| | A1ALCSO | Alpha-1-Antitrypsin Proteotype S/Z by LC-MS/MS, Serum (A1ALC) | wroblewj@mfldclin.org | | Yes | No | | | | 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 |
|
---|
| 4.0 | 6/22/2022 9:20 AM | pionkowd@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 | | Yes | No | | | | 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 |
|
---|
| 8.0 | 6/22/2022 9:42 AM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
88377 |
|
1 |
|
|
88361 |
|
1 |
HER Breast IHC Automated No Reflex |
if appropriate |
|
| | DCORTSO | 11-Deoxycortisol, Serum (DCORT) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | |
| 1.0 | 2/11/2022 12:11 PM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
82634 | | 1 | | |
---|
|
| | 17OHPSO | 17-Hydroxypregnenolone, Serum (17OHP) | wroblewj@mfldclin.org | | Yes | No | | | | 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 |
|
---|
| 7.0 | 7/10/2023 2:12 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
84143 |
|
1 |
|
|
---|
|
| | 17HPSO | 17-Hydroxyprogesterone, Serum | chadwica@mfldclin.org | | Yes | No | | | | 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
| |
| 5.0 | 7/11/2023 9:24 AM | chadwica@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments
|
---|
83498
| | 1
| | |
---|
|
| | FGLIOSO | 1p19q Deletion in Gliomas, FISH, Tissue (GLIOF) | wroblewj@mfldclin.org | | Yes | No | | | | 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 | | |
---|
| 7.0 | 6/22/2022 1:40 PM | pionkowd@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 |
---|
|
| | 21HDRSO | 21-Hydroxylase Ab, S (21OH) | Potter, Joli K | | Yes | No | | | | 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 |
|
| 15.0 | 6/22/2022 1:42 PM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
83516 |
|
|
|
|
---|
|
| | F5NULSO | 5' Nucleotidase (F5NUL) | wroblewj@mfldclin.org | | Yes | No | | | | 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 |
|
---|
| 6.0 | 6/22/2022 1:45 PM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
83915 |
|
1 |
|
|
---|
|
| | HIAASO | 5-Hydroxyindoleacetic Acid 24 Hr U (HIAA) | wroblewj@mfldclin.org | | Yes | No | | | | 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. |
---|
| 8.0 | 2/7/2023 1:33 PM | careygej@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
83497 |
|
1 |
|
|
---|
|
| | HEROIN | 6-Monoacetylmorphine (Heroin Metabolite), Urine | Schalow, Dianne M | | No | No | | | | 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 |
---|
| 20.0 | 10/27/2022 4:16 PM | careygej@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 |
---|
|
| | ACETA | Acetaminophen | Potter, Joli K | | No | No | | | | 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) Red Top Tube (RTT) Lithium or Sodium-heparin Green Top Tube (GTT) EDTA Lavender Top Tube (LTT) | 0.5 mL | 0.3 mL | |
---|
| 26.0 | 1/5/2021 2:44 PM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
80143 |
|
1 |
|
|
---|
|
| | MISC | Acetoacetate, Serum/Plasma (0060SP) | busedj@mfldclin.org | | No | No | | | | 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 |
| 3.0 | 2/25/2020 12:54 PM | drexlerk@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82010 |
|
|
|
|
---|
|
| | ACRB | Acetylcholine Receptor (Muscle AChR) Binding Antibody (ARBI) | Potter, Joli K | | No | No | | | | 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 |
|
---|
| 22.0 | 9/6/2023 2:22 PM | drexlerk@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
83519 |
|
|
|
|
---|
|
| | ARMASO | Acetylcholine Receptor Modulating Antibody (0099521) | careygej@mfldclin.org | | Yes | No | | | | 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 |
---|
| 8.0 | 11/2/2022 9:40 AM | drexlerk@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
83516 | | 1 | Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative of semiquantitative, multiple step method. | |
---|
|
| | AFACESO | Acetylcholinesterase, Amniotic Fluid (ACHE_) | Potter, Joli K | | Yes | No | | | | 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 |
|
| 11.0 | 6/22/2022 1:54 PM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82013 |
|
|
|
|
---|
|
| | ACIDSO | Acid Phosphatase, Prostatic (PACP) | Wroblewski, Jennifer | | Yes | No | | | | 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 |
|
| 9.0 | 6/22/2022 1:21 PM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
84066 |
|
|
|
|
---|
|
| | ACTH Stimulation Test, 60 Min Cortisol | ACTH Stimulation Test, 60 Min Cortisol | Hebert, Lori M | | No | No | | | |
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 |
---|
| 16.0 | 11/10/2023 12:13 PM | drexlerk@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
80400 |
|
|
|
|
---|
|
| | ACTH Stim, 30 and 60 Min Cort | ACTH Stimulation, 30 and 60 Min Cortisols | Hebert, Lori M | | No | No | | | |
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 |
---|
| 15.0 | 11/10/2023 12:15 PM | drexlerk@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
80400 |
|
|
ACTH Stim Panel |
|
82533 |
|
|
Cortisol, total |
|
---|
|
| | APCRVSO | Activated Protein C Resistance V, Plasma (APCRV) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | |
| 5.0 | 6/22/2022 1:29 PM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
85307 | | 1 | | |
---|
|
| | ACRNSO | Acylcarnitines, Quantitative (ACRN) | Potter, Joli K | | Yes | No | | | | 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 |
|
| 15.0 | 6/23/2022 2:49 PM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82017 |
|
|
|
|
---|
|
| | AGU20SO | Acylglycines, Quantitative, Random, Urine (AGU20) | pionkowd@mfldclin.org | | Yes | No | | | | 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. |
| 4.0 | 6/23/2022 2:56 PM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
82542 | | 1 | | |
---|
|
| | ADALXSO | Adalimumab Quantitative with Reflex to Antibody, Serum (ADALX) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | |
| 5.0 | 6/23/2022 3:08 PM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
80145 | | 1 | | |
---|
83520 | | 1 | | if needed |
---|
|
| | ADAMTSO | ADAMTS13 Evaluation (1295) | januszj@mfldclin.org | | No | No | | | | 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 | |
| 13.0 | 4/22/2021 1:29 PM | drexlerk@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) |
|
---|
|
| | ADAMT13 | ADAMTS13 Evaluation, Rapid | Barnes, Alyssa | | No | No | | | | 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 |
| 11.0 | 3/21/2016 4:37 PM | busedj@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
85397 |
|
|
|
|
---|
|
| | FADPFSO | Adenosine Deaminase, Pleural Fluid (FADPF) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | |
| 5.0 | 6/24/2022 9:57 AM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
84311 | | 1 | | |
---|
|
| | LADVSO | Adenovirus, Molecular Detection, PCR, Varies (LADV) | drexlerk@mfldclin.org | | Yes | No | | | | Specimen Type | Preferred Container/Tube | Acceptable Container/Tube | Specimen Volume | Specimen 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
| |
| 2.0 | 11/16/2023 10:59 AM | chadwica@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments
|
---|
87798
|
|
|
| |
---|
|
| | ACTH-P | Adrenocorticotropic Hormone (ACTH) | Schalow, Dianne M | | No | No | | | | 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 |
---|
| 12.0 | 11/22/2022 1:00 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82024 |
|
|
|
|
---|
|
| | ALT | Alanine Amino Transferase | Potter, Joli K | | No | No | | | | 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 |
---|
| 18.0 | 5/23/2023 9:45 AM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
84460 |
|
|
|
|
---|
|
| | ALB | Albumin | Potter, Joli K | | No | No | | | | 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 |
---|
| 17.0 | 5/23/2023 9:46 AM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82040 |
|
|
|
|
---|
|
| | ALB-O | Albumin, Body Fluid | Potter, Joli K | | No | No | | | | 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 |
|
---|
| 12.0 | 2/20/2020 1:34 PM | potterj@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82042 |
|
|
|
|
---|
|
| | ALC | Alcohol, Blood | Potter, Joli K | | No | No | | | | 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 |
|
---|
| 20.0 | 1/4/2021 2:54 PM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82077 |
|
1 |
|
|
---|
|
| | ALSSO | Aldolase, Serum (ALS) | chadwica@mfldclin.org | | Yes | No | | | | 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
|
| 6.0 | 5/24/2023 9:38 AM | chadwica@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments
|
---|
82085
| | 1
| | |
---|
|
| | ALDOUSO | Aldosterone, 24 Hour, Urine (ALDU) | Potter, Joli K | | Yes | No | | | | 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 |
|
| 17.0 | 6/24/2022 10:16 AM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82088 |
|
|
|
|
---|
|
| | ALDSSO | Aldosterone, Serum (ALDS) | Schalow, Dianne M | | Yes | No | | | | 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 |
|
---|
| 16.0 | 6/30/2022 10:38 AM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82088 |
|
|
|
|
---|
|
| | ALDSSOTEST | Aldosterone, Serum (ALDS) Test | potterj@mfldclin.org | | No | No | | | | 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 |
|
---|
| 2.0 | 1/20/2021 9:50 AM | drexlerk@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82088 |
|
|
|
|
---|
|
| | ALKRESO | ALK (2p23) Rearrangement, FISH, Tissue (LCAF) | potterj@mfldclin.org | | Yes | No | | | | 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 |
|
| 22.0 | 6/22/2022 1:50 PM | pionkowd@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 |
---|
|
| | ALKP | Alkaline Phosphatase, Total | Potter, Joli K | | No | No | | | | 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 |
---|
| 19.0 | 5/23/2023 9:47 AM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
84075 |
|
|
|
|
---|
|
| | ALKISO | Alkaline Phosphatase, Total and Isoenzymes, Serum (ALKI) | wroblewj@mfldclin.org | | Yes | No | | | | 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) |
|
---|
| 5.0 | 6/30/2022 11:46 AM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
84080 |
|
1 |
Isoenzymes |
|
84075 |
|
1 |
Alkaline Phosphatase |
|
---|
|
| | ALANSSO | Allergen IgE, Anise (ANSE) | wroblewj@mfldclin.org | | Yes | No | | | | 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 |
|
---|
| 4.0 | 7/11/2022 3:11 PM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
|
| | ALASCSO | Allergen IgE, Ascaris (ASCRI) | wroblewj@mfldclin.org | | Yes | No | | | | 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
|
|
---|
| 4.0 | 5/8/2023 3:16 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
|
| | ALBROSO | Allergen IgE, Broccoli (BROC) | wroblewj@mfldclin.org | | Yes | No | | | | 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 |
|
---|
| 3.0 | 7/11/2022 3:29 PM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
|
| | ALBFTSO | Allergen IgE, Budgerigar Feathers (BFTH) | wroblewj@mfldclin.org | | Yes | No | | | | 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 |
|
|
---|
| 5.0 | 5/3/2023 2:15 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
|
| | ALCHLSO | Allergen IgE, Chili Pepper (CHILI) | wroblewj@mfldclin.org | | Yes | No | | | | 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 |
|
---|
| 3.0 | 7/11/2022 3:49 PM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
|
| | ALCOWSO | Allergen IgE, Cow Epithelium (COW) | wroblewj@mfldclin.org | | Yes | No | | | | 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 |
|
|
---|
| 4.0 | 5/3/2023 3:31 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
|
| | ALFEESO | Allergen IgE, Ferret Epithelium (FEEP) | wroblewj@mfldclin.org | | Yes | No | | | | 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 |
|
---|
| 5.0 | 5/9/2023 9:12 AM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
|
| | FDP1SO | Allergen IgE, Food Panel #2, Serum (FDP1) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | |
| 2.0 | 2/2/2022 1:50 PM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
|
| | ALGSTSO | Allergen IgE, Green String Bean (GSTB) | wroblewj@mfldclin.org | | Yes | No | | | | 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 |
|
|
---|
| 4.0 | 5/4/2023 2:23 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
|
| | ALGUISO | Allergen IgE, Guinea Pig Epithelium (GUIN) | wroblewj@mfldclin.org | | Yes | No | | | | 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 |
|
|
---|
| 4.0 | 5/4/2023 2:27 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
|
| | FCGUMSO | Allergen IgE, Gum Carageenan IgE (FCGUM) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | |
| 1.0 | 2/4/2022 4:00 PM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
|
| | ALHORSO | Allergen IgE, Horse Dander (HORS) | wroblewj@mfldclin.org | | Yes | No | | | | 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 |
|
|
---|
| 4.0 | 5/4/2023 2:38 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
|
| | ALLETSO | Allergen IgE, Lettuce (LETT) | wroblewj@mfldclin.org | | Yes | No | | | | 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 |
|
---|
| 4.0 | 7/12/2022 11:10 AM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
|
| | PCANHSO | Allergen IgE, Pecan Hickory, IgE, Serum (PCANH) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | |
| 1.0 | 2/8/2022 11:03 AM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
|
| | ALPNASO | Allergen IgE, Pineapple (PNAP) | wroblewj@mfldclin.org | | Yes | No | | | | 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 |
|
---|
| 4.0 | 5/5/2023 10:53 AM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
|
| | SQUASO | Allergen IgE, Squash, Serum (SQUA) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | |
| 2.0 | 2/9/2022 11:41 AM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
|
| | WHEYSO | Allergen IgE, Whey, Serum (WHEY) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | |
| 2.0 | 2/2/2022 1:06 PM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
|
| | ALBENSO | Allergen IgE, White Bean (BENW) | wroblewj@mfldclin.org | | Yes | No | | | | 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 |
|
---|
| 5.0 | 7/13/2022 11:41 AM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
|
| | WILLSO | Allergen IgE, Willow, Serum (WILL) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | |
| 1.0 | 2/2/2022 1:18 PM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
|
| | ALJOHSO | Allergen Johnson Grass, IgE (JOHN) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 7.0 | 7/13/2022 11:49 AM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALFODSO | Allergen Panel, Food (FOOD6) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 12.0 | 5/8/2023 12:44 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | APGALSO | Allergen Panel, Galactose-Alpha-1, 3-Galactose (Alpha-Gal) Mammalian Meat Allergy Profile, Serum (APGAL) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | | |
| 5.0 | 10/31/2023 11:52 AM | chadwica@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 4
|
|
|
---|
86008
|
| 1
| | |
---|
|
| | ALHDUSO | Allergen Panel, House Dust (HD1) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 8.0 | 5/4/2023 2:40 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALMOLD | Allergen Panel, Mold (MOLD1) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 9.0 | 5/4/2023 3:17 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALNT1SO | Allergen Panel, Nut #1 (FOOD8) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 8.0 | 5/4/2023 11:40 AM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALPED1 | Allergen Panel, Ped <3 Years (PAS3) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 9.0 | 5/8/2023 3:00 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
5 |
Allergen specific IgE |
|
---|
|
| | ALPED3 | Allergen Panel, Ped >8 Years (PAS8) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 8.0 | 5/8/2023 3:06 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
5 |
Allergen specific IgE |
|
---|
|
| | ALPED2 | Allergen Panel, Ped 3-8 Years (PAS38) | Janusz, Janice M | | Yes | No | | | https://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 |
|
| 8.0 | 5/8/2023 3:04 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
6 |
Allergen specific IgE |
|
---|
|
| | ALRP8SO | Allergen Panel, Respiratory Midwest (RPR8) | wroblewj@mfldclin.org | | Yes | No | | | | 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 |
|
---|
| 4.0 | 5/8/2023 1:01 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82785 |
|
1 |
IgE |
|
86003 |
|
25 |
Each indivual allergen |
|
---|
|
| | MRAST | Allergen Panel, Stinging Insects-5 Allergens (INSEC) | Potter, Joli K | | Yes | No | | | | 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 |
|
---|
| 8.0 | 7/19/2022 11:44 AM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
5 |
|
|
---|
|
| | ALTRESO | Allergen Panel, Tree #1 (TREE1) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 9.0 | 5/8/2023 10:57 AM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALPSISO | Allergen Pistachio, IgE (PISTA) | januszj@mfldclin.org | | Yes | No | | | | 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 |
|
---|
| 8.0 | 5/5/2023 10:27 AM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALALFSO | Allergen, Alfalfa (Medicago sativa) IgE (FALPE) | knoxa@mfldclin.org | | Yes | No | | | | 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 | |
| 3.0 | 7/19/2022 1:09 PM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
|
| | ALAMSO | Allergen, Almond, IgE (ALM) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 7.0 | 7/19/2022 1:16 PM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALAMYSO | Allergen, Alpha-Amylase, IgE (AAMY) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | |
---|
| 4.0 | 7/19/2022 1:22 PM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86008 | | 1 | | |
---|
|
| | ALALBSO | Allergen, Alpha-Lactalbumin, IgE (ALFA) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | |
---|
| 6.0 | 7/19/2022 3:14 PM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86008 | | 1 | | |
---|
|
| | ALTERSO | Allergen, Alternaria tenuis, IgE (ALTN) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 7.0 | 7/19/2022 3:24 PM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALAMXSO | Allergen, Amoxicillin, IgE (AMOXY) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | |
| 3.0 | 7/20/2022 11:45 AM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
|
| | ALANCSO | Allergen, Anchovy, IgE (ANCH) | potterj@mfldclin.org | | Yes | No | | | | 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 |
|
---|
| 4.0 | 5/8/2023 3:09 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
Anchovy, IgE |
|
---|
|
| | ALAPPSO | Allergen, Apple, IgE (APPL) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 12.0 | 5/3/2023 1:28 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALFUMSO | Allergen, Aspergillus fumigatus, IgE (ASP) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 9.0 | 5/3/2023 1:33 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALAVOSO | Allergen, Avocado, IgE (AVOC) | potterj@mfldclin.org | | Yes | No | | | | 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. |
|
---|
| 4.0 | 5/8/2023 3:19 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
|
| | ALBAKSO | Allergen, Bakers Yeast, IgE (BYST) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 7.0 | 7/21/2022 11:20 AM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALBMBSO | Allergen, Bamboo Shoot, IgE, Serum (BAMB) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | |
| 4.0 | 7/21/2022 11:27 AM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
|
| | ALBANSO | Allergen, Banana, IgE (BANA) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 9.0 | 5/3/2023 1:35 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALBRLSO | Allergen, Barley, IgE, Serum (BRLY) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | |
| 5.0 | 7/21/2022 11:51 AM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
|
| | ALBASSO | Allergen, Bass, Black, IgE (43310S) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 9.0 | 6/13/2023 2:12 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALBEFSO | Allergen, Beef, IgE (BEEF) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 8.0 | 5/3/2023 1:39 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALBERSO | Allergen, Bermuda Grass, IgE (BERG) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 9.0 | 5/3/2023 1:45 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
|
| | ALBLCSO | Allergen, Beta-Lactoglobulin, IgE (BLAC) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | |
---|
| 4.0 | 8/16/2022 10:28 AM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86008 | | 1 | | |
---|
|
| | ALBBSO | Allergen, Black Bean, IgE (34410E) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 8.0 | 4/19/2021 1:11 PM | pionkowd@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALBLPSO | Allergen, Black/White Pepper, IgE, Serum (BLPEP) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | |
| 3.0 | 8/16/2022 10:41 AM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
|
| | ALMSSSO | Allergen, Blue Mussel, IgE (MUSS) | pionkowd@mfldclin.org | | Yes | No | | | | 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 | |
| 4.0 | 8/16/2022 11:07 AM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
|
| | ALBLUSO | Allergen, Blueberry, IgE (BLUE) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 9.0 | 5/3/2023 1:47 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALBOXSO | Allergen, Box Elder/Maple, IgE (BXMPL) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 9.0 | 5/4/2023 3:13 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALBRZSO | Allergen, Brazil Nut, IgE (BRAZ) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 8.0 | 5/4/2023 3:26 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALBUCSO | Allergen, Buckwheat, IgE (BUCW) | knoxa@mfldclin.org | | Yes | No | | | | 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 | |
---|
| 3.0 | 8/16/2022 1:25 PM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
|
| | ALBDRSO | Allergen, Budgerigar Droppings, IgE, Serum (BDRP) | knoxa@mfldclin.org | | Yes | No | | | | 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 | |
| 4.0 | 5/3/2023 1:53 PM | chadwica@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
|
| | ALCACSO | Allergen, Cacao/Cocoa, IgE (COCOA) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 8.0 | 5/3/2023 3:20 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALCFTSO | Allergen, Canary Feathers, IgE, Serum (CFTH) | knoxa@mfldclin.org | | Yes | No | | | | 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 | |
---|
| 4.0 | 9/1/2022 2:54 PM | pionkowd@mfldclin.org | CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
|
| | ALCANSO | Allergen, Candida albicans, IgE (CDAB) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 8.0 | 5/3/2023 2:21 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|
| | ALCRTSO | Allergen, Carrot, IgE (CROT) | Janusz, Janice M | | Yes | No | | | | 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 |
|
| 9.0 | 5/3/2023 2:24 PM | chadwica@mfldclin.org | CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
|