test change alert #391 - paml · pdf fileapolipoprotein a-1 test code apoa billing code apo a...
TRANSCRIPT
ANAESN .......................................................................................................................... ANTI-NUCLEAR ANTIBODY (ANA), BY EIA7/17/2012, New
ANAESR ............................................................................................... ANTI-NUCLEAR ANTIBODY (ANA), BY EIA (REFLEXIVE)7/17/2012, New
AP1 (APP1)..................................................................................................................... ANTIPHOSPHOLIPID PANEL 1, (REFLEXIVE)7/17/2012,Alternate Specimens
APOA (APO A)....................................................................................................................................................... APOLIPOPROTEIN A-17/17/2012,Delete
APOAB ........................................................................................................................... APOLIPOPROTEIN A-1 & B100 WITH RATIO7/17/2012, New
APOB (APO B).................................................................................................................................................. APOLIPOPROTEIN B-1007/17/2012,Delete
APOLA .................................................................................................................................................................... APOLIPOPROTEIN A-17/17/2012, New
APOLB ............................................................................................................................................................... APOLIPOPROTEIN B-1007/17/2012, New
APP2 ............................................................................................................................... ANTIPHOSPHOLIPID PANEL 2, (REFLEXIVE)7/17/2012,Alternate Specimens
APP3 ............................................................................................................................... ANTIPHOSPHOLIPID PANEL 3, (REFLEXIVE)7/17/2012,Alternate Specimens
CARB ................................................................................................................................................................................ CARBAMAZEPINE7/17/2012,Reference Ranges
CHROM ...................................................................................................................................................... CHROMIUM, WHOLE BLOOD8/6/2012,Room Temp,Refrigerated,Frozen -20c
CK (CPK)........................................................................................................................................................................... CREATINE KINASE6/12/2012,Reference Ranges
COCOUA ...................................................................................................... CORTISOL/CORTISONE FREE, URINE 24HR [ARUP]7/17/2012, New
CORFUA ........................................................................................................... CORTISOL FREE, URINE 24HR LC-MS/MS [ARUP]7/17/2012, New
CORUFA ....................................................................................................... CORTISOL/CORTISONE FREE, URINE 24HR [ARUP]7/17/2012,Delete
CRCF ................................................................................................... CULTURE, RESPIRATORY CYSTIC FIBROSIS (REFLEXIVE)7/17/2012,Container Type
CUFAR ................................................................................................................ CORTISOL FREE, URINE 24HR LC-MS/MS [ARUP]7/17/2012,Delete
DEXMR ............................................................................................... DEXTROMETHORPHAN AND METABOLITE RATIO, URINE7/17/2012, New
DIG ......................................................................................................................................................................................................... DIGOXIN7/17/2012,Container Type
DILFR (DIL.FREE) ..................................................................................................................................... PHENYTOIN, FREE & TOTAL5/21/2012,Reference Ranges
G6PD ............................................................................................................................ GLUCOSE-6-PHOSPHATE DEHYDROGENASE7/17/2012,Specimen Type
GLUFL (GLU-FLD)......................................................................................................................................................... GLUCOSE, FLUID6/12/2012,Container Type
HDPAP ......................................................................................... HEPARIN-DEPENDENT PLATELET ANTIBODY (SRA) - PANEL7/17/2012,CPT Codes
TEST CHANGE ALERT #391 June 18, 2012
Summary Of Changes
page: 1
ICDAN ...................................................................................................... ALLERGEN, DANDELION (TARAXACUM VULGARE) IGE7/17/2012, New
LDFL (LDH.FLD)............................................................................................................................................................................. LD, FLUID6/12/2012,Container Type
LEF .......................................................................................................................................................... LEFLUNOMIDE AS METABOLITE8/6/2012,Alternate Specimens,Specimen Type
LIPAFL ................................................................................................................................................................................... LIPASE, FLUID6/12/2012,Container Type
MYAGAB ........................ MYELIN ASSOC. GLYCOPROTEIN (MAG) ANTIBODY W/REFLEX TO MAG-SGPG & MAG, EIA7/17/2012, New
NMRLP .......................................................................................................................................................................... NMR LIPOPROFILE6/26/2012,Reference Ranges
NMRLP2 ............................................................................................................................... NMR LIPOPROFILE TEST (LDL-P ONLY)6/26/2012,Reference Ranges
NOROPC ...................................................................................................................................... NOROVIRUS GROUP 1 & 2 RT-PCR5/14/2012,Test Schedule
PORFR .................................................................................................................... PORPHYRINS PROFILE, PLASMA (REFLEXIVE)7/17/2012, New
PORPHM ............................................................................................................... PORPHYRINS PROFILE, PLASMA (REFLEXIVE)5/23/2012,Delete
SIR ........................................................................................................................................................ SIROLIMUS, PARENT DRUG ONLY5/16/2012,Specimen Processing
STONA .................................................................................................................................................. STONE ANALYSIS WITH IMAGE7/17/2012, New
TANTIC ................................................................................................................................... THROMBIN-ANTITHROMBIN COMPLEX5/8/2012,Reference Ranges
TESTED ...................... TESTOSTERONE, TOTAL & FREE, SERUM BY EQUILIBRIUM DIALYSIS & LC & MS/MS [MAYO]5/31/2012,Alternate Specimens,Limitations,Unacceptable Condition
THRUSC .................................................................................................................................. THYROGLOBULIN (TG) + TGAB [USC]7/17/2012,Delete
THYCM ............................................................................................................................................... THYROID CANCER MONITORING7/17/2012, New
TOBIN (TOB2)..................................................................................................................................................... TOBRAMYCIN (PAIRED)5/22/2012,Room Temp
TOBR (TOB)......................................................................................................................................................... TOBRAMYCIN (SINGLE)5/22/2012,Room Temp
TOBRPK (TOB.PK)............................................................................................................................................... TOBRAMYCIN, PEAK5/22/2012,Room Temp
TOBRTR (TOB.TR)......................................................................................................................................... TOBRAMYCIN, TROUGH5/22/2012,Room Temp
TRIFLU (TRI)............................................................................................................................ TRIFLUOPERAZINE, SERUM/PLASMA7/17/2012,Room Temp,Notes,Refrigerated,Minimum Volume,Store and Transport,Test Schedule,Method,Frozen -20c,TurnaroundTime,Preferred Volume,Test Name,Specimen Processing
TSH ................................................................................................................................................................................................................. TSH6/12/2012,Reference Ranges
TEST CHANGE ALERT #391 June 18, 2012
Summary Of Changes
page: 2
ANTI-NUCLEAR ANTIBODY (ANA), BY EIATest Code ANAESN
Billing Code ANAESNEffective 7/17/2012
Synonyms Antinuclear Antibodies; Lupus; Connective Tissue Disorder; Autoimmune Disease; SLE; Anti-Nuclear Antibody,Screen; ANA Screen
Container Type SST tube
Specimen Type Serum
Preferred Volume 0.5 mL
Minimum Volume 0.4 mL
CollectionProcedure
Separate serum from cells and put in separate plastic tube. Avoid using lipemic or hemolyzed serum.
Room Temp 24 hours
Refrigerated 2 weeks
Frozen -20c 1 year
UnacceptableCondition
Plasma or heat inactivated samples, grossly lipemic, hemolyzed should be avoided
Limitations Interfering substances include turbidity and visible bacterial growth. Avoid repeated freeze/thaw cycles.
CPT Codes 86038
Test Schedule Mon, Wed, Fri
Turnaround Time 1-3 days
Method Enzyme-Linked Immunosorbent Assay
Test Includes ANA by EIA, Serum
ReferenceRanges
ANA by EIA, AB LT 1.0 UANA by EIA, Interp Negative
New New Test
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 3
ANTI-NUCLEAR ANTIBODY (ANA), BY EIA (REFLEXIVE)Test Code ANAESR
Billing Code ANAESREffective 7/17/2012
Synonyms Antinuclear Antibodies; Lupus; Connective Tissue Disorder; Autoimmune Disease; SLE; Anti-Nuclear Antibody,Screen; ANA Screen
Container Type SST tube
Specimen Type Serum
Preferred Volume 0.5 mL
Minimum Volume 0.4 mL
CollectionProcedure
Separate serum from cells and put in separate plastic tube. Avoid using lipemic or hemolyzed serum.
Room Temp 24 hours
Refrigerated 2 weeks
Frozen -20c 1 year
UnacceptableCondition
Plasma or heat inactivated samples, grossly lipemic, hemolyzed should be avoided
Limitations Interfering substances include turbidity and visible bacterial growth. Avoid repeated freeze/thaw cycles.
CPT Codes 86038
Test Schedule Mon, Wed, Fri
Turnaround Time 1-3 days
Method Enzyme-Linked Immunosorbent Assay, Multiplex Luminex
Test Includes ANA by EIA, Serum, ANA Confirmatory Antibodies (Reflex)
ReferenceRanges
ANA by EIA, AB LT 1.0 UANA by EIA, Interp Negative
ANA CONFIRMITORY ANTIBODIES
Rangescontinued
DSDNA Autoantibody Negative IU/mL LT 5Smith Autoantibody Negative AI LT 1.0JO-1 Autoantibody Negative AI LT 1.0Ribosomal P Autoantibody Negative AI LT 1.0
Rangescontinued
Chromatin Autoantibody Negative AI LT 1.0RNP Autoantibody Negative AI LT 1.0SMRMP Autoantibody Negative AI LT 1.0SCL-70 Autoantibody Negative AI LT 1.0
Rangescontinued
Centromere B Autoantibody Negative AI LT 1.0SSA (RO) Autoantibody Negative AI LT 1.0SSB (LA) Autoantibody Negative AI LT 1.0
Rangescontinued
Notes When the index value for ANA by EIA is greater than or equal to 2.6 units, it will reflex to additional testing forconfirmation.
Reflex TestingReflex Condition Reflex Test Name Reflex CPT codes
GT 2.6 Units ANAEIA BANAMP 86225, 86235 x 9, 83516
New New Test
ANTIPHOSPHOLIPID PANEL 1, (REFLEXIVE)Test Code AP1
Billing Code APP1Effective 7/17/2012
AlternateSpecimens
SST tube is also acceptable instead of red top tube
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 4
APOLIPOPROTEIN A-1Test Code APOA
Billing Code APO AEffective 7/17/2012
Delete This test is being discontinued. Use the ordercode APOLA to order this test.
APOLIPOPROTEIN A-1 & B100 WITH RATIOTest Code APOAB
Billing Code APOABEffective 7/17/2012
Synonyms Apolipoprotein A-1 & B (Apolipoprotein B/A Ratio); Apolipoprotein APO A/B Ratio (Apolipoprotein B/A Ratio)
Container Type Serum separator tube (gold, brick, SST or corvac) or red top tube (plain)
Store andTransport
Store and transport refrigerated
Specimen Type Serum
Preferred Volume 1.0 mL
Minimum Volume 0.5 mL
Patient Prep Fasting sample recommended
SpecimenProcessing
Separate serum from cells and place in separate plastic tube.
Room Temp 8 hours
Refrigerated 8 days
Frozen -20c 90 days
UnacceptableCondition
Hemolyzed specimen
CPT Codes 82172 x 2
Test Schedule Daily
Turnaround Time 1-3 days
Method Immunotubidometric/Calculation
Test Includes Apolipoprotein A-1, B100 and B/A Ratio, mg/dl
ReferenceRanges
Apolipoprotein A-1 M 79-169 mg/dlApolipoprotein A-1 F 76-214 mg/dlApolipoprotein B100 M 46-174 mg/dlApolipoprotein B100 F 46-142 mg/dl
Rangescontinued
Apolipoprotein B/A Reference range not established
Relative Risk: Male FemaleOne Half Average Risk 0.4 0.3
Rangescontinued
Average Risk 1.0 0.9Twice Average Risk 1.6 1.5
New New Test
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 5
APOLIPOPROTEIN B-100Test Code APOB
Billing Code APO BEffective 7/17/2012
Delete This test is being discontinued. Use the ordercode APOLB to order this test.
APOLIPOPROTEIN A-1Test Code APOLA
Billing Code APOLAEffective 7/17/2012
Synonyms APO-A; APO-A1; High Density Liproprotein; A-1
Container Type Serum separator tube (gold, brick, SST, or corvac) or red top tube (plain)
Store andTransport
Store and transport refrigerated
Specimen Type Serum
Preferred Volume 1.0 mL
Minimum Volume 0.5 mL
Patient Prep Fasting sample recommended
SpecimenProcessing
Separate serum from cells and place in separate plastic tube.
Room Temp 8 hours
Refrigerated 8 days
Frozen -20c 90 days
UnacceptableCondition
Hemolyzed specimen
CPT Codes 82172
Test Schedule Daily
Turnaround Time 1-3 days
Method Immunotubidometric
Test Includes Apolipoprotein A-1, mg/dl
ReferenceRanges
Apolipoprotein A-1 M 79-169 mg/dlApolipoprotein A-1 F 76-214 mg/dl
New New Test
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 6
APOLIPOPROTEIN B-100Test Code APOLB
Billing Code APOLBEffective 7/17/2012
Synonyms APO-B; APO-B100; Low Density Lipoprotein; B-100; Low Density Lipoprotein, B
Container Type Serum separator tube (gold, brick, SST, or corvac) or red top tube (plain)
Store andTransport
Store and transport refrigerated
Specimen Type Serum
Preferred Volume 1.0 mL
Minimum Volume 0.5 mL
Patient Prep Fasting sample recommended
SpecimenProcessing
Separate serum from cells and place in separate plastic tube.
Room Temp 8 hours
Refrigerated 8 days
Frozen -20c 90 days
UnacceptableCondition
Hemolyzed specimens
CPT Codes 82172
Test Schedule Daily
Turnaround Time 1-3 days
Method Immunoturbidimetric
Test Includes Apolipoprotein B-100, mg/dl
ReferenceRanges
Apolipoprotein B-100 M 46-174 mg/dlApolipoprotein B-100 F 46-142 mg/dl
New New Test
ANTIPHOSPHOLIPID PANEL 2, (REFLEXIVE)Test Code APP2
Billing Code APP2Effective 7/17/2012
AlternateSpecimens
SST tube is also acceptable instead of red top tube
ANTIPHOSPHOLIPID PANEL 3, (REFLEXIVE)Test Code APP3
Billing Code APP3Effective 7/17/2012
AlternateSpecimens
SST tube is also acceptable instead of red top tube
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 7
CARBAMAZEPINETest Code CARB
Billing Code CARBEffective 7/17/2012
ReferenceRanges
Carbamazepine ug/mL Therapeutic 4.0-12.0 Toxic GT 15.0
ReferenceRanges
Toxicity can also be seen at lower levels with combined therapy.
CHROMIUM, WHOLE BLOODTest Code CHROM
Billing Code CHROMEffective 8/6/2012
Room Temp 30 days
Refrigerated 30 days
Frozen -20c 30 days
CREATINE KINASETest Code CK
Billing Code CPKEffective 6/12/2012
ReferenceRanges
CK (CPK) F 30-240 U/L M 55-400
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 8
CORTISOL/CORTISONE FREE, URINE 24HR [ARUP]Test Code COCOUA
Billing Code COCOUAEffective 7/17/2012
Container Type Urine, 24-hour plastic urine container
Store andTransport
Store and transport refrigerated
Specimen Type 24-hr urine collection
Preferred Volume 4 mL
Minimum Volume 1 mL
CollectionProcedure
Collect a 24-hour urine specimen. Refrigerate during collection.
SpecimenProcessing
Aliquot 4 mL of a well-mixed 24-hour urine collection into a leakproof plastic urine container. Record total volumeand collection time interval.
Required PatientInfo
Record total volume and collection time interval
Room Temp Unacceptable
Refrigerated 7 days
Frozen -20c 1 month
UnacceptableCondition
RT samples, preservatives or acidified samples
AlternateSpecimens
Random urine specimen
ReferenceLaboratory
ARUP
Reference labTest Code
0092100
CPT Codes 82530, 83789
Test Schedule Sun-Sat
Turnaround Time 2-3 days
Method Quantitative HPLC-TMS
Test IncludesHours Collected, hr; Total Volume, mL; Creatinine, Urine, mg/dL; Creatinine, Urine, mg/d; Cortisol, Urine, Free,ug/gCR; Cortisol Urine, Free, ug/L; Cortisol Urine, Free, ug/d; Cortisone, Urine Free, ug/gCR; Cortisone, Urine,Free, ug/L; Cortisone, Urine, Free ug/d; Cortisol/Cortisone Ratio, Ratio; Interpretation
ReferenceRanges
Hours Collected hrTotal Volume mLCreatinine, Urine mg/dLCreatinine, Urine mg/d
Rangescontinued
M 3-8 yrs 140-700 9-12 yrs 300-1300 13-17 yrs 500-2300 18-50 yrs 1000-2500
Rangescontinued
51-80 yrs 800-2100 81+ yrs 600-2000 F 3-8 yrs 140-700 9-12 yrs 300-1300
Rangescontinued
13-17 yrs 400-1600 18-50 yrs 700-1600 51-80 yrs 500-1400 81+ yrs 400-1300
Rangescontinued
Cortisol, Urine, Free ug/gCR F Prepubertal LT 25 18+ yrs LT 45 Pregnancy LT 59
Rangescontinued
M Prepubertal LT 25 18+ yrs LT 32Cortisol Urine, Free ug/LCortisol Urine, Free ug/d
Rangescontinued
M 3-8 yrs LT 18 9-12 yrs LT 37 13-17 yrs LT 56 18+ yrs LT 60
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 9
CORTISOL/CORTISONE FREE, URINE 24HR [ARUP]Ranges
continued
F 3-8 yrs LT 18 9-12 yrs LT 37 13-17 yrs LT 56 18+ yrs LT 45
Rangescontinued
Cortisone, Urine Free ug/gCRCortisone, Urine Free ug/LCortisone, Urine Free ug/dCortisol/Cortisone Ratio Ratio
Rangescontinued
M 0-17 yrs To be determined 18 yrs 0.15-0.50 F 0-17 yrs To be determined 18+ yrs 0.15-0.50
Rangescontinued
Interpretation The optimal specimen for this testing is a 24-hour urine collection. Mass per day calculations are not reported for the following specimen
Rangescontinued
types: a random collection, a collection with duration of less than 20 hours, a collection with duration of greater than 28 hours, or a collection with total volume less than 400 mL. Ratios to creatinine may be useful for these evaluations.
Rangescontinued Baseline urinary free cortisol excretion less than 5 ug/d may be consistent
with adrenal insufficiency.
New New Test
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 10
CORTISOL FREE, URINE 24HR LC-MS/MS [ARUP]Test Code CORFUA
Billing Code CORFUAEffective 7/17/2012
Container Type 24-hour leak-proof plastic urine container
Supply ItemNumber
1108
Store andTransport
Store and transport refrigerated
Specimen Type 24-hour urine collection
Preferred Volume 4 mL
Minimum Volume 1 mL
CollectionProcedure
Collect a 24-hour urine in a 24-hour leak-proof plastic urine container. Refrigerate during collection.
SpecimenProcessing
Aliquot 4 mL of a well-mixed 24-hour urine collection into a leakproof plastic urine container. Record collectiontime and total volume.
Required PatientInfo
Collection period and total volume on transport tube and request form.
Room Temp Unacceptable
Refrigerated 2 weeks
Frozen -20c 6 months
UnacceptableCondition
Samples with preservatives or acidified and RT samples.
AlternateSpecimens
Random urine specimens
ReferenceLaboratory
ARUP
Reference labTest Code
0097222
CPT Codes 82530
Test Schedule Sun-Sat
Turnaround Time 3-4 days
Method Tandem MS (LC-MS/MS)
Test Includes Time, h; Volume, mL; Creatinine Urine, mg/dL; Creatinine, Urine; mg/d; Cortisol Urine Free, ug/gCr; Cortisol, UrineFree, ug/L; Cortisol, Urine, ug/d; Interpretation
ReferenceRanges
Collection Period hrsVolume mLCreatinine, Urine mg/dLCreatinine, Urine mg/d
Rangescontinued
M 0-2 yrs Not established 3-8 yrs 140-700 9-12 yrs 300-1300 13-17 yrs 500-2300
Rangescontinued
18-50 yrs 1000-2500 51-80 yrs 800-2100 81+ yrs 600-2000 F 0-2 yrs Not established
Rangescontinued
3-8 yrs 140-700 9-12 yrs 300-1300 13-17 yrs 400-1600 18-50 yrs 700-1600
Rangescontinued
51-80 yrs 500-1400 81+ yrs 400-1300Cortisol, Urine Free ug/gCr F Prepubertal LT 25
Rangescontinued
18+ yrs LT 25 Pregnancy LT 59 M Prepubertal LT 25 18+ yrs LT 32
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 11
CORTISOL FREE, URINE 24HR LC-MS/MS [ARUP]Ranges
continued
Cortisol, Urine Free ug/LCortisol, Urine ug/d F 3-8 yrs LT 18 9-12 yrs LT 37
Rangescontinued
13-17 yrs LT 56 18+ yrs LT 45 M 3-8 yrs LT 18 9-12 yrs LT 37
Rangescontinued
13-17 yrs LT 56 18+ yrs LT 60
Interpretation
Rangescontinued
The optimal specimen for this testing is a 24-hour urine collection. Mass per day calculations are not reported for the folliwng specimen types: a random collection, a collection with duration of less than 20 hours, a collection with duration of greater than 28 hours, or a
Rangescontinued
collection with total volume less than 400 mL. Ratios to creatinine may be useful for these evaluations.
Baseline urinary free cortisol excretion less than 5 ug/d may beRanges
continued consistent with adrenal insufficiency.
New New Test
CORTISOL/CORTISONE FREE, URINE 24HR [ARUP]Test Code CORUFA
Billing Code CORUFAEffective 7/17/2012
Delete This test is being discontinued. Use the ordercode COCOUA to order this test.
CULTURE, RESPIRATORY CYSTIC FIBROSIS (REFLEXIVE)Test Code CRCF
Billing Code CRCFEffective 7/17/2012
Container Type Sterile leakproof container for lower respiratory secretions or bacterial transport media for throat swabs
CORTISOL FREE, URINE 24HR LC-MS/MS [ARUP]Test Code CUFAR
Billing Code CUFAREffective 7/17/2012
Delete This test is being discontinued. Use the ordercode CORFUA to order this test.
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 12
DEXTROMETHORPHAN AND METABOLITE RATIO, URINETest Code DEXMR
Billing Code DEXMREffective 7/17/2012
Container Type Urine, leakproof plastic urine container
Store andTransport
Refrigerated
Specimen Type Urine, random
Preferred Volume 2 mL
Minimum Volume 0.7 mL
CollectionProcedure
Collect in a preservative free container.
SpecimenProcessing
See attached
Room Temp Indefinitely
Refrigerated Indefinitely
Frozen -20c Indefinitely
ReferenceLaboratory
NMS
Reference labTest Code
2917U
CPT Codes 82492
Test Schedule Mon-Sun
Turnaround Time Up to 9 days; this is a batched test
Method High Performance Liquid
ReferenceRanges
Dextromethorphan uMolDextrorphan uMolMetablic Ratio
Rangescontinued
Typically, if the dextromethorphan metabolic ratio is greater than 0.30 patients areconsidered to have a deficiency in CYP2D6 expression, while a metabolicratio less than 0.30 categorizes them as an Extensive Metabolizer (normal).
Rangescontinued
New New Test
DIGOXINTest Code DIG
Billing Code DIGEffective 7/17/2012
Container Type Red top tube (plain)
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 13
PHENYTOIN, FREE & TOTALTest Code DILFR
Billing Code DIL.FREEEffective 5/21/2012
ReferenceRanges
Phenytoin, Free ug/mL 1.0-2.0 Toxic 3.0 or more Critical GT 3.0
Rangescontinued
Phenytoin, Total ug/mL 10.0-20.0 Toxic GT 25.0 Critical GT 25
Rangescontinued
% Free 1.0-13.0 % International reference calibrators implemented on March 01, 2010. Expect results to be 10-15% higher than with previous calibrators. No change in therapeutic range.
Rangescontinued
GLUCOSE-6-PHOSPHATE DEHYDROGENASETest Code G6PD
Billing Code G6PDEffective 7/17/2012
Specimen Type Whole blood
GLUCOSE, FLUIDTest Code GLUFL
Billing Code GLU-FLDEffective 6/12/2012
Container Type Green top tube (lithium heparin)
HEPARIN-DEPENDENT PLATELET ANTIBODY (SRA) - PANELTest Code HDPAP
Billing Code HDPAPEffective 7/17/2012
CPT Codes 86022
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 14
ALLERGEN, DANDELION (TARAXACUM VULGARE) IGETest Code ICDAN
Billing Code ICDANEffective 7/17/2012
Container Type Serum separator tube (gold, brick, SST, or corvac)
Store andTransport
Store and transport refrigerated
Specimen Type Serum
Preferred Volume 0.5 mL
Minimum Volume 0.5 mL
SpecimenProcessing
Separate serum from cells and put in separate plastic tube.
Room Temp 4 weeks
Refrigerated 4 weeks
Frozen -20c 1 year
UnacceptableCondition
Lipemic samples may lead to rejection
ReferenceLaboratory
Viracor-IBT
Reference labTest Code
70110S
CPT Codes 86003
Test Schedule Mon-Fri
Turnaround Time 3-4 days
Method ImmunoCAP FEIA
ReferenceRanges
Dandelion IgE < 0.35 kU/L
New New Test
LD, FLUIDTest Code LDFL
Billing Code LDH.FLDEffective 6/12/2012
Container Type Green top tube (lithium heparin)
LEFLUNOMIDE AS METABOLITETest Code LEF
Billing Code LEFEffective 8/6/2012
Specimen Type Serum or plasma
AlternateSpecimens
Lavendar top tube (EDTA), pink (K2EDTA)
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 15
LIPASE, FLUIDTest Code LIPAFL
Billing Code LIPAFLEffective 6/12/2012
Container Type Green top tube (lithium heparin)
MYELIN ASSOC. GLYCOPROTEIN (MAG) ANTIBODY W/REFLEX TOMAG-SGPG & MAG, EIA
Test Code MYAGAB
Billing Code MYAGABEffective 7/17/2012
Container Type Serum separator tube (gold, brick, SST, or corvac)
Store andTransport
Refrigerated
Specimen Type Serum
Preferred Volume 2 mL
Minimum Volume 0.6 mL
Patient Prep Overnight fasting is preferred
CollectionProcedure
Avoid hemolysis
SpecimenProcessing
Separate serum from cells and put in separate plastic tube.
Room Temp 24 hours
Refrigerated 7 days
Frozen -20c 30 days
ReferenceLaboratory
Quest Diagnostics Nichols Institute (SJC)
Reference labTest Code
10063
CPT Codes 84181
Test Schedule Mon, Wed
Turnaround Time 7-12 days
Method Western Blot/Enzyme Immunoassay
ReferenceRanges
MAG Ab (IgM), Western Bl NegMAG-SGPG Ab < or = 1:1600 titerMAG Ab, (IgM), EIA < 1:1600 titer
ReferenceRanges
ComplianceRemarks
This test was developed and its performance characteristics have been determined by Quest Diagnostics NicholsInstitute, San Juan Capistrano. It has not been cleared or approved by the U.S. Food and Drug Administration.The FDA has determined that such clearance or approval is not necessary. Performance characteristics refer tothe analytical performance of the test.
Reflex Testing
Reflex Condition Reflex Test Name Reflex CPT codes
If MAG Ab (IgM), Western Blot is positive MAG-SGPG Ab (IgM), EIA 83520
If MAG Ab (IgM), Western Blot is positive MAG Ab (IgM), EIA 83520
New New Test
Reflex This test may reflex to additional tests depending upon the results of this test. An additional fee will be added if thereflex test is necessary.
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 16
NMR LIPOPROFILETest Code NMRLP
Billing Code NMRLPEffective 6/26/2012
ReferenceRanges
LDL-P LT 1000 nmol/LLDL-C LT 100 mg/dLHDL-C GT 39 mg/dLTriglycerides LT 150 mg/dL
Rangescontinued
Total Cholesterol LT 200 mg/dLHDL-P LT 30.4 umol/LSmall LDL-P LT 528 nmol/LLDL Size GT 20.5 nm
Rangescontinued
LP-IR Score LT 46 umol/L
NMR LIPOPROFILE TEST (LDL-P ONLY)Test Code NMRLP2
Billing Code NMRLP2Effective 6/26/2012
ReferenceRanges
LDL-P LT 1000 nmol/LHDL-P GT 30.4 umol/LSmall LDL-P LT 528 nmol/LLDL Size GT 20.5 nm
ReferenceRanges
LP-IR Score LT 46 umol/L
NOROVIRUS GROUP 1 & 2 RT-PCRTest Code NOROPC
Billing Code NOROPCEffective 5/14/2012
Test Schedule Tue, Fri
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 17
PORPHYRINS PROFILE, PLASMA (REFLEXIVE)Test Code PORFR
Billing Code PORFREffective 7/17/2012
Container Type Green top tube (sodium heparin)
Store andTransport
Frozen
Specimen Type Plasma
Preferred Volume 2 mL
Minimum Volume 0.4 mL
CollectionProcedure
Collect blood sample with foil-wrapped green top tube. Avoid hemolysis.
SpecimenProcessing
Separate plasma by centrifugation. Remove plasma to a light-protected tube. Freeze immediately after separation.
Room Temp 8 hours
Refrigerated 8 hours
Frozen -20c 90 days
UnacceptableCondition
Hemolysis, not light-protected, serum separator tube (SST)
AlternateSpecimens
Plasma not collected in an EDTA (lavendar top) tube. Serum collected in a red top tube (no gel).
ReferenceLaboratory
Quest Diagnostics Nichols Institute (SJC)
Reference labTest Code
5519X
CPT Codes 82492
Test Schedule Tue, Thu
Turnaround Time 4-7 days
Method High Performance Liquid Chromatography (HPLC)
Test Includes Uroporphyrin, mcg/L; Heptacarboxyporphyrin, mcg/L; Hexacarboxyporphyrin, mcg/L; Pentacarboxyporphyrin,mcg/L; Coproporphyrin, mcg/L; Protoporphyrin, mcg/L; Total Porphyrins, mcg/L
ReferenceRanges
Uroporphyrin 0.2 or less mcg/LHeptacarboxyporphyrin 0.2 or less mcg/LHexacarboxyporphyrin 0.3 or less mcg/LPentacarboxyporphyrin 0.4 or less mcg/L
Rangescontinued
Coproporphyrin 0.8 or less mcg/LProtoporphyrin 0.4-4.8 mcg/LTotal Porphyrins 1.0-5.6 mcg/L
Rangescontinued
INTERPRETIVE GUIDE: Elevated Plasma Porphyrins Expected
Acute intermittent porphyria None
Rangescontinued
ALA dehydratase deficiency porphyria NoneCongenital erythropoietic porphyria NoneErythropoietic protoporphyria ProtoporphyrinHepatoerythropoietic porphyria None
Rangescontinued
Hereditary coproporphyria CoproporphyrinPorphyria cutanea tarda Uroporphyrin, HeptacarboxyporphyrinVariegate porphyria Coproporphyrin, Protoporphyrin
Rangescontinued
Patients with hereditary forms of porphyria usually will present with profoundelevations of these analytes (>5-fold) during acute episodes. Moderateelevations (<3-fold) are more often due to medications or environmental factors.
Rangescontinued
New New Test
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 18
PORPHYRINS PROFILE, PLASMA (REFLEXIVE)Test Code PORPHM
Billing Code PORPHMEffective 5/23/2012
Delete This test is being discontinued. Use the ordercode PORFR to order this test.
SIROLIMUS, PARENT DRUG ONLYTest Code SIR
Billing Code SIREffective 5/16/2012
SpecimenProcessing
DO NOT CENTRIFUGE. Draw 30 minutes before next dose as a trough specimen.
STONE ANALYSIS WITH IMAGETest Code STONA
Billing Code STONAEffective 7/17/2012
Synonyms Kidney Stone; Calculi
Container Type Sterile screw cap container
Store andTransport
Ship ambient
Specimen Type Dry kidney stone
CollectionProcedure
Dry stone in sterile screw cap container. Stones originating from sources not related to the kidney should be air-dried, then placed in a plastic tube or a urine collection cup. Do not use tape. Minute specimens may be placed in agelatin capsule.
Room Temp 12 months
Refrigerated 12 months
Frozen -20c 12 months
AlternateSpecimens
Filtered material
ReferenceLaboratory
Quest Diagnostics Nichols Institute (VAL)
Reference labTest Code
4161
CPT Codes 82365
Test Schedule Mon-Sat
Turnaround Time 4-5 days
Method IR (FTIR), Gravimetric
Test Includes Nidus, Component 1, Component 2, Stone Weight
ReferenceRanges
Specimen SourceNidusComponent 1Component 2
ReferenceRanges
Stone Weight
New New Test
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 19
THROMBIN-ANTITHROMBIN COMPLEXTest Code TANTIC
Billing Code TANTICEffective 5/8/2012
ReferenceRanges
Thrombin-Antithrombin Complex < 4.3 ng/mL
TESTOSTERONE, TOTAL & FREE, SERUM BY EQUILIBRIUMDIALYSIS & LC & MS/MS [MAYO]
Test Code TESTED
Billing Code TESTEDEffective 5/31/2012
UnacceptableCondition
Hemolysis, lipemia, or icteric samples. REMOVE THE FOLLOWING: Samples collected in gel separator tubes.
AlternateSpecimens
SST gel tubes
Limitations REMOVE THE FOLLOWING: Serum separator gel tubes are not acceptable.
THYROGLOBULIN (TG) + TGAB [USC]Test Code THRUSC
Billing Code THRUSCEffective 7/17/2012
Delete This test is being discontinued. Use the ordercode THYCM to order this test.
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 20
THYROID CANCER MONITORINGTest Code THYCM
Billing Code THYCMEffective 7/17/2012
Container Type Serum separator tube (gold, brick, SST, or corvac)
Store andTransport
Room temperature
Specimen Type Serum
Preferred Volume 2.5 mL
Minimum Volume 1.5 mL
Patient Prep No sample should be drawn until at least 8 hours after last biotin administration
SpecimenProcessing
Separate serum from cells and put in separate plastic tube
Room Temp 6 days
Refrigerated 7 days
Frozen -20c 28 days
UnacceptableCondition
Hemolysis, lipemia, plasma, icteric
ReferenceLaboratory
Quest Diagnostics Nichols Institute (SJC)
Reference labTest Code
90814
CPT Codes 86800
Test Schedule Mon-Fri
Turnaround Time 9-19 days
Method Electrochemiluminescence/Chemiluminescence/Liquid Chromatography/Tandem Mass Spectrometry
Test Includes Thyroglobulin Antibody, ElectrochemiluminescenceReflex tests: Thyroglobulin, Second Generation (Beckman Coulter) or Thyroglobulin, LC/MS/MS
ReferenceRanges
Thyroglobulin Ab, ECL < or = 20 IU/mL
This Thyroglobulin antibody test was performed using theRoche Modular Analytics E170 Electrochemiluminescent method.
Rangescontinued
Values obtained from different assay methods cannot be usedinterchangeably. Thyroglobulin antibody levels, regardless ofvalue, should not be interpreted as absolute evidence of the presenceor absence of disease.
Rangescontinued
Tg (2nd gen), Beckman < 0.05 ng/mL
Reference range applies to differentiated thyroid cancer patients
Rangescontinued
following treatment.This Thyroglobulin test was performed using the Beckman CoulterChemiluminscent method. Values obtained from different assaymethods cannot be used interchangeably. Thyroglobulin levels,
Rangescontinued
regardless of value, should not be interpreted as absolute evidenceor absence of disease.
Thyroglobulin, LC/MS/MS Adults: < 0.4 ng/mL
Rangescontinued
Reference range applies to differentiated thyroid cancer patientsfollowing treatment.This Thyroglobulin test was performed by tandem mass spectrometry
Rangescontinued
(LC/MS/MS) and does provide quantitative measurements ofThyroglobulin in the presence of anit-Tg antibodies. Valuesobtained from different assay methods cannot be usedinterchangeably. Thyroglobulin levels, regardless of value, should not
Rangescontinued
be interpreted as absolute evidence of the presence or absence ofdisease.
This test was developed and its performance characteristics have
TEST CHANGE ALERT #391 June 18, 2012
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THYROID CANCER MONITORINGRanges
continued
been determined by Quest Diagnostics Nichols Institute, San JaunCapistrano. Performance characteristics refer to the analyticalperformance of the test.
Rangescontinued
Reflex Testing
Reflex Condition Reflex Test Name Reflex CPT codes
If Thyroglobulin Antibody,Electrochemiluminescence is <10 IU/mL
Thyroglobulin, Second Generation 84432
If Thyroglobulin Antibody,Electrochemiluminescence is 10 IU/mL orabove
Thyroglobulin, LC/MS/MS 84432
New New Test
Reflex This test may reflex to additional tests depending upon the results of this test. An additional fee will be added if thereflex test is necessary.
TOBRAMYCIN (PAIRED)Test Code TOBIN
Billing Code TOB2Effective 5/22/2012
Room Temp Unacceptable
TOBRAMYCIN (SINGLE)Test Code TOBR
Billing Code TOBEffective 5/22/2012
Room Temp Unacceptable
TOBRAMYCIN, PEAKTest Code TOBRPK
Billing Code TOB.PKEffective 5/22/2012
Room Temp Unacceptable
TOBRAMYCIN, TROUGHTest Code TOBRTR
Billing Code TOB.TREffective 5/22/2012
Room Temp Unacceptable
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
page: 22
PAML Web Test Directory
TRIFLUOPERAZINE, SERUM/PLASMATest Code TRIFLU
Billing Code TRIEffective 7/17/2012
Store andTransport
Store and transport refrigerated
Preferred Volume 5 mL
Minimum Volume 2.5 mL
SpecimenProcessing
Promptly centrifuge and separate serum into a separate plastic tube.
Room Temp 9 days
Refrigerated 9 days
Frozen -20c 9 months
Test Schedule Mon,Wed,Fri
Turnaround Time 4-7 days
Method Gas Chromatography (GC)
Notes NMS Labs has no experimental or literature-based data regarding the choice of specific specimen collectioncontainers for this test.
TSHTest Code TSH
Billing Code TSHEffective 6/12/2012
ReferenceRanges
TSH uIU/mL M 0-30 days 0.52-16.00 1 mo-5 yrs 0.55-7.10 5-18 yrs 0.37-6.00
Rangescontinued
F 0-30 days 0.72-13.10 1 mo-5 yrs 0.46-8.10 5-18 yrs 0.36-5.80 18+ yrs 0.45-5.10
Rangescontinued
TEST CHANGE ALERT #391 June 18, 2012
The following tables reflect revisions only; other existing data remain unchanged.
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