, BLOOD
HPLC-FL
Test Performed At:
LabCorp
Specimen:
1 gray top tube-whole blood specimen. Do not open, send whole tube.
Refrigerate.
103
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
<10 ug/dl
2 day
Monday, Wednesday, Friday
82600
CYANOCOBALAMIN
See: “Vitamin B12 and Folate, Serum"
CYCLIC CITRULLINATED PEPTIDE AB (CCP)
ELISA
Test Performed At:
LabCorp
Specimen:
1 SST tubes (minimum 1.0 ml of serum). Centrifuge 30 minutes after draw.
Refrigerate specimen.
Reference Values:
0 – 19 units
Analytic Time:
2 days
Day(s) Test Set Up: Monday - Friday
CPT(s) Code:
86200
CYCLOSPORINE, BLOOD
FPIA
Test Performed At:
LabCorp
Specimen:
1 lavender top (EDTA) tube (minimum 2.0 ml of EDTA whole blood).
DO NOT CENTRIFUGE. Send in original tube. Refrigerate specimen after collection.
NOTE:
Therapeutic range applies to trough samples collected just prior to a.m. dose.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Trough therapeutic: 100-400 ng/ml
1 day
Monday - Friday
80158
CYSTIC FIBROSIS, CARRIER SCREEN (SCREENING FOR 32 MUTATIONS)
PCR and Allele-Specific Hybridization, DNA Sequencing
Test Performed At: LabCorp
Specimen:
2 EDTA lavender tube (minimum 4 ml of whole blood). Room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
An interpretive report will be issued
5 days
Monday - Friday
81220
CYSTIC FIBROSIS PLUS, CARRIER SCREEN (SCREENING FOR 97 MUTATIONS)
PCR and Allele-Specific Hybridization, DNA Sequencing
Test Performed At: LabCorp
Specimen:
2 EDTA lavender tube (minimum 4 ml of whole blood). Room temperature.
104
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
An interpretive report will be issued
5 days
Monday - Friday
81220
CYSTINE, QUANTITATIVE, URINE
HPLC
Test Performed At:
Specimen:
NOTE:
LabCorp
5 ml aliquot of 24 hour urine collection. Keep urine refrigerated during 24 hr urine
collection. Add 30 ml 6N HCl. Check pH <=3.0. Freeze specimen.
Collect before IVP.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
5-6 days
Monday - Friday
82131
CYTOLOGY, FINE NEEDLE ASPIRATE
Test Performed At:
Shore Health Laboratories
Specimen:
1 slide container with 95% alcohol, Cytolyte® Filled Specimen Container, 10 positively
charged slides, and 2 empty slide holders for air dried slides, labeled each with patient’s
name in pencil.
NOTE: 1. The following steps are done for each 'pass’. Five passes are typically done.
2. When there is sample in the syringe, draw air into the syringe. Place the open end of the needle
against the slide about ½ inch from the frosted boundary and gently push a 2-3mm drop onto the
slide.
st
3. Place another slide crosswise upside down on the 1 slide and gently rotate until the slides fully
contact, and the drop just begins to spread out.
4. Gently pull the slides apart. Place one slide into the alcohol jar immediately and the other slide is
left to air dry.
5. After making the slides, rinse the needle and syringe in Cytolyte. Repeat steps four more times.
6. Please complete Chesapeake Pathology Associates Request Form and forward with the
specimen. This form is supplied by Shore Health Laboratories. A copy of this form is also printed
in the appendix. Requisitions for this procedure cannot be processed unless the requested
information is supplied.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative for malignant cells
3 days
Monday – Friday
88173, 88305, 88162-59, 88160-59, 88112
CYTOLOGY, NIPPLE DISCHARGE
Test Performed At:
Shore Health Laboratories
Specimen:
1 slide container with 95% alcohol. Slide(s) labeled with patient’s name in pencil.
NOTE:
1. Gently massage the breast until the discharge is seen. Touch a glass slide to the discharge.
Immediately place slide into 95% alcohol. Repeat if necessary. DO NOT allow the specimen on the
slide to dry out.
105
2. Please complete Chesapeake Pathology Associates Request Form and forward with the
specimen. This form is supplied by Shore Health Laboratories. A copy of this form is also printed in
the appendix. Requisitions for this procedure cannot be processed unless the requested information
is supplied.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative for Malignant Cells
3 days
Monday – Friday
88104
CYTOLOGY, THIN PREP
Thin Prep®
Test Performed At:
Shore Health Laboratories
Specimen:
For non-pregnant women, the cytobrush/spatula is inserted into the cervical os and
rotated one-quarter turn. Brush any other suspicious area of the ectocervix. Use the
spatula/brush on any other suspicious areas. Thick areas of blood and mucus are to be
avoided. We recommend the cytobroom for pregnant women or women with a stenotic
os. After specimen collection, take the cytobrush and spatula and in a clockwise circular
motion, rotate 10 X in the vial of Thin Prep® fixative. If using a broom, be sure to knock
the tip against the bottom of the vial to dislodge cells. Dispose of applicator when done.
Tightly close vial and label with patient’s full name.
NOTE: 1.The patient should be mid cycle. If a large amount of mucus or pus is on the cervix, gently remove
it with a moistened cotton-wool swab prior to obtaining the sample.
2. FDA states that a cytobrush and plastic spatula combination, or cytobroom be used for obtaining
pap smears using the Thin Prep process. A wooden spatula CANNOT be used.
3. Please complete “Chesapeake Pathology Associates Request Form” and forward it with the
specimen. This form is supplied by Shore Health Laboratories. A copy of this form is also printed in
the Appendix. Requisitions for this procedure cannot be processed unless the requested
information requested supplied.
Reference Values:
AnalyticTime:
Day(s) Test Set Up:
CPT Code(s):
See report
2 weeks
Monday - Friday
88142 – Thin Prep
CYTOLOGY, PAP SMEAR WITH MATURATION INDEX
ThinPrep or Conventional
Test Performed At:
Shore Health Laboratories
Specimen:
For accurate Maturation Index the specimen must be taken from the lateral vaginal wall,
NOT the cervix. Once the specimen is obtained, place in ThinPrep vial as for routine gyn
cytology. Label with patient's full name.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
2 weeks
Monday - Friday
88155
106
CYTOLOGY, SPUTUM
Test Performed At:
Shore Health Laboratories
Specimen:
Collect early morning deep cough in a specimen container.
NOTE: 1. Follow guidelines in “Laboratory Outpatient Instructions for Sputum Collection” supplied by Shore
Health Laboratories.
2. Please complete “Part B” of a “Chesapeake Pathology Associates Request Form” and forward it
with the specimen. This form is supplied by Shore Health Laboratories. A copy of this form is also
printed in the appendix. Requisitions for this procedure cannot be processed unless the
information requested is supplied.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Descriptive report
3 days
Monday - Friday
88107
CYTOLOGY, TISSUE
See:" Histology, Tissue”
CYTOLOGY, URINE, PLEURAL FLUIDS, ABDOMINAL FLUIDS
Test Performed At:
Shore Health Laboratories
Specimen:
Urine, Pleural Fluids or Abdominal Fluids: Submit specimens in a screw-capped
plastic container. DO NOT ADD ANY FIXATIVE TO THE CONTAINER.
NOTE: 1. Include type of fluid on request form.
2. Please complete “Part B” of a “Chesapeake Pathology Associates Request Form” and forward it
with the specimen. This form is supplied by Shore Health Laboratories. A copy of this form is also
printed in the appendix. Requisitions for this procedure cannot be processed unless the
information requested is supplied.
Urine: Completely empty bladder and discard sample. Any urine other than the first
morning urine is acceptable. Drink plenty of fluids (no alcoholic beverages), and try to
move around before urinating. Start collecting urine in a specimen container; stop
collecting urine before you have completely emptied your bladder. Try to collect at least
50 ml. Label all specimen cups with patient’s name. If the physician has ordered 3
consecutive day collection, you may store the first 2 days' urine in the refrigerator.
NOTE: 1. Date and time of collection are required on request form for processing.
2. Follow guidelines in “Laboratory Outpatient Instructions for Urine Cytology” supplied by Shore
Health Laboratories.
3. Please complete a “Chesapeake Pathology Associates Request Form” and forward it with the
specimen. This form is supplied by Shore Health Laboratories. A copy of this form is also printed
in the appendix. Requisitions for this procedure cannot be processed unless the information
requested is supplied
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Descriptive report
3 days
Monday - Friday
8810
107
CYTOMEGALIC INCLUSION DISEASE (CMID)
See: “Cytomegalovirus (CMV) Detection by Polymerase Chain Reaction (PCR), Spinal Fluid”
“Cytomegalovirus (CMV) Serology, Serum"
CYTOMEGALOVIRUS (CMV)
See: “Culture, Cytomegalovirus (CMV), Blood”
“Culture, Cytomegalovirus (CMV), Urine”
"Cytomegalovirus (CMV) Detection by Polymerase Chain Reaction (PCR), Spinal Fluid”
“Cytomegalovirus (CMV) Serology, Serum"
CYTOMEGALOVIRUS (CMV) ANTIBODY (IgG), SERUM
Enzyme-Linked Fluorescent Immunoassay (ELFIA)
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
NOTE: 1. Acute and convalescent specimens are needed to interpret the results. The convalescent
specimen should be obtained 3 weeks after onset.
2. Label specimens appropriately (acute or convalescent).
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative: < 0.90 ISR
Equivocal: 0.91-1.09 ISR
A test value ≥ 1.10 ISR indicates exposure to CMV. A critical ratio value of > 4
determines a significant increase in antibody level, comparable to a fourfold rise in
antibody titer.
Critical ratio =
Convalescent AU/ml
Acute AU/ml
A critical ratio of 2-4 is suggestive of an increasing antibody level. An additional
convalescent sample should be retested in 7-14 days and used with the acute sample to
recalculate the critical ratio. A critical ratio of < 2 indicates no significant change in
antibody titer.
1 day
Tuesday & Friday
86644
CYTOPLASMIC NEUTROPHIL ANTIBODIES, SERUM (ANCA)
Enzyme Immunoassay
Includes cANCA, pANCA, MPO, and PR3
Test Performed At:
LabCorp
Specimen:
2 SST tubes (minimum 3.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate. Avoid hemolysis.
NOTE:
This test should not be mistaken for granulocyte antibodies.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
2 days
Monday - Saturday
83520 x2
86256 x3
108
D
DARKFIELD SMEAR
See: “Smear, Darkfield"
D-DIMER, QUANTITATIVE
Immunoturbidimetry
Test Performed At:
Shore Health Laboratories
Specimen:
MHE and QAEC: 1 blue-top (sodium citrate) tube.
DGH: 1 Lavender (EDTA) tube
Reference Values:
MHE and QAEC: 0.19-0.52 mg/L
DGH: 100-400 ng/ml
1 day
Daily
85379
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
DEHYDROEPIANDROSTERONE SULFATE (DHEA-S), SERUM
Test Performed At:
Shore Health Laboratories
Specimen:
1 plain, red-top tube or 1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30
minutes after draw. Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Age Dependent
1 day
Monday - Friday
82627
DEOXYCORTICOSTERONE
Mass Spectrometry (MS)
Test Performed At:
LabCorp (500138)
Specimen:
3.0 ml serum from 2 plain red top or 2 SST tubes. Freeze serum.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
2 days
Tuesday
82633
DEPAKENE® (VALPROIC ACID)
See: “Valproic Acid, Serum”
109
DEPAKOTE® (VALPROIC ACID)
See: “Valproic Acid, Serum”
DERMATOPATHOLOGY
See: “Histology, Tissue”
DERMATOPHYTES
See: “Culture, Fungus”
“Culture, Fungus, Blood”
DESIPRAMINE (NORPRAMIN
)
See: “Drug Screen, Plasma”
“Drug Screen, Plasma and Urine”
“Imipramine and Desipramine, Plasma”
“Tricyclic Assay, Serum”
DEXAMETHASONE SUPPRESSION TEST, SERUM
Fluorescent Polarization Immunoassay (FPIA)
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen. Morning (8 a.m.) and afternoon (4 p.m.) specimens are desirable.
For diagnosis of depression disorders, give a 1 mg dose of oral dexamethasone at 11:30
p.m. Draw specimens the following day at 4 p.m. and 11 p.m. for cortisol levels.
NOTE: 1. Include time of collection on request form.
2. If multiple specimens are collected, send separate request form for each specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Cortisol levels
Negative: 0-2.5 ug/dL
Borderline: 2.5-4 ug/dL
Positive: > 4 ug/dL
1 day
Daily
82539
DHEA (DEHYDROEPIANDROSTERONE
See: “Dehydroepiandrosterone (DHEA), Serum”
DHEA (DEHYDROEPIANDROSTERONE), UNCONJUGATED
See: “Dehydroepiandrosterone (DHEA), Serum”
DHEA-S (DEHYDROEPIANDROSTERONE SULFATE)
See: “Dehydroepiandrosterone Sulfate (DHEA-S), Serum”
110
DIALYSIS FLUID COUNT
See: “Cell Count, Differential, Peritoneal Dialysate, Body Fluids/Dialysis Fluid”
DIAZEPAM, SERUM
HPLC
Test Performed At:
LabCorp
Specimen:
1 plain red top tube (minimum 1.0 ml of serum). Draw prior to next dose. Refrigerate.
NOTE:
1. Record time of last dose, dosage level and time specimen was drawn.
2. The plain red top tube should NOT contain gel or silicone.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.1-2.5 ng/ml
3 days
Daily
80154
DIGOXIN, SERUM
Microparticle Enzyme Immunoassay (MEIA)
Test Performed At:
Shore Health Laboratories
Specimen:
Peak: 1 SST tube (minimum 1.0 ml of serum) drawn 60-90 minutes after dose.
Centrifuge SST 30 minutes after draw. Refrigerate specimen. Trough: 1 SST tube
(minimum 1.0 ml of serum) drawn 8-24 hours after dose. Centrifuge SST 30 minutes after
draw. Refrigerate specimen.
Reference Values:
Critical Value:
Therapeutic concentration: 0.8 -2.0 ng/ml
> 2.5 ng/ml
Pediatric toxic concentrations may be higher.
1 day
Daily
80162
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
DILANTIN® (PHENYTOIN)
See: “Phenytoin, Total, Serum”
DIPHENYLHYDANTOIN
See: “Drug Screen, Plasma”
“Drug Screen, Plasma and Urine”
“Phenytoin, Total, Serum”
DIPHTHERIA ANTITOXIN TITER, SERUM
Indirect Hemagglutination
Test Performed At:
Maryland State Health Department
Specimen:
1 SST tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
111
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.01 IU/ml (indicates immunity)
21-28 days
Monday - Friday
86648
DIRECT BILIRUBIN
See: “Bilirubin, Direct, Serum"
DIRECTIGEN, SPINAL FLUID
Latex Agglutination. Includes Haemophilus influenza type B, Streptococcus pneumoniae, Neisseria meningitides,
groups A, B, C, Y, W135, and Group B streptococcus.
Test Performed At:
LabCorp
NOTE:
This test can ONLY be used as an adjunct to bacterial culture. An order for bacterial
culture MUST accompany this order.
Specimen:
1 plain red top tube (minimum 1.0 ml spinal fluid). Forward promptly. Refrigerate.
The plain red top should NOT contain gel or silicone.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Monday - Saturday
87802
87899 x3
DISOPYRAMIDE, SERUM (NORPACE)
FPIA
Test Performed At:
LabCorp
Specimen:
1 ml serum, collected before next dose. Do not use gel barrier tubes. Note time of last
dose, dosage and collection time. Refrigerate.
Reference Values:
Therapeutic concentration:
2.0-5.0 mcg/ml
Toxic concentration:
>8.0 mcg/ml
Analytic Time:
1 day
Day(s) Test Set Up: Monday - Saturday
CPT Code(s):
80299
DIURNAL CORTICOIDS
See: “Cortisol, Serum”
DNA, ANTI
See: “DNA Double Stranded (ds-DNA) Antibody, IgG, Serum”
“LE Package (Quest)”
“Lupus Comprehensive Panel"
112
DNA DOUBLE STRANDED (ds-DNA) ANTIBODY, IGG, SERUM
Enzyme-Linked Immunosorbent Assay (ELISA)
Test Performed At:
LabCorp
Specimen:
1 plain red top tube or 1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes
after draw. Refrigerate.
Reference Values:
<5 IU/ml
>9.0 IU/ml
Analytic Time:
1 day
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
86225
DNA PLOIDY OF SOLID TUMOR BY FLOW CYTOMETRY, PARAFFIN BLOCK
Flow Cytometry
Test Performed At:
LabCorp
Specimen:
Acceptable sources are: bladder, breast, colon, endometrium, kidney, prostate, and thyroid.
Send paraffin-embedded specimen block at room temperature.
NOTE:
Tumor description, diagnosis, pathologist’s name, address, and telephone number are
required on request form for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
DNA diploid
4 days
Monday - Saturday
88182
DOXEPIN (SIN EQUAN) N-DESMETHYLDOXEPIN, SERUM
LCMS-MS
Test Performed At:
LabCorp
Specimen:
1 ml serum from red top tube. Do not use gel barrier tubes. Collect 12 hours after last
dose. Refrigerate.
Reference Values:
Therapeutic concentration:
100-250 ug/L
Analytic Time:
1 day
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
80166
DRUG SCREEN, URINE
Immunochemical
Drugs tested: Amphetamines, Barbiturates, Benzodiazepines, Cocaine, Opiates, Cannabinoids, & Oxycodone
Test Performed At:
Shore Health Laboratories
113
Specimen:
10 ml from a random urine collection in a urine sample cup supplied by Shore
Health Laboratories. No preservative. Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Daily
80100 x13 - drug screen, urine
DRUG SCREEN COMPREHENSIVE, WHOLE BLOOD AND SERUM (COMA OVERDOSE)
Immunochemical
Test Performed At:
LabCorp (007022)
Specimen:
2 red top tube and 2 grey top (oxalate fluoride) tube (4 ml serum and 7 ml whole blood).
Do not use gel barrier tubes. Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Identification and quantitation when possible
1 day
Daily
80154
80101 x3
80185
80196
82003
82980
84600
DYSMORPHIC RBC
Microscopy
Test performed At:
LabCorp
Specimen:
10 ml random urine. Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Daily
81001
E
ECHINOCOCCUS ANTIBODY, SERUM
WB Confirmation
Test Performed At:
LabCorp
Specimen:
1 plain red top tube or 1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes
after draw. Refrigerate specimen.
NOTE:
For investigational use only. Not for use in diagnostic procedures without confirmation of
the diagnosis by another medically established diagnostic product or procedure.
Negative
Reference Values:
114
Analytic Time:
2 days
Day(s) Test Set Up: One day a week
CPT Code(s):
86682
EHRLICHIA CHAFFEENSIS ANTIBODY, SERUM
Indirect Fluorescent Antibody (IFA)
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
NOTE: 1. Acute and convalescent specimens are needed to interpret the results.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Single IFA-lgG titer of ≥1:128 indicates exposure to Ehrlichia chaffeensis.
Specimens demonstrating fourfold rise to ≥1:128 suggest recent or current infection.
1 day
Tuesday & Thursday
86753
ELAVIL® (AMITRIPTYLINE)
See: “Amitriptyline and Nortriptyline, Plasma”
“Drug Screen, Plasma”
“Drug Screen, Plasma and Urine”
ELECTROLYTES, FECES
Ion selective electrode
Includes sodium, potassium and chloride stool
Test Performed At:
LabCorp (823262)
Specimen:
10 grams of 24 hr. timed stool collection. Refrigerate during collection.
NOTE:
Patient should be experiencing diarrhea. Random specimens are acceptable.
specimen only – freeze specimen. Solid samples will be rejected.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
4 days
Tuesday & Thursday
82438
84302
84999
Liquid
ELECTROPHORESIS, PROTEIN, SERUM
Agarose Electrophoresis-Helena. Includes total protein.
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
2 times per week
84165 - electrophoresis, protein, 84155 - total protein
115
ELECTROPHORESIS, PROTEIN, URINE
Agarose Electrophoresis / Concentration. Includes total protein.
Test Performed At:
Shore Health Laboratories
Specimen:
10 ml from a random urine collection in a urine sample cup supplied by Shore Health
Laboratories. Refrigerate specimen.
Reference Values:
NOTE:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Albumin only (present in small amount)
Factors cannot be separated if protein is < 25 mg/dl.
1 day
twice weekly
84999 - concentration
84165 - electrophoresis, protein
84155 - total protein
ENVIRONMENTAL CULTURE
See: “Culture, Environmental”
EOSINOPHILS, NASAL SMEAR
See: “Nasal Smear for Eosinophils”
EOSINOPHILS, TOTAL, BLOOD
Automated
Included as part of the CBC
Test Performed At:
Shore Health Laboratories
Specimen:
1 lavender-top (K2 EDTA) tube (minimum: 1 .0 ml of K2 EDTA whole blood). Invert
several times to mix blood.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0-5%
1 day
Daily
85025
EPO (ERYTHROPOIETIN)
See: “Erythropoietin (EPO), Serum”
EPSTEIN-BARR VIRUS (EBV) ANTIBODIES, SERUM
Immunofluorescence. Includes viral capsid antigens (VCA), IgG and IgM and Epstein-Barr nuclear antigen
(EBNA). These tests are recommended only when a screening procedure (e.g. Monospot) is negative and
Infectiour Mononucleosis is still suspected.
Test Performed At:
LabCorp
116
Specimen:
1 plain red top tube or 1 SST tube (minimum 2.0 ml of serum).
Centrifuge 30 minutes after draw. Send at room temperature.
Reference Values:
See report.
In most populations, at least 90% of the adult population will have been infected with EBV
sometime in the past and, therefore, will have a measurable anti-VCA IgG and anti-EBNA
titer. Antibodies to EBNA develop 6-8 weeks after primary infection and remain present for
life. Presence of VCA/IgM antibodies indicates recent primary infection with EBV.
Analytic Time:
2 days
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
86663
ERYTHROCYTE SEDIMENTATION RATE (ESR)
See: “Sedimentation Rate (ESR)
ERYTHROPOIETIN (EPO), SERUM
Enzyme Immunoassay (EIA)
Useful for diagnosis of anemia and polycythemia as well as a tumor marker.
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum: 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
2.59-18.5 mIU/ml
1 day
Monday - Friday
82668
ESR (ERYTHROCYTE SEDIMENTATION RATE)
See: “Sedimentation Rate (ESR)”
ESTRADIOL, SERUM
Chemluminescense
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum: 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate.
NOTE:
Patient’s sex is required on request form for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day or STAT
Daily
82670
ESTRIOL, SERUM
Radioimmunoassay (RIA)
Test Performed At:
LabCorp
117
Specimen:
1 plain red top tube or SST (minimum 1.0 ml of serum). Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Monday - Saturday
82677
ESTROGEN / PROGESTERONE RECEPTOR ICA (PARAFFIN), IMMUNOPEROXIDASE STAIN
Test Performed At:
Shore Health Laboratories
Specimen:
NOTE:
1 paraffin block.
Submit also H&E slide and a copy of the pathology report with specimen.
Store at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
3 days
Sunday - Friday
88342 x 2
ESTROGEN RECEPTOR ASSAY (ERA) WITH PROGESTERONE RECEPTOR ASSAY (PRA), TISSUE
See: “Estrogen/Progesterone Receptor (Paraffin), Immunoperoxidase Stain”
ESTROGEN
See: “Estradiol, Serum”
"Total Estrogen, Serum"
ESTRONE, SERUM
Radioimmunoassay (RIA) After Column Chromatography
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 0.5 ml of serum). Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
2 days
Tuesday, Thursday, Saturday
82679
ETHANOL
See: “Alcohol, Ethyl, Serum”
ETHOSUXIMIDE, SERUM (ZARONTIN)
FPIA
Test Performed At:
LabCorp
Specimen:
1 ml serum. Do not use gel barrier tubes. Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Monday - Saturday
80168
118
ETHYL ALCOHOL
See: “Alcohol, Ethyl, Serum”
ETOH
See: “Alcohol, Ethyl, Serum”
EXCEDRIN® (ACETAMINOPHEN)
See: “Salicylate, Serum”
F
FACTOR II, DNA ANALYSIS
See: “Prothrombin Gene Mutation”
FACTOR V (LEIDEN) MUTATION
Test Performed At:
LabCorp
Specimen:
2 Lavendar (EDTA) tubes. Send original tubes (whole blood) at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
5 days
Monday - Saturday
83891
83894
83912
83898 x2
FACTOR VIII ACTIVITY
Test Performed At:
LabCorp
Specimen:
1 light blue top 3.2 (citrate) tube (minimum 2.0 ml of citrate plasma). Freeze.
NOTE:
Patient must not be receiving heparin.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Monday - Saturday
85240
FACTORS II, V, VII, IX, X, XI, XII ACTIVITY
See: “Coagulation, Specific Factor Assays, Plasma”
119
FARR TEST
See: “DNA Double Stranded (ds-DNA) Antibody, lgG, Serum”
FAST HEMOGLOBIN
See: “Glycated Hemoglobin, Blood”
FAT, QUALITATIVE, FECES
Sudan Stain
Test Performed At:
Specimen:
Shore Health Laboratories
A minimum of 15 g of stool collected in a gray cup or tightly covered container.
Refrigerate collection.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
<60: Normal, >60: Increased
1 day
Daily
89125
FAT, QUALITATIVE, URINE
Sudan Stain
Test Performed At:
Specimen:
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Shore Health Laboratories
5.0 ml of random urine collected in a urine sample cup supplied by Shore Health
Laboratories.
None seen
1 day
Daily
89125
FAT, QUANTITATIVE, FECES
Test Performed At:
LabCorp
Specimen:
Entire stool specimen (48 or 72 hour). Keep refrigerated during collection. See page 267
“Stool Collections.”
NOTE:
1. Length of collection period is required on request form for processing.
2. Barium interferes with the procedure.
3. Patient should be on a diet including 100 g of fat per day for 3 days prior to
collection period.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
<7 g/24 hrs
4 day
Monday - Thursday
82710
120
FEBRILE AGGLUTININS ** Test discontinued **
Physicians should order specific test based on clinical syndromes.
See: “Q Fever Antibodies, Serum”
FEBRILE ANTIBODY PROFILE (Includes IGG and IGM antibodies for brucella,spotted fever, and typhus fever).
Enzyme immunoassay (EIA) and immunofluorescence
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 2.0 ml serum). Separate and refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
2 days
Tuesday, Thursday, Saturday
86622 x 2, 86757 x 4
FECAL BLOOD
See: “Occult Blood, Feces”
FECAL FAT
See: “Fat, Qualitative, Feces”
“Fat, Quantitative, Feces”
FECAL LEUKOCYTES
See: “WBC, Feces”
FECAL pH
See: “pH, Feces”
FECAL UROBILINOGEN
See: “Urobilinogen”
FELBAMATE (FELBATOL), SERUM
High-Performance Liquid Chromatography (HPLC)
Test Performed At:
LabCorp
Specimen:
1 plain red top tube (minimum 2.0 ml serum) drawn 1 hour prior to next dose. Refrigerate
specimen.
NOTE:
Do not use gel barrier tubes.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Trough 30-50 ug/ml
2 days
Tuesday, Thursday, Saturday
82491
121
FEP (FREE ERYTHROCYTE PROTOPORPHYRIN)
See: “Zinc Protoporphyrin (FEP, Free Erythrocyte Protoporphyrin)”
FERRITIN, SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Males: 23.9-336.2 ng/ml
Females: 11.0-306.8 ng/ml
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
1 day
Daily
82728
FERTILITY TEST - Call Lab before collection
See: “Semen Analysis Complete”
“Semen Analysis, Post Vasectomy”
FETAL CELL STAIN
See: “Fetaldex, Blood”
FETALDEX, BLOOD
Betke-Kleihauer Stain
Includes: Fetal Cells, Maternal Cells, Fetal/Maternal Ratio, Volume of Fetal/Maternal Hemmorage
Test Performed At:
Shore Health Laboratories
Specimen:
1 lavender-top (EDTA) tube (minimum 1.0 ml of EDTA whole blood) from mother
immediately after delivery or as soon as possible.
Store at 4°. Can be analyzed up to 24 hrs. post collection.
NOTE:
Cord blood is NOT acceptable.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0- fetal cells present
1 day
Daily
85460
FETAL FIBRONECTIN (FFN)
Test Performed At:
Shore Health Laboratories
Specimen:
A swab from vaginal pool-placed in special FFN container. Send to laboratory for
STAT testing.
Reference Values:
Negative
122
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
1 day
Daily
82731
FETAL HEMOGLOBIN
See: “APT Test”
“Fetaldex, Blood”
“Hemoglobin Electrophoresis, Blood”
FETAL LUNG MATURITY (LAMELLAR BODY COUNTS)
Optical impedance
Test Performed At:
LabCorp
Specimen:
4 ml amniotic fluid. Amniotic fluid is obtained by needle aspiration into the amiotic sac.
DO NOT CENTRIFUGE. DO NOT FREEZE. Refrigerate.
Reference Values: See report
Analytic Time:
1 day
Day(s) Test Set Up: Monday - Saturday
CPT Code(s):
83664
FETAL MATERNAL RATIO
See: “Fetaldex, Blood”
FIBRINOGEN, PLASMA
Derived from Prothrombin Time
Test Performed At:
Shore Health Laboratories
Specimen:
1 light blue-top tube 3.2 (citrate) tube (minimum 4.0 ml of citrate whole blood). Fill
light blue-top (citrate) tube to blue band on the label of the tube.
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
180-460 mg/dl
< 100 mg/dl
1 day
Daily
85384
FIBRIN SPLIT PRODUCTS (FDP), PLASMA
See: “D-Dimer”
FIFTH DISEASE
See: “Parvovirus B19 Antibodies, IgG and IgM (Separate Determinations), Serum”
FK506
See: “Tacrolimus”
123
FLECAINIDE, SERUM (TAMBOCOR)
HPLC
Test Performed At:
LabCorp (085662)
Specimen:
Serum: 2 plain red top tubes (minimum 3.0 ml serum). Refrigerate.
NOTE:
Do not use gel barrier tubes.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.2-1.0 ug/ml
1 day
Monday - Saturday
82491
FLUORESCENT TREPONEMAL ANTIBODY, ABSORBED (FTAABS)
See: “Syphilis Serology”
FLUORIDE, SERUM
Ion-Chromatography
Test Performed At:
LabCorp (070060)
Specimen:
2 plain red top tubes or 2 royal navy blue EDTA tubes (3 ml serum or plasma).
Separate and maintain at room temperature.
NOTE:
Do not use gel barrier tubes.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
<0.2 mg/L
2-8 days
Batched
82735
FLUOXETINE, SERUM (PROZAC®)
Liquid Chromatography/ MS. Includes the pharmacologically active metabolite, norfluoxetine, which is also
quantitated and reported.
Test Performed At:
LabCorp (706838)
Specimen:
1 plain red top tube (minimum 2.0 ml of serum). Refrigerate specimen.
NOTE:
Do not use gel barrier tubes.
Reference Values:
Fluoxetine: 91-302 ng/ml
Norfluoxetine: 72-258 ng/ml
Analytic Time:
1 day
Day(s) Test Set Up: Monday, Wednesday, Friday
CPT Code(s):
84022
124
FLUPHENAZINE (PROLIXIN)
Liquid Chromatography, TMS
Test Performed At:
LabCorp
Specimen:
1 plain red top tube (minimum 2.0 ml of serum). Refrigerate specimen.
NOTE:
Do not use gel barrier tubes.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Therapeutic 0.3-4.0 ng/ml
2 days
Monday, Wednesday, Friday
84022
FOLATE
See: “Folate, Erythrocytes”
“Vitamin B12 and Folate, Serum”
FOLATE, ERYTHROCYTES
Chemiluminescence
Test Performed At:
LabCorp
Specimen:
2 lavender top (EDTA) tubes. Transfer 1 EDTA tube whole blood to purple plastic tube and
freeze. Refrigerate second EDTA tube.
NOTE:
If “Folate, Erythrocytes” is not specifically indicated on the request form, “Vitamin B12 and
Folate, Serum” will be performed.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
>280 ng/ml
1 day
Monday - Friday
82747
FOLIC ACID
See: “Folate, Erythrocytes”
“Vitamin B12 and Folate, Serum”
FOLLICLE-STIMULATING HORMONE (FSH), SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Daily
83001
125
FRAGILE X PCR WITH REFLEX
PCR followed by agarose get and capillary electrophoresis and if required, Southern blot hybridization.
Test Performed At:
LabCorp
Specimen:
3 lavender top (EDTA) tubes. Forward unprocessed whole blood promptly at ambient
temperature only.
NOTE:
Reason for Referral Plus Relevant Clinical and Family Information must be submitted with
specimen in order to provide correct interpretation of test results.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
An interpretive report will be issued.
21 days
Monday - Friday
81243
FREE CALCIUM
See: “Calcium, Ionized, Serum”
FREE TESTOSTERONE
See: “Testosterone, Total and Free, Serum”
FREE TRIIODOTHYRONINE
See: “T3 (Triiodothyronine), Free, Serum”
FREE T4 (THYROXINE)
See: “T4 (Thyroxine), Free, Serum”
FREE T3 (TRIIODOTHYRONINE
See: “T3 (Triiodothyronine), Free, Serum”
FRUCTOSAMINE, SERUM
Colorimetric
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Send at Room Temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Monday - Friday
82985
126
FSH (FOLLICLE-STIMULATING HORMONE)
See: “Follicle-Stimulating Hormone (FSH), Serum”
FSP (FIBRIN SPLIT PRODUCTS)
See: “D-Dimer”
FTA-ABS (FLUORESCENT TREPONEMAL ANTIBODY, ABSORBED)
See: “STS (Syphilis EIA IgG/IgM) Serum”
FT3 (FREE TRIIODOTHYRONINE)
See: “T3 (Triiodothyronine), Free, Serum”
FUNGUS CULTURE
See: “Culture, Fungus”
“Culture, Fungus, Blood”
G
GALACTOKINASE, BLOOD
Radioisotopic
Galactose-1-phosphate uridyltransferase deficiency is the most common cause of galactosemia. Galactokinase
deficiency is the second most common cause of galactosemia.
Test Performed At:
LabCorp
Specimen:
1 green top (heparin) tube (minimum 5.0 ml; pediatric 2.0 ml of heparinized whole blood).
Refrigerate specimen. Only collect Monday – Wednesday.
Reference Values:
<2 years: 20.1-79.8 mU/g of hemoglobin
>=2 years: 12.1-39.7 mU/g of hemoglobin (literature values)
Analytic Time:
8 days
Day(s) Test Set Up: Tuesday
CPT Code(s):
82759
GALACTOSE-1-PHOSPHATE URIDYL TRANSFERASE (GPUT)
Ultraviolet, Kinetic
This assay is a quantitative measurement of the enzyme GPUT and provides an approximation of the patient’s
genotype. A deficiency of this enzyme is the most common cause of galactosemia. A galactokinase deficiency is
the second most common cause of galactosemia. Those patients with GPUT values of 10.0 U/g hemoglobin or
127
less should be definitively characterized by genotyping, see: “Galactose-1-Phosphate Uridyltransferase (GPUT)
Genotyping, Erythrocytes.” This assay is not useful for diet monitoring of galactosemics.
Test Performed At:
LabCorp
Specimen:
2,green sodium heparin tubes (minimum 3.0 ml whole blood). Refrigerate specimen.
Stable 5 days.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
5 days
Monday - Friday
82775
GALACTOSE, QUANTITATIVE, URINE
Thin-Layer Chromatography (TLC). Confirmed by galactose dehydrogenase.
Galactose-1-phosphate uridyltransferase deficiency is the most common cause of galactosemia. Galactokinase
deficiency is the second most common cause of galactosemia.
Test Performed At:
LabCorp
Specimen:
5.0 ml from a random urine collection in a urine sample cup. Collect specimen 2 hours after
patient has drank a glass of milk. Freeze specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Monday - Friday
84375
GALACTOSE, PLASMA QUANTITATIVE
Spectrophotometry
Test Performed At:
LabCorp
Specimen:
1.0 ml FROZEN plasma from heparinized (green top tube) plasma.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
5 days
Monday - Friday
82760
GAMMA-GLOBULIN
See: “Electrophoresis, Protein, Serum”
“Electrophoresis, Protein, Urine”
GAMMA-GLOBULINS, QUANTITATIVE
See: “Immunoglobulin A (IgA), Serum”
“Immunoglobulin G (lgG), Serum”
“Immunoglobulin M (IgM), Serum”
“Immunoglobulins (lgG, IgA, and IgM), Serum”
128
GAMMA-GLUTAMYLTRANSFERASE (GGT), SERUM
Photometric
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Males: 15-85 U/L
Females: 5-55 U/L
1 day
Daily
82977
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
GAMMA-GLUTAMYLTRANSPEPTIDASE (GGTP)
See: “Gamma-Glutamyltransferase (GGT), Serum”
GAMMA-TOCOPHEROL
See: “Vitamin E, Serum”
GANGLIOSIDE (GD1b AB) IGG & IGM
Enzyme Immunoassay
Test Performed At:
LabCorp (808620)
Specimen:
1 plain red top tube or 1 SST tube (minimum 1.0 ml serum). Centrifuge SST 30 minutes
after collection. Maintain at room temperature. Stable for 5 days.
Reference Values: See Report
Analytic Time:
5 days
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
83520 x2
GARAMYCIN® (GENTAMICIN)
See: “Gentamicin, Serum”
GARDNERELLA VAGINALIS CULTURE
See: “Culture, Gardnerella vaginalis”
129
GASTRIN, SERUM
Chemiluminescence
Test Performed At:
LabCorp
Specimen:
1 plain red top tube or 1 SST tube (minimum 0.5 ml of serum) from a fasting patient.
Centrifuge SST 30 minutes after draw. Serum should be removed and frozen within 1 hour
of collection.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Monday, Wednesday, Friday
82941
GC CULTURE
See: “Culture, Transgrow®”
GC by Nucleic Acid Amplification – see Chlamydia trachomatis by Nucleic Acid Amplification (Genprobe® Aptima®)
GENITAL CULTURE
See: “Culture, Genital”
GENTAMICIN, SERUM
Petinia Technique
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Serum for a peak level should be taken 30
minutes after complete infusion of an intravenous dose or 60 minutes after an
intramuscular or oral dose of gentamicin. Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Therapeutic ranges
Peak: 4 - 8 ug/ml
Trough: 0.2 – 1.9 ug/ml
> 3 ug/ml (trough), > 12 ug/ml (peak)
1 day
Daily
80170
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
GERMAN MEASLES VIRUS
See: “Prenatal Profile”
“Rubella Antibodies, IgM Only, Serum”
“TORCH Panel”
GGT (GAMMA-GLUTAMYLTRANSFERASE)
See: “Gamma-Glutamyltransferase (GGT), Serum”
130
GGTP (GAMMA-GLUTAMYLTRANSPEPTIDASE)
See: “Gamma-Glutamyltransferase (GGT), Serum”
GIARDIA ANTIGEN, FECES
Immuno- assay
Useful for screening for the detection of Giardia antigen present in stool specimens.
Test Performed At:
Shore Health Laboratories
Specimen:
Fresh stool, formalin preserved, or tightly sealed ParaPak® PVA/Formalin specimen.
Refrigerate fresh stool specimen. Formalin preserved or ParaPak® PVA/Formalin tightly
sealed specimen should be kept at ambient temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Monday-Friday
87329
GLOBULIN
See: “Albumin/Globulin (A/G) Ratio, Serum”
“Hepatic panel”
GLOMERULAR BASEMENT MEMBRANE ANTIBODY IGG, SERUM
Enzyme Immunoassay (EIA)
Useful for evaluation of patients with rapidly progressive renal disease and/or pulmonary hemorrhage.
Test Performed At:
LabCorp
Specimen:
1 plain red top tube or 1 SST tube (minimum 1.0 ml serum). Centrifuge SST 30 minutes
after draw. Send at Room Temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.0 – 3.0 units/ml
1 day
Monday - Saturday
83516
GLUCAGON, PLASMA
Radioimmunoassay (RIA) following extraction
Test Performed At:
LabCorp
Specimen:
Requires a Trasylol kit before collecting.
Collect 2 prechilled lavender (EDTA) tubes. Transfer 6 ml whole blood to red top tube
containing 0.25 Trasylol solution. Mix well, centrifuge, and transfer 1.0 ml plasma to labeled
transport tube. Freeze. (See LabCorp instructions)
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
40-130 pg/ml
3 days
Monday
82943
131
GLUCOSE
See: "Basic Metabolic Panel"
“Glucose Challenge, Serum”
“Glucose, 2-Hour Post-Prandial, Plasma”
"Glucose-6-Phosphate Dehydrogenase (G-6-PD) Quantitative, Erythrocytes”
“Glucose Phosphate Isomerase, Erythrocytes”
“Glucose, Plasma or Serum”
“Glucose, Spinal Fluid”
“Glucose Tolerance, 2-Hour, Serum”
“Glucose Tolerance, 3-Hour Prenatal, Serum”
“Glucose Tolerance, 5-Hour, Serum”
“Comprehensive Metabolic Panel”
“Renal Function Panel”
GLUCOSE CHALLENGE, SERUM
Glucose Oxidase or Hexokinase
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube or 1 gray sodium fluoride tube collected 1 hour after a 50 g glucose load
from a fasting patient. Fasting patient is preferred, non-fasting patient is acceptable.
Centrifuge SST 30 minutes after draw. Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
72-139 mg/dl
1 day
Daily
82950
GLUCOSE, 2-HOUR POST-PRANDIAL, PLASMA
Glucose Oxidase or Hexokinase
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum) collected 2 hours after a meal. Centrifuge SST 30
minutes after draw. Refrigerate specimen. NOTE: Draw specimen in gray-top (sodium
fluoride) tube if unable to centrifuge sample within 30 minutes of draw.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
72-139 mg/dl
1 day
Daily
82950
GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G-6-PD)
Kinetic/Spectrophotometric
Test Performed At:
LabCorp
Specimen:
2 lavender EDTA tubes. Send original whole blood tubes. Do not separate. Refrigerate.
132
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
1 day
Monday - Friday
82955
85041
GLUCOSE, PLASMA or SERUM
Glucose Oxidase or Hexokinase
Test Performed At:
Shore Health Laboratories
Specimen:
Plasma: 1 gray-top (sodium fluoride) tube (minimum 0.5 ml of sodium fluoride
plasma) from a fasting patient. Refrigerate specimen.
Serum: 1 SST tube (minimum 0.5 ml of serum) from a fasting patient. Centrifuge
SST tube 30 minutes after draw. Refrigerate.
NOTE: 1. Indicate plasma or serum on request form.
2. Label specimen appropriately (plasma or serum).
Reference Values:
Critical Value:
70 - 109 mg/dl
Newborn < 32 or > 328 mg/dl
Child < 46 or > 445 mg/dl
Adult < 46 or > 484 mg/dl
Analytic Time:
1 day
Day(s) Test Set Up: Daily
CPT Code(s):
82947
GLUCOSE, SPINAL FLUID
Glucose Oxidase or Hexokinase
Test Performed At:
Shore Health Laboratories
Specimen:
1 plain, red-top tube (minimum 0.2 ml of spinal fluid). Refrigerate specimen in a screw
capped, sterile vial after collection. Maintain sterility and forward promptly.
NOTE: The plain, red-top tube should NOT contain gel or silicone.
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
40 - 75 mg/dl
< 37 mg/dl
1 day
Daily
82947
GLUCOSE TOLERANCE, 2-HOUR, SERUM
Glucose Oxidase or Hexokinase
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum: 0.5 ml of serum) for each of the following: Fasting and 2 hrs postprandial. After obtaining fasting specimen, give 75 g of glucose orally before collecting the
remaining specimen. Centrifuge SST 30 minutes after draw. Refrigerate specimens.
NOTE: 1. Draw specimen in gray-top (sodium fluoride) tube if unable to centrifuge sample within 30 minutes
of draw.
2. Follow guidelines in “Patient Preparation for Glucose Tolerance Test” supplied by Shore Health
Laboratories.
3. Label specimens appropriately (corresponding collection time).
133
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Daily
82952 – each additional specimen
82951 - 3 specimens
GLUCOSE TOLERANCE, 3-HOUR PRENATAL, SERUM
Glucose Oxidase or Hexokinase
NOTE: Use this test for pregnant females with glucose of > 140 mg/dl.
Test Performed At: Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum) for each of the following: - Fasting, 1 hour postprandial, 2 hours post-prandial and 3 hours post-prandial. After obtaining fasting specimen,
give 100g of glucose orally before collecting the remaining specimens. Centrifuge SST 30
minutes after draw. Refrigerate specimens.
NOTE: 1. Draw specimen in gray-top (sodium fluoride) tube if unable to centrifuge sample within 30 minutes
of draw.
2. Follow guidelines in “Patient Preparation for Glucose Tolerance Test” supplied by Shore Health
Laboratories.
3. Label specimens appropriately (corresponding collection time).
Reference Values:
Fasting: 70 - 95 mg/dl
1 hour: 70 -180 mg/dl
2 hours: 70 -155 mg/dl
3 hours: 70 - 140 mg/dl
Critical Value:
Fasting > 484 mg/dl
Analytic Time:
1 day
Day(s) Test Set Up: Daily
CPT Code(s):
82952 - each additional specimen
82951 - 3 specimens
GLUCOSE TOLERANCE, 5-HOUR, SERUM
Glucose Oxidase or Hexokinase
Test Performed At: Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum) for each of the following: Fasting,1/2 Hour postprandial,1 Hour post-prandial, 2 Hours post-prandial, 3 Hours post-prandial, 4 Hours postprandial, 5 Hours post-prandial. After obtaining fasting specimen, give 75 g of glucose
orally before collecting the remaining specimens. Centrifuge SST 30 minutes after draw.
Refrigerate specimens.
NOTE: 1. Draw specimen in gray-top (sodium fluoride) tube if not able to centrifuge sample within 30
minutes of draw.
2. Follow guidelines in “Patient Preparation for Glucose Tolerance Test” supplied by Shore Health
Laboratories.
3. Label specimens appropriately (corresponding collection time).
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Daily
82952 - each additional specimen
82951 - 3 specimens
134
GLYCATED HEMOGLOBIN, BLOOD
HPLC
Test Performed At:
Shore Health Laboratories
Specimen:
1 lavender-top (EDTA) tube (minimum 1.0ml of EDTA whole blood). Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
4 – 6.4 % A1C
1 day
Monday - Saturday
83036
GLYCOSYLATED HEMOGLOBIN
See: “Glycated Hemoglobin, Blood”
GONADOTROPIN, CHORIONIC
See: “Alpha-Fetoprotein (AFP) Triple Screen, Serum”
“Chorionic Gonadotropin, Beta-Subunit (Quantitative), Spinal Fluid”
“hCG (Human Chorionic Gonadotropin), Quantitative (Titer), Serum”
“PregnancyTest, Qualitative, Serum”
“Pregnancy Test, Urine”
GOUT (URATES)
See: “Crystals, Body Fluids”
G-6-PD (GLUCOSE-6-PHOSPHATE DEHYDROGENASE)
See: “Glucose-6-Phosphate Dehydrogenase (G-6-PD) Quantitative, Erythrocytes”
GRAM STAIN SMEAR
See: “Smear, Gram Stain”
GRANULOCYTE ANTIBODIES, SERUM (HUMAN GRANULOCYTE EHRLICHIOSIS (HGE) IGG & IGM
IFA
Test Performed At:
LabCorp
Specimen:
1 plain red top or SST tube (minimum 1.0 ml of serum). Refrigerate.
Reference Values:
IgG negative <1:64
IgM negative <1:20
Analytic Time:
8 days
Day(s) Test Set Up: Wednesday
CPT Code(s):
86666 x2
135
GROWTH HORMONE, SERUM
Immunochemiluminometric Assay (ICMA)
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 ml serum) from a fasting patient. Centrifuge
SST 30 minutes after draw. Refrigerate specimen.
NOTE:
If multiple specimens are collected, send separate request form for each specimen and
label specimens with corresponding collection times.
Reference Values:
Children: age dependent
Adults: <6.0 ng/ml
Analytic Time:
1 day
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
83003
GUIAC
See: “Occult Blood, Feces”
H
HAA (HEPATITIS A ANTIBODY)
See: “Hepatitis Bs Antigen (HBsAg), Serum”
“Acute Hepatitis Panel”
HALOPERIDOL, SERUM (HALDOL)
High-Performance Liquid Chromatography (HPLC)
Test Performed At:
LabCorp
Specimen:
2 plain red top, lavender top, or green (heparin) tubes (minimum 4.0 ml serum or plasma).
Refrigerate specimen.
NOTE:
No gel barrier tubes. Record time of last dose, dosage level, and specimen collection time.
Reference Values:
Therapeutic range: 4-26 ng/ml
Toxic: >50 ng/ml
Analytic Time:
1 day
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
80173
136
HAPTOGLOBIN, SERUM
Nephelometry
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
32-205 mg/dl
1 day
Daily
83010
HBeAg (HEPATITIS Be ANTIGEN)
See: “Hepatitis Be Antigen and Antibody (HBeAg and Anti-HBe), Serum”
“Hepatitis Be Antigen (HBeAg), Serum”
HBsAg (HEPATITIS Bs ANTIGEN)
See: “Hepatitis Bs Antigen (HBsAg), Serum”
“Acute Hepatitis Panel”
hCG (HUMAN CHORIONIC GONADOTROPINS)
See: “Alpha-Fetoprotein (AFP) Triple Screen, Serum”
“Chorionic Gonadotropin, Beta-Subunit (Quantitative), Serum”
“hCG (Human Chorionic Gonadotropin), Quantitative (Titer), Serum”
“hCG (Human Chorionic Gonadotropin), Tumor Marker
“Pregnancy Test, Qualitative, Serum”
“Pregnancy Test, Urine”
hCG (HUMAN CHORIONIC GONADOTROPIN), QUANTITATIVE (TITER), SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
< 3 mlU/ml (negative)
3-4.9 mlU/ml (grey zone)
> 4.9 mlU/ml (positive)
Analytic Time:
1 day
Day(s) Test Set Up: Daily
CPT Code(s):
84702
137
hCG (HUMAN CHORIONIC GONADOTROPIN), TUMOR MARKER
Test Performed At: LabCorp
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
NOTE:
Performed on males.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
< 10 mlU/ml (negative)
1 day
Daily
84702
HCT (HEMATOCRIT)
See: “Hemoglobin and Hematocrit, Blood”
HCV (HEPATITIS C VIRUS) RNA DETECTION
See: “Hepatitis C Virus (HCV) RNA by PCR Quantitative”
“Hepatitis C Virus RNA (HCV-RNA)
"Hepatitis C Virus RNA, Genotype"
HDL CHOLESTEROL, SERUM
Detergent Soluble. HDL cannot be run by this method if triglyceride is > 2000 mg/dl.
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Draw specimen following an overnight (12-14
hour) fast. Patient must not consume any alcohol for 24 hours before the specimen is
drawn. Centrifuge SST 30 minutes after draw. Refrigerate.
NOTE: Patient’s age and sex are required on request form for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
>39 mg/dl
1 day
Daily
83718- HDL
84478 - Triglycerides
HDL (HIGH DENSITY LIPOPROTEIN CHOLESTEROL)
See: “Lipid Profile”
“HDL Cholesterol, Serum”
“Lipoprotein Profile, Serum”
HELICOBACTER PYLORI, IGG ANTIBODY, SERUM
FIAX Titer. Useful as a screening test to identify patients with active Helicobacter pylori associated gastritis.
Test Performed At:
LabCorp
138
Specimen:
1 SST tube (minimum 1.0 ml serum). Centrifuge SST 30 minutes after draw. Transfer
serum to a screw-capped, sterile vial after collection. Maintain sterility and forward promptly
at room temperature.
NOTE:
Heat inactivated specimens will not be tested.
Reference Values:
Expected values
<0.91 Negative
0.91-1.09 Borderline
>1.09 Positive
Analytic Time:
2 days
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
86677
HEMATEST
See: “Occult Blood, Feces”
HEMOGLOBIN AND HEMATOCRIT, BLOOD
Electronic Impedance
Test Performed At:
Shore Health Laboratories
Specimen:
1 lavender-top (K2 EDTA) tube (minimum 3.0 ml of K2 EDTA whole blood).
Refrigerate. SPECIMEN CANNOT BE FROZEN.
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
See page 29.
1 day
Daily
85021
HEMOCCULT
See: “Occult Blood, Feces”
HEMOGLOBIN A1C
See: “Glycated Hemoglobin, Blood”
HEMOGLOBIN A2
See “Hemoglobin Electrophoresis “ or “Hemoglobin Evaluation” tests.
HEMOGLOBIN ELECTROPHORESIS, BLOOD
Electrophoresis
In the event that a rare hemoglobin variant is present, please refer to Hemoglobinopathy Evaluation for further
testing.
Test Performed At:
Shore Health Laboratories
Specimen:
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
1 lavender-top (EDTA) tube. Refrigerate. SPECIMEN CANNOT BE FROZEN.
See report
1 week
Batched
83021
139
HEMOGLOBIN F, BLOOD
HPLC
Test Performed At:
LabCorp
Specimen:
1 lavender top (EDTA) tube. Send whole blood. Do not transfer blood to other containers.
Refrigerate. DO NOT FREEZE.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
1 day
Monday - Friday
83021
HEMOGLOBINOPATHY EVALUATION
Electrophoresis
In the event that a rare hemoglobin variant is present, the appropriate tests will be performed and the results
interpreted to identify the hemoglobinopathies or thalassemias.
Test Performed At:
LabCorp
Specimen:
1 lavender-top (EDTA) tube. Refrigerate. SPECIMEN CANNOT BE FROZEN.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 week
Batched
83021
HEMOGLOBIN SOLUBILITY
See: “Hemoglobinopathy Evaluation”
HEMOGLOBIN 5, SCREEN
See: “Sickle Cell Testing, Blood”
HEMOSIDERIN, URINE
Microscopic stain
Test Performed At:
LabCorp
Specimen:
5 ml of the first morning urine collected in a urine sample cup supplied by Shore Health
Laboratories. Refrigerate specimen no longer than 24 hours before returning to Lab. Lab
should freeze specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
None detected
3 days
Monday - Friday
83070
140
HEPATIC PANEL
See: “Acute Hepatic Panel”
HEPATITIS A ANTIBODY
See: “Hepatitis A Antibody, lgG and IgM (Anti-HAV), Serum”
“Acute Hepatitis Panel”
HEPATITIS A ANTIBODY, IgM (ANTI-HAVM/ HAVABM), SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate. Collection date is required on request form for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Monday – Friday
86296
HEPATITIS A ANTIBODY, IGG AND IGM (ANTI-HAV/HAVAB TOTAL), SERUM
Microparticle Enzyme Immunoassay (MEIA)
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml serum). Centrifuge SST 30 minutes after draw. Refrigerate.
NOTE:
Collection date is required on request for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Sunday - Friday
86708
HEPATITIS Bc Ab, IgM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube, minimum 1.0 ml of serum. Centrifuge SST 30 minutes after draw.
Reference Values:
Analytic Time:
Days Set Up:
CPT Code(s):
Negative
1 day
Monday -Friday
86705
141
HEPATITIS Bc AB, IGG AND IGM (ANTI-HBc IGG AND IGM), SERUM (HBc A, TOTAL)
Enzyme Immunoassay (EIA)
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml serum). Centrifuge SST 30 minutes after draw. Refrigerate
NOTE:
Collection date is required on request form for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Monday- Friday
86704
HEPATITIS Be ANTIBODY (ANTI-HBe), SERUM
Enzyme Immunoassay (EIA)
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml serum). Centrifuge SST 30 minutes after draw. Refrigerate.
NOTE:
Heat inactivated specimens will not be tested.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Non-reactive
2 days, if non-reactive
Monday - Friday
86707
HEPATITIS Be ANTIGEN (HBeAg), SERUM
Enzyme Immunoassay (EIA)
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml serum). Centrifuge SST 30 minutes after draw. Refrigerate.
NOTE:
Heat inactivated specimens will not be tested.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Non-reactive
2 days, if non-reactive
Monday - Friday
87350
HEPATITIS Bs
See: “Hepatitis Bs Antibody (Anti-HBs), Serum”
“Hepatitis Bs Antigen (HBsAg), Serum”
“Acute Hepatitis Panel”
142
HEPATITIS Bs ANTIBODY (ANTI-HBs), SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
NOTE:
1 SST tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
Collection date is required on request form for processing.
Reference Values:
Negative
Interpretation depends on clinical setting. See page 246 “Hepatitis Clinical Interpretation
Guide.”
Analytic Time:
1days
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
86291
HEPATITIS Bs ANTIGEN (HBsAg), SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
NOTE: 1. If also collecting blood for other tests, obtain a separate tube dedicated for HBsAg testing.
2. Collection date is required on request form for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
Interpretation depends on clinical setting. See page 246, “Hepatitis Clinical Interpretation
Guide.”
1 days
Monday - Friday
86287
HEPATITIS C ANTIBODY
See: “Hepatitis C Antibody (Anti-HCV), Serum”
“Hepatitis Profile”
HEPATITIS C ANTIBODY (ANTI-HCV), SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
NOTE:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Collection date is required on request form for processing.
Reference Values:
Negative
Interpretation depends on clinical setting. See page 246, “Hepatitis Clinical Interpretation
Guide.”
1 day
Monday - Friday
86302
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
143
HEPATITIS C VIRUS (HCV) RNA BY PCR (VIRAL LOAD)
Test Performed At:
LabCorp
Specimen:
1 PPT Plasma Preparation tube (Ivory top). Minimum 2.3-3.5 ml. Spin and freeze
immediately.
NOTE:
This test is intended to be used to monitor known HCV positive infections. It is not intended
for primary detection of HCV infections.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
5 days
Monday - Saturday
87902
HEPATITIS C VIRUS (HCV) RNA, GENOTYPE NON REFLEX (LIPA)
PCR, DNA Sequencing
Test Performed At:
LabCorp
Specimen:
2 PPT (Plasma Prepartation Tube) (ivory top). Centrifuge and freeze entire tubes within 4
hours.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1-4 days
Monday - Friday
87902
HERPES SIMPLEX CULTURE
See: “Culture, Herpes”
HERPES SIMPLEX VIRUS (HSV) ENCEPHALITIS DETECTION BY POLYMERASE CHAIN REACTION (PCR),
(TYPES 1 & 2)
Test Performed At:
LabCorp
Specimen:
CSF: 1 sterile tube (minimum 0.5 ml spinal fluid). Refrigerate. Stable 7 days.
Serum: 1 SST tube (minimum 1.0 ml of serum). Refrigerate. Stable 7 days.
Plasma: 1 lavender (EDTA) tube (minimum 1.0 ml of plasma). Refrigerate. Stable 7 days.
Whole Blood: 1 lavender (EDTA) tube (minimum 1.0 ml whole blood). Refrigerate. Stable 7
days.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Not detected
5 days
Monday - Friday
87529 x2
144
HERPES SIMPLEX VIRUS (HSV) 1/2 SPECIFIC IGG
IFA
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.5 ml serum). Refrigerate.
Reference Values:
Negative
Additional interpretive information provided with report.
Analytic Time:
1 day
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
86695, 86696
HERPES SIMPLEX VIRUS (HSV) 1/2 SPECIFIC IGM
IFA
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml serum). Refrigerate.
Reference Values:
Negative
Additional interpretive information provided with report.
Analytic Time:
1 day
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
86695, 86696
HERPES (VARICELLA) ZOSTER CULTURE
See: “Culture, Viral”
HETEROPHILE ABSORPTION
See: “Mononucleosis Slide Test, Serum”
HETEROPHILE ANTIBODY
See: “Mononucleosis Slide Test, Serum”
HGB (HEMOGLOBIN)
See: “Hemoglobin and Hematocrit, Blood”
“Hemoglobin A2, Column, Blood”
“Hemoglobin Electrophoresis, Blood”
“Hemoglobinopathy Evaluation"
HGB (HEMOGLOBIN) ELECTROPHORESIS
See: “Hemoglobin Electrophoresis, Blood”
“Hemoglobinopathy Evaluation"
145
HIGH DENSITY CHOLESTEROL (HDC)
See: “Lipid Profile”
“HDL Cholesterol, Serum”
“Lipoprotein Profile, Serum”
HIGH DENSITY LIPOPROTEIN
See: “Lipid Profile”
“HDL Cholesterol, Serum”
“Lipoprotein Profile, Serum”
HIGH DENSITY TRIGLYCERIDE (HDT)
See: “Lipoprotein Profile, Serum”
HISTAMINE, 24 HOUR, URINE
Test Performed At:
LabCorp
Specimen:
Submit and entire 24 hour urine collection in a urine container supplied by Shore Health
Laboratories. Refrigerate Specimen. SHS lab will aliquot 10-15 ml and freeze to send for
testing.
NOTE;
Follow guidelines in “Patient Instructions for 24 hour Urine Collection” supplied by SHL.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See results
3 days
Tuesday & Thursday
83088
HISTOLOGY, TISSUE
Test Performed At:
Shore Health Laboratories
Specimen:
Tissue specimens must be fixed in 10% formalin and placed in a plastic, whitecapped specimen jar supplied by Shore Health Laboratories.
NOTE: 1. Specimen source is required on request form for processing.
2. Please complete “Part B” of a “Chesapeake Pathology Associates Request Form” and forward it
with the specimen. This form is supplied by Shore Health Laboratories. A copy of this form is also
printed in the appendix. Requisitions for this procedure cannot be processed unless the information
requested is supplied.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Descriptive report
3 days
Monday - Friday
88300- 88309
146
HISTONE AUTOANTIBODIES, SERUM
EIA
Test Performed At: LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 ml serum) from a fasting patient. Centrifuge
SST 30 minutes after draw. Maintain at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative: <1.0 units
2 days
Monday, Wednesday, Friday
86235
HISTOPLASMA
See: “Fungus Serology, Serum”
HIV (HUMAN IMMUNODEFICIENCY VIRUS)
See: “Human Immunodeficiency Virus Antibody Type 1 (Anti-HIV-1+2), Serum”
“Human Immunodeficiency Virus.1 (HIV-1+2) Antibody Confirmation by Multispot,”
“Human Immunodeficiency Virus Type 1 (HIV-1) RNA by Polymerase Chain Reaction (PCR), Quantitative,
Plasma”
HLA-B27 ANTIGEN, DISEASE ASSOCIATION, BLOOD
PCR
Test Performed At:
LabCorp
Specimen:
2 lavender (EDTA) tubes. Send whole blood at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
see report
1 day
Monday - Friday
81374
HOMOCYSTEINE, SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
1.0 ml serum from red top tube.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
3.7-13.9 umol/L
1 day
Tuesday & Friday
82131
147
HOMOVANILLIC ACID (HVA), URINE (Random or 24hour)
LCMS/MS
Test Performed At:
LabCorp
Specimen:
Submit 30 ml from a 24 hour urine collection or random sample. Refrigerate specimen.
Follow guidelines in “Patient Instructions for 24 hour Urine Collection” supplied by SHL.
NOTE:
Robaxin, L-dopa interferes with the procedure. It should be discontinued at least 48 hours
prior to collection of specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.0-10.0 mg/24 hr
1 day
Monday - Friday
83150
HPV, THIN PREP
Test Performed At:
Shore Health Laboratories
Specimen:
Cytobrush/spatula is inserted into the cervical os and any other suspicious area of the
ectocervix. Thick areas of blood and mucus are to be avoided. Dispose of applicator when
done. Tightly close the vial and label with patient’s full name and date of birth.
NOTE:
1. The patient should be mid cycle.
2. The HPV test can be run on the same vial as the Thin Prep PAP.
3. Please complete “Chesapeake Pathology Associates Request Form” and forward it with
the specimen. This form is supplied by Shore Health Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative = Not Detected
<= 9 days
Volume Dependent
87621
HS-TSH (HIGH SENSITIVITY THYROID-STIMULATING HORMONE)
See: “Thyroid-Stimulating Hormone - Sensitive (S-TSH), Serum”
HTG (HUMAN THYROGLOBULIN)
See: “Thyroglobulin, Serum”
HTLV-I/II (HUMAN T-Cell LYMPHOTROPIC VIRUS-I/II) ANTIBODIES (these viruses do NOT cause AIDS)
Test Performed At:
LabCorp
Specimen:
1 SST or plain red-top or 1 EDTA tube (minimum 1.5 ml serum or plasma).
Centrifuge and separate serum or plasma. Maintain sample at room temperature.
Reference Values: Negative
Analytic Time:
Set up and reported twice per week
Day(s) Test Set Up:
CPT Code(s):
83790
148
HTLV-I/II (HUMAN T-Cell LYMPHOTROPIC VIRUS-I/II) ANTIBODIES with reflex confirmation by Immunblot
(these viruses do NOT cause AIDS)
Test Performed At:
LabCorp
Specimen:
1 SST or plain red-top or 1 EDTA tube (minimum 1.5 ml serum or plasma).
Centrifuge and separate serum or plasma. Refrigerate specimen.
Auto reflex to Immunoblot confirmation test if screen is positive.
Reference Values: Negative
Analytic Time:
Set up and reported twice per week
Day(s) Test Set Up:
CPT Code(s):
83790
HTLV-I/II (HUMAN T-LYMPHOTROPIC VIRUS-I/II) ANTIBODIES, CONFIRMATION BY IMMUNOBLOT
Test Performed At:
LabCorp
Specimen:
Su1 SST or plain red-top or 1 EDTA tube (minimum 0.5 ml serum or plasma).
Centrifuge and separate serum or plasma. Refrigerate specimen.
Reference Values: See report
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
86687,86688
HUMAN CHORIONIC GONADOTROPIN (hCG)
See: “Alpha-Fetoprotein (AFP) Triple Screen, Serum”
“Chorionic Gonadotropin, Beta-Subunit (Quantitative), Serum”
“hCG (Human Chorionic Gonadotropin), Quantitative (titer), Serum”
“hCG (Human Chorionic Gonadotropin), Tumor Marker, Serum”
“PregnancyTest, Qualitative, Serum”
“Pregnancy Test, Urine”
HUMAN GROWTH HORMONE
See: “Growth Hormone, Serum”
HUMAN IMMUNODEFICIENCY VIRUS ANTIBODY TYPE 1/Type2 (ANTI-HIV-1/2), SERUM
Enzyme Immunoassay (EIA). Reflexed to Western blot assay if reactive.
NOTE: In Maryland, the physician must provide a “Unique Identifier” (U.l.) number. A copy of the “Informed
Consent and Agreement for HIV Testing Form” for use of the patient’s social security number is on p. 19.
Instructions for generating a U.l. number are on p. 21.
Test Performed At: Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate.
NOTE: If also collecting blood for other tests, obtain a separate tube dedicated for HIV testing.
149
Reference Values:
Negative
All positive results will be confirmed with the Western blot assay at an additional charge.
Analytic Time:
1 day
Day(s) Test Set Up: Monday through Friday
CPT Code(s):
86701
HUMAN IMMUNODEFICIENCY VIRUS-1 (HIV-1+2) ANTIBODY, CONFIRMATION BY MULTISPOT
Immunosorbent Blot Technique. Repeat testing performed if indeterminate.
NOTE: In Maryland, the physician must provide a “Unique Identifier” (U.l.) number. A copy of the “Informed
Consent and Agreement for HIV Testing Form” for use of the patient’s social security number is on p. 19.
Instructions for generating a U.l. number are on p. 21.
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST UNOPENED tube. Centrifuge SST 30 minutes after draw.
Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
3 day
Monday - Friday
86701, 86702
HUMAN IMMUNODEFICIENCY VIRUS-1 (HIV-1) RNA BY PCR, QUANTITATIVE, PLASMA (VIRAL LOAD)
NOTE: In Maryland, the physician must provide a “Unique Identifier” (U.l.) number. A copy of the “Informed
Consent and Agreement for HIV Testing Form” for use of the patient’s social security number is on p. 19.
Instructions for generating a U.l. number are on p. 21.
Test Performed At:
LabCorp
Specimen:
1 PPT Plasma Preparation Tube (Ivory top). Centrifuge and freeze.
2 Lavender top (EDTA) tubes also acceptable (minimum 1.5 ml of plasma). Freeze.
NOTE:
This test is used to monitor known HIV positive infections. It is not intended for primary
detection of HIV infections.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
5 days
Monday - Friday
87536
5-HYDROXYINDOLE ACETIC ACID (5-HIAA), URINE
HPLC
Test Performed At:
LabCorp
Specimen:
Submit 10-30 ml from an entire 24 hour urine collection. No preservative (1 g/L boric acid is
acceptable). Refrigerate specimen. Follow guidelines in “Patient Instructions for 24 Hour
Urine Collection” supplied by SHL.
150
NOTE:
Patient should not eat avocados, bananas, eggplant, pineapples, plums, tomatoes, or
walnuts for a 72 hour period prior to start of collection.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
2 days
Monday - Friday
83497
17-HYDROXYPROGESTERONE, SERUM
LC/TMS
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 ml serum). Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
4 days
Monday - Friday
83498
I
IBUPROFEN, SERUM (ADVIL, MOTRIN, NUPRIN)
HPLC
Test Performed At:
LabCorp
Specimen:
1 plain red top tube (minimum 1.0 ml serum). Refrigerate specimen.
NOTE:
The plain red top tube should NOT contain gel or silicone. Plasma from lavender (EDTA) or
grey top tube is also acceptable.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
2 days
Daily
80299
IBUPROFEN, URINE (ADVIL, MOTRIN, NUPRIN)
HPLC
Test Performed At:
LabCorp
Specimen:
10 ml from a random urine. Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
2 days
Monday - Friday
82491
151
IgA, IgG, IgM (IMMUNOGLOBULINS A, G, M)
See: “Immunoglobulin A (IgA), Serum”
“Immunoglobulin G (IgG), Serum”
“Immunoglobulin M (IgM), Serum”
“Immunoglobulins (lgG, IgA, and IgM), Serum”
IgA (IMMUNOGLOBULIN A)
See: “Immunoglobulin A (IgA), Serum”
“Immunoglobulins (IgG, IgA, and IgM), Serum”
IgE (IMMUNOGLOBULIN E)
See: “Immunoglobulin E (IgE), Serum”
IgG (IMMUNOGLOBULIN G)
See: “lgG Subclasses, Serum”
“Immunoglobulin G (lgG), Serum”
“Immunoglobulins (lgG, IgA, and IgM), Serum”
IGG SUBCLASSES, SERUM
Nephelometry
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 2.0 ml serum).
Centrifuge 30 minutes after draw. Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Monday - Saturday
82784
82787 x4
IgM (IMMUNOGLOBULIN M)
See: “Immunoglobulin M (IgM), Serum”
“Immunoglobulins (lgG, IgA, and IgM), Serum”
IMIPRAMINE AND DESIPRAMINE (Tofranil, Imavate, Presamine)
HPLC
Test Performed At:
LabCorp
Specimen:
1 plain red top (minimum 1.0 ml serum) drawn 12 hours after last dose. Do NOT use gel
barrier tubes. Refrigerate specimen.
Reference Values: See report
Analytic Time:
1 day
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
80174
152
IMMUNE COMPLEX C1q BINDING
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 ml serum). Freeze specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
2-3 days
Tuesday & Thursday
86332
IMMUNOFIXATION, SERUM
Includes protein electrophoresis and immunofixation (includes IGA, IGG, and IGM)
Test Performed At:
LabCorp
Specimen:
2 plain red top or 2 SST tube (minimum 5.0 ml serum) from a fasting patient. Centrifuge
SST 30 minutes after draw. Refrigerate specimen. Fasting specimen preferred.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
3 days
Monday - Friday
84155
82784 x3
84165
86334
IMMUNOFIXATION, URINE (RANDOM OR 24 HOUR URINE)
Includes protein electrophoresis and immunofixation
Test Performed At:
LabCorp
Specimen:
Submit 10-30 ml from a 24 hour urine collection or 10-30 ml from a first morning voided
specimen (random urines are also acceptable). Refrigerate specimen during and after
collection.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
3 days
Monday - Friday
84156
84166
86335
IMMUNOGLOBULIN A (IgA)
See: “Immunoglobulin A (IgA), Serum”
“Immunoglobulins (lgG, IgA, and IgM), Serum”
IMMUNOGLOBULIN A (IgA), SERUM
Immunoturbidimetric method
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
153
Reference Values:
Day(s) Test Set Up:
CPT Code(s):
See report
Daily
82784
IMMUNOGLOBULIN, CSF
See: “Immunoglobulin, Spinal Fluid”
IMMUNOGLOBULIN D (IgD), SERUM
Radial Immunodiffusion
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml serum). Centrifuge SST 30 minutes after draw. Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.13-15.27 mg/dl
2 days
Monday - Friday
82784
IMMUNOGLOBULIN E (IgE), SERUM
Chemiluminesence
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report; age specific results.
1 day
Daily
82785
IMMUNOGLOBULIN G (IgG)
See: “IgG Subclasses, Serum”
“Immunoglobulin G (IgG), Serum”
“Immunoglobulins (IgG, IgA, and IgM), Serum”
IMMUNOGLOBULIN G (IgG), SERUM
Turbidimetric method
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Daily
82784
154
IMMUNOGLOBULIN M (IgM)
See: “Immunoglobulin M (IgM), Serum”
“Immunoglobulins (lgG, IgA, and IgM), Serum”
IMMUNOGLOBULIN M (IgM), SERUM
Turbidimetric method
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Daily
82784
IMMUNOGLOBULINS (lgG, IgA, AND IgM), SERUM
Turbidimetric method
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen after collection.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Daily
82784 x 3
IMMUNOGLOBULIN IGG, SPINAL FLUID
Test Performed At:
LabCorp
Specimen:
NOTE:
1 plain, red-top tube (minimum 0.30 ml of spinal fluid). Refrigerate.
The plain, red-top tube should NOT contain gel or silicone.
Routinely third CSF tube is used.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.0-8.6 mg/dl
1 day
Monday, Wednesday, Friday
82784
INDIA INK SMEAR
See: “Smear, India Ink, Spinal Fluid”
155
INDIRECT ANTIGLOBULIN TEST
See: “Antibody Screen, Blood”
“Coombs, Direct and Indirect, Blood”
“Coombs, Indirect, Blood”
“Prenatal Profile”
INDIRECT COOMBS
See: “Antibody Screen, Blood”
“Prenatal Profile”
INFECTIOUS MONONUCLEOSIS ANTIBODY
See: “Epstein-Barr Virus (EBV) Antibodies, Serum”
“Epstein-Barr Virus (EBV) lgG Antibody to Early Antigen, Serum”
INSULIN ANTIBODIES, SERUM (INSULIN AUTOANTIBODIES, IAA)
Antibodies to beef, human, and pork insulin are tested routinely. Radiobinding assay.
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 0.5 ml serum) from a fasting specimen.
Centrifuge 30 minutes after draw. Freeze specimen.
Reference Values: Negative
Analytic Time:
Day(s) Test Set Up: Set up and reported once per week.
CPT Code(s):
86337
INSULIN ASSAY
See: “Insulin, Serum”
INSULIN, SERUM
Chemiluminesence
Test Performed At:
Shore Health Laboratories
Specimen:
1 plain, red-top tube or 1 SST tube (1.0 ml of serum) from a fasting patient. (Nonfasting specimens accepted for special studies.) Refrigerate specimen.
NOTE: 1.If multiple specimens are collected, send separate request form for each specimen.
2. Label specimens appropriately (corresponding collection time).
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
1.9-23.0 uIU/ml
1 day
Daily
83525
156
INTACT PTH (PARATHYROID HORMONE)
See: “Parathyroid Hormone (PTH) Whole Molecule, Serum”
INTRINSIC FACTOR BLOCKING ANTIBODY, SERUM
Radioimmunoassay
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 2.0 ml serum). Centrifuge SST 30 minutes after
draw. Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
2 days
Monday, Wednesday, Friday
86340
IONIZED CALCIUM
See: “Calcium, Ionized, Serum”
IRON AND TOTAL IRON-BINDING CAPACITY, SERUM
Spectrophotometry
Includes iron, total binding capacity unsaturated binding capacity and percent saturation.
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 3.0 ml; pediatric 2.0 ml of serum).
Centrifuge SST 30 minutes after draw. Refrigerate.
Reference Values: See report
Analytic Time:
1 day
Day(s) Test Set Up: Daily
CPT Code(s):
83540 - iron
83550 - total binding capacity
IRON, SERUM
Spectrophotometry
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 3.0 ml; pediatric 2.0 ml of serum). Centrifuge SST 30 minutes
after draw. Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
35-150 ug/dL
1 day
Daily
83540
157
ISLET CELL ANTIBODY, SERUM (PANCREATIC)
Immunofluorescence Assay
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 ml serum).
Centrifuge 30 minutes after draw. Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
7 days
Thursday
86341
ISOENZYME OF CREATINE KINASE (CK)
See: “Creatine Kinase (CK) MB lsoenzyme, Serum”
IVY BLEEDING TIME
Test no longer available.
J
JOINT FLUID COUNT
See: “Cell Count, Joint Fluid”
“Crystals, Body Fluids or Urine”
K
KAPPA / LAMBDA FREE LIGHT CHAINS
Test Performed At:
Labcorp
Specimen:
1 SST or red-top tube (minmum 0.5 ml serum). Centrifuge and separate 30 minutes after
collection. Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Set up and reported on Tuesday and Thursday
83883 x 2
158
KETONES
See: “Acetone, Serum”
KETONES, URINE
Nitroprusside Tablets, Manual
Test Performed At:
Shore Health Laboratories
Specimen:
1.0 ml from a random urine collection in a urine sample cup supplied by Shore Health
Laboratories. Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Daily
82009 - screen
KOH SMEAR
See: “Smear, KOH”
K (POTASSIUM)
See: “Basic & Comprehensive Metabolic Panel”
“Renal Function Panel”
“Potassium, Quantitative, Feces”
“Electrolyte Panel”
"Potassium, Serum”
“Potassium, Urine”
L
LACTATE
See: “Lactic Acid, Plasma”
LACTATE DEHYDROGENASE (LD)
See: “Lactate Dehydrogenase (LD) lsoenzymes, Serum”
“Lactate Dehydrogenase (LD), Serum”
159
LACTATE DEHYDROGENASE (LD) ISOENZYMES, SERUM
Electrophoresis. Includes total LD
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 ml serum) from a fasting patient.
Centrifuge 30 minutes after draw. Send at room temperature.
NOTE:
Include date and time of collection on request form.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Sunday - Friday
83625
83615
LACTATE DEHYDROGENASE (LD), SERUM
Spectrophotometry
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
100-205 lU/L
1 day
Daily
83615
LACTIC ACID, PLASMA
Spectrophotometry
Test Performed At:
Shore Health Laboratories
Specimen:
1 gray-top (sodium fluoride) tube (minimum: 1.2 ml of sodium fluoride plasma). Place
specimen on wet ice. Centrifuge upon draw, separate plasma into a plastic vial, and
transport specimen to Shore Health Laboratories immediately.
Reference Values:
Critical Value:
0.4-2.0 mmol/L
Child > 4.1 mmol/L
Adult > 2.9 mmol/L
1 day
Daily
83605
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
LACTOSE TOLERANCE TEST, SERUM
Glucose Oxidase
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum: 0.5 ml of serum) from each of the following: Fasting (12 hours), 1/2
hour, 1 hour, 1 1/2 hours, 2 hours. After obtaining fasting specimen, give 50 g of lactose
160
dissolved in 500 ml (16 oz) of water before collecting the remaining specimens. The
lactose solution should be prepared a day ahead of specimen draw and refrigerated until
use. Centrifuge SST 30 minutes after draw. Refrigerate specimens.
NOTE: 1. Children can be given less volume of lactose solution. Use 2 g of lactose per kg of body weight.
Add water to make a 1:10 ratio. For example, if 30 g of lactose is needed, add 300 ml of water.
2. Label specimens appropriately with corresponding collection time.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
A flat blood sugar curve associated with diarrhea following the test dose is found in
lactose intolerance, but it must be noted that it may also be found in asymptomatic adults.
With adequate intestinal lactase, there is a rise in blood glucose of at least 20 mg/dl over
the fasting level. An abnormally low rise in blood glucose correlates more than 80% of the
time with actual measurement of a low intestinal lactase in the small bowel biopsy.
1 day
Daily
82951 - first 3 samples
82952 - each additional sample
LANOXIN® (DIGOXIN)
See: “Digoxin, Serum”
LAP (LEUKOCYTE ALKALINE PHOSPHATASE)
See: “Leukocyte Alkaline Phosphatase (LAP) Score”
LDA (LEGIONNAIRES’ DISEASE ANTIBODY)
See: “Legionnaires’ Disease titer, Serum"
LDH (LACTATE DEHYDROGENASE)
See: “Lactate Dehydrogenase (LD) Isoenzymes, Serum”
“Lactate Dehydrogenase (LD), Serum”
“Hepatic Panel”
LDL (LOW DENSITY LIPOPROTEIN) CHOLESTEROL)
See: “LDL, Direct”
“Lipid Profile”
“Lipoprotein Profile, Serum”
LDL, DIRECT
Detergent Soluble
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube; minimum 1 ml serum. Centrifuge 30 mins after draw. Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
<100 mg/dl
1day
Daily
83721
161
LEAD, BLOOD
Anodic Stripping Voltametry
Test Performed At:
LabCorp
Specimen:
1 Royal blue -top (EDTA) tube or tan-top tube,lead free tube. Send UNOPENED tube.
(For pediatric patient can use 0.5 ml in Capiject. If using Capiject by fingerstick, wash and
dry skin and then clean skin with alcohol). Send whole blood and maintain at room
temperature.
Reference Values:
See report.
Critical Values:
Child >10 ug/dl
Adult >80 ug/dl
Analytic Time:
1 day
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
86355
LECITHIN/SPHINGOMYELIN (L/S) RATIO, AMNIOTIC FLUID (includes Creatinine)
Thin-Layer Chromatography (TLC)
Note: Schedule testing with laboratory in advance of specimen collection.
Test Performed At:
LabCorp
Specimen:
Protect specimen from light. Transport specimen to lab immediately Transfer 3-7 ml of
amniotic fluid to clean plain red-top tube. Immediately after collection, centrifuge for
EXACTLY 3 MINUTES AT 500xg. Transfer supernatant to clean, labeled red-top tube and
freeze. Discard original tube and pellet.
The plain red top tube should NOT contain gel or silicone. .
NOTE:
Include estimate of duration of pregnancy in weeks and diabetic state of mother on request
form.
Reference Values:
<1.5 (pulmonary immaturity)
>2 (probable maturity)
1.5-1.9 Indeterminate
Analytic Time:
1 day
Day(s) Test Set Up: Call LabCorp for pickup.
CPT Code(s):
83661
84081
LEGIONELLA URINARY ANTIGEN
Immunochromatographic assay for Legionella pneumophila serogroup 1
Test Performed At:
Shore Health Laboratories
Specimen:
Minimum volume of 2-3 ml urine collected in a urine sample cup. Seal tightly and forward
promptly. Refrigerate if delayed.
162
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1day
Daily
87449
LEGIONNAIRES DISEASE TITER, SERUM, IgG, IgA, IgM
Indirect Immunofluorescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 2.0 ml of serum) is required for each specimen. Centrifuge SST 30
minutes after draw. Refrigerate specimen in a screw-capped, sterile vial after collection.
Maintain sterility and forward promptly.
NOTE: 1. Acute and convalescent specimens are needed to interpret results. The convalescent specimens
should be obtained at 3 and 6 weeks after onset.
2. Label specimens appropriately (acute or convalescent and 3 or 6 weeks).
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
1 day
Tuesday & Friday
86713
LE (LUPUS ERYTHEMATOSUS) PREP
See: “Antinuclear Antibodies (ANA) Screen, Serum”
LEUKEMIA/LYMPHOMA IMMUNOPHENOTYPING BY FLOW CYTOMETRY (LEUKEMIA/LYMPHOMA PANEL)
Includes a panel of lymphocyte and/or myeloid associated surface markers. The appropriate panel is chosen
based on clinical information, specimen type, cellular characteristics, and previous history. This test also includes
review of morphology and morphologic correlation with immunophenotypic results.
NOTE:
This procedure is applicable for cases of acute lymphoblastic leukemia, acute
myelogenous leukemia, chronic lymphoproliferative disorders, and malignant lymphomas.
See “T and B Cell Quantitation by Flow Cytometry” for evaluation of acquired or inherited
immunodeficiencies.
Test Performed At:
LabCorp
Specimen:
Peripheral Blood: 1 green (heparin) tube (preferred) or 1 lavender (EDTA) or
yellow (ACD) tube (3 ml blood preferred, 1 ml minimum) or
Bone Marrow:
1 green (heparin) tube (preferred) or 1 lavender (EDTA) or
yellow (ACD) tube (2 ml bone marrow preferred, 1 ml minimum) or
Body Fluid:
1 lavender (EDTA) tube. (2 ml body fluid required) or
Fresh Tissue:
Place 0.5-1.0 cubic centimeter rof fresh tissue in a bottle containing
RPMI.
Send specimens at Room Temperature.
Specimens should be at lab within 24 hours of collection.
NOTE:
For all specimens, a pathology/diagnostic report, the name and telephone of the ordering
physician, and a brief history are essential to achieve a consultation fully relevant to the
ordering physician’s needs.
163
Reference Values:
This test will be processed as a laboratory consultation. An interpretation of the
immunophenotypic findings and correlation with the morphologic features will be provided
for every case.
Analytic Time:
2 days
Day(s) Test Set Up: Monday - Saturday
CPT Code(s):
See report.
LEUKOCYTE ALKALINE PHOSPHATASE (LAP) SCORE
Cytochemical Stain
Test Performed At:
LabCorp
Specimen:
1 green top (heparin) tube (5 ml of heparinized whole blood). Store at Room Temperature.
6 slides should be made with 24 hours of collection. Smears are stable up to 7 days at
room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
25-130/100 segs
1 day
Monday - Friday
85540
LEVETIRACETAM (KEPPRA) SERUM OR PLASMA
LC/MS-MS
Test Performed At:
LabCorp
Specimen:
1 plain red-top tube, or 1 EDTA lavender tube or 1 green top(heparin) tube
(minimum 1.0 ml of serum or plasma).
Centrifuge 30 minutes after draw. Maintain at room temperature.
.
Note:
DO NOT USE GEL-BARRIER TUBE.
Reference Values:
5.0 – 63.0 ug/ml
Analytic Time:
2 days
Day(s) Test Set Up: Tuesday - Friday
CPT(s) Code:
82542
LH (LUTEINIZING HORMONE)
See: “Luteinizing Hormone (LH), Serum”
LIDOCAINE, SERUM (XYLOCAINE
)
EIA
Test Performed At:
Shore Health Laboratories
Specimen:
1 plain, red-top tube (minimum 0.5 ml of serum). Refrigerate.
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Therapeutic concentration:
> 7.1 ug/ml
1 day
Daily
80176
1.2-5.5 ug/ml
164
LIPASE, SERUM
Panteghini methodology
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
10-51 U/L
1 day
Daily
83690
LIPID PHENOTYPING
See: “Lipoprotein Profile, Serum”
LIPIDS, STOOL
See: “Fat, Qualitative, Feces”
“Fat, Quantitative, Feces”
LIPOPROTEIN (a)
Immunoprecipitin
Test Performed At:
LabCorp
Specimen:
1 SST or 1 lavender (EDTA) tube. (1.0 ml serum or plasma). Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
2 days
Monday - Saturday
83695
LIPOPROTEIN ELECTROPHORESIS
See: “Lipoprotein Profile, Serum”
LIPOPROTEIN FRACTIONATION
See: “Lipoprotein Profile, Serum”
LITHIUM, SERUM
Spectrophotometric endpoint method
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum) 8-12 hours after evening dose (trough).
Centrifuge SST 30 minutes after draw. Refrigerate.
165
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Therapeutic concentration:
> 1.5 mEq/L
1 day
Daily
80178
0.6 -1.2 mEq/L
LIVER BIOPSY
See: “Histology, Tissue"
LIVER/KIDNEY MICROSOME TYPE 1 ANTIBODIES, SERUM
EIA
Test Performed At:
LabCorp
Specimen:
1 plain red top tube or 1 SST tube (minimum 1.0 ml of serum). Centrifuge 30 minutes after
draw. Separate and freeze serum.
Reference Values:
Negative <20 units
If positive, results are tittered.
Analytic Time:
2 days
Day(s) Test Set Up: Tuesday, Thursday, Saturday
CPT Code(s):
86376
LOW DENSITY LIPOPROTEIN (LDL) CHOLESTEROL
See: “Lipid Profile”
“Lipoprotein Profile, Serum”
“LDL, Direct”
LUPUS ANTICOAGULANT, PLASMA
DRVTT – Dilute Russell Viper Venom Test Time
An APTT and DRVTT will be performed. If abnormal, reflex testing to Lupus Anticoagulant – Hexagonal
Phospholipid Neutralization or Lupus Anticoagulant Confirmation test will be performed.
Test Performed At:
LabCorp
Specimen:
3 blue citrate tubes. 3-6 ml sodium citrate plasma from light blue top tube.
Freeze plasma. Plasma should be spun down twice before freezing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Monday - Friday
85613
85670
85705
85732
LUPUS (SLE) COMPREHENSIVE PANEL
Indirect Fluorescent Antibody (IFA), Enzyme Immunoassay (EIA), Farr Radiobinding Assay (RBA), Immunoblot,
Hemagglutination, Nephelometry, Enzyme-Linked Immunosorbent Assay (ELISA)
Test Performed At:
LabCorp
Specimen:
3 plain, red top tube or 3 SST tubes (minimum 5.0 ml of serum). Refrigerate.
166
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2-3 days
Monday - Saturday
86038
86235 x5
86225
86160 x2
86376
86255 x6
86341
LUTEINIZING HORMONE (LH), SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum: 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Daily
83002
LYME DISEASE
See: “Borrelia burgdorferi (Lyme Disease Spirochete) Detection by Polymerase Chain Reaction (PCR)”
“Lyme Disease Antibody, Confirmation, Serum”
“Lyme Disease Antibody, IgG and 1gM, Serum”
“Lyme Disease Serology, IgA, lgG, and 1gM, Serum or Spinal Fluid”
LYME DISEASE ANTIBODY CONFIRMATION, SERUM (WESTERN BLOT)
Western Blot. This is a confirmatory test for samples positive by ELISA.
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (1.0 ml of serum) from a fasting patient.
Centrifuge 30 minutes after draw. Send at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
3 - 5 days
Monday - Friday
86617 x2
LYME DISEASE ANTIBODY, IgG AND IgM, SERUM
Enzyme-Linked Fluorescent Immunoassay (ELFIA)
Determinations are not separate
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimens.
NOTE: 1. Acute and convalescent specimens are needed to interpret results. The convalescent specimens
should be obtained at 3 and 6 weeks after onset.
167
1. Label specimens appropriately (acute or convalescent and 3 or 6 weeks).
NOTE 2: All Positive Lyme Antibody specimens will be referred to Lab Corp for Lyme Serum Western Blot
test
Reference Values:
Negative: < 0.75
Equivocal: ≥ 0.75-< 1.00
Positive: ≥ 1.00
1 day
Monday - Friday
86618
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
LYME DISEASE, PCR
Test Performed At:
LabCorp
Specimen:
Whole Blood: 5 ml whole blood collected in a lavender (EDTA) tube.
Send at room temperature.
Spinal Fluid: 1 ml CSF in a sterile tube. Refrigerate specimen.
Synovial Fluid: 1 ml synovial fluid in ACD tube. Refrigerate specimen.
NOTE:
Positives do not require Western Blot confirmation.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
10 days
Monday - Friday
87476
LYMPHOCYTE PANELS
Lympho 1 (CD3, 4, 8, 19, 56)
Lympho 3 (CD3, 4, 8 + WBC)
Lympho 4 (CD 3, 4, 8)
Lympho 5 (Absolute CD4)
Test Performed At:
LabCorp
Specimen:
1 lavender (EDTA) and 1 yellow ACD-A tube. Send whole blood at room temperature.
Reference Values: See report.
Analytic Time:
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
Panel 1: 86355 86357 86359 86360
Panel 3 & 4: 86359
86360
Panel 5: 86361
LYSOZYME (MURAMIDASE), SERUM
Radial immunodiffusion
Test Performed At:
LabCorp
Specimen:
1 plain red or 1 SST tube (minimum 1.0 ml serum).
168
Centrifuge SST 30 minutes after draw. Freeze.
Reference Values:
Male: 3.0-12.8 ug/ml
Female: 2.5-12.9 ug/ml
Analytic Time:
2 days
Day(s) Test Set Up: Monday, Wednesday, Friday
CPT Code(s):
85549
LYSOZYME (MURAMIDASE), URINE
Radial immunodiffusion
Test Performed At:
LabCorp
Specimen:
1 ml urine. No preservative. Maintain at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
<3.0 Ug/ml
2 days
Monday, Wednesday, Friday
85549
M
MAG ANTIBODY (ANTI MYELIN ASSOCOCIATED GLY. IGM) (NERVE AB IGM)
EIA
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml serum).
Centrifuge SST 30 minutes after draw. Room Temperature. Overnight fast preferred.
NOTE:
Positives reflex to Anti-MAG Ab (Western Blot)
Reference Values: Normal <1600
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
83520
MAGNESIUM
See: “Magnesium, Serum”
“Magnesium, Urine”
“Renal Function Panel”
MAGNESIUM, SERUM
Timed endpoint/calmagite chromogen
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
169
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
1.8 -2.4 mg/dl
Adults: <1.0 or >4.9 mg/dl
1 day
Daily
83735
MAGNESIUM, URINE
Timed endpoint/calmagite chromogen
Test Performed At:
Shore Health Laboratories
Specimen:
Submit an entire 24-hour urine collection in a urine container or 50 ml of random urine.
Refrigerate specimen during & after collection. NOTE: Follow guidelines in “Patient
Instructions for 24-Hour Urine Collection” supplied by Shore Health Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Daily
83735
MALARIA SMEAR
Buffered Giemsa Stain
Test Performed At:
Shore Health Laboratories
Specimen:
3 thin blood film and 3 thick films made from fingerstick or, drops of blood from needle
following venipuncture. There should be no contact with any type of anticoagulant. To
prepare blood films, use only clean, frosted-end, grease-free slides. NOTE: Call 410-8221000 ext. 5520 for questions on procedure. Do not send EDTA blood.
Thin Blood Films: Prepare with a “feathered edge;” should be no more than a single cell thick. Allow film to
thoroughly air dry.
Thick Blood Films: Place a large drop of blood (preferably from a fingerstick) on a slide. Using a corner of a
second slide, spread the drop by literally scratching the carrier slide to make the blood adhere. Do not fix; air
dry only. You should not be able to read newsprint on a good thick smear. Send slides in plastic slide
containers. Ordering doctor will be notified of any positive result. Positive result includes the species of
malaria and the amount of parasite present.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Daily
87207
MATURATION INDEX
See: “Cytology, Pap Smear with Index”
MEASLES VIRUS
See: “Prenatal Panel”
“Rubella Antibodies, IgM Only, Serum”
“Rubella Serology, Serum”
“Rubeola Serology, Serum”
“TORCH Panel”
170
MENINGITIS ANTIGENS
See: “Directigen, Spinal Fluid”
MERCURY, BLOOD
ICP/MS
Test Performed At:
LabCorp
Specimen:
1-7 ml whole blood collected in EDTA Royal Blue tube. Send the whole tube at room
temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0-14.9 ug/L
1 day
Monday - Friday
83825
METALS (HEAVY) SCREEN I, BLOOD
Inductively Coupled Plasma/Mass Spectrometry (ICP/MS). Includes arsenic, lead, and mercury.
Test Performed At:
LabCorp
Specimen:
1-7 ml EDTA Royal Blue tube. Send the whole tube at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
3 days
Monday - Friday
82175
83825
83655
METALS (HEAVY) SCREEN II, BLOOD
Inductively Coupled Plasma/Mass Spectrometry (ICP/MS). Includes arsenic, lead, and mercury and cadmium.
Test Performed At:
LabCorp
Specimen:
1-7 ml EDTA Royal Blue tube. Send the whole tube at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
3 days
Monday - Friday
82175
83825
83655
82300
METALS (HEAVY) SCREEN I, URINE
Graphite Furnace AA/Cold Vapor Absorption. Includes arsenic, lead, and mercury.
Test Performed At:
LabCorp
171
Specimen:
Submit 10-15 ml of urine from either a random or 24 hour urine sample. Maintain at room
temperature. Record volume for 24 hour urine collection.
NOTE:
Patient should not eat seafood for a 48 hour period prior to start of collection.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
3 days
Monday - Friday
82175
83825
83655
82570
METALS (HEAVY) SCREEN II, URINE
Graphite Furnace AA/Cold Vapor Absorption. Includes arsenic, lead, mercury, and cadmium.
Test Performed At:
LabCorp
Specimen:
Submit 10-15 ml of urine from either a random or 24 hour urine sample. Maintain at room
temperature. Record volume for 24 hour urine collection.
NOTE:
Patient should not eat seafood for a 48 hour period prior to start of collection.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
3 days
Monday - Friday
82175
83825
83655
82570
82300
METANEPHRINES, URINE
LC/MS-MS
Test Performed At:
LabCorp
Specimen:
Submit 10-25 ml of urine from 24 hour urine sample. Refrigerate specimen. Record
volume for 24 hour urine collection.
NOTE:
Methylgucamine (Renografin) interferes with the testing procedure. Allow at least 1 week
after administration before collecting sample. Interfering drugs include Aldomet,
chlorpromazine, imipramine, and phenothiazines. Caffeine should be avoided before and
during collection.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Monday - Friday
83835
172
METHADONE (DOLOPHINE)
Gas Chroatography - MS
Test Performed At:
LabCorp
Specimen:
Specimen types are listed in order of preference.
Serum: 1 plain red top tube (minimum 1.0 ml serum). The plain red top tube should not
contain gel. Refrigerate specimen.
Plasma: 1 green top (heparin) or 1 lavender top (EDTA) tube (minimum 1.0 ml plasma).
Refrigerate specimen.
NOTE:
Label specimen and indicate on request form whether specimen is serum or plasma.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Therapeutic range: 100-400 ng/ml
3 -5 days
Wednesday & Friday
83840
METHSUXIMIDE, SERUM (CELONTIN) (SERUM OR PLASMA)
HPLC
Test Performed At:
LabCorp
Specimen:
1 plain red top, 1 lavender (EDTA) top, 1 green top (Na Hep) or 1 grey top tube (minimum
1.0 serum or plasma). Separate and freeze sample. Collect prior to next dose.
NOTE:
The plain red top should NOT contain gel or silicone.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
3 -5 days
Monday - Friday
83858
METHYLMALONIC ACID (MMA), QUANTITATIVE (SERUM OR PLASMA)
Gas Chromatography/Mass Spectrometry (GC/MS)
Serum methylmalonic acid is elevated in most patients with cobalamin deficiency.
Test Performed At:
LabCorp
Specimen:
1 SST or 1 green top (Na Hep) tube (minimum 2.0 serum or plasma). Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
73-376 nmol/L
6 days
Monday - Friday
83921
METHYLPHENIDATE (RITALIN) (SERUM OR PLASMA)
Mass Spectrometry – Liquid Chromatography
Test Performed At:
LabCorp
173
Specimen:
1 plain red top, 1 lavender (EDTA) top, or 1 green top (Na Hep) (minimum 3.0 serum or
plasma). Freeze specimen.
NOTE:
The plain red top should NOT contain gel or silicone.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
5-20 ng/ml
2 days
Tuesday, Thursday, Friday
80299
MICROALBUMIN, 24-HOUR COLLECTION or RANDOM URINE
Turbidimetric
Test Performed At:
Shore Health Laboratories
Specimen:
Submit an entire 24-hour urine collection in a urine container supplied by Shore Health
Laboratories or 1.0 ml random urine. Refrigerate specimen during and after collection.
NOTE: Follow guidelines in “Patient Instructions for 24-Hour Urine Collections” supplied by Shore Health
Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Random: <19.0 mg/L
24-hr: <30 mg/24 hr
Excretion rate: <20 ug/min
1 day
Daily
82043
MITOCHONDRIAL ANTIBODIES, SERUM
ELISA
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 sst tube (minimum 1.0 ml serum ).
Centrifuge 30 minutes after draw. Freeze.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0-20.0 units
2 days
Monday - Friday
83516
MONONUCLEOSIS SLIDE TEST, SERUM
Hemagglutination Slide Test
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Daily
86308
174
MONOSODIUM URATES (MSU)
See: “Crystals, Body Fluids or Urine”
MSU (MONOSODIUM URATES)
See: “Crystals, Body Fluids or Urine”
MUMPS VIRUS ANTIBODY, SERUM
Enzyme-Linked Fluorescent Assay (ELFA)
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 4.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate.
NOTE: Used to determine patient’s immunological experience with Mumps virus.
Reference Values:
0.00-0.34 Negative
0.35-0.49 Equivocal
≥ 0.50 Positive
Analytic Time:
1 day
Day(s) Test Set Up: Tuesday and Thursday
CPT Code(s):
86735
MYCOBACTERIA CULTURE
See: “Culture, Acid-Fast Bacillus”
MYCOLOGY, CULTURE
See: “Culture, Fungus”
“Culture, Fungus, Blood”
MYCOPLASMA CULTURE
See: “Culture, Mycoplasma”
MYCOPLASMA PNEUMONIAE ANTIBODIES IGG/IGM QUANTITATIVE, SERUM
EIA
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 serum or plasma). Send at room temperature
in a screw-capped sterile vial. Maintain sterility and forward promptly.
Reference Values: Negative
IgG <100 U/ml
IgM <770 U/ml
The presence of IgM class antibodies or a fourfold or greater rise in paired sera IgG titer
indicates recent infection. The presence of demonstrable IgG generally indicates past
exposure.
Analytic Time:
2 days
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
86738 x2
175
MYCOPLASMA SEROLOGY
See: “Mycoplasma pneumoniae Antibodies, lgG and IgM, Quantitative, Serum”
MYELOPEROXIDASE ANTIBODIES, SERUM (MPO)
Enzyme Immunoassay (EIA). Useful for evaluation of patients with vasculitis abnd renal disease.
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 serum).
Centrifuge 30 minutes after draw. Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative 0-9 U/ml equivocal
2 days
Monday - Friday
83520
MYOCARDIAL ANTIBODIES, SERUM
Indirect Immunofluorescence
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 serum).
Centrifuge 30 minutes after draw. Maintain at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative <1:20
2 days
Monday, Wednesday, Friday
86256 x2
MYOGLOBIN, QUANTITATIVE, URINE (RANDOM)
Nephelometry
Test Performed At:
LabCorp
Specimen:
10 ml freshly voided urine. No preservatives. Freeze specimen. Collect specimen in early
morning or immediately following exercise.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
<13 ng/ml
2 days
Monday - Friday
83874
176
MYOGLOBIN, SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Male: 17.4-105.7 ng/ml Female: 14.3-65.8 ng/ml
1 day
Daily
83874
N
NASAL SMEAR FOR EOSINOPHILS
Wright’s Stain
Test Performed At:
Shore Health Laboratories
Specimen:
Star-swab® is used to swab the nasal mucous (swab for each nostril), and the mucous is
smeared on clean glass slides. Allow to air dry. NOTE: Label slides appropriately (right
and left nostril).
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
None seen
1 day
Daily
89190
Na (SODIUM)
See: “Electrolyte Panel”
“Basic Metabolic Panel”
“Comprehensive Metabolic Panel”
“Sodium and Potassium, Serum”
“Sodium and Potassium, Urine”
“Renal Function Panel”
NEISSERIA GONORRHOEAE CULTURE
See: “Culture, Transgrow®”
177
NEISSERIA GONORRHOEAE by Nucleic Acid Amplification
See: Chlamydia trachomatis by Nucleic Acid Amplification (Genprobe® - Aptima®) for collection details.
Note: Chlamydia trachomatis and Neisseria gonorrhoeae may be detected in cervical or urethral specimens using
a single sample.
NORTHEAST RAST
EIA (includes alternaria tenuis, cladosporium herbarum, D. farinae mite, Kentucky blue grass, timothy grass,
Lamb’s quarters, ragweed, cat and dog epithelium, and oak)
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 2.0 serum). Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
1 day
Monday - Friday
86003 x10
NORTRIPTYLINE (PAMELOR, AVENTYL) SERUM OR PLASMA
HPLC
Test Performed At:
LabCorp
Specimen:
1 plain red top, 1 lavender (EDTA) top, or 1 green top (Na Hep) (minimum 1.0 serum or
plasma). Refrigerate.
NOTE:
The plain red top should NOT contain gel or silicone.
Reference Values:
Therapeutic range: 50-150 ng/ml
Toxic: >500 ng/ml
Analytic Time:
1 day
Day(s) Test Set Up: Tuesday – Friday and Sunday
CPT Code(s):
80182
NOSE CULTURE
See: “Culture, Nose”
5’NUCLEOTIDASE, SERUM
Enzyme Kinetic
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 serum or plasma). Centrifuge 30 minutes after
draw. Refrigerate. Plasma also acceptable for lavender or green top tube.
178
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.0-10.0 U/L
7 days
Monday, Wednesday, Friday
83915
O
OCCULT BLOOD, FECES
Modified Guaiac
Test Performed At:
Shore Health Laboratories
Specimen:
A minimum of 2 g of fresh (not older than 24 hrs.) stool collected in a gray cup, a tightly
covered container, or on hemoccult cards supplied by Shore Health Laboratories.
Hemoccult cards must be submitted within 14 days. Please designate if for screening
or diagnostic testing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Daily
82270
OCCULT BLOOD, GASTRIC CONTENTS
Modified Guaiac
Test Performed At:
Shore Health Laboratories
Specimen:
Gastric contents collected in a gray cup or tightly covered container supplied by Shore
Health Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Daily
82273
OLIGOCLONAL BANDING, SPINAL FLUID
High Resolution Electrophoresis/ Immufixation
Test Performed At:
LabCorp
Specimen:
Both serum and spinal fluid are required for this test.
Specimens must be draws with 24 hours of each other.
Serum: 1 SST tube (minimum 0.5 ml serum). Centrifuge SST 30 minutes after draw.
Freeze serum.
Spinal Fluid: 1 plain red top tube (minimum 0.5 ml spinal fluid). Freeze spinal fluid.
179
Label specimens appropriately (serum and spinal fluid).
NOTE:
The plain red top should NOT contain gel or silicone.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
2 days
Tuesday - Friday
83916
OSMOLALITY, FECES
Freezing Point Depression
Test Performed At:
LabCorp
Specimen:
A minimum 15 ml of liquid stool collected in a gray cup or tightly covered container. A 24
hour timed specimen is recommended. Stool must be in liquid form. Freeze specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
None established
3 days
Monday - Friday
84999
OSMOLALITY, SERUM
Freezing Point Depression
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Male: 275-295 mOsm/kg
< 250 or > 326 mOsm/kg
1 hour
Daily
83930
Female: 270-290 mOsm/kg
OSMOLALITY, URINE
Freezing Point Depression
Test Performed At:
Shore Health Laboratories
Specimen:
5.0 ml from a random urine collection in a urine sample cup supplied by Shore
Health Laboratories. Refrigerate specimen.
Reference Values:
Male 390 - 1100 mOsm/kg
Female 300 -1100 mOsm/kg
1 day
Daily
83935
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
180
OSMOTIC FRAGILITY, ERYTHROCYTES
Osmotic Lysis (Not specified for hereditary spherocytosis)
Test Performed At:
LabCorp
Specimen:
1 green top (Na Hep) tube. Send 5 ml whole blood and 2 unfixed smears at room
temperature. The specimen must reach the lab within 24 hours. DO NOT draw on Fridays.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
1 day
Monday - Friday
85557
OSTEOCALCIN, SERUM
ELISA
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 serum) from a fasting patient. Avoid hemolysis
and lipemia. Freeze serum specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
3 days
Tuesday & Thursday
83937
O’SULLIVAN SCREEN
See: “Glucose Challenge, Serum”
OVA AND PARASITES, FECES
Giardia lamblia and Cryptosporidium Antigen Tests (EIA)
NOTE: When an Ova & Parasites test request is received, Shore Health System Laboratories will perform
Giardia lamblia and Cryptosporidium sp. antigen tests by immunoassay (EIA).
1. The Giardia Antigen test or Cryptosporidium Antigen test may be ordered separately if desired.
2. If a traditional O&P with concentration and Trichrome stain is desired, specify “Comprehensive Ova
&Parasites.” (See “Ova and Parasites, Comprehensive, Feces”)
3. Specimens received in Formalin/PVA Para-Paks™ will be saved for 2 weeks in case further testing
(Ova and Parasites, Comprehensive) is desired.
Test Performed At:
Shore Health Laboratories
Specimen:
Collect approximately 2 g. of fresh stool using a Formalin/PVA ParaPak® supplied by
Shore Health Laboratories. Do not expose to extreme temperatures.Follow guidelines in
181
“Specimen Collection - Stool Culture, Clostridium difficile or Rotavirus, Ova and Parasites,
Giardia/Cryptosporidium Screen” supplied by Shore Health Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Giardia -Negative,Cryptosporidium - Negative
1 day
Monday - Friday
87329 & 87328
OVA AND PARASITES, COMPREHENSIVE, FECES
Concentration and Trichrome Stain
Test Performed At:
LabCorp
Specimen:
Collect 2 g of fresh stool using a Formalin/PVA ParaPak®. supplied by Shore Health
Laboratories. Do not expose to extreme temperatures. It is strongly recommended that
multiple specimens be submitted for ova and parasite analysis. At least 3 specimens
should be collected, 1 each day.Follow guidelines in “Specimen Collection - Stool Culture,
Clostridium difficile or Rotavirus, Ova and Parasites, Giardia/Cryptosporidium Screen”
supplied by Shore Health Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
No ova or parasites seen
1 day
Monday - Friday
87177
OVARIAN CANCER-RELATED ANTIBODIES
See: “Cancer Antigen 125 (CA 125), Serum”
OXALATE, URINE 24 HOUR
Spectrophotometry. Includes urine creatinine.
Test Performed At:
LabCorp
Specimen:
Submit 10 ml urine from a 24 hour urine collection. Refrigerate specimen during and after
collection. Follow guidelines in “Patient Instructions for 24 Hour Urine Collection” pamphlet
supplied by SHL. pH of aliquot should be adjusted to <3 with 6 N HCl prior to sending.
Samples collected or sent in containers with metal caps and samples containing nitric acid
will NOT be tested.
NOTE:
Avoid taking large doses (>2.0 g orally/24 hours) of Vitamin C prior to and during specimen
collection. High intakes of rhubarb, strawberries, tomatoes, chocolate, cocoa, and tea
cause significant increase in oxalic acid excretion.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Monday - Friday
83945
182
OXYCODONE, URINE (PERCODAN)
Gas Chromatography-GCMS
Test Performed At:
LabCorp
Specimen:
20 ml from random urine collection in a urine cup. Maintain at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
None detected
3 days
Monday - Friday
83925
P
PAP (PROSTATIC ACID PHOSPHATASE)
See: “Acid Phosphatase, Prostatic, Serum”
PAP SMEAR
See: “Cytology, Pap Smear”
“Cytology, Pap Smear with Index"
PARASITIC EXAMINATION
See: “Malaria Smear”
PARASITE SEROLOGY, SERUM
Method is agent dependent
Test Performed At:
Maryland State Health Department
Specimen:
1 SST tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
NOTE: 1. Acute and convalescent specimens are needed to interpret the results. The convalescent specimen
should be obtained 2-3 weeks after onset.
2. Label specimen appropriately (acute or convalescent).
3. Type of parasite is required on request form for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Agent dependent
21-28 days
Monday - Friday
86753
183
PARATHYROID HORMONE (PTH), Intraoperative
Immunochemiluminometric Assay (ICMA) Concomitant calcium
TEST MUST BE SCHEDULED WITH THE LAB 48 HOURS PRIOR TO SURGERY
Test Performed At:
Shore Health Laboratories
Specimen:
1 plain, red-top tube or 1 SST tube (minimum 1.0 ml of serum) from each site.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
None
1 day
Daily
82310
83970 - parathyroid hormone
PARATHYROID HORMONE (PTH) INTACT, SERUM
Immunochemiluminometric Assay (ICMA) Concomitant calcium
Primary test for hyperparathyroidism, secondary hyperparathyroidism, or hypoparathyroidism.
Test Performed At:
Shore Health Laboratories
Specimen:
1 plain, red-top tube or 1 SST tube (minimum 1.0 ml of serum). Centrifuge 30
minutes after draw. Refrigerate specimens.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
PTH: 12 - 88 pg/ml
1 day
Daily
82310
83970 - parathyroid hormone
PARIETAL CELL ANTIBODIES, SERUM
EIA
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 serum). Centrifuge 30 minutes after draw.
Maintain at room temperature
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative <20 units
2 days
Tuesday - Friday
83516
PARTIAL THROMBOPLASTIN TIME (PTT)
See: “Activated Partial Thromboplastin Time (APTT), Plasma”
184
PARVOVIRUS B19 ANTIBODIES, IGG AND IGM (SEPARATE DETERMINATIONS), SERUM
EIA
Useful for detection of Parvovirus B19 IgG and IgM antibodies to aid in diagnosing erythema infectiosum,
Parvovirus B19 aplastic crisis, and other Parvovirus B19 related diseases.
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 0.5 serum). Centrifuge 30 minutes after draw.
Maintain at room temperature.
Reference Values:
See report.
The presence of IgM antibodies indicates recent infection. The presence of IgG antibodies
only is suggestive of past exposure.
Analytic Time:
3 -5 days
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
86747 x2
PATHOLOGY, SURGICAL
See: “Histology, Tissue”
PERPHENAZINE (TRILAFON) (SERUM OR PLASMA)
Liquid Chromatography-tandem MS-MS
Test Performed At:
LabCorp
Specimen:
Collect specimen 10-14 hours after last dose or just prior to next dose.
Protect specimen from light.
Specimens are listed in order of preference.
Serum: 2 plain red top tubes (minimum 3.0 ml serum). The red top tube should not contain
gel or silicone. Refrigerate specimen.
Plasma: 2 green sodium heparine tubes (minimum 3.0 ml plasma).
Refrigerate specimen.
NOTE:
Indicate serum on plasma on request form and specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Monday, Wednesday, Friday
82491
PHENOBARBITAL, SERUM
PETIA Immunoassay
Test Performed At:
Shore Health Laboratories
Specimen:
1 plain, red-top tube (minimum 0.5 ml of serum) drawn prior to next dose.
NOTE: 1. The plain, red-top tube should NOT contain gel or silicone.
2. Therapeutic monitoring- draw blood prior to next dose.
185
3. Oral - times dependent on formulation and dosage due to its long elimination half-life. Actual sampling
time is unimportant. When making comparative measurements, it is important for sample time to be
consistent. Refrigerate specimen after collection.
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Therapeutic concentration: 15-40 ug/ml
> 60 ug/ml
1 day
Daily
80184
PHENOTYPE, BLOOD
See: “Antigen Identification”
PHENYLALANINE, PLASMA
Ion Exchange Chromatography
Test Performed At:
LabCorp (700205)
Specimen:
1 green top (Na Hep) tubes (minimum 0.5 plasma) from a fasting patient; a fast of 4 hours
or more in infants. Centrifuge, promptly separate plasma from cells, and freeze in plastic
vial. Send specimen frozen.
NOTE:
Include patient’s age, tentative diagnosis, therapy, and history on request form.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
5 days
Sunday - Friday
84030
PHENYLKETONURIA, BLOOD
Gel Immunodiffusion. Includes T4.
Test Performed At:
Maryland State Health Department
Specimen:
Whole blood from a heel stick. Fill circles on form supplied by Maryland State Health
Department. Let air dry. Send in envelope to Maryland State Health Department.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
30 days
Varies
84030
84436
PHENYTOIN, TOTAL, SERUM (DILANTIN®)
PETIA Immunoassay
Test Performed At: Shore Health Laboratories
Specimen:
1 plain, red-top tube (minimum 0.5 ml of serum) collected as follows:
IV dose: draw 2-4 hours after dose.
Oral: times dependent on formulation and dosage due to its long elimination half-life.
186
Actual sampling time is unimportant. When making comparative measurements, it is
important for sample time to be consistent. Refrigerate specimen.
NOTE: The plain, red-top tube should NOT contain gel or silicone.
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Therapeutic concentration: 10-20 ug/ml
> 30 ug/ml
1 day
Daily
80185
pH, FECES
Nitrazine Paper
Test Performed At:
Shore Health Laboratories
Specimen:
A minimum of 2g of stool (not older than 24 hrs.) collected in a gray cup or tightly
covered container.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
7.0 - 7.5
1 day
Daily
83986
PHOSPHATASE
See: “Acid Phosphatase, Prostatic, Serum”
“Alkaline Phosphatase lsoenzymes, Serum”
“Alkaline Phosphatase, Serum”
“Leukocyte Alkaline Phosphatase (LAP) Score”
“Hepatic Panel”
“Comprehensive Metabolic Profile”
PHOSPHATE, INORGANIC PHOSPHORUS
See: “Renal Function Panel”
“Phosphorus, Inorganic, Serum”
PHOSPHOLIPID ANTIBODIES (CARDIOLIPIN ANTIBODIES), IGG, IGA, IGM, SERUM
EIA
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 serum). Centrifuge 30 minutes after draw.
Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Monday - Friday
86147 x3
187
PHOSPHOLIPIDS, SERUM
Spectrophotometry
Test Performed At:
LabCorp
Specimen:
1 plain red top tube or 1 SST tube(minimum 0.5 serum). Draw specimen following an
overnight (12-14 hour) fast. Patient must not consume any alcohol for 24 hours before the
specimen is drawn. Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
150-250 mg/dl
2 days
Sunday - Friday
84311
PHOSPHORUS
See: “Renal Function Panel”
“Phosphorus, Inorganic, Serum”
“Phosphorus, Urine”
PHOSPHORUS, INORGANIC, SERUM
Molybdate
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate.
Reference Values:
Critical Value:
Adult: 2.3-4.5 mg/dl
Child < 1.3 or > 8.9 mg/dl
16 yr old-Adult < 1.2 or > 8.9 mg/dl
1 day
Daily
84100
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
PHOSPHORUS, URINE
Molybdate
Test Performed At:
Shore Health Laboratories
Specimen:
Submit an entire 24-hour urine collection in a urine container with no preservative. Urine
containers are supplied by Shore Health Laboratories. Place specimen on wet ice and
transport to Shore Health Laboratories immediately. NOTE: Follow guidelines in “Patient
Instructions for 24-Hour Urine Collection” supplied by Shore Health Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
400 - 1300 mg/24 hours
1 day
Daily
84105 - phosphorus
81050 - urine timed measurement
188
pH, URINE
Nitrazine Paper
Test Performed At:
Shore Health Laboratories
Specimen:
1.0 ml from random urine collection in a urine sample cup supplied by Shore Health
Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
5.0-8.0
1 day
Daily
83986
PINWORM PREPARATION
Scotch Tape Preparation
Test Performed At:
Shore Health Laboratories
Specimen:
Using clear cellulose tape, place preparation on glass slide. Do not use magic
transparent tape.
NOTE: 1. Follow guidelines in “Laboratory Outpatient Instructions for Scotch-Tape Preparation for Pinworms”
supplied by Shore Health Laboratories.
2. Collect specimen in the early a.m. before bathing, changing clothes, or going to the bathroom.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
None detected
1 day
Daily
87208
PKU (PHENYLKETONURIA)
See: “Phenylalanine, Plasma”
“Phenylketonuria, Blood”
PLATELET ANTIBODY TEST, DIRECT
Flow Cytometry
Test Performed At:
LabCorp
Specimen:
12 ml whole blood from 2 yellow ACD tubes or 3 EDTA lavender tubes.. Keep at room
temperature. Must arrive within 72 hours. Specimen cannot be frozen.
Reference Values:
Negative.
Analytic Time:
2 days
Day(s) Test Set Up: Daily
CPT Code(s):
86022
189
PLATELET COUNT
See: “Platelet Count, Blood”
“Blood Count”
PLATELET COUNT, BLOOD
Electrical Impedence
Test Performed At:
Shore Health Laboratories
Specimen:
1 lavender-top (K2 EDTA) tube (minimum 2.0 ml of K2 EDTA whole blood).
NOTE: 1 light blue top 3.2(citrate) tube and 1 lavender top (K2 EDTA) tube are used ONLY on patients with
history of platelet clumping
Reference Value:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
160,000-450,000 cells/mm
See page 29.
1 day
Daily
85595
3
PLATELET FUNCTION, ASPIRIN
Inhibition of Platelet Activity
Test Performed At:
Memorial Hospital at Easton
Specimen:
1 special Greiner Blue Top Tube-MUST ARRIVE AT MHE LAB BEFORE 4 HOURS
AFTER COLLECTION. NOTIFY LAB OF SAMPLE COLLECTION.
Reference Value:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
None
1 day
Daily
85576
PLATELET FUNCTION, P2Y12
Inhibition of Platelet Activity
Test Performed At:
Memorial Hospital at Easton
Specimen:
1 special Greiner Blue Top Tube-MUST ARRIVE AT MHE LAB BEFORE 4 HOURS
AFTER COLLECTION. NOTIFY LAB OF SAMPLE COLLECTION.
Reference Value:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
None
1 day
Daily
85576
190
PNEUMOCOCCAL IGG VACCINE RESPONSE, ELISA
(14 Serotypes) Beade-based Fluoroimmunoassay
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 serum). Refrigerate.
NOTE:
Pre and Post vaccination samples submitted at the same time are highly recommended.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Monday - Thursday
86317 x14
POLIOVIRUS (TYPES 1-3) ANTIBODY
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 2.0 ml serum). Refrigerate specimen.
Reference Values: See report.
Analytic Time:
2 days
Day(s) Test Set Up:
CPT Code(s):
86658 x3
PORPHOBILINOGEN, URINE 24 HOUR
Colorimetric
Test Performed At:
LabCorp
Specimen:
Send 3 ml from a 24 hour urine collection. Freeze specimen in amber tube. Protect from
light. Random urine samples are also acceptable.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.0-1.5 mg/24 hr
5 days
Wednesday & Friday
84110
PORPHYRINS, FRACTIONATION, PLASMA
HPLC
Test Performed At:
LabCorp
Specimen:
2 green top (Na Hep) tubes (minimum 3.0 plasma). Transfer plasma to amber tube to
protect from light. FREEZE.
Reference Values: See report.
Analytic Time:
2 days
Day(s) Test Set Up:
CPT Code(s):
82491
191
PORPHYRINS, FRACTIONATED QUANTITATIVE, URINE
HPLC with Fluorometric Detection
Test Performed At:
LabCorp
Specimen:
Submit 10 ml from a 24 hour urine collection. Place urine in amber bottle to protect from
light. Refrigerate specimen. Random urine samples are also acceptable. Follow
guidelines in “Patient Instructions for 24 hour Urine Collection” supplied by SHL.
NOTE:
The patient should be off medications, if possible, for at least 1 week.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Tuesday - Friday
84120
POST VASECTOMY
See: “Semen Analysis, Post Vasectomy”
POTASSIUM
See: “Basic or Comprehensive Metabolic Panel”
“Renal Function Panel”
“Electrolyte Panel”
“Potassium, Serum”
“Potassium, Urine”
POTASSIUM, SERUM
Ion Selective Electrode
Test performed At:
Shore Health Laboratories
Specimen:
1 SST tube (Minimum 1 ml serum). Centrifuge and refrigerate - avoid hemolysis.
Reference Values:
Critical Value:
Adult: 3.5-5.1 mEq/L
Newborn(<1 month old): <2.8 or >7.8 mEq/L
Child: <2.8 or >6.4 mEq/L
16 yr old-Adult: <2.8 or >6.2 mEq/L
1 day
Daily
84132
Analytical Time:
Day(s) Test Set Up:
CPT Code(s):
POTASSIUM, URINE
Ion Selective Electrode
Test Performed At:
Shore Health Laboratories
Specimen:
2.0 ml random urine or an entire 24 hr. urine collection.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
25 -125 mEq/24hrs.
1 day
Daily
84133
192
PRA (PROGESTERONE RECEPTOR ASSAY)
See: “Estrogen/Progesterone Receptor (Paraffin), Immunoperoxidase Stain”
PREALBUMIN (PAB), SERUM
Turbidimetric method
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum) from a fasting patient. Centrifuge SST 30 minutes
after draw.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Adult: 18 – 35.7 mg/dl
1 day
Daily
84134
PREGNANCY TEST, QUALITATIVE, SERUM
Immunochromatographic Assay
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Daily
84703
PREGNANCY TEST, QUANTITATIVE (TITER)
See: “hCG (Human Chorionic Gonadotropin), Quantitative (Titer), Serum”
PREGNANCY TEST, URINE
Rapid Chromatographic Immunoassay
Test Performed At:
Shore Health Laboratories
Specimen:
Submit first morning urine specimen in a urine sample cup supplied by Shore Health
Laboratories. No preservative.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Daily
81025
193
PRIMIDONE, SERUM/PLASMA
FPIA
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 green top (Na Hep) tube (minimum 1.0 serum or plasma). Refrigerate.
NOTE:
The plain red top should NOT contain gel or silicone.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Therapeutic concentration: 5-12 mcg/ml
1 day
Daily
80188
80184
PRL (PROLACTIN)
See: “Prolactin, Serum”
PROCAINAMIDE, SERUM/PLASMA
Immunoassay
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 green top (Na Hep) tube (minimum 1.0 serum or plasma). Refrigerate.
NOTE:
The plain red top should NOT contain gel or silicone.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
3 -5 days
Monday - Sunday
80192
PROGESTERONE RECEPTOR
See: “Estrogen/Progesterone Receptor (Paraffin), Immunoperoxidase Stain”
PROGESTERONE, SERUM
Chemiluminescense
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen. NOTE: This test should not be used for monitoring well-being
during the 3rd trimester.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Daily
84144
194
PROINSULIN, SERUM
EIA
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 serum) from a fasting patient. Separate serum
and freeze immediately in plastic vial.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
<10.0 pmol/L
7-10 days
Once per week
84206
PROLACTIN, SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Daily
84146
PROPAFENONE, SERUM (RYTHMOL)
Liquid Chromatography, Mass Spectrometry useful for treatment of supraventricular and ventricular rhythm
disturbances.
Test Performed At:
LabCorp
Specimen:
2 plain red top (minimum 3.0 serum). Refrigerate.
NOTE:
The plain red top should NOT contain gel or silicone.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Monday - Friday
80299
PROPOXYPHENE, BLOOD (DARVON) QUANTITATIVE
GC/MS
Test Performed At:
LabCorp
Specimen:
1 plain red top, 1 lavender (EDTA) top, or 1 green top (Na Hep) tube (minimum 1.0 serum
or plasma). Refrigerate. Record time of last dose.
195
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
3 days
Monday, Friday
80367
PROSTATE-SPECIFIC ANTIGEN (PSA), SERUM
Chemiluminescence
Must designate Screen or Diagnostic
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen after collection. NOTE: Include patient’s age on request form.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Age specific-see p. 269
1 day
Daily
84153
PROSTATE SPECIFIC ANTIGEN (TOTAL & FREE)
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 serum). Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
1 day
Daily
84153
84154
PROSTATIC ACID PHOSPHATASE (PAP)
See: “Acid Phosphatase, Prostatic, Serum”
PROTEIN
See: "Comprehensive Metabolic Panel"
“Albumin/Globulin (A/G) Ratio, Serum”
“C-Reactive Protein (CRP), Serum”
“Electrophoresis, Protein, Serum”
“Electrophoresis, Protein, Urine”
“Protein C Antigen, Plasma”
“Protein, Quantitative, Urine”
“Protein, Spinal Fluid”
“Protein, Total, Serum”
196
PROTEIN C ANTIGEN, PLASMA
ELISA
Test Performed At:
LabCorp
Specimen:
1 light blue top tube (minimum 2.0 sodium citrated plasma). Freeze plasma immediately
and send frozen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Monday - Friday
85302
PROTEIN, C-REACTIVE
See: “C-Reactive Protein (CRP), Serum”
PROTEIN ELECTROPHORESIS
See: “Electrophoresis, Protein, Serum”
“Electrophoresis, Protein, Urine”
PROTEIN, QUANTITATIVE, URINE
Turbidimetric
Test Performed At:
Shore Health Laboratories
Specimen:
Submit an entire 24-hour urine collection in a urine container with no preservative. Urine
containers are supplied by Shore Health Laboratories. Place specimen on wet ice and
transport to Shore Health Laboratories immediately. NOTE: Follow guidelines in “Patient
Instructions for 24-Hour Urine Collection” supplied by Shore Health Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
< 149 mg/24 hrs
1 day
Daily
84155 - protein
81050 - urine timed measurement
PROTEIN, SPINAL FLUID
Trichloroacetic Acid Precipitation
Test Performed At:
Shore Health Laboratories
Specimen:
1 plain, red-top tube (minimum 0.5 ml of spinal fluid). Refrigerate specimen. Do not
use gel barrier tubes.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
15-45 mg/dl
1 day
Daily
84155
197
PROTEIN, TOTAL, SERUM
Biuret
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
6.0-8.2 g/dL
1 day
Daily
84155
PROTHROMBIN TIME (PT), PLASMA
Photo Optic
Test Performed At:
Shore Health Laboratories
Specimen:
1 light blue-top 3.2 (citrate) tube. Fill tube completely.
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
9 -13.0 seconds
INR > 5.0
1 day
Daily
85610
PROTHROMBIN GENE MUTATION (FACTOR II, DNA ANALYSIS)
Test Performed At:
LabCorp
Specimen:
3 Lavender (EDTA) or 2 Yellow ACD tubes (minium 7.0ml whole blood).
Send original tubes at room temperature
Reference Values: See report.
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
81240
PRO TIME
See: “Prothrombin Time (PT), Plasma”
PR (PROGESTERONE RECEPTOR)
See: “Estrogen/Progesterone Receptor (Paraffin), Immunoperoxidase Stain”
PSA (PROSTATE-SPECIFIC ANTIGEN)
See: “Prostate-Specific Antigen (PSA), Serum”
"Prostate-Specific Antigen, Total & Free”
198
PTH (PARATHYROID HORMONE)-WHOLE MOLECULE
See: “Parathyroid Hormone (PTH) Intact, Serum”
PTH, RELATED PROTEIN (PEPTIDE)
Immunoradiometric Assay
Test Performed At:
LabCorp
Specimen:
Collect blood into chilled lavender (EDTA) tube noting time of collection. Immediately
immerse the tubes into an ice bath. Centrifuge specimen, separate and freeze plasma.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 -7 days
Monday - Friday
82397
PT (PROTHOMBIN TIME)
See: “Prothrombin Time (PT), Plasma”
PTT (PARTIAL THROMBOPLASTIN TIME)
See: “Activated Partial Thromboplastin Time (APTT), Plasma”
PYLORI, HELICOBACTER (CAMPYLOBACTER PYLORI)
See: “Helicobacter pylori, lgG Antibody, Serum"
PYROPHOSPHATE CRYSTALS
See: “Crystals, Body Fluids”
PYRUVATE KINASE, BLOOD (PYRUVIC ACID)
Spectrophotometry
Test Performed At:
LabCorp
Specimen:
1 grey top tube chilled. Immediately after draw, add 5 ml of whole blood to 5 ml of 8%
perchloric acid. Shake vigorously for 30 seconds. Refrigerate for 5 minutes. Centrifuge for
5-10 minutes. Transfer clear supernatant to transport tube labeled “supernatant”. Note that
second centrifugation may be required. Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.3-0.7 mg/dl
1-2 days
Tuesday, Thursday
84210
199
Q
QUANTIFERON TB GOLD
IGRA
Test Performed At:
LabCorp
Specimen:
Requires a Quantiferon collection kit—3 tubes in kit. Follow instructions and maintain
samples at room temperature.
Note:
Time sensitive-draw only Monday through Friday.
Reference Values: See report
Analytic Time:
4 days
Day(s) Test Set Up: Daily
CPT(s) Code:
86480
Q FEVER ANTIBODIES, IGG, SERUM
IFA
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 0.5 serum). Centrifuge 30 minutes after draw.
Send at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
7-10 days
Wednesday, Friday
86638
Q FEVER ANTIBODIES, IGM, SERUM
IFA
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 0.5 serum). Centrifuge 30 minutes after draw.
Send at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
5-7 days
Tuesday, Thursday
86638
200
QUINIDINE, SERUM/PLASMA
Immunoassay
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 green top (heparin) tube (minimum 1.0 serum or plasma). Do not use
gel barrier tube. Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Therapeutic concentration: 2.0-5.0 mg/dl
1 day
Daily
80194
R
RAPID PLASMA REAGIN (RPR) TEST
See: “Prenatal Profile”
“Syphilis Serology”
RA (RHEUMATOID ARTHRITIS) FACTOR
See: “Lupus Comprehensive Panel”
“Rheumatoid Factor, Serum”
RAPAMYCIN
See: “Sirolimus”
RAPAMUNE
See: “Sirolimus”
REDUCING SUBSTANCE, FECES
Clinitest
Test Performed At:
Shore Health Laboratories
Specimen:
A minimum of 15 g of stool collected in a gray cup or tightly covered container.
Refrigerate specimen. Must be received at Shore Health Laboratories within 24
hours.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
2 days
Daily
84999
201
RENAL-CELL CARCINOMA
See: “DNA Ploidy of Solid Tumor by Flow Cytometry, Paraffin Block”
“Histology, Tissue”
RENAL STONE STUDY
Gross Exam/ X-ray Diffraction
Test Performed At:
LabCorp
Specimen:
Entire renal stone, dried
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Descriptive report
7-14 days
Daily
82370
RENIN ACTIVITY, PLASMA
Immunochemiluminescence
Test Performed At:
LabCorp
Specimen:
3.0 ml plasma from a lavender (EDTA) tube. Centrifuge and separate plasma at room
temperature. FREEZE plasma immediately. The specimen is stable for 24 hours at room
temperature if not frozen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
3 days
Monday- Friday
84244
RESPIRATORY SYNCTIAL VIRUS (RSV) ANTIBODY, SERUM
Complement Fixation
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 2.0 serum). Centrifuge 30 minutes after draw.
Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
2 days
Monday - Friday
86756
202
RESPIRATORY SYNCYTIAL VIRUS (RSV) ANTIGEN, NASOPHARYNGEAL ASPIRATE
EIA
Test Performed At:
Shore Health Laboratories
Specimen:
Call Shore Health Laboratories for collection instructions.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Daily
86313
RETICULOCYTE COUNT, BLOOD
New Methylene B Stain and Flow Cytometry
Test Performed At:
Shore Health Laboratories
Specimen:
1 lavender-top (K2 EDTA) tube (minimum 3.0 ml of K2 EDTA whole blood).
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.5-2.0% corrected retic
1 day
Daily
85044
RF (RHEUMATOID FACTOR)
See: “Lupus Comprehensive Panel”
“Rheumatoid Factor, Serum”
RHEUMATOID ARTHRITIS
See: “Lupus Comprehensive Panel”
“Rheumatoid Factor, Serum”
RHEUMATOID FACTOR
See: “Lupus Comprehensive Panel”
“Rheumatoid Factor, Serum”
RHEUMATOID FACTOR, SERUM
Hemagglutination Slide Test
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Negative
If positive, results are titered.
1 day
Monday - Friday
86430 - screen
86431 - titer
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
203
Rh IMMUNE GLOBULIN WORKUP, (POST PARTUM), BLOOD(RHOGAM)
Agglutination
Hemagglutination
Solid Phase
Indicate if NOT Antepartum. Includes ABO/Rh typing, antibody screen, and fetomaternal hemorrhage rapid screen
NOTE: This procedure is for 72 hours postpartum.
Test Performed At:
Shore Health Laboratories
Specimen:
1 pink-top blood bank tube (minimum: 5.0 ml of whole blood)
Reference Values:
Negative for Rh. Absence of anti-D in plasma
Baby’s Rh type must be Rh (D) positive
1 day
Daily
86900 - ABO type
86901 - D typing
86850 - Screen
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Rh IMMUNE GLOBULIN WORKUP, (ANTEPARTUM), BLOOD(RHOGAM)
Agglutination
Hemagglutination
Solid Phase
Indicate if Antepartum. Includes ABO/Rh typing and antibody screen.
NOTE: This procedure is for > 12 weeks to postpartum.
Test Performed At:
Shore Health Laboratories
Specimen:
1 pink-top blood bank tube (minimum 5.0 ml of whole blood). NOTE: This procedure is for
28 weeks gestation.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative for Rh. Absence of anti-D in plasma
1 day
Daily
86900 - ABO type
86901 - D typing
86850 - Screen
RIBOFLAVIN (VITAMIN B2), PLASMA
HPLC
Useful for detection of riboflavin and evaluation of nutritional and nerve compression disorders.
Test Performed At:
LabCorp
Specimen:
1.5 ml whole blood from lavender (EDTA) tube. Wrap in foil to protect from light.
FREEZE.
NOTE:
Patient must not consume any alcohol or ingest vitamin supplements for 24 hours before
the specimen is drawn.
204
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
137-370 ug/L
2 days
Daily
84252
RICKETTSIAL ANTIBODY
See: “Q fever Antibodies, Serum”
“Rocky Mountain Spotted Fever IgM Antibody, IFA”
RICKETTSIAL SEROLOGY, SERUM
IFA
Test Performed At:
Maryland State Health Department
Specimen:
1 SST tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen after collection.
NOTE: 1. Acute and convalescent specimens are needed to interpret the results. The convalescent specimen
should be obtained 2-3 weeks after onset.
2. Label specimen appropriately (acute or convalescent).
3. Specify rickettsial agent on request form.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Agent dependent
21-28 days
Monday - Friday
86256
RMSF (ROCKY MOUNTAIN SPOTTED FEVER)
See: “Rocky Mountain Spotted Fever IgM Antibody, IFA”
“Rocky Mountain Spotted Fever Serology, Serum”
ROCKY MOUNTAIN SPOTTED FEVER SEROLOGY, SERUM
IFA
Test Performed At:
Shore Health Laboratories
Specimen: SST tube (minimum 3.0 ml of serum). Centrifuge SST 30 minutes after draw.
NOTE: 1. Acute and convalescent specimens are needed to interpret the results. The convalescent specimen
should be obtained 1-2 weeks after onset.
2. Label specimens appropriately (acute or convalescent).
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Single IFA-IgG titer of ≥ 1:128 indicates exposure to Rickettsia rickettsii. Specimens
demonstrating fourfold rise to ≥ 1:128 suggest recent or current infection.
1 day
Tuesday & Thursday
86256
205
ROTAVIRUS ANTIGEN, FECES
IMMUNOCHROMATOGRAPHY
Test Performed At:
Shore Health Laboratories
Specimen:
A minimum of 1.5 g of stool collected in a gray cup or tightly covered container.
Refrigerate specimen. Forward promptly.
Reference Values:
Negative
The virus is eliminated from the infected individual within a few days following acute
infection. A prolonged carrier state has been recognized with rotavirus infection.
Analytic Time:
1 day
Day(s) Test Set Up: Monday, Wednesday, Friday
CPT Code(s):
87425
RPR (RAPID PLASMA REAGIN) TEST
See: “Prenatal Panel”
“Syphilis Serology”
RUBELLA
See: “Prenatal Panel”
“Rubella Antibodies, IgM Only, Serum”
“Rubella Serology, Serum”
“TORCH Panel”
RUBELLA ANTIBODIES, IGM ONLY, SERUM
MEIA
Test for IgM class antibodies is useful in differentiating congenital from primary infections. IgM class antibodies
are present in the acute stage of primary rubella infections or in congenital rubella infections.
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST top tube (minimum 1.0 serum). Centrifuge SST 30 minutes after
draw. Refrigerate specimen and forward promptly.
NOTE:
Include patient’s age on request form.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Monday - Friday
86762
RUBELLA SEROLOGY, SERUM (IgG)
Chemiluminescence
NOTE: This test is for immune status.
Test Performed At:
Shore Health Laboratories
206
Specimen:
1 SST tube (minimum: 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen in a screw-capped, sterile vial after collection. Maintain sterility and
forward promptly.
NOTE: If looking for clinical illness, call Shore Health Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Immune or non-immune
1 day
Daily
86762
RUBEOLA ANTIBODY IgG
Test Performed At:
Lab Corp
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge and refrigerate.
Reference Values: Negative
Analytic Time:
2 days
Day(s) Test Set Up: Monday through Friday
CPT Code(s):
86765
RUBEOLA ANTIBODY IgM
Test Performed At:
Lab Corp
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge and refrigerate.
Reference Values: Negative
Analytic Time:
Positive reported within 4 days
Day(s) Test Set Up: Tuesday and Friday
CPT Code(s):
86765
S
SALICYLATE, SERUM
Colorimetric/Timed Endpoint
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Adult therapeutic range: 4.0-20 mg/dl
> 30 mg/dl
1 day
Daily
80196
207
SCHILLING TEST, URINE
See: “Gastrin, Serum"
SCOTCH TAPE PREP
See: “Pinworm Preparation”
SEDIMENTATION RATE (ESR), SERUM
Westergren, Modified
Test Performed At:
Shore Health Laboratories
Specimen:
1 lavender-top (K2 EDTA) tube (minimum 3.0 ml of K2 EDTA whole blood).
Reference Values:
Males: 0-15 mm/hour
Females: 0-20 mm/hour
1 day
Daily
85651
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
SELENIUM, SERUM
Atomic Absorption Spectrometry
Test Performed At:
LabCorp
Specimen:
1 royal blue trace element blood collection tube. No additive. (minimum 1.0 ml serum).
Specimen must be obtained, processed, and transported according to instructions on p.
257, “Metals Analysis Collection and Transport.” Send original collection tube at room
temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
76-326 ug/L
2 days
Tuesday - Friday
84255
SELENIUM, URINE
GFAAS
Test Performed At:
LabCorp
Specimen:
20 ml urine collected in plastic container. Maintain at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
10-160 ug/L
2 days
Tuesday - Friday
84255
208
SEMEN ANALYSIS, COMPLETE
Manual Procedure
Includes activity grade and viability, count, liquefaction, motility at 1 hour, morphology, pH, viscosity, and volume.
Test Performed At:
Shore Health Laboratories
Specimen:
Semen. Follow guidelines in “Laboratory Outpatient Instructions for Semen Collection”
supplied by Shore Health Laboratories. NOTE: Specimen must be received in the
laboratory within 30 minutes of collection. Due to the amount of technologist time
required to perform this test, we ask that the specimen be delivered prior to 11 a.m. The
reliability of the specimen and the ability to grade motility are compromised in delayed
specimens. Patient is required to answer a questionnaire (see p. 25). Also see Semen
analysis instructions on p. 24.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Results include count, motility, and morphology.
1-2 days
Monday - Friday
89320
SEMEN ANALYSIS, POST VASECTOMY
Manual Procedure
Test Performed At:
Shore Health Laboratories
Specimen:
Semen. Follow guidelines in “Laboratory Outpatient Instructions for Semen Collection”
supplied by Shore Health Laboratories. NOTE: Specimen must be received in the
laboratory within 30 minutes of collection. Due to the amount of technologist time
required to perform this test, we ask that the specimen be delivered prior to 11a.m. The
reliability of the specimen and the ability to grade motility are compromised in delayed
specimens.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
No sperm seen
1 day
Monday - Friday
89300
SENSITIVE THYROID-STIMULATING HORMONE
See: “Thyroid-Stimulating Hormone - Sensitive (S-TSH), Serum”
SEROTONIN, SERUM
HPLC
Test Performed At:
LabCorp
Specimen:
1 plain red top tube (minimum 2.0 serum) from a fasting patient. Separate and freeze
serum within 2 hours of collection. The patient should be medication free for 72 hours prior
to collection.
NOTE:
Avoid bananas, eggplant, pineapple, avocado, prunes, and walnuts.
209
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0-420 ng/ml
1 day
Monday - Friday
84260
SEX HORMONE BINDING GLOBULIN (SHBG), SERUM
ICMA
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 serum or plasma).
Centrifuge 30 minutes after draw. Refrigerate specimen after collection..
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Monday - Friday
84270
SGOT/AST (ASPARTATE AMINOTRANSFERASE)
See: “Aspartate Aminotransferase (AST/SGOT), Serum"
“Hepatic Panel”
“Comprehensive Metabolic Panel”
SGPT/ALT (ALANINE AMINOTRANSFERASE)
See: “Alanine Aminotransferase (ALT/SGPT), Serum”
“Hepatic Panel”
”Comprehensive Metabolic Panel"
SICKLE CELL
See: “Hemoglobin Electrophoresis, Blood”
“Sickle Cell Testing, Blood"
SICKLE CELL TESTING, BLOOD
Solubility Test-Qualitative
Test Performed At:
Shore Health Laboratories
Specimen:
1 lavender-top (EDTA) tube (minimum 1.0 ml EDTA whole blood).
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Friday
85660
SICKLEDEX
See: “Hemoglobin Electrophoresis, Blood”
210
SICKLING TEST
See: “Hemoglobin Electrophoresis, Blood”
“Sickle Cell Testing, Blood”
SIROLIMUS (RAPAMYCIN)
LC/MS-MS
Test Performed At:
LabCorp
Specimen:
1 lavender (EDTA). Send whole blood. Refrigerate.
NOTE:
Trough level: draw 30-60 minutes before next dose.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Monday - Friday
80195
SKIN BIOPSY
See: “Cutaneous Immunofluorescence, Biopsy”
“Cutaneous Leukocyte Immunophenotyping, Biopsy”
“Histology, Tissue”
SMEAR, ACID FAST BACILLI-AFB
See: “Culture, Acid-Fast Bacillus”
SMEAR, GRAM STAIN
Gram Stain
Test Performed At:
Shore Health Laboratories
Specimen:
Maintain sterility and forward promptly on a Culture-swab® or in a tightly sealed sterile cup
or tube.
NOTE: Culture site required on request form for processing.
Reference Values:
Site dependent
Analytic Time:
1 day
Day(s) Test Set Up: Daily
CPT Code(s):
87205
SMEAR, INDIA INK, SPINAL FLUID
India Ink Smear
Test Performed At:
Shore Health Laboratories
Specimen:
1 plain (no additives) STERILE tube (minimum 1.0 ml of spinal fluid).Maintain sterility and
forward tightly capped sterile vial immediately after collection.
NOTE: 1. If specimen is used for bacterial culture, forward immediately after collection
at ambient temperature only.
2. The plain, red-top tube should NOT contain gel or silicone.
211
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Daily
87210
SMEAR, KOH, FUNGUS
Microscopic
Test Performed At:
Shore Health Laboratories
Specimen:
Respiratory secretions, skin scrapings, or tissue. Maintain sterility and forward promptly in
a tightly sealed sterile cup or tube.
NOTE: Culture site required on request form for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Daily
87220
SMEAR, TZANCK
Papanicolaou Stain
Test Performed At:
Shore Health Laboratories
Specimen:
Smears prepared from base of blister. Immediately spray with spraycyte.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
No herpes-like inclusions seen
2 days
Monday - Friday
88160
SMEAR, TRICHOMONAS
Wet Prep
Test Performed At:
Shore Health Laboratories
Specimen:
Genital swab placed in a plain, red-top tube containing 2.0 ml saline.
FORWARD PROMPTLY.
NOTE: The plain, red-top tube should not contain gel or silicone.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Daily
87210
SMOOTH MUSCLE ANTIBODIES, SERUM ( ACTIN )
ELISA
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 serum). Centrifuge 30 minutes after draw.
Separate and refrigerate serum.
212
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative <20 units
2 days
Monday - Saturday
83516
SODIUM AND POTASSIUM
See: “Electrolyte Panel”
“Comprehensive Metabolic Panel"
"Potassium, Serum”
"Potassium, Urine"
“Renal Function Panel”
“Sodium Serum"
“Sodium Urine"
SODIUM, SERUM
Ion-Selective Electrode (ISE)
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate.
Reference Values:
Critical Value:
Adult:136-145 mEq/L
Child: <121 or >156 mEq/L
Adult: <120 or >158 mEq/L
1 day
Daily
84295
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
SODIUM, URINE
Ion-Selective Electrode (ISE)
Test Performed At:
Shore Health Laboratories
Specimen:
2.0 ml from a random urine collection in a urine sample cup supplied by Shore Health
Laboratories or an entire 24-hour urine collection in a urine container with no preservative.
24-Hour urine containers are supplied by Shore Health Laboratories. Refrigerate 24-hour
urine specimen during and after collection. NOTE: Follow guidelines in “Patient
Instructions for 24-Hour Urine Collection” supplied by Shore Health Laboratories.
Reference Values:
Sodium 40-220 mEq/24 hours
No established reference range for random specimens.
1 day
Daily
84300
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
213
SOMATOMEDIN-C SERUM (IGF 1)
Chemiluminescence
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 serum). Refrigerate.
NOTE:
Include patient’s age and sex on request form.
Reference Values:
See report.
Somatomedin C is age and sex dependent.
Analytic Time:
2 days
Day(s) Test Set Up: Sunday - Friday
CPT Code(s):
84305
SPERM COUNT
See: “Semen Analysis Complete”
SPINAL FLUID COUNT
See: “Cell Count, Differential, Spinal Fluid”
SPINAL FLUID CULTURE
See: “Culture, Spinal Fluid (With Gram Stain)”
SPIROCHETE
See: “Borrelia burgdorferi (Lyme Disease Spirochete) Detection by Polymerase Chain Reaction (PCR)”
“Lyme Disease Antibody, Confirmation, Serum”
“Lyme Disease Antibody, lgG and IgM, Serum”
SPUTUM CULTURE
See: “Culture, Respiratory Secretions”
STOOL CYTOTOXICITY ASSAY FOR CLOSTRIDIUM DIFFICILE
See: “Clostridium difficile Toxin-A, Feces”
STOOL CULTURE
See: “Culture, Stool, Formed and “Culture Stool, Not Formed”
STREPTOZYME (ASOT), SERUM
Hemagglutination
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate.
214
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
1 day
Monday - Friday
86063
STRIATIONAL (STRIATED MUSCLE) ANTIBODIES, SERUM
IFA
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 serum; pediatric 0.5 ml serum). Centrifuge SST
30 minutes after draw. Maintain at room temperature.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
<1:40
2 days
Monday - Friday
86255
S-TSH (SENSITIVE THYROID.STIMULATING HORMONE)
See: “Thyroid-Stimulating Hormone - Sensitive (STSH), Serum”
STS
See: “Syphilis Serology”
SUDAN STAIN FOR FAT
See: “Fat, Qualitative, Feces”
SYNOVIAL FLUID
See: “Cell Count, Body Fluid”
“Crystals, Body Fluids or Urine”
STS (RPR), SERUM, SYPHILIS SEROLOGY
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate.
Reference Values:
Nonreactive
If positive, Syphilis EIA IgG/IgM test will reflex and be referred to Maryland State Health
Department for testing.
1 day
Monday - Friday
86592
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
215
STS (SYPHILIS EIA IgG/IgM), SERUM
Note: The Maryland State Laboratories Administration has replaced the confirmatory Syphilis FTA-ABS test
with the confirmatory Syphilis TREP-SURE™ EIA IgG/IgM test.
A “Positive Trep-Sure™” result has the same significance as a “Reactive FTA-ABS” result, and a “Negative
Trep-Sure™” result has the same significance as a “Non-Reactive FTA-ABS” result.
Test Performed At:
Maryland State Health Department
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative
14-21 days
Monday - Friday
86781
STS, SPINAL FLUID
Includes VDRL
Test Performed At:
Maryland State Health Department
Specimen:
1 plain, red-top tube (minimum 1.0 ml of spinal fluid). Avoid hemolysis. Refrigerate.
NOTE: The plain, red-top tube should NOT contain gel or silicone.
Reference Values:
Nonreactive
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
14-21 days
Monday - Friday
86781
___________________________________________________________________________________________
SUBOXONE, URINE
See: Buprenorphine, urine
T
T3 (TRIIODOTHYRONINE), FREE, SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 serum). Centrifuge 30 minutes after draw.
Refrigerate.
216
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
2.5-3.9 pg/ml
1 day
Daily
84481
T3 (TRIIODOTHYRONINE), REVERSE, SERUM
RIA
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen after collection.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 day
Monday, Wednesday, Friday
84481
T3 (TRIIODOTHYRONINE), TOTAL, SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen after collection.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Adults: 87-178 ng/dL
1 day
Daily
84480
T3 (TRIIODOTHYRONINE) UPTAKE, SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge 30 minutes after draw.
Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
32-48%
1 day
Daily
84479
T4 (THYROXINE)
See: “T4 (Thyroxine), Total, Serum”
217
T4 (THYROXINE), FREE, SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge 30 minutes after draw.
Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.6-1.3 ng/dL
1 day
Daily
84439 - Free T4
T4 (THYROXINE), TOTAL, SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
6.0-12.0 ug/dL
1 day
Daily
84436
TACROLIMUS (FK506) (PROGRAF)
Immunoassay
Test Performed At:
LabCorp
Specimen:
1 lavender (EDTA) tube. Send whole tube or 1 ml whole blood. Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Monday - Friday
80197
T- AND B-CELL QUANTITATION BY FLOW CYTOMETRY
See: “Lymphocyte Panels 1, 2, 4, 5”
TCT (THROMBIN CLOTTING TIME)
See: “Thrombin Time, Plasma”
TEGRETOL® (CARBAMAZEPINE)
See: “Carbamazepine-10,11 -Epoxide, Plasma”
“Carbamazepine, Serum”
218
TESTOSTERONE, TOTAL AND FREE, SERUM
Radioimmunoassay (RIA), Extraction Chromatography, Equilibrium dialysis, Calculation
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 2.5 ml of serum). Centrifuge 30 minutes after draw.
Refrigerate serum.
NOTE:
Patient’s age and sex are required on request form for processing. A morning specimen is
preferred.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
2 days
Monday - Friday
84402
84403
TESTOSTERONE, TOTAL ONLY, SERUM
Radioimmunoassay (RIA)
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See Report.
1 day
Daily
84403
TETANUS ANTIBODY
See: “Bacterial Serology, Serum”
TG (THYROGLOBULIN)
See: “Thyroglobulin, Serum”
THEO-DUR® (THEOPHYLLINE)
See: “Theophylline, Serum”
THEOPHYLLINE (AMINOPHYLLINE), SERUM
PETIA Immunoassay method
Test Performed At:
Shore Health Laboratories
Specimen:
Peak: 1 SST tube (minimum 0.5 ml of serum) drawn as follows:
IV dosage: collect specimen prior to IV infusion; 30 minutes after completion of loading
dose, (to measure adequacy of dose); 4-6 hours after beginning therapy.
Oral dosage: collect specimen 2 hours after dose with rapid release drug; 4 hours after
dose with sustained release drug. Centrifuge SST 30 minutes after draw. Refrigerate
specimen.
219
Trough: 1 SST tube (minimum 0.5 ml of serum) drawn prior to next dose. Centrifuge SST
30 minutes after draw. Refrigerate specimen.
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Therapeutic concentration:
10-20 ug/ml
> 25 ug/ml
1 day
Daily
80198
THIOCYANATE, SERUM/PLASMA
Ion Chromatography, Colorimetry
Test Performed At:
LabCorp
Specimen:
1 plain red top, 1 lavender (EDTA) or 1 grey top tube (minimum 1.0 ml serum or plasma).
Refrigerate. The plain red top tube should NOT contain gel or silicone.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
4-7 days
Tuesday & Friday
84430
THREE-DAY MEASLES
See: “Prenatal Profile”
“Rubella Antibodies, IgM Only, Serum”
“Rubella Serology, Serum”
THROAT CULTURE
See: “Culture, Throat”
THROMBIN TIME, PLASMA
Photo-optic
Test Performed At:
LabCorp
Specimen:
1 light blue top (citrate) tube (minimum 2.0 ml plasma). Mix well and centrifuge
immediately after draw. FREEZE.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.0-20.0 sec.
2 days
Monday - Friday
85610
THYROGLOBULIN, SERUM
Radioimmunoassay
This is a monitoring test for differentiated thyroid cancer. Includes Thyroglobin Antibody.
220
NOTE:
THIS TEST IS FOR “RESEARCH PURPOSES ONLY”.
Test Performed At:
LabCorp
Specimen:
2 plain red top or 2 SST tubes (minimum 3.0 ml serum). Centrifuge SST 30 minutes after
draw. Refrigerate specimen. This test is most sensitive for detection of thyroid cancer
recurrence when the patients are off thyroid replacement long enough to have an elevated
thyroid stimulating hormone (TSH) prior to collecting the specimen. The test also can be
used to follow patients with normal TSH. However thyroglobulin values from specimens
with high TSH should not be compared with values with normal TSH, because TSH
stimulation changes the baseline determinations.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
3 days
Monday - Friday
84432
86800
THYROID ANTIBODY GROUP, SERUM
Chemiluminescence Immumometric Assay. Includes thyroglobulin antibodies and thyroid microsomal antibodies
(TPO)
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 ml serum). Centrifuge 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Tg Ab: 0-40 IU/ml
TPO: 0-34 IU/ml
Analytic Time:
1 day
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
86800
86376
THYROID PEROXIDASE ANTIBODIES (TPO)
Immunoassay
Test Performed At:
Shore Health Laboratories
Specimen:
1 plain, red-top tube or 1 SST tube (minimum 1.0 ml of serum). Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
< 35 IU/ml
1 day
Monday-Friday
86376
THYROID-STIMULATING HORMONE (TSH), SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
221
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0.34-5.60 ulU/ml
1 day
Daily
84443
THYROID-STIMULATING IMMUNOGLOBULIN (TSI), SERUM
In Vitro Bioassay Luciferase
Test Performed At:
LabCorp
Specimen:
2 plain red top or 2 SST tube (minimum 3.0 ml serum). Centrifuge 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
<140% basal activity
4 days
Monday - Friday
84445
THYROXINE
See: “T4 (Thyroxine), Free, Serum"
"T4 (Thyroxine), Total Only, Serum”
THYROXINE (T4), TOTAL OR FREE
See: “T4 (Thyroxine), Free, Serum”
“T4 (Thyroxine), Total Only, Serum”
THYROXINE-BINDING GLOBULIN (TBG), FUNCTIONAL, SERUM
Chemiluminescence
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 0.5 ml serum). Centrifuge 30 minutes after draw.
Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
13-39 ug/ml
1-3 days
Sunday - Friday
84442
TIBC (TOTAL IRON-BINDING CAPACITY)
See: “Iron and Total Iron-Binding Capacity Serum”
222
TISSUE TRANSGLUTAMINASE ANTIBODIES, IGA
EIA
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 0.5 ml serum). Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
0-3 U/ml
2 days
Monday - Friday
83516
TOBRAMYCIN, SERUM (PEAK OR TROUGH)
Immunoassay
Test Performed At:
LabCorp
Specimen:
1 plain red top tube for each (minimum 1.0 ml of serum for each). Refrigerate serum. The
plain red top bube should NOT contain gel or silicone. Label specimens as either Peak or
Trough. Serum for a peak level should be collected 30 minutes after completing infusion of
intravenous dose or 60 minutes after an intramuscular or oral dose of tobramycin.
Note:
Information concerning dosage, dosage schedule, and other antimicrobials given
concurrehtly are required on request form for processing.
Reference Values:
Therapeutic ranges
Peak: 6-10 ug/ml
Trough: 0.5-1.5 ug/ml
Analytic Time:
1 day
Day(s) Test Set Up: Daily
CPT Code(s):
80200 Peak
80200 Trough
TOTAL ESTROGEN
RIA
Test Performed At:
LabCorp
Specimen:
2 SST tubes (minimum 3 ml serum). Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
1 day
Monday - Friday
82672
TOTAL PROTEIN
See: “Albumin/Globulin (A/G) Ratio, Serum”
“Electrophoresis, Protein, Serum”
“Electrophoresis, Protein, Urine”
“Protein, Total, Serum”
223
TOXICOLOGY QUANTITATIVE SCREEN, DRUGS
See: “Drug Screen, Plasma”
TOXOPLASMOSIS ANTIBODY
See: "Toxoplasma Antibody IgG, IgM"
TOXOPLASMA ANTIBODY IGG & IGM, SERUM
ELISA. If IgG is equivocal or positive, the IgM will be performed.
Test Performed At:
LabCorp
Specimen:
1 plain red top tube or 1 SST tube (minimum 2.0 ml serum).
Centrifuge 30 minutes after draw. Refrigerate.
NOTE:
Indicate if oular toxoplasmosis is suspected.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Monday - Friday
86777
TOXOPLASMA ANTIBODY, IGG & IGM, CSF
ELISA
Test Performed At:
LabCorp
Specimen:
Minimum 0.5 ml spinal fluid. Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Negative <0.9 ISR
3-5 days
Tuesday & Thursday
86777
86778
TPO (THYROID PEROXIDASE ANTIBODY)
See: “Thyroid peroxidase antibodies, FIA”
TRACHOMATIS, CHLAMYDIA
See: “Chlamydia by DNA Probe (GenProbe)”
“Chlamydia pneumoniae Antibody Panel, Micro IFA”
“Chlamydia Serology, Serum”
“Culture, Chlamydia trachomatis”
TRANSFERRIN (IRON BINDING PROTEIN)
See: “Transferrin, Serum”
224
TRANSFERRIN, SERUM
Turbidimetric method
Test Performed At:
Shore Health Laboratories
Specimen:
1 plain, red-top tube or 1 SST tube (minimum 2.0 ml of serum) from a fasting patient.
Centrifuge 30 minutes after draw. Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Male: 180-329 mg/dl
1 day
Daily
84466
Female: 192-382 mg/dl
TRANSGROW® CULTURE
See: “Culture, Transgrow®”
TRANSPEPTIDASE, GAMMA-GLUTAMYL
See: “Gamma-Glutamyltransferase (GGT), Serum”
TRAZODONE, SERUM/PLASMA
HPLC
Useful for assessment of treatment for depression.
Test Performed At:
LabCorp (071688)
Specimen:
1 plain red top, 1 lavender (EDTA), or 1 green top (heparin) tube (minimum 2 ml serum or
plasma) collected 12 hours after the last dose following a minimum of 5 days on trazodone.
Refrigerate specimen. The plain red top should NOT contain gel or silicone.
NOTE:
Hemolyzed samples cannot be accepted.
Reference Values:
Therapeutic concentration: 800-1600 ng/ml
Toxicity level not established for this test.
Analytic Time:
3 days
Day(s) Test Set Up: Tuesday & Thursday
CPT Code(s):
82491
TRICHOMONAS SMEAR
See: “Smear, Trichomonas”
TRICYCLIC ANTIDEPRESSANTS
See: “Amitriptyline and Nortriptyline, Plasma”
“Drug Screen, Plasma”
“Drug Screen, Plasma and Urine”
“Imipramine and Desipramine, Plasma”
“Tricyclic Assay, Serum”
"Nortriptyline, serum”
225
TRICYCLIC ASSAY, SERUM
HPLC
Includes amitriptyline, desipramine, imipramine, and nortriptyline.
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 lavender (EDTA) tube (minimum 2.0 ml serum or plasma) drawn 12
hours after last dose. The plain red top should NOT contain gel or silicone. Refrigerate
specimen.
NOTE:
The test is not suitable for monitoring therapeutic levels. Toxicity only.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
4 days
Monday - Friday
80101
TRIGLYCERIDES
See: “Lipid Panel”
“Triglycerides, Serum”
TRIGLYCERIDES, SERUM
Spectrophotometry
Test Performed At:
Shore Health Laboratories
Specimen:
NOTE:
1 SST tube (minimum 0.5 ml of serum). Draw specimen following an overnight (12-14
hour) fast. Patient must not consume any alcohol for 24 hours before the specimen is
drawn. Centrifuge SST 30 minutes after draw. Refrigerate specimen.
Patient’s age and sex are required on request form for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Adult: 30-149 mg/dl
1 day
Daily
84478
TRIIODOTHYRONINE
See: “T3 (Triiodothyronine), Free, Serum”
“T3 (Triiodothyronine), Reverse, Serum”
“T3 (Triiodothyronine), Total Only, Serum”
“T3 (Triiodothyronine) Uptake, Serum”
TROPONIN, PLASMA OR SERUM
Chemiluminescence
Test Performed At:
Shore Health Laboratories
Specimen:
Serum: 1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate.
Plasma: 1 green-top (heparin) tube (minimum 1.0 ml of serum). Refrigerate.
226
NOTE: 1. Indicate plasma or serum on request form.
2. Label specimen appropriately (plasma or serum).
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
< 0.5 ng/ml
1 day
Daily
84470
TRYPTOPHAN, PLASMA
HPLC
Test Performed At:
LabCorp
Specimen:
2 green top (heparin) tubes (minimum 4 ml plasma).
Centifruge immediately and FREEZE plasma.
NOTE:
Patient should refrain from foods high in indole: avocado, banana, tomato, plum, walnut,
pineapple, eggplant, tobacco, tea, and coffee 3 days prior to testing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
5 days
Sunday - Friday
82131
TSH (THYROID-STIMULATING HORMONE)
See: “Thyroid-Stimulating Hormone - Sensitive (S-TSH), Serum”
“Thyroid-Stimulating Hormone (TSH), Serum”
TSH (THYROID-STIMULATING HORMONE) FOR EACH TIMED SPECIMEN
See: “Thyrotropin Releasing Hormone (TRH) Stimulation, Serum”
TULAREMIA ANTIBODY, SERUM
Agglutination
Test Performed At:
LabCorp
Specimen:
1 plain red top or SST tube (minimum 2.0 ml serum).
Centrifuge, separate and freeze serum.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
3 days
Monday - Friday
86668 x2
TYLENOL® (ACETAMINOPHEN)
See: “Acetaminophen, Serum”
“Drug Screen, Plasma”
227
TYPE AND Rh
See: “Prenatal Profile”
“Type, Blood”
“Type and Screen, Blood"
TYPE, BLOOD
Agglutination
Hemagglutination
Test Performed At:
Shore Health Laboratories
Specimen:
1 pink-top blood bank tube (minimum 5.0 ml of whole blood).
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Descriptive report
1 day
Daily
86900 - ABO type
86901 - Rh type
TYPE AND SCREEN, BLOOD
Agglutination
Hemagglutination
Antihuman Globulin
Solid Phase
Test Performed At:
Shore Health Laboratories
Specimen:
1 pink-top blood bank tube (minimum 5.0 ml of whole blood).
Reference Values:
Antibody Screen: Negative
If positive, antibody identification will be performed.
Type and Rh: Descriptive report
1 day
Daily
86900 - ABO type
86870 - antibody identification
86850 - antibody screen
86905 - each red cell antigen typing
86901 - Rh type
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
TZANCK SMEAR
See: “Smear, Tzanck”
228
U
URATE CRYSTALS
See: “Crystals, Body Fluids or Urine”
UREA NITROGEN
See: “Renal Function Panel”
“Urea Nitrogen, Serum”
“Urea Nitrogen, Urine”
"Basic Metabolic and Comprehensive Metabolic Panel"
UREA NITROGEN, SERUM
Urease
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate.
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Adult: 8-25 mg/dl
Child: >70 mg/dl
1 day
Daily
84520
20 yr old-Adult: >104 mg/dl
UREA NITROGEN, URINE
Urease
Test Performed At:
Shore Health Laboratories
Specimen:
Submit an entire 12 or 24-hour urine collection in a urine container supplied by Shore
Health Laboratories. Refrigerate specimen during and after collection. Send to Shore
Health Laboratories as soon as possible after collection. NOTE: Follow guidelines in
“Patient Instruction for 24-Hour Urine Collection” supplied by Shore Health Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
7-20 g/24 hours or 4-10 gm/12 hr. collection
1 day
Daily
84540 - urea nitrogen
81050 - urine timed measurement
URIC ACID
See: “Uric Acid, Serum”
“Uric Acid, Urine”
229
URIC ACID, SERUM
Timed endpoint method
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 0.5 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate specimen.
Reference Values:
Males: 4.8-8.7 mg/dl
Females: 2.6-8.0 mg/dl
Males and Females: > 13.0 mg/dl
1 day
Daily
84550
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
URIC ACID, URINE
Uricase
Test Performed At:
Shore Health Laboratories
Specimen:
Submit an entire 24-hour urine collection in a urine container supplied by Shore Health
Laboratories. Refrigerate specimen during and after collection. Send to Shore Health
Laboratories as soon as possible after collection. NOTE: Follow guidelines in “Patient
Instructions for 24-Hour Urine Collection” supplied by Shore Health Laboratories.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
250-750 mg /24 hours
1 day
Daily
84560 - uric acid
81050 - urine timed measurement
URINALYSIS
See: “Urinalysis, Chemical, Urine”
URINALYSIS, CHEMICAL, URINE
Includes color, appearance, bilirubin, glucose, ketones, leukocyte esterase*, nitrite*, occult blood*, protein*,
specific gravity, and urobilinogen.
(*A microscopic exam will automatically be done when any of these items are positive).
Test Performed At:
Shore Health Laboratories
Specimen:
15 ml from a random urine collection in a urine sample cup supplied by Shore Health
Laboratories. Refrigerate specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report
1 day
Daily
81002 - with microscopy
81001 - without microscopy
230
URINE CULTURE
See: “Culture, Urine”
URINE (CYSTO-BLADDER) CULTURE
See: “Culture, Urine (Cysto-Bladder)”
V
VALIUM® (DIAZEPAM)
See: “Diazepam and Nordiazepam, Serum”
“Drug Screen, Plasma”
“Drug Screen, Plasma and Urine”
VALPROIC ACID (DEPAKENE®), SERUM
PETIA Immunoasaay
Test Performed At:
Shore Health Laboratories
Specimen:
Peak: 1 SST tube (minimum 0.5 ml of serum drawn as follows: Syrup dose: collect
specimen 30-60 minutes after single dose for fasting patient. Capsule dose: collect
specimen 2-8 hours after single dose for fasting patient. Enteric coated tablet: collect
specimen 3-7 hours after ingestion. Centrifuge SST 30 minutes after draw. Refrigerate
Trough: 1 SST tube (minimum 0.5 ml of serum) drawn immediately prior to next dose.
Centrifuge SST 30 minutes after draw. Refrigerate.
Reference Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Therapeutic concentration: 50-100 ug/ml
> 200 ug/ml
1 day
Daily
80164
VANCOMYCIN, SERUM
PETIA Immunoassay
Test Performed At:
Shore Health Laboratories
Specimen:
1 plain red top tube (minimum 1 ml serum). A peak level specimen should be taken 30
minutes after complete infusion of intravenous dose or 60 minutes after an intramuscular
or oral dose of vancomycin. Refrigerate.
References Values:
Critical Value:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Therapeutic ranges:
Peak > 80 ug/ml
1 day
Daily
80202
Peak: 20-40 ug/ml
Trough > 25 ug/ml
Trough: 5-10 ug/ml
231
VANILLYLMANDELIC ACID (VMA), URINE (24 HOUR OR RANDOM)
HPLC. Includes Creatinine
Test Performed At:
LabCorp
Specimen:
Submit 10-30 ml from a 24 hour urine collection or random urine. Refrigerate specimen.
The sensitivity of the test is greater on a 24 hour collection than on random specimens.
Stable unpreserved for 5 days. Follow guidelines in “Patient Instructions for 24 hour Urine
Collection” supplied by SHL.
NOTE:
Amoxicillin interferes with the procedure; it should be discontinued at least 3 days prior to
collection of specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Monday - Friday
84585
VARICELLA (HERPES) ZOSTER CULTURE
See: “Culture, viral”
VARICELLA ANTIBODY, IGG SERUM
Enzyme-Linked Fluorescent Assay (ELFA)
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum). Centrifuge SST 30 minutes after draw.
Refrigerate.
NOTE: Used to determine patient’s immunological experience with Varicella virus.
Reference Values:
Analytic Time:
0.00-0.59 Negative
0.60-0.89 Equivocal
≥ 0.90 Positive
1 day
Day(s) Test Set Up: Tuesday and Thursday
CPT Code(s):
86787
VARICELLA ANTIBODY, IGG & IGM SERUM
Test Performed At:
LabCorp
Specimen:
1 SST tube (minimum 2.0 ml of serum). Centrifuge SST 30 minutes after draw.
Maintain at room temperature.
Reference Values:
Analytic Time:
See report
2 days
Day(s) Test Set Up: Monday - Friday
CPT Code(s):
86787 x2
232
VARICELLA-ZOSTER VIRUS (VZV)
See: “Varicella Serology, Serum”
“Varicella-Zoster Virus (VZV) Detection by Polymerase Chain Reaction (PCR), Spinal Fluid”
VARICELLA-ZOSTER VIRUS (VZV) DTECTION BY POLYMERASE CHAIN REACTION (PCR), SPINAL
FLUID
Test Performed At:
LabCorp
Specimen:
0.5 ml spinal fluid in plain red top tube. Freeze specimen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
None detected
1 day
Monday - Friday
87798
VASOACTIVE INTESTINAL POLYPEPTIDE (VIP), PLASMA
Radioimmunoassay (RIA)
Test Performed At:
LabCorp
Specimen:
Requires Trasylol collection kit. Follow instructions included in box. Prepared plasma
sample to be sent frozen.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
23-63 pg/ml
3 days
Monday & Wednesday
84586
VIRAL CULTURE
See: “Culture, Viral”
VIRAL SEROLOGY, SERUM (AND CSF)
(EASTERN EQUINE ENCEPHALITIS, ST. LOUIS ENCEPHALITIS AND WEST NILE VIRUS ONLY)
Agent Dependent
Available for Eastern Equine Encephalitis, St. Louis Encephalitis, West Nile Virus and Rabies (serum only)
Test Performed At:
Maryland State Health Department
Specimen:
Serum - 2 SST tube (minimum 4.0 ml of serum). Centrifuge SST 30 minutes after
draw. Refrigerate.
CSF – 1 plain red top tube (tightly sealed). Minimum 1.0 ml CSF
NOTE: 1. Acute and convalescent sera are needed to interpret the results. The convalescent serum should be
obtained 2-3 weeks after onset.
2. Label serum specimen appropriately (acute or convalescent).
3. Type of viral agent is required on request form for processing.
4. No convalescent serum for Rabies is necessary.
233
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Agent dependent
For clinical illness, a fourfold rise in titer between acute and convalescent specimens
indicates recent infection.
21-28 days
Monday - Friday
86790
VISCOSITY, SERUM
Kinematic Viscosity
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 1.0 ml serum). Centrifuge 30 minutes after
draw. Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
1 day
Monday - Friday
85810
VITAMIN A, SERUM (RETINOL)
HPLC
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 lavender (EDTA) tube (minimum 1.5 ml serum or plasma).
Protect from light. Refrigerate.
NOTE:
Draw specimen following and overnight (12-14 hour) fast. Patient must not consume
any alcohol for 24 hours before specimen is drawn.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
1 day
Monday - Friday
84590
VITAMIN B1 (THIAMINE) (WHOLE BLOOD PERFERRED)
HPLC
Test Performed At:
LabCorp
Specimen:
1 lavender top (EDTA) tube (minimum 1.0 ml plasma). Transfer plasma to amber plastic
vial. FREEZE specimen. Protect specimen from light by wrapping in foil.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
4.0-20.0 ug/L
3 days
Monday - Friday
84425
234
VITAMIN B12 AND FOLATE, SERUM
Chemiluminescence. Includes folate determination.
Test Performed At:
Shore Health Laboratories
Specimen:
1 SST tube (minimum 1.0 ml of serum) from a fasting patient. Centrifuge SST 30
minutes after draw. Refrigerate. Protect specimen from light.
Reference Values:
Vitamin B12: 180 - 914 pg/ml
Folate: >3.6 ng/ml
1 day
Daily
82746 - Folate
82607 - Vitamin B12
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
VITAMIN B12 BINDING CAPACITY, UNSATURATED (UBBC), SERUM
Protein Binding Radioassay
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 SST tube (minimum 2.0 ml serum).
Centrifuge 30 minutes after draw. Refrigerate specimen.
PRECAUTIONS:
This test should not be requested on patients who have recently received radioisotopes
therapeutically or diagnostically.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
725-2045 pg/ml
5 days
Tuesday & Thursday
82608
VITAMIN B6, PLASMA (PYRIDOXINE)
Radioenzymatic Assay
Test Performed At:
LabCorp
Specimen:
2 lavender top (EDTA) tube (minimum 2.0 ml plasma). Wrap in foil to protect from
light or place in amber tube. Freeze plasma.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Monday - Friday
84207
235
VITAMIN D, 1,25 DIHYDROXY, SERUM (CALCITRIOL)
Cartridge Extraction and Radioreceptor Assay
Test Performed At:
LabCorp
Specimen:
2 SST tubes (minimum 3.0 ml serum). Centrifuge SST 30 minutes after draw.
Refrigerate. Protect specimen from light.
NOTE:
Indicate if patient is on any of the following drugs: (1) Anticonvulsants, such as
phenobarbital and dilantin, (2) Any vitamin D preparation, including vitamin D3, vitamin
D2, 1,25-dihydroxy vitamin D3, or dihydrotachysterol.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
10-75 pg/ml
2 days
Monday - Friday
82652
VITAMIN D, 25 HYDROXY (FRAC) (D2 AND D3)
Test Performed At:
LabCorp
Specimen:
2 SST tubes (minimum 2.0 ml serum). Freeze.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
3-5 days
Daily
82306 x2
VITAMIN D, 25-HYDROXY, SERUM TOTAL
Radioimmunoassay
Test Performed At:
LabCorp
Specimen:
1 plain red top, 1 SST or 1 lavender (EDTA) tube (minimum 0.5 ml serum or plasma).
Centrifuge 30 minutes after draw. Refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Adult range: 32-100 ng/ml
2 day
Monday - Friday
82306
VITAMIN E, SERUM
HPLC
Test Performed At:
LabCorp
Specimen:
1 plain red top or 1 green top (heparin) tube (minimum 2.0 ml serum or plasma). Draw
specimen following overnight(12-14 hour) fast. Patient must not consume any alcohol
for 24 hours before the specimen is drawn. Place serum in amber tube and refrigerate.
Protect specimen from exposure to light.
236
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Monday - Friday
84446
VOLATILES, TOX SCREEN - STAT
Gas Chromatography. Includes Ethanol, Methanol, Acetone, and Acetaldehyde.
Test Performed At:
Quest Diagnostics / LabCorp
Specimen:
5 ml whole blood from a gray top tube. Send at room temperature. Prior to specimen
collection, call Quest to arrange for a specimen pick up. Must submit a Quest
requisition. See special procedure for phone numbers and process.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
None detected
4-6 hours
Daily
84600
VOLATILES, TOX SCREEN – NON STAT
Test Performed At:
LabCorp
Specimen:
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
2 grey top tubes unopened. Refrigerate.
None detected
1 day
Monday - Friday
84600
VLDL (VERY LOW DENSITY LIPOPROTEIN)
See: “Lipoprotein Profile, Serum”
W
WARFARIN, SERUM/PLASMA
High-Pressure Liquid Chromatography (H PLC)
Test Performed At:
LabCorp
Specimen:
1 red-top, 1 lavender (EDTA) or 1 green top (heparin) tube (minimum 2.0 ml serum or
plasma). Do not use gel tubes. Separate and refrigerate.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
Therapeutic concentration: 1-10 mg/ml
3 days
Tuesday & Thursday
82491
237
WATER-DIALYSIS UNIT CULTURE
See: “Culture, Water-Dialysis Unit”
WBC, STOOL
Wright’s Stain
Test Performed At:
Shore Health Laboratories
Specimen:
A minimum of 15 g of stool collected in a gray cup or tightly covered container.
Refrigerate. NOTE: Specimen must be tested within 24 hours of collection.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
None seen
1 day
Daily
CPT Code(s):
87205
WESTERGREN SEDIMENTATION RATE
See: “Sedimentation Rate (ESR), Serum”
WHOOPING COUGH
See: "Bordetella pertussis Detection by Polymerase Chain Reaction (PCR)”
“Culture, Bordetella pertussis”
X
XYLOCAINE® (LIDOCAINE)
See: “Drug Screen, Plasma”
“Drug Screen, Plasma and Urine”
“Lidocaine, Serum”
XYLOSE (D-XYLOSE), URINE
Colorimetric. Performed on adults; not recommended for children.
Test Performed At:
LabCorp
Specimen:
See p. 268 “D-xylose” for patient preparation. 5 hour collection of urine after D-xylose
ingestion. Refrigerate.
NOTE:
Patient’s age, dose, times of sampling, and 5 hour volume are required on request form
for processing.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
2 days
Wednesday
84620
238
Y
YEAST CULTURE
See: “Culture, Fungus”
Z
ZINC PROTOPORPHYRIN (FEP, FREE ERYTHROCYTE PROTOPORPHYRIN)
Hematofluorometry
Test Performed At:
LabCorp
Specimen:
1 royal blue (EDTA) tube. Submit original tube at room temperature. Specimen cannot
be frozen. Protect specimen from light.
NOTE:
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
This test is not for workplace exposure.
See report.
1 day
Monday - Friday
84202
ZINC, SERUM/PLASMA
FAA/CP/MS
Test Performed At:
LabCorp
Specimen:
1 red top or 1 royal blue top (EDTA) tube (minimum 2.0 ml serum or plasma). It is
important that the specimen be obtained, processed, and transported according to
instructions on p. 257, “Metals Analysis – Collection and Transport.”
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
70-150 ug/dl
1-3 days
Monday - Friday
84630
239
ZINC, URINE (RANDOM/24 HOUR)
Inductively Coupled Plasma ((CP) Emission Spectroscopy
Test Performed At:
LabCorp
Specimen:
Submit 5 ml from a random or 24 hour urine collection in a urine container washed with
acid. It is important that the specimen be obtained, processed, and transported
according to instructions on p. 257, “Metals Analysis – Collection and Transport.” Send
at room temperature. Follow guidelines in “Patient Instructions for 24 hour Urine
Collection” supplied by SHL.
Reference Values:
Analytic Time:
Day(s) Test Set Up:
CPT Code(s):
See report.
3 days
Tuesday - Friday
84630
82570
ZZP (ZINC PROTOPORPHYRIN)
See: “Zinc Protoporphyrin (FEP, Free Erythrocyte Protoporphyrin”
SPECIAL INSTRUCTIONS
Allergens
Allergens — IgE Antibodies
IgE Antibody, Single Allergen, Serum
This test is useful principally to confirm the allergen specificity in patients with clinically documented allergic
disease. Therefore, requests for these tests should be made after a careful and comprehensive medical history is
taken. Utilized in this way, a single allergen IgE antibody test is cost-effective. A positive result indicates with high
predictive value that allergic signs and symptoms are caused by exposure to the allergen.
IgE Antibodies, Multi-Allergen, Serum
These panels are composed of three types as follows:
• Geographic Area Panel
These panels are especially useful in patients with allergies to inhalants. The panels are divided into
geographic areas to assist in the selection of appropriate allergens. Seasonal recommendations are provided.
• Other Allergen Panels
Tests include other significant allergen groups. These are composed of molds, household, and epithelia
groupings.
The multi-allergen IgE antibody test, combined with measurement of immunoglobulin E in serum, is a very sensitive
first-order test for allergic disease. Positive results indicate a high probability of allergic disease induced by one or
more allergens present in the multi-allergen panel. Negative results effectively rule out allergy except in rare cases
of allergic disease induced by exposure to a single allergen.
Each of these panels may be ordered with or without concurrent measurement of immunoglobulin E.
240
Immunoglobulin E (IgE), Serum
Measurement of the concentration of immunoglobulin E in serum is useful in the initial evaluation of patients
suspected of having an allergic disease. Above-normal concentrations of immunoglobulin E in serum are strongly
associated with allergic disease. However, some allergic individuals do not have above-normal concentrations.
Measurement of serum immunoglobulin E along with the multi-allergen IgE antibody test offers greater sensitivity
for the detection of allergic disease than either test alone.
Allergens Available for Single
Allergen IgE Antibody Testing
For allergens not listed contact the
laboratory
FOODS
Almond
Bamboo Shoot
Barley
Beef
Brazil Nut
Buckwheat
Carrot
Casein
Celery
Chicken Meat
Chocolate
Chub Mackerel
Clam
Coconut
Codfish
Coffee
Corn
Crab
Egg White
Egg Yolk
Garlic
Gluten
Hazelnut
Jack Mackerel-Scad
Lettuce
Lobster
Malt
Milk
Millet, Common
Millet, Foxtail
Millet, Japanese
Oat
Octopus
Orange
Oysters
Pacific Squid
Pea
Peanut
Pecan Nut
Pork
Potato, White
Potato, Sweet
Rice
Rye
Salmon
Sardine-Pilchard
Scallops
Sesame Seed
Shrimp
Soybean
Strawberry
Tomato
Tuna
Wheat
Yeast Baker’s
Mucor racemosus
Penicilhium notatum
Phoma betae
Pityrosporum orbiculare
Rhizopus nigricans
Stemphylium
GRASS
Common Reed
Johnson Grass
Kentucky Blue (June)
Timothy
Wheat, Cultivated
WEEDS
Cocklebur
(Sagebrush)
Common Ragweed (Short)
Dandelion
English Plantain
False Ragweed
Firebush (Kochia)
Giant Ragweed (Tall)
Goldenrod
(Sagebrush)
Lamb’s Quarter
Mugwort
Ox-Eye Daisy
Pigweed
Russian Thistle
Sheep Sorrel
(Dock Yellow)
Tobacco
Western Ragweed
Wormwood
EPIDERMALS
OCCUPATIONAL
Cat Dander/Epitheiuzn
Cow Epitheium
Dog Epitheium
Horse Epithelium
Mixed Feathers
Tobacco Leaf
HOUSE DUST
House Dust (Greer)
House Dust (H/S)
Dermatophagoides
Farinae
Dermatophagoides
pteronyssinus
Blomia Iropicalis
HYMENOPTERA VENOMS
Cockroach
Honey Bee
Moth
Paper Wasp
White Hornet
Yellow Hornet
Yellow Jacket
TREES
MOLDS
Alternaria tenuis
Aspergillus fumigatus
Candida albicans
Cladosporium herbarum
Epicoccum purpuras
Fusarium culmorum
Helminthosporium halodes
Meadow Fescue
Oat, Cultivated
Perennial Rye
Orchard (Cocksfoot)
Alder
Ash (White)
Beech
Birch
Chestnut
Cottonwood/Poplar
Douglas Fir
Elm (White)
Hazelnut Tree
Horse Chestnut
Linden
Maple (Box Elder)
Willow
Mountain Cedar
Oak
Mesquite
Palm (Queen)
Pecan/Hickory
Pine (Australian)
Poplar
Olive Tree
Spruce
Melaleuca Tree
Walnut Tree
Sycamore
Red Top (Bent)
Rye, Cultivated
Sweet Vernal
241
Amino Acid Disorders
Many abnormalities in the metabolism or the transport of amino acids can be detected by analysis of
physiological fluids, urine, plasma, and spinal fluid for free amino acids. Free amino acids are found in
urine or acid filtrates of protein-containing fluids.
Urine and plasma are used for the initial screen for inborn errors of metabolism. Both transport and
metabolic errors can be detected by changes in the amino acid patterns observed. In many cases,
metabolic errors are detected when the renal threshold of the amino acid or metabolite is exceeded;
many intermediary metabolites exhibit low renal thresholds. Because groups of specific amino acids, i.e.,
the dibasic acids, lysine, ornithine, arginine, and cystine have common transport systems, detection of
many disorders is also facilitated by evaluating the pattern of amino acids found in urine.
Many disorders of intermediary metabolism, especially the variants, are characterized by increased
concentrations of a metabolite(s) only when the metabolic pathway is challenged by a substrate load,
i.e., the characteristic metabolite(s) will not occur in excessive concentrations in plasma or urine unless
the patient consumes protein or carbohydrate or is stressed. Stresses include dehydration, fever, or
increase in dietary protein.
Reports will contain suggested diagnoses (when appropriate), confirmatory tests, and additional
suggested laboratory tests. (Milne MD: Disorders of amino acid transport. Brit Med J 1:327-336, 1964; JB
Stanbury, JB Wyngaarden, DS Fredrickson, et al [editors]: Part 3. Disorders of amino acid metabolism. In
The Metabolic Basis of Inherited Disease. Fifth edition. New York, McGraw-Hill Book Company, 1983, pp
229-583)
242
Catecholamine Fractionation
A. Patient Preparation:
The patient must be prepared to minimize the influence of stress and other factors if clinically useful results are
to be obtained. Epinephrine, epinephrine-like drugs, Aldomet®, and Inderal® interfere with the test procedure.
(Inderal® has a physiologic effect even though it does not directly affect the test procedure.) These drugs
should be discontinued 1 week prior to obtaining the sample. The patient must not use tobacco, drink coffee or
tea, or eat anything for at least 4 hours before blood is drawn for the test. Preparation should also include the
placement of an indwelling, heparinized intravenous catheter along with complete instructions and reassurance
regarding the procedure. The patient should then rest for 30 minutes in the supine position in a quiet room
before a specimen is obtained. At the end of these 30 minutes, withdraw 3.0 ml of blood to flush the heparin out
of the catheter before obtaining the specimen.
B. Investigating for Pheochromocytoma or Evaluating Orthostatic (Postural) Hypotension:
For investigation of the possible presence of pheochromocytoma, one specimen drawn while the patient is
supine will suffice. In some patients with pheochromocytoma, plasma catecholamines will be markedly elevated;
in others, values may fall within the observed reference range. In this latter case, follow up with provocative
tests or a 24-hour urine catecholamine determination would be indicated.
For evaluation of orthostatic (postural) hypotension, the patient should be instructed to sit up after the first
specimen is collected and a second specimen is obtained after 15 minutes. Regardless of the baseline value
(whether normal or low), failure of the catecholamines to increase after the patient has been sitting up suggests
a dysfunction of the autonomic nervous system.
C. Specimens should be clearly labeled as supine or sitting. Plasma must be FROZEN within 15 minutes.
Urinary, Free
Urinary fractionated catecholamines are performed on a 24-hour collection. In general, urinary specimens result in
values more consistent than those obtained from plasma. The 24-hour collection tends to decrease transient
elevations found in plasma samples from some patients.
Coagulation Studies
The physician interpreting results may be misled by abnormal results obtained in mishandled specimens.
To ensure the best possible specimen, follow collection requirements as closely as possible.
1. Patient should be fasting, if possible; for certain tests, the patient cannot be receiving anticoagulant
medication (heparin or warfarin/Coumadin®).
2. Collect blood from the patient into light blue-top (sodium citrate) vacuum tubes (those used for
prothrombin time/activated partial thromboplastin time containing 3.2% sodium citrate).
The tubes must fill completely. A clean venipuncture is essential to avoid activation of coagulation by tissue
thromboplastin. Samples containing fibrin clots will, in most cases, be rejected.
3. Please include the requested information (see individual test descriptions) as the testing and
interpretations are dependent on clinical history in many of the more complex abnormalities.
4. Careful sample handling will most often ensure acceptable samples and valid results.
Pediatric Hemostasis References
1. Hathaway WE, Corrigan J: Report of Scientific and Standardization Subcommittee on Neonatal Hemostasis:
normal coagulation data for fetuses and newborn infants. Thromb Haemost 65:323-325, 1991
2. Andrew M, Paes B, Milner R, et al: Development of the human coagulation system in the full term infant.
Blood
70:165-1 72, 1987
3. Andrew M, Paes B, Milner R, et al: Development of the human coagulation system in the healthy premature
infant. Blood 72:1651-1657, 1988
4. Andrew M, Vegh P, Johnston M, et al: Maturation of the hemostatic system during childhood. Blood 80:19982005, 1992
5. Andrew M: The hemostatic system in the infant. In Hematology of Infancy and Childhood. Vol. 1. Fourth
edition. Edited by DG Nathan, FA Oski. Philadelphia, PA, WB Saunders Company, 1993, pp 115-153
6. Hathaway WE, Bonnar J: Perinatal Coagulation. New York, NY, Grune and Stratton, 1978
7. Hathaway WE, Bonnar J: Hemostatic Disorders of the Pregnant Woman and Newborn Infant. New York, NY,
Elsevier Science Publishing Company, 1987
8. MN Bern, FD Frigoletto Jr. (editors): Hematologic Disorders in Maternal-Fetal Medicine. New York, NY,
Wiley-Liss,
1990
9. 5 Suzuki, WE Hathaway, J Bonnar, AH Sutor (editors): Perinatal Thrombosis and Hemostasis. Tokyo,
Springer-Verlag, 1991
10. Hathaway WE, Manco-Johnson M: Disorders of coagulation and platelets in the neonate. In Hematology:
Basic Principles and Practice. Edited by R Hoffman, EJ Benz Jr., SI Shattil, et al. New York, NY, Churchill
Livingstone, 1991, pp 1409-1415
11. Corrigan JJ Jr: Normal hemostasis in the fetus and newborn: coagulation. In Fetal and Neonatal Physiology.
Vol. 2. Edited by RA Polin, WW Fox. Philadelphia, PA, WB Saunders Company, 1992, pp 1368-1371
244
Biopsy Collection and Transport
A. Selection of biopsy sites:
1. Cutaneous immunofluorescence.
a. Pemphigus and pemphigoid groups (including linear IgA bullous dermatosis and chronic bullous disease
of childhood): Biopsy erythematous perilesional skin or mucosa. Avoid erosions, ulcers, and bullae while
obtaining tissue adjacent to active lesions. Label as perilesional skin.
b. Dermatitis herpetiformis: Biopsy normal appearing skin, 0.5-1.0 cm away from lesion. Label as
perilesional skin.
c. Lupus erythematosus: Involved areas of skin such as erythematous or active borders are preferred
biopsy sites to confirm diagnosis of lupus erythematosus, either discoid or systemic. Label as involved
skin. Uninvolved, nonexposed skin is the preferred site to exclude systemic lupus erythematosus. Should
unexposed skin be desired, buttock or medial thigh is suggested. Label as uninvolved, nonexposed skin.
Avoid ulcers, old lesions, and facial lesions, if possible.
d. Mixed connective tissue disease: Biopsy as for lupus erythematosus except when sclerodermoid
features are present. For sclerodermoid features, biopsy inflamed area. Label as involved or uninvolved,
exposed or nonexposed skin.
e. Vasculitis and urticaria: The erythematous or active border of a new lesion is preferred. Avoid old lesions
and ulcers. Label as involved skin. If appropriate skin lesion is not present, diagnosis may sometimes be
made from uninvolved skin.
f. Porphyria cutanea tarda: Biopsy involved skin. Avoid old lesions and ulcers. Label as involved skin.
g. Lichen planus: Biopsy involved skin. Avoid old lesions and ulcers. Label as involved skin.
2. Cutaneous leukocyte immunophenotype.
a. Biopsy involved skin.
B. Choice of methods for fixation and transport of biopsy specimens:
1. Cutaneous immunofluorescence.
Skin or mucosal specimens can be sent by using either the transport medium or the snap-frozen procedure.
The practical value of using transport medium (supplied by Shore Health Laboratories) is recognized for
direct immunofluorescence testing. However, we have found a loss in sensitivity of approximately 10% with
the transport medium as compared with snap-frozen tissue. This may necessitate a repeat biopsy if the
result seems to be false-negative. The assay cannot be performed on specimens fixed in formalin.
2. Cutaneous leukocyte immunophenotype.
a. Biopsy involved skin.
1) This test is used to help differentiate benign from malignant lymphocytic infiltration of the skin as well
as to help classify cutaneous lymphomas. For optimal interpretation, a formaldehyde-fixed H & E
stained section is required. The test may be used in conjunction with molecular genetics studies for
the most accurate assessment of malignancy. It may also be used to help differentiate CD1 positive
from CD1 negative histiocytoses, such as X vs. non-X histiocytoses.
2) This test requires that the tissue be snap-frozen in liquid nitrogen and transported on dry ice.
(Transportation of the tissue in transport medium is not adequate.) An accompanying permanent
hematoxylin and eosin section of the tissue is optimal.
C. Transport medium method for cutaneous immunofluorescence specimens:
Supplies and equipment needed — specimen vial containing medium (vials with transport medium are
supplied by Shore Health Laboratories), forceps, and biopsy instruments.
1. Use a sharp 4-mm punch. If biopsy specimen is to be divided, use at least a 5-mm punch. An excisional
biopsy may be needed. In dividing the specimen, cut with a very sharp razor blade. Do not squeeze or twist
the specimen. Make a clean cut. Specimens larger than 5 mm in diameter should be divided for adequate
fixation in transport medium.
2. Immediately drop specimen into provided vial of transport medium. Label vial, including patient’s name,
identification number, biopsy site, and date. Seal tightly.
245
3. Complete Chesapeake Pathology/Cytology Request Form. Interpretation of the results is facilitated by
having available the following clinical data on the patient: age, sex, clinical diagnosis, biopsy site
(anatomic), exposure of site to sun (exposed, unexposed), and relationship to lesional skin (perilesional,
involved, uninvolved).
4. Mail in containers supplied by Shore Health Laboratories. Do not mail vials filled with transport medium on
dry ice.
246
Hepatitis Clinical Interpretation Guide
HBs
Ag
Anti
HBs
Anti
HBc
Anti
HBc
IgM
HBeAg
AntiHBe
HBV
DNA
Anti
HD
Anti
HAV
Anti
HAV
IgM
Anti
HCV
Interpretation
+
-
-
-
-
-
+/-
-
-
-
-
Early (presymptomatc)
acute type B hepatitis
+
+/-
+
+
+/-
+/-
+/-
-
-
-
-
Acute type B hepatitis
-
-
+
+
-
-
+/-
-
-
-
-
-
+
+
+/-
-
+/-
-
-
-
-
-
Recent hepatitis B
infection in "window"
period
Recovery from type B
hepatitis
-
+/-
+
-
-
-
-
-
-
-
-
Late recovery hepatitis
B
+
+/-
+
-
+/-
+/-
+/-
-
-
-
-
Chronic type B hepatitis
+
+/-
+
-
+/-
+/-
+/-
+
-
-
-
Chronic type D hepatitis
-
-
-
-
-
-
-
-
+
+
-
Recent acute hepatitis
A
-
-
-
-
-
-
-
-
+
-
-
Recovery from hepatitis
A
-
-
-
-
-
-
-
-
-
-
+
-
-
-
-
-
-
-
-
-
-
-
Late acute or chronic
hepatitis C
Early acute type C
hepatitis or non A, B, C,
D hepatitis
-
+
-
-
-
-
-
-
-
-
-
Hepatitis B vaccine
recipient
247
Human Immunodeficiency Virus Clinical Interpretive Guide
Assay Results
Anti HIV 1/2
EIA
Interpretation
HIV 1
Western Blot
Anti HIV 2
EIA
HIV2
Western
Blot
+
+
NT
NT
+
-
-
+
-
+
HIV1 p24
HIV 1
Infection
HIV 2 Infection
+/-
Positive
NT
NT
-
Negative
Negative
-
NT
+
Positive
Negative
-
+
-
-
Negative
Negative
+
-
+
-
+
Positive
Negative
+
-
+
I
-
Negative
Inconclusive
+
-
+
I
+
Positive
Inconclusive
+
-
+
+
-
Negative
Positive
+
-
+
+
+
Positive
Positive
+
I
+
-
-
Inconclusive
Negative
+
I
+
-
+
Positive
Negative
+
I
+
I
-
Inconclusive
Inconclusive
+
I
+
I
+
Positive
Inconclusive
+
I
+
+
-
Inconclusive
Positive
+
I
+
+
+
Positive
Positive
+
I
-
NT
-
Inconclusive
Negative
+
I
-
NT
+
Positive
Negative
Key
+
I
Positive
NT
Not Tested
Negative
Indeterminate
248
IgG Subclasses Reference Values
(mg/dl)
Age
IgG1
IgG2
IgG3
IgG4
0-1 year
194-842
23-300
19-85
0.5-78.0
2-3 years
315-945
38-225
17-68
1.0-54.0
4-5 years
308-945
61-345
10-122
2.0-112
6-7 years
288-918
44-375
16-85
0.4-98.0
8-9 years
432-1020
72-430
13-85
2.0-95.0
10-11 years
423-1080
78-355
17-173
2.0-115
12-13 years
342-1150
10-455
28-125
4.0-136
14-18 years
315-855
64-495
23-198
11-157
>18 years
382-929
241-700
22-178
4-86
249
Lipids and Lipoproteins in Blood Plasma (Serum)
Lipoprotein Profile Significance
Knowledge of certain features of patients’ blood lipoproteins should be useful to the physician. The following
observations are significant:
1.
An increased level of beta-low density lipoprotein (LDL) is a risk factor for atherosclerotic disease.
2. A high level of alpha-1 high density lipoprotein (alpha-1 HDL) may or may not reflect a healthy status. For a
person who has no liver disease or chronic intoxication of any form, a high level of alpha-1 HDL probably is an
indication of a healthy metabolic system and a relatively low risk for atherosclerotic disease. Otherwise, a high
level (or increased concentration) of alpha-1 HDL may reflect the existence of an early stage of primary biliary
cirrhosis or the existence of chronic hepatitis or of alcoholism or some other form of chronic intoxication.
3. High levels of a second form of HDL, alpha-2 HDL (Lp[a]HDL) have been observed in many cases; a
favorable prognostic significance is not associated with this condition. Lp(a)HDL must be accounted for in
interpreting values for total HDL and LDL. Values for Lp(a)HDL cholesterol in serum can be as high as 100
mg/dl. Recent information has shown that small increases in Lp(a)HDL are probably of no prognostic
significance and that larger increases may be prognostically unfavorable in atherosclerotic disease. Depending
on the method used, Lp(a)HDL cholesterol may be measured as a component of total HDL-cholesterol
(ultracentrifugation methods) or total LDL-cholesterol (precipitation methods). Because Lp(a)HDL may be a
significant component of either the LDL or HDL fraction, specimens containing increased Lp(a)HDL should be
identified and the Lp(a)HDL should be quantified separately from alpha-i HDL and beta-LDL. Specimens that
contain quantitatively significant concentrations of Lp(a)HDL can be identified most easily by electrophoresis of
fractions prepared by ultracentrifugation.
4. Hypercholesterolemia apparently has been considered by many persons to be an expression of an
increased concentration of beta-LDL, or type Ila hyperlipoproteinemia. In some patients, however, an increased
or relatively high level of serum cholesterol reflects a high level of alpha-1 HDL. This interpretational problem is
readily resolvable through simple quantitative testing involving ultracentrifugation or selective precipitation or a
combination of these methods. In addition, hypercholesterolemia can be a reflection of the presence of “LP-X,”
the abnormal lipoprotein complex associated with cholestasis, or of anomalous conditions characterized by
increases of the less-well-known lipoproteins such as IDL, alpha-2 LDL (Lp[a]LDL), and alpha-2 HDL
(Lp[a]HDL). Also hypercholesterolemia can reflect the presence of alpha-1 LDL, which is highly indicative of
primary biliary cirrhosis. The basis of hypercholesterolemia in any single case can best be identified through the
combination of electrophoretic screening and quantitative testing, with the method of quantitative testing being
selected according to the forms of the LDLs and HDLs that are prominent in the electrophoregrams.
5. Identification of patients who have type III hyperlipoproteinemia may be helpful for the optimal management
of their problem(s). A definitive analysis must include establishing the presence of an increased population of
cholesterol-rich, very low density lipoprotein (VLDL) particles of sizes much smaller than the primary VLDL
particles. Evaluation of the cholesterol/triglyceride ratio in the isolated total VLDL is a necessary step. Also,
electrophoresis with molecular sieving in polyacrylamide gel can be a helpful test in establishing that a
specimen contains a significant proportion of VLDL particles of small or intermediate size. In some cases, the
presence of a mixture of VLDL particles of small, intermediate, and large sizes makes definitive evaluation
possible only through analysis of the delipidized apolipoproteins F from isolated total VLDL.
6. Abnormalities in the serum lipoprotein profile can suggest various problems in metabolism, liver function,
and renal function in addition to being reflections of problems primarily inherent in lipid transport.
7. For most patients, quantitative analysis of a single lipoprotein fraction is inadequate for evaluation of the
status of the lipoprotein profile. The commonplace special attention focused on HDL cholesterol and on LDL
cholesterol seems to be distracting attention from other significant components of the serum lipoproteins.
Although the serum total cholesterol value and the alpha-1 HDL cholesterol value together can be adequate
primary information for the evaluation of some specimens, in most cases, an adequate evaluation can be
accomplished only with examination of the entire lipoprotein profile.
250
8. An arithmetic estimation of LDL cholesterol (LDLC) has been promoted extensively as a practical measure.
However, for 25% of 321 consecutive cases presented for lipoprotein analysis, the recommended arithmetic
estimations of LDLC were in error by at least 20 mg/dl; in 12% of the 321 cases, the estimations were
sufficiently in error to cause misinterpretations of the lipoprotein profiles and errors in the planning of patient
management regimens. Clearly, the recommended arithmetic estimations are unreliable and can be misleading.
9. Lipoprotein Lp(a), first reported in 1963 by the Norwegian physician-investigator, Kare Berg, consists of an
ordinary LDL particle combined with an additional protein. Like in ordinary LDL, the primary protein in the Lp(a)
particle is apolipoprotein B1OO (molecular weight = approximately 512,000 D); the additional protein (molecular
weight = 275,000-800,000 D), Lp(a)-specific protein, is highly similar to plasminogen. Also, like in ordinary LDL,
most of the lipid is esterified cholesterol and phospholipids.
The Lp(a) particle has been referred to as “the most atherogenic lipoprotein.” Observations over the last
three decades have indicated that Lp(a) increases cardiovascular risk twofold to threefold when its level in
the blood plasma is above 30 mg/ dL; correspondingly, Lp(a) cholesterol would be above 10 mg/dl. Lp(a)
concentrations of 15 mg or less per dL (Lp[aI cholesterol = 5 mg or less per dL) appear not to confer an
increase of risk. Some recent observations have indicated that Lp(a)-associated cardiovascular risk is
significant only when the concentration of the companion risk factor, LDL, is increased, also. One hypothesis
is that while an increased concentration of ordinary LDL promotes the formation of atheroma, Lp(a) interferes
with a normal preventive action of plasminogen.
Our Lipids and Lipoproteins Laboratory has recognized and reported increased Lp(a) in patients’ specimens
since 1967, as a part of routine analysis of lipoprotein profiles. While the density of Lp(a) particles can be in
either the LDL density range (1.01 9-1.063 mg/ml) or the HDL density range (1.063-1.21 mg/ml), in most
cases, the blood of an individual contains only an LDL form (Lp[a]LDL) or an HDL form (Lp[aIHDL) and not
both forms.
The compositional differences between Lp(a)LDL and Lp(a)HDL are not yet fully understood. Size of the
Lp(a)-specific protein probably is one determinant; the size of Lp(a)-specific protein is quite varied in the
population. The number of Lp(a)-specific protein molecules per lipoprotein particle is hypothetically a second
determinant. Whether Lp(a)LDL and Lp(a)HDL differ as cardiovascular risk factors has not been determined.
Concentrations of Lp(a) particles in the blood can be expressed readily either as concentrations of Lp(a)specific protein or as Lp(a) cholesterol. Accurate immunochemical measurement of Lp(a)-specific protein,
however, is a problem. One complicating factor is a high level of homology with plasminogen. A second
complicating factor is a variation of molecular composition in the population. Both factors, obviously, impact
adversely the usual immunochemical type of approach to quantitation of a specific protein based on a unique
and constant antigenicity. A third very significant problem is the issue of how to express the result of a
quantitative test for Lp(a)-specific protein in meaningful terms. Because the molecular size of Lp(a)-specific
protein varies over a broad range in the population (240,000-800,000 D), a test result primarily related to the
number of molecules of Lp(a)-specific protein in a specimen cannot be expressed accurately or meaningfully
in terms of mg protein/dL unless the molecular weight of the Lp(a)-specific protein in that specimen has been
determined. A further complication is that the number of Lp(a)-specific protein molecules per Lp(a) particle
may vary, and, therefore, the number of Lp(a)-specific protein molecules per Lp(a) particle must be
determined in order for the quantitative protein test value to be used as an indicator of the size of the Lp(a)
particle population. An additional related concern is that the degree of atherogenicity of the Lp(a) particle in
any specific case might depend on the molecular size of the Lp(a)-specific protein and/or on the number of
Lp(a)-specific protein molecules per particle. Clearly, a simple test of the quantity of Lp(a)-specific protein in
a specimen does not exist, and the interpretation of quantitative data requires information on the molecular
size of the Lp(a)-specific protein in that specimen and on the clustering of Lp(a)-specific protein molecules on
the Lp(a) particles.
Alternatively, the cholesterol content of Lp(a) particles varies little, and Lp(a) cholesterol can be quantified
readily. In many cases in our experience, we have observed Lp(a) cholesterol to be at levels of 25-50 mg/dl
and in some cases to be above 100 mg/dl. Clearly, Lp(a) can contain significant proportions of the serum
cholesterol. In such cases, knowledge of the concentration of Lp(a) and of the contribution of Lp(a)
251
cholesterol to the serum total cholesterol should be helpful to physicians in their evaluation of cardiovascular
risk levels.
Our Lipids and Lipoproteins Laboratory will continue to measure and report levels of Lp(a) in terms of
cholesterol as a part of routine evaluations of lipoprotein profiles. In addition, the terms Lp(a), Lp(a)HDL, and
Lp(a)LDL will replace in our reports the synonymous terms pre-beta-HDL, alpha-2 HDL, and alpha-2 LDL.
Lipoprotein analysis can provide practical information about a patient’s health. A definitive analysis must
include preparative ultracentrifugation and quantitation of one or more components of each of the various
individual lipoprotein fractions. Electrophoresis of the whole serum, of the isolated VLDLs, and of the LDLs
and HDLs separate from the VLDLs provides an overview analysis to guide subsequent quantitative
analyses; by electrophoresis of the serum and the fractions, the quantitatively significant components are
revealed, and quantitative fractionation can be tailored accordingly. For example, if a specimen contains “LPX” or Lp(a), special maneuvers can be applied to separate and quantify either fraction in terms of its lipid
content or protein content. The testing of lipoprotein profiles in Mayo Medical Laboratories includes
ultracentrifugation, selective precipitation, electrophoresis, electrophoresis with molecular sieving,
quantitation of cholesterol and triglycerides in isolated lipoprotein fractions, and, in some cases, analysis of
apolipoproteins.
252
Cholesterol and Triglyceride Values in Serum Lipoprotein Fractions*
5th-95th Percentile Ranges by Age and Sex
Cholesterol
Age
(yr)
6-11
12-14
15-19
20-29
30-39
40-49
>50
VLDL
3-20
3-25
3-25
3-35
3-35
3-35
3-35
Females
LDL
60-150 (114)
60-150 (114)
60-150 (118)
60-160 (128)
70-170 (140)
80-190 (150)
80-200 (164)
HDL
VLDL
Males
LDL
HDL
34-65
30-65
33-65
34-75
35-80
35-80
35-80
3-20
3-25
3-30
5-45
5-60
5-60
10-60
60-140 (114)
60-140 (111)
60-140 (113)
60-175 (131)
70-190 (147)
70-205 (160)
80-220 (170)
30-70
30-65
30-60
30-65
30-70
30-70
30-70
( ) Values in parentheses approximate the 75th percentile values for LDL cholesterol.
5th-95th Percentile Ranges by Age and Sex
Triglycerides
Age
(yr)
VLDL
Females
LDL
6-7
8-11
12-14
15-19
20-29
30-39
40-49
>50
10-60
5-85
5-85
5-85
5-90
5-90
5-90
10-90
10-25
10-25
10-25
10-25
10-30
10-40
10-40
10-40
HDL
5-15
5-15
5-15
5-15
5-15
5-15
5-15
5-15
VLDL
5-60
5-60
5-90
5-105
5-155
5-155
5-155
15-155
Males
LDL
HDL
10-25
10-25
10-25
10-25
10-30
10-40
10-50
10-50
5-15
5-15
5-15
5-15
5-20
5-20
5-20
5-20
*The values are in mg/dl of serum and represent healthy persons at the mean ages of the age ranges shown
253
Lipid Reference Values
The following set of values by percentiles has been determined at the Mayo Clinic for a defined population of
healthy persons and with analytic systems that have been standardized for accuracy with the Lipid Standardization
Laboratory of the Centers for Disease Control, Atlanta, GA. We recommend use of the 75th percentile values as
upper limits for serum cholesterol and LDL cholesterol and the 95th percentile values for serum triglycerides and
HDL cholesterol. Values are in mg/dl
Cholesterol (mg/dl) — Percentile Ranking by Age and Sex
Females
Percentiles
5
10
20
30
40 50
60
70
75
Age
(yr)
0-5 Not established
6-9
122
129
10-14
124
134
5-19
125
133
20-24
128
134
25-29
134
142
30-34
141
149
35-39
147
156
40-44
155
164
45-49
162
171
50-54
171
180
55-59
179
190
60-64
188
198
65-69
197
208
70-74
207
218
>74
217
229
Age
(yr)
5
141
142
142
144
152
159
167
175
184
192
202
212
222
232
244
150
149
148
152
159
166
175
183
192
202
212
222
233
244
256
154
155
154
158
165
173
182
191
200
210
220
231
242
254
266
158
161
159
163
171
180
188
198
208
218
228
240
252
264
277
162
168
165
169
178
186
196
206
216
227
237
249
261
274
287
167
178
171
177
186
194
204
215
224
236
247
259
271
285
299
173
174
175
181
190
199
209
219
229
241
253
265
278
291
306
Cholesterol (mg/dl) — Percentile Ranking by Age and Sex
Males
Percentiles
10
20
30
40
50
60
70
75
0-5 Not established
6-9
126
133
10-14
130
135
15-19
114
117
20-24
128
135
25-29
140
148
30-34
150
160
35-39
156
166
40-44
162
172
45-49
166
176
50-54
170
180
55-59
173
183
60-64
175
185
65-69
176
186
70-74
177
188
>74
178
190
141
145
130
145
159
170
179
185
190
193
196
198
200
202
202
146
152
139
153
168
178
187
195
200
204
207
209
211
212
213
151
157
145
160
175
187
196
203
208
213
216
218
220
221
223
156
162
151
166
182
194
203
211
217
221
225
228
229
230
231
162
167
156
173
189
202
212
220
226
230
234
237
239
240
241
168
174
162
181
197
211
221
229
236
240
244
247
249
250
251
172
179
167
185
202
216
226
235
242
246
250
253
255
256
257
80
90
95
180
190
180
185
194
204
214
224
235
246
259
271
285
298
313
189
203
199
197
207
217
228
239
251
263
276
290
304
319
334
80
90
95
176
185
173
190
208
222
232
241
248
252
256
259
262
263
264
187
196
190
204
222
238
250
258
264
270
275
278
280
282
282
191
204
198
216
236
250
264
274
280
286
291
295
298
299
300
209
217
212
209
218
229
240
253
265
278
291
306
320
336
352
254
Triglycerides (mg/dl) - Percentile Ranking by Age and Sex
Females
Age
(yr)
0-5
6-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
>74
Percentiles
5
10
20
30
40
50
60
70
80
90
95
Not established
34
39
33
37
33
36
32
36
33
38
35
41
38
42
40
44
41
46
43
49
45
52
47
54
50
56
52
59
54
62
45
44
42
43
44
46
49
52
54
56
59
62
65
68
72
50
51
47
47
49
52
55
57
60
63
66
69
72
76
79
53
56
52
52
54
57
60
63
66
69
72
76
79
83
87
56
63
57
56
59
62
65
68
71
75
78
82
86
90
95
59
68
62
61
64
67
71
74
78
81
85
89
93
98
103
62
77
67
67
70
74
77
81
85
89
93
97
102
107
112
66
90
77
75
78
81
86
89
94
98
103
106
113
118
124
70
100
88
86
89
94
99
104
108
113
119
125
130
137
143
76
121
122
97
100
106
110
117
122
128
134
140
147
154
162
Triglycerides (mg/dl) - Percentile Ranking by Age and Sex
Males
Age
(yr)
0-5
6-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
>74
Percentiles
5
10
Not established
27
32
30
33
31
33
34
41
40
46
43
51
45
54
48
56
50
57
50
58
51
59
51
59
51
59
51
59
51
60
20
30
40
50
60
70
80
90
95
37
40
39
48
56
62
65
67
69
70
71
71
71
71
71
42
46
46
56
64
70
74
77
79
80
81
81
81
82
82
46
51
53
62
72
78
83
86
88
89
90
91
91
91
91
50
56
62
69
80
87
92
96
98
99
100
101
101
101
101
55
61
69
77
88
97
102
106
109
110
111
111
112
112
112
60
66
78
86
98
109
114
119
121
123
124
125
126
126
126
68
74
90
98
113
124
130
135
138
140
142
142
143
143
144
87
92
107
118
136
148
157
162
166
169
170
170
171
172
172
102
103
124
137
157
171
182
189
193
195
197
198
199
199
199
Serum cholesterol and triglycerides are dependent on age and sex. The 75th percentile values are proposed as
guidelines for significant hypercholesterolemia and the 95th percentile for significant triglyceridemia. This should
not be construed to imply that values below these percentiles are without risk in the development of
atherosclerosis, particularly coronary artery disease. The risk of coronary artery disease apparently is present at
lower lipid levels and increases stepwise with increments in serum lipid values.
The predictive value of blood lipid concentrations diminishes with increasing age. Hypertension and cigarette
smoking augment the cardiac risk attendant on hyperlipidemia.
255
It is recommended that persons <60 years of age have serum lipid profiles evaluated (serum cholesterol, LDL
cholesterol, HDL cholesterol, and triglycerides). If two or more of these evaluations have been performed over
several successive years and indicate no evidence for hyperlipidemia, further reevaluations every 4-5 years should
be adequate. Because the age of onset of some of the hyperlipoproteinemias is not entirely known, we recommend
that persons under 50 years of age have a recheck of the lipid screen every 4-5 years. This is particularly true in
the age group of 20-49 years.
Analysis of the serum lipoproteins may be of use if the lipids are abnormal (outside the 75th percentile for
cholesterols or beyond the 95th percentile for triglycerides). Once a lipoprotein analysis has been obtained, routine
repetition of lipoprotein analysis is not necessary; however, reevaluation of the lipoproteins would be appropriate
after a clinically significant change in either the serum cholesterol or triglyceride concentration.
The National Cholesterol Education Program of the National Heart, Lung, and Blood Institute has announced
guidelines for identification and treatment of hyperlipidemia. Those guidelines are not related to age or sex and
consist of the following points:
Serum cholesterol (SC)
mg/dL
Desirable level
Marginally high risk
High risk
<200
200-239
>240
Recommended follow-up:
SC <200
SC = 200-239 and no CHD and no more
than one CHD risk factor including
maleness
SC = 200-239 and two or more
additional CHD risk factors
SC >240
Retest within 5 years
Improve diet and retest annually
—
LDL cholesterol (LDLC)
Desirable level
Marginally high risk
High risk
Action based on lipoprotein profile with
special attention to LDL cholesterol
Medication indicated
mg/dl
<130
130-159
>160
Recommended follow-up:
Diet management:
Without CHD and without more
than one risk factor
With CHD or two other risk
factors
Medication regimen:
Without CHD and without more
than one risk factor
With CHD or two other risk
factors
Initiation Level
mg/dl
Minimal Goal
mg/dl
>160
<160
>130
<130
>190
<160
>160
<130
CHD = coronary heart disease; LDL = low density lipoproteins
256
“Other risk factors” include male sex, family history of CHD, cigarette smoking, hypertension, HDL cholesterol level
below 35 mg/dl, diabetes mellitus, history of cerebrovascular or occlusive peripheral vascular disease, and obesity
equal to 30% or more overweight (Arch Int Med 148:36, 1988).
257
Metals Analysis — Collection and Transport
When multiple blood samples are scheduled for collection from one patient, the trace metal specimens should be
collected first; once the phlebotomy needle has punctured another rubber stopper, it is contaminated and should
not be used for trace metal specimen collection.
Always use an alcohol swab to cleanse the venipuncture site. Avoid iodine-containing disinfectants. Use only
stainless steel phlebotomy needles.
Blood specimens
Specimens for serum testing should be collected in the Trace Element Blood Collection Tube, navy blue top. Allow
the specimen to clot for 30 minutes; then centrifuge the specimen to separate serum from the cellular fraction.
Remove the stopper and carefully pour the serum into a metal-free, transfer vial, avoiding transfer of the cellular
components of blood. DO NOT insert a pipet into the serum to accomplish transfer, and DO NOT ream the sample
with a wooden stick to assist with serum transfer. Place the cap on the vial tightly, attach a specimen label, and
send specimen to the laboratory at refrigerated or frozen temperature.
Specimens for whole blood testing should be collected in a Trace Element Blood Collection Tube, navy blue top,
containing EDTA as an anticoagulant. Leave the specimen in the tube, attach an identification label, and send the
specimen to the laboratory at cool temperature.
Urine specimens
We urge the use of acid-washed plastic containers for specimen collection and transport. Acid stabilized specimen
collection is essential for accurate analysis of calcium, magnesium, and oxalate. If the urine pH is >4, some of
these elements will be lost in the urine sediment such that at the time of aliquot separation, some of the sediment
will be unhomogeneously divided.
DO NOT collect urine specimens in the environment in which exposure is most likely to occur. It is important that
dust from clothing not contribute to the specimen contents.
DO NOT collect urine in metal-based containers such as metal urinals or pans.
Tips to Control Contamination
1. Keep patient specimen area clean and free of dust.
2. It is best to use the metal free blood tubes.
3. DO NOT touch specimen with utensils unless they have been acid-washed.
4. Dialysis patients on heparin may form an uncoagulated serum when centrifuging. Pour off serum as soon as
possible, invert the clotted tube, and repeat centrifugation step to separate cellular fraction if more serum is
needed.
5. DO NOT leave serum on cells more than 60 minutes. Centrifuge and pour serum into metal-free vial.
References
1
Moody JR, Lindstrom RM: Selection and cleaning of plastic containers for storage of trace element samples.
Anal Chem 49:2264-2267, 1977
2
Lecomte R, Paradis P, Monar 5, et al: Trace element contamination in blood-collecting devices. IntJ NucI
Med Biol 6:207-211, 1979
3
Handy RW: Zn contamination in vacutainer tubes. Clin Chem 25:197-198, 1979
4
Ericson SP, McHalsky ML, Rabinow BE, et al: Sampling and analysis techniques for monitoring serum for
trace elements. Clin Chem 32:1 350-1 356, 1986
5
Nixon DE, Moyer TP, Squillace DP, McCarthy IT: Determination of serum nickel by graphite furnace atomic
absorption spectrometry with Zeeman-effect background correction: values in a normal population and a
population undergoing dialysis. Analyst 114:1671-1674, 1989
258
Microbiology Specimen Guide for Viral and Mycoplasma Specimens*
Infective Agent
Isolation Source
Culture Specimen
Adenovirus
Biopsy, conjunctival swab,
rectum, sputum, stool, or throat
Multi microbe transport
medium
Cytomegalovirus
Urine (first voided a.m.
specimen)
Sterile container
Enterovirus (Coxsackie A, B,
ECHO, polio)
Biopsy, rectum, spinal fluid,
stool, throat, urine, or vagina
stool cup -stool
Multi microbe transport
Herpes simplex virus
or vesicular fluid
Scrapings from infected lesion
Swab in Multi microbe
transport media
Herpes (varicella) zoster virus
Scrapings from infected lesion
or vesicular fluid
Swab in Multi microbe
transport media
Influenza virus
Biopsy, stool, or naso-pharyngeal
Swab in Influenza viral
transport medium
Mumps virus
Biopsy, spinal fluid, stool,
or urine
Swab in Multi microbe throat, or
transport medium
Mycoplasma
Throat
Swab in Multi microbe
transport medium
Parainfluenza virus
Biopsy, stool, or throat
Swab in Multi microbe
Medium
Reovirus
Rectum, stool, or throat
Swab in Multi microbe
Medium
Rubeola
Biopsy, conjunctival swab,
sputum, spinal fluid, throat, or
urine
Swab in Multi microbe
medium
*Refrigerate specimen after collection and forward promptly in appropriate transport as noted above.
259
Parathyroid Hormone Assays
Measurement of parathyroid hormone (PTH) plays an important role in the laboratory evaluation of various primary
and secondary disorders of calcium metabolism. A large array of analytical methods are available for measuring
PTH, including radioimmunoassays, immunoradiometric assays (ICMA), and bioassays. There are considerable
differences among these. Because of the superior performance and reliability of the ICMA, the C-terminal
radioimmunoassay and the N-terminal bioassay have been discontinued. Selection of the appropriate method of
analysis and accurate interpretation of the results require knowledge of both the analytic method and the clinical
situation. This often is a problem for both the clinician and the laboratorian.
PTH Metabolism
PTH is produced and secreted by the four parathyroid glands located along the posterior aspect of the thyroid
gland. The hormone is first synthesized as a 1 15-amino acid precursor (pre-pro-PTH). This form is cleaved to proPTH and then to the 84-amino acid “whole” PTH. The precursor forms generally remain within the cells of the
parathyroid gland. After the whole PTH is secreted, it undergoes further cleavage and metabolism to form carboxylterminal fragments (PTH-C; amino acids 53-84); amino-terminal fragments (PTH-N; amino acids 1-34); and midmolecule fragments (PTH-M; amino acids 44-68). Only those portions of the molecule that carry the amino-terminus
(i.e., the whole molecule and PTH-N) are biologically active.
The active forms have half-lives of approximately 5 minutes. The inactive PTH-C fragments, which normally make
up more than 90% of the total circulating PTH, are cleared by the kidney and have a longer half-life, 30-40 minutes.
As the renal function deteriorates, clearance of PTH-C decreases significantly to a half-life of 24-36 hours. As a
result, patients with renal failure may have strikingly high PTH-C values, even in the absence of parathyroid
disease.
The serum calcium level regulates PTH secretion via negative feedback. Decreased calcium level stimulates PTH
release which increases renal tubular reabsorption of calcium, decreases renal tubular reabsorption of phosphorus,
enhances osteoclastic bone resorption and mobilization of calcium from bone, and increases renal synthesis of 1
,25-dihydroxy vitamin D which, in turn, increases intestinal absorption of calcium.
Parathyroid Disorders
The four main disorders affecting calcium metabolism are: 1) primary hyperparathyroidism (PHPT), 2) secondary
hyperparathyroidism, 3) hypercalcemia of malignancy, and 4) hypoparathyroidism. PHPT is the most common
cause of hypercalcemia in asymptomatic, nonhospitalized patients. In PHPT, one or more glands secrete excess
PTH. The cause may be a carcinoma, a benign tumor (adenoma), or diffuse hyperplasia with independent PTH
production and loss of negative feedback control.
In patients with renal failure and persistently low calcium levels, the parathyroid glands may undergo hyperplasia in
an attempt to bring the calcium level to normal. Autonomously functioning adenomas also may develop with time.
As is the case with primary hyperparathyroidism, surgical removal of the adenomatous tissue often is necessary to
prevent the serious consequences of hyperparathyroidism, including kidney stones and bone disease. With renal
failure, various bone diseases not related to hyperparathyroidism (e.g., osteomalacia and aluminum toxicity) may
develop. Determination of PTH level often is necessary to identify the type of bone disease present in these
patients.
Hypercalcemia of malignancy is the most common cause of hypercalcemia in hospitalized patients. In these cases,
the high calcium level is not due to excess PTH. In fact, PTH level may be suppressed in an attempt to lower the
calcium level. Various malignancies may result in hypercalcemia by several different mechanisms. In multiple
myeloma and some cases of bony metastasis, the local erosive effects result in bone destruction and release of
calcium into the peripheral blood. With other tumors, notably squamous cell carcinoma of the lung, breast cancer,
and prostate cancer, the tumor may secrete substances that have PTH-like activity. Recently, such a substance
was identified and named PTH-related peptide (PTHrP). It is a 141-amino acid fragment with significant homology
260
with the first 13 amino acids of the amino-terminal fragment of PTH. PTHrP promotes calcium resorption from bone
and decreases calcium excretion by the kidney.
Hypoparathyroidism results from absence (usually as a result of surgical removal) or hypofunction of the
parathyroid glands. In these cases, PTH and calcium levels are low.
261
Pediatric Literature References
1. Altman PL, Katz DD: Human Health and Disease, Bethesda, MD, Federation of American Societies for
Experimental Biology, 1977
2. Meites S: Pediatric Clinical Chemistry: A Survey of Reference (Normal Values, Methods, and Instrumentation,
with Commentary). Washington, DC, American Association for Clinical Chemistry, 1981
3. DG Nathan, FA Oski (editors): Hematology of Infancy and Childhood. Philadelphia, PA, WB Saunders Company,
1981
4. Stalker HP, Holland NH, Kotchen JM, Kotchen TA: Plasma renin activity in healthy children. I
258, 1976
Pediatr 89:256-
5. Loeuille G-A, Racadot A, Vasseur P, Vandewalle B: Etude des taux Sanguins et Urinaires d’Aldosterone chez
le Nouveau Ne, le Nourrisson et 1’Enfant Normal. Pediatrie 36:335-344, 1981
6. Ducharme JR, Forest MG, De Peretti E, et al: Plasma adrenal and gonadal sex steroids in human pubertal
development. J Clin Endocrinol Metab 42:468-476, 1975
7. Hicks JM, Boeckx RL: Pediatric Clinical Chemistry, Philadelphia. PA, WB Saunders Company, 1984
8. Davis J, Andelman 5: Urinary delta-aminolevulinic acid (ALA) levels in lead poisoning. Arch Environ Health
15:53-59, 1967
9. Allison DI, Walker A, Smith QT: Urinary hydroxyproline: creatinine ratio of normal humans at various ages. Clin
Chim Acta 14:729-734, 1966
10. Meites 5: Pediatric Clinical Chemistry Reference (Normal) Values. Third edition. Washington, DC, American
Association for Clinical Chemistry, 1989
262
Porphyrinogens. Porphyrins, and Porphyrias
The porphyrias are emotionally distressful and potentially lethal disorders that are evidenced prominently with
neurologic and dermatologic expressions. Congenital erythropoietic porphyria (CEP) is evidenced in infancy, but
the porphyrias of other types have been evidenced almost entirely in adulthood in most cases and only rarely
during childhood.
Acute Intermittent Porphyria (AlP), Coproporphyria (CP), and Variegate Porphyria (VP) are three of the more
prevalent forms of porphyria. Acute episodes are characteristic of all three of these forms and most frequently
include mild to severe abdominal pain and psychiatric distress ranging from depression to psychosis.
The episodes of abdominal pain may be so severe as to indicate a need for immediate surgical exploration and
intervention. Whether mild or severe, in most cases of AlP and CP the recurring abdominal discomfort has been the
unnerving factor that has caused patients to seek examination.
Additional episodic characteristics of lesser frequencies include hypertension, paresthesias, fever, and seizures.
AlP, CP, and VP can cause episodes of neuromuscular weakness that can progress quickly to paraparesis and
whole-body paralysis with life-threatening respiratory paralysis; onset of neuromuscular weakness is clearly a
signal for expeditious establishment of a diagnosis and prompt medical intervention.
Expression of AlP does not include skin problems, but 20-30% of known cases of CP and most, if not all, cases of
VP are photosensitive and/or have increased physical fragility of the skin, increased sensitivity to chemical contact,
and increased susceptibility to “neurodermatitis.” Hypertrichosis and regional alopecia may occur in the more
severely expressed cases of CP and VP. The dermopathy resulting from the photosensitivity of CP and VP includes
erythema, urticaria, and blistering and vesicular lesions.
During acute episodes of AlP, CP, and VP, the production and urinary excretion of delta-aminolevulinic acid (5ALA) and porphobilinogen (Pbg) are increased; therefore, quantitation of urinary 5-ALA and Pbg during suspected
acute episode is helpful. AlP can be diagnosed in either the acute state or latent state by quantitation of 5-ALA
dehydratase and Pbg deaminase (uroporphyrinogen I synthase) activities in erythrocytes. CP and VP can be
detected by analysis of the fecal porphyrins: coproporphyrin excretion is increased in CP, and both fecal
coproporphyrins and protoporphyrins are increased in VP. Diminished activity of Cpg oxidase in hepatocytes is
definitive for a diagnosis of CP, and diminished activity in ervthrocvtes is strongly indicative.
Acute attacks of Acute Intermittent Porphyria. Hereditary Coproporphyria and Variegate Porphyria usually are
provoked by medications (barbiturates and antibacterials are among the best known offenders); various other
commonplace substances that are suspect include household or industrial chemicals, agricultural pesticides,
industrial chemical wastes, garden chemicals, and chemicals used in hobby crafts — such as mineral pigments
used in ceramics work and degreasing solvents used in automotive and other mechanical repair work.
Congenital Erythropoietic Porphyria is readily recognizable in early life by photosensitivity and voiding of pink, winered, or dark urine. Diminished activity of uroporphyrinogen III synthase (co-synthase) in erythrocytes is definitive
evidence for a diagnosis.
Porphyria Cutanea Tarda is characterized by photosensitivity and increased urinary excretion of uroporphyrinogen,
uroporphyrin, and the heptacarboxylporphyrinogen and porphyrin. It is potentiated by a partial deficiency of
uroporphyrinogen decarboxylase, and it is provoked into a metabolically active form by factors such as excessive
storage of iron and chronic abuse of alcohol.
Protoporphyria is relatively mild but potentiates the victim for acute solar urticaria and chronic solar eczema. The
chemical features include increased erythrocyte protoporphyrin and greatly increased fecal excretion of
protoporphyrin.
Intoxication Porphyria can be caused by a variety of toxic substances; probably most of the recognized cases have
been caused by ingestion of lead. Heavy metals, halogenated aromatic hydrocarbons, and drugs can suppress
enzymes involved in porphyrinogen metabolism, leading to the accumulation of intermediates. Enzymes known to
be suppressible by toxic substances include aminolevulinic acid dehydratase, porphobilinogen deaminase,
263
uroporphyrinogen decarboxylase, and ferrochelatase. Other porphyrinogen-related enzymes probably can be
suppressed, also. Usually, intoxication porphyria results in increased erythrocyte protoporphyrin, increased urinary
excretion of & ALA and of porphobilinogen, and increased fecal excretion of protoporphyrin. In addition, increased
urinary excretion of porphyrinogens and porphyrins can occur. Coproporphyrinuria has been observed in many
cases of intoxication with industrial chemicals and waste byproducts. Also, intoxication porphyria can mimic
porphyria cutanea tarda in terms of both clinical signs and increased urinary excretion of uroporphyrin and
heptacarboxylporphyrin; this form of intoxication porphyria occurs when the toxin interferes with the production of or
function of uroporphyrinogen decarboxylase.
Expression of the porphyrias in symptoms and pathology is provoked by environmental stresses and/or physiologic
factors that biochemically impact the characteristic diminished enzyme activities of the heme-forming system. The
needs for avoidance of provocative environmental factors and for minimizing risks for potentially lethal acute
episodes mandate the identification of persons with porphyriagenic genes — persons with active porphyria and
persons with latent traits not yet provoked into symptomatic or pathologic status (mainly first degree relatives of
persons with diagnosed porphyria).
The following table should be helpful for categorizing patients as a preliminary to the selection of appropriate
diagnostic tests.
Prevalence Among
Porphyric Persons
Dermopathy
Neuropathy
Other Indicators
Very rare
None
Mild to severe
Intermittent fever,
hypertension
Among most
prevalent
None
Mild to severe
Intermittent fever,
hypertension
Congenital erythropoietic Porphyria (CEP)
Very rare
Very severe,
mutilating; evidence
in infancy
Possibly
Pink, red, or violet
urine staining
diapers
Porphyria cutanea tarda
(PCT)
Among most
prevalent
Mild to severe
Not usually
Siderosis
Coproporphyria (CP)
Among most
prevalent
20-30% of cases;
mild to severe
Mild to severe
Intermittent fever,
hypertension
Variegate porphyria (VP)
Among most
prevalent
Present in 75-80%
of all cases
Mild to severe
Intermittent fever,
hypertension
Protoporphyria (PP)
Quite rare
Mild to severe
Not usually
Abnormal liver
function tests;
gallstones
Intoxication porphyria
(IP)
Among most
prevalent
In some cases,
not in others
Usually
Variable; intermittent
fever, hypertension
Type
RBC &-ALA dehydratase deficiency (ADP)
Acute intermittent
porphyria (AlP)
RBC Pbg deaminase
deficiency
The porphyrinogens of series III are precursors to heme, and the isomeric porphyrinogens of series I are metabolic byproducts
with no known physiologic function. The porphyrins are by-products formed by nonenzymic oxidations of the porphyrinogens.
The following table is a guide for the ordering of tests to establish diagnoses of porphyrias and to establish the
specific type of any individual case.
264
Suspected Porphyria
Recommended Tests
Acute intermittent porphyria (AlP)
Erythrocyte porphobilinogen deaminase (uroporphyrinogen I
synthase) and erythrocyte 5-ALA dehydratase; during acute
episodes urine Pbg, 5-ALA, porphyrins
Congenital erythropoietic porphyria (CEP)
Urine porphyrins by HPLC, erythrocyte porphyrins with
fractionation by HPLC, and uroporphyrinogen III cosynthase in
RBCs
Porphyria cutanea tarda (PCT)
Urine porphyrins; uroporphyrinogen decarboxylase in RBCs
Coproporphyria (CP)
Fecal porphyrins; urine Pbg, 5-ALA, porphyrins; coproporphyri
nogen oxidase (erythrocyte porphobilinogen deaminase and 5ALA dehydratase may be necessary to differentiate from AlP)
Variegate porphyria (VP)
Fecal porphyrins; urine Pbg, 5-ALA, porphyrins; (erythrocyte
porphobilinogen deaminase and 5-ALA dehydratase may be
necessary to differentiate from AlP)
Protoporphyria (PP)
Urine, fecal, and erythrocyte porphyrins with fractionation by
HPLC
Intoxication porphyria (IP) *
Erythrocyte porphyrins; urinary 5-ALA, Pbg, porphyrins; fecal
porphyrins; 5-ALA dehydratase, Pbg deaminase, and/or
uroporphyrinogen decarboxylase in RBCs may be necessary
(Pbg, porphobilinogen; 5-ALA, delta-aminolevulinic acid)
*In some cases, the quantitation of erythrocyte zinc protoporphyrin should be included to distinguish intoxication
porphyria from protoporphyria.
265
Renin- Aldosterone Studies
Preparation for Renin Aldosterone Studies
—
A. Renin-Angiotensin-Aldosterone System:
1. Renin is secreted by the juxtaglomerular cells of the kidneys in response to changes in plasma volume.
An increase in renin normally produces an increase in aldosterone through angiotensin intermediates.
Renin’s physiological effects are manifested mainly through its changes on aldosterone production.
Aldosterone is produced by the adrenal glands and fluctuates normally with changes in renin levels. With
aldosterone-producing tumors, the serum aldosterone level is elevated even though renin may be
suppressed. Aldosterone production results in retention of sodium and excretion of potassium.
B. Usual Laboratory Test Findings in Renin Aldosterone Disorders:
1. Renal disease, such as unilateral renal artery stenosis, results in elevated renin and aldosterone levels.
Renal venous catheterization may be helpful. A positive test is a renal venous renin ratio (affected/normal)
>1 .5.
2. Primary aldosteronism is manifested by low renin and elevated aldosterone levels. The aldosterone level
will not be suppressed by a high salt intake, whereas in normals it will. An elevated urinary aldosterone
excretion rate and increased levels of serum aldosterone associated with low plasma renin activity is
presumptive evidence for primary aldosteronism.
C. Preparation of Patient for Plasma Renin Activity Determination:
1. The traditional method is to discontinue all substances known to affect the renin angiotensin system and
to then rapidly induce extracellular volume contraction by means of a low sodium diet and diuretic
administration. Paradoxically, chronic volume contraction tends to lessen renin secretion. Recently, it has
been shown that it is possible to stimulate renin secretion and assist in lateralization by means of
converting enzyme inhibitors.
a. Volume contraction protocols:
Intake of all diuretic drugs, antihypertensive drugs (other than guanethidine [Ismelin®], which for
some reason does not alter renin secretion), cyclic progestational agents, estrogens, and licorice
should be terminated. The patient should be on a normal sodium diet.
(1) Three-day diet preparation:
(a) For 3 days prior to the test, the patient should limit sodium intake to 20 mEq/day (see
p. 266, “Diet for Renin Test [20 mEq of Sodium]”).
(b) Administer chlorothiazide 0.5 g b.i.d. for 3 days.
(2) Acute (furosemide) preparation:
(a) Administer furosemide 50 mg orally the night before and 40 mg the morning of the
test.
b. Angiotensin converting enzyme inhibition protocol:
It has been shown that acute administration of drugs which block the action of angiotensin
converting enzyme will enhance renin lateralization. Surprisingly, the effect is not seen if three
drugs are given chronically. An advantage of this protocol is that the inhibiting effects of other
drugs can be eliminated and it is unnecessary to allow a washout period to pass. Captopril
(Capoten® — Squibb) is available as a converting enzyme inhibitor. Reports of renal toxicity by a
variety of mechanisms are known. It would appear, however, that a single dose for testing
purposes is relatively innocuous.
(1) Administer captopril 25 mg by mouth 30 minutes prior to the procedure. Caution should be
taken to guard against orthostatic hypotension.
D. Preparation of Patient and Samples for Primary Aldosteronism Study:
1. Primary testing
266
a. No salt depletion is necessary.
b. Collect a 24-hour urine for aldosterone starting at 10 a.m.
c. At 10 a.m. the next day, draw a peripheral blood sample for plasma renin and serum aldosterone
assays. The patient should be in an upright position when sample is drawn.
2. Confirmatory testing
In primary aldosteronism, the plasma renin activity is suppressed. To confirm that the plasma renin
activity is suppressed, a sodium depleted renin test should be performed. Deplete the patient of sodium
by administering 40 mg of furosemide at 6 p.m. and at 10 p.m. the day before the test and at 7 a.m. on
the day of the test. The patient should be upright for 3 hours before the blood specimen is obtained.
Patients with angina or cerebrovascular insufficiency should not have a furosemide stimulation test. For
alternative stimulated renin test, the patient should follow a 20-mEq sodium diet for 3 days and take 0.5 g
of chlorothiazide twice daily.
Diet for Renin Test (20 mEq of Sodium)
FOODS MAY BE DELETED FROM THIS DIET BUT NO FOODS MAY BE ADDED.
Important Information for the Physician: This diet is quite stringent and should be given for 3 days only and under
circumstances such that the patient’s condition and activity can be carefully supervised. In most instances, it is best
to hospitalize the patient because, with this diet, patients who do not have primary aldosteronism are likely to
become hypovolemic and may suffer from orthostatic hypotension of varying degrees.
General Instructions:
1. Eat only foods included in meal plan.
2. Use standard measuring cups and spoons to measure all portions.
3. Use 1/4 pound of beefsteak or ground beef (raw weight) unsalted for noon meal and 1/4 pound chicken
(raw weight) unsalted for evening meal.
4. Vegetables allowed are asparagus, green or wax beans, cabbage, cauliflower, lettuce, and tomatoes,
unsalted.
5. Bread and butter must be unsalted.
6. Use only the measured amount of coffee. Only distilled water may be taken between meals.
7. All food must be prepared without salt; do not use salt at the table.
Breakfast:
1 cup orange juice
1 egg, poached, boiled, or fried in unsalted fat
2 slices unsalted toast
1 shredded wheat biscuit or 2/3 cup unsalted cooked cereal
1/2 cup half & half or milk
1 cup (measuring cup) coffee
Sugar, jam or jelly, and unsalted butter as desired
Noon Meal:
1/2 cup unsalted tomato juice
1/4 pound ground beef or beef steak (raw weight) unsalted; may be broiled or fried with unsalted fat
1/2 cup unsalted potato
1/2 cup unsalted green beans or other allowed vegetable
1 serving fruit
1 cup (measuring cup) coffee
Sugar, jam or jelly, and unsalted butter as desired
Evening Meal:
1/4 pound chicken (unsalted); may be baked, broiled, or fried in unsalted fat
1/2 cup unsalted potato
1 slice unsalted bread
Lettuce salad (vinegar & oil dressing)
1/2 cup unsalted green beans or other allowed vegetable
1 serving fruit
1 cup (measuring cup) coffee
Sugar, jam or jelly, and unsalted butter as desired
267
Stool Collections
A.
Containers and Transport:
Special containers for the collection and processing of fecal specimens are supplied by Shore Health Laboratories.
Please check the specific test listing for preferred transport temperature.
B.
Container Label and Required Information:
1.
Each container has a label affixed.
2.
At the time the container is given to the patient, please:
a.
Fill in the patient name
b.
Review the test to be done and specimen requirements with the patient
• Collection duration
• Diet requirements
• Collection and storage of the specimen until it is returned to you
• One aliquot container should be provided for a random collection
• Provide patient with information on how to obtain additional containers from you should
that be necessary
c.
Instruct patient not to fill any container more than 3/4 full (to the indicated line on the label)
3.
At the time the patient returns the container to you, complete the following information on the label:
a.
Duration of collection should have the appropriate box checked. If timed duration is other
than those listed, please list it on the line provided following Other ___________
b.
Indicate if the entire collection is contained in one container or in multiple containers.
Indicate total number of containers sent.
268
D-Xylose 5 HR URINE
Patient Preparation and Sample Collection
Patient must fast a minimum of 8 hours prior to administration of d-xylose (25 gm d-xylose). Pediatric patients
(younger than 9 years of age) should fast only 4 hours. No restriction on water. Weigh patient for proper dosage of
d-xylose. Weight based dosage of d-xylose for oral administration: 0.5 g/kg body weight up to a maximum of 25
grams of d-xylose. Dissolve in water 10% (w/v) with a maximum of 250 ml. Patient should drink 8 oz (250 ml) of
water after d-xylose administration and another 8 oz after 1 hour. Patient must remain in supine position for
duration of the test except during urine collection. Patient should refrain from foods rich in pentose (fruits,
preserves, and grains) for a 24 hour period prior to the test.
Record total 5 hour urine volume and send aliquot. Record total volume on request form.
269
PSA (PROSTATE SPEC AG), SCREEN NORMAL RANGE
Ages
0 – 60 Days
2 – 60 Months
5 – 40 Years
41 Years
42 Years
43-44 Years
45 Years
46 Years
47- 48 Years
49 Years
50 Years
51 Years
52 Years
53 Years
54 Years
55 Years
56 Years
57 Years
58 Years
59 Years
60 Years
61 Years
62 Years
63 Years
64 Years
65 Years
66 Years
67 Years
68 Years
69 Years
70 Years
71 Years
72 Years
73 Years
74 Years
75 Years
76 Years
77 Years
78 Years
79 Years
80 – 199 Years
Normal Range
0 – 2.0
0 – 2.0
0 – 2.0
0 – 2.1
0 – 2.2
0 – 2.3
0 – 2.4
0 – 2.5
0 – 2.6
0 – 2.7
0 – 2.8
0 – 2.9
0 – 3.0
0 – 3.1
0 – 3.2
0 – 3.3
0 – 3.4
0 – 3.5
0 – 3.6
0 – 3.7
0 – 3.8
0 – 4.0
0 – 4.1
0 – 4.2
0 – 4.4
0 – 4.5
0 – 4.6
0 – 4.8
0 – 4.9
0 – 5.1
0 – 5.3
0 – 5.4
0 – 5.6
0 – 5.8
0 – 6.0
0 – 6.2
0 – 6.4
0 – 6.6
0 – 6.8
0 – 7.0
0 – 7.2
270
INDEX
No main index - tests are listed alphabetically.
271
APPENDIX
272
273