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25059 IBD sgi Diagnostic (1800) with Crohn's Prognostic (2001)

IBD sgi Diagnostic (1800) with Crohn's Prognostic (2001)
Test Code: SGICRSO
Test Components
​This test is a serologic, genetic and inflammation panel of antibodies optimized to detect inflammatory bowel disease (IBD). It includes a proprietary Smart Diagnostic Algorithm to provide added IBD diagnostic clarity.
When the IBD sgi test is positive, the Crohn's Prognostic test will be performed at an additional charge. Crohn's Prognostic test combines proprietary serologic (Anti-CBir1, Anti-OmpC, Anti-12, DNAse sensitive pANCA) and genetic (NOD2 variants SNPs 8, 12, 13) markers in one innovative serogenetic test to provide individualized probabilities for developing disease complications after diagnosis in patients with Crohn's disease (CD).
Useful For
​This test will allow physicians to stratify their Crohn's Disease patients according to their risks of developing complications over time and to manage their disease accordingly. This test also assists providers in personalizing the disease treatment plan for their patients and in helping the provider discuss the risks and benefits of the selected treatment strategy.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum AND Whole Blood ​Red Top Tube (RTT) AND Lavender Top Tube (LTT) ​2 mL serum AND 2 mL EDTA whole blood ​0.5 mL serum AND 2 ml EDTA whole blood
Collection Processing Instructions
​Must submit both serum AND EDTA whole blood.
Specimen Stability Information
Specimen Type Temperature Time
​Serum AND Whole Blood ​ ​Ambient ​7 days
​Refrigerated ​7 days
Rejection Criteria
Not submitting both serum and whole blood Reject
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Prometheus Labs​ ​Monday through Friday ​4-7 days ​ELISA, PCR, Immunofluorescent
Reference Lab
Reference Range Information
Performing Location Reference Range
​Prometheus Labs ​Interpretive Report
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​83520 ​6 ​ASCA IgA & IgG, Anti-OmpC IgA, Anti-CBir1
​82397 ​4 ​Chemiluminescent assay
​86140 ​1

CRP

​86255 ​2 ​Immunofluorescent method, ea
​81479 ​1 ​ATG 16L1 Gene
​81479 ​1 ​EMC 1 Gene
​81479 ​1 ​NKX 2-3 Gene
​81479 ​1 ​STAT3 Gene
​83520​1​Anti-12 ELISA​(if needed)
​81401​1​NOD2/CARD15 PCR​(if needed)
Test Components
​This test is a serologic, genetic and inflammation panel of antibodies optimized to detect inflammatory bowel disease (IBD). It includes a proprietary Smart Diagnostic Algorithm to provide added IBD diagnostic clarity.
When the IBD sgi test is positive, the Crohn's Prognostic test will be performed at an additional charge. Crohn's Prognostic test combines proprietary serologic (Anti-CBir1, Anti-OmpC, Anti-12, DNAse sensitive pANCA) and genetic (NOD2 variants SNPs 8, 12, 13) markers in one innovative serogenetic test to provide individualized probabilities for developing disease complications after diagnosis in patients with Crohn's disease (CD).
Ordering Applications
Ordering Application Description
​Centricity ​IBD sgi Dxn w Crohn's Prognostic (2001)
​Cerner ​IBD sgi Diagnostic w/Crohn's Prognostic
​COM ​IBD sgi Dxn W Crohn's Prognost
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum AND Whole Blood ​Red Top Tube (RTT) AND Lavender Top Tube (LTT) ​2 mL serum AND 2 mL EDTA whole blood ​0.5 mL serum AND 2 ml EDTA whole blood
Collection Processing
​Must submit both serum AND EDTA whole blood.
Specimen Stability Information
Specimen Type Temperature Time
​Serum AND Whole Blood ​ ​Ambient ​7 days
​Refrigerated ​7 days
Rejection Criteria
Not submitting both serum and whole blood Reject
Useful For
​This test will allow physicians to stratify their Crohn's Disease patients according to their risks of developing complications over time and to manage their disease accordingly. This test also assists providers in personalizing the disease treatment plan for their patients and in helping the provider discuss the risks and benefits of the selected treatment strategy.
Test Components
​This test is a serologic, genetic and inflammation panel of antibodies optimized to detect inflammatory bowel disease (IBD). It includes a proprietary Smart Diagnostic Algorithm to provide added IBD diagnostic clarity.
When the IBD sgi test is positive, the Crohn's Prognostic test will be performed at an additional charge. Crohn's Prognostic test combines proprietary serologic (Anti-CBir1, Anti-OmpC, Anti-12, DNAse sensitive pANCA) and genetic (NOD2 variants SNPs 8, 12, 13) markers in one innovative serogenetic test to provide individualized probabilities for developing disease complications after diagnosis in patients with Crohn's disease (CD).
Reference Range Information
Performing Location Reference Range
​Prometheus Labs ​Interpretive Report
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Prometheus Labs​ ​Monday through Friday ​4-7 days ​ELISA, PCR, Immunofluorescent
Reference Lab
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​83520 ​6 ​ASCA IgA & IgG, Anti-OmpC IgA, Anti-CBir1
​82397 ​4 ​Chemiluminescent assay
​86140 ​1

CRP

​86255 ​2 ​Immunofluorescent method, ea
​81479 ​1 ​ATG 16L1 Gene
​81479 ​1 ​EMC 1 Gene
​81479 ​1 ​NKX 2-3 Gene
​81479 ​1 ​STAT3 Gene
​83520​1​Anti-12 ELISA​(if needed)
​81401​1​NOD2/CARD15 PCR​(if needed)
For most current information refer to the Marshfield Laboratory online reference manual.