| | A1ALCSO | Alpha-1-Antitrypsin Proteotype S/Z by LC-MS/MS, Serum (A1ALC) | | 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 |
|
---|
| 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) | | 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 |
|
---|
| 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 |
| | DCORTSO | 11-Deoxycortisol, Serum (DCORT) | | 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 | |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
82634 | | 1 | | |
---|
| 11-Deoxycortisol, 11-Deoxycorticosteroid, Cortodoxone, INN, USAN, BAN, 11-Desoxycortisol, 17-hydroxy-11-deoxycorticosterone, Compound B, Compound S, Corticosterone, Deoxycortisol, Tetrahydro S, Cortoxelone |
| | 17OHPSO | 17-Hydroxypregnenolone, Serum (17OHP) | | 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 |
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
84143 |
|
1 |
|
|
---|
| 17-Hydroxypregnenolone |
| | 17HPSO | 17-Hydroxyprogesterone, Serum | | 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
| |
| CPT | Modifier (if needed) | Quantity | Description | Comments
|
---|
83498
| | 1
| | |
---|
| 17 Alphahydroxyprogesterone; 17 Hydroxy Progesterone, Serum; Hydroxyprogesterone; Progesterone, 17-Hydryoxy
|
| | FGLIOSO | 1p19q Deletion in Gliomas, FISH, Tissue (GLIOF) | | 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 | | |
---|
| 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) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
83516 |
|
|
|
|
---|
| 21 Hydroxylase Antibody, 21-OH Ab, Adrenal Antibody, Hydroxylase Antibody, Anti-Adrenal Antibody, Addison's Disease |
| | F5NULSO | 5' Nucleotidase (F5NUL) | | 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 |
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
83915 |
|
1 |
|
|
---|
| |
| | HIAASO | 5-Hydroxyindoleacetic Acid 24 Hr U (HIAA) | | 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. |
---|
| 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 |
| | HEROIN | 6-Monoacetylmorphine (Heroin Metabolite), Urine | | 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 |
---|
| 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 |
| | ACETA | Acetaminophen | | 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 | |
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
80143 |
|
1 |
|
|
---|
| Datril, Tylenol |
| | MISC | Acetoacetate, Serum/Plasma (0060SP) | | 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 |
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82010 |
|
|
|
|
---|
| Acetoacetic Acid |
| | ACRB | Acetylcholine Receptor (Muscle AChR) Binding Antibody (ARBI) | | 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) |
1.5 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
|
| | ARMASO | Acetylcholine Receptor Modulating Antibody (0099521) | | 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 |
---|
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86043 | | 1 |
| |
---|
| Acetylcholine Receptor Modulating Antibodies (0099521)
AChR Antibody ACHR modulating antibody Muscle nicotinic Acetylcholine Receptor (AChR) Modulating Antibody Myasthenia Gravis Antibodies |
| | AFACESO | Acetylcholinesterase, Amniotic Fluid (ACHE_) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82013 |
|
|
|
|
---|
| AChE-AF (Acetylcholinesterase, Amniotic Fluid), Amniotic Fluid, Acetylcholinesterase |
| | ACIDSO | Acid Phosphatase, Prostatic (PACP) | | 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 |
|
| 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 | | 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 |
---|
| 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 | | 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 |
---|
| 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
|
| | APCRVSO | Activated Protein C Resistance V, Plasma (APCRV) | | 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 | |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
85307 | | 1 | | |
---|
| Activated Protein CV deficient APCRV (Activated Protein C Resistance V) |
| | ACRNSO | Acylcarnitines, Quantitative (ACRN) | | 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 |
|
| 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) |
| | AGU20SO | Acylglycines, Quantitative, Random, Urine (AGU20) | | 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. |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
82542 | | 1 | | |
---|
| 2-Methylbutyryl Glycinuria 2-Methylbutyryl-CoA Dehydrogenase Deficiency EE (Ethylmalonic Encephalopathy) Ethylmalonic Encephalopathy (EE) GA 1 (Glutaric Acidemia Type 1) GA 2 (Glutaric Acidemia Type 2) GA II (Glutaric Acidemia Type II) GAII (Glutaric Acidemia Type 2) GCDH (Glutaryl-CoA Dehydrogenase) Deficiency Glutaric Acidemia (GA) Glutaric Acidemia Type 2 Glutaric Acidemia Type I (GA I) Glutaric Acidemia Type II (GA II) Glutaryl-CoA Dehydrogenase (GCDH) Deficiency Isovaleric Acidemia (IVA) Isovaleryl-CoA Dehydrogenase (IVD) IVA (Isovaleric Acidemia) MADD MCAD (Medium-Chain Acyl-CoA Dehydrogenase) Deficiency MCKAT (Medium-Chain 3-Ketoacyl-CoA Thiolase) Deficiency Medium-Chain 3-Ketoacyl-CoA Thiolase (MCKAT) Deficiency Medium-Chain Acyl-CoA Dehydrogenase (MCAD) Deficiency SBCAD (Short/Branched-Chain Acyl-CoA Dehydrogenase) Deficiency SCAD (Short-Chain Acyl-CoA Dehydrogenase) Deficiency Short-Chain Acyl-CoA Dehydrogenase (SCAD) Deficiency Short/Branched-Chain Acyl-CoA Dehydrogenase (SBCAD) Deficiency n-Acetylglycine n-Propionylglycine Isobutyrylglycine Ethylmalonic acid n-Butyrylglycine 2-Methylsuccinic acid 2-Methylbutyrylglycine Isovalerylglycine Glutaric acid 3-Methylcrotonylglycine n-Tiglylglycine 3-Methylglutaconic acid n-Hexanoylglycine n-Octanoylglycine 3-Phenylpropionylglycine trans-Cinnamoylglycine Suberylglycine Dodecanedioic acid Tetradecanedioic acid Hexadecanedioic acid Acylglycines, Qnt, Ur (AGU20) |
| | ADALXSO | Adalimumab Quantitative with Reflex to Antibody, Serum (ADALX) | | 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 | |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
80145 | | 1 | | |
---|
83520 | | 1 | | if needed |
---|
| |
| | ADAMTSO | ADAMTS13 Evaluation (1295) | | 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 | |
| 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 |
| | ADAMT13 | ADAMTS13 Evaluation, Rapid | | 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 |
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
85397 |
|
|
|
|
---|
| ADAMTS Activity |
| | FADPFSO | Adenosine Deaminase, Pleural Fluid (FADPF) | | 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 | |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
84311 | | 1 | | |
---|
| |
| | LADVSO | Adenovirus, Molecular Detection, PCR, Varies (LADV) | | 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
| |
| CPT | Modifier (if needed) | Quantity | Description | Comments
|
---|
87798
|
|
|
| |
---|
| |
| | ACTH-P | Adrenocorticotropic Hormone (ACTH) | | 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 |
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82024 |
|
|
|
|
---|
| ACTH, Corticotropin
|
| | ALT | Alanine Amino Transferase | | 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 |
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
84460 |
|
|
|
|
---|
| SGPT, Alanine Amino Transaminase
|
| | ALB | Albumin | | 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 |
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82040 |
|
|
|
|
---|
| |
| | ALB-O | Albumin, Body Fluid | | 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 |
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82042 |
|
|
|
|
---|
| Body Fluid Albumin, ALB-O |
| | ALC | Alcohol, Blood | | 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 |
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82077 |
|
1 |
|
|
---|
| Ethanol, Ethyl Alcohol, ETOH |
| | ALSSO | Aldolase, Serum (ALS) | | 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
|
| CPT | Modifier (if needed) | Quantity | Description | Comments
|
---|
82085
| | 1
| | |
---|
| Aldolase, S; Fructose-Biphosphate Aldolase
|
| | ALDOUSO | Aldosterone, 24 Hour, Urine (ALDU) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82088 |
|
|
|
|
---|
| Aldosterone w/Sodium, U Aldosterone with Sodium, Urine Aldosterone 24 Hour Urine (ALDU) 24 ALDOSO |
| | ALDSSO | Aldosterone, Serum (ALDS) | | 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 |
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82088 |
|
|
|
|
---|
| |
| | ALDSSOTEST | Aldosterone, Serum (ALDS) Test | | 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 |
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
82088 |
|
|
|
|
---|
| |
| | ALKRESO | ALK (2p23) Rearrangement, FISH, Tissue (LCAF) | | 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 |
|
| 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) |
| | ALKP | Alkaline Phosphatase, Total | | 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 |
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
84075 |
|
|
|
|
---|
| Alk P'tase, Phosphatase, Alkaline, ALKP
|
| | ALKISO | Alkaline Phosphatase, Total and Isoenzymes, Serum (ALKI) | | 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) |
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
84080 |
|
1 |
Isoenzymes |
|
84075 |
|
1 |
Alkaline Phosphatase |
|
---|
| |
| | ALANSSO | Allergen IgE, Anise (ANSE) | | 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 |
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
| Aniseed, Pimpinella anisum, Sweet Alice, Sweet Cumin |
| | ALASCSO | Allergen IgE, Ascaris (ASCRI) | | 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
|
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
| Ascaris lumbricoides, Common Roundworm
|
| | ALBROSO | Allergen IgE, Broccoli (BROC) | | 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 |
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
| Brassica oleracea var. italica Calabrese Purple Cauliflower Romanesco Spear Cauliflower Winter Cauliflower |
| | ALBFTSO | Allergen IgE, Budgerigar Feathers (BFTH) | | 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 |
|
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
| Budgeri Feathers Budgie feathers Parakeet Feathers
|
| | ALCHLSO | Allergen IgE, Chili Pepper (CHILI) | | 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 |
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
| |
| | ALCOWSO | Allergen IgE, Cow Epithelium (COW) | | 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 |
|
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
| Bos
Taurus
Bull Epithelium
Cattle Epithelium
Cow Dander
Ox Epithelium
Steer Epithelium
Cow
|
| | ALFEESO | Allergen IgE, Ferret Epithelium (FEEP) | | 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 |
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
| Epithelium, ferret Mustela putorius Polecat |
| | FDP1SO | Allergen IgE, Food Panel #2, Serum (FDP1) | | 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 | |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
| Cabbage, Paprika, Spinach, Tomato |
| | ALGSTSO | Allergen IgE, Green String Bean (GSTB) | | 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 |
|
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
| Bean
Common Bean
French Bean
Green Bean
Haricot Bean
Phaseolus vulgaris
Snap Bean
Wax Bean
|
| | ALGUISO | Allergen IgE, Guinea Pig Epithelium (GUIN) | | 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 |
|
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
| Cavin porcellus Cavy |
| | FCGUMSO | Allergen IgE, Gum Carageenan IgE (FCGUM) | | 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 | |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
| |
| | ALHORSO | Allergen IgE, Horse Dander (HORS) | | 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 |
|
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
| Equus caballus Horse Epithelium Horse Hair Horse |
| | ALLETSO | Allergen IgE, Lettuce (LETT) | | 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 |
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
| Lactuca Sativa |
| | PCANHSO | Allergen IgE, Pecan Hickory, IgE, Serum (PCANH) | | 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 | |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
| Carya pecan, Pecan tree, Hickory tree |
| | ALPNASO | Allergen IgE, Pineapple (PNAP) | | 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 |
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
| Ananas Comosus
|
| | SQUASO | Allergen IgE, Squash, Serum (SQUA) | | 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 | |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
| Cheese Pumpkin, Cucumis pepo, Cucurbita maxima, Cucurbita pepo, Curcurbita mixta, Field Pumpkin, Naked-Seeded Pumpkin, Pimpkin, Pumpkin |
| | WHEYSO | Allergen IgE, Whey, Serum (WHEY) | | 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 | |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
| |
| | ALBENSO | Allergen IgE, White Bean (BENW) | | 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 |
|
---|
| 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 |
| | WILLSO | Allergen IgE, Willow, Serum (WILL) | | 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 | |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
| Black Willow Goat Willow Great Sallow Pussy Willow Salix Caprea |
| | ALJOHSO | Allergen Johnson Grass, IgE (JOHN) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| Holcus halepensis, Sorghum controversum, Sorghum halepense, Sorghum miliaceaum |
| | ALFODSO | Allergen Panel, Food (FOOD6) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| Codfish, Cow, Egg White, IgE-Antibodies Multi-Allergen, Milk, Peanut, Soybean, Wheat
|
| | APGALSO | Allergen Panel, Galactose-Alpha-1, 3-Galactose (Alpha-Gal) Mammalian Meat Allergy Profile, Serum (APGAL) | | 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 | | |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 4
|
|
|
---|
86008
|
| 1
| | |
---|
| Galactose IgE Galactose-alpha-1,3 Alpha-Gal |
| | ALHDUSO | Allergen Panel, House Dust (HD1) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| IgE Antibodies, Multi-Allergen Includes: Cockroach, Dermatophagoides farinae, Dermatophagoides pteronyssinus, Hollister-Stier |
| | ALMOLD | Allergen Panel, Mold (MOLD1) | | 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 |
|
| 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 |
| | ALNT1SO | Allergen Panel, Nut #1 (FOOD8) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| Almond, Brazilnut, Coconut, Hazelnut, IgE Antibodies, Multi-Allergen, Peanut
|
| | ALPED1 | Allergen Panel, Ped <3 Years (PAS3) | | 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 |
|
| 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 |
| | ALPED3 | Allergen Panel, Ped >8 Years (PAS8) | | 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 |
|
| 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 |
| | ALPED2 | Allergen Panel, Ped 3-8 Years (PAS38) | | 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) |
0.8 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 |
| | ALRP8SO | Allergen Panel, Respiratory Midwest (RPR8) | | 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 |
|
---|
| 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 |
|
|
|
| | MRAST | Allergen Panel, Stinging Insects-5 Allergens (INSEC) | | 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 |
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
5 |
|
|
---|
| Honeybee Venom, Wasp Venom, White Faced Hornet Venom, Yellow Faced Hornet Venom, Yellow Jacket Venom |
| | ALTRESO | Allergen Panel, Tree #1 (TREE1) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| IgE Antibodies, Multi-Allergen Includes: Birch, Box Elder/Maple, Elm, Oak, Walnut |
| | ALPSISO | Allergen Pistachio, IgE (PISTA) | | 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 |
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| |
| | ALALFSO | Allergen, Alfalfa (Medicago sativa) IgE (FALPE) | | 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 | |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
| Medicago sativa grass FORWARD |
| | ALAMSO | Allergen, Almond, IgE (ALM) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| A. dulcis, Amygdalus communis, Bitter Almond, P. dulcis, Prunus amygdalus, Sweet Almond |
| | ALAMYSO | Allergen, Alpha-Amylase, IgE (AAMY) | | 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 | |
---|
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86008 | | 1 | | |
---|
| Aspergillus oryzae; Occupational, Alpha-amylase |
| | ALALBSO | Allergen, Alpha-Lactalbumin, IgE (ALFA) | | 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 | |
---|
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86008 | | 1 | | |
---|
| Lactalbumin, Alpha; Milk component |
| | ALTERSO | Allergen, Alternaria tenuis, IgE (ALTN) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| Alternaria alternata |
| | ALAMXSO | Allergen, Amoxicillin, IgE (AMOXY) | | 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 | |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
| Amoxicillin, IgE Amoxicilloyl |
| | ALANCSO | Allergen, Anchovy, IgE (ANCH) | | 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 |
|
---|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
Anchovy, IgE |
|
---|
| Anchovis, Ansiovis, Engraulis encrasicolus, Fish, anchovy
|
| | ALAPPSO | Allergen, Apple, IgE (APPL) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| Malus sylvestris, Malus x domestica
|
| | ALFUMSO | Allergen, Aspergillus fumigatus, IgE (ASP) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| Aspergillus Antibody
|
| | ALAVOSO | Allergen, Avocado, IgE (AVOC) | | 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. |
|
---|
| 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) |
| | ALBAKSO | Allergen, Bakers Yeast, IgE (BYST) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| Saccharomyces cerevisiae, Yeast, Baker's, Yeast, Brewers |
| | ALBMBSO | Allergen, Bamboo Shoot, IgE, Serum (BAMB) | | 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 | |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
| Hachiku Madaka Moso Phyllostachys pubescens Pubescent Bamboo |
| | ALBANSO | Allergen, Banana, IgE (BANA) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| Musa spp, Plantain
|
| | ALBRLSO | Allergen, Barley, IgE, Serum (BRLY) | | 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 | |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
| Barleycorn Hordeum vulgare |
| | ALBASSO | Allergen, Bass, Black, IgE (43310S) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| Sea Bass, Centropristis striata
|
| | ALBEFSO | Allergen, Beef, IgE (BEEF) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| Bos spp
|
| | ALBERSO | Allergen, Bermuda Grass, IgE (BERG) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
1 |
|
|
---|
| Bahama Grass, Cynodon dactylon, Devil Grass, Panicum dactylon, Scutch Grass, Star Grass, Wire Grass
|
| | ALBLCSO | Allergen, Beta-Lactoglobulin, IgE (BLAC) | | 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 | |
---|
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86008 | | 1 | | |
---|
| |
| | ALBBSO | Allergen, Black Bean, IgE (34410E) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| Phaseolus spp |
| | ALBLPSO | Allergen, Black/White Pepper, IgE, Serum (BLPEP) | | 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 | |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
| Black Pepper Pepper Piper nigrum White Pepper |
| | ALMSSSO | Allergen, Blue Mussel, IgE (MUSS) | | 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 | |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
| |
| | ALBLUSO | Allergen, Blueberry, IgE (BLUE) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| Blueberry fruit, Fruit blueberry, Highbush Blueberry, Lowbush Blueberry, Vaccinium myrtillis
|
| | ALBOXSO | Allergen, Box Elder/Maple, IgE (BXMPL) | | 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 |
|
| 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
|
| | ALBRZSO | Allergen, Brazil Nut, IgE (BRAZ) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| Bertholletia excelsa, Cream Nut, Para-nut
|
| | ALBUCSO | Allergen, Buckwheat, IgE (BUCW) | | 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 | |
---|
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
| Beech Wheat Canadian Buckwheat Fagopyrum Fagopyrum esculentum French Wheat |
| | ALBDRSO | Allergen, Budgerigar Droppings, IgE, Serum (BDRP) | | 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 | |
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
| Budgie Droppings Melopsittacus undulatus droppings Parakeet droppings |
| | ALCACSO | Allergen, Cacao/Cocoa, IgE (COCOA) | | 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 |
|
| 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)
|
| | ALCFTSO | Allergen, Canary Feathers, IgE, Serum (CFTH) | | 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 | |
---|
| CPT | Modifier (if needed) | Quantity | Description | Comments |
---|
86003 | | 1 | | |
---|
| |
| | ALCANSO | Allergen, Candida albicans, IgE (CDAB) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| Monilia/Candida Albicans
|
| | ALCRTSO | Allergen, Carrot, IgE (CROT) | | 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 |
|
| CPT |
Modifier (if needed) |
Quantity |
Description |
Comments |
86003 |
|
|
|
|
---|
| Daucus carota
|