ghs laboratory outreach test codes and specimen … lab test co… · alpha 1 antitrypsin a1at...

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS UPDATED 11/15/10 Test Name GHS CODE Specimen Type CPT 17-Hydroxyprogesterone, neonatal is in test description test code in Sunquest is 17654 17HP RED. Separate serum after clotting and spinning. Refrigerated. 83498 ABO-Rh Type (including Du) ABRH RED. 1 LAVENDER OR PINK. Refrigerated. 86900 Acetaminophen ACET GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated. 82003 Acetone ACES GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated. 82009 Aerobic Wound Culture AWD CULTURETTE (crush ampule/ provide specimen source/site) Room Temperature. 87070 Albumin ALB GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated. 82040 Alcohol (ETOS) chain of custody ETOS GRAY: Use Betadine to clean venipuncture site. Follow chain of custody collection procedure. Refrigerated. 82055 Alcohol (ETOH) medical nonchain of custody ETOH GRAY: Use Betadine to clean venipuncture site. Refrigerated. 82055 nonchain of custody venipuncture site. Refrigerated. Adrenocorticotrophic Hormone ACTH LAVENDER. Centrifuge and separate plasma specimens from cells. Transfer 1.5 mLs to a plastic, transport tube. Label Sample with "Plasma" sticker. Do not thaw. Frozen. 82024 Aldolase ALD GOLD, RED OR SPECKLED. Refrigerated. 82085 Aldosterone ALDS GOLD, RED OR SPECKLED. Refrigerated. 82088 Alkaline Phosphatase AP GOLD, RED OR SPECKLED. Refrigerated. 84080 Alpha 1 Antitrypsin A1AT GOLD, RED OR SPECKLED. Refrigerated. 82103 Alpha 1 Acid Glycoprotein A1AG GOLD, RED OR SPECKLED. Refrigerated. 82985 Alphafetoprotein AFPT, tumor marker AFPT GOLD,RED OR SPECKLED. Refrigerated. 82105 Page 1

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Page 1: GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN … LAB TEST CO… · Alpha 1 Antitrypsin A1AT GOLD, RED OR SPECKLED. Refrigerated. 82103 Alpha 1 Acid Glycoprotein A1AG GOLD, RED

GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

UPDATED 11/15/10

Test NameGHS

CODESpecimen Type CPT

17-Hydroxyprogesterone, neonatal is in test description test code in Sunquest is 17654

17HP

RED.Separate serum after clotting and spinning. Refrigerated.

83498

ABO-Rh Type (including Du) ABRHRED. 1 LAVENDER OR PINK. Refrigerated.

86900

Acetaminophen ACETGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

82003

Acetone ACESGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

82009

Aerobic Wound Culture AWD

CULTURETTE (crush ampule/ provide specimen source/site) Room Temperature.

87070

Albumin ALBGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

82040

Alcohol (ETOS) chain of custody

ETOS

GRAY: Use Betadine to clean venipuncture site. Follow chain of custody collection procedure. Refrigerated.

82055

Alcohol (ETOH) medical nonchain of custody

ETOHGRAY: Use Betadine to clean venipuncture site. Refrigerated.

82055nonchain of custody venipuncture site. Refrigerated.

Adrenocorticotrophic Hormone ACTH

LAVENDER. Centrifuge and separate plasma specimens from cells. Transfer 1.5 mLs to a plastic, transport tube. Label Sample with "Plasma" sticker. Do not thaw. Frozen.

82024

Aldolase ALDGOLD, RED OR SPECKLED. Refrigerated.

82085

Aldosterone ALDSGOLD, RED OR SPECKLED. Refrigerated.

82088

Alkaline Phosphatase APGOLD, RED OR SPECKLED. Refrigerated.

84080

Alpha 1 Antitrypsin A1ATGOLD, RED OR SPECKLED. Refrigerated.

82103

Alpha 1 Acid Glycoprotein A1AGGOLD, RED OR SPECKLED. Refrigerated.

82985

Alphafetoprotein AFPT, tumor marker

AFPTGOLD,RED OR SPECKLED. Refrigerated.

82105

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Alphafetoprotein AFP, Maternal pregnancy screen2.0

AFP

GOLD, RED OR SPECKLED SEND 3.0 (1.5 MIN) mL serum FROZEN. Icteric or grossly hemolyzed specimens are not acceptable. Split serum into two tubes. Must include gestational age, LMP, weight, race, insulin dependent, number of fetuses and initial or repeat screening. Call Lab for Gestational worksheet: 678.312.4731.

82105

Alphafetoprotein AFP, Maternal pregnancy screen, Triple screen

AFP3

AFPS

GOLD, RED OR SPECKLED SEND 3.0 (1.5 MIN) mL serum FROZEN. Icteric or grossly hemolyzed specimens are not acceptable. Split serum into two tubes. Must include gestational age, LMP, weight, race, insulin dependent, number of fetuses and initial or repeat screening. Call Lab for Gestational worksheet: 678.312.4731.

82105, 82677, 84702

Ammonia GREEN place on ice and tranport to Ammonia (Not recommended for off site collection, as testing must be performed within 30 minutes)

AMM

GREEN place on ice and tranport to Laboratory within 30 min. Refrigerated.Do not freeze.

82140

Amylase, 24 hr. Urine A24

24 HOUR URINE CONTAINER/ NO PRESERVATIVE. 24 hour Urine collection. Refrigerate during collection.

82150

Amylase, Serum AMYGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

82150

ANA positive/negative only ANAGOLD, RED OR SPECKLED. Refrigerated.

86038

ANA with Reflex AANAGOLD, RED OR SPECKLED. Refrigerated.

86038

Anaerobic Wound Culture ANWD

PORT-A-CUL AND CULTURETTE. Requires two swabs: 1 submitted in Culturette *AND* 1 swab placed in anaerobic (Port-a-cul) transport media. Room Temperature.

87075

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Anafranil (aka Clominpramine aka Placil)

CLPN

LAVENDER (plasma), DARK NAVY BLUE (red label, serum), or RED (serum) tube. Centrifuge and immediately separate serum or plasma from the cells. Refrigerate.

80299

Anemia Profile ANEM

GOLD, Refrigerated. 1 LAVENDER, Refrigerated and 1 LAVENDER, Frozen.

82728, 83550, 85025, 82607, 82747, 85014

Angiotensin Converting Enzyme, ACE, ATCE

ATCEGOLD, RED OR SPECKLED. Refrigerated.

82164

Antibody Screen (Indirect Antiglobulin test)

ASRED OR LAVENDER OR PINK. Refrigerated.

86885

Anti Cardiolipin (Profile) Antibody

CARPGOLD, RED OR SPECKLED. Refrigerated.

86147

Anti CCP, Cyclic Citrullinated Peptide AB, IgG

CCPGOLD, RED OR SPECKLED. Refrigerated.

86200

Anti Mitochondrial Antibodies (AMA)

AMCAGOLD, RED OR SPECKLED. Refrigerated.

86256

10- BLUE. (Recommend sending to Laboratory for collection. Plasma must be Platelet poor). Centrifuge, pipette off plasma without disturbing 86146 (3),

Anti Phospholipin Panel MSC

must be Platelet poor). Centrifuge, pipette off plasma without disturbing "buffy coat" into plastic pour off tubes. Centrifuge Plastic pour off tubes, pipette all but button on the bottom into a new plastic pour off tube. Refrigerated.

86146 (3), 86147 (3), 86148 (3)

Anti Smooth Muscle Ab. (aka Actin antibody, IgG)

SMUAGOLD, RED OR SPECKLED. Refrigerated.

86256

Arthritis Profile RAP1

2- GOLD and 1- LAVENDER(Sed rate must be tested within 4 hours) Refrigerated.

86038, 86431, 80053,85652

ASO (Streptozyme) ASO GOLD, RED OR SPECKLED. Frozen. 86063

AST (SGOT) ASTGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84450

Auto Immune Panel AIPGOLD, RED OR SPECKLED. Refrigerated.

82340

Bacterial Antigen Panel BAGPGOLD, RED OR SPECKLED, OR 1 ml of CSF. Frozen.

86403

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Beta-2 microglobulin B2MSGOLD, RED OR SPECKLED. Room Temperature.

82232

Beta Strep Group B Culture BSCCulterette (crush ampule on bottom). Room Temperature.

87077

BHCG, beta subunit For cancer monitoring

BHCG GOLD, RED OR SPECKLED. Frozen. 84702

Bilirubin, Direct DB

GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED or Green Pediatric bullet. Refrigerated.

82248

Bilirubin, Neonatal TBP

GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED or Green Pediatric bullet. Refrigerated.

82247

Bilirubin, Total TBA

GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED or Green Pediatric bullet. Refrigerated.

82247

Blood Culture*** sensitivity-no charge

BLDC

BACTEC BOTTLES, Anaerobic and Aerobic. Use Aseptic TechniqueRoom Temperature.

87040

Blood Urea Nitrogen (BUN) BUNGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84520

B-Natriuretic (BNP) BNP LAVENDER OR PINK. Refrigerated. 83880B-Natriuretic (BNP) BNP LAVENDER OR PINK. Refrigerated. 83880

Bordetella pertussis IgG and IgA

MSC

17825X

GOLD, RED OR SPECKLED. Refrigerated.

86615-90 (4)

Bordetella pertussis, IgGMSC

17826X

GOLD, RED OR SPECKLED. Refrigerated.

86615-90 (2)

C Reactive Protein CRPGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

86140

C-Terminal Peptide CPPT GOLD, RED OR SPECKLED. Frozen. 84681

Calcium CAGOLD,GREEN LITH-HEP, RED OR SPECKLED. Refrigerated.

82310

Cancer Antigen 19 (CARBOHYDRATE ANTIGEN 19-9)

CA19GOLD,RED OR SPECKLED. Refrigerated.

86316

Cancer Antigen 125 C125

GOLD, RED OR SPECKLED. Grossly hemolyzed samples are unacceptable. Refrigerated.

86316

Cancer Antigen 27.29 CA27

GOLD, RED OR SPECKLED. Grossly hemolyzed samples are unacceptable. Room Temperature.

Page 4

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Candida Albicans IgG, IgM, IgA (Quest test code 30440X)

MSC

RED. Centrifuge and separate serum, pipette into plastic pour off tube, write RED SERUM on plastic tube. Room Temperature.

86628x 3

Candida albicans Antigen and Antibody Detection Panel (Quest test code 6643)

MSC

RED. Centrifuge and separate serum, pipette into plastic pour off tube, write RED SERUM on plastic tube. Refrigerated.

86403, 86628

Cannabinoids CANBURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated.

G0431

Carbamazepine(Tegretol) CRMZGOLD,GREEN LITH-HEP, RED OR SPECKLED. Refrigerated.

80156

Cardiac Profile CARDGREEN LITH. HEPARIN. Refrigerated.

82550, 83615, 84450

Cardiolipin Antibody CARPGOLD, RED OR SPECKLED OR BLUE. Refrigerated.

86147

CBC (includes platelets/differential if abnormal)

CBC LAVENDER. Refrigerated. 85025abnormal)

CEA, EIA CEAGOLD, RED OR SPECKLED. Refrigerated.

82378

Celiac Disease Panel CELGOLD, RED OR SPECKLED. Refrigerated.

82784

Ceruloplasmin CRPMGOLD, RED OR SPECKLED. Refrigerated.

82390

Cervical Biopsy PATHCervical sample in FORMALIN CONTAINER. Room Temperature

88305

Chem 7 (BMP-Basic Metabolic Panel)

CH7GOLD,GREEN LITH-HEP, RED OR SPECKLED. Refrigerated.

80048

Chlamydia/Chlamydophila Ab Panel 3 (IgG,IgA,IgM)

CHLM

GOLD, RED OR SPECKLED. Refrigerated. Testing includes: C. pneumoniae IgM, IgA, IgGC. trachomatis IgM, IgA, IgGC. psittaci IgM, IgA, IgG

86631x6, 86632x3

Page 5

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Chlamydia culture (legal cases, abuse) any site

CHC

DACRON/RAYON SWAB from endocervix, urethra, conjunctiva, rectal mucosa (without feces) fluid aspirate, tissue, nasopharynx or throat in MICROTEST (M4) microbe

transport tube. Do not use wood

swabs or cotton swab.

Specimens should befrozen -70 degrees C or colder Frozen.

Stability:-Room Temperature NO-Refrigerated: 72 hours-Frozen: 30 days (-70c)

87110, 87140

Air dried Conjunctival SLIDE or Endocervical SLIDE or Urethral SLIDE or Rectal SLIDE or Nasopharyngeal SLIDE or useMICRO TRAK(R) Chlamydia trachomatis Direct SpecimenCollection kit. Collection instructions: Before

Chlamydia Direct FA, rectum, throat, eyes

CFA

Collection instructions: Before specimen collection, removeand discard mucous and exudates/pus to preventinterference with assay performance.Rejection criteria:Vaginal or penile specimens will be rejected. Specimensidentified nonspecifically as genital will be rejected.Transport Container: Slide HolderTransport Temperature: Room TemperatureFrozen: unacceptable

87270

Chlamydia and GC DNA Probe GCCP

BLUE DNA CULTURETTE (Male) PINK DNA CULTURETTE (Female). Room Temperature.

87491, 87591

Chlamydia DNA probe CDNA

BLUE DNA CULTURETTE (Male) PINK DNA CULTURETTE (Female). Room Temperature.

87491

Page 6

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Chlamydia/GC Urine APTIMA MSC

URINE. Room Temperature: The patient should not have urinated for at least one hour prior to specimen collection. Direct patient to provide a first-catch urine into a urine collection cup, the rest of the void in the toilet. Collection of larger volumes of urine may result in specimen dilution that may reduce test sensitivity. Female patients should not cleanse the labial area prior to providing the specimen. Minimum: 2 mL

87491, 87591

Chlamydia Urine, APTIMA MSC

URINE. Room Temperature: The patient should not have urinated for at least one hour prior to specimen collection. Direct patient to provide a first-catch urine into a urine collection cup, the rest of the void in the toilet. Collection of larger volumes of urine may result in specimen dilution that may reduce test sensitivity. Female patients should not cleanse the labial area prior to providing the specimen.

87491

area prior to providing the specimen. Minimum: 2 mL

Cholesterol, Total CHOGOLD,GREEN LITH-HEP, RED OR SPECKLED. Refrigerated.

82465

Clomipramine (aka Anafranil aka Placil)

CLPN

DARK NAVY BLUE, LAVENDER OR RED. Centrifuge and pipette the plasma or serum (carefully) from the red cells, pipette into plastic pour off tube. Refrigerated.

80299

Clostridium Toxin Difficile CLOT

PLASTIC, LEAK PROOF CONTAINER (must receive in 30 minutes or Refrigerate)

87230

Clozapine/norclozapine CLOZ

GREEN SODIUM HEPARIN, LAVENDER OR RED**Do not use gel barrier tubes. Grossly hemolytic or lipemic samples are unacceptable. Centrifuge and immediately separate plasma or serumfrom the cells into a plastic, screw-capped vial. Frozen.

80154

Page 7

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Cofactor 5 Leiden Assay COF5LAVENDER, whole blood. Important: keep Room Temperature.

85220

Complement C3 C3CS

GOLD, RED, SPECKLED. Avoid hemolysis. Centrifuge serum specimens within 1 hour of collection. Immediately pipette serum into sterile, plastic, screw-capped vial(s) and freeze. Do not allow samples to thaw. Frozen.

86161

Complement C4 C4CS

GOLD, RED, SPECKLED. Avoid hemolysis. Centrifuge serum specimens within 1 hour of collection. Immediately pipette serum into sterile, plastic, screw-capped vial(s) and freeze. Do not allow samples to thaw. Frozen.

86161

C3 and C4 complement group MSC

GOLD, RED, SPECKLED. Avoid hemolysis. Centrifuge serum specimens within 1 hour of collection. Immediately pipette serum into sterile, plastic, screw-capped vial(s) and freeze. Do not allow samples to thaw. Frozen.

86161 x 2

Complement , total (50) CH50

GOLD, RED, SPECKLED. Avoid hemolysis. Centrifuge serum specimens within 1 hour of collection. Immediately pipette serum into sterile, plastic, screw-capped vial(s) and freeze. Do not allow samples to thaw. Frozen.

86162

Comprehensive Metabolic Panel (CMP)

CMPGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

80053

Copper CU

DARK BLUE NAVY (RED LABEL OR PURPLE LABEL). Refrigerated.Patient should refrain from taking vitamins, mineral or herbal supplements for at least 1 week prior to sample collection.Centrifuge and immediately separate serum or plasma from the cells into a pour-off plastic (trace metal free, element free tube). Contact laboratory for the special pour off tube.

82525

Page 8

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Cortisol AM CORAGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

82533

Cortisol PM CORPGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

82533

CPK, Total CKGREEN LITH. HEPARIN. Refrigerated.

82550

Creatinine Clearance, 24 hr. Urine

CRCL

GOLD and 24 HOUR URINE CONTAINER/ NO PRESERVATIVE. 24 hour Urine collection. Refrigerate during collection. Document Total Volume. Keep refrigerated during collection.

82570

Creatinine, Serum CREGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

82565

Cryptosporidium Specific Antigen

CSASStool in SAF (Yellow) TRANSPORT container. Room Temperature.

87328

Cryptococcal Antigen, Serum CCASGOLD, RED OR SPECKLED. Refrigerated.

86403

Cryptococcal Antigen Titer CRATGOLD, RED OR SPECKLED. Refrigerated.

86171

Cyclic Citrullinated Peptide AB, Anti CCP CCP

GOLD, RED, SPECKLED. Refrigerated.

86200Anti CCP CCPRefrigerated.

86200

Cystic Fibrosis Screen MSC

2- LAVENDER, whole blood. Room Temperature. Instructions: Please indicate the ethnicity of the patient. Specimen stability is crucial. Send immediately. Do not freeze.

83891, 83900, 83901x13,

83909, 83912, 83914x32

Cytoplasmic neutrophil antibody

CYNE

GOLD OR RED. Patient must be fasting. Centrifuge and transfer serum specimens to pour-off tubes. Refrigerated or Frozen.

86021

D Dimer QDIM

BLUE. Refrigerated. Blood should fill to the black error on side of tube. Gently invert tube 6 times.

85379

Depakote aka Depakene aka Valproic Acid

VAP

GOLD,GREEN LITH-HEP, RED OR SPECKLED. Refrigerated. Recommended collection 30 min prior to dose

80164

DHEA, unconjugate DHEU

RED. Centrifuge, pipette serum into plastic pour off tube. Place "Serum" sticker on pour off tube. Frozen

82626

Page 9

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Dhea Sulfate DHEAGOLD, RED, SPECKLED. Refrigerated.

82627

Digoxin DIGGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

80162

Dilantin DILGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

80185

Drug Screen, Urine Chain of custody 6 panel

IDP6

CHAIN CUSTODY URINE: Follow chain of custody collection procedure.This includes testing for the following with auto GC/MSconfirmation and integrity check: amphetamines, barbs, benzo's, Cannabinoids (THC), cocaine, opiates.

80100

Drug Screen, Urine Chain of custody 12 panel

ID12

CHAIN CUSTODY URINE: Follow chain of custody collection procedure.This includes testing for the following with auto GC/MS confirmation and integrity check: amphetamines, barbs, benzo's, Cannabinoids (THC), cocaine, fentanyls, meperidine, oxycodones, phencyclidines,

80100

oxycodones, phencyclidines, propoxyphene, methadone, opiates, tramodol. Room Temperature.

Drug Screen, Urine (Medical) UTOX

UTOXURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated.

80100

Drug Screen, Serum (Medical) BTOXGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

80100

Ear Culture *** sensitivity-no charge

EARCCULTURETTE or NP Swab. Room Temperature.

87070

Electrolytes LYTEGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

80051

Electrolytes, Urine LYTUURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated.

80051

EOS Count, Total EOST LAVENDER. Refrigerated. 85048

EOS Smear EOSS

SMEAR ON GLASS SLIDE. Urine, Sputum, or Nasal Smear. Refrigerated.

89190

Epstein Barr Virus Ab EBRGOLD, RED, SPECKLED. Refrigerated.

86665

Page 10

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Estradiol ES17GOLD, RED OR SPECKLED. Refrigerated.

82670

Estrogen ETTSGOLD, RED OR SPECKLED. Refrigerated.

82672

Ethanol (ETOS) chain of custody

ETOS

CHAIN OF CUSTODY. GRAY Must Use BETADINE to cleanse the venipuncture site. DO NOT USE ALCOHOL. Room Temperature.

82055

Ethanol (blood alcohol), non chain of custody

ETOH

GREEN LITHIUM HEPARIN or GOLD. Use BETADINE to cleanse the venipuncture site. DO NOT USE ALCOHOL. Room Temperature.

82055

ENAA ( Antibodies to extractable nuclear antigens: Anti Smith (SM) and Anti U1RNP

ENAAGOLD, RED OR SPECKLED. Refrigerated.

86235

Eye Culture ***sensitivity-no charge

EYECCULTURETTE (crush ampule). Room Temperature

87070

2 -LIGHT BLUE. Frozen. Blood should fill to the black error on side of tube. Gently invert tube 6 times. Centrifuge, then pipette plasma

Factor VIII (8) Activity (Collection by Laboratory recommended)

F8AC

times. Centrifuge, then pipette plasma (without disturbing red cells) into plastic pour-off tube. Centrifuge plastic pour-off tube and, again, pipette plasma (leaving button on bottom) into new plastic pour-off tube. Place "Plasma" label on pour off tube. Frozen.

85240

Factor VIII (8) Antigen (von Willebrand Factor antigen) (Collection by Laboratory recommended)

F8AG

2 -LIGHT BLUE. Frozen. Blood should fill to the black error on side of tube. Gently invert tube 6 times. Centrifuge, then pipette plasma (without disturbing red cells) into plastic pour-off tube. Centrifuge plastic pour-off tube and, again, pipette plasma (leaving button on bottom) into new plastic pour-off tube. Place "Plasma" label on pour off tube. Frozen.

85246

Fecal Occult Blood x 3 OCBLHemoccult Card x 3. Room Temperature.

82270

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Feces Culture ***sensitivity-no charge

FECC

Feces Transport vial (Orange) add stool until liquid rises to black line on side of transport vial. Room Temperature.

87045

Ferritin FERRGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

82728

Fibrinogen FIBR

BLUE. Refrigerated. Blood should fill to the black error on side of tube. Gently invert tube 6 times.

85384

Fluid, Albumin FALB RED. Refrigerated. 82042

Fluid, Amylase FAMY RED. Refrigerated. 82150

Fluid, AST FAST RED. Refrigerated. 84450

Fluid, Cell Count and Differential

FLDA RED. Refrigerated. 89051

Fluid, Cell Count and Differential (Synovial)

SYNA RED. Refrigerated. 89051

Fluid, Chloride FCL RED. Refrigerated. 82438

Fluid, Creatinine FCRE RED. Refrigerated. 82570

Fluid, Glucose FGLU RED. Refrigerated. 82947

Fluid, Hematocrit FHCT LAVENDER. Refrigerated. 85014

Fluid, LDH FLDH RED. Refrigerated. 83615

Fluid, PH FPH RED. Refrigerated. 83986

Fluid, Specific Gravity FSPG RED. Refrigerated. 84315

Fluid, Total Protein FTP RED. Refrigerated. 84155

Fluid, Uric Acid FURA RED. Refrigerated. 84560

Fluid, Triglycerides FTGL RED. Refrigerated. 84478

Fluids, Culture ***sensitivity-no charge

BF RED. Room Temperature. 87070

Folate, RBC & Vitamin B12 (MAPS profile)

MAPS

GOLD and 1 LAVENDER Refrigerated and 1 LAVENDER Frozen, whole blood.

82747, 82607

Folate, Serum FOLSGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

82746

Page 12

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Free Kappa Lambda light chain with ration

FKLR

GOLD, RED OR SPECKLEDSpecimen Rejection Criterion: Grossly hemolyzed samples or grossly lipemic samples are unacceptable. Refrigerated.

83883 (2)

Free and Total Prostatic Specific Antigen

FPRS

GOLD, RED OR SPECKLED. Centrifuge, pour into plastic pour-off tube. Place "Serum" sticker on pour off rube. Rejection criterion: Gross hemolysis, gross lipemia, or gross icterus. Frozen..

84153, 84154

Fructosamine FRUCGOLD, RED OR SPECKLED. Refrigerated.

82985

FSH FSHGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

83001

FTA antibodies (Treponema Pallidum)

FTAAGOLD, RED OR SPECKLED. Refrigerated.

86780

Fungus Culture ***sensitivity-no charge

FUNG

STERILE CONTAINER or CULTURETTE (Crush Ampule). Room Temperature.

87107

G6PD G6PDLAVENDER, whole blood.

82955G6PD G6PDLAVENDER, whole blood. Refrigerated.

82955

Gabapentin level GABA

LAVENDER. Draw sample two hours after last dose at steady-state. Do not use gel barrier tubes. Centrifuge, pipette plasma from cells as soon as possible. Pipette into plastic pour off tube. Place "Plasma" label on pour off tube.Transport at room temperature.

80299

Gamma-glutamyl Trans (GGTP)

GGTGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

82977

GC Screen GCCULTURETTE (crush ampule). Refrigerated.

80299

GC and Chlamydia DNA Probe GCCP

BLUE DNA CULTURETTE (Male) PINK DNA CULTURETTE (Female). Room Temperature.

87491, 87591

GC DNA Probe GDNA

BLUE DNA CULTURETTE (Male) PINK DNA CULTURETTE (Female). Room Temperature.

87591

Page 13

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

GC/Chlamydia Urine APTIMA MSC

URINE. Room Temperature: The patient should not have urinated for at leastone hour prior to specimen collection. Direct patient toprovide a first-catch urine into a urine collection cup, the rest of the void in the toilet. Collection of larger volumes of urine may result in specimen dilution that may reduce test sensitivity. Female patients should not cleanse thelabial area prior to providing the specimen. Minimum: 2 mL

87491, 87591

GC Urine, APTIMA MSC

URINE. Room Temperature: The patient should not have urinated for at leastone hour prior to specimen collection. Direct patient toprovide a first-catch urine into a urine collection cup, the rest of the void in the toilet. Collection of larger volumes of urine may result in specimen

87591

of urine may result in specimen dilution that may reduce test sensitivity. Female patients should not cleanse thelabial area prior to providing the specimen. Minimum: 2 mL

Genital Culture ***sensitivity-no charge

GENCCULTURETTE (crush ampule). Room Temperature.

87070

Gentamycin, Random GENRGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

80170

GGTP (GGT) GGTGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

82977

Giardia Specific AG, Stool GSASStool in SAF (Yellow) transport container. Room Temperature.

87329

Glucose GLU

GOLD, GREEN LITHIUM HEPARIN, RED, GRAY OR SPECKLED. Refrigerated.

82947

Glucose, Post -Prandial GLUP

GOLD, GREEN LITHIUM HEPARIN, RED, GRAY OR SPECKLED. Refrigerated.

82950

Page 14

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Glucose-6-Phos Dehydrogenase

G6PDLAVENDER, whole blood. Refrigerated.

82955

Glyco Hemoglobin A1C HBG1 LAVENDER. Refrigerated. 83036

Gram Stain GSBCULTURETTE (crush ampule) or Air-dried smear. Room Temperature.

87205

HCG, pregnancy test reflects to quantitation if positive, at no charge

HCGCGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84702

HCG, pregnancy test urine UHCGURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated.

81025

HCG, Beta (for neoplasm not pregnancy)

BHCGGOLD, RED OR SPECKLED. Refrigerated.

84702

HEA4, Ovarian Cancer Monitoring

MSC

RED. Frozen. Centrifuge, pipette serum into plastic pour-off tube. Place "Serum" label on pour-off tube.Instructions: Rejection criterion: Specimens exhibiting lipemia,

86305

2- GOLD and 1 LAVENDER. Refrigerated.

Use all Codes 85025,80053,84443,Health Profile 01 HEAL

Refrigerated. Includes: CBC, TSH, LIPP, IRON, FERR, CMP, URA

84443,80061,83540,82728,84550

Health Profile 02 HEA2

2 -GOLD and 1 -LAVENDER. Refrigerated. Includes: CMP, CBC, LIPP, FERR

Use all Codes 85025, 80061, 82728, 80053

Health Profile 03 HEA3GOLD and LAVENDER. Refrigerated.Includes: FERR, CBC

Use all Codes 80053, 82728

Health Profile 04 HEA42 - GOLD. Refrigerated.Includes: LIPP, TIBC, MAG, CMP. Refrigerated.

Use all Codes 80053, 80061, 83735, 83550

Heavy Metal, blood: arsenic, lead, mercury

HMB

DARK NAVY BLUE, whole blood. Refrigerated. Patient should refrain from eating seafood, or taking mineral and herbal supplements for at least 3 days before specimen collection. To avoid contamination, use powderless gloves.

83015

Page 15

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Heavy Metal, 24 hr urine: arsenic, lead, mercury, creatinine

HMS

24 hour urine collection in Acid Washed, Metal Free Container (Call the Laboratory for this collection container). Refrigerated. Keep Refrigerated during collection. Fish, shellfish, and kelp should not be consumed for at least one week before specimen collection. Please specify on the request form and on The urine container the total 24-hour urine volume.

83015

Heavy Metal 19, 24 hr urine: nickel, arsenic, lead, mercury, zinc, copper, chromium, creatinine cadmium

HM19

24 hour urine collection in Acid Washed, Metal Free Container (Call the Laboratory for this collection container). Refrigerated. Keep Refrigerated during collection. Fish, shellfish, and kelp should not beconsumed for at least one week before specimen collection. Please specify on the request form and onthe urine container the total 24-hour urine volume.

82175, 82300, 82495, 82525, 82570, 83655, 83825, 83885,

84630

Hematocrit, Micro MHCTLAVENDER PEDIATRIC BULLET. Refrigerated.

85014Refrigerated.

Hemochromatosis DNA HCHR LAVENDER. Room Temperature. 83890

Hemoglobin & Hematocrit HH LAVENDER. Refrigerated.85014,85018

Hemoglobin A1C HGB1 LAVENDER. Refrigerated. 83036

Hemoglobin Electrophoresis (EVALUATION)

HGBE LAVENDER. Refrigerated. 83020

Hepatitis A Antibody, IGM HAABGOLD, RED OR SPECKLED. Refrigerated.

86708

Hepatitis B Antibody HBABGOLD, RED OR SPECKLED. Refrigerated.

86706

Hepatitis B Core AB HBCGGOLD, RED OR SPECKLED. Refrigerated.

86704

Hepatitis B Surface Antigen HBAGGOLD, RED OR SPECKLED. Refrigerated.

87340

Hepatitis Be Antibody BEAGOLD, RED OR SPECKLED. Refrigerated.

86707

Hepatitis Be antigen & antibody (HBV Infectivity profile)

HBVPGOLD, RED OR SPECKLED. Refrigerated.

86707, 87350

Page 16

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Hepatitis B Virus drug resistance

MSCWHITE PPT TUBE (EDTA), Centrifuge and Freeze entire tube.

83891, 83894, 83900,

83904 x4, 83912

Hepatitis B Virus DNA ultraquant

HBVDGOLD, RED OR SPECKLED. Refrigerated.

87517

Hepatitis C Antibody NON-A,B)

HEPCGOLD, RED OR SPECKLED. Refrigerated.

86302

Hepatitis C genotype by PCR (must perform HCV Hepatitis C Virus RNA along with this test)*

HCVGWHITE PPT TUBE (EDTA), Centrifuge and Freeze entire tube.

87902

Hepatitis C Virus RNA Ultraquant by PCR*

HCVWHITE PPT TUBE (EDTA), Centrifuge and Freeze entire tube.

87522

Hepatitis (D) Delta AB HBDAGOLD, RED OR SPECKLED. Refrigerated.

86692

Hepatitis Profile HEPPGOLD, RED OR SPECKLED. Refrigerated.

80059

Herpes Simplex Culture HSCRED CAP VIRAL transport media. Refrigerated.

87255

GOLD, RED OR SPECKLED. Herpes Simplex DNA by PCR HDNA

GOLD, RED OR SPECKLED. Refrigerated.

87529

Herpes Simplex Virus1&2, IgG HSABGOLD, RED OR SPECKLED. Refrigerated.

86695-90, if (+) reflects

to 86696-90

HIV DNA by PCR HIVDLAVENDER, whole blood. Room Temperature.

83898

HIV 1 by RNA by PCR, ultraquant

HIVP

LAVENDER. Centrifuge, pipette plasma (gently) without disturbing red cells, pipette plasma into plastic pour off tube. Place "Plasma" label on pour off tube. Frozen.

83898

HIV Antibodies (HTLV3) HIVGOLD, RED OR SPECKLED. Refrigerated.

86703

HLA A,B,C PHENOTYPE PROFILE

HLAPACD CANARY YELLOW tube, whole blood. Room Temperature.

86813

HLA B 27, DNA typing H27B

ACD CANARY YELLOW tube, whole blood or 1 Lavender (whole blood). Room Temperature.

86812

Page 17

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Homocysteine level HMCS

RED, GOLD, OR SPECKLED1 mL SerumInstructions: Place the specimen in a refrigerator bath for 30 minutes after collection. Centrifuge the specimen as soon as possible after complete clot formation has taken place. Refrigerated.

83090

H-pylori (helicobacter pylori antibody)

HPYGOLD, RED OR SPECKLED. Refrigerated.

86677

H-pylori (stool) HPYS

Random Stool in a PLASTIC, LEAK PROOF CONTAINER. Frozen.Instructions: Patients should be off Proton Pump Inhibitors (PPI), antibiotics, or bismuth for two weeksbefore specimen collection.

87339

Human Chorionic Gonadotropin (HCG), Beta, for pregnancy (POS + reflexes to quantitation)

HCGCGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84702

Human Chorionic Gonadotropin (HCG), Beta, for BHCG

GOLD, RED OR SPECKLED. 84702Gonadotropin (HCG), Beta, for

neoplasm not pregnancy

BHCGGOLD, RED OR SPECKLED. Refrigerated.

84702

Hypersensitivity Pneumonitis Panel

HPNPGOLD, RED OR SPECKLED. Refrigerated.

86329

IGF Binding Protein 1 MSC

GOLD, RED OR SPECKLED. Instructions: Overnight fasting is preferred. Room Temperature.

83519

IGF Binding Protein 2 MSC

GOLD, RED OR SPECKLED. Instructions: Overnight fasting is preferred. Room Temperature.

83519

IGF Binding Protein 3 MSC

GOLD, RED OR SPECKLED. Instructions: Overnight fasting is preferred. Room Temperature.

83519

IGF I, (Insulin Like Growth Hormone)Electrochemiluminescence

INGF

GOLD, RED OR SPECKLED. Refrigerated.Instructions: Rejection Criteria:Gross hemolysis; Gross lipemia;Slightly, moderately, and grossly icteric samples.

84305

Page 18

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Imipramine/Desipramine aka Tofranil

IMDE

LAVENDER, GRAY, GREEN SODIUM HEPARIN, RED. Room Temperature. Do not use gel separator tubes. Collect just before next dose or at least 12 hours after last dose.

80174

Immune Status Panel, MMR MMRGOLD, RED OR SPECKLED. Refrigerated.

86735, 86762, 86765

Immunoglobulin A (IgA) IGAGOLD, RED OR SPECKLED. Refrigerated.

82784

Immunoglobulin E (IgE) IGEGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

86785

Immunoglobulin G (IgG) IGGGOLD, RED OR SPECKLED. Refrigerated.

82784

Immunoglobulin M (IgM) IGMGOLD, RED OR SPECKLED. Refrigerated.

82784

Immunoglobulin, quant. (IgA, IgG, IgM )

IGB

GOLD, RED OR SPECKLEDInstructions: Overnight fasting is preferred. Serum should beseparated immediately from clot.Centrifuge within 1 hour of collection and transfer serum specimens to sterile, plastic, screw-capped vial(s).

82784x3

sterile, plastic, screw-capped vial(s). Refrigerated.

Inflammatory Bowel Disease Differentiation Panel: Includes C-ANCA titer; P-ANCA titer; Atypical P-ANCA titer;PROTEINASE-3 ANTIBODY; Myeloperoxidase Antibody; ANCA Screen with Reflex to ANCA Titer; Saccharomyces cerevisiae Antibody (ASCA) IgA; Saccharomyces cerevisiae Antibody (ASCA) IgG;

MSC

6- GOLD, RED OR SPECKLED. Instructions: Patient must be fasting. Centrifuge and transfer serum specimens to clean, plastic, screw-capped vial(s). Refrigerated.

86021x3, 86671x2

Influenza A and B FLU

NASAL SWABS, NASOPHARYNGEAL SWAB OR WASHINGS. Room Temperature. No charcoal, gel swabs or viral transport media accepted.

87400 x 2

Insulin Level INSSGOLD, RED OR SPECKLED. Refrigerated.

83525

Page 19

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Insulin Like Growth Factor IGF I, Electrochemiluminescence

INGF

GOLD, RED OR SPECKLED. Refrigerated.Instructions: Rejection Criteria:Gross hemolysis; Gross lipemia;Slightly, moderately, and grossly icteric samples.

84305

Iron Profile, Total TIBCGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84466,83540

Iron, Serum IRONGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

83540

Keppra level (Levetiracetam) KPRA

RED, LAVENDER or GREEN SODIUM HEPARIN. Centrifuge and transfer serum or plasma to pour-off tube. Frozen.

80299

KOH Prep KOH

STERILE CONTAINER. Specify source on requisition. Room Temperature.

87220

Lamotrigine (Lamictal) LAMT

RED. Refrigerated. Recommendation: Draw 1/2 to 1 hour before next dose at steady-state.

87449

LDH LDGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

83615RED OR SPECKLED. Refrigerated.

Lead levels LB

For Adults: DARK NAVY BLUE, whole blood. Refrigerated.For children: LAVENDER Pediatric bullet. Follow Lead collection procedure.

83655

Legionella Antigen, urine LAGU

Instructions: Refrigerate urine immediately aftercollection. Store refrigerated 2-8 degrees C for up to14 days. For longer periods, store frozen -20 degrees C.Transport refrigerated urine samples refrigerated (coldpacks) to the laboratory.

87449

Levetiracetam (Keppra) KPRA

RED, LAVENDER or GREEN SODIUM HEPARIN. Centrifuge and transfer serum or plasma to pour-off tube. Frozen.

80299

LH(Luteinizing hormone) LHGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

83002

Page 20

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Lipase LIPSGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

83690

Lipid Profile LIPPGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

80061

Lithium LITHGOLD, RED OR SPECKLED. Refrigerated.

80178

Liver Kidney Microsome Ab. IgG (LKM-1)

ALKMGOLD, RED OR SPECKLED. Refrigerated.

86376

Liver Profile LIVRGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

80076

Lupus Like Anticoagulant LUPU

6 -BLUE. Blood should fill to the black error on side of tube. Gently invert tube 6 times. Centrifuge, then pipette plasma (without disturbing red cells) into plastic pour-off tube. Centrifuge plastic pour-off tube and, again, pipette plasma (leaving button on bottom) into new plastic pour-off tube. Place "Plasma" label on pour off tube. Frozen.

80500, 85610, 85613. If

reflexed to additional

testing, add: 85210,85220,85230,85240,85

250, 85260, 85270,85280,8

5597x2, 85611, 85635, 85670,85732

Frozen. 85611, 85635, 85670,85732

Lyme IgG and IgM antibodies LYGM

GOLD, RED OR SPECKLED. Refrigerated.Rejection criterion: Gross hemolysis or gross lipemia is unacceptable.

86618

Lymphocyte CD4 helper/inducer Subset Panel 4

LTHSLAVENDER, whole blood, important keep room temperature

88182

Lymphocyte Subset Panel 5 CD4MLAVENDER, whole blood, important keep room temperature

86361

Lysozyme Muramindase LYSS

GOLD, RED OR SPECKLED.Centrifuge serum specimens within 1 hour of collection. Transfer serum to sterile, plastic,screw-capped vial(s). Refrigerated.

85549

Macrocytic Anemia Profile MAPS

GOLD, Refrigerated. 1 LAVENDER, Refrigerated and 1 LAVENDER, Frozen.

82747, 82607

Magnesium MAGGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

83735

Page 21

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

MAIC Blood Cul-X MAIC

GREEN SODIUM HEPARIN, whole blood. Room Temperature or Specimen (list source) in a STERILE, LEAK PROOF CONTAINER. Room Temperature.

87116

Malaria Workup MALW LAVENDER. Refrigerated. 87207

Mercury level MRY

DARK NAVY BLUE (EDTA purple label), whole blood. Refrigerated. Patient should refrain from eating seafood, or taking mineral and herbal supplements for at least 3 days before specimen collection. To avoid contamination, use powderless gloves.

83825

Methylmalonic Acid MMA

RED. Centrifuge and pipette serum into plastic pour-off tubes. Place "Serum" label on pour off tube. Frozen.

82131

Micro albumin/creatinine ration, urine

MALUURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated.

82043

Add $20.00 to any miscellaneous test Miscellaneous Test

Add $20.00 to any miscellaneous test price quoted by GMC-Laboratory

MMR (Measles, mumps, rubella immune status)

MMR2 -GOLD, 2 -RED OR 2 -SPECKLED. Refrigerated.

86762

Monospot MSPTGOLD, RED OR SPECKLED. Refrigerated.

86403

Myasthenia Gravis Profile MGP

RED. Centrifuge, pipette serum into plastic pour-off tube. Place "Serum" Label on pour-off tube. Frozen.

83519

Mycoplasma Pneumonia Ab, IgG and IgM

MYCOGOLD, RED OR SPECKLED. Refrigerated.

86738

Myoglobin, Serum baseline MGBSGREEN LITH. HEPARIN. Refrigerated.

83874

Myoglobin, Urine MGBUURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated.

83874

Nasal Culture ***sensitivity-no charge

NASACULTURETTE (crush ampule). Room Temperature.

87077

Page 22

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Neisseria Gonorrhoeae RNA Urine use Aptima ™ urine collect kit

MSC

URINE. Room Temperature: The patient should not have urinated for at leastone hour prior to specimen collection. Direct patient toprovide a first-catch urine into a urine collection cup, the rest of the void in the toilet. Collection of larger volumes of urine may result in specimen dilution that may reduce test sensitivity. Female patients should not cleanse thelabial area prior to providing the specimen. Minimum: 2 mL

87591

Nicotine (continine), urine COTURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated.

83887

Nortryptyline/Amitriptyline aka Pamelor

AN

RED. Room Temperature.Collect just before next dose or at least 12 hours after last dose. Do not use serum separator (gel barrier) tubes.

80152

RED. Room Temperature.

Nortriptyline only NORT

RED. Room Temperature.Collect just before next dose or at least 12 hours after last dose. Do not use serum separator (gel barrier) tubes.

80182

Occult Blood x 3 OCBL Hemoccult Card x 3 82270

Osmolality, Serum OSMSGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

83930

Osmolality, Urine UOSMURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated.

83935

Ova and Parasites OPSStool in SAF (Yellow) transport container. Room Temperature.

87177

Package 15 (OB panel) includes: CBC, RPR, RUB,HBAG, TYSC

PK152 -LAVENDER and 3 -GOLD. Refrigerated.

85025, 86592, 86762, 87340, 86885, 86900

Parathyroid hormone, INTACT PTHGOLD, RED OR SPECKLED. Refrigerated.

83970

PH, Stool SPHRandom Stool in PLASTIC, LEAK PROOF CONTAINER. Frozen.

83986

Page 23

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Phenobarbital PHENGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

80184

Phosphorus PHOGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84100

Pin Worm Prep PWP Scotch Tape/Slide Prep. 87172

Placil, (aka Anafranil aka Clomipramine)

CLPN

LAVENDER (plasma), DARK NAVY BLUE( red label, serum), or RED (serum) tube. Refrigerate. Centrifuge and immediately separate serum or plasma from the cells.

80299

Platelet PLT LAVENDER. Refrigerated. 85049

Platelet Function Study CEPI

2 -BLUE. Refrigerated. Blood should fill to the black error on side of tube. Gently invert tube 6 times.

85576 x 2

Poliovirus Antibody, (Neutralization) Titer

MSCGOLD, RED OR SPECKLED. Refrigerated.

86382x3

Potassium KGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84132

Prealbumin PALBGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84134

Pregnancy test, reflexes to Pregnancy test, reflexes to quantitation if positive at no charge

HCGCGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84702

Procainamide & N. Acetyl Procainamide (Pronestyl)

PCM RED. Refrigerated. 80192

Progesterone PGTRGOLD, RED OR SPECKLED. Refrigerated.

84144

Prograf (Tacrolimas level) PRGF

LAVENDER, whole blood. Room Temperature.Instructions: Drug regimens, time and date of drug administration are to be noted on requisition.Therapeutic range applies to trough specimens drawn justbefore a.m. dose. Optimal time to draw specimen: 0.5-1 hour before next oral dose. Rejection criterion: Clotted specimens or gel barrier tubes.

80197

Prolactin PRLAGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84146

Page 24

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Prostatic Specific Antigen, Free and Total

FPRS

GOLD, RED OR SPECKLED. Centrifuge, pour into plastic pour-off tube. Place "Serum" sticker on pour off rube. Rejection criterion: Gross hemolysis, gross lipemia, or gross icterus. Frozen.

84153, 84154

Prostatic Specific Antigen PRSAGOLD, RED OR SPECKLED. Refrigerated.

84152

Protein C and S Activity CSAC

2- BLUE. Centrifuge, carefully pipette plasma (without disturbing the red cells) into pour off tube. Label with "Plasma" label. Frozen.

85303, 85306

Protein Electrophoresis SPE

GOLD, RED OR SPECKLED. Refrigerated. Fasting sample preferred.

84155, 84165

Protein, Total TPGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84155

Protein, Total (24 h Urine) TPU

24 hr. Urine Container (document volume and total hours collected). Refrigerated.

84156

Protime with INR PTI

BLUE. Refrigerated. Blood should fill to the black error on side of tube. Gently invert tube 6 times.

85610Gently invert tube 6 times.

PTT PTT

BLUE. Refrigerated. Blood should fill to the black error on side of tube. Gently invert tube 6 times.

85730

Quetiapine (Seroquel) serum or plasma

MTS

Lavender, spin and pipette plasma into plastic pour off tube (write 'plasma') orRed top tube, spin and pipette serum into pour off tube (write 'serum'). Refrigerated.

80299

Quinidine QN

RED, Centrifuge and transfer serum or plasma to a polypropylene or polyethylene transport tube. Frozen.

80194

Rabies Titer RABTGOLD, RED OR SPECKLED. Refrigerated.

86317

Rapid Strep Screen RSSCULTURETTE (crush ampule). Refrigerated.

87430

Rast Individual Allergens MSCGOLD, RED OR SPECKLED. Refrigerated.

86003 x number of allergens

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Reducing Substance, Stool STRDRandom Stool in PLASTIC, LEAK PROOF CONTAINER. Frozen.

81005

Renal Function Panel/Profile RENLGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

80069

Renin Activity REN

LAVENDER. Centrifuge, pipette plasma (gently) without disturbing red cells, pipette plasma into plastic pour off tube. Place "Plasma" label on pour off tube. Frozen.

84244

Respiratory Culture ***sensitivity-no charge

RESPSTERILE CONTAINER. Room Temperature.

87070

Respiratory Syncytial Virus RESY RSV Collect Kit. Room Temperature. 87280

Retic Count RET LAVENDER. Refrigerated. 85044

Rheumatoid Arthritis Factor RAGOLD, RED OR SPECKLED. Refrigerated.

86430

Rotavirus Antigen, Stool ROAN

Random Stool in PLASTIC, LEAK PROOF CONTAINER. Refrigerate immediately.

87425

RPR RPRGOLD, RED OR SPECKLED. Refrigerated.

86592Refrigerated.

RSV, Respiratory Sync Virus RESY

Collect nasopharyngeal specimen (wash or swab). Submit in saline or viral transport media. Do not send culturette swabs. Room Temperature.

87280

Rubella RUBGOLD, RED OR SPECKLED. Refrigerated.

86762

Salicylate, Serum SALIGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

80196

Salmonella and/or Shigella (order Stool culture)

FECC

Feces Transport vial (Orange) add stool until liquid rises to black line on side of transport vial. Room Temperature.

87045

Sed Rate, Westergren ESR LAVENDER. Refrigerated. 85652

Semen Analysis SMAN

PLASTIC, LEAK PROOF CONTAINER (must receive within 30 min. of collection). Critical to keep sample wrapped in towel next to the body.

89320

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Seroquel (Quetiapine), serum or plasma

MTS

LAVENDER, spin and pipette plasma into plastic pour off tube, place "Plasma" label on pour off tube orRed top tube, spin and pipette serum into pour off tube, place "Serum" label on pour-off tube. Refrigerate.

80299

Sickle Cell (Hemoglobin Electrophoresis)

HGBE LAVENDER. Refrigerated. 83020

Sickle Cell Screen, positive/negative only

SIKL LAVENDER. Refrigerated. 85660

Sodium, Serum NAGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84295

Sputum Culture ***sensitivity-no charge

RESPSputum in STERILE CONTAINER. Room Temperature.

87070

Sputum for AFB QAFBSputum in STERILE CONTAINER. Room Temperature.

87015

Staph Screen STAPCULTURETTE (crush ampule). Room Temperature.

87081

LAVENDER, whole blood. Room Temperature.Instructions: Drug regimens, time and

Tacrolimus (Prograf) level PRGF

Instructions: Drug regimens, time and date of drug administration are to be noted on requisition.Therapeutic range applies to trough specimens drawn just before a.m. dose. Optimal time to draw specimen: 0.5-1 hour before next oral dose. Rejection criterion: Clotted specimens or gel barriertubes.

80197

T3, Free (SEND-OUT) aka triiodothyronine, free

T3FGOLD, RED OR SPECKLED. Refrigerated.

84481

T3, Total T3GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84480

T3, Uptake (SEND-OUT) T3UGOLD, RED OR SPECKLED. Refrigerated.

84479

T4, Free FT4 GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84439

T4, Total T4GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84436

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Tegretol (aka Carbamazepine) CRMZGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

80156

Testosterone- need red top tube

TEST

RED. Refrigerated.Unacceptable Specimens:Samples exhibiting gross hemolysis and samples collected in any gel-separator tubes are unacceptable.

84403

Testosterone group, free & total

TG

RED. Refrigerated.Unacceptable Specimens:Samples exhibiting gross hemolysis and samples collected in any gel-separator tubes are unacceptable.

84402, 84403

Theophylline THEOGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

80198

Throat Culture ***sensitivity-no charge

THRCULTURETTE (crush ampule). Room Temperature.

87077

Thyroglobulin Ab TRGNGOLD, RED OR SPECKLED. Refrigerated.

86800

Thyroid Peroxidase TPAGOLD, RED OR SPECKLED. Refrigerated.

86376

Thyroid Profile- TSH preformed reflexes if abnormal- TSH

GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84443preformed reflexes if abnormal-n/c

TSHRED OR SPECKLED. Refrigerated.

84443

Thyroid Stimulating Immunoglobulin (TSI)

TSIG

GOLD, RED OR SPECKLED. Refrigerated. Rejection Criteria: Gross hemolysis, gross lipemia or gross icterus

83516

Thyroxine Binding Globulin TBGGOLD, RED OR SPECKLED. Refrigerated.

84442

Tissue Transglutaminase IgG TTRGGOLD, RED OR SPECKLED. Refrigerated.

83516

Tobramycin, Random TOBRGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

80200

Tofranil aka Imipramine and Desipramine

IMDE

LAVENDER, GRAY, GREEN SODIUM HEPARIN, RED. Room Temperature. Do not use gel separator tubes. Collect just before next dose or at least 12 hours after last dose.

80174

Total Iron Profile TIBCGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84466,83540

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Total Protein, 24 hr Urine TPU

24 HOUR URINE CONTAINER/ NO PRESERVATIVE. 24 hour Urine collection. Refrigerate during collection. (document volume and total hours collected)

84156

Total Protein/Creatinine Ratio TPCRURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated

84156,82570

Toxoplama IGM TXPMGOLD, RED OR SPECKLED. Refrigerated.

86778

Toxoplasma IGG TXPGOLD, RED OR SPECKLED. Refrigerated.

86777

Transferrin TFNGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84466

Tricyclics Class, Serum TRIGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

80102

Triglycerides TGLGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84478RED OR SPECKLED. Refrigerated.

TSH, third generation 3TSHGOLD, RED OR SPECKLED. Refrigerated.

84443

TSH, Thyroid Stimulating Hormone reflexes if abnormal- n/c

TSHGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84443

Type and Rh, blood ABRHLAVENDER, PINK OR RED. Refrigerated.

86900

Uric Acid URAGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

84550

Urinalysis- reflexes to microscopic (n/c) if abnormal

UMACUrine Cylinder Transport Tube. Refrigerated.

81001

Urine Culture ***sensitivity-no charge

URCUrine Culture Transport (Vacutainer). Room Temperature.

87086

Urine for Micro albumin/creatinine ration

MALUURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated

82043, 82570

Page 29

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Urine for Chlamydia/GC APTIMA

MSC

URINE. Room Temperature: The patient should not have urinated for at leastone hour prior to specimen collection. Direct patient toprovide a first-catch urine into a urine collection cup, the rest of the void in the toilet. Collection of larger volumes of urine may result in specimen dilution that may reduce test sensitivity. Female patients should not cleanse thelabial area prior to providing the specimen. Minimum: 2 mL

87491, 87591

Urine Porphyrins PQ

24 HOUR URINE COLLECTION. ** MUST PROTECT FROM LIGHT**. Indicate total volume on the transport container. Pour off 50 mL into a leak rook, screw top container. Document Total volume on the 50 mL aliquot. Frozen.

84120

UTOX, Urine (medical - no UTOX

URINE OR WHITE URINE 80100

UTOX, Urine (medical - no chain of custody)

UTOXURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated.

80100

Valproic Acid (Depakene) VAPGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

80164

Vancomycin VANRGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

80202

Varicella Zoster, IgG VZGOLD, RED OR SPECKLED. Refrigerated.

86787

Vitamin B12 (only) VB12GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.

82607

Vitamin D 25-Hydroxy VD

RED. Fasting specimen is preferred, but not required. Collectblood into plain red top tube without anticoagulant. Allow blood toclot at room temperature for 30 minutes prior to spinning. Spin for 20 minutes and pipette the serum from the cells immediately. Place "Serum" label on pour-off tube. Room Temperature.

82306

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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS

Test NameGHS

CODESpecimen Type CPT

Vitamin D,1, 25 dihydroxy D125

RED. Fasting specimen is preferred, but not required. Collectblood into plain red top tube without anticoagulant. Allow blood toclot at room temperature for 30 minutes prior to spinning. Spin for 20 minutes and pipette the serum from the cells immediately. Place "Serum" label on pour-off tube. Room Temperature.

82652

WBC (stool) include yeast WBY

Feces Transport vial (Orange) add stool until liquid rises to black line on side of transport vial. Room

87205side of transport vial. Room Temperature.

Zinc, serum ZNCS

DARK NAVY BLUE, red labeled metal free; pipette into metal free plastic pour off tube. Call laboratory for metal free supplies: 678.312.4731. Refrigerated.

84630

Adjustments/Updates made 11/15/10

Page 31