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Specimen Requirements
  
  
  
CPT Codes
  
A1ALCSO Alpha-1-Antitrypsin Proteotype S/Z by LC-MS/MS, Serum (A1ALC)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​1.25 mL ​0.5 mL
4.06/22/2022 9:20 AMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​82103 ​1
​82542 ​1
​82104 ​1 If needed​
  
HER2FSO HER2 Amp, Breast Cancer, FISH, Tissue (H2BR)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Tissue ​Tissue Block
​No ​Slides ​4un, 1 H&E ​2un, 1 H&E
8.06/22/2022 9:42 AMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
88377 ​1
88361 ​1 ​HER Breast IHC Automated No Reflex ​if appropriate
  
DCORTSO11-Deoxycortisol, Serum (DCORT)pionkowd@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL​0.4 mL
1.02/11/2022 12:11 PMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​82634​1
  
17OHPSO17-Hydroxypregnenolone, Serum (17OHP)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​1 mL ​0.5 mL
7.07/10/2023 2:12 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​84143 ​1
  
17HPSO17-Hydroxyprogesterone, Serumchadwica@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)

​Serum
​Red Top Tube (RTT)
​0.6 mL
​0.25 mL
5.07/11/2023 9:24 AMchadwica@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments

​83498
​1
  
FGLIOSO1p19q Deletion in Gliomas, FISH, Tissue (GLIOF)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​​Tissue ​Tissue Block
​No ​Slides​Six consecutive, unstained and 1 hematoxylin and eosin-stained slide
7.06/22/2022 1:40 PMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​88271

2

​DNA probe, each
​88291 ​1 ​Interpretation and Report
​88271 1 ​Probe, +1 ​if needed
​88271 ​2 ​Probe, +2 ​if needed
​88271 ​3 ​Probe, +3 ​if needed
​88271 ​2 ​Probe set, count ​if needed
​88274 ​1 ​Interphases, 25-99 ​if needed
​88275 ​1 ​Interphases, 100-300 ​if needed
​88274 ​1 ​Interphases, <25 ​if needed
  
21HDRSO21-Hydroxylase Ab, S (21OH)Potter, Joli K
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Red Top Tube (RTT)​ Serum Separator Tube (SST)​ 1 mL​ 0.20 mL​
15.06/22/2022 1:42 PMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
83516
  
F5NULSO5' Nucleotidase (F5NUL)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Serum Separator Tube (SST) ​Red Top Tube (RTT) ​1 mL ​0.5 mL
6.06/22/2022 1:45 PMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​83915 ​1
  
HIAASO5-Hydroxyindoleacetic Acid 24 Hr U (HIAA)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​*Dietary Restrictions and Drug Interactions ​Urine from 24-hour urine collection
​10 mL Urine Tube ​Plastic Urine Container ​5 mL ​1 mL ​1 mL
Note:  Add 25 mL of 50% acetic acid as preservative at start of collection. Use 15 mL of 50% acetic acid for children <5 years old.​​​​​​​​
​ ​ ​ ​ ​ ​
8.02/7/2023 1:33 PMcareygej@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
83497​ ​1
  
HEROIN6-Monoacetylmorphine (Heroin Metabolite), UrineSchalow, Dianne M
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ Urine​ Sage urine collection container​ Sterile plastic container with no preservatives​ 10 mL​ 7 mL​ 4 mL​
20.010/27/2022 4:16 PMcareygej@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
80356 1​ 6-Monoacetylmorphine (Heroin Metabolite) Confirmation
G0480​ 1​ 6-Monoacetylmorphine (Heroin Metabolite) Confirmation For Marshfield Clinic and Medicare/Medicaid​
  
ACETAAcetaminophenPotter, Joli K
NoNo
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​NoPlasma/Serum​Lithium-heparin Plasma Separator Tube (PST)

Serum Separator Tube (SST)

Red Top Tube (RTT)

Lithium or Sodium-heparin Green Top Tube (GTT)
 
EDTA Lavender Top Tube (LTT)​
0.5 mL​0.3 mL​
26.01/5/2021 2:44 PMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
80143​ ​1
  
MISCAcetoacetate, Serum/Plasma (0060SP)busedj@mfldclin.org
NoNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum ​Red Top Tube (RTT) ​3 mL ​1.2 mL
​Plasma ​EDTA Lavender Top Tube (LTT) ​3 mL ​1.2 mL
3.02/25/2020 12:54 PMdrexlerk@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​82010
  
ACRBAcetylcholine Receptor (Muscle AChR) Binding Antibody (ARBI)Potter, Joli K
NoNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum Red Top Tube (RTT)​ Serum Separator Tube (SST)​ 1.5 mL​ 1.0 mL​
22.09/6/2023 2:22 PMdrexlerk@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​83519
  
ARMASOAcetylcholine Receptor Modulating Antibody (0099521)careygej@mfldclin.org
YesNo
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No​Serum​Serum Separator Tube (SST)​0.5 mL​0.3 mL
8.011/2/2022 9:40 AMdrexlerk@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
83516​​1​Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative of semiquantitative, multiple step method.
  
AFACESOAcetylcholinesterase, Amniotic Fluid (ACHE_)Potter, Joli K
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Amniotic fluid ​ Amniotic fluid container​ 1 mL​ 0.3 mL​
11.06/22/2022 1:54 PMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​82013
  
ACIDSOAcid Phosphatase, Prostatic (PACP)Wroblewski, Jennifer
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​1 mL ​0.4 mL
9.06/22/2022 1:21 PMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​84066
  
ACTH Stimulation Test, 60 Min Cortisol ACTH Stimulation Test, 60 Min CortisolHebert, Lori M
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ Serum or Plasma​Serum Separator Tube (SST)​Red Top Tube (RTT)​, Lithium-heparin Plasma Separator Tube (PST), Sodium-heparin Green Top Tube (GTT)0.5 mL​0.3 mL​0.255 mL​
16.011/10/2023 12:13 PMdrexlerk@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
80400​
  
ACTH Stim, 30 and 60 Min Cort ACTH Stimulation, 30 and 60 Min CortisolsHebert, Lori M
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ Serum or Plasma​Serum Separator Tube (SST)Red Top Tube (RTT),Lithium-heparin Plasma Separator Tube (PST), Sodium-heparin Green Top Tube (GTT) 0.5 mL​0.3 mL​0.255 mL​
15.011/10/2023 12:15 PMdrexlerk@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
80400​ ACTH Stim Panel​
82533​ Cortisol, total​
  
APCRVSOActivated Protein C Resistance V, Plasma (APCRV)pionkowd@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Platelet-Poor Plasma​Citrated Light Blue Top Tube (BTT)​1 mL​0.5 mL
5.06/22/2022 1:29 PMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
85307​​1
  
ACRNSOAcylcarnitines, Quantitative (ACRN)Potter, Joli K
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Plasma​ Sodium-heparin Green Top Tube (GTT)​ EDTA Lavender Top Tube (LTT) or Lithium Heparin Green Top Tube (GTT) ​ 0.1 mL​ 0.04 mL​
15.06/23/2022 2:49 PMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​82017
  
AGU20SOAcylglycines, Quantitative, Random, Urine (AGU20)pionkowd@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Urine​Plastic, 10-mL urine tube​10 mL​4 mL​If insufficient collection volume, submit as much as possible in a single container; the laboratory will determine if volume is sufficient for testing.
4.06/23/2022 2:56 PMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​82542​1
  
ADALXSOAdalimumab Quantitative with Reflex to Antibody, Serum (ADALX)pionkowd@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Serum Separator Tube (SST)​Red Top Tube (RTT)​0.5 mL​0.35 mL
5.06/23/2022 3:08 PMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​80145​1
​83520​1​if needed
  
ADAMTSOADAMTS13 Evaluation (1295)januszj@mfldclin.org
NoNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Plasma​ (preferred) ​Citrated Blue Top Tube (BTT) ​Three 0.5 mL aliquots ​Two 0.4 ml aliquots
​Serum ​Red Top Tube (RTT) ​Three 0.5 mL aliquots ​Two 0.4 ml aliquots
​Whole Blood​Light Blue Top Tube​​Three 0.5 mL aliquots​​Two 0.4 ml aliquots
13.04/22/2021 1:29 PMdrexlerk@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
85397​ ​1 ADAMTS13 Activity​
​85335 ​1 ADAMTS13 Inhibitor (if performed)​
​83520 ​1 ADAMTS13 Antibody (if performed)​
  
ADAMT13ADAMTS13 Evaluation, RapidBarnes, Alyssa
NoNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Plasma​ Citrated Blue Top Tube (BTT)​ Two 0.75 mL  aliquots​
Two 0.75 mL 
aliquots​
 0.5 mL​
11.03/21/2016 4:37 PMbusedj@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​85397
  
FADPFSOAdenosine Deaminase, Pleural Fluid (FADPF)pionkowd@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Pleural Fluid​Leak Proof Container​0.5 mL​0.2 mL
5.06/24/2022 9:57 AMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​84311​1
  
LADVSOAdenovirus, Molecular Detection, PCR, Varies (LADV)drexlerk@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Body Fluid (Pleural, peritoneal, ascites, pericardial, or amniotic)​
​Sterile Container




​0.5 mL

​0.5 mL

Respiratory (Bronchial washing, bronchoalveolar lavage, nasopharyngeal aspirate or washing, sputum, or tracheal aspirate)
Sterile Container
​​1 mL

0.5 mL



​Cerebrospinal Fluid

Sterile Vial


​​0.5 mL​
0.3 mL


​Stool
​Stool Collection kit
​​​​​


​1 g

​​0.5 g



​Nasal 

Swab placed in multimicrobe medium (M4-RT, M4, or M5) or Eswab








​Throat
​Swab placed in multimicrobe medium (M4-RT, M4, or M5) or Eswab








Genital
​Swab placed in multimicrobe medium (M4-RT, M4, or M5 or Eswab















​Ocular
​Swab placed in multimicrobe medium (M4-RT, M4, or M5) or Eswab









​Tissue 
​Sterile container containing 1 mL to 2 mL of sterile saline or multimicrobe medium (M4-RT, M4, or M5)
​Entire Collection



​​Urine (Random)
Sterile Container
​​1 mL

0.3 mL

2.011/16/2023 10:59 AMchadwica@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
87798






  
ACTH-PAdrenocorticotropic Hormone (ACTH)Schalow, Dianne M
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ Plasma​ EDTA Pink Top Tube (PTT)-pre-chilled​ EDTA Lavender Top Tube (LTT)-pre-chilled​ 0.5 mL​ 0.5 mL​ 0.4 mL​
12.011/22/2022 1:00 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
82024 ​
  
ALTAlanine Amino TransferasePotter, Joli K
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No Plasma​/Serum Lithium-heparin Plasma Separator (PST)​, Serum Separator Tube (SST) Lithium or Sodium-heparin Green Top (GTT), Red Top Tube (RTT) 1 mL​ 0.5 mL​ 0.6 mL whole blood​
18.05/23/2023 9:45 AMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​84460
  
ALBAlbuminPotter, Joli K
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ Plasma​/Serum

Lithium-heparin Plasma Separator Tube (PST), Serum Separator Tube (SST)

Lithium or Sodium-heparin Green Top Tube (GTT), Red Top Tube (RTT)​ 1 mL​ 0.5 mL​ 0.1 mL​
17.05/23/2023 9:46 AMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
82040 ​
  
ALB-OAlbumin, Body FluidPotter, Joli K
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No Body Fluid​
Syringe
 
No Additive Waste Tube​
Sterile screw top container​ 2.0 mL​ 0.5 mL​
12.02/20/2020 1:34 PMpotterj@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
82042 ​
  
ALCAlcohol, BloodPotter, Joli K
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No Plasma​/Serum ​Lithium-heparin Plasma Separator Tube (PST), Serum Separator Tube (SST)

Lithium or Sodium-heparin Green Top (GTT), Red Top (RTT)
Gray Top (GYTT)​

0.5 mL​ 0.2 mL​
20.01/4/2021 2:54 PMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
82077 ​1
  
ALSSOAldolase, Serum (ALS)chadwica@mfldclin.org
YesNo

Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
​Serum
​​Red Top Tube (RTT)
​1 mL
​0.5 mL
6.05/24/2023 9:38 AMchadwica@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments

​82085
​1
  
ALDOUSOAldosterone, 24 Hour, Urine (ALDU)Potter, Joli K
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume
Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Urine​ Plastic, 10-mL urine tube​ 10 mL​ 1 mL​
17.06/24/2022 10:16 AMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​82088
  
ALDSSOAldosterone, Serum (ALDS)Schalow, Dianne M
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ Serum​ Red Top Tube (RTT)​ ​Serum Separator Tube (SST) 1.2 mL​ 1.2 mL
16.06/30/2022 10:38 AMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
82088 ​
  
ALDSSOTESTAldosterone, Serum (ALDS) Testpotterj@mfldclin.org
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​1.2 mL ​0.6 mL
2.01/20/2021 9:50 AMdrexlerk@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​82088
  
ALKRESOALK (2p23) Rearrangement, FISH, Tissue (LCAF)potterj@mfldclin.org
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Tissue
FFPE
tumor tissue block
Slides 4 consecutive, unstained, 5 micron thick sections placed on positively charged slides and 1 H&E slide 3 consecutive, unstained, 5 micron thick sections placed on positively charged slides and 1 H&E slide
22.06/22/2022 1:50 PMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​88291 1 Interpretation and report​ ​​​
​88271​ 2 ​​Probe Set, 1ST
88271​​ 2 Probe, +2 ​​​as needed
88271​​ ​1 ​Probe, +1 ​​​as needed
​88271​ ​2 ​​Probe, +2 ​​​as needed
88271​​ ​3 ​​Probe, +3 ​​​as needed
​88274​ ​1 ​Interphases, <25​ ​​​as needed
​88274​ ​1 ​Interphases, 25-99 ​​​as needed
​88275 ​1 ​Interphases, >100 ​​​as needed
  
ALKPAlkaline Phosphatase, TotalPotter, Joli K
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ Plasma​/Serum Lithium -heparin Plasma Separator (PST)​, Serum Separator Tube (SST)
Lithium or Sodium-heparin Green Top (GTT), Red Top (RTT)
 
1 mL​ 0.5 mL​ 0.5 mL whole blood​
19.05/23/2023 9:47 AMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
84075 ​
  
ALKISOAlkaline Phosphatase, Total and Isoenzymes, Serum (ALKI)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Serum Separator Tube (SST) ​Red Top Tube (RTT) ​1 mL (divided into 2 tubes, each containing 0.5 mL) ​0.5 mL (divided into 2 tubes, each containing 0.25 mL)
5.06/30/2022 11:46 AMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​84080 ​1 ​Isoenzymes
​84075 ​1 ​Alkaline Phosphatase
  
ALANSSOAllergen IgE, Anise  (ANSE)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​0.5 mL ​0.3 mL
4.07/11/2022 3:11 PMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
  
ALASCSOAllergen IgE, Ascaris (ASCRI)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Serum Separator Tube (SST) ​Red Top Tube (RTT)​ ​0.5 mL for each 5 allergens requested For 1 allergen: 0.3 mL; For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL deadspace
4.05/8/2023 3:16 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
  
ALBROSOAllergen IgE, Broccoli (BROC)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​0.5 mL ​0.3 mL
3.07/11/2022 3:29 PMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
  
ALBFTSOAllergen IgE, Budgerigar Feathers (BFTH)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum Serum Separator Tube (SST) Red Top Tube (RTT)
​0.3 mL
5.05/3/2023 2:15 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
  
ALCHLSOAllergen IgE, Chili Pepper (CHILI)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​0.5 mL for every 5 allergens requested ​0.3 mL
3.07/11/2022 3:49 PMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
  
ALCOWSOAllergen IgE, Cow Epithelium (COW)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Serum Separator Tube (SST) Red Top Tube (RTT) ​0.3 mL
4.05/3/2023 3:31 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
  
ALFEESOAllergen IgE, Ferret Epithelium (FEEP)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum Serum Separator Tube (SST) Red Top Tube (RTT)
​0.5 mL ​0.3 mL
5.05/9/2023 9:12 AMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
  
FDP1SOAllergen IgE, Food Panel #2, Serum (FDP1)pionkowd@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL​0.3 mL
2.02/2/2022 1:50 PMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1
  
ALGSTSOAllergen IgE, Green String Bean (GSTB)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum Serum Separator Tube (SST) ​Red Top Tube (RTT)
​0.3 mL
4.05/4/2023 2:23 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
  
ALGUISOAllergen IgE, Guinea Pig Epithelium (GUIN)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Serum Separator Tube (SST) Red Top Tube (RTT) ​0.3 mL
4.05/4/2023 2:27 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
  
FCGUMSOAllergen IgE, Gum Carageenan IgE (FCGUM)pionkowd@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL​0.5 mL
1.02/4/2022 4:00 PMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1
  
ALHORSOAllergen IgE,  Horse Dander (HORS)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum Serum Separator Tube (SST) Red Top Tube (RTT) ​0.3 mL
4.05/4/2023 2:38 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
  
ALLETSOAllergen IgE, Lettuce (LETT)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​0.5 mL ​0.3 mL
4.07/12/2022 11:10 AMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
  
PCANHSOAllergen IgE, Pecan Hickory, IgE, Serum (PCANH)pionkowd@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3 mL
1.02/8/2022 11:03 AMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1
  
ALPNASOAllergen IgE, Pineapple (PNAP)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum Serum Separator Tube (SST) Red Top Tube (RTT) ​0.5 mL ​0.3 mL
4.05/5/2023 10:53 AMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
  
SQUASOAllergen IgE, Squash, Serum (SQUA)pionkowd@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3 mL
2.02/9/2022 11:41 AMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1
  
WHEYSOAllergen IgE, Whey, Serum (WHEY)pionkowd@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 for every 5 allergens requested​0.3 mL
2.02/2/2022 1:06 PMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1
  
ALBENSOAllergen IgE, White Bean (BENW)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​0.5 mL ​0.3 mL
5.07/13/2022 11:41 AMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments

86003

​1
  
WILLSOAllergen IgE, Willow, Serum (WILL)pionkowd@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3 mL
1.02/2/2022 1:18 PMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1
  
ALJOHSOAllergen Johnson Grass, IgE (JOHN)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Red Top Tube (RTT)​ ​Serum Separator Tube (SST) ​0.5 mL
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
7.07/13/2022 11:49 AMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​
  
ALFODSOAllergen Panel, Food (FOOD6)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) Red Top Tube (RTT) ​0.5 mL
0.3 mL
12.05/8/2023 12:44 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​
  
APGALSOAllergen Panel, Galactose-Alpha-1, 3-Galactose (Alpha-Gal) Mammalian Meat Allergy Profile, Serum (APGAL)pionkowd@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Serum Separator Tube (SST)Red Top Tube (RTT)​1.5 mL
5.010/31/2023 11:52 AMchadwica@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​4


​86008

​1
  
ALHDUSOAllergen Panel, House Dust (HD1)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) Red Top Tube (RTT) ​0.7 mL
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
8.05/4/2023 2:40 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​
  
ALMOLDAllergen Panel, Mold (MOLD1)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) Red Top Tube (RTT)
​0.5 mL
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
9.05/4/2023 3:17 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​
  
ALNT1SOAllergen Panel, Nut #1 (FOOD8)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Serum Separator Tube (SST) Red Top Tube (RTT) 0.5 mL​
0.3 mL
8.05/4/2023 11:40 AMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​
  
ALPED1Allergen Panel, Ped <3 Years (PAS3)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) ​Red Top Tube (RTT) ​0.7 mL for every 5 allergens requested
For 1 allergen: 0.5 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL deadspace
9.05/8/2023 3:00 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​ 5​ ​Allergen specific IgE
  
ALPED3Allergen Panel, Ped >8 Years (PAS8)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Serum Separator Tube (SST) ​Red Top Tube (RTT) ​0.7 mL for every 5 allergens requested
For 1 allergen: 0.5 mL
For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
8.05/8/2023 3:06 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​ ​5 ​Allergen specific IgE
  
ALPED2Allergen Panel, Ped 3-8 Years (PAS38)Janusz, Janice M
YesNohttps://testreference.marshfieldlabs.org/sites/ltrm/Human/Search/SitePages/results.aspx?k=PrimarySendoutID:354&s=Human
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Serum Separator Tube (SST) ​Red Top Tube (RTT) 0.8 mL for every 5 allergens requested For 1 allergen: 0.6 mL
For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL deadspace
8.05/8/2023 3:04 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​ 6​ Allergen specific IgE​
  
ALRP8SOAllergen Panel, Respiratory Midwest (RPR8)wroblewj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Serum Separator Tube (SST) Red Top Tube (RTT) ​2 mL ​1.55 mL
4.05/8/2023 1:01 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​82785 ​1 ​IgE
​86003 ​25 ​Each indivual allergen
  
MRASTAllergen Panel, Stinging Insects-5 Allergens (INSEC)Potter, Joli K
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum Red Top Tube (RTT)​ ​Serum Separator Tube (SST) ​0.8 mL
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space​
8.07/19/2022 11:44 AMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​ 5​
  
ALTRESOAllergen Panel, Tree #1 (TREE1)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) Red Top Tube (RTT) ​0.5 mL
0.3 mL
9.05/8/2023 10:57 AMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​
  
ALPSISOAllergen Pistachio, IgE (PISTA)januszj@mfldclin.org
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Serum Separator Tube (SST) ​Red Top Tube (RTT) ​0.5 mL for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
8.05/5/2023 10:27 AMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​86003
  
ALALFSOAllergen, Alfalfa (Medicago sativa) IgE (FALPE)knoxa@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL​0.5 mL
3.07/19/2022 1:09 PMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1
  
ALAMSOAllergen, Almond, IgE (ALM)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​0.5 mL for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
7.07/19/2022 1:16 PMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​
  
ALAMYSOAllergen, Alpha-Amylase, IgE (AAMY)pionkowd@mfldclin.org
YesNo
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3 mL
4.07/19/2022 1:22 PMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86008​1
  
ALALBSOAllergen, Alpha-Lactalbumin, IgE (ALFA)pionkowd@mfldclin.org
YesNo
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3 mL
6.07/19/2022 3:14 PMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86008​1
  
ALTERSOAllergen, Alternaria tenuis, IgE (ALTN)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Red Top Tube (RTT) ​Serum Separator Tube (SST) 0.5 mL​ for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
7.07/19/2022 3:24 PMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​
  
ALAMXSOAllergen, Amoxicillin, IgE (AMOXY)pionkowd@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL​0.3 mL
3.07/20/2022 11:45 AMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1
  
ALANCSOAllergen, Anchovy, IgE (ANCH)potterj@mfldclin.org
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum ​Serum Separator Tube (SST) Red Top Tube (RTT) ​0.5 mL for every 5 allergens requested ​0.3 mL for 1 allergen; For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
4.05/8/2023 3:09 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​​ ​1 ​Anchovy, IgE
  
ALAPPSOAllergen, Apple, IgE (APPL)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Serum Separator Tube (SST) Red Top Tube (RTT) ​0.5 mL for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
12.05/3/2023 1:28 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​
  
ALFUMSOAllergen, Aspergillus fumigatus, IgE (ASP)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) ​Red Top Tube (RTT) 0.5 mL​ for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
9.05/3/2023 1:33 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​
  
ALAVOSOAllergen, Avocado, IgE (AVOC)potterj@mfldclin.org
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum Serum Separator Tube (SST)
Red Top Tube (RTT) 0.5 mL for every 5 allergens requested

For 1 allergen:  ​0.3 mL​

For more than 1 allergen: (0.05 mL x number of allergens) = 0.25 mL dead space.

4.05/8/2023 3:19 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​​ ​1
  
ALBAKSOAllergen, Bakers Yeast, IgE (BYST)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Red Top Tube (RTT)​ ​Serum Separator Tube (SST) 0.5 mL ​for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
7.07/21/2022 11:20 AMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​
  
ALBMBSOAllergen, Bamboo Shoot, IgE, Serum (BAMB)pionkowd@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube​0.5 mL for every 5 allergens requested​0.3 mL
4.07/21/2022 11:27 AMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1
  
ALBANSOAllergen, Banana, IgE (BANA)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) ​Red Top Tube (RTT) ​0.5 mL for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
9.05/3/2023 1:35 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​
  
ALBRLSOAllergen, Barley, IgE, Serum (BRLY)pionkowd@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3
5.07/21/2022 11:51 AMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1
  
ALBASSOAllergen, Bass, Black, IgE (43310S)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum ​Red Top Tube (RTT) 0.5 mL 340 uL
9.06/13/2023 2:12 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​86003
  
ALBEFSOAllergen, Beef, IgE (BEEF)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) Red Top Tube (RTT) ​0.5 mL for each 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
8.05/3/2023 1:39 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​
  
ALBERSOAllergen, Bermuda Grass, IgE (BERG)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST)
Red Top Tube (RTT)
​0.5 mL for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
9.05/3/2023 1:45 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​ ​1
  
ALBLCSOAllergen, Beta-Lactoglobulin, IgE (BLAC)pionkowd@mfldclin.org
YesNo
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3 mL
4.08/16/2022 10:28 AMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86008​1
  
ALBBSOAllergen, Black Bean, IgE (34410E)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum ​Red Top Tube (RTT) 0.5 mL ​340 uL
8.04/19/2021 1:11 PMpionkowd@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
​86003
  
ALBLPSOAllergen, Black/White Pepper, IgE, Serum (BLPEP)pionkowd@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3 mL
3.08/16/2022 10:41 AMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1
  
ALMSSSOAllergen, Blue Mussel, IgE (MUSS)pionkowd@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (STT)​0.5 mL for every 5 allergens requesed​0.3 mL
4.08/16/2022 11:07 AMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1
  
ALBLUSOAllergen, Blueberry, IgE (BLUE)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) ​Red Top Tube (RTT) ​0.5 mL for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
9.05/3/2023 1:47 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​
  
ALBOXSOAllergen, Box Elder/Maple, IgE (BXMPL)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Serum Separator Tube (SST) Red Top Tube (RTT)
​0.5 mL for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
9.05/4/2023 3:13 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​
  
ALBRZSOAllergen, Brazil Nut, IgE (BRAZ)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Serum Separator Tube (SST) ​Red Top Tube (RTT) ​0.5 mL for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
8.05/4/2023 3:26 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​
  
ALBUCSOAllergen, Buckwheat, IgE (BUCW)knoxa@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3 mL
3.08/16/2022 1:25 PMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1
  
ALBDRSOAllergen, Budgerigar Droppings, IgE, Serum (BDRP)knoxa@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​SerumSerum Separator Tube (SST)
Red Top Tube (RTT)​0.5 mL for every 5 allergens requested​0.3 mL
4.05/3/2023 1:53 PMchadwica@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1
  
ALCACSOAllergen, Cacao/Cocoa, IgE (COCOA)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) Red Top Tube (RTT)
​0.5 mL for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
8.05/3/2023 3:20 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​
  
ALCFTSOAllergen, Canary Feathers, IgE, Serum (CFTH)knoxa@mfldclin.org
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3 mL
4.09/1/2022 2:54 PMpionkowd@mfldclin.org
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1
  
ALCANSOAllergen, Candida albicans, IgE (CDAB)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) Red Top Tube (RTT) 0.5 mL​ for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
8.05/3/2023 2:21 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003
  
ALCRTSOAllergen, Carrot, IgE (CROT)Janusz, Janice M
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Serum Separator Tube (SST) Red Top Tube (RTT) ​0.5 mL for every 5 allergens ordered
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
9.05/3/2023 2:24 PMchadwica@mfldclin.org
CPT Modifier
(if needed)
Quantity Description Comments
86003​
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