TEST CHANGE ALERT #381
October 17, 2011
Summary Of Changes
TestCode(s) Test Description
AC/BASE (VBG) ...............VENOUS ACID BASE PROFILE( Specimen Requirements)
ADQPCR ...................................ADENOVIRUS DNA, QUANT, RT-PCR (New)
APTCG CHLAMYDIA TRACHOMATIS/NEISSERIA GONORRHOEAE BY AMPLIFIED DETECTION (TMA)
(Description, Method, Reference Range)
APTCT CHLAMYDIA TRACHOMATIS BY AMPLIFIED DETECTION (TMA) (Description, Specimen
Requirements, Method, Reference Range)
APTNG NEISSERIA GONORRHOEAE BY AMPLIFIED DETECTION (TMA) (Description, Method,
Reference Range)
AQP4AB ...................................AQUAPORIN-4 RECEPTOR ANTIBODY (New)
ARTISU ...ARSENIC TOTAL INORGANIC, URINE (Description, Specimen Requirements)
BORABB .............................BORDETELLA PERTUSSIS ABS, AGM BY IB (New)
BPAAIA ..............................BORDETELLA PERTUSSIS AB, IGA BY IB (New)
BPAGIA ..............................BORDETELLA PERTUSSIS AB, IGG BY ID (New)
BPAMIA ..............................BORDETELLA PERTUSSIS AB, IGM BY IB (New)
CAMPAB .............CAMPYLOBACTER JEJUNI ANTIBODY IGG (Specimen Requirements)
CGC ...........CULTURE, NEISSERIA GONORRHOEAE, REFLEX (Specimen Requirements)
CMPCRA ...............................CYTOMEGALOVIRUS PCR, AMNIOTIC FLD (New)
COCID ......................................COCCIDIOIDES ANTIBODY BY ID (New)
DA10 ...................................DRUGS OF ABUSE SCREEN 10 (CPT Coding)
DA10+ ........................DRUGS OF ABUSE SCREEN 10 + ALCOHOL (CPT Coding)
DA2 .....................................DRUGS OF ABUSE SCREEN 2 (CPT Coding)
DA2+ ..........................DRUGS OF ABUSE SCREEN 2 + ALCOHOL (CPT Coding)
DA5 .....................................DRUGS OF ABUSE SCREEN 5 (CPT Coding)
DA5+ ..........................DRUGS OF ABUSE SCREEN 5 + ALCOHOL (CPT Coding)
DA6 .....................................DRUGS OF ABUSE SCREEN 6 (CPT Coding)
DA7 .....................................DRUGS OF ABUSE SCREEN 7 (CPT Coding)
DA7+ ..........................DRUGS OF ABUSE SCREEN 7 + ALCOHOL (CPT Coding)
FLATYP .............................INFLUENZA A SUBTYPING RT-PCR (CPT Coding)
FLUOR.EXP.U (FLUUR) .....FLUORIDE, URINE (Description, Specimen Requirements)
FPSA (RATPSA) PROSTATE SPECIFIC ANTIGEN, FREE & TOTAL (Method, Specimen
Requirements, Notes)
GM1COM GANGLIOSIDE (ASIALO-GM1, GM1, GM2, GD1A GD1A, & GQ1B) Antibodies
(Description, Specimen Requriements, Reference Range)
HGBS (SQT) HGB S, QUANTITATIVE (Flexilab code was incorrectly published on Test
Change Alert # 380)
HIST .......................................HISTAMINE (Specimen Requirements)
HLAABG ............................................HLA-A & B GENOTYPING (New)
HLACEL CELIAC DISEASE (HLA-DQA1*05, HLA-DQB1*02, AND HLA-DQB1*03:02) GENOTYPING
(New)
HLACG .................................................HLA-C GENOTYPING (New)
HLADRG ...............................................HLA-DR GENOTYPING (New)
HSPCRA .........................................HSV PCR, AMNIOTIC FLUID (New)
ICEWI ...................................ALLERGEN, EGG WHOLE, IGG [IBT] (New)
IL28BA .............INTERLEUKIN 28 B (IL28B)-ASSOCIATED VARIANTS, 2SNPS (New)
INTACT.PTH (PTHI) PTH-INTACT (WHOLE MOLECULE) (Specimen Requirements, Reference
Range, Method)
IODUQM ..........................................IODINE, 24 HOUR, URINE (New)
LAMA .........................LYMPHOCYTE AG & MITOGEN PROLIF PNL (CPT Coding)
PSA .......................................PROSTATIC SPECIFIC ANTIGEN (Notes)
PSAPR ....................PROSTATE SPECIFIC ANTIGEN, POST PROSTECTOMY (Notes)
PSAR PROSTATIC SPECIFIC AG (REFLEXIVE) (Method, Specimen Requirements, Notes)
PTHINT PTH INTACT NO CALCIUM (Specimen Requirements, Method, Reference Range)
RESPCR ..............................FLU A, FLU B AND RSV BY PCR (CPT Coding)
RESPRX ........................FLU A, FLU B, RSV PCR (REFLEXIVE) (CPT Coding)
SCANMU ...........SYNTHETIC CANNABINOID METABOLITES,
QUALITATIVE, URINE (New)
SS.LAP (LAP) .....................LEUK ALK PHOS STAIN (Specimen Requirements)
TESTED TESTOSTERONE, TOTAL & FREE, SERUM BY EQUILIBRIM DIALYSIS & LS-MS/MS
(Description)
PAML TEST CHANGE ALERT #381 page: 2
TEST CHANGE ALERT #381
October 17, 2011
The following tables reflect revisions only; other existing data remain unchanged.
AC/BASE VBG VENOUS ACID BASE PROFILE( Specimen
Requirements)
order code flexilab code
Effective
Immediately
Specimen
Requirements 1 mL lithium heparin whole venous blood (green top tube) Immerse tube completely in ice water. Test
must be performed within 1 hr of collection. Store and transport on ice water.
ADQPCR
order code
ADQPCR
flexilab code
ADENOVIRUS DNA, QUANT, RT-PCR (New)
Effective
11/15/2011
Method
RT-PCR
CPT4
87799
Specimen
Requirements 1 mL of a respiratory specimen in (M4 or V-C medium). Store and transport refrigerated.
Comments
1) Min Amt: 0.35 mL. 2) Other acceptable specimens: Sputum, bronchial lavage/wash, plasma or whole
blood (ACD, EDTA), serum (no additive red top tube or SST), CSF or urine. 3) Unacceptable conditions:
frozen whole blood. 4) Stability: RT-48 hours, Refrigerated-1 week, Frozen-1 month. 5) Focus# 46995.
Other
This test was developed and its performance characteristics have been determined by Focus Diagnostics.
Performance characteristics refer to the analytical performance of the test. This test is performed pursuant
to a license agreement with Roche Molecular Systems, Inc.
Reference
Ranges
Source
Adenovirus DNA Not detected LT 500 copies/mL
Quant RT-PCR This test was developed and its
performance characteristics have
been determined by Focus
Diagnostics. Performance
characteristics refer to the
analytical performance of the
test. This test is performed
pursuant to a license agreement
with Roche Molecular Systems, Inc.
PAML TEST CHANGE ALERT #381 page: 3
APTCG APTCG CHLAMYDIA TRACHOMATIS/NEISSERIA
GONORRHOEAE BY AMPLIFIED DETECTION
(TMA) (Description, Method, Reference Range)
order code flexilab code
Effective
11/15/2011
Method
TMA by Gen-Probe APTIMA
Reference
Ranges
Source
Chlamydia Not detected
trachomatis
by Amplified
RNA
Neisseria Not detected
gonorrhoeae
by Amplified
RNA
APTCT APTCT CHLAMYDIA TRACHOMATIS BY AMPLIFIED
DETECTION (TMA) (Description, Specimen
Requirements, Method, Reference Range)
order code flexilab code
Effective
11/15/2011
Method
TMA by Gen-Probe APTIMA
Specimen
Requirements Female endocervical, male urethral or conjunctival swab collected with the Aptima Swab Specimen
Transport Tube or urine, first void, not clean catch, collected in Aptima urine specimen transport tube.
Transport swabs in kits at RT, refrig or frozen. Urine samples not in kits must be refrig & rec'd within 24hrs
of collection. Indicate source. This code may be used for conjunctival specimens. Aptima collection kits
required. This test is not recommended for use with genital or urine specimens in prepubescent children
or medicolegal cases. ThinPrep liquid pap also acceptable ONLY if special Aptima aliquot made prior to
other testing. Conjunctival swabs submitted in Aptima specimen transport tubes. Vaginal swabs collected
with designated Aptima vaginal swab collection kit.
Comments
1)Min Amt: 2mL, not to exceed 30 mL. 2) Unacceptable conditions respiratory or rectal swabs;
endocervical & urethral swabs not collected in the Aptima Swab and specimens collected and submitted
with the white cleaning swab, which is for preparatory cleaning. GENPROBE PACE 2 collection tubes are
not acceptable. 3) Stability: RT-Swabs-2 months, Urine in media-1 month, Urine not in media-not stable;
Refrigerated- Swabs-2mo, Urine in media-1mo, Urine not in media-24hrs; Frozen-both 3 mo.
Reference
Ranges
Source
Chlamydia Not detected
trachomatis
by Amplified
RNA
PAML TEST CHANGE ALERT #381 page: 4
APTNG APTNG NEISSERIA GONORRHOEAE BY AMPLIFIED
DETECTION (TMA) (Description, Method, Reference
Range)
order code flexilab code
Effective
11/15/2011
Method
TMA by Gen-Probe APTIMA
Reference
Ranges
Source
N. gonorrhoeae Not detected
by Amplified
RNA
AQP4AB
order code
AQP4AB
flexilab code
AQUAPORIN-4 RECEPTOR ANTIBODY (New)
Effective
11/15/2011
Method
Semi-Quant ELISA
CPT4
83516
Specimen
Requirements 1 mL serum (SST tube). Separate serum from cells ASAP or within 2 hours of collection & transfer serum
to a separate plastic tube. Store & transport refrigerated.
Comments
1) Min Amt: 0.3 mL. 2) Unacceptable conditions: CSF, amniotic fluid, ocular fluid, peritoneal fluid, synovial
fluid, or plasma. Contaminated, hemolyzed, icteric or lipemic specimens. Avoid repeated freeze/thaw
cycles. 3) Stability: RT-72 hours, Refrigerated-2 weeks, Frozen-1 month. 4) ARUP# 2003036.
Compliance(RU
O) This test uses a kit designated by the manufacturer as "for research use, not for clinical use." The
performance characteristics of this test were validated by ARUP Laboratories, Inc. The U.S. Food and
Drug Administration (FDA) has not approved this test. The results are not intended to be used as the sole
means for clinical diagnosis or patient management decisions. ARUP is authorized under Clinical
Laboratory Improvement Amendments (CLIA) and by all states to perform high-complexity testing.
Reference
Ranges
Aquaporin-4 Negative 4 or less U/mL
Receptor Indeterminate 5
Antibody Positive 6 or greater
This test uses a kit designated by
the manufacturer as "for research
use, not for clinical use." The
performance characteristics of this
test were validated by ARUP
Laboratories. The U.S. Food & Drug
Administration (FDA) has not
approved or cleared this test. The
results are not intended to be used
as the sole means for clinical
diagnosis or patient management
decisions. ARUP is authorized under
Clinical Laboratory Improvement
Amendments (CLIA) and by all states
to perform high-complexity testing.
PAML TEST CHANGE ALERT #381 page: 5
ARTISU ARTISU ARSENIC TOTAL INORGANIC, URINE (Description,
Specimen Requirements)
order code flexilab code
Effective
12/05/2011
Specimen
Requirements 6 mL urine, collected at the end of shift, end of work week in a trace metal free or acid washed plastic
container. Store & transport refrigerated. Avoid exposure to gadolinium-based contrast media for 48 hours
prior to sample collection.
Comments
1) Min Amt: 2 mL. 2) Stability: RT-1 week, Refrigerated-1 week, Frozen-28 days. 3) Other acceptable
specimens: trace metal free Hydrochloric acid or Nitric acid (0.1 mL of 12M acid/10 mL urine) preserved
specimens. 4) NMS# 0468U.
BORABB
order code
BORABB
flexilab code
BORDETELLA PERTUSSIS ABS, AGM BY IB (New)
Effective
11/15/2011
Method
Qualitative Immunblot
CPT4
86615 x 3
Specimen
Requirements 1 mL serum (SST tube). Separate serum from cells ASAP or within 2 hours of collection and put in a
separate plastic tube. Store and transport refrigerated. This assay tests for the presence of pertussis toxin
(PT), pertussis toxin PT 100 (PT-100), and filamentous hemagglutinin antibody (FHA).
Comments
1) Min Amt: 0.2 mL. 2) Unacceptable conditions: heat-inactivated specimens. 3) Stability: RT-48 hours,
Refrigerated-2 weeks, Frozen-1 year. 4) ARUP# 2004328.
Compliance(RU
O) This test uses a kit designated by the manufacturer as "for research use, not for clinical use." The
performance characteristics of this test were validated by ARUP Laboratories, Inc. The U.S. Food and
Drug Administration (FDA) has not approved this test. The results are not intended to be used as the sole
means for clinical diagnosis or patient management decisions. ARUP is authorized under Clinical
Laboratory Improvement Amendments (CLIA) and by all states to perform high-complexity testing.
Reference
Ranges
B. pertussis Negative
AB, IgA by IB This test uses a kit designated by
the manufacturer as "for research
not for clinical use." The
performance characteristics of this
test were validated by ARUP
Laboratories. The U.S. Food & Drug
Administration (FDA) has not
approved or cleared this test. The
results are not intended to be used
as the sole means for clinical
diagnosis or patient management
decisions. ARUP is authorized under
Clinical Laboratory Improvement
Amendments (CLIA) and by all states
to perform high-complexity testing.
B. pertussis Negative
AB, IgG by IB
This test uses a kit designated by
the manufacturer as "for research
use, not for clinical use." The U.S
Food & Drug Administration (FDA)
PAML TEST CHANGE ALERT #381 page: 6
has not approved or cleared this
test. The results are not intended
to be used as the sole means for
clinical diagnosis or patient
management decisions. ARUP is
authorized under Clinical
Laboratory Improvement Amendments
(CLIA) and by all states to perform
high-complexity testing.
Bordetella Negative
pertussis AB,
IgM by IB
This uses a kit designated by the
manufacturer as "for research
use, not for clinical use." The
performance characteristics of this
test were validated by ARUP
Laboratories. The U.S. Food & Drug
Administration (FDA) has not
approved or cleared this test. The
results are not intended to be used
as the sole means for clinical
diagnosis or patient management
decisions. ARUP is authorized under
Clinical Laboratory Improvement
Amendments (CLIA) and by all states
to perform high-complexity
testing.
BPAAIA
order code
BPAAIA
flexilab code
BORDETELLA PERTUSSIS AB, IGA BY IB (New)
Effective
11/15/2011
Method
Qualitative Immunoblot
CPT4
86615
Specimen
Requirements 1 mL serum (SST tube). Separate serum from cells ASAP or within 2 hours of collection & transfer serum
to a separate plastic tube. Store & transport refrigerated. This assay tests for the presence of pertussis
toxin (PT) and filamentous hemagglutinin antibody (FHA).
Comments
1) Min Amt: 0.15 mL. 2) Unacceptable conditions: contaminated or heat- inactivated specimens. 3)
Stability: RT-48 hours, Refrigerated-2 weeks, Frozen-1 year. 4) ARUP# 2004316.
Compliance(RU
O) This test uses a kit designated by the manufacturer as "for research use, not for clinical use." The
performance characteristics of this test were validated by ARUP Laboratories, Inc. The U.S. Food and
Drug Administration (FDA) has not approved this test. The results are not intended to be used as the sole
means for clinical diagnosis or patient management decisions. ARUP is authorized under Clinical
Laboratory Improvement Amendments (CLIA) and by all states to perform high-complexity testing.
Reference
Ranges
B. pertussis Negative
AB, IgA by IB This test uses a kit designated by
the manufacturer as "for research
not for clinical use." The
performance characteristics of this
test were validated by ARUP
PAML TEST CHANGE ALERT #381 page: 7
Laboratories. The U.S. Food & Drug
Administration (FDA) has not
approved or cleared this test. The
results are not intended to be used
as the sole means for clinical
diagnosis or patient management
decisions. ARUP is authorized under
Clinical Laboratory Improvement
Amendments (CLIA) and by all states
to perform high-complexity testing.
BPAGIA
order code
BPAGIA
flexilab code
BORDETELLA PERTUSSIS AB, IGG BY ID (New)
Effective
11/15/2011
Method
Qualitative Immunoblot
CPT4
86615
Specimen
Requirements 1 mL serum (SST tube). Separate serum from cells ASAP or within 2 hours of collection and transfer
serum to a separate plastic tube. Store and transfer refrigerated. This assay tests for the presence of
pertussis toxin (PT), pertussis toxin PT 100 (PT-100), and filamentous hemagglutinin antibody (FHA).
Comments
1) Min Amt: 0.15 mL. 2) Unacceptable conditions: heat-inactivated samples. 3) Stability: RT-48 hours,
Refrigerated-2 weeks, Frozen-1 year. 3) ARUP# 2004327.
Compliance(RU
O) This test uses a kit designated by the manufacturer as "for research use, not for clinical use." The
performance characteristics of this test were validated by ARUP Laboratories, Inc. The U.S. Food and
Drug Administration (FDA) has not approved this test. The results are not intended to be used as the sole
means for clinical diagnosis or patient management decisions. ARUP is authorized under Clinical
Laboratory Improvement Amendments (CLIA) and by all states to perform high-complexity testing.
Reference
Ranges
B. pertussis Negative
AB, IgG by IB
This test uses a kit designated by
the manufacturer as "for research
use, not for clinical use." The U.S
Food & Drug Administration (FDA)
has not approved or cleared this
test. The results are not intended
to be used as the sole means for
clinical diagnosis or patient
management decisions. ARUP is
authorized under Clinical
Laboratory Improvement Amendments
(CLIA) and by all states to perform
high-complexity testing.
PAML TEST CHANGE ALERT #381 page: 8
BPAMIA
order code
BPAMIA
flexilab code
BORDETELLA PERTUSSIS AB, IGM BY IB (New)
Effective
11/15/2011
Method
Qualitative Immunoblot
CPT4
86615
Specimen
Requirements 1 mL serum (SST tube). Separate serum from cells ASAP or within 2 hours of collection and transfer
serum to a separate plastic tube. Store and transport refrigerated. This assay tests for the presence of
pertussis toxin (PT) and filamentous hemagglutinin antibody (FHA).
Comments
1) Min Amt: 0.15 mL. 2) Unacceptable conditions: heat-inactivated specimens. 3) Stability: RT-48 hours,
Refrigerated-2 weeks, Frozen-1 year. 4) ARUP# 2004326.
Compliance(RU
O) This test uses a kit designated by the manufacturer as "for research use, not for clinical use." The
performance characteristics of this test were validated by ARUP Laboratories, Inc. The U.S. Food and
Drug Administration (FDA) has not approved this test. The results are not intended to be used as the sole
means for clinical diagnosis or patient management decisions. ARUP is authorized under Clinical
Laboratory Improvement Amendments (CLIA) and by all states to perform high-complexity testing.
Reference
Ranges
Bordetella Negative
pertussis AB,
IgM by IB
This uses a kit designated by the
manufacturer as "for research
use, not for clinical use." The
performance characteristics of this
test were validated by ARUP
Laboratories. The U.S. Food & Drug
Administration (FDA) has not
approved or cleared this test. The
results are not intended to be used
as the sole means for clinical
diagnosis or patient management
decisions. ARUP is authorized under
Clinical Laboratory Improvement
Amendments (CLIA) and by all states
to perform high-complexity
testing.
CAMPAB CAMPAB CAMPYLOBACTER JEJUNI ANTIBODY IGG
(Specimen Requirements)
order code flexilab code
Effective
Immediately
Comments
1) Min Amt: 0.15 mL. 2) Other acceptable specimens: EDTA, heparin & citrated plasma. Test will be run
with a disclaimer. 3) Unacceptable conditions: avoid repeated freeze/thaw cyles. 4) Stability: RT-2 days,
Refrigerated-2 weeks, Frozen-1 year. 5) ARUP# 0098841.
PAML TEST CHANGE ALERT #381 page: 9
CGC CGC CULTURE, NEISSERIA GONORRHOEAE, REFLEX
(Specimen Requirements)
order code flexilab code
Effective
11/15/2011
Specimen
Requirements Urethra, cervix, throat or rectum swab in bacterial transport medium. Store and transport at room
temperature or refrigerated. Indicate source.
Comments
1) Unacceptable conditions: dry swabs, frozen specimens, or specimens older than 24 hours from time of
collection. 2) Stability: RT-24 hours, Refrigerated-24 hours, Frozen-unacceptable. 3) PSHMC-Microbiology
Department.
CMPCRA
order code
CMPCRA
flexilab code
CYTOMEGALOVIRUS PCR, AMNIOTIC FLD (New)
Effective
11/15/2011
Method
Qual PCR
CPT4
87496
Specimen
Requirements 1 mL frozen amniotic fluid in a sterile leakpoof plastic container and freeze. Store and transport frozen.
Ship 650.
Comments
1) Min Amt: 0.5 mL. 2) Unacceptable conditions: nonsterile or leaking containers. 3) Stability: RT-8 hours,
Refrigertated-3 days, Frozen-3 months. 4) ARUP# 0060040.
Compliance(AS
R) Analyte Specific Reagents (ASR) are used in many laboratory tests necessary for standard medical care
and generally do not require U.S. Food and Drug Administration (FDA) approval or clearance. This test
was developed and its performance characteristics determined by ARUP Laboratories, Inc. It has not been
approved or cleared by the U.S. Food and Drug Administration. This test should not be regarded as
investigational or for research use.
Reference
Ranges
CMV Source
CMV Detection, Not Detected
PCR
Analyte Specific Reagents (ASR)
are used in many laboratory tests
necessary for standard medical care
and generally do not require U.S.
Food and Drug Administration
approval. This test was developed
and its performance characteristics
determined by ARUP Lab, Inc. It
has not been approved by the U.S.
Food & Drug Administration. This
test should not be regarded as
investigational or for research
use.
PAML TEST CHANGE ALERT #381 page: 10
COCID
order code
COCID
flexilab code
COCCIDIOIDES ANTIBODY BY ID (New)
Effective
11/15/2011
Method
Qualitative ID
CPT4
86635
Specimen
Requirements 0.5 mL serum (SST tube). Separate serum from cells and put in separate plastic tube. Store and transport
refrigerated. This test uses culture filtrates of Coccidioides immitis and includes IDCF and IDTP antigens.
Comments
1) Min Amt: 0.15 mL. 2) Other acceptable specimens: CSF. 3) Unacceptable conditions: bloody or grossly
hemolyzed specimens. Avoid repeated freeze/ thaw cycles. 4) Stability: RT-48 hours, Refrigerated-2
weeks, Frozen-1 year. 5) ARUP# 0050183.
Reference
Ranges
Coccidioides None Detected
Antibody by
ID
DA10
order code
DA10
flexilab code
DRUGS OF ABUSE SCREEN 10 (CPT Coding)
Effective
Immediately
CPT4
80101 x 10
DA10+ DA10+ DRUGS OF ABUSE SCREEN 10 + ALCOHOL (CPT
Coding)
order code flexilab code
Effective
Immediately
CPT4
80101 x 11
DA2
order code
DA2
flexilab code
DRUGS OF ABUSE SCREEN 2 (CPT Coding)
Effective
Immediately
CPT4
80101x 2
DA2+ DA2+ DRUGS OF ABUSE SCREEN 2 + ALCOHOL (CPT
Coding)
order code flexilab code
Effective
Immediately
CPT4
80101 x 3
PAML TEST CHANGE ALERT #381 page: 11
DA5
order code
DA5
flexilab code
DRUGS OF ABUSE SCREEN 5 (CPT Coding)
Effective
Immediately
CPT4
80101 X 5
DA5+ DA5+ DRUGS OF ABUSE SCREEN 5 + ALCOHOL (CPT
Coding)
order code flexilab code
Effective
Immediately
CPT4
80101 x 6
DA6
order code
DA6
flexilab code
DRUGS OF ABUSE SCREEN 6 (CPT Coding)
Effective
Immediately
CPT4
80101 x 6
DA7
order code
DA7
flexilab code
DRUGS OF ABUSE SCREEN 7 (CPT Coding)
Effective
Immediately
CPT4
80101 x 7
DA7+ DA7+ DRUGS OF ABUSE SCREEN 7 + ALCOHOL (CPT
Coding)
order code flexilab code
Effective
Immediately
CPT4
80101 x 8
FLATYP
order code
FLATYP
flexilab code
INFLUENZA A SUBTYPING RT-PCR (CPT Coding)
Effective
11/15/2011
CPT4
87502 x 2, 87503
FLUOR.EXP.U FLUUR FLUORIDE, URINE (Description, Specimen
Requirements)
order code flexilab code
Effective
12/05/2011
Specimen
Requirements 8 mL pre-shift or end of shift urine. Collect in acid washed or trace metal free plastic container. Avoid
exposure to gadolinium-based contrast media for 48 hours prior to sample collection. Store and transport
refrigerated.
PAML TEST CHANGE ALERT #381 page: 12
FPSA RATPSA PROSTATE SPECIFIC ANTIGEN, FREE & TOTAL
(Method, Specimen Requirements, Notes)
order code flexilab code
Effective
11/22/2011
Method
ICMA
Comments
1) Min Amt: 0.8 mL. 2) Other acceptable specimens: serum (red top tube- plain). 3) Unacceptable
conditions: heat-inactivated samples, and samples stabilized with azide. 4) Minimum detectable
concentration for Total PSA is 0.01 ng/mL and for Free PSA is 0.01 ng/mL. 5) Stability: RT-3 hrs,
Refrigerated-8 days, Frozen-3 months. 6) PSHMC-Immunology Department.
GM1COM GM1COM GANGLIOSIDE (ASIALO-GM1, GM1, GM2, GD1A
GD1A, & GQ1B) Antibodies (Description, Specimen
Requriements, Reference Range)
order code flexilab code
Effective
Immediately
Specimen
Requirements 0.3 mL serum (SST tube). Separate the serum from the cells ASAP & put in a separate plastic tube. Store
and transport refrigerated.
Comments
1) Min Amt: 0.1 mL. 2) Unacceptable conditions: room temperature samples. Plasma, CSF, or other body
fluids. Heat-inactivated, severely icteric, lipemic, contaminated or hemolyzed samples. 3) Stability:
unacceptable, Refrigerated-2 weeks, Frozen-1 year. 4) ARUP# 0051033.
Reference
Ranges
Asialo GM1 Abs IV
IgG/IgM
Ganglioside IV
GM1 Abs IgG/M
Ganglioside IV
GM2 Abs IgG/M
Ganglioside IV
GD1a Abs IgG
/IgM
Ganglioside IV
GD1b Abs
IgG/IgM
Ganglioside IV
GQ1b Abs,
IgG/IgM
29 or less Negative IV
30-50 Weak Positive IV
51-150 Positive IV
151 or greater Strong Positive IV
This test uses a kit designated by
the manufacturer as "for research
use, not for clinical use." The
performance characteristics of this
test were validated by ARUP
Laboratories, Inc. The U.S. Food
and Drug Administration (FDA) has
not approved this test. The results
PAML TEST CHANGE ALERT #381 page: 13
are not intended to be used as the
sole means for clinical diagnosis
or patient management decisions.
ARUP is authorized under clinical
Laboratory Improvement Amendments
(CLIA) and by all states to perform
high-complexity testing.
HGBS SQT HGB S, QUANTITATIVE (Flexilab code was
incorrectly published on Test Change Alert # 380)
order code flexilab code
HIST
order code
HIST
flexilab code
HISTAMINE (Specimen Requirements)
Effective
Immediately
Comments
1) Min Amt: 0.2 mL. 2) Other acceptable specimens: EDTA frozen whole blood (lavender top tube). Test
will be run with a disclaimer due to specimen type. 3) Unacceptable conditions: non-frozen samples. 4)
Stability: RT-2 hours, Refrigerated-24 hours, Frozen-2 weeks. 5) ARUP# 0070037.
HLAABG
order code
HLAABG
flexilab code
HLA-A & B GENOTYPING (New)
Effective
11/15/2011
Method
PCR/Sequence Specific Oligonucleotide Probe Hybridization
CPT4
83891, 83900 x 2, 83896 x 10, 88384, 88385, 83912
Specimen
Requirements 5 mL EDTA whole blood (lavender top tube). Store and transport at room temperature. HLA TEST
REQUEST FORM RECOMMENDED. Counseling & informed consent are recommended for genetic
testing. Consent forms are available online at www.aruplab.com.
Comments
1) Min Amt: 3 mL. 2) Other acceptable specimens: K2EDTA or ACD Solution A or B whole blood (pink or
yellow top tubes). 3) Unacceptable conditions: lithium or sodium whole blood (green top tubes). 4)
Stability: RT-72 hours, Refrigerated-1 week, Frozen-unacceptable. 4) ARUP# 2002801.
Reference
Ranges
HLA Class I,
Locus A*,
Allele 1
HLA Class I,
Locus A*,
Allele 2
HLA Class I,
Locus B*,
Allele 1
HLA Class,
Locus B*,
Allele 2
HLA-AB Geno-
typing Interp
PAML TEST CHANGE ALERT #381 page: 14
HLACEL HLACEL CELIAC DISEASE (HLA-DQA1*05, HLA-DQB1*02,
AND HLA-DQB1*03:02) GENOTYPING (New)
order code flexilab code
Effective
11/15/2011
Method
PCR/FM
CPT4
83891, 83898, 83900, 83912
Specimen
Requirements 3 mL EDTA whole blood (lavender top tube). Store and transport at room temperature or refrigerated. HLA
Test Request Form Recommended. Counseling and informed consent are recommended for genetic
testing. Consent forms are available online at www.aruplab.com
Comments
1) 1 mL. 2) Other acceptable specimens: K2EDTA or ACD Solution A or B whole blood (pink or yellow top
tube). 3) Stability: RT-1 week, Refrigerated-1 week, Frozen-unacceptable. 4) ARUP# 2005018.
Compliance(Ge
netic) The performance characteristics of this test were validated by ARUP Laboratories, Inc. The U.S. Food
and Drug Administration (FDA) has not approved or cleared this test. However, FDA approval or
clearance is currently not required for clinical use of this test. The results are not intended to be used as
the sole means for clinical diagnosis or patient management decisions. ARUP is authorized under Clinical
Laboratory Improvement Amendments (CLIA) and by all states to perform high-complexity testing.
Reference
Ranges
Celiac
(HLA-DQA1*05)
Celiac
(HLA-DQB1*02)
Celiac
(HLA-DQB1*
03:02)
Celiac HLA
Interp The performance characteristics of
this test were validated by ARUP
Laboratories. The U.S. Food & Drug
Administration (FDA) has not
approved or cleared this test.
However, FDA approval or clearance
is currently not required for
clinical use of this test. The
results are not intended to be used
as the sole means for clinical
diagnosis or patient management
decisions. ARUP is authorized under
CLIA and by all states to perform
high-complexity testing.
HLACG
order code
HLACG
flexilab code
HLA-C GENOTYPING (New)
Effective
11/15/2011
Method
PCR/Sequence Specific Oligonucleotide Probe Hybridizaton
CPT4
83891, 83900, 83896 x 10, 88384, 88385 ,83912
Specimen
Requirements 5 mL EDTA whole blood (lavender top tube). Store and transport at room temperature. Counseling and
PAML TEST CHANGE ALERT #381 page: 15
informed consent are recommended for genetic testing. Consent forms are available online at
www.aruplab.com.
Comments
1) Min Amt: 3 mL. 2) Other acceptable specimens: K2EDTA or ACD Solution A or B whole blood (pink or
yellow top tube). 3) Unacceptable conditions: specimens collected in sodium or lithium heparin whole
blood (green top tubes). 4) Stability: RT-72 hours, Refrigerated-1 week, Frozen- unacceptable. 5) ARUP#
2002807.
Reference
Ranges
HLA C by SSP
Interp
HLA Class I,
Locus Cw*,
Allele 1
HLA Class I,
Locus Cw*,
Allele 2
HLADRG
order code
HLADRG
flexilab code
HLA-DR GENOTYPING (New)
Effective
11/15/2011
Method
PCR/Sequence Specific Oligonucleotide Probe Hybridization
CPT4
83891, 83898, 83896 x 10, 88384, 88385, 83912
Specimen
Requirements 5 mL EDTA whole blood (lavender top tube). Store and transport at room temperature. HLA Test Request
Form Recommended. Counseling & informed consent are recommended for genetic testing. Consent
forms are available online at www.aruplab.com.
Comments
1) Min Amt: 3 mL. 2) Other acceptable specimens: K2EDTA or ACD Solution A or B whole blood (pink or
yellow top tube). 3) Unacceptable conditions: sodium or lithium whole blood (green top tubes). 4) Stability:
RT-72 hours, Refrigerated-1 week, Frozen-unacceptable. 5) ARUP# 2002798.
Reference
Ranges
HLA Class II,
Locus DRB1*,
Allele 1
HLA Class II,
Locus DRB1*,
Allele 2
HLA-DR
Genotyping
Interp
HSPCRA
order code
HSPCRA
flexilab code
HSV PCR, AMNIOTIC FLUID (New)
Effective
11/15/2011
Method
Qual PCR
CPT4
87529
Specimen
Requirements 1 mL frozen amniotic fluid in a sterile leakproof plastic container. Store and transport frozen. Ship 650.
Comments
1) Min Amt: 0.5 mL. 2) Stability: RT-8 hours, Refrigerated-3 days, Frozen-3 months. 3) Unacceptable
PAML TEST CHANGE ALERT #381 page: 16
conditions: Nonsterile or leaking container. Heparinized samples. 4) ARUP# 0060041.
Compliance(AS
R) Analyte Specific Reagents (ASR) are used in many laboratory tests necessary for standard medical care
and generally do not require U.S. Food and Drug Administration (FDA) approval or clearance. This test
was developed and its performance characteristics determined by ARUP Laboratories, Inc. It has not been
approved or cleared by the U.S. Food and Drug Administration. This test should not be regarded as
investigational or for research use.
Reference
Ranges
HSV Source
HSV by PCR Not Detected
Analyte Specific Reagents (ASR) are
used in many laboratory tests
necessary for standard medical
care and generally do not require
U.S. Food & Drug Adm. approval.
This test was developed and its
performance characteristcs
determined by ARUP Lab, Inc. It has
not been approved by the U.S. Food
& Drug Administration. This test
should not be regarded as
investigation or for research use.
This test is performed pursuant
to an agreement with Roche
Molecular Systems, Inc.
ICEWI
order code
ICEWI
flexilab code
ALLERGEN, EGG WHOLE, IGG [IBT] (New)
Effective
11/15/2011
Method
EIA
CPT4
86001
Specimen
Requirements 0.5 mL serum (SST tube). Separate serum from cells and put in a separate plastic tube. Store and
transport refrigerated.
Comments
1) Min Amt: 0.5 mL. 2) Stability: RT-1 week, Refrigerated-1 month, Frozen-1 year. 3) IBT# 47820.
Other
This test was developed and its performance characteristics determined by Viracor-IBT Laboratories. It
has not been cleared or approved by the FDA.
Reference
Ranges
Egg Whole, IgG LT 2.0 mcg/mL
This test was developed and its
performance characteristics
determined by Viracor-IBT
Laboratories. It has not been
cleared or approved by the FDA.
PAML TEST CHANGE ALERT #381 page: 17
IL28BA IL28BA INTERLEUKIN 28 B (IL28B)-ASSOCIATED
VARIANTS, 2SNPS (New)
order code flexilab code
Effective
11/15/2011
Method
Qualitative PCR/Qualitative FM
CPT4
83891, 83900, 83896 x 4, 83912
Specimen
Requirements 3 mL EDTA whole blood (lavender top tube). Store and transport refrigerated. Patient History for
Molecular Genetic Testing is required. Forms are available online at www.aruplab.com
Comments
1) Min Amt: 1 mL. 2) Other acceptable specimens: K2EDTA or ACD Solution A or B whole blood (pink or
yellow top tubes). 3) Stability: RT-72 hours, Refrigerated-1 week, Frozen-unacceptable. 4) ARUP#
2004680.
Compliance(Ge
netic) The performance characteristics of this test were validated by ARUP Laboratories, Inc. The U.S. Food
and Drug Administration (FDA) has not approved or cleared this test. However, FDA approval or
clearance is currently not required for clinical use of this test. The results are not intended to be used as
the sole means for clinical diagnosis or patient management decisions. ARUP is authorized under Clinical
Laboratory Improvement Amendments (CLIA) and by all states to perform high-complexity testing.
Reference
Ranges
IL28B-Assoc
Variants,
2 SNP's
Specimen
Type
IL28B
rs12979860
IL28B
rs8099917
IL28B-Assoc
Variants,
SNPs Interp
The performance characteristics of
this test were validated by ARUP
Lab. The U.S.Food & Drug Adm (FDA)
has not approved or cleared this
test. However, FDA approval or
clearance is currently not required
for clinical use of this test. The
results are not intended to be used
as the sole means for clinical
diagnosis or patient management
decisions. ARUP is authorized
under CLIA and by all states to
perform high-complexity testing.
PAML TEST CHANGE ALERT #381 page: 18
INTACT.PTH PTHI PTH-INTACT (WHOLE MOLECULE) (Specimen
Requirements, Reference Range, Method)
order code flexilab code
Effective
11/15/2011
Method
ICMA
Specimen
Requirements 2 mL frozen lithium heparin (green top tube). Separate plasma promptly & put in separate plastic tube &
freeze. CRITIAL FROZEN. Separate samples must be submitted when multiply tests are ordered. Store &
transport frozen. This is the test of choice for evaluation of calcium & parathyroid disorders. This assay is
for the whole molecule (intact) PTH.
Comments
1) Min Amt: 1 mL. 2) Other acceptable specimens: serum. 3) Stability: RT-4 hours, Refrigerated-48 hours,
Frozen-6 months. 4) PSHMC-Immunology Department.
Reference
Ranges
PTH (INTACT) 12-88 pg/mL
Calcium 8.5-10.5 mg/dL
IODUQM
order code
IODUQM
flexilab code
IODINE, 24 HOUR, URINE (New)
Effective
11/15/2011
Method
ICP/MS
CPT4
83789
Specimen
Requirements 10 mL aliquot of a 24 hour urine collection in a leakproof plastic urine container with no metal caps or
glued inserts. Store and transport refrigerated. Record total volume and collection period. This must be
refrigerated within 4 hours of completion of the 24 hour collection.
Comments
1) Min Amt: 3 mL. 2) Gadolinium, iodine and barium are known to interfere with most metals test. It any
contrast media containing any of these has been administered do not collect the specimen for 96 hours. 3)
Stability: RT-2 weeks, Refrigerated-2 weeks, Frozen-2 weeks.4) MAYO# 9549.
Reference
Ranges
Iodine, 24 hr, 16-150 yrs 93-1125 mcg/sp
Urine
Collection hrs
Period
Urine Volume mLs
Iodine 16-150 yrs 26-705 mcg/L
Concentration
LAMA LAMA LYMPHOCYTE AG & MITOGEN PROLIF PNL (CPT
Coding)
order code flexilab code
Effective
Immediately
CPT4
86353 x 5
PAML TEST CHANGE ALERT #381 page: 19
PSA
order code
PSA
flexilab code
PROSTATIC SPECIFIC ANTIGEN (Notes)
Effective
11/22/2011
Comments
1) Min Amt: 0.5 mL. 2) Stability: Refrigerated-14 days. 3) Serum is the only acceptable specimen. TAT
longer if dilutions required. 4) Minimum detectable concentration is 0.01 ng/mL.
PSAPR PSAPR PROSTATE SPECIFIC ANTIGEN, POST
PROSTECTOMY (Notes)
order code flexilab code
Effective
11/22/2011
Comments
1) Min Amt: 0.5 mL. 2) Stability: Refrigerated-14 days. 3) Serum is the only acceptable specimen. 4)
Minimum detectable concentration is 0.01 ng/mL.
PSAR PSAR PROSTATIC SPECIFIC AG (REFLEXIVE) (Method,
Specimen Requirements, Notes)
order code flexilab code
Effective
11/22/2011
Method
ICMA
Comments
1) Min Amt: 0.8 mL. 2) Other acceptable specimens: serum (red top tube- plain). 3) Unacceptable
conditions: heat-inactivated samples, and samples stabilized with azide. 4) Minimum detectable
concentration for Total PSA is 0.01 ng/mL and for Free PSA is 0.01 ng/mL. 5) Stability: RT-3 hours,
Refrigerated-8 days, Frozen-3 months. 6) PSHMC-Immunology Department.
PTHINT PTHINT PTH INTACT NO CALCIUM (Specimen
Requirements, Method, Reference Range)
order code flexilab code
Effective
11/15/2011
Method
ICMA
Specimen
Requirements 2 mL frozen lithium heparin plasma (green top tube). Separate plasma from cells promptly & freeze in
separate plastic tube. Store & transport frozen. THIS ASSAY IS FOR THE WHOLE MOLECULE (INTACT)
PTH AND NO CALCIUM IS REPORTED. This is a CRITICAL FROZEN.
Comments
1) Min Amt: 1 mL. 2) Other acceptable specimens: serum. 3) Stability: RT-4 hours, Refrigerated-48 hours,
Frozen-6 months. 4) PSHMC-Immunology Department.
Reference
Ranges
Intact PTH 12-88 pg/mL
Whole
Molecule
PAML TEST CHANGE ALERT #381 page: 20
RESPCR
order code
RESPCR
flexilab code
FLU A, FLU B AND RSV BY PCR (CPT Coding)
Effective
11/15/2011
CPT4
87798, 87502 x 2
RESPRX RESPRX FLU A, FLU B, RSV PCR (REFLEXIVE) (CPT
Coding)
order code flexilab code
Effective
11/15/2011
CPT4
87502 x 2, 87798
SCANMU SCANMU SYNTHETIC CANNABINOID METABOLITES,
QUALITATIVE, URINE (New)
order code flexilab code
Effective
11/15/2011
Method
LC-MS/MS
CPT4
83788
Specimen
Requirements 2 mL random urine collection in a leakproof plastic urine container. Store and transport refrigerated.
Comments
1) Min Amt: 1.5 mL 2) Stability: RT-1 month, Refrigerated-1 month, Frozen- 1 month. 3) NMS# 4280U.
Reference
Ranges
JWH-018 Hydrox Negative
Metabolites
JWH-073 Hydrox Negative
Metabolites
SS.LAP
order code
LAP
flexilab code
LEUK ALK PHOS STAIN (Specimen Requirements)
Effective
Immediately
Specimen
Requirements One sodium heparin whole blood (green top tube) and 3 well-made, non-fixed, non- EDTA blood smears.
An additional EDTA tube or CBC results are optional, but preferred. Protect from light. Store and transport
at room temperature. Indicate source.
TESTED TESTED TESTOSTERONE, TOTAL & FREE, SERUM BY
EQUILIBRIM DIALYSIS & LS-MS/MS (Description)
order code flexilab code
Effective
Immediately
PAML Web Test Directory
PAML TEST CHANGE ALERT #381 page: 21