Hugh Chatham Memorial Lab Tests
A/G ratio
Synonym:
Instructions: Calculation, must order Albumin, Total Protein
Container:
Specimen:
Alternate Specimen:
Preferred / Minimum Volumes: /
Stability:
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s):
Schedule:
Turn around:
Methodology:
Reference Values:
ABO
Synonym: BLOOD TYPE
Instructions: THIS TEST DOES NOT INCLUDE THE RH TYPE
Container: EDTA LAVENDER TUBE
Specimen: WHOLE BLOOD
Alternate Specimen: NONE
Preferred / Minimum Volumes: 5 ML / 1 ML
Stability: 72 HOURS
Patient Prep: NONE
Required Patient Info: NONE
Collection: NORMAL PHLEBOTOMY
Collection Notes: NONE
Processing: REFRIGERATE
Unacceptable: HEMOLYSIS, BACTERIAL OR OTHER CONTAMINATION
Limitations: ABNORMAL PLASMA PROTEINS, COLD AGGLUTININS, POSITIVE DIRECT
ANTIGLOBULIN TEST, AND IN SOME CASES BACTEREMIA MAY INTERFERE WITH TEST
INTERPRETATION
CPT Code(s): 86900
Schedule:
Turn around: 24 HOURS
Methodology: : HEMAGGLUTINATION
Reference Values: NONE
1
ABO, Rh, Antibody Screen
Synonym: Type and Screen
Instructions: Does not include crossmatched units
Container: EDTA
Specimen: Whole Blood
Alternate Specimen: None
Preferred / Minimum Volumes: 5 mL EDTA whole blood / 3 ml EDTA whole blood
Stability: 72 hours at 2 - 8 C
Patient Prep: None
Required Patient Info: Name, Date of Birth, MR number
Collection: Normal Venipuncture
Collection Notes: Mix well. Sign and date tube.
Processing: Per established blood bank protocol
Unacceptable: Unsigned tube. Clotted specimen. Hemolysis
Limitations: None
CPT Code(s): 86900,86901,86850
Schedule: As received
Turn around: 1 hour
Methodology: Gel column agglutination
Reference Values: None
ABO/Rh
Synonym: BLOOD TYPE
Instructions: THIS TEST INCLUDES AN ABO GROUP AND RH TYPE.
Container: 1 EDTA LAVENDER TUBE, 1 RED TOP TUBE
Specimen: WHOLE BLOOD, SERUM
Alternate Specimen: NONE
Preferred / Minimum Volumes: 4 ML WHOLE BLOOD, 7 ML SERUM / 1 ML WHOLE BLOOD, 3 ML
SERUM
Stability: 72 HOURS
Patient Prep: NONE
Required Patient Info: NONE
Collection: NORMAL PHLEBOTOMY
Collection Notes: NA
Processing: CENTRIFUGE RED TOP TUBE, REFRIGERATE
Unacceptable: HEMOLYSIS, BACTERIAL OR OTHER CONTAMINATION
Limitations: NA
CPT Code(s): 86900,86901
Schedule: NA
Turn around: 24 HOURS
Methodology: HEMAGGLUTINATION
Reference Values:
2
Acetaminophen
Synonym: Tylenol, paracetamol
Instructions:
Container: Plain Red Top, no Gel
Specimen: Serum
Alternate Specimen: None
Preferred / Minimum Volumes: 0.5 mL / 0.3 mL
Stability: 8 hours @ RT
Patient Prep: None required
Required Patient Info: None
Collection:
Collection Notes: Last dose information is helpful.
Processing: Centrifuge specimen
Unacceptable: Gel barrier tubes. DO NOT USE SST OR PST TUBES>
Limitations:
CPT Code(s): 82003
Schedule:
Turn around: 2 Hours
Methodology: turbidimetric inhibition immunoassay
Reference Values: 10 – 30 µg/mL
Activated Partial Thromboplastin Time
Synonym: APTT, PTT
Instructions: If a patient's hematocrit is above 55%, the volume in the citrate tube will need to be adjusted.
Container: 3.2% sodium citrate tube (blue)
Specimen: plasma
Alternate Specimen:
Preferred / Minimum Volumes: 2.7 mL for current type of tube used. / 90% of full draw
Stability: 24 hours @ RT or @ 2-8 C. Freeze immediately if testing is delayed >24 hours.
Patient Prep:
Required Patient Info:
Collection: If using the vacutainer system, draw blue top first. If using the butterfly system, collect a waste
tube or plain red top first, then collect the blue top.
Collection Notes: NA
Processing:
Unacceptable: Clotted specimen, inadequate volume, tube used other than a blue top.
Limitations:
CPT Code(s): 85230
Schedule:
Turn around:
Methodology:
Reference Values:
3
AFB Smear
Synonym: Acid fast smear; Mycobacteria smear
Instructions: For respiratory sources three separate specimens collected on separate days is recommended.
Container: Sterile container with tight screw cap seal
Specimen: sputum or respiratory aspirate, biopsy, blood, body fluid, tissue, urine
Alternate Specimen:
Preferred / Minimum Volumes: 5-10 ml; 50 ml for urines; 2 cm for tissue / 5 ml; 25 ml for urines
Stability: 72 hours refrigerated
Patient Prep:
Required Patient Info: Past exposure info helpful
Collection: Deep cough-first morning specimen for sputum: If evaluating for TB protocol-3 separate
specimens on three separate days is recommended
Collection Notes:
Processing:
Unacceptable: Inadequate volume; unlabeled or leaking specimen containers
Limitations:
CPT Code(s): 87206
Schedule: As ordered
Turn around: 24 hours for stat and respiratory sources
Methodology: Fluorescence (stain method)
Reference Values:
Albumin
Synonym: N/A
Instructions: CMPF (3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid) present in sera of patients with
renal failure has been reported to give falsely low albumin values.
Container: SST or Green Top Gel Tube
Specimen: Plasma
Alternate Specimen: EDTA plasma
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: None required
Required Patient Info: None
Collection:
Collection Notes:
Processing: Centrifuge specimen
Unacceptable: Potassium oxalate and sodium fluoride tubes
Limitations:
CPT Code(s): 82040
Schedule:
Turn around: 1 day
Methodology: bromcresol purple (BCP)
Reference Values: 3.2-5.5g/dL
4
Albumin, Body Fluid
Synonym: Albumin, Pericardial; Albumin, Peritoneal; Albumin, Pleural
Instructions:
Container: Sterile cup
Specimen: Pericardial, peritoneal, or pleural fluid
Alternate Specimen:
Preferred / Minimum Volumes: 1 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Centrifuge to remove cellular debris from supernatant. Analyze supernatant.
Unacceptable: Highly viscous fluid
Limitations: Highly viscous fluids will be forwarded to a reference lab for processing.
CPT Code(s): 82042
Schedule: As received
Turn around: 1 day
Methodology: Bromcresol purple
Reference Values: Not established.
ALP (Alkaline Phosphatase)
Synonym: Alkaline Phosphatase
Instructions:
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 0.5 mL / 0.3 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s): 84075
Schedule: As received
Turn around: 1 day
Methodology: ALP reagent is used to measure alkaline phosphatase activity by a kinetic rate method using
a 2-amino-2-methly-1propanol (AMP) buffer
Reference Values: 38 - 126 IU/L
5
ALT (Alanine Aminotransferase)
Synonym: SGPT (Serum Glutamic Pyruvate Transaminase)
Instructions:
Container: PST or SST (green,red or gold top)
Specimen: Serum or plasma
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Very hemolyzed or lipemic specimen.
Limitations:
CPT Code(s): 82140
Schedule: As received
Turn around: 1 day
Methodology: ALT reagent is used to measure analyte activity by a kinetic rate method.
Reference Values: 10 - 40 IU/L
Ammonia
Synonym: NH4, NH3
Instructions:
Container: EDTA (Lavendar top)
Specimen: EDTA plasma
Alternate Specimen: None
Preferred / Minimum Volumes: 0.5 mL / 0.3 mL
Stability: Place on ice immediately after drawing the specimen. Centrifuge immediately and analyze within
20 minutes.
Patient Prep: Patient should fast for 12 hours to avoid lipemia which interferes with testing.
Required Patient Info: Time of collection.
Collection: Keep specimen on ice.
Collection Notes:
Processing: Do not use hemolyzed samples. Place on ice immediately after drawing the specimen.
Centrifuge immediately and analyze within 20 minutes.
Unacceptable: Hemolysis
Limitations:
CPT Code(s): 82140
Schedule: As received
Turn around: 1 hour
Methodology: AMM reagent is used to measure Ammonia by a timed endpoint method.
Reference Values: 16-60 ug/dL (PLASMA)
6
Amylase, Body Fluid
Synonym: Amylase, Pericardial; Amylase, Peritoneal; Amylase, Pleural
Instructions:
Container: Sterile cup
Specimen: Pericardial, peritoneal, or pleural fluid
Alternate Specimen:
Preferred / Minimum Volumes: 1 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Allow sample to reach room temperature before testing.
Unacceptable: Improperly labeled specimen.
Limitations:
CPT Code(s): 82150
Schedule: As received
Turn around: 1 day
Methodology: CNP triose/CNPG3
Reference Values:
Amylase, serum/plasma
Synonym: Amylase
Instructions:
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 0.5 mL / 0.3 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Improperly labeled specimen.
Limitations:
CPT Code(s): 82150
Schedule: As received
Turn around: 1 day
Methodology: AMY reagent is used to measure amylase activity by an enzymatic rate method.
Reference Values: 25-125 U/L
7
Antibody Identification
Synonym: Antibody ID
Instructions:
Container: EDTA
Specimen: EDTA Whole Blood
Alternate Specimen: None
Preferred / Minimum Volumes: 6 mL / 3 mL
Stability: 3 days if kept at 2-8 C
Patient Prep: None required
Required Patient Info: Previous transfusions
Collection: Normal venipuncture
Collection Notes: Mix Well. Sign and date tubes.
Processing: Per established blood bank protocol
Unacceptable: SST collection tubes
Limitations: Hemolyzed collection
CPT Code(s): 86970
Schedule: 7am - 4pm M-F
Turn around: 8 hours
Methodology: gel column agglutination
Reference Values:
AST
Synonym: SGOT (Serum Glutamic Transaminase)
Instructions:
Container: Red, Green, or Gold
Specimen: Serum or Plasma
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection: NORMAL PHLEBOTOMY
Collection Notes: Mix well. Sign and Date Tubes
Processing: Centrifuge to remove plasma/serum from cells.
Unacceptable: Hemolysis, icterus or lipemia.
Limitations:
CPT Code(s): 84450
Schedule: As received
Turn around: 1 day
Methodology: AST reagent is used to measure aspartate aminotransferase activity by an enzymatic rate
method.
Reference Values: 10-42 IU/L
8
Basic Metabolic Profile
Synonym: Fluid Balance, BMP
Instructions: Panel includes: Sodium, potassium, chloride, carbon dioxide, BUN, Creatinine, Calcium, and
Glucose
Container: PST or SST (green, red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: Fast for 12 hours prior to test.
Required Patient Info: Fasting status indicated on request
Collection:
Collection Notes:
Processing: Centrifuge specimen
Unacceptable: Improperly labeled specimen.
Limitations:
CPT Code(s): 80048
Schedule: As received
Turn around: 1 day
Methodology: See each individual test for methodologies
Reference Values: See each individual test for respective reference range information.
Beta hCG, Quantitative
Synonym: Quantitative HCG
Instructions: Serum or plasma
Container: Red, Green, or Gold
Specimen: Plamsa or Serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: Store samples tightly stoppers @ room temp for no longer than eight hours. IF more than eight
hours, refrigerate. If the sample will not be completed within 48 hours, freeze. Thaw samples only once.
Patient Prep:
Required Patient Info:
Collection: NORMAL PHLEBOTOMY
Collection Notes: Mix well. Sign and date tubes
Processing: Centrifuge specimen
Unacceptable:
Limitations: Perform test immediately
CPT Code(s): 84702
Schedule: As received
Turn around: 1 Day
Methodology: Chemiluminescent immunoassay
Reference Values: 0.5-1000 mIU/mL
9
Biopsy culture
Synonym: Tissue culture; Lymph node culture
Instructions: A homogenation step is required to set up specimen. CPT coding for microbiology cannot
always be determined before the culture is completed. Additional codes may apply.
Container: Sterile container with tight screw cap seal
Specimen: Tissue; nodes
Alternate Specimen:
Preferred / Minimum Volumes: 2 cm tissue/node / 1 cm
Stability:
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Bring to lab immediately upon collection
Unacceptable: unlabeled specimens; swab
Limitations:
CPT Code(s): 87070,87073;87176 see instructions
Schedule: as ordered
Turn around: Prelim in 1 day; final in 5-7 days
Methodology: Culture
Reference Values: No growth
Bleeding time
Synonym:
Instructions:
Container:
Specimen:
Alternate Specimen:
Preferred / Minimum Volumes: /
Stability:
Patient Prep:
Required Patient Info:
Collection: An incision is made using a template device on the patient's arm. A blood pressure cuff is
maintained at 40 mm/Hg and hemostasis is timed at 30 sec. intervals.
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s): 85002
Schedule:
Turn around:
Methodology:
Reference Values:
10
Blood culture
Synonym:
Instructions: 2 sets from 2 seperate sites prior to antibiotics
Container: Direct draw into culture media preferred, SPS acceptable.
Specimen: Whole blood
Alternate Specimen:
Preferred / Minimum Volumes: 5-10 mL per culture bottle / 1 mL
Stability: TRecommend transfer of SPS within 2 hours.
Patient Prep:
Required Patient Info:
Collection: Strict aseptic technique with chlorhexadine
Collection Notes: The transfer of specimens into the appropriate culture media should be performed
immediately, within four hours is recommended
Processing:
Unacceptable: unlabeled specimens, aseptic scrub omitted, prolonged delay in processing
Limitations:
CPT Code(s): 87040; see instructions
Schedule: As ordered
Turn around: Real time monitoring of cultures for positives, negatives reported in 48 hours & five days
Methodology: Reflectometers with CO2 sensors in culture bottles
Reference Values: Negative; No growth after 5 days.
BNP
Synonym: brain natriuretic peptide, B-type natriuretic peptide
Instructions:
Container: EDTA Lavender Tube
Specimen: Plasma
Alternate Specimen:
Preferred / Minimum Volumes: 1 mL / 0.5mL
Stability: 6 hours
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s): 83880
Schedule: As ordered
Turn around: 2 hours
Methodology:
Reference Values:
11
Body Fluid Cell Count
Synonym:
Instructions: INCLUDES WBC COUNT AND RBC COUNT, ALSO DIFF IF WBC IS > OR = 5.
Container: EDTA Lavender Tube for all fluids except CSF which should be submitted in CSF vials
Specimen: Pericardial, peritoneal, pleural fluid, CSF
Alternate Specimen:
Preferred / Minimum Volumes: 2 mL / 1 mL
Stability:
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Perform immediately upon receipt.
Unacceptable: Clotted specimen. Highly viscous fluid.
Limitations: Highly viscous fluids will be forwarded to a reference lab for processing.
CPT Code(s): 89050
Schedule: As ordered
Turn around: 2 hours
Methodology: Hemacytometer
Reference Values:
BUN
Synonym: Urea nitrogen or Urea
Instructions:
Container: Red, Green, Gold, or Urine
Specimen: Serum, Plasma, or Urine
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection: NORMAL PHLEBOTOMY
Collection Notes: Mix well. Sign and Date tubes.
Processing: Centrifuge specimen
Unacceptable:
Limitations:
CPT Code(s): 84520
Schedule: As received
Turn around: 1 day
Methodology: Enzymatic rate method
Reference Values: 6-20 mg/dL Serum/Plasma. Urine (timed) 12-20g/24hrs.
12
Calcium
Synonym: CALC
Instructions:
Container: Red, Green, Gold, or properly collected urine (timed/random)
Specimen: Serum, Plasma, or Urine
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: A fasting specimen is desirable
Required Patient Info:
Collection: NORMAL PHLEBOTOMY
Collection Notes: Mix well. Sign and Date tubes.
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Gross hemolysis. Specimen collected in an EDTA tube. LIpemia or icterus.
Limitations:
CPT Code(s): 82310
Schedule: As received
Turn around: 1 day
Methodology: Determines total calcium concentration by indirect potentiometry utilizing a calcuim ion
selective electrode in conjunction with a sodium reference electrode.
Reference Values: Serum/Plasma 8.5 - 10.5 mg/dL
Carbamazepine
Synonym: Tegretol
Instructions:
Container: Plain Red Top
Specimen: Serum
Alternate Specimen:
Preferred / Minimum Volumes: 0.5 mL / 0.3 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: Draw level 15-30 minutes before the next dose.
Required Patient Info: Last dose, next dose information.
Collection:
Collection Notes: DO NOT USE GEL BARRIER TUBES
Processing:
Unacceptable: Lipemia
Limitations:
CPT Code(s): 80156
Schedule: Lipemia
Turn around: 1 day
Methodology: The carbamazepine concentration by a particle enhanced turbidimetric inhibition
immunoassay method.
Reference Values: 4 - 10 ug/mL Toxic >12 ug/mL
13
Carbon dioxide
Synonym: CO2
Instructions:
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: Tube must reain stoppered until analysis to prevent losses of CO2 into the atmosphere.
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Hemolysis
Limitations: Underfilling of the collection tube may account for low CO2 values.
CPT Code(s): 82374
Schedule: As received
Turn around: 1 day
Methodology: Determines total carbon dioxide using a pH rate of change method utilizing a glass carbon
dioxide electrode in conjunction with a glass pH reference electrode.
Reference Values: 21 - 32 mmol/L
Cardiac Enzymes
Synonym:
Instructions: Test includes: CK, CKMB, Troponin
Container: PST or SST (green, red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable:
Limitations:
CPT Code(s): 82550, 82553, 84484
Schedule: As ordered.
Turn around: 1 hour
Methodology: See each individual test for methodologies.
Reference Values: See each individual test
14
CBC Hemogram and Platelet
Synonym: CBC, COMPLETE BLOOD COUNT
Instructions: WBC,RBC,HGB,HCT,MCV,MCH,MCHC,RDW,PLT,MPV
Container: EDTA (lavender)
Specimen: whole blood
Alternate Specimen:
Preferred / Minimum Volumes: 3.0 mL / 1.0 mL
Stability: 12 hours @ RT, 24 hours @ 2-8 C
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: MIx well with anticoagulant by immediately inverting tube 8-10 times.
Processing:
Unacceptable: Clotted specimen, hemolysis, inadequate volume
Limitations: Perform test within 5 hours for optimum results
CPT Code(s): 85025, 85007(with manual differential)
Schedule: As received
Turn around: 2 Hours
Methodology: VCS technology with Coulter principle
Reference Values: (Male/Female) WBC 3.58-11.07 X10^3/uL,(Female) RBC 3.691-4.877 X10^6/uL,
(Male) RBC 4.270-5.493 X 10^6/uL, (Female) Hgb 11.35-14.35g/dL, (Male) Hgb12.92-16.12g/dL,
(Female) Hct 33.27-41.39%, (Male) Hct 37.65-46.48%, (Male/Female) MCV 79.30-94.80fL,
(Male/Female) MCH 26.80-33.16pg, (Male/Female) MCHC 33.51-35.54g/dL, (Male/Female) RDW 11.9915.14%, (Male/Female) Plt 165.40-352.90 X 10^3uL, (Male/Female) MPV 7.51-10.65fL
Cerebrospinal Fluid Analysis
Synonym: CSF Analysis, Spinal Fluid Analysis. Lumbar Puncture
Instructions: Test includes: Volume, Appearance, Cell Count, Differential, Glucose, Protein
Container: Sterile container
Specimen: Cerebrospinal Fluid
Alternate Specimen:
Preferred / Minimum Volumes: 2 mL / 1 mL
Stability: 8 hours @ 2 – 8° C. Cell counts should be performed within one hour of receipt.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Centrifuge to remove cellular debris from supernatant. Analyze supernatant
Unacceptable: Improperly labeled specimen, clotted specimen
Limitations:
CPT Code(s): 82947, 84155, 85040, 89051
Schedule: As received
Turn around: 1 hour
Methodology: See each individual test for methodologies.
Reference Values: See each individual tests. Diff: Adults Neonates Lymphs 40-80% 5-35% Monocytes 1545% 50-90% Segs 2-6% 0-8%
15
Chloride, Plasma/Serum
Synonym: Cl
Instructions:
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Improperly labeled specimen.
Limitations:
CPT Code(s): 82435
Schedule: As received
Turn around: 1 day
Methodology: Indirect potentiometry
Reference Values: 101 - 111 mmol/L
Chloride, Urine
Synonym: Cl, Urine
Instructions:
Container: 24 hour urine container - no preservative, or random urine in sample cup
Specimen: Urine, random or timed
Alternate Specimen:
Preferred / Minimum Volumes: 5 mL aliquot. / 1 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info: Volume of 24 hour collection.
Collection: Keep specimen on ice.
Collection Notes:
Processing: Centrifuge to remove cellular debris from supernatant. Analyze supernatant.
Unacceptable: Improperly labeled specimen.
Limitations:
CPT Code(s): 82436
Schedule: As received
Turn around: 1 day
Methodology: Indirect potentiometry
Reference Values: 110 - 250 mmol/24 Hours
16
Cholesterol
Synonym: CHOL
Instructions: A fasting specimen is recommended for lipid testing in general as other lipids (primarily
triglyceride) are greatly affected by dietary intake. Cholesterol can adequately be measured on fasting and
non-fasting specimens.
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 0.5 mL / 0.3 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: Fast for 12 hours prior to test.
Required Patient Info: State whether fasting or non-fasting.
Collection:
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells
Unacceptable: Hemolysis or icterus.
Limitations:
CPT Code(s): 82465
Schedule: As received
Turn around: 1 day
Methodology: Measure cholesterol concentration by a timed-endpoint method.
Reference Values: <200 mg/dL
CK (Creatine Kinase)
Synonym: CPK (Creatine Phosphokinase)
Instructions:
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: Avoid excersise prior to venipuncture.
Required Patient Info:
Collection:
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Hemolysis
Limitations:
CPT Code(s): 82550
Schedule: As received
Turn around: 1 day
Methodology: Enzymatic rate method.
Reference Values: Male: 38-174 IU/L Female: 26-140 IU/L
17
Complete Blood Count with Differential
Synonym: CDIFF, CBC with Diff, CBC with differential, CBC with manual diff
Instructions: WBC,RBC,HGB,HCT,MCV,MCH,MCHC,RDW,PLT,MPV,DIFFERENTIAL
Container: EDTA (lavender)
Specimen: whole blood
Alternate Specimen:
Preferred / Minimum Volumes: 3.0 mL / 1.0 mL
Stability: 12 hours @ RT, 24 hours @ 2-8 C
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: MIx well with anticoagulant by immediately inverting tube 8-10 times.
Processing:
Unacceptable: Clotted specimen, hemolysis, inadequate volume
Limitations: Perform test within 5 hours for optimum results
CPT Code(s): 85025
Schedule: As received
Turn around: 2 Hours
Methodology: VCS technology with Coulter principle
Reference Values: (Male/Female) WBC 3.58-11.07 X10^3/uL,(Female) RBC 3.691-4.877 X10^6/uL,
(Male) RBC 4.270-5.493 X 10^6/uL, (Female) Hgb 11.35-14.35g/dL, (Male) Hgb12.92-16.12g/dL,
(Female) Hct 33.27-41.39%, (Male) Hct 37.65-46.48%, (Male/Female) MCV 79.30-94.80fL,
(Male/Female) MCH 26.80-33.16pg, (Male/Female) MCHC 33.51-35.54g/dL, (Male/Female) RDW 11.9915.14%, (Male/Female) Plt 165.40-352.90 X 10^3uL, (Male/Female) MPV 7.51-10.65fL, (Male/Female)
NE% 43.33-71.94%, (Male/Female) LY% 16.75-43.51%, (Male/Female) MO% 4.56-12.37%,
(Male/Female) EO% 0.70-7.80%, (Male/Female) BA% 0.22-1.13%, (Male/Female) NE# 1.87-7.18 X
10^3uL, (Male/Female) LY# 1.10-2.73 X 10^3uL, (Male/Female) MO# 0.29-0.82 X 10^3uL,
(Male/Female) EO# 0.04-0.48 X 10^3uL, (Male/Female) BA# 0.02-0.08 X 10^3uL
Comprehensive Metabolic Profile
Synonym: CMP
Instructions: Panel includes: Sodium, Chloride, Potassium, Carbon dioxide, BUN, Calcium, Creatinine,
Total Protein, Albumin, ALP, ALT, AST, Total Bilirubin, and Glucose.
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 2 mL / 1.0 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: Fast for 12 hours prior to test.
Required Patient Info: Fasting status indicated on request
Collection:
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells
Unacceptable: Improperly labeled specimen
Limitations:
CPT Code(s): 80053
Schedule: As received
Turn around: 1 day
Methodology: See each individual test for methodologies.
Reference Values: See each individual test for respective reference range information
18
Creatine Kinase (CK), MB
Synonym: CKMB
Instructions:
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Improperly labeled specimen.
Limitations: Do not use previously frozen specimens.
CPT Code(s): 82553
Schedule: As received
Turn around: 1 day
Methodology: Two-site immunoenzymatic assay.
Reference Values: 0.0 - 4.0 ng/mL
Creatinine Clearance, 24 hour urine
Synonym:
Instructions: Void at 8 am and discard specimen. Collect all urine the next 24 hours including the 8 am
specimen the next morning. Record the 24 hour urine volume.
Container: 24 hour urine container - no preservative & PST
Specimen: Urine & plasma/serum
Alternate Specimen:
Preferred / Minimum Volumes: 5 mL aliquot of 24 hour specimen / 2 mL aliquot of 24 hour specimen
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: Keep specimen on ice or refrigerated during collection.
Processing:
Unacceptable: Incomplete collection.
Limitations:
CPT Code(s): 82575
Schedule: As received
Turn around: 1 day
Methodology: Jaffe reaction method
Reference Values:
19
Creatinine, 24Hour Urine
Synonym:
Instructions: Void at 8 am and discard specimen. Collect all urine the next 24 hours including the 8 am
specimen the next morning. Record the 24 hour urine volume.
Container: 24 hour urine container - no preservative
Specimen: Urine
Alternate Specimen:
Preferred / Minimum Volumes: 5 mL aliquot of 24 hour specimen / 2 mL aliquot of 24 hour specimen
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: Keep specimen on ice or refrigerated during collection.
Processing:
Unacceptable: Incomplete collection.
Limitations:
CPT Code(s): 82570
Schedule: As received
Turn around: 1 day
Methodology: Jaffe reaction method.
Reference Values:
Creatinine, CR-S (Serum/Plasma)
Synonym: CR-S
Instructions:
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Improperly labeled specimen.
Limitations:
CPT Code(s): 82565
Schedule: As received
Turn around: 1 day
Methodology: Jaffe reaction method.
Reference Values: 0.5 - 1.2 mg/dL
20
Creatinine, Random Urine
Synonym:
Instructions:
Container: Sterile cup
Specimen: Urine
Alternate Specimen:
Preferred / Minimum Volumes: 2 mL / 1 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Centrifuge to remove cellular debris from supernatant. Analyze supernatant.
Unacceptable: Improperly labeled specimen.
Limitations:
CPT Code(s): 82570
Schedule: As received
Turn around: 1 day
Methodology: Jaffe reaction method
Reference Values:
Crossmatch
Synonym:
Instructions:
Container:
Specimen:
Alternate Specimen:
Preferred / Minimum Volumes: /
Stability:
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s):
Schedule:
Turn around:
Methodology:
Reference Values:
21
CRP
Synonym: C-Reactive Protein
Instructions:
Container: PST OR SST (GREEN, RED OR GOLD TOP)
Specimen: Plasma or Serum
Alternate Specimen:
Preferred / Minimum Volumes: 1 mL / 0.5mL
Stability: 8 hours @ RT
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s): 86141
Schedule: As received
Turn around: 2 Hours
Methodology: Immunoassay
Reference Values: <1.0 mg/dL
Crystals, Body Fluid
Synonym:
Instructions: Synovial fluid only
Container: Green top heparin tube
Specimen: synovial fluid
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 ml / 0.5 mL
Stability: Must be fresh and analysis performed as soon as possible after collection to prevent degeneration
of crystals.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: Must be fresh and analysis performed as soon as possible after collection to prevent
degeneration of crystals.
Processing:
Unacceptable: Clotted specimen (Highly viscous fluids may be forwarded to a reference lab for
processing.)
Limitations: Perform test immediately
CPT Code(s): 89060
Schedule: As received
Turn around: 2 hours
Methodology: Polarized light
Reference Values: No crystals
22
DBIL (Direct Bilirubin)
Synonym: Conjugated Bilirubin
Instructions: Bilirubin is extremely photosensitive. A 50% decrease in bilirubin within 1 hour has been
reported for samples exposed to direct sunlight. For optimal stability, specimens should be stored in the
dark at low temperature.
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 50 uL (Does not allow for repeat testing
Stability: 3 days @ 2 – 8° C (Light protected)
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: PROTECT FROM LIGHT!
Processing:
Unacceptable:
Limitations:
CPT Code(s): 82248
Schedule: As received
Turn around: 1 day
Methodology:
Reference Values: 0.00 - 0.20 mg/dL
D-Dimer
Synonym:
Instructions:
Container:
Specimen:
Alternate Specimen:
Preferred / Minimum Volumes: /
Stability:
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s):
Schedule:
Turn around:
Methodology:
Reference Values:
23
Digoxin
Synonym: Lanoxin
Instructions:
Container: Plain Red Top
Specimen: Serum ONLY
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: Draw 6 - 8 hours after the last dose.
Required Patient Info: Last dose, next dose information.
Collection:
Collection Notes:
Processing:
Unacceptable: Gel barrier tubes.
Limitations:
CPT Code(s): 80162
Schedule: As received
Turn around: 1 day
Methodology:
Reference Values: 0.80 - 2.00 ng/mL
Direct antiglobulin (Coomb's test)
Synonym: Direct Coombs, DAT
Instructions:
Container: EDTA Whole Blood
Specimen: Whole Blood
Alternate Specimen:
Preferred / Minimum Volumes: 5 mL / 0.5 mL
Stability: 3 days @ 2-8 C
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable: Grossly hemolyzed or visibly contaminated blood specimens.
Limitations:
CPT Code(s): 86880
Schedule: As received
Turn around: 2 hours
Methodology: Negative
Reference Values:
24
Ear/Eye culture
Synonym:
Instructions: CPT coding for microbiology cannot always be determined before the culture is completed.
Additional codes may apply.
Container: Bacterial swab transport; culturette amies or stuart's
Specimen: Abscess, drainage
Alternate Specimen:
Preferred / Minimum Volumes: 2 swabs / 1 swab
Stability: 24 hours in bacterial swab transport @ room temperature
Patient Prep:
Required Patient Info: source and or site
Collection:
Collection Notes: Aspirates should be ordered as a fluid culture and handled as such
Processing:
Unacceptable: Unlabeled specimens; specimens received in expired transport devices; specimens received
after prolonged delay
Limitations:
CPT Code(s): 87070; see instruction
Schedule: as ordered
Turn around: Prelim in 24 hours; Final in 48-72 hours
Methodology: Culture
Reference Values: No growth. Note: Routine/normal body site flora may be reported.
Electrolyte Pane, Random or Timed Urine
Synonym: Lytes, Urine
Instructions: Test includes: Sodium, Potassium, Chloride
Container: Sterile Cup
Specimen: Urine, random or timed
Alternate Specimen: Random urine
Preferred / Minimum Volumes: 5 mL aliquot of 24 hour specimen / 2 mL aliquot of 24 hour specimen
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: .Centrifuge to remove cellular debris from supernatant. Analyze supernatant.
Unacceptable:
Limitations:
CPT Code(s): 80051
Schedule: As received
Turn around: 1 day
Methodology: See each individual test
Reference Values: See each individual test
25
Electrolyte Panel
Synonym: Lytes
Instructions: Panel includes:Sodium, potassium, chloride, and carbon dioxide.
Container: PST or SST (green, red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Hemolysis
Limitations:
CPT Code(s): 80051
Schedule: As received
Turn around: 1 day
Methodology: See each individual test for methodologies.
Reference Values: See each individual test for respective reference range information.
Erythrocyte Sedimentation Rate
Synonym: ESR, sed rate
Instructions:
Container: EDTA (lavender), ESR vacuum tubes
Specimen: whole blood
Alternate Specimen:
Preferred / Minimum Volumes: 3.0 mL(EDTA) To indicated line (ESR Vacuum Tubes) / 2.0ml (EDTA),
To indicated line (ESR Vacuum Tubes)
Stability: 4 hours @ RT, 72 hours @2-8 C(vacuum tube), 4 hours@RT, 12 hours@2-8 C(EDTA tube)
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: If collected in ESR vacuum tubes, blood must be to line indicated on tube.
Processing:
Unacceptable: Clotted specimen, hemolysis, inadequate volume
Limitations: Bring refrigerated specimens to room temp before testing
CPT Code(s): 85652
Schedule: As received
Turn around: 1hour
Methodology: Westergren method
Reference Values: 0-20mm/hr
26
Ethanol, serum or plasma
Synonym: Alcohol
Instructions:
Container: PST, SST or Plain Red (Green, Gold or Red top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability:
Patient Prep: Use non-alcohol germicidal skin cleanser. Use povidone-iodine or similar product. Analyze
promptly to minimize evaporative losses
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s): 82055
Schedule: As received
Turn around: 1 day
Methodology: Enzymatic rate method.
Reference Values: 0.0 - 11.0 mg/dL (Cutoff = 10 mg/dL)
FERRITIN
Synonym:
Instructions:
Container: Red, Green, or Gold
Specimen: Serum or Plasma
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection: NORMAL PHLEBOTOMY
Collection Notes: Mix well. Sign and Date tubes
Processing: Centrifuge specime
Unacceptable:
Limitations: Perform within 8 hours or refrigerate.
CPT Code(s): 82782
Schedule: As received
Turn around: 1 Day
Methodology: Chemiluminescent immunoassay
Reference Values: 11 - 306 ng/mL
27
Fetalscreen
Synonym: Feto-maternal bleed screening test
Instructions: Test for the presence of fetal red blood cells in maternal circulation after delivery.
Container: EDTA whole blood
Specimen: EDTA whole blood from a postpartum venipuncture
Alternate Specimen: None
Preferred / Minimum Volumes: 3 mL / 1 mL
Stability: 3 days @ 2 - 8 C
Patient Prep: None
Required Patient Info: None
Collection: Normal Venipuncture
Collection Notes: Must be collected after delivery (postpartum)
Processing: Per established blood bank protocol
Unacceptable: Improperly labeled tube
Limitations: Specimen must be from a Rh(D) negative mother.
CPT Code(s):
Schedule: As received
Turn around: 1 hour
Methodology: Indirect RBC agglutination
Reference Values: None
Fibrinogen
Synonym: Fibrinogen
Instructions: Full tube required
Container: Blue tube
Specimen: Sodium Citrate Plasma
Alternate Specimen: None
Preferred / Minimum Volumes: 3.2mL / 3.2mL
Stability: 24 hours unopened
Patient Prep: None
Required Patient Info:
Collection: Normal Venipuncture
Collection Notes: Draw discard tube if collecting with butterfly
Processing: Centrifuge specimen
Unacceptable: Clotted specimen , gross hemolysis, gross lipemia, inadequate volume,inappropriate tube
Limitations: Perform testing within 4 hours after collection
CPT Code(s): 85384
Schedule: As received
Turn around: 1 Hour
Methodology: Light Scatter
Reference Values: 262-577mg/dL
28
Fluid culture
Synonym: Body fluid culture
Instructions: Aseptic collection required. CPT coding for microbiology cannot always be determined
before the culture is completed. Additional codes may apply.
Container: Sterile collection device; sterile screw cap container; syringes with needles are discouraged due
to safety-please transfer to a sterile screw cap container for transport
Specimen: Body fluid aspirates(Thoracentesis, pleural, peritoneal, ascites, pericardial,synovial); CSF
Alternate Specimen:
Preferred / Minimum Volumes: 5-10 ml / 1 ml
Stability: Maintain @ room temperature
Patient Prep: Aseptic scrub of aspiration site
Required Patient Info: source and or site
Collection:
Collection Notes:
Processing: Process immediately; Gram stains of CSF are performed and reported within 1 hour of receipt
Unacceptable: Unlabeled specimens or mislabeled specimens; leaking specimen containers
Limitations:
CPT Code(s): 87070;87073;87015 see instruction
Schedule: as ordered
Turn around: Prelim in 24 hours with updates daily; Final in 5-7 days
Methodology: Culture
Reference Values: No growth
Folate
Synonym: Folic Acid
Instructions: This test should not be ordered for patients who recently received radioisotopes,
methotrexate, or other folic acid antagonists.
Container: Red, Green or Gold
Specimen: Serum or Plasma
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 2 days @ 2 - 8°C, 2 months @ -20°C. Light protected.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: PROTECT FROM LIGHT!
Processing: Centrifuge specimens.
Unacceptable: Do not use hemolyzed samples
Limitations:
CPT Code(s): 82746
Schedule: As received
Turn around: 1 Day
Methodology: Chemiluminescent immunoassay
Reference Values: 2.90 - 17.0 ng/mL
29
FTI
Synonym: Free Thyroxine Index
Instructions: Calculation (must order T3 Uptake and T4)
Container:
Specimen:
Alternate Specimen:
Preferred / Minimum Volumes: /
Stability:
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s):
Schedule:
Turn around:
Methodology:
Reference Values:
fTSH
Synonym: fast Thyroid Stimulating Hormone
Instructions:
Container: Red, Green, or Gold
Specimen: Serum or Plasma
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection: NORMAL PHLEBOTOMY
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Improperly labeled specimen.
Limitations:
CPT Code(s): 84443
Schedule: As received
Turn around: 1 Day
Methodology: Chemiluminescent immunoassy
Reference Values: 0.34 - 5.60 uIU/mL
30
Genital culture
Synonym: Gonorrhea culture; GC culture
Instructions: CPT coding for microbiology cannot always be determined before the culture is completed.
Additional codes may apply.
Container: bacterial swab transport
Specimen: Body fluid, discharge, pus, swab of genital lesions, urethral discharge
Alternate Specimen:
Preferred / Minimum Volumes: 2 swabs / 1 swab
Stability: Transport to the lab immediately
Patient Prep: Do not collect urethral specimens until 1 hour after urination; Primary female site should be
endocervix; vaginal collection site offers less sensitivity
Required Patient Info: source and or site
Collection:
Collection Notes: Transport immediately; special growth requirements are necessary for the recovery of
genital pathogens
Processing:
Unacceptable: Unlabeled or mislabeled specimens; grossly contaminated culture devices; inappropriate
transport device
Limitations:
CPT Code(s): 87070 See instruction
Schedule: as ordered
Turn around: 48-72 hours
Methodology: Culture
Reference Values: Negative; No Neisseria gonorrhoeae isolated. Note: Routine/normal body site flora may
be reported.
Gentamicin
Synonym: Gent
Instructions:
Container: Red top tube
Specimen: Serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5
Stability: 3 days
Patient Prep: Draw specimen 6-8 hours after last does
Required Patient Info:
Collection: Normal Phlebotomy
Collection Notes:
Processing: Centrifuge to remove serum from cells
Unacceptable: Gel barrier tubes
Limitations:
CPT Code(s):
Schedule:
Turn around:
Methodology:
Reference Values:
31
GGT (Gamma Glutamyl Transpeptidase)
Synonym: GGT
Instructions:
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Improperly labeled specimen.
Limitations:
CPT Code(s): 82977
Schedule: As received
Turn around: 1 day
Methodology: Enzymatic rate method
Reference Values: 7 - 64 IU/L
Globulin
Synonym:
Instructions:
Container: SST, Green top, Gold top
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 / 0.5
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s):
Schedule:
Turn around:
Methodology:
Reference Values:
32
Glucose, Body Fluid
Synonym: Glucose, Peericardial; Glucose, Peritoneal; Glucose, Pleural
Instructions:
Container: .Sterile cup
Specimen: Fresh body fluid.
Alternate Specimen: Gray top (Sodium fluoride)
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C if collected in sodium fluoride (gray top).
Patient Prep:
Required Patient Info: Fluid type
Collection:
Collection Notes:
Processing: Centrifuge to remove cellular debris from supernatant. Analyze supernatant.
Unacceptable: Improperly labeled specimen.
Limitations:
CPT Code(s): 82945
Schedule: As received
Turn around: 1 day
Methodology: Hexokinase
Reference Values: Not established.
Glucose, Cerebrospinal fluid
Synonym: CSF Glucose
Instructions:
Container: Sterile container
Specimen: Cerebrospinal Fluid
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C if collected in sodium fluoride (gray top).
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: Indicate the order the tubes are collected in and indicate a tube for analysis if a tube
other than number 2 is desired.
Processing:
Unacceptable: Improperly labeled specimen.
Limitations:
CPT Code(s): 82945
Schedule: As received
Turn around: 1 day
Methodology: Hexokinase
Reference Values: 40 - 70 mg/dL
33
Glucose, plasma/serum
Synonym: Blood Sugar
Instructions:
Container: PST or SST (green, red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: Patient should fast for 12 hours.
Required Patient Info: Fasting status indicated on request.
Collection:
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Patient not fasting.
Limitations:
CPT Code(s): 82947
Schedule: As received
Turn around: 1 day
Methodology: Hexokinase
Reference Values: 70-99 mg/dL
Gram Stain
Synonym: Slide; Smear; Stain
Instructions:
Container: Bacterial swab transport; Sterile container with tight screw cap seal
Specimen: Abscess, aspirate, body fluid, biopsy, blood, genital sources, sputum, tissue
Alternate Specimen:
Preferred / Minimum Volumes: 1 swab, 0.5 ml fluid /
Stability: 24 hours in transport device @ room temperature
Patient Prep:
Required Patient Info:
Collection: source and or site
Collection Notes:
Processing:
Unacceptable: unlabeled or mislabeled specimen, inappropriate transport device, prolonged delay in
receipt of specimen
Limitations:
CPT Code(s): 87205
Schedule: as ordered
Turn around: < 24 hours
Methodology: Microscopic evaluation
Reference Values: Depends on the site of specimen. Normally sterile body sites should not contain any
bacteria.
34
HDLD Cholesterol
Synonym: High Density Lipoprotein, HDL
Instructions:
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: Fast for 12 hours prior to test.
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s): 83718
Schedule: As received
Turn around: 1 day
Methodology: Timed-endpoint method.
Reference Values: 40 - 59 mg/dL
Hematocrit
Synonym: HCT
Instructions:
Container: EDTA (lavender)
Specimen: whole blood
Alternate Specimen:
Preferred / Minimum Volumes: 3.0 mL / 1.0 mL
Stability: 12 hours @ RT, 24 hours @ 2-8 C
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: MIx well with anticoagulant by immediately inverting tube 8-10 times.
Processing:
Unacceptable: Clotted specimen, hemolysis, inadequate volume
Limitations: Perform test within 5 hours for optimum results
CPT Code(s): 85014
Schedule: As received
Turn around: 2 Hours
Methodology: VCS technology with Coulter principle
Reference Values: Female 33.27%-41.39%, Male 37.65%-46.48%
35
Hemoglobin
Synonym: HGB,HB
Instructions:
Container: EDTA (lavender)
Specimen: whole blood
Alternate Specimen:
Preferred / Minimum Volumes: 3.0 mL / 1.0 mL
Stability: 12 hours @ RT, 24 hours @ 2-8 C
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: MIx well with anticoagulant by immediately inverting tube 8-10 times.
Processing:
Unacceptable: Clotted specimen, hemolysis, inadequate volume
Limitations: Perform test within 5 hours for optimum results
CPT Code(s): 85018
Schedule: As received
Turn around: 2 Hours
Methodology: VCS technology with Coulter principle
Reference Values: Female 11.35g/dl-14.35g/dl, Male 12.92g/dl-16.12g/dl
Hemoglobin A1c
Synonym: Glycohemoglobin, Hb A1c
Instructions:
Container: EDTA (Lavendar top)
Specimen: Whole blood
Alternate Specimen: Na Heparin, Li Heparin , Na Citrate, Na Fluoride
Preferred / Minimum Volumes: 2.0 mL / 1.0 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Process well mixed whole blood.
Unacceptable:
Limitations:
CPT Code(s): 83036
Schedule: As received
Turn around: 1 day
Methodology: Colorimetric mehtod. Utilizes two cartridges, Hb2 and A1c2, to determine A1c
concentration as a percentage of total hemoglobin
Reference Values: 4.8 - 6.0 %
36
Hemoglobin and Hematocrit
Synonym: H&H, H AND H,HH
Instructions:
Container: EDTA (lavender)
Specimen: whole blood
Alternate Specimen:
Preferred / Minimum Volumes: 3.0 mL / 1.0 mL
Stability: 12 hours @ RT, 24 hours @ 2-8 C
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: MIx well with anticoagulant by immediately inverting tube 8-10 times.
Processing:
Unacceptable: Clotted specimen, hemolysis, inadequate volume
Limitations: Perform test within 5 hours for optimum results
CPT Code(s): 85018, 85014
Schedule: As received
Turn around: 2 Hours
Methodology: VCS technology with Coulter principle
Reference Values: Hemoglobin Female 11.35g/dl-14.35g/dl, Male 12.92g/dl-16.12g/dl HematocritFemale 33.27%-41.39%, Male 37.65%-46.48%
Hepatic Function Panel
Synonym: HFP, Liver Panel
Instructions: Panel includes: Total Protein, Albumin, Total Bilirubin, Direct Bilirubin, ALP, ALT, and
AST.
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 2 mL / 1.0 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Improperly labeled specimen.
Limitations:
CPT Code(s): 80076
Schedule: As received
Turn around: 1 day
Methodology: See each individual test for methodologies.
Reference Values: See each individual test for respective for respective reference range information.
37
IBC
Synonym: TIBC, Total Iron Binding Capacity
Instructions:
Container:
Specimen:
Alternate Specimen:
Preferred / Minimum Volumes: /
Stability:
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s):
Schedule:
Turn around:
Methodology:
Reference Values:
Indirect antiglobulin (Antibody Screen)
Synonym:
Instructions:
Container:
Specimen:
Alternate Specimen:
Preferred / Minimum Volumes: /
Stability:
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s):
Schedule:
Turn around:
Methodology:
Reference Values:
38
Indirect Bilirubin
Synonym:
Instructions: Calculation, must order T. Bil. and D. Bil.)
Container:
Specimen:
Alternate Specimen:
Preferred / Minimum Volumes: /
Stability:
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s):
Schedule:
Turn around:
Methodology:
Reference Values:
INFECTIOUS MONONUCLEOSIS
Synonym: MONO
Instructions:
Container: EDTA (lavender), PST or SST (green, red,or gold top)
Specimen: Whole blood, Fingerstick, Serum or Plasma
Alternate Specimen:
Preferred / Minimum Volumes: 50 uL / 50 uL
Stability: 2 days @ 2-8 C
Patient Prep:
Required Patient Info:
Collection: NORMAL PHLEBOTOMY
Collection Notes:
Processing: Centrifuge serum/plasma tube (red,green,or gold top tube)
Unacceptable:
Limitations: Perform test immediately
CPT Code(s):
Schedule: As received
Turn around: 1 HOUR
Methodology:
Reference Values:
39
INFLUENZA A and B
Synonym: FLU A and B
Instructions:
Container:
Specimen: NASOPHARYNGEAL WASH/ASPIRATE AND NASOPHARYNGEAL SWAB or THROAT
SWAB
Alternate Specimen:
Preferred / Minimum Volumes: N/A / N/A
Stability: may be stored in suitable transport medium and maintatined for 72 hours @ 2-8 C , 7 days @ -20
C exception of throat swabs
Patient Prep: NONE
Required Patient Info: NONE
Collection: NASOPHARYNGEAL OR THROAT SWAB
Collection Notes: Nasopharyngeal washes/aspirates, nasopharyngeal swabs and throat swabs.
Processing:
Unacceptable:
Limitations: Perform test immediately
CPT Code(s):
Schedule: As received
Turn around: 1 HOUR
Methodology:
Reference Values:
INR
Synonym:
Instructions: MUST ORDER PT
Container:
Specimen:
Alternate Specimen:
Preferred / Minimum Volumes: /
Stability:
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s):
Schedule:
Turn around:
Methodology:
Reference Values:
40
Iron
Synonym:
Instructions:
Container:
Specimen:
Alternate Specimen:
Preferred / Minimum Volumes: /
Stability:
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s):
Schedule:
Turn around:
Methodology:
Reference Values:
Ketones, Serum or Urine
Synonym: Acetest, Blood Acetone
Instructions:
Container: Plain Red Top, Gold Top or Random Urine
Specimen: Serum or Urine
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 8 hours @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable: Improperly labeled specimen.
Limitations:
CPT Code(s): 82009
Schedule: As received
Turn around: 1 hour
Methodology: Nitroprusside reaction
Reference Values: Negative
41
KOH Prep
Synonym: KOH Prep
Instructions: Transport to the lab ASAP
Container: Sterile leakproof container or swab
Specimen: Aspirates, body fluid, hair,nails, skin,vaginal and penile discharges
Alternate Specimen:
Preferred / Minimum Volumes: 5mL fluids,swab collected in sterile container / 1mL fluids ,swab
Stability: 24hours@RT for fluids, all others transport to lab ASAP
Patient Prep: Call lab for specifics concerning hair, skin and nails,
Required Patient Info:
Collection: Collect swab,fluids, hair, nail, skin scraping and transport ASAP
Collection Notes: Must be transported to lab ASAP to prevent drying out of swabs
Processing:
Unacceptable: Unlabeled specimn or name discrepancy between specimen and request label.Specimens
received after a prolonged delay, leaking specimens
Limitations: Swabs perform testing immediately, Fluids ASAP
CPT Code(s): 87220
Schedule: As received
Turn around: 1 hour
Methodology: Direct microscopic examination
Reference Values: Male and female to determine the presence or absence of fungal forms in clinical
specimens submitted for direct microscopic exam
Lactic Acid
Synonym: Lactate
Instructions: Intravenous injection of epinephrine, glucose, bicarbonate, or other infusions that modify the
acid-base balance causes an elevation in lactate (and also pyruvate) levels not necessarily related to
hypoxia.
Container: Sodium fluoride/potassium oxylate (Gray top)
Specimen: Oxylate plasma
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: Keep on ice and analyze within 30 minutes. Plasma may be removed and stored refrigerated for
up to 24 hours. Freeze plasma for up to 1 month. @
Patient Prep: Patient should fast for 12 hours and be at complete rest.
Required Patient Info: Fasting status indicated on request.
Collection: Collect without stasis (tourniquet). Place tube on ice.
Collection Notes: KEEP SPECIMEN ON ICE.
Processing: Centrifuge to remove plasma from cells. Process immediately.
Unacceptable:
Limitations:
CPT Code(s): 83605
Schedule: As received
Turn around: 1 hour
Methodology: Measuring the absorbance due to the chromophore using an endpoint technique.
Reference Values: 4.5 - 19.8 mg/dL
42
Lactic Dehydrogenase
Synonym: LDH, LD
Instructions:
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: Centrifuge to remove plasma/serum from cells.
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable: Hemolysis
Limitations:
CPT Code(s): 83615
Schedule: As received
Turn around: 1 day
Methodology: Enzymatic rate method. Lactate to pyruvate
Reference Values: 91 - 180 IU/L
Lactic Dehydrogenase, Body Fluid
Synonym: LDH,Body Fluid
Instructions:
Container: Sterile container
Specimen: Pericardial, peritoneal, or pleural fluid
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Allow sample to reach room temperature before testing.
Unacceptable: Improperly labeled specimen.
Limitations:
CPT Code(s): 83615
Schedule: As received
Turn around: 1 day
Methodology: Enzymatic rate method. Lactate to pyruvate
Reference Values: Not established
43
LDL
Synonym: LDLD
Instructions:
Container: Red or Green top
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info: Fasting status indicated on request
Collection: Normal phlebotomy
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s):
Schedule:
Turn around:
Methodology:
Reference Values:
Lipase
Synonym:
Instructions:
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Hemolysis
Limitations:
CPT Code(s): 83690
Schedule: As received
Turn around: 1 day
Methodology: Colorimetric
Reference Values: 22 - 51 U/L
44
Lipid Panel
Synonym:
Instructions: Panel includes: Total Cholesterol (Measured), HDL Cholesterol (Measured), Triglyceride
(Measured), LDL (Calculation), VLDL (Calulation).
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 2.0 mL / 1.0 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: Fast for 12 hours prior to test.
Required Patient Info: Fasting status indicated on request.
Collection:
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Hemolysis
Limitations:
CPT Code(s): 80061
Schedule: As received
Turn around: 1 day
Methodology: See each individual test for methodologies.
Reference Values: See each individual test for respective reference range information.
Lithium
Synonym: Eskalith
Instructions: Draw specimen 6 - 8 hours after the last dose.
Container: Plain Red Top
Specimen: Serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: Draw specimen 6 - 8 hours after the last dose.
Required Patient Info: Last dose, next dose information.
Collection:
Collection Notes:
Processing: Centrifuge to remove serum from cells.
Unacceptable: Gel barrier tubes.
Limitations:
CPT Code(s): 80178
Schedule: As received
Turn around: 1 day
Methodology: Colorimetric
Reference Values:
45
Magnesium
Synonym: Mg
Instructions: Because magnesium is three times more concentrated in erythrocytes than in serum,
hemolyzed samples will give spuriously elevated results.
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Hemolysis or icterus.
Limitations:
CPT Code(s): 83735
Schedule: as received
Turn around: 1 day
Methodology: Timed-endpoint method
Reference Values: 1.8 - 2.5 mg/dL
MicroTotal Protein
Synonym: MTP
Instructions:
Container: Urine or CSF
Specimen:
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: Specimen collection done by patient or physician, must be submitted to laboratory for testing
in a timely manner.
Required Patient Info:
Collection: 24 hr Urine collection, random urine, spinal tap
Collection Notes: Transport to laboratory immediately for testing
Processing:
Unacceptable: Hemolysis
Limitations:
CPT Code(s):
Schedule: As received
Turn around: 1 day
Methodology:
Reference Values: Urine: 6- 150 mg/dL, CSF 6-300 mg/dL
46
MRSA screen
Synonym:
Instructions: This culture order is for surveillance testing only.
Container: culturette swab device
Specimen: Anterior nares
Alternate Specimen:
Preferred / Minimum Volumes: 2 swabs; swab both R & L nare / 1 swab (bilateral swab)
Stability: 24 hours maintained at room temp
Patient Prep: none
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable: mislabeled, missing info, no match specimen,specimen contaminating outside of collection
device, expired or inappropriate collection device
Limitations:
CPT Code(s): 87077
Schedule: as ordered
Turn around: 24-36 hours
Methodology: Chromogenic agar
Reference Values: No MRSA isolated; Negative
Nasopharyngeal Culture
Synonym: NP Culture; Nares culture
Instructions: CPT coding for microbiology cannot always be determined before the culture is completed.
Additional codes may apply.
Container: Bacterial swab transport
Specimen: Nasopharyngeal swab
Alternate Specimen:
Preferred / Minimum Volumes: 2 swabs / 1 swab
Stability: 24 hours @ room temperature in appropriate transport device
Patient Prep: Site; Do not use for MRSA surveillance; refer to MRSA screen.
Required Patient Info:
Collection: Guide the flexible swab into the nares and into the nasopharynx. Leave swab in place at the
septum and floor of nose for 15 seconds. Rotate and remove. Place into appropriate transport device.
Collection Notes:
Processing:
Unacceptable: unlabeled or mislabeled specimens; inappropriate transport device; prolonged delay in
receiptm of specimen
Limitations:
CPT Code(s): 87070
Schedule: as ordered
Turn around: 48-72 hours
Methodology: Culture
Reference Values: Negative for pathogenic bacteria.
47
Occult blood, Stool
Synonym: Hemoccult; Guaiac test
Instructions: Patients should not take vitamin C for 3 days prior to testing.
Container: Test card with stool smear or clean screw cap container with tight seal; stool transport vial
Specimen: Stool
Alternate Specimen:
Preferred / Minimum Volumes: Collection card or 1 g stool; 1 ml liquid stool /
Stability: Maintain card @ room temp or refrigerate stool transport vial
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable: unlabeled or mislabeled specimens; inappropriate transport device; insufficient volume for
test; leaking specimen containers
Limitations: Most methods lack sensitivity to small amounts of blood and might fail to detect slow rates of
blood loss. At least three samples, from separate bowel movements should increase sensitivity. Many
substances and conditions interfere with guaiac tests.
CPT Code(s): 82270
Schedule: as ordered
Turn around: Stat and routine
Methodology: Guiac reaction
Reference Values: Negative
Phenobarbitol
Synonym:
Instructions:
Container: Plain Red Top
Specimen: Serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection: Normal Phlebotomy
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s):
Schedule: As received
Turn around: 1 day
Methodology:
Reference Values:
48
Phenytoin
Synonym: Dilantin, Diphenylhydantoin, PHY
Instructions:
Container: Plain Red Top
Specimen: Serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C
Patient Prep: Draw level 15-30 minutes before the next dose.
Required Patient Info: Last dose, next dose information.
Collection:
Collection Notes:
Processing:
Unacceptable: Gel barrier tubes.
Limitations:
CPT Code(s): 80185
Schedule: As received
Turn around: 1 day
Methodology: Immunoturbidimetric
Reference Values: 10 - 20ug/mL
Phosphorus
Synonym:
Instructions:
Container: Red, Green, or Gold top tubes
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: Centrifuge to remove plasma/serum from cells.
Required Patient Info:
Collection: Normal phlebotomy
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Hemolysis or icterus.
Limitations:
CPT Code(s):
Schedule:
Turn around:
Methodology:
Reference Values:
49
Platelet Count, Automated
Synonym: PLT Count, PLTS
Instructions:
Container: EDTA (lavender)
Specimen: whole blood
Alternate Specimen:
Preferred / Minimum Volumes: 3.0 mL / 1.0 mL
Stability: 12 hours @ RT, 24 hours @ 2-8 C
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: MIx well with anticoagulant by immediately inverting tube 8-10 times. If platelet
clumping is suspected, collect a blue top sodium citrate tube along with the EDTA tube.
Processing:
Unacceptable: Clotted specimen, hemolysis, inadequate volume
Limitations: Perform test within 5 hours for optimum results
CPT Code(s): 85049
Schedule: As received
Turn around: 2 Hours
Methodology: VCS technology with Coulter principle
Reference Values: Female/Male 165.40 x 10^3/uL-352.90 x 10^3/uL
Potassium
Synonym: K+
Instructions:
Container: PST, or SST (green, red, or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0mL / 0.5mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: Plasma specimen is desired for confirmation of high Potassium results
Required Patient Info:
Collection: Normal Phlebotomy
Collection Notes: Serum or plasma must be seperated from red blood cells immediately to decrease the
risk of falsely eleveated results.
Processing: Centrifuge specimen and immediately remove serum or plasma from red blood cells.
Unacceptable: Hemolysis
Limitations: Perform testing immediately
CPT Code(s):
Schedule: As received
Turn around: 1 day
Methodology:
Reference Values: 3.6- 5.0 mmol/L
50
Pregnancy Test, Serum Qualitative
Synonym: hCG Serum
Instructions:
Container: Plain Red Top or Gold Top
Specimen: Serum
Alternate Specimen:
Preferred / Minimum Volumes: 1 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Centrifuge to remove serum from cells.
Unacceptable: Improperly labeled specimen.
Limitations:
CPT Code(s): 84703
Schedule: As received
Turn around: 1 hour
Methodology: EIA
Reference Values: Negative
Pregnancy Test, Urine
Synonym: hCG, Urine
Instructions:
Container: Sterile container
Specimen: First Morning Urine prefered.
Alternate Specimen:
Preferred / Minimum Volumes: 1 mL / 0.5 mL
Stability:
Patient Prep: Centrifuge to remove cellular debris from supernatant. Analyze supernatant.
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable: Gross contamination with blood or bacteria.
Limitations:
CPT Code(s): 81025
Schedule: As received
Turn around: 1 hour
Methodology: EIA
Reference Values: Negative
51
Prostate Specific Antigen
Synonym: PSA
Instructions: An erroneously elevated PSA level can be observed if a serum specimen in collected follwing
a digital rectal examination (DRE), needle biopsy or transurethral resection.
Container: Red, or Gold
Specimen: SERUM ONLY
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 8 hours @ 2 – 8° C. 3 days @ -20° C.
Patient Prep:
Required Patient Info:
Collection: NORMAL PHLEBOTOMY
Collection Notes: Mix well. Sign and Date tubs.
Processing: Centrifuge specimen
Unacceptable:
Limitations: Freeze specimens if a delay in testing is anticipated
CPT Code(s): 84513
Schedule: As received
Turn around: 1 Day
Methodology: Chemiluminescent immunoassay
Reference Values: 0.0 - 4.0 ng/mL
Prothrombin Time
Synonym: PT
Instructions: Full tube required
Container: Blue Tube
Specimen: Sodium Citrate Plasma
Alternate Specimen: None
Preferred / Minimum Volumes: 3.2 mL / 3.2 mL
Stability: 24 hours unopened
Patient Prep: None
Required Patient Info:
Collection: Normal Phlebotomy
Collection Notes: Draw discard tube if collecting with butterfly
Processing: Centrifuge specimen
Unacceptable: Gross hemolysis, inadequate volume, inappropriate container, gross lipemia
Limitations: Perform test within 4 hours after collection ; freeze plasma if a delay is expected
CPT Code(s): 85610
Schedule: As received
Turn around: 1 Hour
Methodology: Light Scatter
Reference Values: 9.2 - 11.2 SECONDS
52
PTT
Synonym: APTT
Instructions: Full tube required
Container: Blue Tube
Specimen: Sodium Citrate Plasma
Alternate Specimen: None
Preferred / Minimum Volumes: 3.2 mL / 3.2 mL
Stability: 24 hours unopened
Patient Prep: None
Required Patient Info:
Collection: Normal Phlebotomy
Collection Notes: Draw discard tube if collecting with butterfly
Processing: Centrifuge specimen
Unacceptable: Gross hemolysis, inadequate volume, inappropriate container,gross lipemia
Limitations: Perform test within 4 hours after collection ; freeze plasma if a delay is expected
CPT Code(s):
Schedule: As received
Turn around: 1 Hour
Methodology: Light Scatter
Reference Values: 22.0 - 34.0 SECONDS
Red Blood Cell Count (Blood or Body Fluid)
Synonym: RBC, Erythrocyte Count, Red Cell Count
Instructions:
Container: EDTA-Lavender (Blood), CSF(CSF Tube), All Other Body Fluids(EDTA-Lavender)
Specimen: Whole Blood, Body Fluids
Alternate Specimen:
Preferred / Minimum Volumes: 3.0 mL / 1.0 mL
Stability: 12 hours @ RT for blood, 24 hours @ 2-8 C for blood. One hour for body fluids at RT
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: Tube #3 will be used on all body fluids unless otherwise specified
Processing:
Unacceptable: Clotted specimen, hemolysis, inadequate volume, inappropriate container
Limitations: Perform test within 5 hours for optimum results on blood, 2 hours on body fluids
CPT Code(s): 85041(blood),89051(body fluid)
Schedule: As received
Turn around: 2 Hours
Methodology: VCS technology with Coulter principle(blood), hemocytomer(fluid)
Reference Values:
53
Reducing Substances
Synonym: Clinitest, urine
Instructions: This test is performed only on children one year old or younger
Container: Urine container
Specimen: Urine
Alternate Specimen:
Preferred / Minimum Volumes: 3 mL / 1 mL
Stability: 1 hour @ RT, 2 hours @ 2-8 C.
Patient Prep:
Required Patient Info:
Collection: Use on fresh urine since glucose and other reducing sugars are consumed by bacteria.
Collection Notes:
Processing: If test cannot be performed immediately, refrigerate.
Unacceptable: Urine that is too old.
Limitations: Best if performed on fresh urine.
CPT Code(s): 84999
Schedule: Upon receipt
Turn around:
Methodology: Clinitest reagent tablets using 5-drop method.
Reference Values: Negative
Renal Panel
Synonym:
Instructions: Test includes: Albumin, Calcium, CO2, Chloride, Creatinine, Glucose, Phosphorus,
Potassium, BUN, Sodium,
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Improperly labeled specimen.
Limitations:
CPT Code(s): 80069
Schedule: As received
Turn around: 1 day
Methodology: See each individual test for methodologies.
Reference Values: See each individual test.
54
RESPIRATORY SYNCYTICAL VIRUS
Synonym: RSV
Instructions:
Container: NASOPHARYNGEAL SWABS AND WASHES
Specimen: NASOPHARYNGEAL SWABS AND WASHES
Alternate Specimen:
Preferred / Minimum Volumes: N/A / N/A
Stability: 72 hours @2-8 C, 7 days @ -20 C
Patient Prep: NONE
Required Patient Info: NONE
Collection: NASOPHARYNGEAL
Collection Notes: For Nasopharyngeal swabs, polyester or rayon-tipped swabs with an aluminum wire are
recommended.
Processing:
Unacceptable:
Limitations: Perform test immediately
CPT Code(s):
Schedule: As received
Turn around: 1 HOUR
Methodology:
Reference Values:
Rh Phenotyping, Complete
Synonym:
Instructions: Should be performed on specimens prior to RBC transfusion
Container: EDTA
Specimen: EDTA Whole Blood
Alternate Specimen: None
Preferred / Minimum Volumes: 3 mL / 3 mL
Stability: 14 days at 2 -8 C
Patient Prep: None required
Required Patient Info: Previous transfusions
Collection: Normal Venipunture
Collection Notes: Mix well. Signn and Date tubes.
Processing: Per established blood bank protocol
Unacceptable: SST Collection Tubes
Limitations: Patient recently transfused
CPT Code(s): 86905
Schedule: 7am - 4pm M-F
Turn around: 1 hour
Methodology: Tube Testing
Reference Values: N/A
55
RhoGam Injection
Synonym: Rh Immune Globulin injection
Instructions: ABO and Rh(D). Does not include fetal screening test
Container: EDTA whole blood
Specimen: EDTA whole blood
Alternate Specimen: None
Preferred / Minimum Volumes: 5 mL EDTA whole blood / 3 mL EDTA whole blood
Stability: 3 days at 2 - 8 C
Patient Prep: None required
Required Patient Info: Length of currrent pregnancy
Collection: Normal venipuncture
Collection Notes: Mix well. Sign and date tubes.
Processing: Per established blood bank protocol.
Unacceptable: Improperly labeled tubes. Clotted specimens.
Limitations: For Rh(D) negative individuals and Rh(D) negative females who are at 19 weeks or less in
their current pregnancy
CPT Code(s): J2790
Schedule: As received
Turn around: 1 hour
Methodology: Gel column agglutination
Reference Values: None
RhoGam Workup
Synonym: Rh Immune Globulin Workup
Instructions: Workup includes ABO, Rh(D), Antibody screening, and Fetalscreen
Container: EDTA whole blood
Specimen: EDTA whole blood from a postpartum female
Alternate Specimen: None
Preferred / Minimum Volumes: 5 mL EDTA whole blood / 3 mL EDTA whole blood
Stability: 3 days at 2 - 8 C
Patient Prep: Must be collected after delivery
Required Patient Info: Previous RhoGam injections
Collection: Normal venipuncture
Collection Notes: Must be collected after delivery
Processing: Per established blood bank protocol
Unacceptable: Antepartum specimens
Limitations: None
CPT Code(s): J2790
Schedule: As received
Turn around: 1 - 2 hours
Methodology: Tube testing
Reference Values: None
56
Salicylate
Synonym: Aspirin, Salicylic acid, Acetylsalicylic acid
Instructions:
Container: Plain Red Top
Specimen: Serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: Draw 2-6 hours after the last dose for optimal measurement.
Required Patient Info:
Collection:
Collection Notes: DO NOT USE GEL BARRIER TUBES.
Processing:
Unacceptable: Gel barrier tubes.
Limitations:
CPT Code(s): 80196
Schedule: As received
Turn around: 1 day
Methodology: Timed-endpoint method
Reference Values: 2.8 - 20 mg/dL
Sed Rate
Synonym:
Instructions:
Container: EDTA (lavender)
Specimen: Whole blood
Alternate Specimen:
Preferred / Minimum Volumes: 3.0mL /
Stability:
Patient Prep: Mix specimen well
Required Patient Info:
Collection:
Collection Notes: Mix well with anticoagulant immediately by inverting the tube 8-10 times
Processing:
Unacceptable: Clotted specimens, or gross hemolysis
Limitations:
CPT Code(s):
Schedule: As received
Turn around: 1 day
Methodology:
Reference Values:
57
dium
Synonym: Na
Instructions:
Container: PST or SST(green, red, or gold)
Specimen: Plasma or Serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0mL / 0.5mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: None required
Required Patient Info:
Collection: Normal Phlebotomy
Collection Notes:
Processing: Centrifuge to remove serum/plasma from cells
Unacceptable: Hemolysis
Limitations:
CPT Code(s):
Schedule: As received
Turn around: 1 day
Methodology:
Reference Values: 135- 145 mmol/L
Sputum Culture
Synonym: Respiratory Culture
Instructions:
Container: Sterile Cup with a tight screw cap seal
Specimen: Expectorated sputum, induced or suctioned sputum, bronchial wash
Alternate Specimen:
Preferred / Minimum Volumes: 5-10 mL sputum, 10 mL wash/lavage fluid / 5 mL sputum
Stability: Refrigerate if setup is delayed
Patient Prep:
Required Patient Info: Collection source or procedure
Collection:
Collection Notes:
Processing: Process immediately upon receipt
Unacceptable: Contamination of oral flora. Excessive squamous epithelial cells on slide will be a cause for
rejection and recollection.
Limitations:
CPT Code(s):
Schedule:
Turn around:
Methodology: Culture
Reference Values: Normal respiratory flora
58
Stool Culture
Synonym: Stool for enteric pathogens, Fecal culture
Instructions: CPT coding for microbiology cannot always be determined before the culture is completed.
Additional codes may apply.
Container: Fecal transport system; clean dry container with a tight screw cap seal
Specimen: Stool; colon aspirate
Alternate Specimen:
Preferred / Minimum Volumes: 1 gram or 1-5 ml / 1 gram; 1 ml
Stability: If not in fecal transport- transport to lab immediately upon collection
Patient Prep: Avoid collection following barium enemas-allow 48 hours post procedure
Required Patient Info:
Collection:
Collection Notes: A single stool specimen cannot be used to rule out bacteria as a cause of diarrhea
Processing:
Unacceptable: Unlabeled or mislabeled specimens; inappropriate transport conditions; expired transport
devices
Limitations: Diapers are not a recommended transport device
CPT Code(s): 87045;87046 x 2
Schedule: As ordered
Turn around: 48-72 hours
Methodology: Culture
Reference Values: Negative for Salmonella, Shigella, Campylobacter or Yersinia species
Strep Screen, Group A
Synonym: Strep A Test; Strep throat screen; Rapid strep test
Instructions: This test is performed 24hours a day an a routine and STAT basis.
Container: STERILE SWAB
Specimen: THROAT SWAB
Alternate Specimen:
Preferred / Minimum Volumes: N/A / N/A
Stability: 8 hours @ RT, 72 hours @ 2-8 C
Patient Prep: NONE
Required Patient Info: NONE
Collection: THROAT SWAB
Collection Notes:
Processing:
Unacceptable:
Limitations: Perform test immediately
CPT Code(s):
Schedule: As received
Turn around: 1 HOUR
Methodology:
Reference Values:
59
Synovial Fluid Analysis
Synonym: Joint fluid analysis
Instructions:
Container: sterile container, syringe
Specimen: synovial fluid
Alternate Specimen:
Preferred / Minimum Volumes: 3.0 mL / 1.0 mL
Stability: Perform cell count within one hour
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable: clotted specimen
Limitations:
CPT Code(s): 89051
Schedule:
Turn around:
Methodology:
Reference Values:
TBIL (Total Bilirubin)
Synonym: TBIL
Instructions:
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C (Light protected)
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: PROTECT FROM LIGHT!
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Improperly labeled specimen.
Limitations:
CPT Code(s): 82247
Schedule: As received
Turn around: 1 day
Methodology: Diazo method
Reference Values: 0.00 - 0.20 mg/dL
60
Theophylline
Synonym:
Instructions:
Container: Plain Red Top
Specimen: Serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection: Normal Phlebotomy
Collection Notes:
Processing: Centrifuge to remove serum from cells
Unacceptable: Hemolysis
Limitations:
CPT Code(s):
Schedule: As received
Turn around: 1 day
Methodology:
Reference Values: 10- 20 mg/dL
Therapeutic phlebotomy
Synonym:
Instructions:
Container:
Specimen:
Alternate Specimen:
Preferred / Minimum Volumes: /
Stability:
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing:
Unacceptable:
Limitations:
CPT Code(s):
Schedule:
Turn around:
Methodology:
Reference Values:
61
Throat Culture
Synonym: Strep throat Culture; Group A Beta strep culture
Instructions: : This test is a strep screen only.Notify the lab if a more comprehensive study indicated.A
nasopharyngeal culture is recommended for upper respiratory pathogens. Throat swabs submitted for GC
must be indicated for proper setup.
Container: Bacterial swab transport amies or stuart's medium (culturette)
Specimen: material from posteria pharanyx, tonsils, inflammed area of throat
Alternate Specimen:
Preferred / Minimum Volumes: 2 swabs / 1 swab
Stability: 24 hours @ room temperature in bacterial swab transport
Patient Prep:
Required Patient Info: source and or site; specify if for GC
Collection:
Collection Notes:
Processing:
Unacceptable: unlabeled or mislabeled specimens, expired transport devices, prolonged delay in receipt of
specimen
Limitations:
CPT Code(s): 87070;87081 See instruction
Schedule: as ordered
Turn around: 36-48 hours
Methodology: Culture
Reference Values: Negative; No Beta strep Group A isolated, No Beta strep
THYROID UPTAKE
Synonym: T3 Uptake
Instructions:
Container: Red,Green, or Gold
Specimen: Serum or Plasma
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: Store samples tightly stoppered @ room temp for no longer than eight hours. If assay is not
complete within 8 hrs, refrigerate. If assay can not be complete in 48 hours, freeze.
Patient Prep:
Required Patient Info:
Collection: NORMAL PHLEBOTOMY
Collection Notes: Mix well. Sign and Date tubes.
Processing: Centrifuge specimen
Unacceptable:
Limitations: Perform test within 8 hours or refrigerate
CPT Code(s):
Schedule: As received
Turn around: 1 Day
Methodology:
Reference Values:
62
Tobramycin
Synonym:
Instructions:
Container: Plain Red
Specimen: Serum
Alternate Specimen:
Preferred / Minimum Volumes: /
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection: Normal Phlebotomy
Collection Notes:
Processing: Centrifuge to remove serum from cells
Unacceptable: Hemolysis
Limitations:
CPT Code(s):
Schedule: As received
Turn around: 1 day
Methodology:
Reference Values: Peak: 6-15 mg/dL ; Trough: 0- 2.0 mg/dL
Total Protein
Synonym: TP
Instructions:
Container: Urine, Body fluids, PST, or SST
Specimen: Plasma, Serum, Body fluids, Urine, or CSF
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection: Normal Phlebotomy, 24 hour urine, random urine, body fluids, or CSF collection.
Collection Notes:
Processing: Centrifuge to remove serum, plasma or body fluids from red blood cells. Use supernatent of
body fluids for testing.
Unacceptable: Hemolysis
Limitations:
CPT Code(s):
Schedule: As received
Turn around: 1 day
Methodology:
Reference Values: Urine: 50-100 mg/dL ; Serum 6.4-8.2 g/dL
63
Total T4
Synonym: Thyroxine (T4)
Instructions:
Container: Red, Green, or Gold
Specimen: Serum or Plasma
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: Store tightly stoppered tubes @ room temp for no longer than 8 hours. If sample not completed
within 8 hours, refrigerate. If sample not complete within 24 hours, freeze.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: Mix well and Sign and Date Tubes
Processing: Centrifuge specimen
Unacceptable:
Limitations: Perform test within 8 hours or refrigerate
CPT Code(s):
Schedule: As received
Turn around: 1 Day
Methodology:
Reference Values: 0.5-30.0 ng/mL
Transferrin
Synonym:
Instructions:
Container: PST or SST(green, red, or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection: Normal phlebotomy
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Hemolysis or icterus.
Limitations:
CPT Code(s):
Schedule: As received
Turn around: 1 day
Methodology:
Reference Values: 215- 365 mg/dL
64
Triglyceride
Synonym: Trig
Instructions:
Container: PST or SST (green, red, or gold top tubes)
Specimen: Plasma or Serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection: Normal Phlebotomy
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Hemolysis, icterus or lipemia.
Limitations:
CPT Code(s):
Schedule: As received
Turn around: 1 day
Methodology:
Reference Values: 35-149 mg/dL
TROPONIN
Synonym: cTnI
Instructions: Use only Heparinized PLASMA only
Container: Lithium heparin plasma
Specimen: PLASMA
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: Store samples tightly stoppered @ room temp for no longer than two hours. Samples should be
centrifuged and refrigerated within two hours of blood draw.
Patient Prep:
Required Patient Info:
Collection: NORMAL PHLEBOTOMY
Collection Notes: Mix well. Sign and date tubes
Processing: Centrifuge specimen
Unacceptable:
Limitations: Perform test immediately
CPT Code(s): 84484
Schedule: As received
Turn around: 1 HOUR
Methodology: Chemiluminescent immunoassay
Reference Values: 0.01-100.0 ng/mL
65
TSH
Synonym: TSH
Instructions:
Container: PST, SST (green, red, or gold top tubes)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0mL / 0.5mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection: Normal Phlebotomy
Collection Notes:
Processing: Centrifuge to remove serum/ plasma from cells
Unacceptable: Hemolysis
Limitations:
CPT Code(s):
Schedule: As received
Turn around: 1 day
Methodology:
Reference Values: .34- 5.60 mcIU/mL
Type and Crossmatch
Synonym: Compatibility Testing
Instructions: ABO, Rh, Antibody Screen, Crossmatch
Container: EDTA whole blood
Specimen: EDTA whole blood
Alternate Specimen: None
Preferred / Minimum Volumes: 2 - 5 mL EDTA collection tubes / 5 mL EDTA whole blood
Stability: 3 days at 2 - 8 C
Patient Prep: None
Required Patient Info: None
Collection: Normal Venipuncture
Collection Notes: Mix well. Sign and date tubes. Band patient AT bedside.
Processing: Per established blood bank protocol
Unacceptable: Improperly labeled tubes. Clotted specimen. Hemolysis.
Limitations: None
CPT Code(s):
Schedule: Immediately
Turn around: 2 Hours
Methodology: Gel column agglutination. Tube testing.
Reference Values: None
66
Uric Acid
Synonym: Uric
Instructions:
Container: PST or SST (green,red or gold top)
Specimen: Plasma or serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep:
Required Patient Info:
Collection:
Collection Notes:
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable: Lipemia
Limitations:
CPT Code(s): 84550
Schedule: As received
Turn around: 1 day
Methodology: Timed-endpoint method
Reference Values: 2.6 - 7.2 mg/dL
Urinalysis
Synonym: Urinalysis
Instructions: Color, appearance, specific gravity ,pH,protein, glucose, ketones, blood, leukocyte esterase,
nitrite, bilirubin and urobilinogen are done on all routine urines
Container: Sterile Urine Cup
Specimen: Urine
Alternate Specimen: None
Preferred / Minimum Volumes: 2-10mL / 1mL
Stability: Refrigerate
Patient Prep: Voided specimen ,Clean Catch midstream specimen is perferred
Required Patient Info:
Collection: Voided Urine or Clean Catch Urine
Collection Notes:
Processing: Initial Urine chemistries, centrifuge specimen. microscopic exam if indicated
Unacceptable: Improper labeling, specimens more than 24 hours old
Limitations: Perform test within 2 hours
CPT Code(s):
Schedule: As received
Turn around: 2 Hours
Methodology: Reagent Strip
Reference Values: Call laboratory for ranges
67
Urine Culture
Synonym:
Instructions: CPT coding for microbiology cannot always be determined before the culture is completed.
Additional codes may apply.
Container: Sterile container with tight screw cap seal
Specimen: Urine
Alternate Specimen: Cath specimen
Preferred / Minimum Volumes: 5-10 ml / 1 ml
Stability: Refrigerate if > 2 hours before processing/setup; 24 hours refrigerated
Patient Prep: A clean catch midstream specimen is required for random collection
Required Patient Info:
Collection: Bring to lab immediately upon collection
Collection Notes: Instruct patient on proper procedure for a clean catch-midstream specimen
Processing: Process within 2 hours of collection; refrigeration required when a delay in processing
anticipated
Unacceptable: unlabeled or mislabeled specimen; inappropriate specimen container; prolonged delay in
specimen processing
Limitations: Do not collect from the drainage bag of an indwelling catheter. Catheter tips are considered
contaminated and therefore are not cultured.
CPT Code(s): 87086; See instruction
Schedule: as ordered
Turn around: 24-72 hours
Methodology: Culture
Reference Values: No growth. Note: Usual site flora in low numbers such as diphtheroids, alpha or gamma
strep, and coag negative staph in asymptomatic patients may be commensal flora.
Valproic Acid
Synonym: Depakote, Depakene, Valproate
Instructions:
Container: Plain Red Top
Specimen: Serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: Draw level 15-30 minutes before the next dose.
Required Patient Info: Last dose, next dose information.
Collection:
Collection Notes:
Processing: Centrifuge to remove serum from cells.
Unacceptable: Gel barrier tubes.
Limitations:
CPT Code(s): 80164
Schedule: As received
Turn around: 1 day
Methodology: immunoturbidimetric
Reference Values: 50 - 100 ug/mL Toxic: > 100 ug/mL
68
Vancomycin
Synonym: Vancocin
Instructions: Draw trough levels 15-30 minutes before the next dose. Draw peak levels 2 hours after a 1
hour infusion is complete.
Container: Plain Red Top
Specimen: Serum
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 3 days @ 2 – 8° C.
Patient Prep: See special instructions above.
Required Patient Info: Last dose, next dose information.
Collection:
Collection Notes:
Processing: Centrifuge to remove serum from cells.
Unacceptable: Gel barrier tubes.
Limitations:
CPT Code(s): 80202
Schedule: As received
Turn around: 1 day
Methodology: Immunoturbidimetric
Reference Values: 26.0 - 32.0 ug/mL
Vitamin B12
Synonym: VIT B12
Instructions: This test should not be done for patients who have recently undergone a Schilling test. Draw
specimens prior to vitamin B12 therapy or blood transfusion.
Container: Serum or Plasma
Specimen: Serum or Plasma
Alternate Specimen:
Preferred / Minimum Volumes: 1.0 mL / 0.5 mL
Stability: 2 days @ 2 - 8°C, 2 months @ -20°C.
Patient Prep:
Required Patient Info:
Collection: NORMAL PHLEBOTOMY
Collection Notes: PROTECT FROM LIGHT!
Processing: Centrifuge to remove serum / plasma from cells.
Unacceptable:
Limitations:
CPT Code(s): 82607
Schedule: As received
Turn around: 1 Day
Methodology:
Reference Values: 180 - 914 pg/mL
69
Wet Prep
Synonym: Wet Prep
Instructions:
Container: Swab or 1-2 drops of fluid,
Specimen: Vaginal swab, male urethral swab
Alternate Specimen:
Preferred / Minimum Volumes: Swab submitted in saline with no more than 3ml.of saline / 1 ml saline
Stability: 2 hours room temp
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: Submit swab(s) in saline ASAP
Processing:
Unacceptable: Improper labeling, specimens more than 2 hours old, overdilution of specimen with saline
Limitations: Perform test within 2 hours
CPT Code(s):
Schedule: As received
Turn around: 30 min
Methodology:
Reference Values:
White Blood Cell Count/Blood
Synonym: WBC, Cell Count, leukocyte count
Instructions:
Container: EDTA (lavender)
Specimen: whole blood
Alternate Specimen:
Preferred / Minimum Volumes: 3.0 mL / 1.0 mL
Stability: 12 hours @ RT, 24 hours @ 2-8 C
Patient Prep:
Required Patient Info:
Collection:
Collection Notes: MIx well with anticoagulant by immediately inverting tube 8-10 times.
Processing:
Unacceptable: Clotted specimen, hemolysis, inadequate volume
Limitations: Perform test within 5 hours for optimum results
CPT Code(s): 85048(blood)
Schedule: As received
Turn around: 2 Hours
Methodology: VCS technology with Coulter principle (blood)
Reference Values: Female/Male 3.58 x 10^3/uL-11.07 x 10^3/uL
70
Wound Culture
Synonym: Aerobic Culture; General culture
Instructions: CPT coding for microbiology cannot always be determined before the culture is completed.
Additional codes may apply.
Container: Bacterial swab transport, Sterile container with tight screw cap seal
Specimen: Abscess, aspirate, drainage
Alternate Specimen:
Preferred / Minimum Volumes: 5-10 ml / 1 ml
Stability:
Patient Prep: Aseptic technique for aspirates should be followed
Required Patient Info: source and or site
Collection: Cleanse area around abscess or wound to remove contaminating skin flora. Remove crusted
and dry material and obtain from sinus tract of lesion.
Collection Notes: Aspirates or anaerobic transport devices required for anaerobic culture.
Processing:
Unacceptable: unlabeled or mislabeled specimens; inappropriate transport device; expired transport device;
prolonged delay in specimen processing
Limitations:
CPT Code(s): 87340; See instruction
Schedule: as ordered
Turn around: 72 hours- 5 days
Methodology: Culture
Reference Values: No growth. Note: Routine/normal body site flora may be present.
71