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Specimen Requirements
CPT Codes
Synonyms, Keywords
  
A1ALCSO Alpha-1-Antitrypsin Proteotype S/Z by LC-MS/MS, Serum (A1ALC)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​1.25 mL ​0.5 mL
CPT Modifier
(if needed)
Quantity Description 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

  
HER2FSO HER2 Amp, Breast Cancer, FISH, Tissue (H2BR)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Tissue ​Tissue Block
​No ​Slides ​4un, 1 H&E ​2un, 1 H&E
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

  
DCORTSO11-Deoxycortisol, Serum (DCORT)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL​0.4 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​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

  
17OHPSO17-Hydroxypregnenolone, Serum (17OHP)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​1 mL ​0.5 mL
CPT Modifier
(if needed)
Quantity Description Comments
​84143 ​1
​17-Hydroxypregnenolone
  
17HPSO17-Hydroxyprogesterone, Serum
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)

​Serum
​Red Top Tube (RTT)
​0.6 mL
​0.25 mL
CPTModifier
(if needed)
QuantityDescriptionComments

​83498
​1

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

  
FGLIOSO1p19q Deletion in Gliomas, FISH, Tissue (GLIOF)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​​Tissue ​Tissue Block
​No ​Slides​Six consecutive, unstained and 1 hematoxylin and eosin-stained slide
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
Oligodendroglioma
  
21HDRSO21-Hydroxylase Ab, S (21OH)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Red Top Tube (RTT)​ Serum Separator Tube (SST)​ 1 mL​ 0.20 mL​
CPT Modifier
(if needed)
Quantity Description Comments
83516
 21 Hydroxylase Antibody, 21-OH Ab, Adrenal Antibody, Hydroxylase Antibody, Anti-Adrenal Antibody, Addison's Disease​
  
F5NULSO5' Nucleotidase (F5NUL)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Serum Separator Tube (SST) ​Red Top Tube (RTT) ​1 mL ​0.5 mL
CPT Modifier
(if needed)
Quantity Description Comments
​83915 ​1
  
HIAASO5-Hydroxyindoleacetic Acid 24 Hr U (HIAA)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​*Dietary Restrictions and Drug Interactions ​Urine from 24-hour urine collection
​10 mL Urine Tube ​Plastic Urine Container ​5 mL ​1 mL ​1 mL
Note:  Add 25 mL of 50% acetic acid as preservative at start of collection. Use 15 mL of 50% acetic acid for children <5 years old.​​​​​​​​
​ ​ ​ ​ ​ ​
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

  
HEROIN6-Monoacetylmorphine (Heroin Metabolite), Urine
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ Urine​ Sage urine collection container​ Sterile plastic container with no preservatives​ 10 mL​ 7 mL​ 4 mL​
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​
  
ACETAAcetaminophen
NoNo
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​NoPlasma/Serum​Lithium-heparin Plasma Separator Tube (PST)

Serum Separator Tube (SST)

Red Top Tube (RTT)

Lithium or Sodium-heparin Green Top Tube (GTT)
 
EDTA Lavender Top Tube (LTT)​
0.5 mL​0.3 mL​
CPT Modifier
(if needed)
Quantity Description Comments
80143​ ​1
Datril, Tylenol​
  
MISCAcetoacetate, Serum/Plasma (0060SP)
NoNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum ​Red Top Tube (RTT) ​3 mL ​1.2 mL
​Plasma ​EDTA Lavender Top Tube (LTT) ​3 mL ​1.2 mL
CPT Modifier
(if needed)
Quantity Description Comments
​82010
​Acetoacetic Acid
  
ACRBAcetylcholine Receptor (Muscle AChR) Binding Antibody (ARBI)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum Red Top Tube (RTT)​ Serum Separator Tube (SST)​ 1.5 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
  
ARMASOAcetylcholine Receptor Modulating Antibody (0099521)
YesNo
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No​Serum​Serum Separator Tube (SST)​0.5 mL​0.3 mL
CPTModifier
(if needed)
QuantityDescriptionComments
86043​​1

​​Acetylcholine Receptor Modulating Antibodies (0099521)

AChR Antibody

ACHR modulating antibody

Muscle nicotinic Acetylcholine Receptor (AChR) Modulating Antibody

Myasthenia Gravis Antibodies

  
AFACESOAcetylcholinesterase, Amniotic Fluid (ACHE_)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Amniotic fluid ​ Amniotic fluid container​ 1 mL​ 0.3 mL​
CPT Modifier
(if needed)
Quantity Description Comments
​82013
​AChE-AF (Acetylcholinesterase, Amniotic Fluid), Amniotic Fluid, Acetylcholinesterase
  
ACIDSOAcid Phosphatase, Prostatic (PACP)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​1 mL ​0.4 mL
CPT Modifier
(if needed)
Quantity Description Comments
​84066
Acid Phosphatase, Prostatic Isoenzyme, ELISA, PAP, Prostatic Acid Phosphatase, Phosphatase
  
ACTH Stimulation Test, 60 Min Cortisol ACTH Stimulation Test, 60 Min Cortisol
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ Serum or Plasma​Serum Separator Tube (SST)​Red Top Tube (RTT)​, Lithium-heparin Plasma Separator Tube (PST), Sodium-heparin Green Top Tube (GTT)0.5 mL​0.3 mL​0.255 mL​
CPT Modifier
(if needed)
Quantity Description Comments
80400​
​​​Cosyntrophin Stimulation Test
Adrenocorticol (ACTH) Stimulation Test
Cortrosyn Stimulation Test​, Cortisol

  
ACTH Stim, 30 and 60 Min Cort ACTH Stimulation, 30 and 60 Min Cortisols
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ Serum or Plasma​Serum Separator Tube (SST)Red Top Tube (RTT),Lithium-heparin Plasma Separator Tube (PST), Sodium-heparin Green Top Tube (GTT) 0.5 mL​0.3 mL​0.255 mL​
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
  
APCRVSOActivated Protein C Resistance V, Plasma (APCRV)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Platelet-Poor Plasma​Citrated Light Blue Top Tube (BTT)​1 mL​0.5 mL
CPTModifier
(if needed)
QuantityDescriptionComments
85307​​1

​Activated Protein CV deficient

APCRV (Activated Protein C Resistance V)

  
ACRNSOAcylcarnitines, Quantitative (ACRN)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Plasma​ Sodium-heparin Green Top Tube (GTT)​ EDTA Lavender Top Tube (LTT) or Lithium Heparin Green Top Tube (GTT) ​ 0.1 mL​ 0.04 mL​
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)
  
AGU20SOAcylglycines, Quantitative, Random, Urine (AGU20)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Urine​Plastic, 10-mL urine tube​10 mL​4 mL​If insufficient collection volume, submit as much as possible in a single container; the laboratory will determine if volume is sufficient for testing.
CPTModifier
(if needed)
QuantityDescriptionComments
​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)

  
ADALXSOAdalimumab Quantitative with Reflex to Antibody, Serum (ADALX)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Serum Separator Tube (SST)​Red Top Tube (RTT)​0.5 mL​0.35 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​80145​1
​83520​1​if needed

​Humira

  
ADAMTSOADAMTS13 Evaluation (1295)
NoNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Plasma​ (preferred) ​Citrated Blue Top Tube (BTT) ​Three 0.5 mL aliquots ​Two 0.4 ml aliquots
​Serum ​Red Top Tube (RTT) ​Three 0.5 mL aliquots ​Two 0.4 ml aliquots
​Whole Blood​Light Blue Top Tube​​Three 0.5 mL aliquots​​Two 0.4 ml aliquots
CPT Modifier
(if needed)
Quantity Description Comments
85397​ ​1 ADAMTS13 Activity​
​85335 ​1 ADAMTS13 Inhibitor (if performed)​
​83520 ​1 ADAMTS13 Antibody (if performed)​
ADAMTS13 Activity, ADAMTS13, ADAMTS13 Inhibitor, VWF Cleaving Protease
  
ADAMT13ADAMTS13 Evaluation, Rapid
NoNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Plasma​ Citrated Blue Top Tube (BTT)​ Two 0.75 mL  aliquots​
Two 0.75 mL 
aliquots​
 0.5 mL​
CPT Modifier
(if needed)
Quantity Description Comments
​85397
ADAMTS Activity
  
FADPFSOAdenosine Deaminase, Pleural Fluid (FADPF)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Pleural Fluid​Leak Proof Container​0.5 mL​0.2 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​84311​1

​ADA Pleural

  
LADVSOAdenovirus, Molecular Detection, PCR, Varies (LADV)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Body Fluid (Pleural, peritoneal, ascites, pericardial, or amniotic)​
​Sterile Container




​0.5 mL

​0.5 mL

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

0.5 mL



​Cerebrospinal Fluid

Sterile Vial


​​0.5 mL​
0.3 mL


​Stool
​Stool Collection kit
​​​​​


​1 g

​​0.5 g



​Nasal 

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








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








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















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









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



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

0.3 mL

CPTModifier
(if needed)
QuantityDescriptionComments
87798






ADV (Adenovirus)

  
ACTH-PAdrenocorticotropic Hormone (ACTH)
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ Plasma​ EDTA Pink Top Tube (PTT)-pre-chilled​ EDTA Lavender Top Tube (LTT)-pre-chilled​ 0.5 mL​ 0.5 mL​ 0.4 mL​
CPT Modifier
(if needed)
Quantity Description Comments
82024 ​
​​​ACTH, Corticotropin​
  
ALTAlanine Amino Transferase
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No Plasma​/Serum Lithium-heparin Plasma Separator (PST)​, Serum Separator Tube (SST) Lithium or Sodium-heparin Green Top (GTT), Red Top Tube (RTT) 1 mL​ 0.5 mL​ 0.6 mL whole blood​
CPT Modifier
(if needed)
Quantity Description Comments
​84460
​SGPT, Alanine Amino Transaminase​
  
ALBAlbumin
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ Plasma​/Serum

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

Lithium or Sodium-heparin Green Top Tube (GTT), Red Top Tube (RTT)​ 1 mL​ 0.5 mL​ 0.1 mL​
CPT Modifier
(if needed)
Quantity Description Comments
82040 ​
  
ALB-OAlbumin, Body Fluid
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No Body Fluid​
Syringe
 
No Additive Waste Tube​
Sterile screw top container​ 2.0 mL​ 0.5 mL​
CPT Modifier
(if needed)
Quantity Description Comments
82042 ​
Body Fluid Albumin, ALB-O​
  
ALCAlcohol, Blood
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No Plasma​/Serum ​Lithium-heparin Plasma Separator Tube (PST), Serum Separator Tube (SST)

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

0.5 mL​ 0.2 mL​
CPT Modifier
(if needed)
Quantity Description Comments
82077 ​1
Ethanol, Ethyl Alcohol, ETOH​
  
ALSSOAldolase, Serum (ALS)
YesNo

Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
​Serum
​​Red Top Tube (RTT)
​1 mL
​0.5 mL
CPTModifier
(if needed)
QuantityDescriptionComments

​82085
​1

​​Aldolase, S; Fructose-Biphosphate Aldolase​

  
ALDOUSOAldosterone, 24 Hour, Urine (ALDU)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume
Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Urine​ Plastic, 10-mL urine tube​ 10 mL​ 1 mL​
CPT Modifier
(if needed)
Quantity Description Comments
​82088

Aldosterone w/Sodium, U
Aldosterone with Sodium, Urine

Aldosterone 24 Hour Urine (ALDU)

24 ALDOSO

  
ALDSSOAldosterone, Serum (ALDS)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ Serum​ Red Top Tube (RTT)​ ​Serum Separator Tube (SST) 1.2 mL​ 1.2 mL
CPT Modifier
(if needed)
Quantity Description Comments
82088 ​
  
ALDSSOTESTAldosterone, Serum (ALDS) Test
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​1.2 mL ​0.6 mL
CPT Modifier
(if needed)
Quantity Description Comments
​82088
  
ALKRESOALK (2p23) Rearrangement, FISH, Tissue (LCAF)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Tissue
FFPE
tumor tissue block
Slides 4 consecutive, unstained, 5 micron thick sections placed on positively charged slides and 1 H&E slide 3 consecutive, unstained, 5 micron thick sections placed on positively charged slides and 1 H&E slide
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
​Lung carcinoma, Non-small cell lung cancer (NSCLC)
  
ALKPAlkaline Phosphatase, Total
NoNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ Plasma​/Serum Lithium -heparin Plasma Separator (PST)​, Serum Separator Tube (SST)
Lithium or Sodium-heparin Green Top (GTT), Red Top (RTT)
 
1 mL​ 0.5 mL​ 0.5 mL whole blood​
CPT Modifier
(if needed)
Quantity Description Comments
84075 ​
Alk P'tase, Phosphatase, Alkaline, ALKP​
  
ALKISOAlkaline Phosphatase, Total and Isoenzymes, Serum (ALKI)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Serum Separator Tube (SST) ​Red Top Tube (RTT) ​1 mL (divided into 2 tubes, each containing 0.5 mL) ​0.5 mL (divided into 2 tubes, each containing 0.25 mL)
CPT Modifier
(if needed)
Quantity Description Comments
​84080 ​1 ​Isoenzymes
​84075 ​1 ​Alkaline Phosphatase
  
ALANSSOAllergen IgE, Anise  (ANSE)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​0.5 mL ​0.3 mL
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
Aniseed, Pimpinella anisum, Sweet Alice, Sweet Cumin
  
ALASCSOAllergen IgE, Ascaris (ASCRI)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Serum Separator Tube (SST) ​Red Top Tube (RTT)​ ​0.5 mL for each 5 allergens requested For 1 allergen: 0.3 mL; For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL deadspace
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1

Ascaris lumbricoides, Common Roundworm

  
ALBROSOAllergen IgE, Broccoli (BROC)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​0.5 mL ​0.3 mL
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1

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

  
ALBFTSOAllergen IgE, Budgerigar Feathers (BFTH)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum Serum Separator Tube (SST) Red Top Tube (RTT)
​0.3 mL
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
Budgeri Feathers
Budgie feathers
Parakeet Feathers
  
ALCHLSOAllergen IgE, Chili Pepper (CHILI)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​0.5 mL for every 5 allergens requested ​0.3 mL
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
Capsicum frutescens
  
ALCOWSOAllergen IgE, Cow Epithelium (COW)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Serum Separator Tube (SST) Red Top Tube (RTT) ​0.3 mL
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
Bos Taurus
Bull Epithelium
Cattle Epithelium
Cow Dander
Ox Epithelium
Steer Epithelium
Cow

  
ALFEESOAllergen IgE, Ferret Epithelium (FEEP)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum Serum Separator Tube (SST) Red Top Tube (RTT)
​0.5 mL ​0.3 mL
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
Epithelium, ferret
Mustela putorius
Polecat
  
FDP1SOAllergen IgE, Food Panel #2, Serum (FDP1)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL​0.3 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1

​Cabbage, Paprika, Spinach, Tomato

  
ALGSTSOAllergen IgE, Green String Bean (GSTB)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum Serum Separator Tube (SST) ​Red Top Tube (RTT)
​0.3 mL
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
Bean
Common Bean
French Bean
Green Bean
Haricot Bean
Phaseolus vulgaris
Snap Bean
Wax Bean
  
ALGUISOAllergen IgE, Guinea Pig Epithelium (GUIN)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Serum Separator Tube (SST) Red Top Tube (RTT) ​0.3 mL
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
Cavin porcellus
Cavy
  
FCGUMSOAllergen IgE, Gum Carageenan IgE (FCGUM)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL​0.5 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1
  
ALHORSOAllergen IgE,  Horse Dander (HORS)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum Serum Separator Tube (SST) Red Top Tube (RTT) ​0.3 mL
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
Equus caballus
Horse Epithelium
Horse Hair
Horse
  
ALLETSOAllergen IgE, Lettuce (LETT)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​0.5 mL ​0.3 mL
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
Lactuca Sativa
  
PCANHSOAllergen IgE, Pecan Hickory, IgE, Serum (PCANH)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1

​Carya pecan, Pecan tree, Hickory tree

  
ALPNASOAllergen IgE, Pineapple (PNAP)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum Serum Separator Tube (SST) Red Top Tube (RTT) ​0.5 mL ​0.3 mL
CPT Modifier
(if needed)
Quantity Description Comments
​86003 ​1
Ananas Comosus
  
SQUASOAllergen IgE, Squash, Serum (SQUA)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1

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

  
WHEYSOAllergen IgE, Whey, Serum (WHEY)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 for every 5 allergens requested​0.3 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1

​Cow's Whey

  
ALBENSOAllergen IgE, White Bean (BENW)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​0.5 mL ​0.3 mL
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
  
WILLSOAllergen IgE, Willow, Serum (WILL)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1

​Black Willow

Goat Willow

Great Sallow

Pussy Willow

Salix Caprea

  
ALJOHSOAllergen Johnson Grass, IgE (JOHN)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Red Top Tube (RTT)​ ​Serum Separator Tube (SST) ​0.5 mL
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
CPT Modifier
(if needed)
Quantity Description Comments
86003​
​Holcus halepensis, Sorghum controversum, Sorghum halepense, Sorghum miliaceaum
  
ALFODSOAllergen Panel, Food (FOOD6)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) Red Top Tube (RTT) ​0.5 mL
0.3 mL
CPT Modifier
(if needed)
Quantity Description Comments
86003​
​Codfish, Cow, Egg White, IgE-Antibodies Multi-Allergen, Milk, Peanut, Soybean, Wheat
  
APGALSOAllergen Panel, Galactose-Alpha-1, 3-Galactose (Alpha-Gal) Mammalian Meat Allergy Profile, Serum (APGAL)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Serum Separator Tube (SST)Red Top Tube (RTT)​1.5 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​4


​86008

​1

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

  
ALHDUSOAllergen Panel, House Dust (HD1)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) Red Top Tube (RTT) ​0.7 mL
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
CPT Modifier
(if needed)
Quantity Description Comments
86003​
​IgE Antibodies, Multi-Allergen
Includes: Cockroach, Dermatophagoides farinae, Dermatophagoides pteronyssinus, Hollister-Stier
  
ALMOLDAllergen Panel, Mold (MOLD1)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) Red Top Tube (RTT)
​0.5 mL
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
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

  
ALNT1SOAllergen Panel, Nut #1 (FOOD8)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Serum Separator Tube (SST) Red Top Tube (RTT) 0.5 mL​
0.3 mL
CPT Modifier
(if needed)
Quantity Description Comments
86003​
Almond, Brazilnut, Coconut, Hazelnut, IgE Antibodies, Multi-Allergen, Peanut​
  
ALPED1Allergen Panel, Ped <3 Years (PAS3)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) ​Red Top Tube (RTT) ​0.7 mL for every 5 allergens requested
For 1 allergen: 0.5 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL deadspace
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
  
ALPED3Allergen Panel, Ped >8 Years (PAS8)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Serum Separator Tube (SST) ​Red Top Tube (RTT) ​0.7 mL for every 5 allergens requested
For 1 allergen: 0.5 mL
For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
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
  
ALPED2Allergen Panel, Ped 3-8 Years (PAS38)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Serum Separator Tube (SST) ​Red Top Tube (RTT) 0.8 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
  
ALRP8SOAllergen Panel, Respiratory Midwest (RPR8)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Serum Separator Tube (SST) Red Top Tube (RTT) ​2 mL ​1.55 mL
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
 
  
MRASTAllergen Panel, Stinging Insects-5 Allergens (INSEC)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum Red Top Tube (RTT)​ ​Serum Separator Tube (SST) ​0.8 mL
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space​
CPT Modifier
(if needed)
Quantity Description Comments
86003​ 5​
​Honeybee Venom, Wasp Venom, White Faced Hornet Venom, Yellow Faced Hornet Venom, Yellow Jacket Venom
  
ALTRESOAllergen Panel, Tree #1 (TREE1)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) Red Top Tube (RTT) ​0.5 mL
0.3 mL
CPT Modifier
(if needed)
Quantity Description Comments
86003​
​IgE Antibodies, Multi-Allergen
Includes: Birch, Box Elder/Maple, Elm, Oak, Walnut
  
ALPSISOAllergen Pistachio, IgE (PISTA)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Serum Separator Tube (SST) ​Red Top Tube (RTT) ​0.5 mL for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
CPT Modifier
(if needed)
Quantity Description Comments
​86003
Pistacia Vera
  
ALALFSOAllergen, Alfalfa (Medicago sativa) IgE (FALPE)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL​0.5 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1

​Medicago sativa grass FORWARD

  
ALAMSOAllergen, Almond, IgE (ALM)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​0.5 mL for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
CPT Modifier
(if needed)
Quantity Description Comments
86003​
A. dulcis, Amygdalus communis, Bitter Almond, P. dulcis, Prunus amygdalus, Sweet Almond
  
ALAMYSOAllergen, Alpha-Amylase, IgE (AAMY)
YesNo
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​86008​1

​Aspergillus oryzae; Occupational, Alpha-amylase

  
ALALBSOAllergen, Alpha-Lactalbumin, IgE (ALFA)
YesNo
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​86008​1

​Lactalbumin, Alpha; Milk component

  
ALTERSOAllergen, Alternaria tenuis, IgE (ALTN)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Red Top Tube (RTT) ​Serum Separator Tube (SST) 0.5 mL​ for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
CPT Modifier
(if needed)
Quantity Description Comments
86003​
​Alternaria alternata
  
ALAMXSOAllergen, Amoxicillin, IgE (AMOXY)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL​0.3 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1

​Amoxicillin, IgE

Amoxicilloyl

  
ALANCSOAllergen, Anchovy, IgE (ANCH)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum ​Serum Separator Tube (SST) Red Top Tube (RTT) ​0.5 mL for every 5 allergens requested ​0.3 mL for 1 allergen; For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
CPT Modifier
(if needed)
Quantity Description Comments
86003​​ ​1 ​Anchovy, IgE

​Anchovis, Ansiovis, Engraulis encrasicolus, Fish, anchovy

  
ALAPPSOAllergen, Apple, IgE (APPL)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Serum Separator Tube (SST) Red Top Tube (RTT) ​0.5 mL for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
CPT Modifier
(if needed)
Quantity Description Comments
86003​
​Malus sylvestris, Malus x domestica
  
ALFUMSOAllergen, Aspergillus fumigatus, IgE (ASP)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) ​Red Top Tube (RTT) 0.5 mL​ for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
CPT Modifier
(if needed)
Quantity Description Comments
86003​
​​Aspergillus Antibody
  
ALAVOSOAllergen, Avocado, IgE (AVOC)
YesNo
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum Serum Separator Tube (SST)
Red Top Tube (RTT) 0.5 mL for every 5 allergens requested

For 1 allergen:  ​0.3 mL​

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

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)

  
ALBAKSOAllergen, Bakers Yeast, IgE (BYST)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Red Top Tube (RTT)​ ​Serum Separator Tube (SST) 0.5 mL ​for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
CPT Modifier
(if needed)
Quantity Description Comments
86003​
Saccharomyces cerevisiae, Yeast, Baker's, Yeast, Brewers
  
ALBMBSOAllergen, Bamboo Shoot, IgE, Serum (BAMB)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube​0.5 mL for every 5 allergens requested​0.3 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1

​Hachiku
Madaka
Moso
Phyllostachys pubescens
Pubescent Bamboo

  
ALBANSOAllergen, Banana, IgE (BANA)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) ​Red Top Tube (RTT) ​0.5 mL for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
CPT Modifier
(if needed)
Quantity Description Comments
86003​
​​Musa spp, Plantain
  
ALBRLSOAllergen, Barley, IgE, Serum (BRLY)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1

​Barleycorn

Hordeum vulgare

  
ALBASSOAllergen, Bass, Black, IgE (43310S)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum ​Red Top Tube (RTT) 0.5 mL 340 uL
CPT Modifier
(if needed)
Quantity Description Comments
​86003
​​Sea Bass, Centropristis striata
  
ALBEFSOAllergen, Beef, IgE (BEEF)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) Red Top Tube (RTT) ​0.5 mL for each 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
CPT Modifier
(if needed)
Quantity Description Comments
86003​
​Bos spp
  
ALBERSOAllergen, Bermuda Grass, IgE (BERG)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST)
Red Top Tube (RTT)
​0.5 mL for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
CPT Modifier
(if needed)
Quantity Description Comments
86003​ ​1
​Bahama Grass, Cynodon dactylon, Devil Grass, Panicum dactylon, Scutch Grass, Star Grass, Wire Grass​
  
ALBLCSOAllergen, Beta-Lactoglobulin, IgE (BLAC)
YesNo
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​86008​1

​Milk Component

  
ALBBSOAllergen, Black Bean, IgE (34410E)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum ​Red Top Tube (RTT) 0.5 mL ​340 uL
CPT Modifier
(if needed)
Quantity Description Comments
​86003
​Phaseolus spp
  
ALBLPSOAllergen, Black/White Pepper, IgE, Serum (BLPEP)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1

​Black Pepper

Pepper

Piper nigrum

White Pepper

  
ALMSSSOAllergen, Blue Mussel, IgE (MUSS)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (STT)​0.5 mL for every 5 allergens requesed​0.3 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1

​Mytilus edulis

  
ALBLUSOAllergen, Blueberry, IgE (BLUE)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) ​Red Top Tube (RTT) ​0.5 mL for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
CPT Modifier
(if needed)
Quantity Description Comments
86003​
Blueberry fruit,  Fruit blueberry, Highbush Blueberry, Lowbush Blueberry, Vaccinium myrtillis
  
ALBOXSOAllergen, Box Elder/Maple, IgE (BXMPL)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Serum Separator Tube (SST) Red Top Tube (RTT)
​0.5 mL for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
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
  
ALBRZSOAllergen, Brazil Nut, IgE (BRAZ)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Serum Separator Tube (SST) ​Red Top Tube (RTT) ​0.5 mL for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
CPT Modifier
(if needed)
Quantity Description Comments
86003​
Bertholletia excelsa, Cream Nut, Para-nut
  
ALBUCSOAllergen, Buckwheat, IgE (BUCW)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1

​Beech Wheat
Canadian Buckwheat
Fagopyrum
Fagopyrum esculentum
French Wheat

  
ALBDRSOAllergen, Budgerigar Droppings, IgE, Serum (BDRP)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​SerumSerum Separator Tube (SST)
Red Top Tube (RTT)​0.5 mL for every 5 allergens requested​0.3 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1

​Budgie Droppings
Melopsittacus undulatus droppings
Parakeet droppings

  
ALCACSOAllergen, Cacao/Cocoa, IgE (COCOA)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) Red Top Tube (RTT)
​0.5 mL for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
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)
  
ALCFTSOAllergen, Canary Feathers, IgE, Serum (CFTH)
YesNo
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum​Red Top Tube (RTT)​Serum Separator Tube (SST)​0.5 mL for every 5 allergens requested​0.3 mL
CPTModifier
(if needed)
QuantityDescriptionComments
​86003​1

​Serinus canarius

  
ALCANSOAllergen, Candida albicans, IgE (CDAB)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) Red Top Tube (RTT) 0.5 mL​ for every 5 allergens requested
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
CPT Modifier
(if needed)
Quantity Description Comments
86003
​Monilia/Candida Albicans
  
ALCRTSOAllergen, Carrot, IgE (CROT)
YesNo
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Serum Separator Tube (SST) Red Top Tube (RTT) ​0.5 mL for every 5 allergens ordered
For 1 allergen: 0.3 mL/For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL dead space
CPT Modifier
(if needed)
Quantity Description Comments
86003​
Daucus carota
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