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Specimen Requirements

CPT Codes

Synonyms, Keywords

Created

Modified

26047

A1ALCSO

Alpha-1-Antitrypsin Proteotype S/Z by LC-MS/MS, Serum (A1ALC)

Yes

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

CPT	Quantity	Comments
82103	1
82542	1
82104	1	If needed

a-1-Antitrypsin, Proteotype
A1A Proteotyping
AAT Proteotyping
Alpha 1 Antitrypsin
Alpha-1-Antitrypsin by MS
Anti-Alpha-1-Trypsin
Antitrypsin
Antitrypsin, Proteotyping
Pi Typing (Alpha-1-Antitrypsin Proteotyping)
Protease Inhibitor Allo Typing

12/4/2017 9:03 AM

6/22/2022 9:20 AM

26079

HER2FSO

HER2 Amp, Breast Cancer, FISH, Tissue (H2BR)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
88377		1
88361		1	HER Breast IHC Automated No Reflex	if appropriate

Breast Carcinoma

c-erb-b2 Amplification Test (FISH)

TI HER2FSO

4/9/2018 10:23 AM

6/22/2022 9:42 AM

26638

SSCTUSO

S-Sulfocysteine Panel, Urine (SSCTU)

Yes

Specimen Type	Preferred Container/Tube	Acceptable Container/Tube	Specimen Volume	Specimen Minimum Volume (allows for 1 repeat)	Pediatric Minimum Volume (no repeat)
Urine	Urine Tube, 10 mL (T068)	Plastic, 10 mL urine tube	3 mL	2 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
82542		1	Column chromatography, non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen

Hypoxanthine, S-Sulfocysteine, Uric Acid, Xanthine, Hereditary xanthinuria, Isolated sulfite oxidase deficiency, Lesch-Nyhan syndrome, Molybdenum cofactor deficiency, Xanthine dehydrogenase and xanthine aldehyde oxidase dual deficiency, Xanthine dehydrogenase deficiency, Xanthine dehydrogenase/xanthine aldehyde oxidase/sulfite oxidase combined deficiency

11/13/2024 11:38 AM

11/13/2024 12:09 PM

26420

DCORTSO

11-Deoxycortisol, Serum (DCORT)

Yes

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	0.4 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
82634		1

11-Deoxycortisol, 11-Deoxycorticosteroid, Cortodoxone, INN, USAN, BAN, 11-Desoxycortisol, 17-hydroxy-11-deoxycorticosterone, Compound B, Compound S, Corticosterone, Deoxycortisol, Tetrahydro S, Cortoxelone

2/11/2022 12:02 PM

2/11/2022 12:11 PM

26027

17OHPSO

17-Hydroxypregnenolone, Serum (17OHP)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
84143		1

17-Hydroxypregnenolone

9/18/2017 10:30 AM

11/30/2023 9:27 AM

26559

17HPSO

17-Hydroxyprogesterone, Serum

Yes

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)		0.6 mL	0.25 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
83498		1

17 Alphahydroxyprogesterone; 17 Hydroxy Progesterone, Serum; Hydroxyprogesterone; Progesterone, 17-Hydryoxy

7/10/2023 2:15 PM

7/11/2023 9:24 AM

26000

FGLIOSO

1p19q Deletion in Gliomas, FISH, Tissue (GLIOF)

Yes

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

CPT	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

Oligodendroglioma

5/1/2017 9:47 AM

6/22/2022 1:40 PM

23209

21HDRSO

21-Hydroxylase Ab, S (21OH)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
83516

21 Hydroxylase Antibody, 21-OH Ab, Adrenal Antibody, Hydroxylase Antibody, Anti-Adrenal Antibody, Addison's Disease

4/3/2013 2:54 PM

6/22/2022 1:42 PM

26011

F5NULSO

5' Nucleotidase (F5NUL)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
83915		1

8/14/2017 11:57 AM

6/22/2022 1:45 PM

26096

HIAASO

5-Hydroxyindoleacetic Acid 24 Hr U (HIAA)

Yes

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.

CPT	Modifier (if needed)	Quantity	Description	Comments
83497		1

5-HIAA (5-Hydroxyindolacetic Acid)
5-OH-Indoleacetic Acid
Carcinoid Syndrome
HIAA (Hydroxyindoleacetic Acid)
Serotonin Metabolite

5-Hydroxyindoleacetic Acid 24 Hr U (HIAA)

24 HIAASO

4/24/2018 12:14 PM

2/7/2023 1:33 PM

25146

HEROIN

6-Monoacetylmorphine (Heroin Metabolite), Urine

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

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

6-MAM, 6-AM, Heroin

4/3/2013 3:04 PM

10/27/2022 4:16 PM

22153

ACETA

Acetaminophen

Fasting Required

Specimen Type

Preferred Container/Tube

Acceptable Container/Tube

Specimen Volume

Specimen Minimum Volume
(allows for 1 repeat)

Pediatric Minimum Volume
(no repeat)

Plasma/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

CPT	Modifier (if needed)	Quantity	Description	Comments
80143		1

Datril, Tylenol

4/3/2013 2:31 PM

1/16/2025 2:28 PM

25462

MISC

Acetoacetate, Serum/Plasma (0060SP)

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

CPT	Modifier (if needed)	Quantity	Description	Comments
82010

Acetoacetic Acid

11/20/2014 8:48 AM

2/25/2020 12:54 PM

22156

ACRB

Acetylcholine Receptor (Muscle AChR) Binding Antibody (ARBI)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86041

Acetylcholine Receptor (Muscle AChR) Antibodies, AChR (Acetylcholine Receptor), Anti -Neuromuscular Junction Receptor Antibodies, Myasthenia Gravis Antibodies, Acetylcholine Receptor Binding Antibody

4/3/2013 2:31 PM

12/29/2023 10:57 AM

26383

ARMASO

Acetylcholine Receptor Modulating Antibody (0099521)

Yes

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)		0.5 mL		0.3 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
86043		1

Acetylcholine Receptor Modulating Antibodies (0099521)

AChR Antibody

ACHR modulating antibody

Muscle nicotinic Acetylcholine Receptor (AChR) Modulating Antibody

Myasthenia Gravis Antibodies

2/3/2022 2:15 PM

12/29/2023 11:11 AM

23213

AFACESO

Acetylcholinesterase, Amniotic Fluid (ACHE_)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
82013

AChE-AF (Acetylcholinesterase, Amniotic Fluid), Amniotic Fluid, Acetylcholinesterase

4/3/2013 2:54 PM

6/22/2022 1:54 PM

25066

ACIDSO

Acid Phosphatase, Prostatic (PACP)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
84066

Acid Phosphatase, Prostatic Isoenzyme, ELISA, PAP, Prostatic Acid Phosphatase, Phosphatase

4/3/2013 3:03 PM

6/22/2022 1:21 PM

22164

ACTH Stimulation Test, 60 Min Cortisol

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

CPT	Modifier (if needed)	Quantity	Description	Comments
80400

Cosyntrophin Stimulation Test

Adrenocorticol (ACTH) Stimulation Test

Cortrosyn Stimulation Test, Cortisol

4/3/2013 2:31 PM

10/25/2024 1:38 PM

23278

ACTH Stim, 30 and 60 Min Cort

ACTH Stimulation, 30 and 60 Min Cortisols

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

CPT	Modifier (if needed)	Quantity	Description	Comments
80400			ACTH Stim Panel
82533			Cortisol, total

Cosyntrophin Stimulation Test

Adrenocorticol (ACTH) Stimulation Test

Cortrosyn Stimulation Test, Cortisol

4/3/2013 2:56 PM

10/25/2024 1:40 PM

26231

APCRVSO

Activated Protein C Resistance V, Plasma (APCRV)

Yes

Specimen Type	Preferred Container/Tube	Acceptable Container/Tube	Specimen Volume	Specimen 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

CPT	Modifier (if needed)	Quantity	Description	Comments
85307		1

Activated Protein CV deficient

APCRV (Activated Protein C Resistance V)

6/18/2020 2:51 PM

6/22/2022 1:29 PM

22166

ACRNSO

Acylcarnitines, Quantitative (ACRN)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
82017

2-Methylbutyryl-CoA Dehydrogenase Deficiency
3-Methylcrotonyl Carboxylase Deficiency
Biotinidase (Multiple Carboxylase) Deficiency
CPT-II (Carnitine Palmitoyl Transferase Deficiency Type II)
Electron-Transfer Flavoprotein (ETF) Deficiency
Glutaric Acidemia (GA)
Glutaric Acidemia Type I (GA I)
Glutaric Acidemia Type II (GA II)
Glutaryl-CoA Dehydrogenase (GCDH) Deficiency
Isobutyryl-CoA Dehdrogenase (IBDH) Deficiency
Isovaleric Acidemia (IVA)
Long-Chain 3-Hydroxyacyl-CoA Dehydrogenase (LCHAD) Deficiency
MADD (Multiple Acyl-CoA Dehydrogenase Deficiency)
Malonic aciduria
Medium-Chain Acyl-CoA Dehydrogenase (MCAD) Deficiency
Methylmalonic Acidemia
Methylmalonic Aciduria (MMA)
Multiple Acyl-CoA Dehydrogenase Deficiency (MADD)
S/MCHAD (Short/Medium-Chain 3-Hydroxyacyl-CoA Dehydrogenase) Deficiency
SCAD (Short-Chain Acyl-CoA Dehydrogenase) Deficiency
Short/Medium-Chain 3-Hydroxyacyl-CoA Dehydrogenase (S/MCHAD) Deficiency
Trifunctional Protein (TFP) Deficiency
Very Long-Chain Acyl-CoA Dehydrogenase (VLCAD) Deficiency
2-Methyl-3-hydroxybutyryl CoA Dehydrogenase Deficiency
3-Hydroxy-3-Methylglutaryl-CoA (HMG-CoA) Lyase Deficiency
3-Methylglutaconyl-CoA Hydratase Deficiency
Beta-ketothiolase Deficiency
Carnitine-acylcarnitine Translocase (CACT) Deficiency
Formiminoglutamic Aciduria (FIGLU)
Formiminotransferase (FIGLU) Deficiency
Holocarboxylase Synthetase Deficiency
Succinyl-CoA Ligase (SUCLA2) Deficiency
SUCLA2 (Succinyl-CoA Ligase) Deficiency
3-Methylglutaconic Aciduria Type I
3-Methylglutaconic Aciduria Type 1
Propionic Acidemia (PA)

4/3/2013 2:31 PM

6/23/2022 2:49 PM

26299

AGU20SO

Acylglycines, Quantitative, Random, Urine (AGU20)

Yes

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	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.

CPT	Modifier (if needed)	Quantity	Description	Comments
82542		1

2-Methylbutyryl Glycinuria
2-Methylbutyryl-CoA Dehydrogenase Deficiency
EE (Ethylmalonic Encephalopathy)
Ethylmalonic Encephalopathy (EE)
GA 1 (Glutaric Acidemia Type 1)
GA 2 (Glutaric Acidemia Type 2)
GA II (Glutaric Acidemia Type II)
GAII (Glutaric Acidemia Type 2)
GCDH (Glutaryl-CoA Dehydrogenase) Deficiency
Glutaric Acidemia (GA)
Glutaric Acidemia Type 2
Glutaric Acidemia Type I (GA I)
Glutaric Acidemia Type II (GA II)
Glutaryl-CoA Dehydrogenase (GCDH) Deficiency
Isovaleric Acidemia (IVA)
Isovaleryl-CoA Dehydrogenase (IVD)
IVA (Isovaleric Acidemia)
MADD
MCAD (Medium-Chain Acyl-CoA Dehydrogenase) Deficiency
MCKAT (Medium-Chain 3-Ketoacyl-CoA Thiolase) Deficiency
Medium-Chain 3-Ketoacyl-CoA Thiolase (MCKAT) Deficiency
Medium-Chain Acyl-CoA Dehydrogenase (MCAD) Deficiency
SBCAD (Short/Branched-Chain Acyl-CoA Dehydrogenase) Deficiency
SCAD (Short-Chain Acyl-CoA Dehydrogenase) Deficiency
Short-Chain Acyl-CoA Dehydrogenase (SCAD) Deficiency
Short/Branched-Chain Acyl-CoA Dehydrogenase (SBCAD) Deficiency
n-Acetylglycine
n-Propionylglycine
Isobutyrylglycine
Ethylmalonic acid
n-Butyrylglycine
2-Methylsuccinic acid
2-Methylbutyrylglycine
Isovalerylglycine
Glutaric acid
3-Methylcrotonylglycine
n-Tiglylglycine
3-Methylglutaconic acid
n-Hexanoylglycine
n-Octanoylglycine
3-Phenylpropionylglycine
trans-Cinnamoylglycine
Suberylglycine
Dodecanedioic acid
Tetradecanedioic acid
Hexadecanedioic acid

Acylglycines, Qnt, Ur (AGU20)

2/11/2021 12:01 PM

5/16/2024 8:22 AM

26217

ADALXSO

Adalimumab Quantitative with Reflex to Antibody, Serum (ADALX)

Yes

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	0.35 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
80145		1
83520		1		if needed

Humira

6/10/2020 11:39 AM

6/23/2022 3:08 PM

24877

ADAMTSO

ADAMTS13 Evaluation (1295)

Specimen Type	Preferred Container/Tube	Acceptable Container/Tube	Specimen Volume	Specimen Minimum Volume (allows for 1 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

CPT	Quantity	Description
85397	1	ADAMTS13 Activity
85335	1	ADAMTS13 Inhibitor (if performed)
83520	1	ADAMTS13 Antibody (if performed)

ADAMTS13 Activity, ADAMTS13, ADAMTS13 Inhibitor, VWF Cleaving Protease

5/10/2013 9:25 AM

4/22/2021 1:29 PM

25008

ADAMT13

ADAMTS13 Evaluation, Rapid

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

CPT	Modifier (if needed)	Quantity	Description	Comments
85397

ADAMTS Activity

4/3/2013 3:02 PM

3/21/2016 4:37 PM

26283

FADPFSO

Adenosine Deaminase, Pleural Fluid (FADPF)

Yes

Specimen Type	Preferred Container/Tube	Acceptable Container/Tube	Specimen Volume	Specimen Minimum Volume (allows for 1 repeat)	Pediatric Minimum Volume (no repeat)
Pleural Fluid	Leak Proof Container		0.5 mL	0.2 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
84311		1

ADA Pleural

11/16/2020 3:27 PM

6/24/2022 9:57 AM

26533

LADVSO

Adenovirus, Molecular Detection, PCR, Varies (LADV)

Yes

Specimen Type	Preferred Container/Tube	Specimen Volume	Specimen Minimum Volume (allows for 1 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

CPT	Modifier (if needed)	Quantity	Description	Comments
87798

ADV (Adenovirus)

4/6/2023 11:37 AM

11/16/2023 10:59 AM

22168

ACTH-P

Adrenocorticotropic Hormone (ACTH)

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

CPT	Modifier (if needed)	Quantity	Description	Comments
82024

ACTH, Corticotropin

4/3/2013 2:31 PM

10/25/2024 1:48 PM

22169

ALT

Alanine Amino Transferase

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

CPT	Modifier (if needed)	Quantity	Description	Comments
84460

SGPT, Alanine Amino Transaminase

4/3/2013 2:31 PM

1/16/2025 2:42 PM

22171

ALB

Albumin

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

CPT	Modifier (if needed)	Quantity	Description	Comments
82040

4/3/2013 2:31 PM

1/16/2025 2:48 PM

22170

ALB-O

Albumin, Body Fluid

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

CPT	Modifier (if needed)	Quantity	Description	Comments
82042

Body Fluid Albumin, ALB-O

4/3/2013 2:31 PM

1/16/2025 2:39 PM

22173

ALC

Alcohol, Blood

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

CPT	Modifier (if needed)	Quantity	Description	Comments
82077		1

Ethanol, Ethyl Alcohol, ETOH

4/3/2013 2:31 PM

1/16/2025 2:53 PM

26548

ALSSO

Aldolase, Serum (ALS)

Yes

Specimen Type	Preferred Container/Tube	Acceptable Container/Tube	Specimen Volume	Specimen Minimum Volume (allows for 1 repeat)
Serum	Red Top Tube (RTT)		1 mL	0.5 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
82085		1

Aldolase, S; Fructose-Biphosphate Aldolase

5/24/2023 9:04 AM

5/24/2023 9:38 AM

22178

ALDOSO

Aldosterone, 24 Hour, Urine (ALDU)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
82088

Aldosterone w/Sodium, U
Aldosterone with Sodium, Urine
Aldosterone 24 Hour Urine (ALDU)
24 ALDOSO

4/3/2013 2:31 PM

11/12/2024 3:10 PM

22177

ALDSSO

Aldosterone, Serum (ALDS)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
82088

4/3/2013 2:31 PM

6/30/2022 10:38 AM

26152

ALDSSOTEST

Aldosterone, Serum (ALDS) Test

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

CPT	Modifier (if needed)	Quantity	Description	Comments
82088

6/13/2019 1:34 PM

1/20/2021 9:50 AM

24914

ALKRESO

ALK (2p23) Rearrangement, FISH, Tissue (LCAF)

Yes

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

CPT	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

Lung carcinoma, Non-small cell lung cancer (NSCLC)

4/11/2013 9:58 AM

6/22/2022 1:50 PM

22183

ALKP

Alkaline Phosphatase, Total

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

CPT	Modifier (if needed)	Quantity	Description	Comments
84075

Alk P'tase, Phosphatase, Alkaline, ALKP

4/3/2013 2:31 PM

1/16/2025 2:57 PM

26646

ALKPSO

Alkaline Phosphatase, Total and Isoenzymes, Serum (ALKP)

Yes

Fasting Required	Specimen Type	Preferred Container/Tube	Acceptable Container/Tube	Specimen Volume	Specimen Minimum Volume (allows for 1 repeat)	Pediatric Minimum Volume (no repeat)
8 hours	Serum	Serum Separator Tube (SST)	Red Top Tube (RTT)	1 mL	1 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
84075		1
84080		1

Alkaline Phosphatase, Tot and Iso,S

1/30/2025 11:44 AM

2/3/2025 8:04 AM

26090

ALANSSO

Allergen IgE, Anise (ANSE)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Aniseed, Pimpinella anisum, Sweet Alice, Sweet Cumin

4/24/2018 7:47 AM

7/11/2022 3:11 PM

26070

ALASCSO

Allergen IgE, Ascaris (ASCRI)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Ascaris lumbricoides, Common Roundworm

3/21/2018 11:45 AM

5/8/2023 3:16 PM

26092

ALBROSO

Allergen IgE, Broccoli (BROC)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Brassica oleracea var. italica
Calabrese
Purple Cauliflower
Romanesco
Spear Cauliflower
Winter Cauliflower

4/24/2018 8:03 AM

7/11/2022 3:29 PM

26071

ALBFTSO

Allergen IgE, Budgerigar Feathers (BFTH)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Budgeri Feathers
Budgie feathers
Parakeet Feathers

3/21/2018 11:52 AM

5/3/2023 2:15 PM

26073

ALCOWSO

Allergen IgE, Cow Epithelium (COW)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Bos Taurus
Bull Epithelium
Cattle Epithelium
Cow Dander
Ox Epithelium
Steer Epithelium
Cow

3/21/2018 12:08 PM

5/3/2023 3:31 PM

26093

ALFEESO

Allergen IgE, Ferret Epithelium (FEEP)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Epithelium, ferret
Mustela putorius
Polecat

4/24/2018 8:09 AM

5/9/2023 9:12 AM

26377

FDP1SO

Allergen IgE, Food Panel #2, Serum (FDP1)

Yes

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	0.3 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Cabbage, Paprika, Spinach, Tomato

2/2/2022 1:39 PM

2/2/2022 1:50 PM

26074

ALGSTSO

Allergen IgE, Green String Bean (GSTB)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Bean
Common Bean
French Bean
Green Bean
Haricot Bean
Phaseolus vulgaris
Snap Bean
Wax Bean

3/21/2018 12:14 PM

5/4/2023 2:23 PM

26075

ALGUISO

Allergen IgE, Guinea Pig Epithelium (GUIN)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Cavin porcellus
Cavy

3/21/2018 12:20 PM

5/4/2023 2:27 PM

26076

ALHORSO

Allergen IgE, Horse Dander (HORS)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Equus caballus
Horse Epithelium
Horse Hair
Horse

3/21/2018 12:26 PM

5/4/2023 2:38 PM

26094

ALLETSO

Allergen IgE, Lettuce (LETT)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Lactuca Sativa

4/24/2018 8:19 AM

7/12/2022 11:10 AM

26405

PCANHSO

Allergen IgE, Pecan Hickory, IgE, Serum (PCANH)

Yes

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	0.3 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Carya pecan, Pecan tree, Hickory tree

2/8/2022 10:55 AM

2/8/2022 11:03 AM

26048

ALPNASO

Allergen IgE, Pineapple (PNAP)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Ananas Comosus

12/18/2017 9:01 AM

5/5/2023 10:53 AM

26409

SQUASO

Allergen IgE, Squash, Serum (SQUA)

Yes

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	0.3 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Cheese Pumpkin, Cucumis pepo, Cucurbita maxima, Cucurbita pepo, Curcurbita mixta, Field Pumpkin, Naked-Seeded Pumpkin, Pimpkin, Pumpkin

2/9/2022 11:27 AM

2/9/2022 11:41 AM

26373

WHEYSO

Allergen IgE, Whey, Serum (WHEY)

Yes

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 for every 5 allergens requested	0.3 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Cow's Whey

2/2/2022 12:55 PM

2/2/2022 1:06 PM

26091

ALBENSO

Allergen IgE, White Bean (BENW)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Bean
Cannellini Bean
Great Northern Bean
Haricot Bean
Marrow Bean
Phaseolus vulgaris
Pinto Bean
White Kidney Bean

4/24/2018 7:55 AM

7/13/2022 11:41 AM

26375

WILLSO

Allergen IgE, Willow, Serum (WILL)

Yes

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	0.3 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Black Willow

Goat Willow

Great Sallow

Pussy Willow

Salix Caprea

2/2/2022 1:09 PM

2/2/2022 1:18 PM

24801

ALJOHSO

Allergen Johnson Grass, IgE (JOHN)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

Holcus halepensis, Sorghum controversum, Sorghum halepense, Sorghum miliaceaum

4/3/2013 2:58 PM

7/13/2022 11:49 AM

23300

ALFODSO

Allergen Panel, Food (FOOD6)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

Codfish, Cow, Egg White, IgE-Antibodies Multi-Allergen, Milk, Peanut, Soybean, Wheat

4/3/2013 2:56 PM

5/8/2023 12:44 PM

26287

APGALSO

Allergen Panel, Galactose-Alpha-1, 3-Galactose (Alpha-Gal) Mammalian Meat Allergy Profile, Serum (APGAL)

Yes

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)	1.5 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		4
86008		1

Galactose IgE
Galactose-alpha-1,3
Alpha-Gal

12/3/2020 11:55 AM

10/31/2023 11:52 AM

23270

ALHDUSO

Allergen Panel, House Dust (HD1)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

IgE Antibodies, Multi-Allergen
Includes: Cockroach, Dermatophagoides farinae, Dermatophagoides pteronyssinus, Hollister-Stier

4/3/2013 2:55 PM

5/4/2023 2:40 PM

24930

ALMOLD

Allergen Panel, Mold (MOLD1)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

IgE Antibodies, Multi-Allergen

Includes: Alternaria tenuis, Aspergillus fumingatus, Candida albicans, Cladosporium herbarum, Helminthosporium halodes, Penicillium notatum

4/3/2013 3:00 PM

5/4/2023 3:17 PM

24981

ALNT1SO

Allergen Panel, Nut #1 (FOOD8)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

Almond, Brazilnut, Coconut, Hazelnut, IgE Antibodies, Multi-Allergen, Peanut

4/3/2013 3:01 PM

5/4/2023 11:40 AM

24797

ALPED1

Allergen Panel, Ped <3 Years (PAS3)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		5	Allergen specific IgE

Allergen-Multiple, Allergen-Specific IgE (Immunoglobulin E) Antibody Screen
Includes: Egg White, Milk, Wheat, Soybean, House Dust Mites/D.F

4/3/2013 2:58 PM

5/8/2023 3:00 PM

24799

ALPED3

Allergen Panel, Ped >8 Years (PAS8)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		5	Allergen specific IgE

Allergen-Multiple, Allergen-Specific IgE (Immunoglobulin E) Antibody Screen
Includes: House Dust Mites/D.F., Short Ragweed, Timothy Grass, Cat Epithelium, Alternaria Tenuis

4/3/2013 2:58 PM

5/8/2023 3:06 PM

24798

ALPED2

Allergen Panel, Ped 3-8 Years (PAS38)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		6	Allergen specific IgE

Allergen-Multiple, Allergen-Specific IgE (Immunoglobulin E) Antibody Screen
Includes: Egg White, House Dust Mites/D.F., Timothy Grass, Short Ragweed, Cat Epithelium, Alternaria Tenuis

4/3/2013 2:58 PM

5/8/2023 3:04 PM

26039

ALRP8SO

Allergen Panel, Respiratory Midwest (RPR8)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
82785		1	IgE
86003		25	Each indivual allergen

	Immunoglobulin E (IgE), S
	House Dust Mites/D.P., IgE
	House Dust Mites/D.F., IgE
	Cat Epithelium, IgE
	Dog Dander, IgE
	Bermuda Grass, IgE
	Timothy Grass, IgE
	Cockroach, IgE
	Penicillium, IgE
	Cladosporium, IgE
	Aspergillus Fumigatus, IgE
	Alternaria Tenuis, IgE
	Box Eld/Maple, S, IgE
	Mountain Cedar, IgE
	Oak, IgE
	Elm, IgE
	Walnut Tree, IgE
	Eastern Sycamore, IgE
	Cottonwood, IgE
	White Ash, IgE
	Pecan Hickory, IgE
	Mulberry, IgE
	Short Ragweed, IgE
	Russian Thistle, IgE
	Rough Pigweed, IgE
	Rough Marsh Elder, IgE

11/1/2017 11:51 AM

5/8/2023 1:01 PM

23246

MRAST

Allergen Panel, Stinging Insects-5 Allergens (INSEC)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		5

Honeybee Venom, Wasp Venom, White Faced Hornet Venom, Yellow Faced Hornet Venom, Yellow Jacket Venom

4/3/2013 2:55 PM

7/19/2022 11:44 AM

23254

ALTRESO

Allergen Panel, Tree #1 (TREE1)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

IgE Antibodies, Multi-Allergen
Includes: Birch, Box Elder/Maple, Elm, Oak, Walnut

4/3/2013 2:55 PM

5/8/2023 10:57 AM

24772

ALPSISO

Allergen Pistachio, IgE (PISTA)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

Pistacia Vera

8/14/2013 11:20 AM

5/5/2023 10:27 AM

26251

ALALFSO

Allergen, Alfalfa (Medicago sativa) IgE (FALPE)

Yes

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	0.5 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Medicago sativa grass FORWARD

7/1/2020 4:38 PM

7/19/2022 1:09 PM

23256

ALAMSO

Allergen, Almond, IgE (ALM)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

A. dulcis, Amygdalus communis, Bitter Almond, P. dulcis, Prunus amygdalus, Sweet Almond

4/3/2013 2:55 PM

7/19/2022 1:16 PM

26178

ALAMYSO

Allergen, Alpha-Amylase, IgE (AAMY)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86008		1

Aspergillus oryzae; Occupational, Alpha-amylase

1/9/2020 3:08 PM

7/19/2022 1:22 PM

26176

ALALBSO

Allergen, Alpha-Lactalbumin, IgE (ALFA)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86008		1

Lactalbumin, Alpha; Milk component

1/9/2020 2:45 PM

7/19/2022 3:14 PM

23261

ALTERSO

Allergen, Alternaria tenuis, IgE (ALTN)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

Alternaria alternata

4/3/2013 2:55 PM

7/19/2022 3:24 PM

26221

ALAMXSO

Allergen, Amoxicillin, IgE (AMOXY)

Yes

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	0.3 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Amoxicillin, IgE

Amoxicilloyl

6/10/2020 12:54 PM

7/20/2022 11:45 AM

25678

ALANCSO

Allergen, Anchovy, IgE (ANCH)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1	Anchovy, IgE

Anchovis, Ansiovis, Engraulis encrasicolus, Fish, anchovy

7/7/2017 3:38 PM

5/8/2023 3:09 PM

24934

ALAPPSO

Allergen, Apple, IgE (APPL)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

Malus sylvestris, Malus x domestica

4/3/2013 3:00 PM

5/3/2023 1:28 PM

23258

ALFUMSO

Allergen, Aspergillus fumigatus, IgE (ASP)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

Aspergillus Antibody

4/3/2013 2:55 PM

5/3/2023 1:33 PM

25674

ALAVOSO

Allergen, Avocado, IgE (AVOC)

Yes

Fasting Required

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.

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Persea americana

Varieties: Guatemalan: Persea nubigena var guatamalensis L.Wms Mexican: P. Americana var. drymifolia Blake West Indian: P. Americana Mill var. Americana(P. gratissima Gaertn)

7/7/2017 1:57 PM

5/8/2023 3:19 PM

24826

ALBAKSO

Allergen, Bakers Yeast, IgE (BYST)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

Saccharomyces cerevisiae, Yeast, Baker's, Yeast, Brewers

4/3/2013 2:59 PM

7/21/2022 11:20 AM

26227

ALBMBSO

Allergen, Bamboo Shoot, IgE, Serum (BAMB)

Yes

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	0.5 mL for every 5 allergens requested	0.3 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Hachiku
Madaka
Moso
Phyllostachys pubescens
Pubescent Bamboo

6/10/2020 3:00 PM

7/21/2022 11:27 AM

24980

ALBANSO

Allergen, Banana, IgE (BANA)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

Musa spp, Plantain

4/3/2013 3:01 PM

5/3/2023 1:35 PM

26219

ALBRLSO

Allergen, Barley, IgE, Serum (BRLY)

Yes

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	0.3

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Barleycorn

Hordeum vulgare

6/10/2020 12:22 PM

7/21/2022 11:51 AM

23379

ALBASSO

Allergen, Bass, Black, IgE (43310S)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

Sea Bass, Centropristis striata

4/3/2013 2:56 PM

5/10/2024 2:37 PM

25010

ALBEFSO

Allergen, Beef, IgE (BEEF)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

Bos spp

4/3/2013 3:02 PM

5/3/2023 1:39 PM

24802

ALBERSO

Allergen, Bermuda Grass, IgE (BERG)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Bahama Grass, Cynodon dactylon, Devil Grass, Panicum dactylon, Scutch Grass, Star Grass, Wire Grass

4/3/2013 2:58 PM

5/3/2023 1:45 PM

26180

ALBLCSO

Allergen, Beta-Lactoglobulin, IgE (BLAC)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86008		1

Milk Component

1/9/2020 3:27 PM

8/16/2022 10:28 AM

23401

ALBBSO

Allergen, Black Bean, IgE (34410E)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

Phaseolus spp

4/3/2013 2:57 PM

5/10/2024 2:28 PM

26220

ALBLPSO

Allergen, Black/White Pepper, IgE, Serum (BLPEP)

Yes

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	0.3 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Black Pepper

Pepper

Piper nigrum

White Pepper

6/10/2020 12:40 PM

8/16/2022 10:41 AM

26233

ALMSSSO

Allergen, Blue Mussel, IgE (MUSS)

Yes

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 (STT)	0.5 mL for every 5 allergens requesed	0.3 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Mytilus edulis

6/18/2020 3:15 PM

8/16/2022 11:07 AM

24935

ALBLUSO

Allergen, Blueberry, IgE (BLUE)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

Blueberry fruit, Fruit blueberry, Highbush Blueberry, Lowbush Blueberry, Vaccinium myrtillis

4/3/2013 3:00 PM

5/3/2023 1:47 PM

23255

ALBOXSO

Allergen, Box Elder/Maple, IgE (BXMPL)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

Acer-negundo, Ash Maple, Ashleaf Maple, Black Ash, Box Elder Tree, California Boxelder, Cut-leaved Maple, Cutleaf Maple, Manitoba Maple, Maple Ash, Maple Tree, Maple/Box elder Tree, Negundo Maple, Red River Maple, Stinking Ash, Sugar Ash, Three-leaved maple, Western Box Elder

4/3/2013 2:55 PM

5/4/2023 3:13 PM

23281

ALBRZSO

Allergen, Brazil Nut, IgE (BRAZ)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

Bertholletia excelsa, Cream Nut, Para-nut

4/3/2013 2:56 PM

5/4/2023 3:26 PM

26249

ALBUCSO

Allergen, Buckwheat, IgE (BUCW)

Yes

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	0.3 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Beech Wheat
Canadian Buckwheat
Fagopyrum
Fagopyrum esculentum
French Wheat

7/1/2020 4:18 PM

8/16/2022 1:25 PM

26230

ALBDRSO

Allergen, Budgerigar Droppings, IgE, Serum (BDRP)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Budgie Droppings
Melopsittacus undulatus droppings
Parakeet droppings

6/17/2020 10:00 AM

5/3/2023 1:53 PM

25012

ALCACSO

Allergen, Cacao/Cocoa, IgE (COCOA)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

Chocolate/Cacao (Theobroma cacao) (Note: Chocolate contains several components but only the Cocoa/Cacao component is evaluated)

4/3/2013 3:02 PM

5/3/2023 3:20 PM

26248

ALCFTSO

Allergen, Canary Feathers, IgE, Serum (CFTH)

Yes

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	0.3 mL

CPT	Modifier (if needed)	Quantity	Description	Comments
86003		1

Serinus canarius

7/1/2020 4:06 PM

9/1/2022 2:54 PM

24959

ALCANSO

Allergen, Candida albicans, IgE (CDAB)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

Monilia/Candida Albicans

4/3/2013 3:01 PM

5/3/2023 2:21 PM

24936

ALCRTSO

Allergen, Carrot, IgE (CROT)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86003

Daucus carota

4/3/2013 3:00 PM

5/3/2023 2:24 PM

25106

ALCSNSO

Allergen, Casein, IgE (CASE)

Yes

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

CPT	Modifier (if needed)	Quantity	Description	Comments
86008

4/3/2013 3:03 PM

5/3/2023 2:27 PM

1 - 100

View in Web Browser

/sites/ltrm/Human/_layouts/15/VisioWebAccess/VisioWebAccess.aspx?listguid={ListId}&itemid={ItemId}&DefaultItemOpen=1

0x0

0x1

FileType

vdw

255

View in Web Browser

/sites/ltrm/Human/_layouts/15/VisioWebAccess/VisioWebAccess.aspx?listguid={ListId}&itemid={ItemId}&DefaultItemOpen=1

0x0

0x1

FileType

vsdx

255

View in Web Browser

/sites/ltrm/Human/_layouts/15/VisioWebAccess/VisioWebAccess.aspx?listguid={ListId}&itemid={ItemId}&DefaultItemOpen=1

0x0

0x1

FileType

vsdm

255

Compliance Details

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0x0

0x1

ContentType

0x01

898

Edit in Browser

/_layouts/15/images/icxddoc.gif?rev=40

/sites/ltrm/Human/_layouts/15/formserver.aspx?XsnLocation={ItemUrl}&OpenIn=Browser&Source={Source}

0x0

0x1

FileType

xsn

255

Edit in Browser

/_layouts/15/images/icxddoc.gif?rev=40

/sites/ltrm/Human/_layouts/15/formserver.aspx?XmlLocation={ItemUrl}&OpenIn=Browser&Source={Source}

0x0

0x1

ProgId

InfoPath.Document

255

Edit in Browser

/_layouts/15/images/icxddoc.gif?rev=40

/sites/ltrm/Human/_layouts/15/formserver.aspx?XmlLocation={ItemUrl}&OpenIn=Browser&Source={Source}

0x0

0x1

ProgId

InfoPath.Document.2

255

Edit in Browser

/_layouts/15/images/icxddoc.gif?rev=40

/sites/ltrm/Human/_layouts/15/formserver.aspx?XmlLocation={ItemUrl}&OpenIn=Browser&Source={Source}

0x0

0x1

ProgId

InfoPath.Document.3

255

Edit in Browser

/_layouts/15/images/icxddoc.gif?rev=40

/sites/ltrm/Human/_layouts/15/formserver.aspx?XmlLocation={ItemUrl}&OpenIn=Browser&Source={Source}

0x0

0x1

ProgId

InfoPath.Document.4

255

View in Browser

javascript:(function(){var a=document.createElement('a');a.href=SPClientTemplates.Utility.ReplaceUrlTokens('~site/_layouts/15/xlviewer.aspx?id={ItemUrl}&DefaultItemOpen=1');GoToLinkOrDialogNewWindow(a)})()

0x0

0x1

FileType

xlsx

255

View in Browser

0x0

0x1

FileType

xlsm

255

View in Browser

0x0

0x1

FileType

xlsb

255

View in Browser

0x0

0x1

FileType

ods

255

Document Set Version History

/_layouts/15/images/versions.gif?rev=40

javascript:SP.UI.ModalDialog.ShowPopupDialog('{SiteUrl}'+ '/_layouts/15/DocSetVersions.aspx' + '?List={ListId}&ID={ItemId}')

0x0

ContentType

0x0120D520

330

Send To other location

/_layouts/15/images/sendOtherLoc.gif?rev=40

javascript:GoToPage('{SiteUrl}' + '/_layouts/15/docsetsend.aspx' + '?List={ListId}&ID={ItemId}')

0x0

ContentType

0x0120D520

350

Pages This system library was created by the Publishing feature to store pages that are created in this site. // <![CDATA[ _spBodyOnLoadFunctionNames.push("setupPageDescriptionCallout"); // ]]>

Pages

This system library was created by the Publishing feature to store pages that are created in this site.