Specimen Collection Manual St. Joseph Mercy Oakland Laboratory REMARKABLE MEDICINE. REMARKABLE CARE.

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St. Joseph Mercy Oakland Laboratory
REMARKABLE MEDICINE. REMARKABLE CARE.
Specimen
Collection Manual
08/14
SJMO LABORATORY
GENERAL INFORMATION
This manual was reviewed and approved by:

Sherwin Imlay M.D.
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Sherwin P. Imlay, M.D.
Laboratory Director
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SJMO LABORATORY
GENERAL INFORMATION
TABLE OF CONTENTS
Click on the links below to access each section of the manual.
Introduction
Laboratory Locations
Telephone Numbers
Inpatient And Outpatient Orders
Laboratory Requisitions/Orders
Labeling Specimens
Patient Identifiers
Specimen Rejection
Courier Services
Test Supply Orders
Charting
Critical Values
STAT Testing
Venipuncture and Blood Collection
Order Of Draw
Visual Aids For Specimen Collection
Microbiology Collection Instructions
Visual Aids For Microbiology Collection
Patient Instructions
Laboratory Test Directory
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07/14
SJMO LABORATORY
GENERAL INFORMATION
ABOUT OUR LABORATORY: The laboratory of SJMO is accredited by the College of American
Pathologists. Staff includes pathologists licensed in both clinical and anatomic pathology, specialists
in Blood Bank Hematology, Chemistry and Microbiology, ASCP-registered medical technologists and
technicians, certified phlebotomists and other support personnel. The SJMO Laboratory has a
comprehensive test directory and participates in an extensive quality management program.
LABORATORY LOCATIONS
There are several convenient laboratory locations, with flexible hours to meet our patient’s needs.
Hours vary by location.
Medical Office Building Laboratory
44555 Woodward Avenue, Suite 040
Pontiac, MI 48341
Phone: (248) 858-3258
Fax: (248) - 858 - 3688
Hours: Monday through Friday, 8:30 a.m. to 5 p.m.
Outpatient Laboratory (Inside St. Joseph Mercy Oakland)
44405 Woodward Avenue. First Floor
Pontiac, MI 48341
Phone: (248) 858-3250
Fax: (248)858-6262
Hours: Monday through Friday, 7 a.m. to 5 p.m., Saturday 7:30 a.m. to 11:30 a.m.
Bloomfield Satellite Laboratory
42557 Woodward Ave., Suite 220
Bloomfield Hills, MI 48304
Phone: (248) 335-7834
Fax: (248)-335-7874
Hours: Monday through Friday, 7:45 a.m. to 5:30 p.m.
Union Lake Satellite Laboratory
2630 Union Lake Road, Suite 200
Commerce Township, MI 48382
Phone: (248) 366-0612
Fax: (248) 360 - 5226
Hours: Monday through Friday, 8 a.m. to 4:30 p.m.
(Closed 12:15 to 1:15 p.m.)
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SJMO LABORATORY
GENERAL INFORMATION
Clarkston Satellite Laboratory
7210 Ortonville Road, Suite 100
Clarkston, MI 48346
Phone: (248) 620-2940
Fax: 248 - 620 – 0468
Hours: Monday through Friday, 7:30 a.m. to 6 p.m.
Saturdays 8 a.m. to 1p.m.
Lake Orion Satellite Laboratory
1375 S. Lapeer Road, Suite 210
(Located within Mercy Medical Group)
Lake Orion, MI 48360
Phone: (248) 814-7310
Fax: 248-814-9978
Hours: Monday through Friday, 8:30 a.m. to 5 p.m.
(Closed 1 to 2 p.m.)
Waterford Satellite Laboratory
5800 Highland Road
Waterford, MI 48327
Phone: (248) 673-7583
Fax: (248) 674-1453 Hours: Monday through Friday 8:30 a.m. to 5 p.m.
(Closed 12:15 to 1:15 p.m.)
Lexus Satellite Lab
44200 Woodward Ave., Suite 105
Pontiac, MI 48341
Phone: (248) 334-7195
Fax: (248) 332-3747
Hours: Monday through Friday, 8:30 a.m. to 5 p.m.
(Closed 1 to 2 p.m.)
White Lake Urgent Care
320 Town Center Boulevard (in the Village Lakes Plaza)
White Lake, MI 48386
Phone: (248) 758-7800
Fax: (248)698-4281
Hours: Monday through Friday 8 a.m. to 9 p.m.
Sat and Sun 8 a.m. to 8 p.m.
Lake Orion Urgent Care
1375 S Lapeer Rd, Suite 106
Lake Orion, MI 48360
Phone: (248)693-9040
Fax: (248)693-9007
Hours: Monday through Friday 8 a.m. to 9 p.m.
Sat and Sun 8 a.m. to 8 p.m.
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SJMO LABORATORY
GENERAL INFORMATION
Waterford Urgent Care
5210 Highland Rd, Suite 100
Waterford, MI 48327
Phone: (248)673-2474
Fax: (248)618-0355
Hours: Monday through Friday 8 a.m. to 9 p.m.
Sat and Sun 8 a.m. to 8 p.m.
LABORATORY TELEPHONE NUMBERS AND KEY PERSONNEL
PATHOLOGY DEPARTMENT
248-858-3190
Medical Director, Clinical Laboratory
Medical Director, Anatomic Pathology
Medical Director, Blood Bank
Medical Director, Chemistry
Medical Director, Hematology
Medical Director, Microbiology
Dr. Sherwin Imlay
Dr. James Furlong
Dr. Sherwin Imlay
Dr. Brian Edelman
Dr. Donald Peven
Dr. John Fischer
MAIN LABORATORY TELEPHONE
MAIN LABORATORY FAX
248-858-3600
248-858-6675
Laboratory Information Systems
Laboratory Quality Manager
248-858-3196
248-858-3449
Director of Laboratory Services
Client Service Representatives
Anatomic Pathology/Cytology
Anatomic Pathology/Cytology Supervisor
Blood Bank
Blood Bank Supervisor
Chemistry
Chemistry and Hematology Supervisor
Coagulation and Urinalysis
Mercy Lab and Phlebotomy Supervisors
Microbiology
Microbiology Supervisor
PM Shift Supervisor
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248-858-6179
248-858-6295
248-858-3198
LABORATORY DEPARTMENTS
248-858-6883
248-858-6231
248-858-3272
248-858-6062
248-857-6706
248-858-6980
248-858-6728
248-858-6295
248-858-6256
248-858-6187
248-858-3296
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07/14
SJMO LABORATORY
GENERAL INFORMATION
ORDERING LABORATORY TESTS
INPATIENT ORDERS
Inpatient orders are placed electronically though the hospital information system.
OUTPATIENT ORDERS
Outpatient orders may be placed electronically or may be marked on a laboratory requisition form.
Each request form should include the following:
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Patient’s name (first and last)
Date and time of collection
Date of birth
Sex
Diagnosis code
Patient’s address and phone number
Source of specimen ( if pathology & microbiology requisition)
Date of last menses, pregnancy status, surgical history, previous abnormal paps or biopsies
( if cytology requisition)
Requesting physicians(s) phone number(s)
Billing information
Tests requested
Physician /provider signature
The following request forms for outreach testing are available:
 General Laboratory Requisition Form (see Figure 1)
 Cytopathology / Histology Requisition Form (see Figure 2)
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07/14
SJMO LABORATORY
GENERAL INFORMATION
Figure1: Sample General Laboratory Requisition Form
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07/14
SJMO LABORATORY
GENERAL INFORMATION
Figure 2: Sample Histology/Cytology Test Requisition Form
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SJMO LABORATORY
GENERAL INFORMATION
LABELING OF SPECIMENS
To ensure the proper specimen identification it is essential that each tube or container be legibly
labeled with the following information:
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Patient’s first and last name
Patient’s Date of birth
Date and time of collection
Initials of person collecting specimens
Site and type of specimen (For Microbiology specimens, tissue biopsies, excisions, and
cytology)
Cytology slide specimens require that the site and source be noted on the slide(s) in
pencil.
INPATIENT SPECIMEN LABELING JOB AID
Specimens must be labeled at the bedside immediately after collection
All tubes specimens from the patient must be labeled with computer generated label or
 Patient’s first and last name
 Date of birth
 Date and time of collection
 Initials of person collecting specimens
 Site and type of specimen (For cultures, tissue biopsies, excisions, and cytology)
Ensure information on the label matches the patient's wristband EXACTLY.
Place the label on the tube horizontally as shown.
Do not wrap the label around the tube
Do not flag the label
Do not cover any of the tube cap with the label
PATIENT IDENTIFIERS Inpatient and Outpatient
Properly identify the patient using two patient identifiers. See St Joseph Mercy Oakland Policy –
Patient Identifiers.
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SJMO LABORATORY
GENERAL INFORMATION
SPECIMEN REJECTION
Occasionally, specimens are delivered to the laboratory without complete patient ID, with incorrect
patient identification or without any patient identification. In the event that the specimen(s) are
incorrectly submitted the following procedures will be used.
Incompletely Labeled Specimens
 Inpatient: Specimen must be recollected. In rare instances when the specimen cannot be
recollected the physician must sign an Inpatient Mislabel Specimen Consent Form for the
labeling corrections.
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Outpatient: The office is contacted and a Mislabel/Unlabeled Specimen Consent Form for the
labeling corrections if provided to the physician.
Unlabeled Specimens
 Inpatient: Unlabeled or specimens labeled with wrong patient information must be redrawn.
In rare instances when the specimen cannot be recollected the physician must sign off on the
labeling corrections. Blood bank specimens will always need to be recollected.
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Outpatient: The office is contacted and a Mislabel/Unlabeled Specimen Consent Form for the
labeling corrections if provided to the physician.
The laboratory will contact the physician's office for follow up on the following issues.
 Test requested - No specimen received
 Misspelled name, or unable to read
 Clotted specimen
 QNS (insufficient specimen)
 Hemolyzed specimen
 Incorrect specimen container or collection tube
 Specimen improperly collected
 Specimen not transported properly
 Stability exceeded
 A specimen received without an order
 No diagnosis code given.
COURIER SERVICE
St. Joseph Mercy Oakland Laboratory provides a courier service for routine and stat pick- up
service to physician offices and clinics.
A lock box can be provided for after hour pick-ups.
TEST SUPPLIES
Inpatient: Within the hospital, supplies for laboratory testing are obtained through the SJMO Supply
Chain. Some specialized supplies may be obtained directly from the Laboratory.
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SJMO LABORATORY
GENERAL INFORMATION
Outpatients: The lab will supply all forms, blood collection tubes and a l l m a t e r i a l s r e l a t e d
t o s p e c i m e n c o l l e c t i o n . (See supply order form).
Figure 3: Lab Supply Order Form
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SJMO LABORATORY
GENERAL INFORMATION
CHARTING
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Charts can be delivered to the physician’s office by the courier, fax or electronic interface.
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Critical values will be called to the licensed caregiver. . See the complete list of SJMO
Hospital Critical Values for more detail.
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Outpatient results are routinely sent to the referring physician. Additional copies will be sent
to consulting physician(s) if indicated on the Test Requisition Form.
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Reports can be delivered to the physician’s office by the courier, put in the physician’s
mailbox in the hospital, faxed or printed at the office.
CRITICAL VALUES
The laboratory values that will be called 24 hours/day, 7 days/week are as follows
The following critical results will only be called once every 24 hours: CKMB% and Troponin
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SJMO LABORATORY
GENERAL INFORMATION
TEST – TEST CODE
CRITICAL ABNORMAL
TEST RESULT
Below
Above
OUTPATIENT EXCEPTION
Blood Bank
Positive
HIV LD
HIV Rapid
Negative
Positive
General Chemistry
Bilirubin total (>3 months)
Bilirubin total (0-3 months)
Bilirubin, direct (0 - 3 months)
BUN (0-28 day)
BUN – (1 mo -150 yr)
Calcium, ionized, @ pH 7.4
Calcium, total
Carboxy-Hemoglobin (CO-HGB) (0 - 5 yrs)
Carboxy-Hemoglobin (CO-HGB) (>5 yrs)
Chloride
CO2
Inorganic Phosphorus
Potassium
Sodium
Uric Acid
Inorganic Phosphorus
Enzymes
Amylase
CK (outpatient physician offices only)
CK
CKMB Index - %
Glucose
Glucose, random–peds (0-1 mo)
Glucose, random-peds (1 mo–5 yrs)
Glucose, random - (> 5 yrs)
Glucose (fasting) - pediatrics (0 - 12 months)
Glucose (fasting) - adult (> 12 months)
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3.7 mg/dl
7 mg/dl
70 mEq/L
9 mEq/L
1 mg/dl
3 mEq/L
125 mEq/L
15 mg/dl
15 mg/dl
2 mg/dl
50 mg/dl
114 mg/dl
6.3 mg/dl
13 mg/dl
10%
20%
140 mEq/L
After office hours call in AM
40 mEq/L
After office hours call in AM
After office hours call in AM
After office hours call in AM
6 mEq/L
155 mEq/L
17.0 mg/dl
1 mg/dl
300U/L
1000U/L
10,000U/L
3%
40 mg/dl
60 mg/dl
60 mg/dl
40 mg/dl
60 mg/dl
After office hours call in AM
After office hours call in AM
200 mg/dl
450 mg/dl
450 mg/dl
180 mg/dl
450 mg/dl
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07/14
SJMO LABORATORY GUIDE
GENERAL INFORMATION
TEST – TEST CODE
Glucose, (fasting) – DM
Glucose, (fasting) – Gestational DM
Glucose - 1 Hr, 2 Hr, 2Hr (Diabetes), 3Hr, 4Hr, 5
6Hr
Glucose
– 2 Hr Post Prandial
Therapeutic Drug Monitoring (TDM)
Digoxin
Lithium
Theophylline
Toxicology
Acetaminophen
Carbamazepine
CRITICAL
ABNORMAL
Below
TEST
RESULT
60 mg/dl
40 mg/dl
60 mg/dl
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TEST – TEST CODE
450 mg/dl
450 mg/dl
450 mg/dl
2.4 ng/ml
2 mEq/L
23 mcg/ml
100 mcg/ml
15 mcg/ml
Phenytoin (Dilantin)
Gentamicin (random, peak)
Gentamicin (trough)
Phenobarbital
Salicylate
Tobramycin (random, peak)
Tobramycin (trough)
Valproic Acid
Vancomycin (random, peak, trough)
Hematology - Coagulation
Hemoglobin, newborn (0 - 7 days)
Hemoglobin (> 7 days) - inpatient
Hemoglobin (> 7 days) - outpatient
Hematocrit, newborn (0 - 7 days)
PTT
Prothrombin Time INR
Platelets, newborn (0 – 1 month)
Platelets (> 1 month)
WBC, newborn (0 - 1 month)
WBC (> 1 month)
OUTPATIENT
EXCEPTION
Above
30 mcg/ml
12 mcg/ml
3 mcg/ml
50 mcg/ml
30 mg/dl
12 mcg/ml
3 mcg/ml
125 mcg/ml
50 mcg/ml
13.1 g/dl
6.1 g/dl
7.1 g/dl
40%
23.9 g/dl
68%
99 sec
5.9
100,001/mm
30,001/mm3
5001/mm3
29.9 x
10/mm3
2.1 x 10/mm3 29.9
x
10/mm3
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SJMO LABORATORY GUIDE
GENERAL INFORMATION
TEST – TEST CODE
Neutrophils
Malaria smear
Send Outs
AFP Screen
Caffeine
Chlamydia
CMV IgM
Complete Viral Culture, CSF only
Neisseria Gonorrhoeae (GC)
Norovirus
Pertussis
Syphilis Antibody or FTA
Varicella IgM
Urinalysis
Glucose for Pediatrics (AGE<10)
CRITICAL ABNORMAL
TEST RESULT
Below
Above
OUTPATIENT EXCEPTION
1.1 x 10/mm3
Positive
Positive
30 mcg/ml
Positive
Positive
After office hours call in AM
Positive
After office hours call in AM
Positive
Positive
Positive
Positive
Positive
After office hours call in AM
After office hours call in AM
After office hours call in AM
After office hours call in AM
After office hours call in AM
Trace
After office hours call in AM
Microbiology
Positive Fungal Culture with Blastomycosis, Histoplasmosis, Coccidiomycosis or Cryptococcosis
Positive Blood culture
Positive AFB smear*, ** or culture *
Positive culture for Mycobacterium tuberculosis **
Positive CSF Gram Stain or Positive CSF cultures
Positive Cryptococcal antigen
Positive Group B strep antigen (CSF) or culture on infant ≤ 2 weeks of age
Positive Legionella culture or antigen
Positive Listeria monocytogenes culture (CSF, Blood)
Positive Neisseria meningitidis (CSF, Blood only) – must call to Doctor and floor
Staphylococcus aureus that is intermediate or resistant to vancomycin
(VISA/VRSA) Positive Clostridium difficile toxin
Possible bioterrorism agent or emerging infection
*After office hours call in AM
**If unable to contact a responsible licensed caregiver contact Infection Control and the
Oakland County Health Department, TB Control Division
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SJMO LABORATORY GUIDE
GENERAL INFORMATION
Outreach specimens collected from offsite clients will have a turnaround time of 4 hours from
notification.
LABORATORY APPROVED STAT LIST
Category A: Goal: 91% of all Inpatient STATS completed within 30 minutes.
Blood Gases
Category B: Goal: 91% of all Inpatient STATS completed within 60 minutes.
Acetaminophen
Electrolytes
Ethanol
Ammonia
FFN- Fetal Fibrinectin
Amylase (serum)
Fibrinogen
Bilirubin, Total (adult)
Glucose, serum or CSF
Bilirubin, T&D (neonatal)
Gram Stain (CSF)
BNP
Group B Strep Antigen (CSF) 4N/NICU infants
BUN
hCG - serum and urine (qualitative)
Calcium/ Ca++
BhCG - serum (quantitative)
Carbon Monoxide
Influenza Ag Testing ER + 4 N
CBC w/auto differential
HIV Screen
Cell count (CSF)
Iron
CKMB
Lactic Acid,
CK, Total
Lithium
Chloride, serum or CSF
Lamellar Count
Creatinine, serum
Lamellar Count
Digoxin
Magnesium
Dilantin®
Methemoglobin
Dimer
Osmolality
Drug Screen – serum
Partial Thromboplastin Time (PTT)
- Ethanol (quantitative)
Phosphorus
- Acetaminophen (quantitative)
Platelet Count
- Salicylates (quantitative)
Potassium, serum
- Tricyclics (qualitative)
Protein, CSF
Drug Screen – urine
Prothrombin Time (PT)
- Opiates (qualitative)
RSV
- Cocaine (qualitative)
Salicylates
- Benzodiazepine (qualitative)
Sodium, serum
- PCP (qualitative)
Strep Screen
- Barbiturates (qualitative)
Theophylline
- Methadone (qualitative)
Troponin I
Urinalysis
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Venipuncture and Blood Collection
Revised 08/26/14
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Table of Contents
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A. Equipment
B. Preparation of the patient
C. Blood collection
D. Special collections
E. Collection tube, anticoagulant, specimen amounts
F. Patient reactions
G. Powerchart ordering and lab sweeps
H. Rejection of specimens
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A. EQUIPMENT
• Phlebotomy cart or tray with the following items:*
Disposable Gloves
Alcohol preps
Sterile Gauze
Syringes
Safety needles
Butterfly needles
Adhesive bandage or tape
Vacutainer holders
Indelible marking pen
Biohazard bags
Sharps container
Evacuated tubes
Luer Adaptors
Microtainer containers
Lancets
Blood transfer device
*If a tray is utilized, it may not be brought into the patient’s room.
*A cart or tray may not be brought into an isolation room.
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B. PREPARATION
• The phlebotomist should use correct hand hygiene per hospital
policy.
• Review order/labels for all tests that are to be collected to
determine the correct tubes and special collections that may be
required.
• Correctly identify the patient. Refer to the lab policy “Patient
Identification and Specimen Labeling Policy”.
• In an outpatient setting, patients under 18 years old cannot be
drawn unless parental consent form has been signed and
consent has been documented by the staff over the phone.
Minors with standing orders for blood work may have a parent
signed consent form on file enabling them to have the
venipuncture without a parent present for each visit.
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B. PREPARATION (cont.)
• Verify that the appropriate pretest preparation such as fasting,
drug infusions, etc. has occurred.
• Explain the procedure to the patient. (If the patient refuses to
have their blood drawn, do not proceed. For inpatients inform
the nurse and document the delay, if an outpatient inform the
ordering physicians office.)
• If needed, raise the patient’s bed remembering to return the bed
to the original position.
• Prepare the equipment.
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C. Blood Collection
Selection of venipuncture site and tourniquet application:
• Put on gloves.
• Apply the tourniquet gently (do not apply the tourniquet too
tight as it will compress the artery).
• Ask the patient to close their hand. Do not have the patient
pump his hand or to make a tight fist. This can cause
hemoconcentration and hemolysis.
• Locate a vein by site and palpitation. Vein palpitation is
performed with the index and second fingers and is more
important than being able to see the vein. The three veins most
often used are the cephalic, basilica, and median cubital.
• Do not leave the tourniquet on longer than one minute. This
can cause hemoconcentration and hemolysis.
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C. Blood Collection (cont.)
Venipuncture using a vacutainer:
• Cleanse the site in a circular motion, starting at inside of the site
and working outward in widening concentric circles.
• Allow the alcohol to dry for 30 seconds. (If you are collecting an
alcohol level, use another method of cleansing.)
• Do not touch the site again.
• Attach the vacutainer holder to the needle.
• The vein should be anchored with the phlebotomists thumb 1-2
inches below the venipuncture site.
• Insert the needle, with the bevel up, at an angle between 15 and 30
degrees from the arm.
• Collect the tubes in the correct order of draw by gently pushing
the tube on the end of the adaptor keeping the needle as stable as
possible. (Order of Draw: Blood cultures, Blue, Red, SST, Orange,
Green, Purple or pink, Gray, and Yellow.)
• Once the blood flow is established, release the tourniquet and
have the patient open his hand .
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C. Blood Collection (cont.)
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Allow the tubes to fill until the vacuum is exhausted and the blood
flow ceases.
As each tube is removed it should be inverted several times to
ensure mixing.
Before taking the needle out of the patient’s arm, remove the last
tube being collected.
Remove the needle as quickly as possible, activate the safety
device, and immediately place sterile gauze over the puncture site.
Invert the tubes 8-10 times.
Hold pressure on the site until the bleeding stops. If the bleeding
continues for greater than 5 minutes or is excessive, the nurse
should be notified. In the outpatient areas, if bleeding continues
greater than 5 minutes apply cold compresses maintaining
pressure on the site. Have the patient elevate the arm above heart.
If unable to stop bleeding, notify the ordering physician.
Bandage the site.
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C. Blood Collection (cont.)
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Label the specimens. (Refer to the lab policy “Patient Identification
and Labeling Policy.”) Labels are placed lengthwise and aligned
straight directly below the cap with patients last name at the top.
Always label at patient's bedside. Record the patients A# from the
wristband (inpatient), date, time of collection, and your initials
onto each label.
In the outpatient setting, the patient must remain in the chair until
labeling is complete. The specimen must have 2 patient identifiers
on the tube. (The Laboratory order label, or the patient name
and/or date of birth or requisition label with number.)
Dispose of supplies: All needles must be disposed of in a sharps
container. Gloves, gauze, tape, and tourniquets should be
disposed of in the patient’s trash receptacle.
Return the bed to original position. Turn off the lights if you
turned them on. Thank patient as leaving. Wash your hands.
Inpatient specimens should be sent to the lab in a biohazard bag
within 20 minutes of collection. Outpatient specimens should be
in the lab within 2 hours or centrifuged.
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C. Blood Collection (cont.)
Venipuncture using a needle and syringe :
• The advantages of using a syringe include:
• It is easier to collect blood from tiny/fragile veins with a syringe
because the phlebotomist can control the amount of pressure
exerted on fragile veins.
• The blood appears in the hub of the needles confirming that the
needle is in the vein.
• The procedure for drawing blood with a syringe is the same as
with a Vacutainer (see above) except for:
• the syringe plunger must be pulled back on.
• A transfer device is used to put the blood in the appropriate
tubes (using the same order of draw as above).
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C. Blood Collection (cont.)
Venipuncture using a winged infusion set:
• The advantages of using winged infusions sets include:
• Ease of draw with persons with tiny or poor veins or when
drawing from veins in the hand. Butterfly needles are available
in 23g and 25g.
• When drawing, blood will show in the tubing indicating you are
in a vein.
• Winged infusion sets can be used with a vacutainer system or
syringe.
The procedure for drawing blood with a winged infusion set is
the same as with a Vacutainer (see above) except for:
• A discard tube (non-additive or blue top) should be drawn before
a blue top so that the blood collection tubing dead space is
accounted for to ensure that the blue top tube is filled for the
proper anticoagulant/blood ratio. When using a syringe, a
transfer device is attached to put the blood into the appropriate
tubes.
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D. Special Collections
Timed Collections:
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There are two basic types of timed collections:
A single blood specimen ordered to be drawn at a specific time
(glucose, PTT, or drug levels)
A test that may require several blood specimens collected over a
period of time (glucose tolerance tests, PTT, PT, CBC, Troponins).
Collecting Glucose Tolerance Tests:
The glucose tolerance test (GTT) is a procedure performed for the
diagnosis of diabetes mellitus or hypoglycemia. A glucose level is
determined with a glucometer prior to the patient being given a
glucose solution to drink. If the glucometer result is greater than 140,
the test is discontinued.
The patient is given a glucose solution to drink and additional glucose
levels are drawn at timed intervals. Timing of the specimen collection
is critical, because test results are related to the scheduled times.
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D. Special Collections (CONT.)
Diurnal Specimens:
• Phlebotomist can be requested to draw specimens for tests at
specific times, usually corresponding to the peak diurnal level.
Plasma cortisol levels drawn between and 0800 and 1000 will be
twice as high as levels drawn at 1600.
Therapeutic Drugs:
• To ensure patient safety and medication effectiveness, the blood
levels of many therapeutic drugs must be closely monitored.
Examples of frequently monitored therapeutic drugs are:
Digoxin, phenobarbital, lithium, gentamycin, tobramycin,
vancomycin, amikacin, and theophylline. Random specimens are
occasionally requested; however, the most beneficial levels are
those drawn before the next dosage is given (trough level) and
shortly after the medication is given (peak level).
• Therapeutic drug monitoring collections are coordinated between
pharmacy, nursing, and the phlebotomist.
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D. Special Collections (cont.)
Timed Coagulation Studies:
• All coagulation collection tubes must be filled 90% for accurate
results.
• PT’s are commonly ordered to monitor oral anticoagulant
therapy. Patients are often collected every 4 hours.
• PTT’s are commonly used for monitoring heparin and are
ordered as timed collections. The time of collection is critical
to the pharmacy determining the dosing level of heparin for the
patient.
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E. COLLECTION TUBE AND SPECIMEN
AMOUNTS
• All blood tubes with anticoagulant should be filled to ensure
the correct anticoagulant to blood ratio.
• Specimen amount, tube type, and any special collection
requirements are listed along the bottom of every laboratory
order label. The laboratory’s information system updates
specimen changes immediately, ensuring the accuracy of the
information on all laboratory order labels.
• To maximize the efficiency of the automated line the minimum
volume of 3ml should be collected for all chemistry tests and a
minimum volume of 1.5 ml for all hematology tests run at
SJMO.
• Blood Bank specimens require a minimum volume of 1ml.
• All specimens collected in a microtainer should be filled to the
appropriate line.
• The following chart outlines the collection tubes (with additive),
tube size, min-tube volume and the associated tests.
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E. COLLECTION TUBE AND SPECIMEN
AMOUNTS
TUBE
ADDITIVE
TUBE SIZE
VOLUME
TESTS
Mint Green Top
Lithium Heparin
4.5 ml
3.0 ml
Chemistry
Lavender Top
K2 EDTA
4.0 ml
1.5 ml
Hematology
Blue Top
Na Citrate
2.7 ml
2.7 ml
Coagulation
White/clear top
None
6.0 ml
3.0 ml
Urine Chemistry
SST
Separator Gel
4.5 ml
3.0 ml
Chemistry
Orange
RST Thrombin
5.0 ml
3.0 mL
Troponin
Navy Blue Top
None
6.0 ml
Warde Catalogue
Aluminum, zinc,
copper , Selenium
Navy Blue Top
EDTA
7.0 ml
Warde Catalogue
Lead, Arsenic,
Mercury, Heavy
Metals
Green
Na Heparin
10.0 ml
Warde Catalogue
Cytogenetics, fish,
Vit. B1
Yellow
ACD
6.0 ml
Warde Catalogue
Flow cytometry
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F. PATIENT REACTIONS
Occasionally a patient may have a reaction that may result in
loss of consciousness. Fainting occurs when the blood leaves
the extremities and collects in the trunk of the body resulting in
a deficiency of the blood supply to the brain. The following
symptoms may indicate a reaction:
• Extreme paleness
• Nausea
• Sweating
• Coldness of the skin
• Dizziness
• Numbness-tingling
• Loss of consciousness
• Perspiration
• Convulsions
• Weakness
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F. PATIENT REACTIONS (cont.)
If a patient should have a reaction the following steps
should be followed:
Inpatient:
•
•
•
•
•
•
Notify the nurse by using the call button. Do not leave the patient
unattended.
If the patient is in a sitting position, lower the head to the knees,
make sure that you hold the patient in the chair.
Apply cold compresses to the forehead and the back of the neck.
If the reaction is severe, it may be necessary to have the patient lie
down and elevate their feet.
If the patient is nauseated, instruct the patient to breathe deeply and
slowly through their nose, so they do not hyperventilate.
If they are vomiting have emesis basin and tissues ready.
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F. PATIENT REACTIONS (cont.)
Outpatient:
On campus labs:
• If the patient does not respond call 222 – Emergency Operator
and inform them which lab you are located at.
Off campus labs:
• If patient does not respond Call 911
• When the patient has revived, offer them a drink of water or
juice.
• Make sure the patient is fully recovered before you release them.
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G. ORDERING PRIORITIES AND LAB SWEEP
TIMES- INPATIENT
• STAT: To be used only when the physician requests the test
is to be done STAT. The labels are produced immediately on
the floors, should be drawn within 20mins, and resulted in
60mins for most tests.
• ASAP: Label prints immediately and is drawn when the
phlebotomist is rounding the floors. Given priority over
routines.
• TIMED: Labels print for the time ordered. Should be drawn at
the time indicated. Priority is after STATS.
• ROUTINE: Use this priority to minimize venipuncture of
patient. Labels are printed at specific default times throughout
the day. (3am, 6am, 10am, 3pm, 8pm). Blood is drawn
throughout the day as phlebotomist is rounding the floors.
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H. REJECTION OF SPECIMENS BY LAB
• Specimens may be rejected by laboratory personnel for the
following reasons:
• Specimens without the two correct patient identifiers will be
rejected unless signed off by a physician. (missing date,
time and or initials can be corrected by the person drawing
the blood by coming to the lab to correct).
• Inadequate specimen volume.
• Inappropriately stored or transported specimens
REFERENCES:
•
NCCLS: Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture: Approved Standard –
Fifth Addition. Volume 23 Number 32.
•
Kathy Sobanski, MT(ASCP), Core Lab Supervisor
•
Marian Hutchins, MT(ASCP), Phlebotomy Supervisor
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Specimen Collection Visual Aids
REMARKABLE MEDICINE. REMARKABLE CARE.
Click on the links below to access these visual aids.
Vacutainer Tube Guide
Order of Draw
Microtainer Tube Guide
Safety-Lok Blood Collection Set
Blood Transfer Device
Processing Urine specimens with the Vacutainer Urine Collection Kit
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;
Microbiology Collection Instructions
REMARKABLE MEDICINE. REMARKABLE CARE.
SJMO LABORATORY
MICRO COLLECTION
II. MICROBIOLOGY COLLECTION BY SPECIMEN TYPE
Detailed collection instructions for common microbiology specimens.
SPECIMEN SOURCE
Body Fluids
(Abdominal, Ascites, Bile, Joint, Pericardial, Peritoneal, Pleural,
Synovial)
COLLECTION
INSTRUCTIONS
1. Disinfect overlying skin with alcohol and tincture of iodine or CHG.
2. Obtain specimen via percutaneous needle aspiration or surgery.
3. Transport immediately to Lab.
4. Always submit as much fluid as possible; never submit a swab
immersed in fluid.
SPECIMEN SOURCE
Bone Marrow
COLLECTION
INSTRUCTIONS
Before proceeding, obtain a SPS Vacutainer tube from Microbiology.
SPS is the anticoagulant of choice for bacterial, fungal or
AFB/Mycobacterial agents.
1. Must be collected by a physician using sterile technique.
2. Prepare skin as for a blood culture.
3. Aspirate bone marrow percutaneously using a needle and syringe.
SPECIMEN SOURCE
COLLECTION
INSTRUCTIONS
Bordetella Pertussis Detection by PCR
Due to the fastidious nature of the organism and the low sensitivity of
both culture and DFA, diagnosis by PCR is the current method of
choice.
Collect a nasopharyngeal (not throat) specimen on a wire Dacron
swab:
1. Seat the patient comfortably and tilt the head back.
2. Insert the wire swab thru the nares until resistance is met due to
contact with the nasopharynx.
3. Rotate the swab gently and allow the swab to maintain contact with
the nasopharynx for 20-30 seconds.
4. Place swab immediately in an approved transport medium.
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SJMO LABORATORY
MICRO COLLECTION
SPECIMEN SOURCE
COLLECTION
INSTRUCTIONS
Bronchoalveolar lavage, Bronchial Brush or Wash or Tracheal
aspirate
1. Place aspirate or washing in a sputum trap.
2. Place brush in a sterile container with 1 ml or less of non bacteriostatic saline.
SPECIMEN SOURCE
COLLECTION
INSTRUCTIONS
Catheter, I.V.
1. Cleanse the skin around the catheter site with alcohol or alcohol +
tincture of iodine.
2. Aseptically remove and clip the 5 cm /2 inch distal tip of the
catheter directly into a sterile container.
3. Transport immediately to Laboratory to prevent drying.
COMMENTS
Acceptable IV catheters for semiquantitative culture (Maki method):
Central, CVP, Hickman, Broviac, Peripheral, Arterial, Umbilical,
Hyperalimentation, Swan-Ganz.
SPECIMEN SOURCE
Catheter, Foley
COLLECTION
INSTRUCTIONS
Foley catheters will NOT be accepted since growth represents distal
urethral flora.
SPECIMEN SOURCE
Cellulitis
COLLECTION
INSTRUCTIONS
1. Cleanse site by wiping with sterile saline or 70% alcohol.
2. Aspirate the area of maximum inflammation (commonly the center
rather than leading edge) with a fine needle and syringe.
3. Draw a small amount of sterile saline into the syringe.
4. Remove needle (with a protective device) and replace with sterile
cap.
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SJMO LABORATORY
MICRO COLLECTION
SPECIMEN SOURCE
Chlamydia Culture
COLLECTION
INSTRUCTIONS
ANY SOURCE IS ACCEPTABLE BUT CHLAMYDIA CULTURES ARE
GENERALLY RESERVED FOR THE FOLLOWING SPECIMEN
TYPES: BUBOES/LUNG/ SPUTUM/NASOPHARYHX & FOR THE
SOLE PURPOSE OF TREATING SEXUAL ABUSE CASES, in which
throat, rectal and/or vaginal specimens may be submitted. This
information cannot be used as evidence in court since no chain of
command is used.
1. Collect with a Dacron culture swab.
2. Place directly into Viral/Chlamydia Transport Medium.
SPECIMEN SOURCE
Chlamydia trachomatis – Amplified Probe
COLLECTION
INSTRUCTIONS
See Instruction for collection of Neisseria gonorrhoeae Amplified
Probe.
SPECIMEN SOURCE
Cerebrospinal Fluid
Physician collected specimen. Collect by Lumbar Puncture. Tube 2 is
preferred for culture.
SPECIMEN SOURCE
Continuous Ambulatory peritoneal Dialysate Fluid (CAPD)
Submit fluid 50 ml or more of fluid in sterile container.
SPECIMEN SOURCE
Decubitus Ulcer
COLLECTION
INSTRUCTIONS
Decubitus culture generally provides questionable microbial information
but under circumstances of repeated treatment failure, decubitus culture
may be warranted. Specimen(s) of choice: Biopsy > aspirate > swab.
1. Cleanse surface with sterile saline.
2. If a sample biopsy is not available, use a 1 ml syringe with a 23 gauge
needle containing 0.2 - 0.4 ml of sterile nonbacteriostatic saline to
aspirate the base of the lesion.
3. Transfer material to a sterile tube/container or safely remove the
needle & cap and replace with a sterile cap.
4. Transport to Laboratory.
5. If neither a biopsy nor aspirate can be obtained, vigorously swab the
base of the lesion.
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SJMO LABORATORY
MICRO COLLECTION
SPECIMEN SOURCE
COLLECTION
INSTRUCTIONS
Dental Culture
(Gingival, Periodontal, Periapical, Vincent's stomatitis)
1. Carefully cleanse gingival margin and supragingival tooth surface
to remove saliva, debris and plaque.
2. Using a periodontal scaler, carefully remove subgingival lesion
material and transfer to anaerobic transport system.
3. Prepare smears collected in the same fashion.
SPECIMEN SOURCE
COLLECTION
INSTRUCTIONS
Ear – Inner
Tympanocentesis reserved for complicated/recurrent/chronic
persistent otitis media.
1. INTACT EAR DRUM: Clean ear canal with soap solution. Collect
fluid via syringe aspiration technique.
2. RUPTURED EAR DRUM: Collect fluid on flexible-shaft swab via
an auditory-speculum.
3. Place fluid/aspirate in a sterile container.
4. Transport to Laboratory.
SPECIMEN SOURCE
Ear – Outer
COLLECTION
INSTRUCTIONS
1. Remove any debris/crust from the ear canal with a moistened swab.
2. Obtain a sample by firmly rotating a swab in the outer canal.
COMMENTS
For otitis externa, vigorous swabbing is required since surface
swabbing may miss streptococcal cellulitis.
SPECIMEN SOURCE
Eye – Conjunctiva
COLLECTION
INSTRUCTIONS
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Sample both eyes with separate swabs (pre-moistened with sterile
saline) by rolling over each conjunctiva. NOTE: Mini-tip swab is
available from Microbiology.
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SJMO LABORATORY
MICRO COLLECTION
SPECIMEN SOURCE
Eye – Corneal Scrapings
COLLECTION
INSTRUCTIONS
1. Instill 1-2 drops of local anesthetic.
2. Using a sterile spatula scrape ulcers/lesions and inoculate directly
onto media obtained to Laboratory. (NOTE: Media should be at room
temperature.)
3. If desired, apply remaining material to 2 clean glass slides for
staining.
COMMENTS
It is generally recommended that swabs for conjunctival culture be
taken prior to anesthetic application, whereas corneal scrapings are
obtained after.
SPECIMEN SOURCE
Feces - Clostridium difficile Toxin
COLLECTION
INSTRUCTIONS
Transfer 5 ml of liquid soft stool directly into a clean, dry container.
(Soft stool: defined as assuming the shape of its container.)
COMMENTS
Patients should be passing 5 stools/24hr, the consistency of which
should be liquid/soft. Formed stool will not be tested.
SPECIMEN SOURCE
Feces –Stool Culture/Ova and Parasite Exam/Rotavirus
COLLECTION
INSTRUCTIONS
1. Pass stool into a clean container. Place a piece of plastic wrap
under the toilet seat to aid in collection in adults.
2. For pediatric patients, do not collect from diapers. Turning diaper
“inside out” may aid in collection.
3. For test requiring multiple specimens, do not collect multiples on
same day. Generally, multiple samples should be spaced at least 1
day apart.
COMMENTS
Avoid contamination with urine or water from the toilet as this may
prevent recovery.
For parasite examinations, patient should not have ingested barium
bismuth or other antidiarrheal preparations for at least 7 days.
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SJMO LABORATORY
MICRO COLLECTION
SPECIMEN SOURCE
Feces - Rectal Swab
COLLECTION
INSTRUCTIONS
1. Carefully insert a swab ~1 inch beyond the anal sphincter.
2. Gently rotate the swab to sample the anal crypts.
COMMENTS
Reserved for detecting GC, Shigella, HSV, and anal carriage of S
pyogenes OR for patients unable to pass a stool specimen.
SPECIMEN SOURCE
Gastric Wash/Lavage
COLLECTION
INSTRUCTIONS
Collect in the early morning before eating and while still in bed in order
to obtain sputum swallowed during sleep. Please call the
Microbiology Laboratory before collecting the Specimen.
1. Introduce a nasogastric tube orally/nasally to the stomach.
2. Perform lavage with 25-50 mLs of chilled sterile distilled water.
3. Recover sample and place in a leak-proof, sterile container.
4. Before removing the NG tube, release suction and clamp.
COMMENTS
The specimen must be taken to the Laboratory and processed
promptly, since mycobacteria die rapidly in gastric washings.
Gastric Specimens in general do not yield meaningful culture results
except perhaps for septic infants or for older individuals with
obstructions high in the intestine. Bacterial colony counts for gastric
secretions are of questionable value.
Anaerobic bacteria can inhabit normal gastric secretions, and
interpretations of culture results may be difficult. The presence of
large numbers of bacteria in gastric secretions usually indicates an
alkaline pH shift caused by regurgitation of duodenal secretions in
patients with intestinal obstructions.
SPECIMEN SOURCE
Hair (Dermatophytosis)
COLLECTION
INSTRUCTIONS
1. Using forceps collect at least 10-12 affected hairs with the base of
the hair-shaft remaining intact.
2. Place in a clean tube or container.
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SJMO LABORATORY
MICRO COLLECTION
COMMENTS
Scalp scales, if present, should be collected along with scrapings of
active borders of lesions. Note any antifungal therapy taken recently.
SPECIMEN SOURCE
Gangrenous Tissue
COMMENTS
See Wound.
Sampling of superficial tissue should be discouraged; tissue biopsy or
aspirates are preferred.
SPECIMEN SOURCE
Genital - Female - Amniotic Fluid
COLLECTION
INSTRUCTIONS
1. Aspirate via amniocentesis, Cesarean section, or intrauterine
catheter.
2. Transfer fluid to sterile container plus Anaerobic Transport tube.
COMMENTS
Swabbing or aspiration of vaginal membrane is not acceptable due to
vaginal contamination.
SPECIMEN SOURCE
Genital - Female – Bartholin Gland
COLLECTION
INSTRUCTIONS
1. Disinfect skin with alcohol and tincture of iodine.
2. Aspirate fluid from ducts.
SPECIMEN SOURCE
Genital - Female – Cervix
COLLECTION
INSTRUCTIONS
1. Visualize the cervix using a speculum without lubricant.
2. Remove mucus/secretions from the cervix with swab and discard.
3. Firmly yet gently, sample the endocervical canal with a sterile
swab.
SPECIMEN SOURCE
Genital - Female - Cul de sac
COLLECTION
INSTRUCTIONS
1. Disinfect skin with alcohol and tincture of iodine or CHG.
2. Submit aspirate/fluid in sterile container plus Anaerobic Transport tube.
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SJMO LABORATORY
MICRO COLLECTION
SPECIMEN SOURCE
Genital - Female – Endometrium
COLLECTION
INSTRUCTIONS
1. Collect transcervical aspirate via a telescoping catheter.
2. Transfer to sterile container plus Anaerobic Transport tube.
SPECIMEN SOURCE
Genital - Female - Products of Conception
COLLECTION
INSTRUCTIONS
1. Submit a portion of tissue in a sterile container.
2. If obtained by Caesarian section, immediately transfer to an
Anaerobic Transport tube, plus sterile container.
SPECIMEN SOURCE
Genital - Female – Urethra
COLLECTION
INSTRUCTIONS
1. Remove exudate from the urethral orifice.
2. Collect discharge material on a swab by massaging the urethra
against the pubic symphysis through the vagina.
COMMENTS
If no discharge can be obtained, wash the external urethra with
betadine soap and rinse with water. Then, insert an urethrogenital
swab 2 - 4 cm into the urethra, rotate while maintaining for 2 seconds.
SPECIMEN SOURCE
Genital - Female – Vagina
COLLECTION
INSTRUCTIONS
1. Wipe away any excessive amounts of secretion or discharge.
2. Obtain secretions from the mucosal membrane of the vaginal vault
with a sterile swab.
3. If a smear is also requested, obtain it using a second swab.
COMMENTS
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For intrauterine devices (IUD's), place entire device into a sterile
container and submit at room temperature. 1-2 ml of nonbacteriostatic saline may be added for moisture.
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SJMO LABORATORY
MICRO COLLECTION
SPECIMEN SOURCE
Genital - Male – Prostate
COLLECTION
INSTRUCTIONS
1. Cleanse the glans with soap & water.
2. Massage prostate through rectum.
3. Collect fluid on a sterile swab or in a sterile tube.
SPECIMEN SOURCE
Genital - Male – Urethra
COLLECTION
INSTRUCTIONS
Insert an urethrogenital swab 2-4 cm into the urethral lumen, rotate
while maintaining for 2 seconds. NOTE: Mini-tip swab available from
Microbiology.
SPECIMEN SOURCE
Genital Lesion - Male or Female
COLLECTION
INSTRUCTIONS
1. Using a sterile gauze pad cleanse the lesion with sterile saline and
remove its surface.
2. Allow a transudate to accumulate.
3. While pressing the base of the lesion, firmly sample with a sterile
swab.
SPECIMEN SOURCE
Hair (Dermatophytosis)
COLLECTION
INSTRUCTIONS
1. Using forceps collect at least 10-12 affected hairs with the base of
the hair shaft remaining intact.
2. Place in a clean tube or container.
COMMENTS
Scalp scales, if present, should be collected along with scrapings of
active borders of lesions. Note any antifungal therapy taken recently.
SPECIMEN SOURCE
Lymph Node
COLLECTION
INSTRUCTIONS
1. Collect aseptically and avoid indigenous microbiota.
2. Do not immerse in saline or other fluid or wrap in gauze.
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SJMO LABORATORY
MICRO COLLECTION
SPECIMEN SOURCE
Mouth/ Oral Lesion
COLLECTION
INSTRUCTIONS
1. Remove oral secretions/debris from the surface of lesion with a
swab, and then discard.
2. Using a second swab, vigorously sample the lesion avoiding any
areas of normal tissue.
SPECIMEN SOURCE
Nail – Dermatophytosis
COLLECTION
INSTRUCTIONS
1. Wipe the nail with 70% alcohol using gauze (not cotton.)
2. Clip away a generous portion of the affected area and collect
material/debris from UNDER the nail.
3. Place in a clean container.
SPECIMEN SOURCE
Nasal
COLLECTION
INSTRUCTIONS
1. Insert a swab, premoistened with sterile saline, approx. 2 cm into
the nares.
2. Rotate the swab against the nasal mucosal.
COMMENTS
Anterior nose cultures are reserved for detecting staphylococcal and
streptococcal carriers, or for nasal lesions.
SPECIMEN SOURCE
Nasopharynx
COLLECTION
INSTRUCTIONS
1. Gently insert a Dacron swab into the posterior nasopharynx via the
nose.
2. Rotate slowly for 5-20 seconds to absorb secretions; remove, and
inoculate media at bedside or place swab in transport medium.
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SJMO LABORATORY
MICRO COLLECTION
SPECIMEN SOURCE
Neisseria gonorrhoeae - Amplified Probe
COLLECTION
INSTRUCTIONS
1. Use unisex swab for urethral cervical collection.
2. For genital specimens, instruct patient not to urinate 1 hour prior to
sample.
3. Urethral specimen: Insert swab 2-3 cm into the urethra. Gently
rotate the swab ensuring contact with all urethral surfaces for 3-5
seconds. Withdraw swab and break into transport tube.
COMMENTS
PLEASE NOTE:
FOR THE TEST TO BE VALID ONLY THE SWABS PROVIDED IN
THE COLLECTION KIT MAY BE USED!
Probes for both GC & Chlamydia can be performed from a single
swab.
This is the method of choice for sexually transmitted cases, but NOT
SEXUAL ABUSE CASES. SEXUAL ABUSE CASES MUST BE
COLLECTED & TESTED BY THE MICHIGAN STATE POLICE.
MICROBIOLOGY RESULTS ARE TO BE USED FOR TREATMENT
PURPOSES ONLY. THEY ARE NOT PERMISSIBLE AS EVIDENCE
IN COURT!
SPECIMEN SOURCE
Respiratory (Lower) BAL/BBW Tracheal Aspirate
COLLECTION
INSTRUCTIONS
1. Place aspirate/wash into a sputum trap.
2. Place brush in a sterile container with saline.
SPECIMEN SOURCE
Respiratory (Lower) Sputum, Expectorated
COLLECTION
INSTRUCTIONS
1. Collect Specimen under the DIRECT supervision of a nurse or
physician.
2. Have patient rinse/gargle with water.
3. Instruct patient to cough DEEPLY to produce a lower respiratory
specimen (not post-nasal fluid) into a sterile container.
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SJMO LABORATORY
MICRO COLLECTION
SPECIMEN SOURCE
Respiratory (Lower)Sputum, Induced
COLLECTION
INSTRUCTIONS
1. Have patient rinse his mouth with water after brushing gums/
tongue to minimize contaminating specimen with food particles,
mouthwash, or oral drugs which may inhibit the growth of bacteria.
2. With the aid of a nebulizer, have the patient inhale ~25 mLs of 310% sterile saline.
3. Avoid sputum contamination with nebulizer reservoir water.
Saprophytic mycobacteria in tap water may produce false-positive AFB
culture or smear results.
4. Collect the induced sputum into a sterile container.
SPECIMEN SOURCE
Skin – Dermatophytosis
COLLECTION
INSTRUCTIONS
1. Cleanse the affected area with 70% alcohol.
2. Gently scrape the surface of the skin at the active margin of the
lesion. Do not draw blood.
3. Place sample in clean container.
SPECIMEN SOURCE
Skin Lesion Material
COLLECTION
INSTRUCTIONS
1. Swabs in transport medium (Amie’s or Stuarts) are acceptable only
if biopsy sample or aspirate is not obtainable.
2. For cutaneous ulcer, collect biopsy sample from periphery of lesion,
or aspirate material from under margin of lesion.
COMMENTS
If infection was acquired in Africa, Australia, Mexico, South America,
Indonesia, New Guinea or Malaysia, note on request, because
Mycobacterium ulcerans may require prolonged incubation for primary
isolation.
Dry swabs are unacceptable for culture.
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SJMO LABORATORY
MICRO COLLECTION
SPECIMEN SOURCE
Throat for Group A Strep
COLLECTION
INSTRUCTIONS
1. Using a tongue depressor, depress the tongue.
2. Vigorously sample the posterior pharynx, tonsils/pillars and areas of
purulence, exudation or ulceration.
3. Microbiology recommends using a dual swab during collection, so
that one swab may be used for a "RAPID STREP SCREEN" and the
second swab is available for a culture.
COMMENTS
Order throat culture and note R/O yeast for Candidiasis/Thrush.
Notify Microbiology if C. diphtheriae, N. gonorrhoeae, Vincent’s
disease or Arcanobacterium are suspected.
SPECIMEN SOURCE
Tissue
COLLECTION
INSTRUCTIONS
1. Submit in a sterile container.
2. For small samples, add several drops of non-bacteriostatic, sterile
saline to keep moist. Do not immerse in saline or wrap in gauze.
3. DO NOT ALLOW TISSUE TO DRY OUT.
COMMENTS
Always submit as much tissue as possible. NEVER submit a swab that
has simply been rubbed over the surface.
Specimens submitted in Formalin or other preservatives are
unacceptable for culture.
SPECIMEN SOURCE
Urine - Indwelling Catheter/Foley
COLLECTION
INSTRUCTIONS
1. Disinfect the catheter collection port with 70% alcohol.
2. Aseptically, collect 5-10 mLs of urine using a needle/syringe.
3. Transfer to a sterile tube/container/Gray Vacutainer.
COMMENTS
RETURN TO TEST DIRECTORY
Urine samples collected directly from indwelling catheter bags are
NOT acceptable.
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SJMO LABORATORY
MICRO COLLECTION
SPECIMEN SOURCE
Urine - Midstream (Female)
COLLECTION
INSTRUCTIONS
1. Thoroughly cleanse the urethral area with soap & water.
2. Rinse with wet gauze pads /towelletes.
3. While holding the labia apart, begin voiding.
4. After several milliliters have passed, collect a midstream portion
without stopping the flow of urine.
SPECIMEN SOURCE
Urine - Midstream (Male)
COLLECTION
INSTRUCTIONS
1. Cleanse the glans with soap & water.
2. Rinse with wet gauze pads/towelletes.
3. While holding the foreskin retracted, begin voiding.
4. After several milliliters have passed, collect a midstream portion
without stopping the flow of urine.
SPECIMEN SOURCE
Urine – Straight Catheter
COLLECTION
INSTRUCTIONS
1. Thoroughly cleanse the urethral area with soap & water.
2. Rinse with wet gauze pads.
3. Aseptically, insert a catheter into the bladder.
4. After allowing ~15 mLs to pass, collect urine to be submitted in a
sterile container.
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SJMO LABORATORY
MICRO COLLECTION
SPECIMEN SOURCE
Wound/Abscess
COLLECTION
INSTRUCTIONS
Closed Wound/Abscess:
1. Remove surface exudate by wiping with sterile saline.
2. Allow surface to dry.
3. Using a needle with Luer-tip syringe, aspirate abscess wall material.
4. Remove needle using a protective device; then recap syringe.
5. Label syringe and place in a sealable, leak-proof-specimen transport bag.
6. Alternatively, the aspirated material may be transferred to a sterile
container. Also inoculate Anaerobic transport if anaerobic infection suspected.
7. Deliver PROMPTLY to Microbiology.
Open Wound/Abscess:
1. Remove surface exudate by wiping with sterile saline.
2. Allow surface to dry.
3. If possible, aspirate.
4. Alternatively, pass a swab(s) deep into the lesion and firmly sample the
lesion's advancing edge. For mycobacterial culture, 2 swabs are preferred.
5. Return swab(s) to transport sleeve.
6. Label appropriately.
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SJMO LABORATORY
MICRO COLLECTION
= REFRIGERATE OR
SEND ON ICE
ACID FAST CULTURE
MICROBIOLOGY SPECIMEN COLLECTION GUIDE
ANAEROBIC CULTURE
BLOOD CULTURE
10/08
BODY FLUID /TIISUE CULTURE
CHLAMYDIA CULTURE
CHLAMYDIA TRACHOMATIS /NEISSERIA
GONORRHOEAE BY AMPLIFIED PROBE,URINE
CLOSTRIDIUM DIFFICILE TOXIN
FUNGUS CULTURE
GENITAL CULTURE
GROUP B STREP SCREEN
HERPES CULTURE/PCR
OVA AND PARASITE EXAMINATION
ROTAVIRUS
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PERTUSSIS PCR
RSV ANTIGEN
CHLAMYDIA TRACHOMATIS & NEISSERIA
GONORRHOEAE BY AMPLIFIED
PROBE,CERVIX & URETHRA
EAR/EYE* CULTURE
*Mini-tip swab preferred for eye culture
GIARDIA/PARASITE ANTIGEN
INFLUENZA ANTIGEN
PINWORM
SPUTUM/RESPIRATORY CULTURE
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SJMO LABORATORY
MICRO COLLECTION
= REFRIGERATE OR
SEND ON ICE
STOOL CULTURE
MICROBIOLOGY SPECIMEN COLLECTION GUIDE
THROAT/RAPID STREP SCREEN
URINE CULTURE
10/08
VAGINITIS SCREEN
(AFFIRM)
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VIRAL CULTURE
GRAY TOP URINE
VACUTAINER
OR
STERILE CUP, REFRIGERATED
TISSUE/WOUND CULTURE
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Microbiology Specimen Collection
Visual Aids
Click on the links below to access each document.
AFB Collection
Anaerobic Culture
ATTEST Spore Checks
Blood Culture Collection
Clean-Catch Urine Specimen Collection
Eye Culture Collection
Fecal Testing
Foley Urine Collection
GBS Collection
Genital Culture Collection
Nasopharyngeal Swab Collection
Sputum Culture Collection
Stool Culture Collection
Throat Culture Collection
Wound Culture Collection
Aptima/GC Chlamydia Probe
Viral Culture
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SJMO LABORTORY MICROBIOLOGY VISUAL AIDS
St. Joseph Mercy Oakland Laboratory Visual Aid
AFB/ACID-FAST STAIN AND CULTURE SPECIMEN REQUIREMENTS
SOURCE
BLOOD
SPS VACUTAINER ,
3.3 ML
BODY
FLUID/CSF
BRONCHIAL
WASH/BAL
1.0 ML MINIMUM
BODY FLUID
3 ML MINIMUM
0.5 ML MINIMUM
CSF
10 ML OPTIMAL
5-101 ML
PEROPTIMAL
DAY/
SAME SOURCE
1 PER DAY/
SAME SOURCE
STERILE LEAKPROOF
CONTAINER/
LP TUBE
LUKEN
TUBE/STERILE,
LEAK-PROOF
CONTAINER
GASTRIC
STOOL
TISSUE
URINE
STERILE LEAK-PROOF
CONTAINER
STERILE LEAKPROOF CONTAINER
STERILE LEAK-PROOF
CONTAINER
STERILE LEAK-PROOF
CONTAINER
3 ML MINIMUM
1 ML MINIMUM
1 GRAM OF STOOL
MINIMUM
10 ML OPTIMAL
10 ML OPTIMAL
1 PER DAY
SPECIMENS SHOULD
BE COLLECTED AT
LEAST 8 HOURS
APART. SEE
COMMENTS
STERILE LEAKPROOF
CONTAINER
SPUTUM
WOUND/
ASPIRATE
STERILE LEAKPROOF CONTAINER
CONTAINER
VOLUME
1 ML MINIMUM
5ML OPTIMAL
REPLICA LIMITS
2 PER DAY
COMMENTS
CLEAN SKIN WITH CHG
OR IODINE + ALCOHOL
PRIOR TO
COLLECTION. COLLECT
TWO 3.32 ml YELLOW
VACUTAINERS or ONE
10 ml SPS
VACUTAINERS FOR
EACH CULTURE
ORDERED.
CSF: TUBE 2
PREFERRED.
SUBMIT
UNCENTRIFUGED
SPECIMEN.
REPLACE CAP OF
LUKEN TUBE WITH
SOLID CAP TO
PREVENT LEAKS
DURING
TRANSPORT
NEUTRALIZE pH
WITH SODIUM
CARBONATE IF
TRANSPORT TO
SJMO LAB WILL BE
>4 HOURS
10 GRAM OF STOOL
OPTIMAL
1 PER DAY
COLLECT SPECIMEN
FROM DEEP COUGH. DO
NOT SUBMIT SALIVA.
SUBMIT 3 CONSECUTIVE
SPECIMENS COLLECTED
8-24 HOURS APART. AT
LEAST ONE SPECIMEN
MUST BE FIRST MORNING.
SPECIFY IF SPECIMEN IS
EXPECTORATED,
ASPIRATED OR INDUCED.
VISIBLE PIECE OF
TISSUE
NA
UTILIZED IN
IMMUNOCOMPROMISED PATIENTS AS
AN AID IN DIAGNOSING
DISSEMINATED
INFECTION WITH M.
AVIUM COMPLEX
5 ML MINIMUM
40 ML OPTIMAL
1 PER DAY
COLLECT 3 CONSECUTIVE
FIRST MORNING URINE
SPECIMENS.
0.5 ML MINIMUM
ASPIRATE OR BIOPSY
SAMPLE
1 PER DAY
/SAME SOURCE
AEROBIC SWAB
SPECIMENS WILL BE
ACCEPTED BUT YIELD
IS MINIMAL
CRITERIA
FOR
REJECTION
MISLABELLED SPECIMEN, UNLABELED SPECIMEN, LEAKING SPECIMEN, QUANTITY NOT SUFFICIENT, DELAY IN TRANSPORT, IMPROPER TRANSPORT TEMPERATURE, AND INCORRECT PRESERVATIVE.
24 HOUR POOLED URINE OR SPUTUM COLLECTIONS ARE NOT ACCEPTABLE.
STORAGE/
TRANSPORT
SJMO: TRANSPORT TO LAB IMMEDIATELY.
FOR LOCATIONS OTHER THAN SJMO: REFRIGERATE AFTER COLLECTION & DURING TRANSPORT. TRANSPORT TO LAB WITHIN 24 HOURS IS OPTIMAL
LABORATORY
PROCEDURE: AFB SPECIMEN REQUIREMENTS
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CREATED BY: CAY
UPDATED: 10/10/10
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SJMO LABORTORY MICROBIOLOGY VISUAL AIDS
St. Joseph Mercy Oakland Laboratory Visual Aid
SPECIMENS FOR ANAEROBIC CULTURE
Acceptable Specimens: aspirated pus, tissue, body fluids, suprapubic urine TTA and lung aspirates. Tissues fluids and aspirates are always preferred over swab samples.
Unacceptable Specimens: throat, NP swabs, sputum, gastric contents, feces, swabs from decubitus ulcers, skin, voided urine, stool, prostatic or seminal fluid and vaginal or cervical swabs.
Always submit an aerobic swab with an anaerobic swab.
Submit in anaerobic transport container or for fluids and aspirates sterile container. Transport to Laboratory IMMEDIATELY.
.
LABORATORY
PROCEDURE: ANAEROBIC CULTURE
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CREATED BY: CAY
UPDATED: 02/10/10
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SJMO LABORTORY MICROBIOLOGY VISUAL AIDS
quote text box.]
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SJMO LABORTORY MICROBIOLOGY VISUAL AIDS
St. Joseph Mercy Oakland Laboratory Visual Aid
BLOOD CULTURE COLLECTION
DO NOT COVER BAR CODES ON BOTTLES!
DO NOT USE EXPIRED BOTTLES!
Adult Blood Culture Set
Pediatric Bottle
SKIN ANTISEPSIS:
●Skin antisepsis is critical. Clean skin with CHG (Chlorhexidene gluconate) swab or scrub. Air-dry
for 30 seconds. Collect sample.
●DO NOT use CHG is infants <2 months of age. Alcohol + iodine should be used for skin antisepsis
in infants <2 months old.
●For allergy to CHG or iodine, clean site with alcohol 3 times prior to drawing blood culture.
●Avoid drawing from lines. If line draw required, please order as catheter draw and indicate on
bottle. To diagnose line sepsis often one set is drawn thru the catheter and the second set is
peripheral.
NUMBER OF SETS:
●Collect two blood cultures in adult patients. A set consists of an aerobic + an anaerobic bottle.
●For pediatric patients, a single pediatric bottle is usually sufficient.
●Order of more than two sets in a 24-hour period requires Pathology approval.
TIMING:
●For orders of BLOOD CULTURE x2, It is not necessary to collect the cultures 10-30 minutes apart.
Blood culture x2 may be collected “back-to back” from two different venipuncture sites.
●Always collect blood culture as close to the patient’s fever spike as possible.
●Subacute bacterial endocarditis requires multiple blood cultures spaced at defined intervals.
VOLUME OF DRAW:
●Aerobic bottle 5-10 ml acceptable, 8-10 ml optimal
●Anaerobic bottle: 3-7 ml acceptable, 5-7 ml optimal
●Pediatric Bottle: 1-3 ml required
●DO NOT OVERFILL OR UNDERFILL BOTTLES AS THIS MAY AFFECT RECOVERY.
SPECIAL COLLECTIONS:
●Recovery of yeast, fungus and AFB require collection of 2 yellow SPS Vacutainers. Obtain from
Lab.
●Notify Lab if Brucella is suspected.
LABORATORY
PROCEDURE: BLOOD CULTURE
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CREATED BY: CAY
UPDATED: 02/10
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SJMO LABORTORY MICROBIOLOGY VISUAL AIDS
St. Joseph Mercy Oakland Laboratory Visual Aid
COLLECTION OF A CLEAN-CATCH URINE SPECIMEN
1. Unscrew the cap of the urine specimen cup. Place the cup on the counter. Place the cap on the counter, face up. Do not touch the inside of the cup or cap.
2. Thoroughly cleanse genitalia with towelettes as follows:
a. Male:
− Wipe the head of the penis in a single motion with the first towelette. Repeat with two other
towelettes. If not circumcised, hold the foreskin back before cleansing.
− Urinate a small amount in the toilet.
− Proceed to the next step.
b. Female:
− Separate the labia. Wipe the inner labial folds front to back in a single motion with two towelettes. Wipe down through the center of the labial folds with a third
towelette.
− Keep the labia separated, and urinate a small amount into the toilet.
− Proceed to the next step.
3. Place the cup under the stream of urine, and continue to urinate into the cup.
4. Finish voiding into the toilet.
5. Place the cap on the cup.
6. Label the specimen and transport to the laboratory immediately. If a delay in transport is expected the specimen should
be refrigerated or placed into a urine preservative tube (see below).
LABORATORY
PROCEDURE: CCMS URINE COLLECTION
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CREATED BY: CAY
UPDATED: 02/10/10
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SJMO LABORTORY MICROBIOLOGY VISUAL AIDS
St. Joseph Mercy Oakland Laboratory Visual Aid
COLLECTION OF AN EYE CULTURE
Conjunctival Swab
1. Sample both eyes with separate swabs (premoistened with sterile saline) by rolling over each conjunctiva.
2. Insert swab into collection/transport tube.
3. If desired, use additional swab to collect material for smear.
Apply to clean glass slide for staining.
Corneal Scrapings
1. Obtain conjunctival swab as described above.
2. Instill 1-2 drop of local anesthetic.
3. Using a sterile spatula scrape ulcers/lesions and inoculate directly onto media.
4. Apply remaining material to 1-2 clean glass slides for staining. It is generally recommended that swabs for conjunctival culture be taken prior
to anesthetic application, whereas corneal scrapings are obtained after.
LABORATORY
PROCEDURE: EYE CULTURE
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CREATED BY: CAY
UPDATED: 02/10/10
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SJMO LABORTORY MICROBIOLOGY VISUAL AIDS
St. Joseph Mercy Oakland Laboratory Visual Aid
FECAL TESTING
STOOL CULTURE:



Detects Salmonella species, Shigella species, Campylobacter and enterohemorrhagic/shiga-toxin producing E. coli.
Culture for Vibrio, Yersinia performed with special request.
Collect at least 2 samples to rule out bacterial gastroenteritis.
OVA AND PARASITE EXAM and PARASITE ANTIGEN:



Detects protozoans and parasites found in stool samples.
Collect at least two specimens to rule out parasitic infection.
Prompt transport is required for fresh stool, especially when protozoan infections suspected.
PINWORM COLLECTION:

Sticky paddle for Pinworm Collection (Device type May vary)
GIARDIA ANTIGEN:



Detects presence
of Giardia lamblia in stool.
LABORATORY
CREATED BY: CAY
PROCEDURE:
FECALkit
TESTING
UPDATED: 02/10/10
Collect stool
using same
as for parasites.
If both ova and parasite exam and Giardia antigen are ordered, collection of one set of vials is sufficient.
If
both parasite
exam
Giardia(Enterobius
antigen only
one collection kit is needed.
 Detects
infection
withand
pinworm
vermicularis).
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SJMO LABORTORY MICROBIOLOGY VISUAL AIDS
St. Joseph Mercy Oakland Laboratory Visual Aid
COLLECTION OF A URINE CULTURE FROM AN INDWELLING CATHETER
1. Disinfect the catheter collection port with 70% alcohol.
2. Aseptically, collect 5-10 mLs of urine using a needle/syringe.
3. Transfer urine to a Gray Top (Urine Culture) Vacutainer tube or a sterile cup.
4. Transport to Laboratory.
5. Stability: Gray top Urine Culture Vacutainer: 48 hours at room temperature.
Sterile Cup: 2 hours at room temperature, 24 hours if refrigerated.
Urine samples collected directly from indwelling catheter bags are NOT acceptable for culture.
Foley catheter tips cannot be cultured.
X
CORRECT
INCORRECT
LABABORATORY
PROCEDURE: FOLEY URINE COLLECTION
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CREATED BY: CAY
UPDATED: 07/10/10
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X
SJMO LABORTORY MICROBIOLOGY VISUAL AIDS
St. Joseph Mercy Oakland Laboratory Visual Aid
COLLECTION OF A VAGINAL RECTAL SPECIMEN FOR GBS
Make sure swab is labeled with name, MRN or date of birth and date and time of collection. GBS swabs should be
collected between 35-37 weeks of gestation.
LABORATORY
PROCEDURE: GBS COLLECTION
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CREATED BY: CAY
UPDATED: 02/10/10
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SJMO LABORTORY MICROBIOLOGY VISUAL AIDS
St. Joseph Mercy Oakland Laboratory Visual Aid
GENITAL TESTING
GENITAL CULTURE (GCA/GCAD):
●Detects Neisseria gonorrhoeae, yeast in significant numbers, Gardnerella vaginalis, Group B
Streptococcus.
●Store at room temperature. DO NOT REFRIGERATE.
●NOTE: Gardnerella vaginalis is best detected by Vaginitis probe (VAG DNA) or gram stain.
●Collect vaginal/rectal swab and order Group B Strep Screen for detection of GBS in pregnant patients.
CHLAMYDIA TRACHOMATIS/NEISSERIA GONORRHOEAE PROBE (APTIMA/CHGCRNA):
●Cervix and urethra are acceptable specimens.
●For females use white swab for cleaning; discard.
●For males and females collect specimen with blue swab.
●Use only swab provided with kit.
●Submit blue swab in Aptima Unisex Collection tube.
VAGINITIS
PROBE
DNA):
NOTE: Urine
can be (AFFIRM/VAG
tested, but requires
first void specimen and special transport kit.
●Detects Gardnerella vaginalis, Trichomonas vaginalis and Candida species.
●Use only swab provided with kit.
●Preservative stabilizes specimen for 72 hours.
HERPES SIMPLEX PCR:
●Submit genital swab or swab of lesion in viral transport medium. Refrigerate until
transport.
LABORATORY
PROCEDURE: GENITAL TESTING
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CREATED BY: CAY
UPDATED: 008/18/14
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SJMO LABORTORY MICROBIOLOGY VISUAL AIDS
St. Joseph Mercy Oakland Laboratory Visual Aid
COLLECTION OF A NASOPHARYNGEAL (NP) SPECIMEN
The technique described below can be used for Rapid Influenza testing, Rapid RSV, Bordetella pertussis PCR/culture and viral culture for
some agents.
1. Immobilize the patient's head.
2. Gently insert nasopharyngeal swab into a nostril until the posterior nares is reached.
3. Leave the swab in place for up to 10 seconds. This procedure may induce coughing and tearing.
If resistance is encountered during insertion of the swab, remove it and attempt insertion of the opposite nostril.
4. Remove the swab slowly.
5. Place in transport media. (VIRAL TRANSPORT FOR FLU, RSV, VIRAL CULTURE AND PERTUSSIS PCR.)
LABORATORY
PROCEDURE: NP SPECIMEN
CODE: RSC PERTUSSIS or
INFLUAB OR RSV OR VIRAL CULTURE *
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CREATED BY: CAY
UPDATED: 08/14/14
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SJMO LABORTORY MICROBIOLOGY VISUAL AIDS
St. Joseph Mercy Oakland Laboratory Visual Aid
COLLECTION OF A SPUTUM SAMPLE
1. Before collecting a sputum specimen, the patient should rinse his mouth with water and remove dentures. Rinsing the mouth lessens the
contamination of sputum specimens from oropharyngeal secretions and their associated normal oral flora.
2. Sputum specimens must contain lower respiratory tract secretions.
3. Patients should be instructed to cough as deeply as possible. Appropriately collected induced specimens or
aspirations are recommended for adult patients who cannot produce acceptable sputum samples. Consultation with
Respiratory Therapy may be required.
4. Collect the sputum specimen generated from a deep, productive cough in a clean, sterile specimen cup.
The traps used with suction devices are also acceptable.
5. The specimen should be refrigerated and transported to the laboratory immediately.
First morning sputum specimens are the best, especially if a Mycobacteria (AFB) culture has been ordered. Expectorated sputum specimens
are unacceptable for Pneumocystis testing. An induced sputum or
bronchoscopy specimen should be submitted.
LABORATORY
PROCEDURE: SPUTUM CULTURE
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CREATED BY: CAY
UPDATED: 08/08/12
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SJMO LABORTORY MICROBIOLOGY VISUAL AIDS
St. Joseph Mercy Oakland Laboratory Visual Aid
COLLECTION OF A STOOL CULTURE SAMPLE
The ideal specimen for a stool culture is a non-formed, preferably diarrheal, sample. Bacterial enteric pathogens should not be ruled out based
on a single negative specimen; therefore multiple specimens should be collected. Two separate specimens, collected on different days, should
be obtained. Routine stool culture will not be performed on patients hospitalized for more than 4 days.
1. Collect the stool by placing a piece of plastic under the seat of the toilet or collecting in the sample collector provided.
Transfer the specimen to a sterile specimen cup.
2. The specimen should be transported to the laboratory immediately.
3. Specimens should be stored at room temperature prior to transportation to the Laboratory.
Routine culture includes culture for Salmonella, Shigella, Enterohemorrhagic E. coli and Campylobacter. If other bacterial enteric pathogens,
mycobacteria, parasites or viruses (rotavirus) are suspected, tests for these organisms must be ordered separately.
Ova and Parasite Examination and Cryptosporidium/Giardia antigen also require separate order.
LABORATORY
PROCEDURE: STOOL CULTURE
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CREATED BY: CAY
UPDATED: 02/10/10
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SJMO LABORTORY MICROBIOLOGY VISUAL AIDS
St. Joseph Mercy Oakland Laboratory Visual Aid
COLLECTION OF A THROAT SPECIMEN
1. Shine a bright light into the oral cavity of the patient so that the swab can be guided to the posterior pharynx.
2. The patient is instructed to tilt his/her head back and breathe deeply.
3. Depress the tongue with a tongue depressor to help visualize the posterior pharynx.
4. Use a sterile Dacron swab. Extend the swab to the back of the throat between the tonsil pillars and behind
the uvula.
5. Have the patient phonate a long ‘aah’ which will lift the uvula and help to prevent
gagging.
6. The tonsil areas and posterior pharynx should be firmly rubbed with the swab.
7. Care should be taken not to touch the teeth, cheeks, gums or tongue when inserting
or removing the swab to
minimize contamination with normal mouth flora.
LABORATORY
PROCEDURE: THROAT CULTURE
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CREATED BY: CAY
UPDATED: 02/10/10
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SJMO LABORTORY MICROBIOLOGY VISUAL AIDS
St. Joseph Mercy Oakland Laboratory Visual Aid
COLLECTION OF A WOUND CULTURE
All wound cultures must be clearly labeled with specific designations as to the site and nature of the wound. Example: Abscess from right thumb or drainage from trach
site. Simply labeling as “Wound Culture” is not acceptable. THE COLLECTION OF FLUID OR TISSUE IS PREFERABLE TO THE COLLECTION OF SPECIMENS ON
SWABS.
1. Open transport swab pack, and peel apart at the point labeled “TO OPEN” until the swab cap is visible.
2. Remove the sterile swabs and collect the specimen.
a. The collection of superficial cultures is discouraged.
b. Pass the swabs deep into the lesion to firmly sample the lesion’s fresh border.
3. Remove the transport tube of medium from the package.
4. Remove and discard the cap from the tube. Place the swabs into the medium, and push the swab cap firmly onto the tube.
5. Label and send to the Laboratory immediately.
6. Specimens should be stored at room temperature prior to transportation to the Laboratory.
7. Anaerobic cultures are useful for deep wounds and those involving the gastrointestinal or genitourinary tracts. A foul odor and copious pus are indications that an
anaerobic culture should be requested. A special anaerobic swab (shown below) is required. Never submit an anaerobic swab alone. Anaerobic infections are usually
mixed and require an aerobic plus anaerobic swab.
Aerobic Swab
LABORATORY
PROCEDURE: WOUND
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Anaerobic Swab
CREATED BY: CAY
UPDATED: 02/10/10
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SJMO LABORTORY MICROBIOLOGY VISUAL AIDS
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SJMO LABORTORY MICROBIOLOGY VISUAL AIDS
DISEASE/SYMPTOMS
VIRUSES
RECOMMENDED SPECIMEN
Cardiac
Myocarditis and Pericarditis
Coxsackie B 1-5
Echovirus
Pericardial fluid, throat swab
Pericardial fluid, throat swab
Congenital and Neonatal Infections
Rubella Cytomegalovirus
Herpes Simplex Virus
Enterovirus
Varicella-Zoster Virus
CSF, throat, urine
Urine, throat, blood, tissue, CSF
CSF, throat, brain biopsy, vesicle
CSF, throat, stool, brain biopsy, autopsy
Vesicle, throat
Gastrointestinal/Gastroenteritis
Adenovirus
Astrovirus
Norovirus
Rotavirus
Herpes Simplex Virus
Stool
Stool
Stool
Stool
Genital swab, vesicle swab, vesicle fluid
Malaise Syndrome
Cytomegalovirus
Epstein-Barr Virus
Blood, urine, throat swab
Serological testing only
Neurologic
Aseptic Meningitis and Encephalitis
Adenovirus
Arbovirus
Cytomegalovirus
Enterovirus
Herpes Simplex Virus
LCM Measles
Mumps
Parechovirus
Varicella-Zoster Virus
CSF, brain biopsy, blood
CSF, brain biopsy, blood
Brain biopsy, CSF
CSF, throat swab, stool, brain biopsy
CSF, brain biopsy, blood
Serological testing only CSF,
urine
CSF, urine
CSF, stool
CSF, brain biopsy, skin lesions
Ocular
Conjunctivitis and Keratitis
Adenovirus
Cytomegalovirus
Enterovirus
Herpes Simplex Virus
Varicella-Zoster Virus
Eye swab
Eye swab
Eye swab
Corneal or conjunctival scrapings
Eye swab, corneal or conjunctival scrapings
Genital Infections
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SJMO LABORTORY MICROBIOLOGY VISUAL AIDS
DISEASE/SYMPTOMS
VIRUSES
RECOMMENDED SPECIMEN
Respiratory Tract Infections
Adenovirus
Enterovirus
human Metapneumovirus
Influenza A/B
Parainfluenza 1/2/3
Rhinovirus
RSV
SARS
NP swab, transtracheal aspirate, throat swab
NP swab, throat swab
NP, throat swab, bronchial wash, lung tissue
NP, throat swab, sputum
NP, throat swab
NP, throat swab
NP swab, aspirate or wash
NP, throat swab, bronchial wash, lung tissue
Respiratroy
Pneumonia
Adenovirus
Cytomegalovirus Herpes
Simplex Virus
human Metapneumovirus
Influenza A/B
Parainfluenza 1/2/3
RSV
SARS
Varicella-Zoster Virus
Throat swab, nasopharyngeal (NP), bronchial wash, tissue
Urine, throat swab, lung tissue, blood, bronchial wash
Throat swab, bronchial wash, lung tissue, oral lesion, blood
NP, throat swab, bronchial wash, lung tissue
Throat wash, sputum, lung tissue, NP, bronchial wash
Throat swab, sputum, lung tissue, NP, bronchial wash
NP, bronchial wash, lung tissue
NP, throat swab, bronchial wash, lung tissue
Lung tissue, bronchial wash, skin lesions, blood
Skin /Cutaneous
Enterovirus
Herpes Simplex Virus
HHV-6
Measles
Parvovirus B19
Rubella
Varicella-Zoster Virus
Vesicle swab, throat swab, stool
Vesicle swab
Serology/PCR Blood,
throat swab
Serology/PCR
Throat swab, CSF, urine
Scrapings from fresh vesicle
Exanthems and Enanthems
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Patient Collection Instructions
REMARKABLE MEDICINE. REMARKABLE CARE.
SJMO LABORATORY
PATIENT INSTRUCTIONS
Click on the links below for printable patient collection instructions.
Clostridium difficile Toxin A/B or Rotavirus Antigen Collection
Fecal Occult Blood Collection
Ova and Parasite Collection
Pinworm Collection
Semen Collection - Fertility
Semen Collection - Post Vasectomy
Sputum Collection
Stool Collection
Urine Culture Collection
Urine Collection
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SJMO LABORATORY
PATIENT INSTRUCTIONS
Clostridium difficile Toxin A/B or Rotavirus Antigen Collection
Patient Instructions
St. Joseph Mercy Oakland
44405 Woodward
Pontiac, Michigan 48341
1-248-858-3600
Your physician has ordered a laboratory test which will require you to collect a stool sample.
Please follow the instructions below to ensure accurate results
Step
1.
2.
3.
4.
Instructions
Confirm the collection container is labeled correctly with:
 your (the patient) first and last name,
 the date and time of collection, and
 another identifier such as date of birth or medical record number.
Incorrectly or incompletely labeled specimens will not be tested.
Do not use laxatives, antacids or antidiarrheal medication for at least 1 week before collection
of the specimen.
First pass urine into the toilet (if you have to).
Collect the stool specimen in the container provided or place a large plastic bag/plastic wrap
may be placed over the toilet opening (but under the toilet seat) and the stool specimen
passed onto the plastic.
The stool specimen must not come in contact with water or urine.
5.
6.
7.
8.
9.
10.
Note: For small children having diarrhea, fasten plastic kitchen wrap to the diaper using
childproof safety pins or turn the diaper inside out. After the bowel movement, remove stool
from the liner and transfer it into the collection vial. Stool collected in diapers is not acceptable.
Carefully unscrew the cap from the plastic collection container. Do not touch the inside of the
lid or container with your fingers.
Using the applicator stick, fill the container half full.
Do not add any foreign materials such as toilet paper or plastic wrap.
Collect stool from areas that look bloody, mucoid or watery.
Close the screw cap tightly.
Seal the container in the zip locked section of the bag and requisition in the pouch section of
the bag.
Wash your hands with soap and water.
Bring the container and lab requisition to the laboratory as soon as possible (within 18 hours).
Keep the sample refrigerated/cold until it is brought to the lab. Prolonged delays will affect the
test results.
07/14
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SJMO LABORATORY
PATIENT INSTRUCTIONS
Fecal Occult Blood
Patient Instructions
St. Joseph Mercy Oakland
44405 Woodward
Pontiac, Michigan 48341
1-248-858-3600
Your physician has ordered a laboratory test which will require you to collect a stool sample.
Please follow the instructions below to ensure accurate results
Step
1.
2.
3.
4.
5.
6.
7.
8.
Open the collection kit provided by your physic.
Place the collection paper inside the toilet. A piece of plastic wrap stretched over the toilet bowl
may also be used.
Have a bowel movement on the paper or plastic.
Remove the green cap with probe from the bottle,
Scrape the stool with the probe.
Return the probe to the vial. Seal tightly.
Complete the information on the label. Write your name, date of birth and collect date.
Package and mail immediately. Test must be received within 15 days of collection.
07/14
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PATIENT INSTRUCTIONS
Ova and Parasite Examination
Patient Instructions
WARNING: The preservative in the collection containers are poisonous. Keep out of reach of
children.
Step
Instructions
1
Confirm the collection container is labeled correctly with:

your (the patient) first and last name
the date and time of collection

date of birth.
Incorrectly or incompletely labeled specimens will not be tested.
2
Do not use laxatives, antacids or antidiarrheal medication for at least week before collection of the specimen. If these
medications were used within the last week, the detection of some parasites may be compromised.
3
Collect the stool specimen in a clean wide-mouthed container (e.g. paper plate or ice cream pail) or a large plastic
bag/plastic wrap may be placed over the toilet opening (but under the toilet seat) and the stool specimen passed onto
the plastic.
The stool specimen must not come in contact with water or urine.
Note: For small children having diarrhea, fasten plastic kitchen wrap to the diaper using child proof safety pins. After
the bowel movement, remove stool from the liner and transfer it into the collection vials. Alternately the diaper may be
put on “inside –out” with the outer plastic next to the child’s skin. Please do this at home. Stool submitted in diapers
cannot be accepted for testing.
Carefully unscrew the cap from the plastic collection container. Do not touch the inside of the lid or container with
your fingers.
4
5
Using the fork/spoon which is attached to the lid of the preservative container, place scoopfuls of stool into the
containers especially from areas that look bloody, mucousy or watery.
6
Add stool until the liquid comes to the ‘FILL LINE’ on the container. Do not overfill. Mix
thoroughly with the fork/spoon.
Do not add any foreign materials such as toilet paper or plastic wrap.
. Close the screw cap tightly. If using container with preservative, shake the container several times.
. Seal the container in the zip locked section of the bag. Put the Patient History Sheet and lab
requisition in the pouch section of the bag.
Wash your hands with soap and water.
Bring the container, requisition, and Patient History Sheet to any laboratory as soon as possible
(within 18 hours). Keep the sample at room temperature until it is brought to the lab. DO NOT
refrigerate it. Prolonged delays will affect the test results.
7
8
9
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07/14
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PATIENT INSTRUCTIONS
Pinworm Collection
Patient Instructions
St. Joseph Mercy Oakland
44405 Woodward
Pontiac, Michigan 48341
1-248-858-3600
Your physician has ordered a laboratory test which will require you to collect a sample for
pinworm examination. Please follow the instructions below to ensure accurate results
Step
Instructions
1.
Confirm the collection container is labeled correctly with:
your (the patient) first and last name, the date and time of collection,
and another identifier such as date of birth or medical record number.
Incorrectly or incompletely labeled specimens will not be tested.
2.
3.
The ideal time for this procedure is early in the morning before emptying the bowels.
Unscrew the cap from the container. Inside the container is a plastic paddle. One side
of the paddle is coated with a non-toxic, mildly sticky material. Do not touch the sticky
surface with your fingers.
Using moderate pressure, press the sticky surface against the skin surrounding the
anus.
Place the paddle back into the container and tighten the cap.
Seal the container in the zip-locked section of the bag and lab requisition in the pouch
section of the bag.
Wash your hands with soap and water.
Bring the container and requisition to the laboratory as soon as possible. Prolonged
delays will affect the test results.
4.
5.
6.
7.
8.
07/14
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PATIENT INSTRUCTIONS
Semen Sample
Patient Instructions
Fertility Specimen
St. Joseph Mercy Oakland
44405 Woodward
Pontiac, Michigan 48341
1-248-858-3600
FERTILITY SPECIMENS:
Planning
 Collect specimen for semen analysis between two days and seven days from the time of most recent
ejaculation.
 Semen specimens are accepted in the Hematology laboratory Monday through Friday from 7:30 AM until 2:30
PM. If you have questions or need directions, please call the Hematology laboratory at 248-858-3249.
 Specimen must be delivered to the laboratory within one hour of collection, which is most easily accomplished if
it is collected at the hospital (in one of the rest rooms).
 Specimen can be collected at home provided that it can be delivered to the hospital within one hour.
Collection
 Collect the specimen by masturbation using the supplied container to catch the entire specimen.
 Do not use lubricants or other substances that may contaminate the specimen.
 Inform lab staff if part of the specimen is not caught.
 Do not use a condom to collect the specimen; condoms can kill or damage sperm, and it is impossible to get
the entire sample out of a condom.
 Make note of the time that the specimen is collected. That time will need to be indicated on the request form in
the lab.
Delivery
 The specimen must be kept at room or body temperature while being transported; if it is cooled (below or 64F)
or heated (above or 104F) it will be ruined.
 The specimen and accompanying paperwork should be delivered directly to the laboratory in the basement of
the hospital. (Hematology lab is in the basement. Take the G wing elevators down to LL.) You need not stop at
the hospital registration desk.
 Be sure to give the specimen directly to a technologist to ensure that it is examined while still fresh.
 Make sure that the entire request form (that you will be given in the lab) is filled in before leaving the laboratory
or your sample cannot be processed. Bring your Physician’s order, insurance information, and your driver’s
license with you.
07/14
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Semen Sample
Post-Vasectomy Testing
Patient Instructions
St. Joseph Mercy Oakland
44405 Woodward
Pontiac, Michigan 48341
1-248-858-3600
BEFORE COLLECTION:
• Do not ejaculate (either through sexual intercourse or masturbating) for at least 3
days before collection.
COLLECTION: • Collect a sample in the sterile container provided by the laboratory. Do
not collect the sample in a condom. Condoms contain a powder that destroys
spermatozoa.
AFTER COLLECTION:
• Sample will ONLY be accepted if:
1) Collected in sterile container provided by laboratory or your doctor. Container must
be labeled with patient’s first and last name AND date of birth
NOTE: tests will not be done if the specimen is not labeled correctly
2) Delivered to the laboratory within one (1) hour of collection Keep the sample at body
temperature (for example, place container in an inside pocket) from the time it is
collected until it is delivered to
the laboratory
DO NOT place specimen in laboratory drop off box, give
specimen directly to laboratory staff.
3) Delivered before 2pm Monday-Friday.
Samples will not be accepted on weekends or holidays.
07/14
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PATIENT INSTRUCTIONS
Sputum Collection
Patient Instructions
St. Joseph Mercy Oakland
44405 Woodward
Pontiac, Michigan 48341
1-248-858-3600
Your physician has ordered a laboratory test which will require you to collect a sputum sample.
Please follow the instructions below to ensure accurate results.
Step
1.
2.
3.
4.
5.
6.
7.
8.
9.
10
Instructions
Confirm the collection container is labeled correctly with:
•your (the patient) first and last name,
•the date and time of collection, and
•another identifier such as date of birth or medical record number.
Incorrectly or incompletely labeled specimens will not be tested.
The ideal time to collect the sample is early in the morning just after getting out of
bed. However, sample may be collected at any time sputum is available to be
produced.
Gargle and rinse your mouth with water.
Sputum collection for Culture and Sensitivity — Do not use mouthwash or brush
teeth with toothpaste immediately before collection.
Open the container and hold it very close to your mouth.
Take as deep a breath as you can and cough, deeply from within the chest. Do
not spit saliva into the container.
The sample you cough should look thick and be white, yellow or green in color. A
minimum of 5 mLs (approx .1 tablespoon) of sample is required.
Close the container lid tightly and give sample to your caregiver right away.
If you are at home, seal the sample in the zip locked section of the bag and the
lab requisition in the pouch section of the bag.
Bring the container and lab requisition to the laboratory as soon as possible. If
unable to return the sample to the laboratory right away, the sample can be
stored in the refrigerator for up to 24 hours. Prolonged delays will affect the test
results.
If your doctor has ordered multiple sputum cultures, collect only one specimen
per day. Bring the sample to the laboratory within 18-24 hours of collection.
07/14
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PATIENT INSTRUCTIONS
-
Stool Culture Collection
Patient Instructions
St. Joseph Mercy Oakland
44405 Woodward
Pontiac, Michigan 48341
1-248-858-3600
Your physician has ordered a laboratory test which will require you to collect a stool sample.
Please follow the instructions below to ensure accurate results
Step
1.
2.
3.
4.
Instructions
Confirm the collection container is labeled correctly with:
 your (the patient) first and last name,
 the date and time of collection, and
 another identifier such as date of birth or medical record number.
 Incorrectly or incompletely labeled specimens will not be tested.
Do not use laxatives, antacids or antidiarrheal medication for at least 1 week before collection
of the specimen.
First pass urine into the toilet (if you have to.)
Collect the stool specimen in the container provided or a large plastic bag/plastic wrap may be
placed over the toilet opening (but under the toilet seat) and the stool specimen passed onto
the plastic.
The stool specimen must not come in contact with water or urine.
5.
6.
7.
8.
9.
10.
Note: For small children having diarrhea, fasten plastic kitchen wrap to the diaper using
childproof safety pins or turn the diaper inside out. After the bowel movement, remove stool
from the liner and transfer it into the collection vial. Stool collected in diapers is not acceptable
for testing.
Carefully unscrew the cap from the plastic collection container. Do not touch the inside of the
lid or container with your fingers.
Using the fork/spoon which is attached to the lid of each container, place scoopfuls of stool into
the container especially from areas that look bloody, mucoid or watery.
Add stool until the liquid comes to the ‘FILL LINE’ on the container. Do not overfill. Mix
thoroughly with the fork/spoon. If multiple collections are required to reach the fill line, add
some stool to both vials with each collection.
Seal the container in the zip locked section of the bag and requisition in the pouch section of
the bag.
Wash your hands with soap and water.
Bring the container and lab requisition to any laboratory as soon as possible (within 18
hours.) Keep the sample at room temperature until it is brought to the lab. Prolonged delays
will affect the test results.
07/14
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PATIENT INSTRUCTIONS
Urine Culture Collection
Patient Instructions
St. Joseph Mercy Oakland
44405 Woodward
Pontiac, Michigan 48341
1-248-858-3600
Your physician has ordered a laboratory test which will require you to collect a urine
sample. Please follow the instructions below to ensure accurate results.
Step
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Step
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Female Instructions:
Remove the cap from the collection cup. Be careful not to touch the inside of the cup.
Wash your hands with soap and water.
Separate the folds of skin around the urinary opening. Cleanse the area around the urinary
opening with the first towelette. Repeat using the second towelette.
Void the first portion of urine into the toilet.
As you continue to void, bring the collection cup into the “midstream” to collect the urine
specimen. DO NOT touch the inside of the cup with the hands or any other body part. Void
the remainder of urine into the toilet.
Close the cup touching only the outside of the cap and cup.
Label the specimen with your name, date of birth and date and time of collection.
Wash your hands with soap and water.
Give the specimen to the nurse or medical assistant.
If collecting at home, refrigerate the specimen cup after collection and during transport to the
Lab.
Male Instructions:
Remove the cap from the collection cup. Be careful not to touch the inside of the cup.
Wash your hands with soap and water.
Cleanse the penis using the first towelette beginning at the tip and working toward the base.
Repeat with the second towelette.
Void the first portion of urine into the toilet.
As you continue to void, bring the collection cup into the “midstream” to collect the urine
specimen. DO NOT touch the inside of the cup with the hands or any other body part. Void
the remainder of urine into the toilet.
Close the cup touching only the outside of the cap and cup.
Label the specimen with your name, date of birth and date and time of collection.
Wash your hands with soap and water
Give the specimen to the nurse or medical assistant.
If collecting at home, refrigerate the specimen cup after collection and during transport to the
Lab.
07/14





Collect the specimen in the blue cup as described above.
Fill the tubes contained in the kit if instructed to do so. The nurse or medical assistant may fill these
for you.
The gray tube is for culture. The yellow tube or tiger tube is for urinalysis.
If you are given only a sterile cup without tubes, keep the urine sample cold after collection and during transport
to the Lab or Physician’s office.
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;
SJMO Laboratory
Test Directory
REMARKABLE MEDICINE. REMARKABLE CARE.
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SJMO TEST DIRECTORY HOME PAGE
Click below to link to an alphabetical list of tests performed in the SJMO Laboratory:
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Tests not performed in the SJMO Laboratory are referred to
Warde Medical Laboratory (WML)*. For information on tests
not listed in the SJMO directory, please visit the WML website below or
contact the SJMO Laboratory at 1-248-858-3600.
*The SJMO Laboratory and Warde Medical Laboratory are members of Michigan Consolidated Laboratories (MCL).
Tests not available at WML will be submitted to an alternate reference laboratory.
WARDE MEDICAL LABORATORY TEST DIRECTORY
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CLICK ON THE TEST NAME IN THE LIST BELOW
FOR TEST DETAILS:
A
ABO Group and RH Type
Acetaminophen
Acid Fast Culture
Alanine Aminotransferase (ALT or SGPT)
Albumin
Alkaline Phospatase
Ammonia
Amylase
Anaerobic Culture
Antibody Elution Procedure
Antibody Identification
Antibody Screen (Indirect CoombsTest)
Antibody Titer
Antinuclear Antibody
Antithrombin III
Arthropod Insect ID
ASO/Anti-Streptolysin O
Aspartate Aminotransferase
B
Bacterial Antigen
Bactericidal Level
Band Counts
Basic Metabolic Panel
Beta Hydroxybutyrate (Quantitative)
Bilirubin, Direct
Bilirubin, Total
Blood Gases
Blood Culture
Blood Urea Nitrogen (BUN)
BNP B Natriuretic Peptide
Body Fluid Culture
Body Fluids, Cytology
Bone Marrow
Bone Marrow Culture
Bordetella pertussis PCR
Brushing, non-gynecologic cytology
C
C3 Complement
C4 Complement
C-Reactive Protein, High Sensitivity
C-Reactive Protein Non-cardiac
Calcium
Carbon dioxide, Total
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Carcinoembryonic Antigen (CEA)
Catheter (IV) Culture
Cell Count, Cerebrospinal Fluid (CSF)
Cell Count, Miscellaneous Body Fluids
Cerebrospinal Fluid (CSF) Culture
Cerebrospinal Fluid Non-gynecologic Cytology
Chlamydia Culture
Chlamydia DFA (Microtrak)
Chlamydia trachomatis Amplified Probe
Chloride
Cholesterol
Cholesterol, HDL
Cholesterol, LDL
Chromosome Analysis
Circulating Anticoagulant (Mixing Study)
Clostridium difficile toxin, Molecular
Complete Blood Count, CBC
Comprehensive Metabolic Panel
Consultation, Intraoperative
Consultation Surgical Pathology
Cord Blood Evaluation
Cortisol
Corynebacterium diphtheriae Culture
Creatinine
Creatinine Kinase
Creatinine Kinase with CK-MB Fraction
Crossmatch (Compatibility Testing)
Cryptococcal Antigen (CSF/Serum)
Cryptosporidium Stain/Antigen
Cyst fluid, Non-gynecologic cytology
D
Digoxin
Dimer
Direct Antiglobulin Test (Direct Coombs)
Direct Smear Only Gram stain
E
Ear Culture
Electrolytes, Blood
Eosinophil Smears (Urine Only)
Estradiol
Ethanol
Eye Culture
F
Factor VIII Assay
Factor IX Assay
Factor 10A Inhibition
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Fecal Occult Blood
Fecal Reducing Substances
Ferritin
Fetal Fibronectin
Fetal Hemoglobin Test
Fibrinogen
Fine Needle Aspiration, Deep Tissue
Fine Needle Aspiration, Superficial Tissue
Flow Cytometry, Lymph Node
Folate
Follicle Stimulating Hormone
Fresh Frozen Plasma
Frozen Tissue Section Rapid Screen for Malignancy
Fungal Culture (Hair, Skin, Nail)
Fungal Culture, Blood
Fungal Culture, Other Source
G
Gamma Glutamyl Transpeptidase
Gastric Occult Blood
GC Screen (Culture)
Genital Culture (Cervix, Vagina, Urethra, Prostate)
Genital Culture (Other Source)
Gentamicin
Giardia Antigen
Glucose, Fasting
Glucose, Random
Glucose, Spinal Fluid (CSF)
Glucose Tolerance Test
Group B Strep Screen (Genital)
Gynecologic Cytology, Thin Prep PAP test
Gynecologic Cytology, Thin Prep PAP test with Reflexive HPV
H
Haptoglobin
HCG, Beta Qualitative
HCG, Beta Quanitative
HCG, Serum
HCG, Urine
Hemoglobin A1C
Hepatitis A Antibody (IgM)
Hepatitis B Core Antibody (IgM)
Hepatitis B Surface Antibody
Hepatitis B Surface Antigen
Hepatitis C Antibody
Herpes simplex PCR
Human Immunodeficiency Virus (HIV), Antibody Screen
Human Papillomavirus (HPV) DNA Probe, High Risk
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I
Immunofixation (Serum)
Immunofixation (Urine)
Immunoglobulins, Quantitative (IgG, IgA, IgM)
Influenza A and B antigen
Ionized Calcium
Iron and Iron Binding Capacity
J
K
Kidney Biopsy
KOH Preparation
L
Lactate Dehydrogenase
Lactic Acid
Lamellar Body Counts
Lead
Legionella Culture
Legionella Urinary Antigen
Leukocyte Reduced Red Blood Cells
Lipase
Lipid Profile
Lipoprotein Low Density, Direct Measurement
Lithium
Luteinizing Hormone
Lyme Antibody
M
Magnesium
Malaria Smear
Microalbumin
Mononucleosis Screen
MRSA Screen Culture
Mycoplasma/Ureaplasma Culture
N
Neisseria gonorrhoeae Amplified Probe
Nipple Secretion, Non-gynecologic Cytology
O
Osmolality, Serum
Osmolality, Urine
Ova and Parasite Examination
P
Partial Thromboplastin Time
Path CBC
Path Eval
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pH, Body Fluids
pH, Feces
Phenobarbital
Phenytoin (Dilantin)
Phospohorus, Blood
Phospohorus, Urine
Pinworm Preparation
Platelet Function Analysis
Platelets
Plavix Response Test
Potassium
Prealbumin
Progesterone
Prolactin
Prostate Specific Antigen
Protein, Cerebrospinal Fluid
Protein C
Protein Electrophoresis
Protein, Total
Protein, Urine 24 hour
Prothrombin Time (PT)
Q
R
Rapid Strep Screen
Respiratory Culture (Bronchial Wash, BAL)
Respiratory Culture Induced Sputum
Respiratory Culture, Expectorated Sputum
Respiratory Screening Culture (Legionella, etc.)
Respiratory Syncytial Virus (RSV) Antigen
Reticulocyte Count
Rheumatoid Factor
Rotavirus Antigen
Rubella IgG
S
Salicylate
Sedimentation Rate
Semen Analysis
Semen Analysis, Post Vasectomy
Skin Biopsy, Immunofluorescence
Sodium
Sodium, Urine
Spore Check
Sputum, Cytology
Stool Culture
Surgical Tissue
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T
T3, Free
T3, Total
T4, Free
T4, Total
Tegretol
Testosterone, Total
Throat Culture
Thyroid Stimulating Hormone
Tissue Culture
Tissue Culture, Quantitative
Tobramycin
Toxoplasma, IgG
Transferrin
Triglycerides
Troponin
Tzanck Smear: Viral Studies for Herpes, Pemphigus
U
Uric Acid, Blood
Urinalysis
Urine Culture
Urine Cytology
Urine, Microscopic
Urine Reducing Substances
V
Vaginitis Screen
Vancomycin
Virus Culture
Vitamin B12
Vitamin D
W
Washing/Lavage Cytology: Bronchial Tracheal or Esophageal
Wound Culture
X
Y
Z
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ABO GROUP AND RH TYPE
TEST NAME:
ABO GROUP AND RH TYPE
CPT CODE:
86900 & 86901
SPECIMEN REQUIREMENT:
Pink top EDTA vacutainer tube
COLLECTION REQUIREMENT:
INPATIENTS: Name, Medical Record Number (MRN),
date, and time of collection, initials of phlebotomist and A#.
OUTPATIENTS: 2 patient identifiers, date of collection,
initials of phlebotomist.
METHOD:
Agglutination
LAB SECTION PERFORMING TEST:
Blood Bank
AVAILABILITY:
Daily
TURNAROUND TIME:

1 day

60 minutes for STATs
GENERAL USE OF TEST:
To identify a person’s blood type for any reason:
compatibility, testing, prenatal workup.
STORAGE REQUIREMENTS:
Room temperature or at 1-8 C.
Revised 07/14.
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ACETAMINOPHEN
TEST NAME:
ACETAMINOPHEN
ALTERNATE TEST NAME:
TYLENOL
CPT CODE:
82003
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (lithium heparin) OR
0.5 mL serum from a gold top tube (SST).
REFERENCE RANGE:
10-30 ug/mL
CRITICAL VALUE:
>100 ug/mL
METHOD:
Immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
COLLECTION REQUIREMENTS:
Acetaminophen specimens should not be drawn earlier than
4 hours after ingestion. If the time of ingestion is not known,
2 or more blood samples taken at two or three hour intervals
may be used to estimate acetaminophen half-life and
assess toxicity.
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Drug toxicity, monitoring therapeutic levels.
LIMITATIONS:
Alcohol and Phenobarbital may interfere by accelerating
Acetaminophen toxicity.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2- 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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ALANINE AMINOTRANSFERASE
TEST NAME:
ALANINE AMINOTRANSFERASE
ALTERNATE TEST NAME:
ALT, SGPT
CPT CODE:
84460 (ALT)
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST).
REFERENCE RANGE:
Male: 17-63 U/L
Female: 9-54 U/L
METHOD:
Enzymatic
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Liver function
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for at least 5 days
after testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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ALBUMIN
TEST NAME:
ALBUMIN
CPT CODE:
82040
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST)
REFERENCE RANGE:
0 – 1 mo: 2.6 – 4.1 g/dL
1 mo -6 mo: 2.8 – 4.6 g/dL
6 mo – 1 yr: 2.8 – 4.8 g/dL
1 yr – 150 yrs: 3.5 – 4.8 g/dL
METHOD:
Colorimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Nutritional status, blood oncotic pressure.
LIMITATIONS:

Albumin concentrations vary with posture.

Results from an upright posture may be
approximately 0.3 g/dL higher than those from a
recumbent posture.

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to1 month.

Samples will be capped and held for 5 days after
testing.
SPECIMEN PREPARATION:
STORAGE REQUIREMENTS:
Revised 07/14.
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TEST DIRECTORY
ALKALINE PHOSPHATASE
TEST NAME:
ALKALINE PHOSPHATASE
ALTERNATE TEST NAME:
CPT CODE:
84075
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST)
REFERENCE RANGE:
AGE
0 MOS to 1 MO
1 MO to 1 YR
1 YR – 3 YRS
3 YRS – 6 YRS
6 YRS – 9 YRS
9YRS – 12 YRS
12 YRS – 15 YRS
15-18 YRS
>= 18 years
FEMALE
75-316 IU/L
82 - 383 IU/L
104-345 IU/L
93-309 IU/L
69 -325 IU/L
42- 362 IU/L
74-390 IU/L
52-171 IU/L
38-126 IU/L
MALE
48-406 IU/L
124 - 341 IU/L
108 - 317IU/L
93 - 309IIU/L
69 - 325 IU/L
51-332 IU/L
50 - 162 IU/L
47 - 119IU/L
38 - 126IU/L
METHOD:
Enzymatic
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Liver function, bone disease.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2- 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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TEST DIRECTORY
AMMONIA
TEST NAME:
AMMONIA
CPT CODE:
82140
SPECIMEN REQUIREMENT:





AMMONIA: The specimen of choice is sodium or
lithium heparinized tubes (green top).
Collect by standard venipuncture techniques and keep
on ice.
Centrifuge specimen immediately.
Remove plasma from cells within 15 minutes of
collection.
Store at 2 - 8C in a tightly stoppered plain transport
tube.
REFERENCE RANGE:
19-60 ug/DL
METHOD:
Colorimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:

Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of STAT specimens will be reported within 35
minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Ammonia-hepatic failure, liver necrosis and Reyes
Syndrome.
LIMITATIONS:
Failure to place sample on ice after collection or failure
to promptly separate cells and plasma can result in
falsely elevated levels of ammonia.
SPECIMEN PREPARATION:
Centrifuge specimen and remove the plasma from cells
within 15 minutes of collection.
STORAGE REQUIREMENTS:
If not analyzed immediately, a tightly stoppered plasma
sample is stable for up to 30 minutes when stored on
ice.
Revised 07/14.
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TEST DIRECTORY
AMYLASE
TEST NAME:
AMYLASE
CPT CODE:
82150
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST) OR
0.5 mL plasma from a green top tube (heparin).
REFERENCE RANGE:
0 – 1 MO: 0-18 IU/L
1 MO – 26 WKS: 0-43 IU/L
26 WKS – 1 YR: 0-81 IU/L
1 YR -18 YRS: 0 – 106 IU/L
>18 YRS: 28-100 IU/L
CRITICAL VALUE:
>300 IU/L
METHOD:
Enzymatic
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:

Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of STAT specimens will be reported within 30
minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Pancreatitis, obstruction in pancreatic duct and
macroamylasemia.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen, separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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ANTIBODY ELUTION PROCEDURE
TEST NAME:
ANTIBODY ELUTION PROCEDURE
CPT CODE:
86860
SPECIMEN REQUIREMENT:
Pink top EDTA tube
COLLECTION REQUIREMENT:
EDTA vacutainer tubes
INPATIENTS: Name, Medical Record Number (MRN), date,
and time of collection, initials of phlebotomist and A#.
OUTPATIENTS: 2 patient identifiers, date of collection,
initials of phlebotomist.
REFERENCE RANGE:
Negative
CRITICAL VALUE:
Patient undergoing a delayed transfusion reaction.
METHOD:
Acid elution technique
LAB SECTION PERFORMING TEST:
Blood Bank
AVAILABILITY:
Daily
TURNAROUND TIME:
1 day
GENERAL USE OF TEST:
Test is performed on patient’s red blood cells when a
positive direct antiglobulin test is obtained, shortened red
cell survival is suspected and patient has been transfused in
the last three months.
LIMITATIONS:
The amount of antibody bound to the cells, dissociation
of antibody during the washing procedure and degree
to which immunoglobulin is denatured by low pH during
dissociation.
STORAGE REQUIREMENTS:
Room temperature or at 1 - 8C.
Revised 07/14.
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ANTIBODY IDENTIFICATION
TEST NAME:
ANTIBODY IDENTIFICATION
CPT CODE:
86860
SPECIMEN REQUIREMENT:
Pink EDTA vacutainer tube
COLLECTION REQUIREMENT:
INPATIENTS: Name, Medical Record Number (MRN),
date, and time of collection, initials of phlebotomist and A#.
OUTPATIENTS: 2 patient identifiers, date of collection,
initials of phlebotomist.
REFERENCE RANGE:
Negative
METHOD:
Capture or agglutination
LAB SECTION PERFORMING TEST:
Blood Bank
AVAILABILITY:
Daily
TURNAROUND TIME:
1 day (usually)
GENERAL USE OF TEST:
To identify an alloantibody in a sensitized patient.
LIMITATIONS:
This test is performed automatically when a positive
antibody screening is obtained.
SPECIMEN PREPARATION:
None
STORAGE REQUIREMENTS:
Room temperature or at 1 - 8C.
Revised 07/14.
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ANTIBODY TITER
TEST NAME:
ANTIBODY TITER
CPT CODE:
86886
SPECIMEN REQUIREMENT:
Pink EDTA vacutainer tube
COLLECTION REQUIREMENT:
INPATIENTS: Name, Medical Record Number (MRN),
date, and time of collection, initials of phlebotomist and A#.
OUTPATIENTS: 2 patient identifiers, date of collection,
initials of phlebotomist.
CRITICAL VALUE:
A rise in antibody titer of more than two tubes over the
previous sample suggests that HDN is possible.
METHOD:
Agglutination using anti-IgG monospecific reagents.
LAB SECTION PERFORMING TEST:
Blood Bank
AVAILABILITY:
Daily
TURNAROUND TIME:
48 hours
GENERAL USE OF TEST:
To follow obstetrical patients to determine a change in titer
of clinically significant antibodies known to cause HDN.
STORAGE REQUIREMENTS:
Room temperature or at 1 - 8C.
Revised 07/14.
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ANTINUCLEAR ANTIBODY
TEST NAME:
ANTINUCLEAR ANTIBODY
(Positive screens will be titered)
CPT CODE:
86038, 86039
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST) OR red top tube
REFERENCE RANGE:
Negative (less than 1:160)
METHOD:
Indirect fluorescent antibody HEP-2 substrate
LAB SECTION PERFORMING TEST:
Reference Laboratory
AVAILABILITY:
Screen Sunday-Friday , Titer: Monday-Friday
TURNAROUND TIME:

Results of screens will be available within 1 day

All screens positive will be quantitated on the next
scheduled run.
GENERAL USE OF TEST:
Collagen vascular diseases.
LIMITATIONS:
Some drugs, such as hydralazine and procainamide,
may induce ANA.
Grossly hemolyzed icteric or lipemic specimens cannot be
used.
SPECIMEN PREPARATION:

Collect specimen using standard laboratory procedures.

Centrifuge specimens; separate serum from cells within
2 hours of collection if possible.

Store serum samples at 2-8C.

Repeat freezing and thawing may cause deterioration of
test specimen.
STORAGE REQUIREMENTS:
.
Revised 07/14.
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ANTIBODY SCREEN (Indirect Coombs Test)
TEST NAME:
ANTIBODY SCREEN (Indirect Coombs Test)
CPT CODE:
86850
SPECIMEN REQUIREMENT:
Pink EDTA vacutainer tube
COLLECTION REQUIREMENT:
INPATIENTS: Name, Medical Record Number (MRN), date,
and time of collection, initials of phlebotomist and A#.
OUTPATIENTS: 2 patient identifiers, date of collection,
initials of phlebotomist.
REFERENCE RANGE:
Negative
CRITICAL VALUE:
Antibody detection on STAT request.
METHOD:
Capture or Agglutination
LAB SECTION PERFORMING TEST:
Blood Bank
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

24 hours for routines

60 minutes for STATs
GENERAL USE OF TEST:
To determine if sensitization to red cell antigens has
occurred. If screen is positive, antibody identification will be
performed.
PATIENT PREPARATION:
An armband is required on inpatients and outpatients
scheduled for transfusion so that positive patient
identification can be established.
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ANTITHROMBIN III
TEST NAME:
ANTITHROMBIN III
85300
CPT CODE:
SPECIMEN REQUIREMENT:
Plasma from a blue top tube (sodium citrate)
METHOD:
Chromogenic detection
LAB SECTION PERFORMING TEST:
Reference Lab
AVAILABILITY:
Monday-Friday
TURNAROUND TIME:
3 Days
GENERAL USE OF TEST:
Evaluation of antithrombin deficiencies associated
with high risk of thromboembolic disorders.
STORAGE REQUIREMENTS:
See Reference Laboratory Instructions
Revised 07/14.
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TEST DIRECTORY
ASO (STREPTOZYME)
TEST NAME:
ASO (STREPTOZYME)
CPT CODE:
86060
SPECIMEN REQUIREMENT:
Draw blood in a SST. Spin, separate and send 1.0 mL
serum (0.5 mL minimum) refrigerated in a screw-capped
plastic vial OR
Plasma: EDTA, heparin (lithium) OR
Serum: Red-top
REFERENCE RANGE:
Less than 200 IU/mL
METHOD:
Nephelometry
LAB SECTION PERFORMING TEST:
Reference Laboratory
AVAILABILITY:
Sunday through Friday
TURNAROUND TIME:
1 Day
GENERAL USE OF TEST:
Serodiagnosis of recent streptococcal infections.
LIMITATIONS:


SPECIMEN PREPARATION:
STORAGE REQUIREMENTS:
False positives may be associated with liver disease
or bacterial contamination of specimens.
Streptococcal infections already treated with
antibiotics may not produce increased results.

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.

Refrigerate at 2 - 8C up to 72 hours.

Samples are capped and held for 5 days after testing.
Revised 07/14.
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ASPARTATE AMINOTRANSFERASE
(AST or SGOT)
TEST NAME:
ASPARTATE AMINOTRANSFERASE
(AST or SGOT)
CPT CODE:
84450
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) or
0.5 mL serum from a gold top tube (SST)
REFERENCE RANGE:
0-150 YRS: 15 – 41 IU/L
METHOD:
Enzymatic
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Cardiac function or liver function.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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BAND COUNTS
TEST NAME:
BAND COUNTS
Alternate TEST NAME:
BANDS
CPT CODE:
SPECIMEN REQUIREMENT:
Minimum of 1 ml lavender top tube (EDTA) OR
250 uL lavender microtainer
COLLECTION REQUIREMENT:
Test is only available for neonates under 3 months of age
METHOD:
Manual enumeration of percentage of bands per 100 WBCs
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:
GENERAL USE OF TEST:
STORAGE REQUIREMENTS:


Same shift testing
Results of specimens requested STAT will be
reported within 60 minutes of receipt in the
laboratory.
May be used to help manage febrile neonates. The validity
of the band count has been questioned by many because
of the imprecision of band numbers obtained from a 100
cell count and the variability in band identification.
Sample must be analyzed within 24 hours of collection. Test
may be added on if slide has already been made. Test may
be added on if slide has already been made. Contact Lab for
availability.
Revised 07/14.
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BASIC METABOLIC PANEL
TEST NAME:
ALTERNATE TEST NAME:
BASIC METABOLIC PANEL
(Na, K, Cl, C02, Gluc, Bun, Calcium, Creatinine + GFR)
BMP
CPT CODE:
80048
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST)
REFERENCE RANGE:
See individual tests
CRITICAL VALUE:
See individual tests
METHOD:
See individual tests
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Evaluation of various serum biochemistry constituents.
LIMITATIONS:
Grossly hemolyzed or lipemic specimens.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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BETA HYDROXYBUTYRATE (QUANTITATIVE)
TEST NAME:
BETA HYDROXYBUTYRATE (QUANTITATIVE)
CPT CODE:
82010
SPECIMEN REQUIREMENT:
1 mL plasma from a green top tube (heparin).
REFERENCE RANGE:
0.02 – 0.27 mmol/L
METHOD:
Enzymatic
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:

Daily or STAT
TURNAROUND TIME:

Same shift testing.

If ordered STAT, within 60 minutes of receipt in the
laboratory.
GENERAL USE OF TEST:
To diagnose Diabetic Ketoacidosis (DKA) and monitor the
results of treatment.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen, separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.
STORAGE REQUIREMENTS:
Revised 07/14.
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BILIRUBIN, DIRECT
TEST NAME:
BILIRUBIN, DIRECT
CPT CODE:
82248
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST)
REFERENCE RANGE:
0.1 – 0.5 mg/dL
CRITICAL VALUE:
0-3 Mos.: >2.0 mg/dL
METHOD:
Colorimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Liver function test useful in the diagnosis of jaundice due to
liver disease, hemolytic anemia.
LIMITATIONS:
Specimen must be protected from light.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
Protect specimen from light.
STORAGE REQUIREMENTS:

Revised 07/14.
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BILIRUBIN, TOTAL
TEST NAME:
BILIRUBIN, TOTAL
CPT CODE:
82247
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin). OR
0.5 mL serum from a gold top tube (SST)
REFERENCE RANGE:
AGE
0-1 Day
1 Day-2 Days
2 Days-5 Days
>5 Days
CRITICAL VALUE:
RANGE
0-5.1 mg/dl
0-7.2 mg/dl
0-10.3 mg/dl
0.4-2.0 mg/dl
>15.0 mg/dl
METHOD:
Colorimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Liver function test useful in the diagnosis of jaundice due to
liver disease, hemolytic anemia.
LIMITATIONS:
Specimen must be protected from light.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.


Refrigerate at 2 - 8C up to 48 hours.
Samples will be capped and held for 5 days after
testing.
Protect specimen from light.
STORAGE REQUIREMENTS:

Revised 07/14.
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BLOOD GASES
(pH, pO2, pCO2, HCO3, TCO2, BE)
TEST NAME:
BLOOD GASES
(pH, pO2, pCO2, HCO3, TCO2, BE)
CPT CODE:
82803
SPECIMEN REQUIREMENT:


REFERENCE RANGE:
Whole blood in heparinized syringe obtained by arterial
(ABG) or venous (VBG) puncture, cord blood (CBG)
obtained by physician.
Specimen should be transported immediately in ice
slurry.
Adult Normal Range
Arterial:
pH
7.35 – 7.45
pCO2
35 – 45 mmHg
pO2
75-110 mmHg
HCO3
22 – 26 mmol/L
TCO2
22 – 27 mmol/L
0-4 Weeks
Arterial:
pH
pCO2
pO2
Venous:
7.35 – 7.45
35 – 45 mmHg
50-80 mmHg
pH
pCO2
pO2
HCO3
TCO2
7.32 – 7.42
41 – 51 mmHg
25 – 40 mmHg
24 – 28 mmol/L
25 – 29 mmol/L
Cord Blood
Arterial
pH
7.15 – 7.43
pCO2
31.1 – 74.3 mmHg
pO2
3.8 – 33.8 mmHg
HCO3
13.3 – 27.5 mmol/L
CRITICAL VALUE:
Venous
7.24 – 7.49
23.2 – 49.2 mmHg
15.4 – 48.2 mmHg
15.9 – 24.7 mmol/L
pH <7.24 or >7.56
pCO2 <19 or >71 mmHg
pO2 <54 mmHg
0-4 Weeks
pH <7.24 or >7.48
pCO2 <33 or >62 mmHg
pO2 <33 or >101 mmHg
METHOD:
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LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
All specimens handled as STAT.
GENERAL USE OF TEST:
Determination of acid-base status, respiratory function.
LIMITATIONS:

Clotted sample, liquid anti-coagulants can
cause dilution effect if improper ratio of
sample to anti- coagulant when collected,
contamination with room air.

Specimens must be submitted on ice
immediately after being drawn.
NOTE:
O2 deliver or room air should be noted.
Revised 07/14.
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BLOOD UREA NITROGEN
(BUN)
TEST NAME:
BLOOD UREA NITROGEN(BUN)
ALTERNATE TEST NAME:
BUN
CPT CODE:
84520
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST).
REFERENCE RANGE:
0 – 4 wks: 1 – 16 mg/dl
4 wks – 150 yrs: 5 - 25 mg/dl
CRITICAL VALUE:
0 – 4 wks: >50 mg/dl
4 wks – 150 yrs: > 115 mg/dl
METHOD:
Enzyme conductivity
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:
 Same shift testing.
 Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Evaluation of kidney function.
 Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.
STORAGE REQUIREMENTS:
 Refrigerate at 2 – 8C up to 48 hours.
 Samples will be capped and held for 5 days after
testing.

Revised 07/14.
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BNP (B Natriuretic Peptide)
TEST NAME:
BNP (B Natriuretic Peptide)
CPT CODE:
83880
SPECIMEN REQUIREMENT:
1.0 mL from a lavender EDTA tube.
(large EDTA tube required)
REFERENCE RANGE:
<100 pg/mL
METHOD:
Immunoenzymatic
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of STAT specimens will be reported within 60
minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Aid in the diagnosis and assessment of severity of
congestive heart failure.
LIMITATIONS:


Concentrations may be elevated in patients:
 who are experiencing a heart attack
 who are candidates for renal dialysis
 who have had renal dialysis
This test has been formulated to minimize the
effects of antibodies on the assay. However,
clinicians should carefully evaluate results from
patients suspected of having such antibodies.
SPECIMEN PREPARATION:
Centrifuge sample and remove plasma within 7 hours of
collection.
STORAGE REQUIREMENTS:

Plasma stored at room temperature or 2 - 8C is stable
for 24 hours.

Samples are capped and held for 5 days after testing.
Revised 07/14.
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BODY FLUIDS, CYTOLOGY
(Pleural fluid, Peritoneal fluid (Ascites fluid) & Pericardial Fluid)
TEST NAME:
BODY FLUIDS, CYTOLOGY (Pleural fluid, Peritoneal
fluid (Ascites fluid) & Pericardial fluid)
CPT CODE:
88108
SPECIMEN REQUIREMENT:
 10-100 mL fresh body cavity fluid.
 The practice of salvaging large amounts of fluid is not
recommended.
 If available, a full bottle of fresh unfixed fluid is preferred in
addition to the aliquot.
COLLECTION REQUIREMENT:
 Include 5 units of heparin per mL of fluid in a clean,
sealed plastic or glass container.
 Submit fresh without fixative.
REFERENCE RANGE:
Negative for malignant cells.
METHOD:
Modified Papanicolaou
LAB SECTION PERFORMING TEST:
Cytology
AVAILABILITY:
Monday through Friday (0800 to 1630)
TURNAROUND TIME:
24 – 72 hours
GENERAL USE OF TEST:
To establish the presence of primary or metastatic
neoplasm.
STORAGE REQUIREMENTS:
Refrigerate
Revised 07/14.
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BONE MARROW
TEST NAME:
BONE MARROW
CPT CODE:
85097 (Aspirate smears)
88305 (Clot)
88305 (Biopsy)
85060 (Peripheral blood smears)
SPECIMEN REQUIREMENT:
Bone marrow, aspirate and/or biopsy specimen.
REFERENCE RANGE:
Results interpreted by pathologist.
METHOD:
Microscopic examination of modified Wright’s Giemsa Stain,
paraffin embedded tissue sections.
LAB SECTION PERFORMING TEST:
Hematology / Anatomic Pathology
AVAILABILITY:
Weekdays, 0730 to 1200
TURNAROUND TIME:

GENERAL USE OF TEST:
Bone marrow morphology
PATIENT PREPARATION:

Physician’s responsibility.

Consent form signed.

Physician’s office to schedule with Scheduling
Department at 83777. Scheduling will send pink form to
Hematology.

If procedure is to be performed at bedside on floor, call
Hematology for scheduling.

Physician and technologist meet at bedside

If cultures required, inform scheduler so that proper
tubes will be collected.
24-32 hours in most cases
Revised 07/14.
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SJMO LABORATORY
TEST DIRECTORY
BRUSHING, NON-GYNECOLOGIC CYTOLOGY (Bronchial slides, Esophageal, Gastric,
Small Bowel, Colonic)
TEST NAME:
BRUSHING, NON-GYNECOLOGIC CYTOLOGY (Bronchial
slides, Esophageal, Gastric, Small Bowel, Colonic)
ALTERNATE TEST NAME:
CPT CODE:
88104, 88112-Thin Prep
SPECIMEN REQUIREMENT:

After brushing the lesion, Yes if slides are made

Place brush tip in container with 30ml Cytolyt.

Label slide with patient name.
COLLECTION REQUIREMENT:
Glass slides, container and 95% ETOH are ob0tained from
the laboratory.
REFERENCE RANGE:
Negative for malignant cells.
METHOD:
Modified Papanicolaou
LAB SECTION PERFORMING TEST:
Cytology
AVAILABILITY:
Monday through Friday (0800 to 1630)
TURNAROUND TIME:
24 – 72 hours
GENERAL USE OF TEST:
To establish the presence of primary or metastatic
neoplasm.
LIMITATIONS:
Specimen is considered non-diagnostic if epithelium
lining the site of the brush is not present.
Revised 07/14.
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TEST DIRECTORY
C3 COMPLEMENT
TEST NAME:
ALTERNATE TEST NAME:
C3 COMPLEMENT
C3
CPT CODE:
86160
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube OR
0.5 mL serum from a gold top tube (SST).
REFERENCE RANGE:
79 – 152 mg/dL
METHOD:
Turbidimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing and STAT within 60 minutes
GENERAL USE OF TEST:
 Decrease in autoimmune diseases, serum sickness,
acute glomerulonephritis and LE with renal involvement.
 Increase in acute phase responses, obstructive jaundice
and some connective tissue diseases (excluding SLE).
LIMITATIONS:
Hemolyzed or lipemic specimens should not be used.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.

Store spun and separated serum samples at
-15C to 8C.
Samples will be held for 5 days after testing.
STORAGE REQUIREMENTS:


Repeat freezing and thawing may cause deterioration of
test specimen.
Revised 07/14.
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TEST DIRECTORY
‘
C4 COMPLEMENT
TEST NAME:
ALTERNATE TEST NAME:
C4 COMPLEMENT
C4
CPT CODE:
86160
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube OR
0.5 mL serum from a gold top tube (SST).
REFERENCE RANGE:
16 - 38 mg/dL
METHOD:
Turbidimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing + STAT within 60 minutes
GENERAL USE OF TEST:
To detect individuals with inborn deficiency of this factor or
those with immunologic disease in whom hypercatabolism of
complement causes reduced levels. These diseases
include: Lupus, serum sickness, glomerulonephritis, chronic
active hepatitis and others.
LIMITATIONS:
Hemolyzed or lipemic specimens should not be used.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.

Store spun and separated serum samples at
-15C to 8C.
Samples will be held for 5 days after testing.
STORAGE REQUIREMENTS:


Repeat freezing and thawing may cause deterioration of
test specimen.
Revised 07/14
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TEST DIRECTORY
C-REACTIVE PROTEIN
(High Sensitivity)
TEST NAME:
C-REACTIVE PROTEIN (High Sensitivity)
CPT CODE:
86141
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top heparin tube OR
serum from a gold top tube (SST)
REFERENCE RANGE:
<7.48 mg/L
METHOD:
Nephelometry
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of STAT specimens will be reported within 60
minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Used in evaluation of myocardial infarction, stress, trauma,
infection, inflammation, surgery and neoplastic proliferation.
LIMITATIONS:
Hemolyzed or lipemic specimens should not be used.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.

Refrigerate a 2 - 8C up to 72 hours.

Samples will be held for 5 days after testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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C-REACTIVE PROTEIN
(Non-Cardiac)
TEST NAME:
C-REACTIVE PROTEIN (Non Cardiac)
ALTERNATE TEST NAME:
CPT CODE:
86140
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top heparin tube
OR 0.5 mL serum from a gold top tube (SST)
.
REFERENCE RANGE:
<1.0 mg/dL
METHOD:
Turbidimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Used in evaluation of stress, trauma, infection, inflammation
and surgery.
LIMITATIONS:
Hemolyzed or lipemic specimens should not be used.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be held for 5 days after testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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TEST DIRECTORY
CALCIUM
TEST NAME:
ALTERNATE TEST NAME:
CALCIUM
Ca
CPT CODE:
82310
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST) OR
0.5 mL plasma from a green top tube (heparin).
REFERENCE RANGE:
Age
0-1 Wk
1 Wk-1 Mo
1 Mo-3 Mo
3 Mo – 6 Mo
6 Mo – 1 Yr
1Yr – 3 Yrs
3 Yrs – 11 Yrs
11 Yrs- 13 Yrs
13 Yrs – 15 Yrs
15 Yrs – 19 Yrs
19 Yrs-150 Yrs
Male
7.6 – 11.3 mg/dL
8.8 – 11.6 mg/dL
8.7 – 11.2 mg/dL
8.5 – 11.3 mg/dL
8.0 – 11.0 mg/dL
8.9 – 9.9 mg/dL
9.0 – 10.1 mg/dL
9.0 – 10.6 mg/dL
9.3 – 10.7 mg/dL
9.0 – 10.7 mg/dL
8.5 – 10.5 mg/dL
Female
7.8– 11.2 mg/dL
8.6 – 11.8 mg/dL
8.2 – 11.0 mg/dL
8.0 – 11.4 mg/dL
8.0 – 11.0 mg/dL
8.9 – 9.9 mg/dL
9.0 – 10.1 mg/dL
9.0 – 10.6 mg/dL
9.3 – 10.7 mg/dL
9.0 – 10.7 mg/dL
8.5 – 10.5 mg/dL
CRITICAL VALUE:
<7.0 or >13.0 mg/dL
METHOD:
Ion Selective Electrode
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Evaluation of calcium metabolism.
LIMITATIONS:




RETURN TO TEST DIRECTORY
Recumbent patients may have 0.2 – 0.3 mg/dL lower
levels.
Blood from patients on EDTA therapy cannot be
used.
Blood from patients on Hypaque radiographic
contrast agent cannot be used.
Blood collected w/stasis may have calcium
concentrations 15% higher.
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TEST DIRECTORY


SPECIMEN PREPARATION:
STORAGE REQUIREMENTS:
R
Protective gloves manufactured with calcium
carbonate powders may cause elevated test results
because of contamination of sample handling
supplies. Use powder-free gloves; handle supplies
with clean hands.
Note: Gloves labeled as powder-free may contain
some contaminating powder agents on the inside of
the gloves.

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days
after testing.

R
Revised 07/14.
e
v
i
s
e
d
0
7
/
1
4
.
R
e
v
i
s
e
d
0
7
/
1
4
.
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TEST DIRECTORY
CARBON DIOXIDE, TOTAL
TEST NAME:
CARBON DIOXIDE, TOTAL
ALTERNATE TEST NAME:
CO2
CPT CODE:
82374
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST) OR
0.5 mL plasma from a green top tube (heparin).
REFERENCE RANGE:
22 – 31 mmol/L
CRITICAL VALUE:
<10 or >40 mmol/L
METHOD:
pH rate change
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of specimens requested STAT will be reported
within 30 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Evaluation of acid-base status.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14
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CARCINOEMBRYONIC ANTIGEN
TEST NAME:
CARCINOEMBRYONIC ANTIGEN (CEA)
ALTERNATE TEST NAME:
CEA
CPT CODE:
82378
SPECIMEN REQUIREMENT:
1 mL serum from a gold top tube (SST) or red top tube
REFERENCE RANGE:
Less than 3.0 ng/mL
METHOD:
Chemiluminescent immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Adjunctive aid in management of patients with
gastrointestinal carcinoma.
LIMITATIONS:



SPECIMEN PREPARATION:
STORAGE REQUIREMENTS:
Not to be used as a screening test for the detection
or the presence of cancer.
Elevations in circulating levels may be observed in
smokers, as well as patients with non-colorectal or
pancreatic neoplasms.
Patients who have been regularly exposed to
animals or immunoglobulin fragments may produce
antibodies that interfere with immunoassays.

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
Revised 7/14.
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CELL COUNT, CEREBROSPINAL FLUID
(RBC, WBC, Total Cell Count & Differential when needed)
TEST NAME:
CELL COUNT, CEREBROSPINAL FLUID
(RBC, WBC, Total Cell Count & Differential when needed)
CPT CODE:
89051
SPECIMEN REQUIREMENT:



0.5 mL cerebrospinal fluid collected in sterile screw cap
LP tubes, which are labeled #1, #2, #3 and #4.
Cell counts will be performed on tube #3
3
REFERENCE RANGE:
0 – 5 cells/mm
METHOD:
Manual using hemocytometer
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Evaluation of cellular exudation into cerebral spinal space.
LIMITATIONS:
None
STORAGE REQUIREMENTS:
Cell count must be performed immediately due to rapid cell
lysis on standing.
Revised 07/14
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CELL COUNT, MISC. BODY FLUIDS
(RBC, WBC & Differential when needed)
TEST NAME:
CELL COUNT, MISC. BODY FLUIDS
(RBC, WBC & Differential when needed)
CPT CODE:
89050
SPECIMEN REQUIREMENT:
Thoracentesis, paracentesis or other body fluids
collected in a lavender top vacutainer tube (EDTA).
METHOD:
Manual using hemocytometer
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of specimens requested STAT will be reported
within 60-90 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Evaluation of pleural, pericardial or abdominal fluid
accumulation to determine etiology.
LIMITATIONS:
Results may be affected if clotted or debris in the
sample.
STORAGE REQUIREMENTS:
Cell count must be performed immediately due to rapid cell
lysis on standing.
Revised 07/14
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CEREBROSPINAL FLUID
NON-GYNECOLOGIC CYTOLOGY
TEST NAME:
CEREBROSPINAL FLUID
NON-GYNECOLOGIC CYTOLOGY
CPT CODE:
88112
SPECIMEN REQUIREMENT:
1-10 mL second or third tube.
COLLECTION REQUIREMENT:
 Deliver to Cytology Laboratory immediately.
 After hours CSF, submit fresh. Do not add fixative.
REFERENCE RANGE:
Negative for malignant cells.
METHOD:
Modified Papanicolaou
LAB SECTION PERFORMING TEST:
Cytology
AVAILABILITY:
Monday through Friday (0800 to 1630)
TURNAROUND TIME:
One to two working days.
GENERAL USE OF TEST:
To establish the presence of primary or metastatic
neoplasm.
Revised 07/14.
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CHLORIDE
TEST NAME:
ALTERNATE TEST NAME:
CHLORIDE
Cl
CPT CODE:
82435
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST)
REFERENCE RANGE:
95 –111 mEq/L
<70 OR >140 mEq/L
CRITICAL VALUE:
METHOD:
Ion Selective Electrode
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.

Decrease in overhydration, chronic respiratory acidosis
and congestive heart failure.
Increase in dehydration, renal tubular acidosis and
excessive infusion of normal saline.
GENERAL USE OF TEST:

LIMITATIONS:
Grossly hemolyzed specimens should be rejected for
analysis.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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CHOLESTEROL
TEST NAME:
CHOLESTEROL
CPT CODE:
82465
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST)
REFERENCE RANGE:
<200 mg/dL
METHOD:
Enzymatic
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Increase in inherited defect lipoprotein metabolism,
endocrine disease, renal disease and decreased liver
function impairment.
PATIENT PREPARATION:
Fasting is preferred.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
The National Cholesterol Education Program has published reference
cholesterol values for cardiovascular risk to be:
Less than 200 mg/Dl
201 – 239 mg/Dl
240 mg/dL and greater
Low risk
Borderline risk
High risk
Revised 07/14.
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CHOLESTEROL, HDL
TEST NAME:
CHOLESTEROL, HIGH DENSITY (HDL)
CPT CODE:
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL of serum from a gold top tube (SST)
REFERENCE RANGE:
40-59 mg/dL
METHOD:
Detergent/enzymatic
LAB SECTION PERFORMING TEST: Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Suspected coronary heart disease.
LIMITATIONS:
Fasting is preferred.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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CHOLESTEROL, LDL
TEST NAME:
CHOLESTEROL, LDL
(Calculated from total cholesterol, triglyceride and HDL
cholesterol)
ALTERNATE TEST NAME:
LDL
CPT CODE:
SPECIMEN REQUIREMENT:
1.0 mL serum from a gold top tube (SST) OR
plasma from a green top tube (heparin).
REFERENCE RANGE:
<100 mg/Dl
METHOD:
Calculation: LDL Cholesterol = T cholesterol – HDLC –
Triglyceride/5
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Monday – Friday
TURNAROUND TIME:
Daily
GENERAL USE OF TEST:
Prediction of risk of coronary arterial atherosclerosis.
PATIENT PREPARATION:
Fasting is preferred.
LIMITATIONS:
LDL cannot be accurately calculated on samples that
have triglyceride levels greater than 400 mg/dL.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14
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CHROMOSOME ANALYSIS
TEST NAME:
CHROMOSOME ANALYSIS
ALTERNATE TEST NAME:
Products of Conception or Stillbirth, Genetic Analysis
CPT CODE:
88237, 88264 88305
SPECIMEN REQUIREMENT:

3cm products of conception, skin or fascia.

1cm of placenta (including chorionic villi).

Patient history required.

Sterile container containing sterile saline.

Avoid contamination.
COLLECTION REQUIREMENT:
3
3
REFERENCE RANGE:
See report
METHOD:
Sent to reference laboratory
LAB SECTION PERFORMING TEST:
Anatomic Pathology
AVAILABILITY:

Monday through Friday (0800 to 1600).

Notify Anatomic Pathology Lab at 248-858-319.

Weekends and holidays send specimen to Laboratory
Specimen Processing. Specimen will be examined on
the next working day.
TURNAROUND TIME:
Next Business Day
GENERAL USE OF TEST:
To cultivate and study the products of conception in habitual
aborters.
LIMITATIONS:
If specimen does not consist of viable products of
conception, there may be no cell growth.
STORAGE REQUIREMENTS:

Refrigerate

Do not freeze
Revised 07/14.
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CIRCULATING ANTICOAGULANT (MIXING STUDY)
TEST NAME:
CIRCULATING ANTICOAGULANT (MIXING STUDY)
CPT CODE:
Plasma from three full blue top tubes (sodium citrate)
SPECIMEN REQUIREMENT:
REFERENCE RANGE:
Photometric Detection
METHOD:
LAB SECTION PERFORMING TEST:
Coagulation
Daily
AVAILABILITY:
TURNAROUND TIME:
24 hours in most cases
GENERAL USE OF TEST:
Helpful in discerning between a factor deficiency or a
circulating anticoagulant.
STORAGE REQUIREMENTS:
Plasma must be spun 2 times and removed from cells.
O
Freeze at -20 C within 4 hours of collection time if testing not
immediately performed.
Revised 07/14.
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COMPLETE BLOOD COUNT (CBC)
TEST NAME:
COMPLETE BLOOD COUNT (CBC)
(WBC, RBC, Hgb, Hct, MCV, MCHC, RDW, MPV, PLT,
Automated Differential) Manual differential performed when
established criteria are met.
CPT CODE:
85025
SPECIMEN REQUIREMENT:

3 mL lavender top tube (EDTA).

Minimum of 1 mL required OR 250 L lavender
microtainer.
REFERENCE RANGE:
Reference range listed on report.
METHOD:
Direct current, electrical impedance, light scatter and
fluorescence.
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift of collection.

STAT: 30 to 60 minutes.
GENERAL USE OF TEST:
Evaluation of peripheral blood parameters.
SPECIMEN REQUIREMENT:

Collect specimen using standard lab procedures.

Gently invert tube several times immediately after
collection.
Do not centrifuge.

STORAGE REQUIREMENTS:
Sample must be analyzed within 24 hours of collection when
stored at room temperature or within 48 hours when stored
at 2 - 8C.
Revised 07/14
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COMPREHENSIVE METABOLIC PANEL
TEST NAME:
COMPREHENSIVE METABOLIC PANEL
(Total Protein, Albumin, A/G Ratio, T. Bilirubin, Ca, Alk Phos,
BUN, Creat, AST, Gluc, Na, K, Cl, CO2, Anion GAP, ALT,GFR)
CPT CODE:
80053
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin).
0.5 mL serum from a gold top tube (SST)
REFERENCE RANGE:
See individual tests.
METHOD:
See individual tests.
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

If ordered STAT: 60 minutes from receipt in laboratory.
GENERAL USE OF TEST:
Evaluation of various serum biochemistry constituents.
SPECIMEN REQUIREMENT:

Collect specimen using standard lab procedures.

Collect specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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CONSULTATION, INTRAOPERATIVE
TEST NAME:
ALTERNATE TEST NAME:
CONSULTATION, INTRAOPERATIVE
Pathology Consultation During Surgery
CPT CODE:
88329, 88331, 88332, 88333
SPECIMEN REQUIREMENT:
Surgical tissue.
COLLECTION REQUIREMENT:
Fresh tissue.
REFERENCE RANGE:
Normal tissue.
METHOD:
Gross examination; consultation.
LAB SECTION PERFORMING TEST:
Anatomic Pathology
AVAILABILITY:

Monday through Friday 8:00 AM to 4:00 PM.

Notify Pathology Secretary at 248-858-3190.

Other hours, notify Pathologist on call at 248-407-1603.
TURNAROUND TIME:
15 – 20 minutes.
GENERAL USE OF TEST:
To evaluate specimen adequacy; determine course of
surgery.
STORAGE REQUIREMENTS:
Immediately deliver to Anatomic Pathology for Pathologist
examination.
Revised 07/14.
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CONSULTATION, SURGICAL PATHOLOGY
TEST NAME:
CONSULTATION, SURGICAL PATHOLOGY
CPT CODE:
88305
SPECIMEN REQUIREMENT:


Hematoxylin and eosin stained slides. When
appropriate, special stained slides, unstained slides or
paraffin blocks.
Outside report and billing information.

Requisition requesting consultation.
REFERENCE RANGE:
Normal tissue
METHOD:
Light microscopy
LAB SECTION PERFORMING TEST:
Anatomic Pathology
AVAILABILITY:
Monday through Friday, 0800 to 1630
TURNAROUND TIME:
One to Two business days.
GENERAL USE OF TEST:
Second opinion regarding diagnoses will be rendered by
staff pathologist in consultation with colleagues when
appropriate.
Revised 07/14.
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TEST DIRECTORY
CORD BLOOD EVALUATION
TEST NAME:
CORD BLOOD EVALUATION
CPT CODE:
86900 / 86901 / 86880 / 86850
COLLECTION REQUIREMENT:
INPATIENTS: Name, Medical Record Number (MRN), date,
and time of collection, initials of phlebotomist and A#.
REFERENCE RANGE:

CRITICAL VALUE:
Direct Coombs positive; antibody screen and/or group
specific screen positive.
METHOD:
Agglutination
LAB SECTION PERFORMING TEST:
Blood Bank
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:


GENERAL USE OF TEST:


Direct Coombs negative.
Expected turnaround time for STATs is 2 hours from
time the specimen is received.
Routine turnaround time is 8 hours from the time the
specimen is received.
To determine ABO or Rh incompatibility between mother
and newborn.
To identify Hemolytic Disease of the Newborn (HDN). If
direct antiglobulin test and/or ABO group mismatch
exists between mother and newborn, eluates and/or
antibody identification techniques will be performed to
determine the possible cause of the Hemolytic Disease
of the Newborn (HDN).
PATIENT PREPARATION:
Obtain cord blood samples free of contamination with
Wharton’s Jelly.
LIMITATIONS:
If blood sample is grossly contaminated with Wharton’s
Jelly, the test may be invalid.
STORAGE REQUIREMENTS:
Refrigerate sample(s) at 1° - 8°C.
Revised 07/14.
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TEST DIRECTORY
CORTISOL
TEST NAME:
CORTISOL
CPT CODE:
82533
SPECIMEN REQUIREMENT:
0.5 mL from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST).
REFERENCE RANGE:
Morning: 8.7 – 22.4 g/dL
Evening:<10 g/dL
9-24 hour Post Dexamethasone: : <5 g/dL
METHOD:
Chemiluminescence
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Addison’s Syndrome, Cushing’s Syndrome and adrenal
tumor.
LIMITATIONS:


Diurnal variation
Patients who have been regularly exposed to
animals or immunoglobulin fragments may produce
antibodies that interfere with immunoassays.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for at least 5 days
after testing.
STORAGE REQUIREMENTS:
Revised 07/14
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CREATININE
TEST NAME:
CREATININE
CPT CODE:
82565
SPECIMEN REQUIREMENT:
0.5 mL of plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST)
REFERENCE RANGE:
0-4 weeks: 0.5 – 1.2 mg/dL
>4 weeks: 0.4 – 1.4 mg/dL
CRITICAL VALUE:
0-4 weeks: >2.1 mg/dL
>4 weeks: >11.1 mg/dL
METHOD:
Colorimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Kidney function, shock, dehydration
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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CREATININE KINASE
TEST NAME:
CREATININE KINASE
ALTERNATE TEST NAME:
CK
CPT CODE:
82550
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top heparin tube OR
0.5 mL serum from a gold top tube (SST)
REFERENCE RANGE:
0.5 mL of plasma from a green top tube (heparin).
Female: 41-200 IU/L
Male: 52-300 IU/L
CRITICAL VALUE:
>1,000 IU/L
METHOD:
Enzymatic
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of specimens requested STAT will be reported
within 30 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Myocardial infarction; skeletal muscular disease.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 8 – 12 hours or 2 – 3 days
at -15C to 8C prior to analysis.
Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:

Revised 07/14.
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CREATININE KINASE (TOTAL) WITH CK-MB FRACTION
TEST NAME:
CREATININE KINASE (TOTAL) WITH CK-MB FRACTION
CPT CODE:
82553 82550
SPECIMEN REQUIREMENT:
0.5 mL from a green top tube (heparin) OR
1 mL serum from a g o l d top tube (SST).
REFERENCE RANGE
AND CRITICAL VALUES:
Male:
CK 52-300 IU/L Critical >1000 IU/L
CKMB 0.6-6.3
%CKMB 0.0-3.0% Critical >3.0
Female:
CK 41-200 IU/L Critical >1000 IU/L
CKMB 0.6-6.3
%CKMB 0.0-3.0% Critical >3.0
METHOD:
CK – enzymatic
CKMB - chemiluminescent
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Myocardial infarction, muscular dystrophy, other muscle
disease.
LIMITATIONS:

CK-MB will be added if CK is >130.
For CKMB: Patients who have been regularly
exposed to animals or immunoglobulin fragments
may produce antibodies that interfere with
immunoassays.
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TEST NAME:
CREATININE KINASE (TOTAL) WITH CK-MB FRACTION

Collect specimen using standard laboratory
procedures.

Centrifuge specimen; separate serum/plasma from
cells within 2 hours of collection.

See storage requirements for creatine kinase (CK)

For CK-MB refrigerate at 2-8 C up to 48 hours. Freeze
o
at -20 C or colder for prolonged storage prior to
analysis

Samples will be capped and held for 5 days after
testing.
SPECIMEN PREPARATION:
STORAGE REQUIREMENTS:
o
Revised 07/14.
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CROSSMATCH (COMPATIBILITY TESTING
TEST NAME:
CROSSMATCH (COMPATIBILITY TESTING)
CPT CODE:
86920
SPECIMEN REQUIREMENT:
EDTA vacutainer tube.
COLLECTION REQUIREMENT:
INPATIENTS: Name, Medical Record Number (MRN), date, and time of
collection, initials of phlebotomist and A#.
OUTPATIENTS: 2 patient identifiers, date of collection, initials of
phlebotomist.
REFERENCE RANGE:
Compatible unit.
METHOD:
1. Computer Crossmatch
2. Capture
3. Agglutination.
LAB SECTION PERFORMING
TEST:
Blood Bank
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:


GENERAL USE OF TEST:
60 minutes for STATs (10 minutes if type and screen are already
done on sample).
Day shift for routines.
To determine compatibility of red cell units required for transfusion.
Phenotyping of blood units and the patient may need to occur to find
compatible units of blood.
Revised 07/14.
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TEST DIRECTORY
CYST FLUID, NON-GYNECOLOGIC CYTOLOGY: BREAST, OVARIAN, RENAL
TEST NAME:
CYST FLUID, NON-GYNECOLOGIC CYTOLOGY:
BREAST, OVARIAN, RENAL
CPT CODE:
88112
SPECIMEN REQUIREMENT:
Fresh fluid
COLLECTION REQUIREMENT:
10 mL of fluid.
REFERENCE RANGE:
Negative for malignant cells.
METHOD:
Modified Papanicolaou
LAB SECTION PERFORMING TEST:
Cytology
AVAILABILITY:
Monday – Friday, 0800 to 1630
TURNAROUND TIME:
24 – 48 hours
GENERAL USE OF TEST:
To establish the presence of primary or metastatic
neoplasm.
STORAGE REQUIREMENTS:
Refrigerate
Revised 07/14.
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DIMER
TEST NAME:
DIMER
CPT CODE:
85379
SPECIMEN REQUIREMENT:
Purple top tube (EDTA).
REFERENCE RANGE:
Reference range listed on report
METHOD:
Fluorescence immunoassay.
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

STAT specimens will be reported within 30-60
minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Dimer results < 400 ng/mL DDU are the cutoff level
used to rule out deep venous thrombosis(DVT) or
Pulmonary embolism(PE) in patients determined to be at
low risk for thromboembolic disease
STORAGE REQUIREMENTS:
Whole blood EDTA good for 24 hours at room temperature
2 - 8C.
Revised 07/14.
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TEST DIRECTORY
DIGOXIN
(LANOXIN)
TEST NAME:
DIGOXIN (LANOXIN)
CPT CODE:
80162
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST).
REFERENCE RANGE:
0.5 – 2.0 ng/mL
CRITICAL VALUE:
>2.5 ng/mL
METHOD:
Immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

STAT specimens will be reported within 60 minutes of
receipt in the laboratory.
GENERAL USE OF TEST:
Diagnosis of digoxin toxicity or insufficient dosage.
PATIENT PREPARATION:
Specimen should be drawn at least 6 hours after last oral
dose.
LIMITATIONS:
Specimen collected from patient on Dig-A-Bind.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.
STORAGE REQUIREMENTS:


to 
Samples will be capped and held for 5 days after
testing.
Revised 07/14.
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TEST DIRECTORY
DIRECT ANTIGLOBULIN (DIRECT COOMBS) TEST
TEST NAME:
DIRECT ANTIGLOBULIN (Direct Coombs) TEST
ALTERNATE TEST NAME:
DAT
CPT CODE:
86880
SPECIMEN REQUIREMENT:
EDTA vacutainer tube
COLLECTION REQUIREMENT:
INPATIENTS: Name, Medical Record Number (MRN), date,
and time of collection, initials of phlebotomist and A#.
OUTPATIENTS: 2 patient identifiers, date of collection,
initials of phlebotomist.
REFERENCE RANGE:
Negative
CRITICAL VALUE:
Positive test detected on cord blood or recently transfused
patient.
METHOD:
Agglutination using anti-IgG and anti-C3bC3d
monospecific reagents.
LAB SECTION PERFORMING TEST:
Blood Bank
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Routine: 24 hours

STAT: 15 minutes

For the detection of antibody bound in vivo to the
patient’s red cells.
An eluate and/or antibody identification techniques may
be required to find the source of a positive direct
antiglobulin test.
GENERAL USE OF TEST:

STORAGE REQUIREMENTS:
Room temperature or at 1 - 8C.
Revised 07/14.
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ELECTROLYTES, BLOOD
(Sodium, Potassium, Chloride & Carbon Dioxide)
TEST NAME:
ELECTROLYTES, BLOOD
(Sodium, Potassium, Chloride & Carbon Dioxide + AGAP)
CPT CODE:
80051
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube
REFERENCE RANGE:
Na: 133 – 145 mEq /L
K: 3.5 – 5.3 mEq/L
Cl: 95 – 111 mEq/L
AGAP 6 – 27
CO2
0- 1 WK: 17- 26 mEq/L
1 WK – 1MO: 17- 27 mEq/L
1MO – 6 MOS: 17 – 29 mEq/L
6 MOS – 1 YR: 18 – 29 mEq/L
1 YR – 150 YRS: 22 – 32 mEq/L
CRITICAL VALUE:
Na = <124 or >156 mEq/L
K
= <2.9 or >6.1 mEq/L
CO2
= <8 or >41 mEq/L
Cl: <70 or >141 mEq/L
METHOD:
Ion Selective Electrode
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:
●
Same shift testing.
●
STAT specimens will be resulted within 60 minutes of
receipt in the laboratory.
GENERAL USE OF TEST:
Electrolyte balance
LIMITATIONS:
Hemolyzed specimens elevate potassium levels.
SPECIMEN PREPARATION:
●
Collect specimens using standard lab procedures.
●
Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.
●
Refrigerate at 2o – 8oC up to 48 hours.
.
Samples
will be capped and held for 5 days after
STORAGE REQUIREMENTS:
●
testing.
Revised 07/14.
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EOSINOPHIL SMEARS
(Urine Only)
TEST NAME:
EOSINOPHIL SMEARS
(Urine Only)
CPT CODE:
89190
SPECIMEN REQUIREMENT:
Freshly voided urine.
REFERENCE RANGE:
Positive >1%
Negative <1%
METHOD:
Microscopic examination of cytospin Wright’s stained
smears.
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
24 hours
TURNAROUND TIME:
24 hours
GENERAL USE OF TEST:
Urinary tract infections (UTIs) and AIN (acute
interstitial nephritis) are associated with urinary
eosinophils.
STORAGE REQUIREMENT:
Perform on freshly voided urine or store sample at
o
2-8 C for testing within 24 hours.
Revised 07/14
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ESTRADIOL
TEST NAME:
ESTRADIOL
CPT CODE:
82670
SPECIMEN REQUIREMENT:
0.5 ml plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST).
REFERENCE RANGE:
Male: 0 – 47 pg/mL
Female:
Mid-Follicular Phase: 27 – 122 pg/mL
Periovulatory:
95 – 433 pg/mL
Mid-Luteal Phase:
49 – 291 pg/mL
Post-Menopausal:
0 – 40 pg/mL
METHOD:
Chemiluminescent Immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

STAT specimens will be reported within 60 minutes of
receipt in the laboratory.
GENERAL USE OF TEST:
Used to assess gonadal dysfunction including delayed
puberty, amenorrhea and menopause.
LIMITATIONS:
Patients who have been regularly exposed to animals or
immunoglobulin fragments may produce antibodies that
interfere with immunoassays.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14
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ETHANOL
(Medical Evaluation Only)
TEST NAME:
ETHANOL
(Medical Evaluation Only)
CPT CODE:
82055
SPECIMEN REQUIREMENT:
0.5 mL plasma from a gray top tube (sodium
fluoride/potassium oxalate) OR
0.5 mL serum from a gold top tube (SST).
REFERENCE RANGE:
None detected.
CRITICAL VALUE:
NA
METHOD:
Enzymatic
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:

Daily, STAT
TURNAROUND TIME:

Same shift testing.

STAT specimens will be reported within 60 minutes of
receipt in the laboratory.
GENERAL USE OF TEST:
Quantitative measurement of ethanol.
PATIENT PREPARATION:
Venipuncture: Do not use alcohol prep or any other volatile
disinfectants to cleanse draw site.
SPECIMEN PREPARATION:

Deliver tightly stopped tube to laboratory.

Centrifuge specimens; remove serum/plasma from cells
within 2 hours of collection.
Assay immediately after opening the sample tube.

STORAGE REQUIREMENTS:
Samples will be capped and held for 5 days after testing.
Revised 07/14
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FACTOR VIII ASSAY
TEST NAME:
FACTOR VIII ASSAY
CPT CODE:
SPECIMEN REQUIREMENT:
Plasma from a full blue top tube (sodium citrate).
COLLECTION REQUIREMENT:
METHOD:
LAB SECTION PERFORMING TEST:
Chromogenic detection
Reference Laboratory
Monday-Saturday
AVAILABILITY:
TURNAROUND TIME:
5-&
Days
Aids in detection of factor deficiencies.
GENERAL USE OF TEST:
PATIENT PREPARATION:
o
Plasma should be removed from cells and frozen at -20 C
within 4 hours of collection time.
Revised 07/14.
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FACTOR IX ASSAY
TEST NAME:
FACTOR IX ASSAY
CPT CODE:
SPECIMEN REQUIREMENT:
Plasma from a full blue top tube (sodium citrate).
COLLECTION REQUIREMENT:
METHOD:
LAB SECTION PERFORMING TEST:
Chromogenic detection
Reference Laboratory
AVAILABILITY:
TURNAROUND TIME:
< 24 hours
Aids in detection of factor deficiencies.
GENERAL USE OF TEST:
PATIENT PREPARATION:
See Reference Laboratory Instructions
Revised 07/14.
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FACTOR 10 A INHIBITION
FACTOR 10 A INHIBITION
TEST NAME:
CPT CODE:
SPECIMEN REQUIREMENT:
Plasma from a full blue top tube (sodium citrate).
COLLECTION REQUIREMENT:
METHOD:
LAB SECTION PERFORMING TEST:
Chromogenic Detection
Coagulation
Daily
AVAILABILITY:
TURNAROUND TIME:
GENERAL USE OF TEST:
PATIENT PREPARATION:
< 24 hours
Provides quantitative determination of unfractionated
and low molecular weight heparins.
Plasma should be removed from cells and frozen at 20oC within 4 hours of collection time if testing is not
immediately performed.
Revised 07/14.
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FECAL REDUCING SUBSTANCES
TEST NAME:
FECAL REDUCING SUBSTANCES
CPT CODE:
81099
SPECIMEN REQUIREMENT:
● Random fresh stool in a plastic screw top container.
● Transport to the laboratory immediately after collection.
REFERENCE RANGE:
Negative.
METHOD:
Benedict’s copper reduction reaction.
LAB SECTION PERFORMING TEST:
Urinalysis
AVAILABILITY:
24 hours
TURNAROUND TIME:
24 hours.
GENERAL USE OF TEST:
Increased amounts of reducing substance in fecal material
is indicative of malabsorption syndromes and is often
performed on infants who have failure to thrive syndrome.
STORAGE REQUIREMENTS:
Must be frozen within 2 hours of collection.
Revised 07/14.
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FERRITIN
TEST NAME:
FERRITIN
CPT CODE:
82728
SPECIMEN REQUIREMENT:
0.5 mL from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST)
REFERENCE RANGE:
Male:
23.9 – 336.2 ng/mL
Female: 11.0 – 306.8 ng/mL
METHOD:
Chemiluminescence
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:

Depletion of iron stores (anemia).

Also aids in diagnosis of diseases affecting iron
metabolism (hemochromatosis).
LIMITATIONS:

Patients who have been regularly exposed to
animals or immunoglobulin fragments may produce
antibodies that interfere with immunoassays.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate serum at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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FETAL FIBRONECTIN
TEST NAME:
FETAL FIBRONECTIN
CPT CODE:
82731
SPECIMEN REQUIREMENT:
Specimen collected from the posterior fornix of the vagina
using the Adeza Biomedical Specimen Collection Kit.
REFERENCE RANGE:
N/A
METHOD:
Lateral flow, solid phase immunosorbent assay.
LAB SECTION PERFORMING TEST:
Hematology/Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:
Same shift of collection or 60 minutes if STAT.
GENERAL USE OF TEST:
Detection of fetal fibronectin as an aid in assessing the risk
of pre-term delivery.
SPECIMEN COLLECTION:
After collection, submerge the tip of the applicator swab in
the tube of buffer, break the shaft even with the top of the
tube, cap and push down tightly to secure the top.
LIMITATIONS:

Grossly bloody samples will be rejected.

Results of this test should be used in conjunction
with information from the clinical evaluation and
other diagnostic procedures.
STORAGE REQUIREMENTS:
If not tested within 8 hours, refrigerate at 2 - 8C within 3
days of collection.
Revised 07/14.
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FETAL HEMOGLOBIN TEST
(Kleihauer-Betke Acid Elution)
TEST NAME:
FETAL HEMOGLOBIN TEST
(Kleihauer-Betke Acid
Elution)
CPT CODE:
85460
SPECIMEN REQUIREMENT:
EDTA vacutainer tube
COLLECTION REQUIREMENT:
Two unique patient identifiers, date of specimen collection
and initials of individual collecting the blood sample on tube
label.
REFERENCE RANGE:
0.0 – 0.5%
METHOD:
Based on resistance of fetal hemoglobin to elution by citrate
buffer.
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
Daily
TURNAROUND TIME:
24 hours
GENERAL USE OF TEST:


Identification and enumeration of fetal cells in the
maternal circulation.
To determine the correct dosage of Rh immune globulin
to be administered.
LIMITATIONS:
The blood sample must be less than 24 hours old at the
time of testing.
STORAGE REQUIREMENTS:
Store at 2 - 8C if not performed immediately.
Revised 07/14.
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FIBRINOGEN
TEST NAME:
FIBRINOGEN
CPT CODE:
85384
SPECIMEN REQUIREMENT:
Plasma from one full blue top tube (sodium citrate)
REFERENCE RANGE:
Reference range listed on report.
METHOD:
Photometric detection
LAB SECTION PERFORMING TEST:
Hematology/Coagulation
AVAILABILITY:
Daily
TURNAROUND TIME:
30 - 60 minutes
GENERAL USE OF TEST:
Fibrinogen is an acute phase reactant as well as
the focal point in the coagulation process.
Consumption of fibrinogen is a major and clinically
threatening aspect of disseminated intravascular
coagulation.
LIMITATIONS:
Hemolysis. Icteric or lipemic specimens
SPECIMEN PREPARATION:
Mix immediately after drawing.
Incomplete filling of vacutainer tube.
STORAGE REQUIREMENTS:
Plasma is stable for 4 hours at room temperature or at 2 8C.
Revised 07/14.
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FINE NEEDLE ASPIRATION, DEEP TISSUE
(Lung, Kidney, Pancreas, Liver, Etc.)
TEST NAME:
FINE NEEDLE ASPIRATION, DEEP TISSUE
(Lung, Kidney, Pancreas, Liver, Etc.)
CPT CODE:
88173 – Interpretation and report
88172 – Immediate study to determine specimen
adequacy
SPECIMEN REQUIREMENT:
Needle aspirate, entire specimen.
COLLECTION REQUIREMENT:
 Place small amount of aspirated specimen on end of
glass slide(s).
 Use a second glass slide to smear material and
immediately fix in 95% alcohol.
 Send up six (6) slides (optimum).
 Place remaining material in Cytolyt.
 When a STAT evaluation of specimen adequacy is
required; notify the laboratory in advance of specimen
collection.
REFERENCE RANGE:
Negative for malignant cells.
METHOD:
Modified Papanicolaou
LAB SECTION PERFORMING TEST:
Cytology
AVAILABILITY:
Monday through Friday (0800 to 1630).
TURNAROUND TIME:
One to two working days.
GENERAL USE OF TEST:
To establish the presence of primary or metastatic
neoplasm.
LIMITATIONS:
Inadequate specimens.
STORAGE REQUIREMENTS:
Deliver immediately to Cytology Laboratory.
Revised 07/14.
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FINE NEEDLE ASPIRATION, SUPERFICIAL TISSUE
(Breast, Thyroid, Prostate, Etc.)
TEST NAME:
FINE NEEDLE ASPIRATION, SUPERFICIAL TISSUE
(Breast, Thyroid, Prostate, Etc.)
CPT CODE:
88173 – Interpretation and report
SPECIMEN REQUIREMENT:
Needle aspirate, entire specimen.
COLLECTION REQUIREMENT:

Place small amount of aspirated specimen on end of
glass slide(s).

Use a second glass slide to smear material and
immediately fix in 95% alcohol.

Send up six (6) slides (optimum).

Place remaining material in Cytolyt.

When a STAT evaluation of specimen adequacy is
required; notify the laboratory in advance of specimen
collection.
REFERENCE RANGE:
Negative for malignant cells.
METHOD:
Modified Papanicolaou
LAB SECTION PERFORMING TEST:
Cytology
AVAILABILITY:


Monday through Friday (0800 to 1630).
STAT evaluations must be scheduled including EBUS.
Endo does not schedule Stat FNA.
TURNAROUND TIME:
One to two working days.
GENERAL USE OF TEST:
To establish the presence of primary or metastatic
neoplasm.
STORAGE REQUIREMENTS:
Deliver immediately to Cytology Laboratory.
Revised 07/14.
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FLOW CYTOMETRY,
LYMPH NODE
TEST NAME:
FLOW CYTOMETRY, LYMPH NODE
CPT CODE:
Varies according to tests performed.
SPECIMEN REQUIREMENT:
Lymph node cut into fragments.
COLLECTION REQUIREMENT:
Sterile tube pre-filled with RPMI media (obtain from
Anatomic Pathology at 562-7418).
REFERENCE RANGE:
Written report
METHOD:
Flow Cytometry
LAB SECTION PERFORMING TEST:

Sent to Reference Laboratory.

For additional information, call Anatomic Pathology at
562-7418.
AVAILABILITY:

Monday through Friday (0800 to 1630).

Not STAT.
TURNAROUND TIME:
Approximately one week
GENERAL USE OF TEST:

Diagnosis of lymphoma.

Applicable in cases of chronic lympho-proliferative
disorders and malignant lymphomas.
LIMITATIONS:
Adequacy of sample.
STORAGE REQUIREMENTS:
Deliver immediately to Cytology Laboratory.
Revised 07/14.
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TEST DIRECTORY
FOLATE
TEST NAME:
FOLATE
CPT CODE:
82746
SPECIMEN REQUIREMENT:
1 mL plasma from a green top tube (heparin) OR
1 mL serum from a gold top tube (SST)
REFERENCE RANGE:
Greater than 5.9 ng/Ml
METHOD:
Chemiluminescent immunoassay.
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Folate is an essential vitamin vital to cell growth and DNA
synthesis. Folate deficiency can lead to megaloblastic
anemia followed by severe neurological problems.
PATIENT PREPARATION:
Fasting preferred.
LIMITATIONS:


Patient’s true folate status may be masked by whole
blood transfusions.
Patients who have been regularly exposed to
animals or immunoglobulin fragments may produce
antibodies that interfere with immunoassays.
INTERFERENCE:
Hemolysis
SPECIMEN PREPARATION:
Centrifuge and separate serum/plasma from cells
immediately after collection.
STORAGE REQUIREMENTS:

Refrigerate at 2 - 8C up to 8 hours.
Revised 07/14.
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FOLLICLE STIMULATING HORMONE
TEST NAME:
FOLLICLE STIMULATING HORMONE
CPT CODE:
83001
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST).
REFERENCE RANGE:
FSH (mIU/mL)
Adult Male:
1.27– 19.26 mIU/mL
Adult Female:
Follicular
3.85 – 8.78 mIU/mL
Luteal
1.79 – 5.12 mIU/mL
Mid-Cycle Peak
4.54 – 22.51 mIU/mL
Post-Menopausal
16.74 – 113.59 mIU/mL
METHOD:
Chemiluminescent Immunoassay.
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing
GENERAL USE OF TEST:
Assessment of pituitary function and to distinguish between
primary and secondary gonadal failure.
LIMITATIONS:

SPECIMEN PREPARATION:
STORAGE REQUIREMENTS:

FSH values vary widely during the different phases
of the normal female menstrual cycle.
Patients who have been regularly exposed to
animals or immunoglobulin fragments may produce
antibodies that interfere with immunoassays.

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.
Revised 07/14
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FRESH FROZEN PLASMA (FFP)
FRESH FROZEN PLASMA (FFP)
CPT
CODE:
EST NAME:
SPECIMEN REQUIREMENT:
Pink EDTA vacutainer tube if blood type is not on file.
METHOD:
Thawing is performed using a 37C waterbath.
LAB SECTION PERFORMING TEST:
Blood Bank
AVAILABILITY:
STAT on all 3 shifts
TURNAROUND TIME:
45 minutes
GENERAL USE OF TEST:
For the treatment of coagulation deficiencies or to replace
depleted coagulation factors.
PATIENT PREPARATION:
Refer to Transfusion Guidelines.
LIMITATIONS:

Fresh frozen plasma is administered as ABO
compatible without regard to Rh type.
Revised 07/14.
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FROZEN TISSUE SECTION:
RAPID SCREEN FOR MALIGNANCY
TEST NAME:
FROZEN TISSUE SECTION:
RAPID SCREEN FOR MALIGNANCY
CPT CODE:
88331,
88332
performed.)
SPECIMEN REQUIREMENT:
Fresh tissue (excluding bone and calcified tissue).
COLLECTION REQUIREMENT:

Operative diagnosis and source must be provided.

If an infectious disease is suspected, a warning must be
stated on the requisition and specimen label.
(CPT codes vary based upon testing
REFERENCE RANGE:
Results interpreted by consulting Pathologist.
METHOD:
Cryotomy, Microscopy
LAB SECTION PERFORMING TEST:
Histology
AVAILABILITY:

Monday through Friday; 0800 to 1630

Other times, notify Pathologist on call.
TURNAROUND TIME:
Approximately 20 minutes.
GENERAL USE OF TEST:
Provisional histologic diagnosis and aid to surgical therapy.
LIMITATIONS:
Occasional false negative result.
Revised 07/14.
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GAMMA GLUTAMYL TRANSPEPTIDASE
TEST NAME:
GAMMA GLUTAMYL TRANSPEPTIDASE
ALTERNATE TEST NAME:
CPT CODE:
SPECIMEN REQUIREMENT:
REFERENCE RANGE:
METHOD:
GGT
82977
0.5 mL plasma from a green top tube (heparin) OR
serum from a gold top tube (SST
AGE
0 WKS to 1 WK
1WK to 1 MO
1 MOS to 3 MOS
3 MOS to 6 MOS
6 MOS to 12 MOS
>12 MOS
FEMALE
18-148 IU/L
16-140 IU/L
16-140 IU/L
13-123 IU/L
8-59 IU/L
7-50 IU/L
MALE
25-168 IU/L
23-174 IU/L
16-147 IU/L
5-93 IU/L
8-38 IU/L
7-50 IU/L
Enzymatic
LAB SECTION PERFORMING TEST: Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Liver function
SPECIMEN PREPARATION:
Collect specimen using standard lab procedures.
Centrifuge specimen, separate serum/plasma from cells within
2 hours of collection.
STORAGE REQUIREMENTS:
Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after testing.
Revised 07/14.
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GENTAMICIN
TEST NAME:
GENTAMICIN
CPT CODE:
80170 Random
Peak
Trough
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST) OR
0.5 mL from a green top tube (heparin).
REFERENCE RANGE:
Gentamicin: 0.5 – 10.0
Gentamicin Peak: 5.0-10.0 g/mL
Gentamicin Trough: 0.5 – 1.5 g/mL
CRITICAL VALUE:
Gentamicin: 12.1 g/mL
Gentamicin Peak: 12.1 g/mL
Gentamicin Trough: 3.1 g/mL
METHOD:
Immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
To monitor antibiotic therapy and to test for insufficient or
toxic serum levels of gentamicin.
PATIENT PREPARATION:


SPECIMEN PREPARATION:
STORAGE REQUIREMENTS:

Trough: Specimen is drawn 30 minutes to immediately
prior to next dose.
Peak:
 Drawn 30 minutes after the infusion is complete
for “traditional dosing” regime.
 Drawn 60 minutes after infusion is complete
when following the “once daily dosing” regime.
Collect specimen using standard laboratory procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.
Refrigerate at 2C up to 48 hours.
Samples will be capped and held for 5 days after testing.
Revised 07/14
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GLUCOSE, FASTING
TEST NAME:
GLUCOSE, FASTING
CPT CODE:
82947
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR a
gray top tube (potassium oxalate/sodium fluoride) OR
serum from a gold top tube (SST)
REFERENCE RANGE:
0-4 wks: 45 – 99 mg/dL
>4wks: 65-99 mg/dL
CRITICAL VALUE:
0-4 wks: <39 or >200 mg/dL
>4wks: <58 or >450 mg/dL
METHOD:
Glucose
oxidase
<50 or >400
mg/dL
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Evaluation of carbohydrate metabolism.
PATIENT PREPARATION:
Fasting, if indicated.
SPECIMEN PREPARATION:

Collect specimen using standard laboratory procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14
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GLUCOSE, RANDOM
TEST NAME:
GLUCOSE, RANDOM
CPT CODE:
82947
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR a
gray top tube (potassium oxalate/sodium fluoride) OR
serum from a gold top tube (SST)
REFERENCE RANGE:
0-4 wks: 45 – 99 mg/dL
>4wks: 65-00 mg/dL
CRITICAL VALUE:
0-5 wks: <39 or >201 mg/dL
>4wks: <59 or >451 mg/dL
METHOD:
<50
or >400
mg/dL
Glucose
oxidase
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Carbohydrate metabolism disorders.
SPECIMEN PREPARATION:

Collect specimen using standard laboratory procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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GLUCOSE, SPINAL FLUID
TEST NAME:
GLUCOSE, SPINAL FLUID
CPT CODE:
82945
SPECIMEN REQUIREMENT:
0.5 mL spinal fluid in a sterile plastic CSF screw cap tube
(#1).
REFERENCE RANGE:
40 – 70 mg/dL
METHOD:
Glucose oxidase with glucose electrode.
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Diagnosis of central nervous system disorders.
LIMITATIONS:
Grossly bloody specimen; bacterial contamination.
SPECIMEN PREPARATION:
If specimen is cloudy or bloody, centrifuge and remove the
supernatant within 30 minutes of collection.
STORAGE REQUIREMENTS:
Refrigerate at 2 - 8C for up to 5 days
Revised 07/14
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GLUCOSE TOLERANCE, BLOOD
TEST NAME:
GLUCOSE TOLERANCE, BLOOD
CPT CODE:
82947, 82950 Standard Oral
82951, 82952 (Standard Gestational
82950 Gestational Screen
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (ST) OR plasma from
a green top tube (heparin), OR a gray top tube
(potassium oxalate/sodium fluoride).
NOTE: Use same tube type consistently throughout test.
REFERENCE RANGE:
Standard 2 Hour Tolerance:
Fasting:
65 – 99 mg/dL
120 mines:
75 – 139 mg/dL
Glucose 1 Hour OB Screen: 75 – 135 mg/dL
Standard 3 Hour Gestational:
Fasting:
65 – 99 mg/dL
1 Hour:
70 – 179 mg/dL
2 Hours:
70 – 154 mg/dL
3 Hours:
70 – 139 mg/dL
CRITICAL VALUE:
<60 or >450 mg/dL
METHOD:
Glucose oxidase
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:

TURNAROUND TIME:
Results will be reported upon completion of tolerance test.
GENERAL USE OF TEST:
Endocrine disorders, carbohydrate metabolism.
PATIENT PREPARATION:

Fasting; no smoking.

Administer Dexicola after baseline test is performed.

Patient can drink water.

Collect specimen using standard laboratory procedures.
SPECIMEN PREPARATION:
STORAGE REQUIREMENTS:

Monday through Friday.
 Centrifuge specimen; separate serum from cells within 2
 Refrigerate at15C to C up to 48 hours.
.Samples will be capped and held for 5 days after testing
Revised 07/14.
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GYNECOLOGIC CYTOLOGY, THIN PREP® PAP TEST™ (2 Pages)
TEST NAME:
GYNECOLOGIC CYTOLOGY, THIN PREP® PAP TEST™
CPT CODE:
Varies based on testing performed.
COLLECTION REQUIREMENT:
This test requires a Thin Prep® Pap Test™ Collection Kit
which is supplied by the Anatomic Pathology Laboratory at
248-858-6883
SPECIMEN REQUIREMENT:
After visualization of the cervix is accomplished, collect the
sample.
Brush / Spatula Collection:
Obtain an adequate sampling from the ectocervix using a
plastic spatula. Rinse the spatula into the Preserv Cyt®
solution vial by swirling the spatula vigorously in the vial 10
times. Discard the spatula. Insert the brush into the cervix
until only the bottom most fibers are exposed. Slowly rotate
or turn in one direction. Do not over rotate.
Rinse the brush in the Preserv Cyt® solution by rotating the
device in the solution 10 times while pushing against the vial
wall. Swirl the brush vigorously to further release material.
Discard the brush.
REFERENCE RANGE:
Bethesda Reporting.
METHOD:
Modified Papanicolaou, manual screening.
LAB SECTION PERFORMING TEST:
Cytology
AVAILABILITY:
Monday through Friday, 08:00 – 16:3 0.5 mL
TURNAROUND TIME:
Approximately one week.
GENERAL USE OF TEST:

Screening of unsuspected or confirmation of suspected
atypia, pre-malignant or malignant changes.

Follow up of patients with known and/or treated premalignant or malignant lesions.
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
Evaluation of inflammatory/infections or benign
proliferative conditions.
PATIENT PREPARATION:

Patient to avoid douches 38-72 hours prior to exam.

Obtain specimen prior to bimanual exam.

Use an unlubricated speculum (saline or warm water
may be used).
Revised 07/14.
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GYNECOLOGIC CYTOLOGY, THIN PREP PAP WITH REFLEXIVE HPV
TEST NAME:
GYNECOLOGIC CYTOLOGY, THIN PREP PAP WITH
REFLEXIVE HPV
CPT CODE:
Varies based on testing performed.
SPECIMEN REQUIREMENT:
Refer to Gynecologic Cytology, Thin Prep® PAP Test™
Specimen Collection for collection guidelines.
Remarks:
Must be ordered in conjunction with Thin Prep® PAP Test™.
Thin Prep PAP test results with a diagnosis of ASCUS will be
sent for High Risk HPV testing by Digene method unless the
box on the requisition indicating HPV testing is not desired
has been checked. Vial must be kept at 4° to 37°C.
Stability:
Three weeks ambient temperature, three weeks
refrigerated. Do not freeze.
Revised 07/14.
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HAPTOGLOBIN, BLOOD
TEST NAME:
HAPTOGLOBIN, BLOOD
CPT CODE:
83010
SPECIMEN REQUIREMENT:
0.5 ml from a green top OR
0.5 mL serum from a gold top tube (SST).
REFERENCE RANGE:
Adults: 36 – 195 mg/dL
METHOD:
Turbidimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Monday through Friday.
TURNAROUND TIME:
Daily
GENERAL USE OF TEST:
Intravascular hemolysis.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.

Store spun and separated serum samples at -15°C to
°8C.
Samples will be held for 5 days after testing.
STORAGE REQUIREMENTS:

Revised 07/14
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HCG, BETA
(QUALITATIVE SERUM)
TEST NAME:
HCG, BETA (QUALITATIVE SERUM)
CPT CODE:
84703
SPECIMEN REQUIREMENT:
0.5 mL serum from a red top tube
REFERENCE RANGE:
Assay reported as positive or negative.
METHOD:
Chromatographic immunoassay.
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

STAT specimens will be reported within 60 minutes of
receipt in the laboratory.
GENERAL USE OF TEST:
Detection of pregnancy
LIMITATIONS:
None.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held 5 days after testing.
STORAGE REQUIREMENTS:
Revised 07/14
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HCG, BETA (QUANTITATAIVE)
TEST NAME:
HCG, BETA (QUANTITATIVE)
CPT CODE:
84702
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST)
REFERENCE RANGE:
Non-pregnant females: Less than 5.0 mIU/mL.
METHOD:
Chemiluminescent immunoassay.
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

If ordered STAT, within 60 minutes of receipt in the
laboratory.

Hydatidiform mole.

Choriocarcinoma.

Ectopic pregnancy.

Threatened or missed abortion.
GENERAL USE OF TEST:
LIMITATIONS:
Patients who have been regularly exposed to animals or
immunoglobulin fragments may produce antibodies that
interfere with immunoassays.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held 5 days after testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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HCG, SERUM
TEST NAME:
HCG, SERUM
CPT CODE:
Red top tube only ( no additives)
SPECIMEN REQUIREMENT:
COLLECTION REQUIREMENT:
METHOD:
Chromogenic immunoassay
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift of Collection
If ordered STAT, within 60 minutes of receipt in the
Laboratory.
GENERAL USE OF TEST:
Detection of pregnancy
STORAGE REQUIREMENTS:



Room temperature if tested immediately
Store at 2-8o C for up to 48 hours
Samples greater than 48 hours old are unacceptable
Revised 07/14.
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HCG, URINE
TEST NAME:
HCG, URINE
CPT CODE:
84703
SPECIMEN REQUIREMENT:
1 mL of urine.
REFERENCE RANGE:
Assay reported as Positive or Negative
METHOD:
Chromatographic immunoassay.
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift of collection.

If ordered STAT, within 60 minutes of receipt in the
laboratory.
GENERAL USE OF TEST:
Detection of pregnancy.
SPECIMEN PREPARATION:
Submit urine in a clean, dry container.
STORAGE REQUIREMENTS:

Room temperature if testing immediately.

Store at 2-8 C for up to 48 hours.

Bring to room temperature before testing.

Specimens greater than 48 hours old will be
unacceptable.
o
Revised: 07/14
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HEMOGLOBIN A1C
TEST NAME:
HEMOGLOBIN A1C
CPT CODE:
83036
SPECIMEN REQUIREMENT:
0.5 mL whole blood (EDTA) from a lavender top tube.
REFERENCE RANGE:
4.0 – 6.0%
METHOD:
Ion exchange HPLC.
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Monday-Saturday.
GENERAL USE OF TEST:
Monitor diabetic patient.
LIMITATIONS:
Hemoglobin variants may interfere.
STORAGE REQUIREMENTS:
Whole blood samples are stable for 5 days at 2 - 8C.
Revised 07/14.
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HEPATITIS A
ANTIBODY (IgM)
TEST NAME:
HEPATITIS A ANTIBODY (IgM)
CPT CODE:
86709
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST) OR
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL plasma from a purple top tube (EDTA.)
REFERENCE RANGE:
Negative
METHOD:
Chemiluminescent immunoassay.
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Monday – Friday
TURNAROUND TIME:
Daily Monday-Friday.
GENERAL USE OF TEST:
Acute Hepatitis A is associated with Hepatitis A IgM
antibodies.
LIMITATIONS:
Test cannot determine patient’s immune status to
Hepatitis A.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.

Refrigerate at 2° - 8°C up to 7 days.

Samples will be capped and held for 7 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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HEPATITIS B
CORE ANTIBODY (IgM)
TEST NAME:
HEPATITIS B CORE ANTIBODY (IgM)
CPT CODE:
86705
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST) OR
0.5 mL plasma from a green top tube (lithium heparin) OR
0.5 mL plasma from a purple top tube (EDTA.)
REFERENCE RANGE:
Negative
METHOD:
Chemiluminescent immunoassay.
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Monday – Friday
TURNAROUND TIME:
Daily. Monday-Friday.
GENERAL USE OF TEST:
Acute Hepatitis B is associated with Hepatitis B core IgM
antibodies.
LIMITATIONS:
Test cannot determine patient’s immune status to
Hepatitis B.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.

Refrigerate at 2° - 8°C up to 1 week.

Samples will be capped and held for 7 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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HEPATITIS B SURFACE ANTIBODY,
QUALITATIVE AND QUANTITATIVE
TEST NAME:
HEPATITIS B SURFACE ANTIBODY
QUALITATIVE AND QUANTITATIVE
CPT CODE:
86706
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST) OR
0.5 mL plasma from a green top tube (lithium heparin) OR
0.5 mL plasma from a purple top tube (EDTA.)
REFERENCE RANGE:
Qualitative: Unvaccinated: Negative Or Vaccinated: Positive
Quantitative: Unvaccinated 10mIU/ml or Vaccinated >10
mIU/L.
METHOD:
Chemiluminescent immunoassay.
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily Monday – Friday
TURNAROUND TIME:
Daily
GENERAL USE OF TEST:


SPECIMEN PREPARATION:
STORAGE REQUIREMENTS:
Presence of Hepatitis B antibody indicates resolved
infection and/or lasting immunity.
Presence of antibody also used to monitor post
vaccination immunity.

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Freeze at or below C for prolonged storage prior to
analysis.
Samples will be capped and held for 5 days after
testing.

Revised 07/14.
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TEST DIRECTORY
HEPATITIS B SURFACE ANTIGEN
TEST NAME:
HEPATITIS B SURFACE ANTIGEN
CPT CODE:
87341
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST) OR
0.5 mL plasma from a green top tube (lithium heparin) OR
0.5 mL plasma from a purple top tube (EDTA.)
REFERENCE RANGE:
Negative
METHOD:
Enzyme Immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:

Monday – Friday

Can be ordered STAT for expedited newborn/ maternal
testing, testing of source patient following a needlestick
injury or testing of new/traveling dialysis patient.

Daily

STAT results will be reported the same shift.
TURNAROUND TIME:
GENERAL USE OF TEST:
Detection of surface antigen to Hepatitis B.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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HEPATITIS C ANTIBODY
TEST NAME:
HEPATITIS C ANTIBODY
CPT CODE:
86803
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST) OR
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL plasma from a purple top tube (EDTA.)
REFERENCE RANGE:
Negative
METHOD:
Chemiluminescent immunoassay.
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Monday – Friday
TURNAROUND TIME:
Daily Monday-Friday.
GENERAL USE OF TEST:
Signals acute, resolving or chronic infection.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.

Refrigerate at 2 - 8C up to 7 days.

Freeze at or below C for prolonged storage prior to
analysis.
Samples will be capped and held for 5 days after
testing.
PATIENT PREPARATION:

Revised 07/14.
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TEST DIRECTORY
HUMAN IMMUNODEFICIENCY VIRUS (HIV 1, 2) ANTIBODY SCREEN
TEST NAME:
HUMAN Immunodeficiency VIRUS (HIV 1, 2)
ANTIBODY SCREEN (BLOOD AND BODY FLUID/NEEDLESTICK
EXPOSURE OR NEWBORN/MATERNAL TESTING ONLY)
CPT CODE:
G0432
SPECIMEN REQUIREMENT:
0.5 ml plasma from a green top OR
0.5 ml serum from a red top
REFERENCE RANGE:
Negative
METHOD:
Immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
Daily
AVAILABILITY:
TURNAROUND TIME:

Can be ordered STAT for expedited newborn/ maternal
testing or testing of source patient and/or hospital
employee following a needlestick injury.

Labor & Delivery and Needlestick profile 1 hour

All other patients – 24 hours-48 hours
GENERAL USE OF TEST:
Detection of antibody to HIV-1, 2.
LIMITATIONS:
All positive results will be sent to a reference laboratory for
confirmatory testing.
SPECIMEN PREPARATION:
Collect specimen using standard lab procedures.
STORAGE REQUIREMENTS:

Store at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
Revised 07/14.
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HUMAN PAPILLOMAVIRUS (HPV)
DNA PROBE, HIGH RISK
TEST NAME:
HUMAN PAPILLOMAVIRUS (HPV) DNA PROBE, HIGH
RISK
CPT CODE:
87621
SPECIMEN REQUIREMENT:
Cervical specimen submitted in Preserv Cyt Solution (Thin
Prep Pap Test System)OR Cervical specimen or Cervical
Biopsy in Digene Transport
COLLECTION REQUIREMENT

After visualization of the cervix is accomplished, collect the sample.

Brush / Spatula Collection: Obtain an adequate sampling from the
ectocervix using a plastic spatula.
Rinse the spatula into the Preserv Cyt Solution vial by swirling the
spatula vigorously in the vial 10 times.
Discard the spatula. Insert the brush into the cervix until
only the bottom most fibers are exposed. Slowly rotate or turn in one
direction. DO NOT OVER ROTATE.
Rinse the brush in the Preserv Cyt Solution by rotating the device in
the solution 10 times while pushing against the vial wall. Swirl the
brush vigorously to further
release material. Discard the brush.

Tighten the cap so that the torque line on the cap
passes the torque line on the vial.
REFERENCE RANGE:
Negative
METHOD:
Hybrid Capture 2 Procedure
LAB SECTION PERFORMING TEST:
Reference Laboratory
AVAILABILITY:
Daily, Monday-Friday
TURNAROUND TIME:
7 days
GENERAL USE OF TEST:
Screening for HPV high-risk infection.
LIMITATIONS:


STORAGE REQUIREMENTS:

Not intended to be substituted for regular cervical
cytology screening.
Does not differentiate between the various high-risk
HPV types.
Room temperature 14 days. Refrigerated 3 weeks.
Revised 07/14.
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IMMUNOFIXATION (SERUM)
TEST NAME:
IMMUNOFIXATION (SERUM)
CPT CODE:
(86334)
SPECIMEN REQUIREMENT:
1 mL serum from a gold top tube (SST)
REFERENCE RANGE:
See Interpretive Report
METHOD:
Immunoprecipitation
LAB SECTION PERFORMING TEST:
Reference Laboratory
AVAILABILITY:
Monday – Friday
TURNAROUND TIME:
1 - 3 days
GENERAL USE OF TEST:
.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.

Refrigerate spun and separated specimens at 2 - 8C
for up to 5 days.
STORAGE REQUIREMENTS:
Revised 07/14.
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IONIZED
CALCIUM
TEST NAME:
IONIZED CALCIUM
CPT CODE:
82330
SPECIMEN REQUIREMENT:

3 mL green top tube. Or 7mL yellow top tube (SST)

Do not remove the tube stopper.

Place on ice.

Do not centrifuge.
REFERENCE RANGE:
1.17 – 1.33 mmol/L
CRITICAL VALUE:
<0.80 or >10.0 mmol/L
METHOD:
ISE
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of STAT specimens will be reported within 30
minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Measure of physiologically active calcium fraction.
SPECIMEN PREPARATION:
Collect specimen using standard laboratory procedures.
STORAGE REQUIREMENTS:
Stable on ice for 3 hours OR 18 hours serum if spun and
never uncapped.
O7/14
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IMMUNOFIXATION (URINE)
TEST NAME:
IMMUNOFIXATION (URINE)
CPT CODE:
(86335)
SPECIMEN REQUIREMENT:

REFERENCE RANGE:
See interpretive report.
METHOD:
Immunoprecipitation
LAB SECTION PERFORMING TEST:
Reference Labortory
AVAILABILITY:
Monday - Friday
TURNAROUND TIME:
GENERAL USE OF TEST:
LIMITATIONS:
STORAGE REQUIREMENTS:
5 mL of urine from a 24-hour urine specimen, collected
on ice, containing no preservatives in a plastic container
obtained from the laboratory.
Random urine may also be used.
1 - 3 days
Gammopathy – Abnormal immunoglobulins – Bence Jones
Proteinuria.

No preservatives.

Refrigerate specimen during collection.
Refrigerate at 2 - 8C up to a week.
Revised 07/14.
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IMMUNOGLOBULINS, QUANTITATIVE (IgG, IgA, IgM)
TEST NAME:
IMMUNOGLOBULINS, QUANTITATIVE
(IgG, IgA, IgM)
CPT CODE:
82784 x3
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST).
See Interpretive Report for Details
REFERENCE RANGE:
METHOD:
Turbidimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Daily, 60 minutes for STAT requests
GENERAL USE OF TEST:
Evaluation of humoral immunity.
SPECIMEN PREPARATION:

Collect specimen using standard laboratory procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.

Refrigerate at 2 - 8C up to 72 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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IRON AND IRON BINDING CAPACITY
TEST NAME:
IRON AND IRON BINDING CAPACITY
CPT CODE:
83540
SPECIMEN REQUIREMENT:
1 mL serum from a gold top tube (SST) OR
1 mL plasma from a green top tube (heparin).
REFERENCE RANGE:
IRON (Total): Male: ………….45 – 182 g/dL
Female: ……….28 – 170 g/dL
IRON % Saturation:…………..25 – 50%
TRANSFERRIN: Male:……..180 – 329 mg/dL
Female:….192 – 382 mg/dL
TIBC: 261-478
METHOD:
Colorimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:

Daily
TURNAROUND TIME:

Routine, same shift testing.

Results of specimens for total iron studies requested
STAT will be reported within 60 minutes of receipt in the
laboratory.
GENERAL USE OF TEST:
Evaluation of iron metabolism.
PATIENT PREPARATION:
Fasting is recommended.
LIMITATIONS:
Contraindicated during iron therapy.
SPECIMEN PREPARATION:

Collect specimen using standard laboratory procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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.
KIDNEY BIOPSY
TEST NAME:
KIDNEY BIOPSY
CPT CODE:
As appropriate for testing performed.
SPECIMEN REQUIREMENT:

Tissue

Call Histology Lab before collecting specimen.

Patient history required.

The ordering physician will need to submit a kidney
biopsy requisition for the reference laboratory with the
specimen. These are available through Anatomic
Pathology.
REFERENCE RANGE:
Results interpreted by consulting Pathologist.
METHOD:
Sent out to reference laboratory.
LAB SECTION PERFORMING TEST:
Anatomic Pathology
AVAILABILITY:

TURNAROUND TIME:
Approximately one week.
GENERAL USE OF TEST:
Histologic diagnosis.
STORAGE REQUIREMENTS:
Must immediately be examined in the Pathology
Department in sterile saline.
Monday through Friday; 0800 to 163 0.5 mL
Revised 07/14.
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LACTATE DEHYDROGENASE
TEST NAME:
LACTATE DEHYDROGENASE
ALTERNATE TEST NAME:
LDH
CPT CODE:
83615
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST)
REFERENCE RANGE:
AGE
0 MOS to 1 MO
1 MO to 3 MOS
3 MOS to 6 MOS
6 MOS to 12 MOS
12 MOS to 3 YRS
3 YRS to 6 YRS
6 YRS to 9YRS
9 YRS to 15 YRS
15 YRS to 19 YRS
>= 19 years
FEMALE
187-600 IU/L
152-353 IU/L
158-353 IU/L
152-327 IU/L
164-286 IU/L
155-280 IU/L
141-237 IU/L
129-231 IU/L
117-213 IU/L
98-192 IU/L
MALE
178-629 IU/L
158-373 IU/L
135-376 IU/L
129-367 IU/L
164-286 IU/L
155-280 IU/L
141-237 IU/L
129-231 IU/L
117-213 IU/L
98-192IU/L
METHOD:
Enzymatic
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Cardiac and liver disorder, hematologic disorders, certain
tumors.
LIMITATIONS:
Hemolyzed samples should not be used; hemolysis will
cause falsely elevated results.
SPECIMEN PREPARATION:

Collect specimen using standard laboratory procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Samples will be capped and held for 5 days after
testing.
Do not freeze or refrigerate prior to analysis.
STORAGE REQUIREMENTS:

Revised 07/14.
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LACTIC ACID
TEST NAME:
LACTIC ACID
CPT CODE:
83605
SPECIMEN REQUIREMENT:

1 mL plasma from a green top tube (heparin).

If possible, collect specimen without applying a
tourniquet.
Specimen must be placed on ice immediately after
collection.

REFERENCE RANGE:
CRITICAL VALUE:
0.5 – 2.2 MEQ/L
>4.1 MEQ/L
METHOD:
Electrode
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

STAT specimens in 60 minutes.
GENERAL USE OF TEST:
Detection of tissue hypoxia, diabetes mellitus, malignancies,
glycogen storage disease, ethanol, methanol or salicylate
ingestion and metabolic acidosis.
PATIENT PREPARATION:
The patient should avoid any exercise of the arm or hand
before or during collection of specimen.
SPECIMEN PREPARATION:

Collect specimen using standard laboratory procedures.

Centrifuge specimen; remove plasma from cells within
15 minutes of collection.
STORAGE REQUIREMENTS:
Specimen can be stored for 4 hours on ice (unspun)
or up to 5 days if refrigerated.
Revised 07/14
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LAMELLAR BODY COUNTS
TEST NAME:
LAMELLAR BODY COUNTS
CPT CODE:
Amniotic Fluid
SPECIMEN REQUIREMENT:
COLLECTION REQUIREMENT:
METHOD:
Should be performed 1 hour after collection. Samples
containing blood, meconium or mucus will not be
processed.
Platelet channel of automated hematology cell counter
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:


Same shift of collection
STAT: 30-60 minutes
GENERAL USE OF TEST:
May be used as a rapid screen to predict fetal lung maturity.
Immature or indeterminate results should be followed by more
specific test performed as send outs.
STORAGE REQUIREMENTS:
Stable for 1 hour after collection, can be frozen if necessary.
Revised 07/14.
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LEAD
TEST NAME:
LEAD
CPT CODE:
83655 (Venous lead level) (Capillary lead level)
SPECIMEN
REQUIREMENT:
REFERENCE RANGE
AND CRITICAL
VALUES/FOLLOWUP:
0.2 mL to 1.0 mL in dark blue top (EDTA) tube OR lavender top OR brown top tube. If sample
drawn is capillary, indicate on tube.
Blood lead in children according to CDC Classification (May 13, 2013)
Blood Lead
Comment
< 5 µg/dL
Not lead-poisoned
5-9.9 µg/dL
Rescreen within 6 months.
Provide lead education and prevention strategies
10-14 µg/dL
Rescreen within 3 months. Provide lead education and preventions strategies.
15-19 µg/dL
Rescreen again in 1-3 months. Provide lead education and prevention strategies.
20-44 µg/dL
Provide lead education and prevention strategies. Provide environment investigation and control current lead hazards.
45-69 µg/dL
Provide lead education and prevention strategies and refer for chelation therapy.
>70 µg/dL
Provide lead education and prevention strategies plus hospitalized child for chelation therapy immediately. A medical emergency.
*Elevated levels of blood lead should be confirmed with a second specimen before remedial action is instituted.
Elevated capillary blood specimens should be repeated using a venous specimen due to possible contamination.
Adults:
Blood Lead
Comment
Less than 1 0.5 mL0
No action required
ug/dL
1 0.5 mL0-24.9 ug/dL
Identify and minimize exposure
25.0-49.9 ug/dL
Remove from exposure if symptomatic
5 0.5 mL0-79.9 ug/dL
Remove from lead exposure. Immediate medical evaluation required.
>= 8 0.5 mL0 ug/dL
Chelation may be indicated if symptomatic. Seek consultation.
METHOD:
Atomic Absorption Spectrophotometry
LAB SECTION
PERFORMING TEST:
Reference Laboratory
AVAILABILITY:
Daily-Sunday-Friday
TURNAROUND TIME:
1-2 days
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GENERAL USE OF TEST:
Determine lead levels.
LIMITATIONS:
Contact Reference Laboratory.
SPECIMEN
PREPARATION:

STORAGE
REQUIREMENTS:
 Store at 2 - 8C until testing is performed for up to 1 month. Freezing is not
recommended...

Collect sample using standard venipuncture or capillary puncture procedures.
Completed samples will be retained for 7 days after assay.
Revised 07/14.
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LEUKOCYTE REDUCED RED BLOOD CELLS
TEST NAME:
LEUKOCYTE REDUCED RED BLOOD CELLS
CPT CODE:
SPECIMEN REQUIREMENT:
Pink EDTA vacutainer tube is required for a crossmatch.
COLLECTION REQUIREMENT:


METHOD:
Two unique patient identifiers on tube label date of
specimen collection and initials of individual collecting
the blood sample.
The patient must be positively identified using a
Securline blood band.
Capture or Agglutination
LAB SECTION PERFORMING TEST:
Blood Bank
AVAILABILITY:
STAT on all 3 shifts.
TURNAROUND TIME:
45 minutes to 1 hour.
GENERAL USE OF TEST:


PATIENT PREPARATION:
Indicated for any patient who requires a packed red cell
product.
Indicated for treatment of symptomatic anemia in
patients who require only an increase of oxygen carrying
capacity and red blood cells mass.
Refer to Transfusion Guidelines.
Revised 07/14.
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LIPASE
TEST NAME:
LIPASE
CPT CODE:
83690
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST)
REFERENCE RANGE:
22 – 51 IU/L
METHOD:
Enzymatic
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

STAT specimens in 60 minutes.
GENERAL USE OF TEST:
Acute pancreatitis; obstruction of pancreatic duct.
SPECIMEN PREPARATION:

Collect specimen using standard laboratory procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14
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LIPID PROFILE
TEST NAME:
LIPID PROFILE
(HDL, Cholesterol, Triglycerides, LDL and Chol/HDL
Ratio + CHD RISK)
CPT CODE:
80061
SPECIMEN REQUIREMENT:
2 plasma from a green top tube (heparin) OR serum from a
gold top tube (SST)
REFERENCE RANGE:
See individual tests.
METHOD:
See individual tests.
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Daily and STAT within 60 minutes
GENERAL USE OF TEST:
See individual tests.
PATIENT PREPARATION:
Fasting is preferred.
SPECIMEN REQUIREMENT:

Collect specimen using standard lab procedures.

Collect specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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LIPOPROTEIN LOW DENSITY DIRECT MEASUREMENT
TEST NAME:
LIPOPROTEIN LOW DENSITY
DIRECT MEASURMENT
CPT CODE:
83721
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL of serum from a gold top tube (SST)
.
REFERENCE RANGE:
<100 mg/dL
METHOD:
Detergent/colorimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Used for the evaluation of coronary heart disease.
LIMITATIONS:
Fasting is preferred.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 5 days.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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LITHIUM
TEST NAME:
LITHIUM
CPT CODE:
80178
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST) OR
0.5 mL serum from a red top tube (plain)
COLLECTION REQUIREMENT:
Recommended time for collection is 8-12 hours post dose.
REFERENCE RANGE:
0.6 – 1.2 mEq/L
CRITICAL VALUE:
>2.0 mEq/L
METHOD:
Colorimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Therapeutic monitoring of lithium.
SPECIMEN PREPARATION:

Collect specimen using standard laboratory procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.

Refrigerate at 2 - 8C up to 1 week.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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LUTEINIZING
HORMONE
TEST NAME:
LUTEINIZING HORMONE
CPT CODE:
83002
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST).
REFERENCE RANGE:
Adult Male: 1.24 – 12.86 mIU/mL
Adult Female:
Follicular: 2.12 – 1 0.89 mIU/mL
Ovulatory:19.18 - 103.03 mIU/mL
Luteal: 1.2 – 12.86 mIU/mL
Postmenopausal: 1 0.5 mL87 – 58.64 mIU/mL
METHOD:
Chemiluminescent Immunoassay.
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:

Regulation of menstrual cycle.

Maintenance of pregnancy.

Assessment of hypothalamic function and pituitary
function.
To distinguish between primary or secondary gonadal
failure.

LIMITATIONS:
Patients who have been regularly exposed to animals or
immunoglobulin fragments may produce antibodies that
interfere with immunoassays.
SPECIMEN PREPARATION:

Collect specimen using standard laboratory procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.
STORAGE REQUIREMENTS:
Revised 07/14.
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LYME ANTIBODY
TEST NAME:
LYME ANTIBODY (IgG, IgM)
CPT CODE:
86618
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST).
REFERENCE RANGE:
No antibody detected.
METHOD:
Chemiluminescent Immunoassay
LAB SECTION PERFORMING TEST:
Reference Laboratory
AVAILABILITY:
Monday, Wednesday and Friday.
TURNAROUND TIME:
2 Days
GENERAL USE OF TEST:
For use in the detection of Lyme Disease caused by the tickborne spirochete Borrelia burgdorferi.
LIMITATIONS:
Early stages of infections may not produce detectable
levels of antibody.
SPECIMEN PREPARATION:

Collect specimen using standard laboratory procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection

Refrigerate at 2 - 8C up to 5 days.

Samples will be capped and held for 7 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14
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MAGNESIUM
TEST NAME:
MAGNESIUM
CPT CODE:
83735
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
serum from a gold top tube (SST)
REFERENCE RANGE:
1.8 – 2.5 mg/dL
CRITICAL VALUE:
<1.0 mg/dL or >5.0 mg/dL
METHOD:
Colorimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Evaluation of metabolic disorders.
LIMITATIONS:
None
SPECIMEN PREPARATION:

Collect specimen using standard laboratory procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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MALARIA SMEAR
TEST NAME:
MALARIA SMEAR
CPT CODE:
87207
SPECIMEN REQUIREMENT:
3 mL whole blood (EDTA) in a lavender top vacutainer
REFERENCE RANGE:
No parasite observed.
METHOD:
Examination of thin and thick smears.
LAB SECTION PERFORMING TEST:
Hematology and Microbiology
AVAILABILITY:

TURNAROUND TIME:

GENERAL USE OF TEST:

Suspected malarial disease.

Microscopic examination of thick and thin blood smears
for blood borne parasites.

A single negative result does not rule out the
presence of Malaria organisms.
Multiple samples over a 36-hour period are
recommended.
Antimalarial chemotherapy; improper timing of
collection.
LIMITATIONS:


Daily
Average 1-2 days.
SPECIMEN PREPARATION:
Venipuncture or capillary collection should take place just
prior to or at onset of chills.
STORAGE REQUIREMENTS:
Smears must be made within 1 hour of collection.
Revised 07/14.
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MICROALBUMIN
TEST NAME:
MICROALBUMIN
CPT CODE:
82043
SPECIMEN REQUIREMENT:
Random urine or 24-hour urine collected with no
preservative in a plastic container obtained from the
laboratory.
REFERENCE RANGE:
Random: 0 – 30 mg/L
24-hour Urine: 0 – 30 mg/24 HOUR VOLUME
METHOD:
24 Hour: Turbidimetric
Random: Turbidimetric + Jaffe Rate
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Same shift for random. Day shift only for 24 hours
TURNAROUND TIME:
Same shift for random. Day shift only for 24 hours
GENERAL USE OF TEST:
Aids in the diagnosis of kidney and intestinal disease.
STORAGE REQUIREMENTS:

Refrigerate at 2 - 8C up to 72 hours.

Samples will be capped and held for 5 days after
testing.
Do not freeze samples.

Revised 07/14.
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MONONUCLEOSIS, SCREEN
TEST NAME:
MONONUCLEOSIS, SCREEN
CPT CODE:
86308
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST) OR
plasma from a lavender top tube (EDTA).
REFERENCE RANGE:
Negative
METHOD:
Immunochromatographic dipstick technology
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:


Results of routine specimens collected by 9:00 PM will
be reported by 7:00 AM.
Results of specimens requested STAT will be reported
within 30 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
The detection of heterophile antibodies related to infectious
mononucleosis.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 1 week.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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NIPPLE SECRETION, NON-GYNECOLOGIC CYTOLOGY
TEST NAME:
NIPPLE SECRETION (NIPPLE DISCHARGE)
NON-GYNECOLOGIC CYTOLOGY
CPT CODE:
88160
SPECIMEN REQUIREMENT:
Nipple secretion; glass slides, container with 95% ethyl
alcohol are available from the Cytology Laboratory.
COLLECTION REQUIREMENT:




Gently squeeze the subareolar area and nipple with
thumb and forefinger.
When secretion occurs, allow a pea-sized drop to
accumulate on the apex of the nipple.
Move slide across the nipple, smearing the secretion(s)
across the slide and fix immediately in 95% ETOH.
Label slide with the patient’s name.
REFERENCE RANGE:
Negative for malignant cells.
METHOD:
Modified Papanicolaou
LAB SECTION PERFORMING TEST:
Cytology
AVAILABILITY:
Monday through Friday; 0800 to 163 0.5 mL
TURNAROUND TIME:
One to two working days.
GENERAL USE OF TEST:
To establish the presence of primary or metastatic
neoplasm.
STORAGE REQUIREMENTS:
Refrigerate
Revised 07/14.
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OSMOLALITY, SERUM
TEST NAME:
OSMOLALITY, SERUM
CPT CODE:
83930
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube OR
0.5 mL serum from a gold top tube (SST).
REFERENCE RANGE:
275 – 295 mOsm/Kg
METHOD:
Freezing point depression.
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT.
TURNAROUND TIME:

Same shift testing.

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Dehydration, electrolyte balance.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.

Refrigerate at 2° - 8°C up to 1 week.

Samples will be capped and held for at least 48 hours
after testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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OSMOLALITY, URINE
TEST NAME:
OSMOLALITY, URINE
CPT CODE:
83935
SPECIMEN REQUIREMENT:
0.5 mL random urine
REFERENCE RANGE:
Female: 390 – 1090 mOsm/Kg
Male: 300 – 1090 mOsm/Kg
METHOD:
Freezing point depression.
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Dehydration, concentrating ability of the kidney.
SPECIMEN PREPARATION:
Keep specimens refrigerated until analysis.
STORAGE REQUIREMENTS:
Refrigerate at 2 - 8 up to a week.
Revised 07/14.
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PARTIAL THROMBOPLASTIN TIME
TEST NAME:
ALTERNATE TEST NAME:
ACTIVATED PARTIAL THROMBOPLASTIN TIME
PTT
CPT CODE:
85730
SPECIMEN REQUIREMENT:
Plasma from a full blue top tube (sodium citrate).
REFERENCE RANGE:
Reference range listed on report.
CRITICAL VALUE:
>100 secs.
METHOD:
Photometric detection
LAB SECTION PERFORMING TEST:
Hematology/Coagulation
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

STAT = 30 – 60 min.
GENERAL USE OF TEST:
Measurement of intrinsic coagulation system.
LIMITATIONS:

Heparin therapy should be noted on requisition.

Clotted specimen, inadequate filling of tube,
specimen greater than 4 hours old (or 2 hours old
if patient received heparin), improper labeling,
hemolyzed, icteric or lipemic specimens,
specimen drawn above an IV.

Mix well immediately after drawing.

Centrifuge at within four hours of collection.

Store unopened tube at room temperature or 2 - 8C
for up to 4 hours (or 2 hours if patient on heparin)prior
to analysis.
SPECIMEN PREPARATION:
STORAGE REQUIREMENTS:
Revised 07/14
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PATH CBC
TEST NAME:
PATH CBC
CPT CODE:
SPECIMEN REQUIREMENT:

3mL lavender top tube (EDTA)

Minimum of 1 mL required or 250 ul lavender
microtainer
COLLECTION REQUIREMENT:
METHOD:
Pathologist reviews prepared slide and enters comment in
computer.
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
Daily
TURNAROUND TIME:
GENERAL USE OF TEST:
STORAGE REQUIREMENTS:
24 hours, not performed on Sundays.
A physician may request a pathologist to review a blood
smear slide for various abnormalities.
24 hours of collection at room temperature. Test may be
added if a slide has been already prepared – call x3249 to
check availability.
Revised 07/14.
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PATH EVAL(COMPREHENSIVE REPORT)
TEST NAME:
PATH EVAL (COMPREHENSIVE REPORT)\
CPT CODE:
SPECIMEN REQUIREMENT:


3mL lavender top tube (EDTA)
Minimum of 1 mL required or 250 ul lavender
microtainer
COLLECTION REQUIREMENT:
Order must include diagnosis/reason for requesting
comprehensive report or a completed history sheet filled
out on all outpatients. Fax to 248-858-3078.
METHOD:
Direct current, electrical impedance. Light scatter and
fluorescence. Pathologist reviews all results.
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
CBC and Reticulocyte parameters are available STAT or
daily.
TURNAROUND TIME:
24 hours, not performed on Sundays
GENERAL USE OF TEST:
The physician may request a comprehensive pathology review
in certain patient cases. The pathologist performs a review of
the complete history and medical records and dictates a
completed report. Test parameters performed include CBC,
Differential and Reticulocyte count including a final evaluation
report performed by the pathologist.
STORAGE REQUIREMETNS:
Sample must be analyzed within 24 hours of collection at
room temperature.
Revised 07/14.
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pH, BODY FLUIDS
TEST NAME:
pH, BODY FLUIDS
CPT CODE:
82800
SPECIMEN REQUIREMENT:
Body fluid submitted in a green top tube (heparin) OR
a red top tube (Plain) OR a gold top tube OR other
clean or sterile leak-proof container
REFERENCE RANGE:
Should be interpreted in regard to fluid type submitted.
METHOD:
Ion Selective Electrode BG or dipstick
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Determine pH of clinical specimen.
STORAGE REQUIREMENTS:
Refrigerate at 2 - 8C for up to a week.
Revised 07/14.
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pH, FECES
TEST NAME:
pH, FECES
CPT CODE:
84999
SPECIMEN REQUIREMENT:

REFERENCE RANGE:
pH 5.0 – 6.0
METHOD:
Clinitek Advantus or Multistix manual dipstick
LAB SECTION PERFORMING TEST:
Urinalysis
AVAILABILITY:
Daily
TURNAROUND TIME:
24 hours
GENERAL USE OF TEST:
Low pH of stool (acidic) is seen in lactose intolerance or
where there is rapid intestinal transit time as in diarrhea.
PATIENT PREPARATION:
No barium procedures, laxatives or antiamebic drugs for one
week prior to specimen collection.
STORAGE REQUIREMENTS:
Freeze within 2 hours of collection if testing is not performed
immediately.
Stool must be < 2 hours old
Revised 07/14.
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PHENOBARBITAL
TEST NAME:
PHENOBARBITAL
CPT CODE:
80184
SPECIMEN REQUIREMENT:

REFERENCE RANGE:
15 – 40 μg/Ml
CRITICAL VALUE:
>50 μg/mL
METHOD:
Immunoassay/Turbidimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

STATs will be resulted within 60 minutes of receipt in
the laboratory.
0.5 mL plasma from a green top tube (heparin) OR
serum from a gold top tube (SST).
GENERAL USE OF TEST:
Monitor phenobarbital levels to ensure appropriate therapy.
PATIENT PREPARATION:
Trough: One hour prior to next dose.
SPECIMEN PREPARATION:

Collect specimen using standard laboratory procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for at least 48 hours
after testing.
STORAGE REQUIREMENTS:
Revised 07/14
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PHENYTOIN (DILANTIN)
TEST NAME:
PHENYTOIN (DILANTIN)
CPT CODE:
80185
SPECIMEN REQUIREMENT:

REFERENCE RANGE:
10 – 20 μg/mL
CRITICAL VALUE:
340 μg/mL
METHOD:
Turbidimetric Inhibition Immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing; reported the same day.

STATs will be resulted within 60 minutes of receipt in
the laboratory.
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST).
GENERAL USE OF TEST:
Monitor phenytoin levels to ensure appropriate therapy.
PATIENT PREPARATION:
Trough: One hour prior to next dose.
SPECIMEN PREPARATION:

Collect specimen using standard laboratory procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for at least 48 hours
after testing.
STORAGE REQUIREMENTS:
Revised 07/14
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PHOSPHORUS, BLOOD
TEST NAME:
PHOSPHORUS, BLOOD
CPT CODE:
84100
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST)
REFERENCE RANGE:
CRITICAL VALUE:
AGE
0 MOS to 1 MO
1 MO to 3 MOS
3 MOS to 12 MOS
12 MOS to 2 YRS
2 YRS to 13 YRS
13 YRS to 16 YRS
16 YRS TO 18 YRS
>= 18 years
FEMALE
3.1 -7.7 mg/dL
3.1 -7.2 mg/dL
3.1 – 6.8 mg/dL
3.1 – 6.3 mg/dL
3.1 – 5.9 mg/dL
3.1 - 5.5mg/dL
3.1 – 4.8 mg/dL
2.4. - 4.7mg/dL
MALE
2.8 -7.0 mg/dL
3.1 -6.6 mg/dL
3.1 – 6.6 mg/dL
3.1 – 6.2 mg/dL
3.1 – 5.9 mg/dL
3.1 - 5.3mg/dL
3.1 – 5.1 mg/dL
2.4. - 4.7mg/dL
<0.9mg/dL
METHOD:
Colorimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Measurement of phosphorus is used in the diagnosis and
treatment of parathyroid gland and kidney diseases, and
Vitamin D imbalance.
SPECIMEN PREPARATION:

Collect specimen using standard laboratory procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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PHOSPHORUS, URINE
TEST NAME:
PHOSPHORUS, URINE
CPT CODE:
84105
SPECIMEN REQUIREMENT:
Random urine or 24-hour urine collected with no
preservative in a plastic container obtained from the
laboratory.
REFERENCE RANGE:
0.4 mL – 1.3 G/24 hrs
METHOD:
Colorimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same Day testing.
GENERAL USE OF TEST:
Measurement of phosphorus is used in the diagnosis and
treatment of parathyroid gland and kidney diseases, and
Vitamin D imbalance.
SPECIMEN PREPARATION:

No preservatives necessary.

Refrigerate specimen during collection and until
analysis.
STORAGE REQUIREMENTS:
Refrigerate at 2 - 8C up to 3 days.
Revised 07/14
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TEST NAME:
PLATELET FUNCTION ANALYSIS
PLATELET FUNCTION ANALYSIS
CPT CODE:
Sodium citrate whole blood
SPECIMEN REQUIREMENT:
COLLECTION REQUIREMENT:


METHOD:
Sample must be collected on campus. Call x83249 for
kit. After collection, sample must be walked to the lab
(DO NOT transport in the Pneumatic tube system)
Test cannot be performed if platelet count is <50,000 or
hematocrit <25.
Test cartridge system on PFA-100 instrument
LAB SECTION PERFORMING TEST:
Coagulation
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:
Same shift testing
GENERAL USE OF TEST:
Aids in detection of platelet dysfunction.
STORAGE REQUIREMENTS:
Test must be performed after at least 30 minute but no more
than 4 hours after collection time.
Revised 07/14.
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PLATELETS
TEST NAME:
PLATELETS
CPT CODE:
P9035 or P9037
SPECIMEN REQUIREMENT:
Pink EDTA or plain red top vacutainer tube if blood type is
not on file.
COLLECTION REQUIREMENT:
METHOD:
Leukoreduced plateletpheresis or irradiated products used.
LAB SECTION PERFORMING TEST:
Blood Bank
AVAILABILITY:
STAT on all three shifts.
TURNAROUND TIME:
30 minutes
GENERAL USE OF TEST:
To correct platelet deficiencies if clinical indicated.
PATIENT PREPARATION:
Refer to Transfusion Guidelines.
Revised 07/14.
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PLAVIX RESPONSE TEST
TEST NAME:
PLAVIX RESPONSE TEST
CPT CODE:
85576 X2
SPECIMEN REQUIREMENT:
Call 83249 to obtain kit.

COLLECTION REQUIREMENTS:
Sample must be collected on campus. Call x83249 for
collection kit. After collection, samples must be walked to
the Laboratory. DO NOT transport by pneumatic tube
system.

Whole blood may be collected from venous or arterial
sites using a 21-gauge or larger needle first drawn in
a in 3.2% regular blue top tube, then two Greiner
tubes filled to the black diamonds.

Blood samples should be obtained from an extremity
free of IV fluids.
Collect a discard tube first (at least 2 mL). Gently invert
the sample tubes 5 times to ensure complete mixing.

REFERENCE RANGE:

Research suggests that there is variability in response
to clopidogrel (Plavix).
P2Y12 Reaction Units (PRU) reference range =194-418
 Lower PRU levels implymore anti-platelet effect.
METHOD:
Turbimetric based optical system that measures platelet
induced aggregation.
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of STAT specimens will be reported within 30
minutes of receipt in the lab.
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GENERAL USE OF TEST:
To measure the level of patient P2Y12 receptor blockade.
LIMITATIONS:
Patients with inherited platelet disorders, such as von
Willebrand Factor Deficiency, Glanzmann
Thrombasthenia and Bernard-Soulier Syndrome, have
not been studied with this assay.
SPECIMEN PREPARATION:


Specimens must be assayed within 4 hours of
collection.
Specimens that are not assayed within 4 hours will be
rejected.
Revised 07/14.
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POTASSIUM
TEST NAME:
POTASSIUM
CPT CODE:
84132
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
serum from gold top tube (SST)
REFERENCE RANGE:
3.5 – 5.3 mEq/L
CRITICAL VALUE:
<2.9 mEq/L or >6.0 mEq/L
METHOD:
Ion Selective Electrode
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Electrolyte balance
LIMITATIONS:
Hemolysis falsely increases potassium.
PATIENT PREPARATION:

SPECIMEN PREPARATION:
STORAGE REQUIREMENTS:

The patient should avoid any exercise of the arm or
hand before or during collection because opening and
closing the fist increases concentrations by 10 to 20%.
Do not draw from an arm receiving IV.

Collect specimen using standard laboratory procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
Revised 07/14.
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PREALBUMIN
TEST NAME:
PREALBUMIN
CPT CODE:
84134
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST).
REFERENCE RANGE:
18 – 38 mg/dL
METHOD:
Turbidimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Aids in the assessment of the patient’s nutritional status.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.

Refrigerate at 2 - 8C up to 72 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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PROGESTERONE
TEST NAME:
PROGESTERONE
CPT CODE:
84144
0.5mL serum from a red top tube.
SPECIMEN REQUIREMENT:

REFERENCE RANGE:
Serum can be stored for up to 12 hours on the gel of the
SST tube.
Male: 0.14 – 2.06 ng/ml
Female:
Mid -Follicular: 0.31 – 1.52 ng/mL
Mid-Luteal 5.16 – 18,56 ng/ml
Postmenopausal: <0.08 – 0.78 ng/mL
First Trimester: 4.73 – 50.74 ng/mL
Second Trimester: 19.41- 45.30 ng/mL
METHOD:
Chemiluminescence
LAB SECTION PERFORMING TEST:
Reference Laboratory
AVAILABILITY:
Daily, Monday-Friday
TURNAROUND TIME:
1-2 Days
GENERAL USE OF TEST:
Progesterone is a steroid hormone that plays an important
role in the preparation for and maintenance of pregnancy,
and is a reliable method to detect ovulation.
LIMITATIONS:
Patients who have been regularly exposed to animals or
immunoglobulin fragments may produce antibodies that
interfere with immunoassays.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells
IMMEDIATELY

Refrigerate serum at 2 - 8C up to 3 days..

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14
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TEST DIRECTORY
PROLACTIN
EST NAME:
PROLACTIN
CPT CODE:
84146
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST).
SPECIMEN REQUIREMENT:
REFERENCE RANGE:
NONE
METHOD:
Chemiluminescent immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing
GENERAL USE OF TEST:
Pituitary function test useful in the detection of prolactin
secreting pituitary tumors with or without galactorrhea and in
the assessment of pituitary dysfunction. Pituitary adenoma,
amenorrhea, galactorrhea and infertility.
LIMITATIONS:
Patients who have been regularly exposed to animals or
immunoglobulin fragments may produce antibodies that
interfere with immunoassays.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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PROSTATE SPECIFIC ANTIGEN
TEST NAME:
PROSTATE SPECIFIC ANTIGEN
CPT CODE:
84153
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST) OR
0.5 mL serum from a red top tube (plain).
REFERENCE RANGE:
Less than 4.0 ng/mL
METHOD:
Chemiluminescent immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing
GENERAL USE OF TEST:
An adjunctive test used as an aid in the management of
prostate cancer patients.
LIMITATIONS:



SPECIMEN PREPARATION:
STORAGE REQUIREMENTS:
Serum PSA measurement is not an absolute test for
malignancy. The PSA value should be used in
conjunction with information available from clinical
evaluation and other diagnostic procedures.
Specimens obtained from patients undergoing
prostate manipulation procedures may give
erroneous results.
Patients who have been regularly exposed to
animals or immunoglobulin fragments may produce
antibodies that interfere with immunoassays.

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 3
hours of collection.

Refrigerate serum at 2 - 8C up to 24 hours.
Revised 07/14.
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PROTEIN, CEREBROSPINAL FLUID
TEST NAME:
PROTEIN, CEREBROSPINAL FLUID
CPT CODE:
84157
SPECIMEN REQUIREMENT:
0.5 mL cerebrospinal fluid collected in a sterile plastic CSF
screw cap tube (#1).
REFERENCE RANGE:
15 – 45 mg/Dl
METHOD:
Colorimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Diagnosis of cerebrospinal fluid pathological processes.
LIMITATIONS:
Presence of hemoglobin may elevate levels.
SPECIMEN PREPARATION:
If specimen is cloudy or bloody, centrifuge and remove the
supernatant within 4 hours of collection.
STORAGE REQUIREMENTS:
Refrigerate serum at 2 - 8C up to a week.
Revised 07/14.
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PROTEIN C
TEST NAME:
PROTEIN C
CPT CODE:
SPECIMEN REQUIREMENT:
Plasma from a full blue top tube (sodium citrate)
COLLECTION REQUIREMENT:
METHOD:
Chromogenic detection
LAB SECTION PERFORMING TEST:
Reference Laboratory
AVAILABILITY:
Monday-Friday
TURNAROUND TIME:
GENERAL USE OF TEST:
STORAGE REQUIREMENTS:
3 Days
Deficiency of the Vitamin K dependent Protein C is
associated with recurrent venous thrombosis.
o
Plasma should be removed from cells and frozen at -20 C
within 4 hours of collection.
Revised 07/14.
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TEST DIRECTORY
PROTEIN ELECTROPHORESIS (SERUM)
TEST NAME:
PROTEIN ELECTROPHORESIS (SERUM)
(Albumin, Alpha 1, Alpha 2, Beta and Gamma fractions, Serum
Total Protein)
CPT CODE:
84165 84155
SPECIMEN REQUIREMENT:
1.0 mL serum from a gold top tube (SST).
REFERENCE RANGE:
Albumin
3.7-4.9 g/dL 52.9-66.9%
Alpha-1 Globulin
0.2- 0.4 g/dL 3.3-5.8%
Alpha-2 Globulin
0.5- 0.9 g/dL 7.5-13.4%
Beta Globulin
0.6-1.0 g/dL 8.5-13.7%
Gamma Globulin
0.6-1.4 g/dL 8.8-19.2%
Total serum protein 6.4-8.2 g/dL
METHOD:
Electrophoresis
LAB SECTION PERFORMING TEST:
Reference Laboratory
AVAILABILITY:
Monday – Friday
TURNAROUND TIME:
One Day
GENERAL USE OF TEST:
SPECIMEN PREPARATION:
STORAGE REQUIREMENTS:

Collect specimen using standard lab procedures.

Centrifuge specimen;
 Refrigerate serum at 2 - 8C up to 10 days or store
frozen up to 1 month.
.
Revised 07/14.
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PROTEIN, TOTAL
TEST NAME:
PROTEIN, TOTAL
CPT CODE:
80002
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST) OR
0.5 mL plasma from a green top tube (heparin).
REFERENCE RANGE:
AGE
0MOS – 1 MO
1M0 – 6 MOS
MALE
4.1 – 6.3 g/dL
4.7 – 6.7 g/dL
FEMALE
4.2 – 6.2 g/dL
4.4 – 6.6 g/dL
6MOS- 12 MOS
12MOS – 18 YRS
>= 18 YRS
5.5 – 7.0 g/dL
5.7 – 7.9 g/dL
6.1 -7.9 g/dL
5.6 – 7.9 g/dL
5.7 – 7.9 g/dL
6.1 -7.9 g/dL
METHOD:
Colorimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Detection of hypo and hyperproteinemia.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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PROTEIN, URINE 24-HOUR
TEST NAME:
PROTEIN, URINE 24-HOUR
CPT CODE:
84156
SPECIMEN REQUIREMENT:
Random urine or a 24-hour urine collected with no
preservatives in a plastic container obtained from the
laboratory.
REFERENCE RANGE:
50 – 100 mg/24 hours
METHOD:
Colorimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing for urine protein.
24 hour urine protein performed on day shift
Performed STAT (60 minutes) for Labor and Delivery.
GENERAL USE OF TEST:
Detection of clinically significant proteinuria.
LIMITATIONS:

No preservatives necessary.

Collect timed specimens on ice or refrigerate
specimen during collection.
Urine samples should not be collected after intense
physical exertion, or acute fluid load or deprivation.
Collect specimens prior to administration of
contrast media.


SPECIMEN PREPARATION:
Centrifuge specimen before analysis to remove particulate
matter.
STORAGE REQUIREMENTS:

Refrigerate at 2 - 8C up to 3 days.

Do not freeze.
Revised 07/14.
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PROTHROMBIN TIME
TEST NAME:
PROTHROMBIN TIME
CPT CODE:
85610
SPECIMEN REQUIREMENT:
Plasma from a full blue top tube (sodium citrate).
REFERENCE RANGE:
Reference range listed on report.
CRITICAL VALUE:
INR > 6.0
METHOD:
Photometric Detection
LAB SECTION PERFORMING TEST:
Hematology/Coagulation
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

STAT: 30 – 60 minutes
GENERAL USE OF TEST:
Evaluation of extrinsic coagulation system and Vitamin K
dependent factors.
LIMITATIONS:

Clotted specimen.

Improper labeling.

Specimen greater than 24 hours old.

Incomplete filling of vacutainer.

Hemolyzed, icteric or lipemic specimen.

Anticoagulant therapy should be noted on
requisition.
SPECIMEN PREPARATION:

Mix immediately after drawing.
STORAGE REQUIREMENTS:

Store unopened tube at room temperature or 2-8 C. for
up to 24 hours prior to analysis.
o
Revised 07/14.
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RETICULOCYTE COUNT
TEST NAME:
ALTERNATE TEST NAME:
RETICULOCYTE COUNT
Retics
CPT CODE:
85045
SPECIMEN REQUIREMENT:
3 mL whole blood (EDTA) from lavender top tube OR
250 uL from a lavender microtainer.
REFERENCE RANGE:
0-2 Wks Old:: 2.5 – 6.5%
>2 Wks Old: 0.4 – 2.0%
METHOD:
1. Supervital dye stains reticulocytes which are then
measured by light scatter, direct measurements and
opacity characteristics on analyzer.
2. Manually stained smear using new methylene blue
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
Daily
TURNAROUND TIME:
24 hours
GENERAL USE OF TEST:
Evaluation of the rate of red cell production in the bone
marrow.
LIMITATIONS:

Recently transfused patients.

Clotted specimen.

Specimens for reticulocyte counts are stable at room
temperature or 2 - 8C for 24 hours after collection.
STORAGE REQUIREMENTS:
Revised 07/14.
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RHEUMATOID FACTOR (RA)
TEST NAME:
RHEUMATOID FACTOR (RA)
CPT CODE:
86431
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST).
REFERENCE RANGE:
Less than 14U/mL
METHOD:
Turbidimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Monday through Friday
TURNAROUND TIME:
Results of specimens collected by 7:00 AM will be reported
by 3:00 PM.
GENERAL USE OF TEST:
Detection of rheumatoid arthritis.
SPECIAL PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen and separate serum from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 1 week.

Samples will be capped and held for at least 48 hours
after testing.
Do not freeze samples.
STORAGE REQUIREMENTS:

Revised 07/14.
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RUBELLA (IgG)
TEST NAME:
RUBELLA (IgG)
CPT CODE:
86762
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST).
REFERENCE RANGE:
Immune
METHOD:
Chemiluminescent immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
For the quantitative measurement of IgG antibodies to
rubella virus in serum and to aid in the determination of
immune status.
LIMITATIONS:
Patients who have been regularly exposed to animals or
immunoglobulin fragments may produce antibodies that
interfere with immunoassays.
SPECIAL PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen and separate serum from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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SALICYLATE
TEST NAME:
SALICYLATE
CPT CODE:
80196
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST) OR
0.5 mL plasma from a green top tube (heparin).
REFERENCE RANGE:
0-19 mg/dL
CRITICAL VALUE:
>30 mg/dL
METHOD:
Enzymatic
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.

Monitor therapeutic drug level.

Salicylate toxicity and poisoning.

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
GENERAL USE OF TEST:
SPECIMEN PREPARATION:
STORAGE REQUIREMENTS:
Revised 07/14
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SEDIMENTATION RATE
TEST NAME:
SEDIMENTATION RATE
ALTERNATE TEST NAME:
ESR
CPT CODE:
85651
SPECIMEN REQUIREMENT:
4.0 mL whole blood in a purple top tube(EDTA)
REFERENCE RANGE:
Male: 0-10 mm/hour
Female: 0-20 mm/hour
METHOD:
Modified Westergren using light transmittance
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
Daily
TURNAROUND TIME:
Same Shift Testing
GENERAL USE OF TEST:
Non-specific activity of disease processes.
SPECIMEN PREPARATION:
Gently invert tube six times immediately after collection.
STORAGE REQUIREMENTS:


Blood kept at room temperature must be analyzed within
24 hours of collection.
Store at room temperature or 2 - 8C.
Revised 07/14.
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SEMEN ANALYSIS
TEST NAME:
SEMEN ANALYSIS
CPT CODE:
89320
SPECIMEN REQUIREMENT:
Single, total ejaculate submitted within 30-60 minutes in
clean glass container. 4 oz. plastic screw top container,
second choice.
REFERENCE RANGE:
Reference range listed on report
METHOD:
Manual count using hemocytometer and morphology
determination.
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
M-F 7:30 A/M. – 2:30 P.M. No weekends or holidays.
TURNAROUND TIME:
Up to 3 business days.
GENERAL USE OF TEST:
Quantitative and qualitative examination of seminal fluid in
the diagnosis of male infertility.
PATIENT PREPARATION:

SPECIMEN PREPARATION:

Patient should abstain from sexual activity for the three
days prior to specimen collection.
Patient should receive our instruction sheet.

Specimen is deposited directly into container.

Exact time of collection must be noted on container or
requisition.
Specimen must be kept at body temperature while being
transported to the laboratory.


STORAGE REQUIREMENTS:
Specimen must be received in the lab within one hour of
collection.
Keep sample warm; do not refrigerate.
Revised 07/14.
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SEMEN ANALYSIS POST VASECTOMY
TEST NAME:
SEMEN ANALYSIS
POST VASECTOMY
CPT CODE:
89300
SPECIMEN REQUIREMENT:


Single, total ejaculate submitted in clean glass or
plastic screw top container.
Submission within 4 hours is preferred.
REFERENCE RANGE:
Sperm absent
METHOD:
Microscopic examination
LAB SECTION PERFORMING TEST:
Hematology
AVAILABILITY:
Before 5:00 P.M. Monday – Friday. No weekends or
Holidays. May be delivered to outpatient labs.
TURNAROUND TIME:
3 business days.
GENERAL USE OF TEST:
Determine presence or absence of sperm after vasectomy
procedure.
PATIENT PREPARATION:
Patient should abstain from sexual activity for the three days
prior to specimen collection.
SPECIMEN PREPARATION:

Specimen is deposited directly into container.

Time of collection must be noted on container or
requisition.
Revised 07/14.
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SKIN BIOPSY IMMUNOFLUORESCENCE
TEST NAME:
SKIN BIOPSY
IMMUNOFLUORESCENCE
CPT CODE:
SPECIMEN REQUIREMENT:

Tissue biopsy: specimen must be received in the
laboratory within 24 hours.

Notify Anatomic Pathology before collecting specimen.
COLLECTION REQUIREMENT:
Pre-filled container of transport media obtain from Histology
Lab, (Michelle’s Fixative) 248-858-6883.
REFERENCE RANGE:
See report
METHOD:
Sent to reference lab
LAB SECTION PERFORMING TEST:
Anatomic Pathology
AVAILABILITY:
Monday through Friday, 0800 to 1630
TURNAROUND TIME:
Approximately 1 week
GENERAL USE OF TEST:
Used to demonstrate in vivo fixation of antibody in
autoimmune diseases.
STORAGE REQUIREMENTS:
Refrigerate
Revised 07/14.
TEST NAME:
RETURN TO TEST DIRECTORY
CPT CODE:
SPECIMEN REQUIREMENT:
SURGICAL TISSUE
ROUTINE TISSUE PATHOLOGY
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Determined
by specimen type and dia
Fresh tissue
SJMO LABORATORY
TEST DIRECTORY
SODIUM
TEST NAME:
SODIUM
CPT CODE:
84295
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST)
REFERENCE RANGE:
133 – 145 mEq/L
CRITICAL VALUE:
<124 OR >160 mEq/L
METHOD:
Ion Selective Electrode
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of specimens requested STAT will be reported
within 60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Electrolyte balance.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
STORAGE REQUIREMENTS:
Revised 07/14.
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SODIUM, URINE
TEST NAME:
SODIUM, URINE
CPT CODE:
84300
SPECIMEN REQUIREMENT:
Random urine or 24-hour urine collected with no
preservative in a plastic container obtained from the
laboratory.
REFERENCE RANGE:
40 - 220 mEq/24 hours
METHOD:
Ion Selective Electrode
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
Day shift only for 24-hour urine sodium
GENERAL USE OF TEST:
Renal function.
SPECIMEN PREPARATION:

No preservations necessary.

Refrigerate during collection.

Refrigerate at 2 - 8C up to 3 days.
STORAGE REQUIREMENTS:
Revised 07/14.
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SPUTUM, CYTOLOGY
TEST NAME:
SPUTUM, CYTOLOGY
CPT CODE:
88161 or 88112 if thin prep made
SPECIMEN REQUIREMENT:
2 mL of deep cough sputum. Three to five consecutive early
morning deep cough specimens are necessary.
COLLECTION REQUIREMENT:
Fix with equal volume. Received fresh.
REFERENCE RANGE:
Negative for malignant cells.
METHOD:
Modified Papanicolaou
LAB SECTION PERFORMING TEST:
Cytology
AVAILABILITY:
Monday – Friday; 0800 to 163 0.5 mL
TURNAROUND TIME:
One to two working days.
GENERAL USE OF TEST:
To establish the presence of primary or metastatic
neoplasm.
PATIENT PREPARATION:
Upon arising, the patient rinses mouth and coughs forcefully
and vigorously to expectorate a deep cough specimen into a
plastic container.
LIMITATIONS:
If dust-pigmented laden macrophages are not identified,
specimen will be reported as unsatisfactory.
Revised 07/14.
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SURGICAL TISSUE
TEST NAME:
SURGICAL TISSUE
ROUTINE TISSUE PATHOLOGY
CPT CODE:
Determined by specimen type and diagnosis.
SPECIMEN REQUIREMENT:
Fresh tissue
COLLECTION REQUIREMENT:

10% Neutral buffered formalin.

Operative diagnosis required.
REFERENCE RANGE:
Results interpreted by consulting Pathologist.
METHOD:

Paraffin embedded tissue sections.

Microscopy
LAB SECTION PERFORMING TEST:
Histology
AVAILABILITY:
Monday through Friday, 0800 to 1630
TURNAROUND TIME:
24 – 48 hours
GENERAL USE OF TEST:
Histologic diagnosis
Revised 07/14.
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T3, FREE
TEST NAME:
T3, FREE
CPT CODE:
84480
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube.
REFERENCE RANGE:
2.5 – 3.9 pg/mL
METHOD:
Chemiluminescent immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing
GENERAL USE OF TEST:
Evaluate thyroid function.
LIMITATIONS:
Patients who have been regularly exposed to animals or
immunoglobulin fragments may produce antibodies that
interfere with immunoassays.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.
STORAGE REQUIREMENTS:

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
Revised 07/14.
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T3, TOTAL
TEST NAME:
T3, TOTAL
CPT CODE:
84480
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube.
REFERENCE RANGE:
0.5 mL9 – 1.8 ng/mL
METHOD:
Chemiluminescent immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing
GENERAL USE OF TEST:
Evaluate thyroid function.
LIMITATIONS:
Patients who have been regularly exposed to animals or
immunoglobulin fragments may produce antibodies that
interfere with immunoassays.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.
STORAGE REQUIREMENTS:

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
Revised 07/14.
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T4, FREE
TEST NAME:
T4, FREE
CPT CODE:
84439
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube.
REFERENCE RANGE:
0.5 – 1.64 ng/dl
METHOD:
Chemiluminescent immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing
GENERAL USE OF TEST:
Evaluate thyroid function.
LIMITATIONS:
Patients who have been regularly exposed to animals or
immunoglobulin fragments may produce antibodies that
interfere with immunoassays.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.
STORAGE REQUIREMENTS:

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
Revised 07/14.
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T4, TOTAL
TEST NAME:
T4, TOTAL
CPT CODE:
84436
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube.
REFERENCE RANGE:
6.1– 12.2 ug/mL
METHOD:
Chemiluminescent immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing
GENERAL USE OF TEST:
Evaluate thyroid function.
LIMITATIONS:
Patients who have been regularly exposed to animals or
immunoglobulin fragments may produce antibodies that
interfere with immunoassays.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.
STORAGE REQUIREMENTS:

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
Revised 07/14.
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TEST DIRECTORY
TEGRETOL (CARBAMAZEPINE)
TEST NAME:
TEGRETOL
(CARBAMAZEPINE)
CPT CODE:
81056
SPECIMEN REQUIREMENT:

REFERENCE RANGE:
4 - 12 g/mL
CRITICAL VALUE:
>15 g/mL
METHOD:
Immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
COLLECTION REQUIREMENTS:

Trough: Immediately prior to next oral dose.

Peak: Draw 3 hours after oral dose.
0.5 mL serum from a plain red top tube OR
0.5 mL serum from a gold top tube OR
0.5 mL plasma from a green top tube (heparin).
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing

Results of STAT specimens will be reported within
30-60 minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Monitor therapeutic drug levels.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.
STORAGE REQUIREMENTS:

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
Revised 07/14.
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TESTOSTERONE, TOTAL
TEST NAME:
TESTOSTERONE, TOTAL
CPT CODE:
84403
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST) OR
0.5 mL plasma from a green top tube (heparin).
REFERENCE RANGE:
Male (age >18 yrs.):
Female (age >21 yrs):
METHOD:
Chemiluminescent immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing
GENERAL USE OF TEST:

175 - 781 ng/dL
10 - 75 ng/dL
In males: used to investigate sexual dysfunction.

In females: investigate infertility, amenorrhea and
hirsuitism.
LIMITATIONS:
Patients who have been regularly exposed to animals or
immunoglobulin fragments may produce antibodies that
interfere with immunoassays.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.
STORAGE REQUIREMENTS:

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
Revised 07/14.
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THYROID STIMULATING HORMONE
TEST NAME:
THYROID STIMULATING HORMONE
(Ultrasensitive TSH)
CPT CODE:
84443
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
serum from yellow tube (SST)
REFERENCE RANGE:
0.34 – 5.60 IU/mL
METHOD:
Chemiluminescent immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing
GENERAL USE OF TEST:
Differential diagnosis of primary hypothyroidism from
secondary hypothyroidism.
LIMITATIONS:
Patients who have been regularly exposed to animals or
immunoglobulin fragments may produce antibodies that
interfere with immunoassays.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.
STORAGE REQUIREMENTS:

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
Revised 07/14
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TOBRAMYCIN (NEBCIN)
TEST NAME:
TOBRAMYCIN (NEBCIN)
CPT CODE:
80200 : Random : Trough
: Peak
SPECIMEN REQUIREMENT:
0.5 mL serum from a 7 mL gold top tube (SST) OR
plasma from a green top tube (heparin).
REFERENCE RANGE:
Tobramycin 0.0 – 10.0 g/mL
Tobramycin Trough 0.0 – 1.9g/mL
Tobramycin Peak 5.0- 10.0 g/mL
CRITICAL VALUE:
Tobramycin 12.1 g/mL
Tobramycin Trough 3.1 g/mL
Tobramycin Peak 12.1 g/mL
METHOD:
Immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
To monitor antibiotic therapy; test for insufficient or toxic
levels of tobramycin.
PATIENT PREPARATION:

Trough: 30 minutes to immediately prior to next dose.

Peak: 30 minutes after infusion is complete.

Collect specimen using standard lab procedures.
SPECIMEN PREPARATION:

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.
STORAGE REQUIREMENTS:

Refrigerate at 2 - 8C up to 48 hours prior to analysis. If
analysis is delayed more than 48 hours, freeze samples at 15C to -20C.

Samples will be capped and held for 4 days after
testing.
Revised 07/14
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TOXOPLASMA (IgG)
TEST NAME:
TOXOPLASMA (IgG)
CPT CODE:
86777
SPECIMEN REQUIREMENT:
0.5 mL serum from in a gold top tube (SST).
REFERENCE RANGE:
See Reference Laboratory Report
METHOD:
Immunofluorescence
LAB SECTION PERFORMING TEST:
Reference Laboratory
AVAILABILITY:
Monday-Friday
TURNAROUND TIME:
1-2 Days
GENERAL USE OF TEST:
For use in the detection of antibodies to the protozoan
parasite Toxoplasma gondii.
LIMITATIONS:
Sera collected very early in the acute stages of the
disease may have antibody too low to detect.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.
STORAGE REQUIREMENTS:

Refrigerate at 2 - 8C up to 48 hours. If longer storage
is needed, freeze at C for up to 2 months.

Samples will be capped and held for 5 days after
testing.
Revised 07/14.
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TRANSFERRIN
TEST NAME:
TRANSFERRIN
CPT CODE:
84466
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
serum from a gold tube (SST)
REFERENCE RANGE:
180 – 329 mg/dL (male)
192 – 382 mg/dL (female)
METHOD:
Turbidimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Aids in diagnosis of malnutrition, acute inflammation, and
infection, assessment of renal function and red blood cell
disorders.
SPECIMEN PREPARATION:
Collect specimen using standard lab procedures.
STORAGE REQUIREMENTS:

If not assayed within 8 hours of collection, store at 2 8C for 48 hours.
Revised 07/14.
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TRIGLYCERIDES
TEST NAME:
TRIGLYCERIDES
CPT CODE:
84478
SPECIMEN REQUIREMENT:
0.5 mL plasma from a green top tube (heparin) OR
serum from a gold top tube (SST)
REFERENCE RANGE:
40 - 149 mg/dL
METHOD:
Enzymatic
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing
GENERAL USE OF TEST:
Hyper or hypo lipidemia.
PATIENT PREPARATION:
Fasting is preferred.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.
STORAGE REQUIREMENTS:

Refrigerate at 2 - 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
Revised 07/14.
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TROPONIN
TEST NAME:
TROPONIN
CPT CODE:
84484
SPECIMEN REQUIREMENT:
0.5 mL plasma from an orange top tube OR
0.5 mL serum from a gold top tube (SST)for
outpatients only
REFERENCE RANGE:
Reference Interval: < 0.5 mL03 ng/mL
(Interpretation: Negative – repeat testing in four to six hours
if clinically indicated.)
CRTICAL VALUE:
> 0.5 mL40 ng/mL
METHOD:
Chemiluminescent immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

STAT specimens will be reported within 30-60
minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Cardiac specific marker, which is released after AMI or
ischemic damage.
LIMITATIONS:
Patients who have been regularly exposed to animals or
immunoglobulin fragments may produce antibodies that
interfere with immunoassays.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate plasma from cells within
2 hours of collection.
STORAGE REQUIREMENTS:
Revised 07/14.
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
Specimens may be stored for up to 24 hours at 2 - 8C.
 Samples will be capped and held for 5 days after testing.

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TZANCK SMEAR: VIRAL STUDIES FOR HERPES, PEMPHIGUS
TEST NAME:
TZANCK SMEAR
CPT CODE:
88160
SPECIMEN REQUIREMENT:
Direct scrapes of lesion at margins of the vesicle.
COLLECTION REQUIREMENT:

Firmly scrape the margins of the lesion with moist end of
tongue depressor.

Spread cellular material evenly on glass slide(s) and
immediately immerse in 95% ETOH.

Label slide(s) with patient’s name.

Collection materials may be obtained from Laboratory.
83600
REFERENCE RANGE:
No viral inclusion bodies identified.
METHOD:
Modified Papanicolaou
LAB SECTION PERFORMING TEST:
Cytology
AVAILABILITY:
Monday – Friday; 800 to 1630
TURNAROUND TIME:
One to two working days.
GENERAL USE OF TEST:
To establish the presence of viral disease; herpes virus
infection or pemphigus.
PATIENT PREPARATION:

Superficial skin lesions should be moistened before
scraping to remove loose, degenerated cellular debris and
serum crust.

Apply wet compresses over lesion for ½ hour.
STORAGE REQUIREMENTS:
Refrigerate
Revised 07/14.
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URIC ACID, BLOOD
TEST NAME:
URIC ACID, BLOOD
CPT CODE:
84550
SPECIMEN REQUIREMENT:
0.5 m plasma from a green top tube (heparin) OR
0.5 mL serum from a gold top tube (SST)
REFERENCE RANGE:
AGE
000 MOS to 1 MO
1 MO to 3 MOS
3 MOS to 12 MOS
12 MOS to 9 YRS
3 YRS to 6 YRS
9 YRS to 11 YRS
11 YRS to 13 YRS
15 YRS to 19 YRS
>= 19 years
MALE
1.2 – 4.9 mg/dL
1.3 – 5.8 mg/dL
1.3 – 6.7 mg/dL
1.7 – 5.0 mg/dL
2.3 – 5.4 mg/dL
2.7 – 6.8mg/dL
2.4 – 7.9 mg/dL
4.0- 8.7 mg/dL
4.8 – 8.7 mg/dL
FEMALE
1.3 – 6.2 mg/dL
1.3 – 5.8 mg/dL
1.3 – 6.7 mg/dL
1.7 – 5.0 mg/dL
3.0 – 4.7 mg/dL
3.0 - 5.8mg/dL
3.0 – 5.8 mg/dL
3.0 – 5.9 mg/dL
2.6 – 8.0 mg/dL
METHOD:
Colorimetric
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing.
GENERAL USE OF TEST:
Diagnosis of gout and other metabolic disorders.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum/plasma from cells
within 2 hours of collection.
STORAGE REQUIREMENTS:

Refrigerate at 2 – 8C up to 48 hours.

Samples will be capped and held for 5 days after
testing.
Revised 07/14.
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URINALYSIS
TEST NAME:
URINALYSIS
(pH, Color, Appearance, Specific Gravity, Protein, Leukocytes, Glucose,
Ketone, Nitrite, Urobilinogen, Bilirubin, Hemoglobin and Microscopic if
required)
CPT CODE:
81003
SPECIMEN REQUIREMENT:
10 mL from a first morning clean catch midstream,
catheterized specimen or random specimen
REFERENCE RANGE:
Reference ranges listed on report.
METHOD:
Chemical reaction using a dipstick on automated instrument
LAB SECTION PERFORMING TEST:
Urinalysis
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:

Same shift testing.

Results of STAT specimens will be reported within 30
minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Evaluate kidney function, endocrine or metabolic disorders.
SPECIMEN PREPARATION:
Submit random, clean catch midstream urine random
urine or a catheterized sample in a labeled, sealed
container. Aliquot urine to a yellow top tube.
STORAGE REQUIREMENTS:

Refrigerate up to 24 hours before analysis.

Specimens left at room temperature for more than 2
hours are unacceptable.
Revised 07/14.
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URINE CYTOLOGY
TEST NAME:
URINE CYTOLOGY
CPT CODE:
88112
SPECIMEN REQUIREMENT:
 Second morning specimen, voided or catheterized.
 50mL of urine, not less than.
 Received fresh with NO fixative
COLLECTION REQUIREMENT:
Pour all urine into conical tube and replace cap.
REFERENCE RANGE:
Negative for malignant cells.
METHOD:
Modified Papanicolaou
LAB SECTION PERFORMING
TEST:
Cytology
AVAILABILITY:
Monday through Friday – 0800 to 1630
TURNAROUND TIME:
One to two working days.
GENERAL USE OF TEST:
To establish the presence of primary or metastatic neoplasm.
PATIENT PREPARATION:

After first morning void, patient may be hydrated with one
glass of water every 30 minutes for three hours.

Instructions to the patient are included in the patient
education section of this guide.
LIMITATIONS:
First morning or 24-hour urine samples are unsatisfactory.
Revised 07/14
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URINE, MICROSCOPIC
TEST NAME:
URINE, MICROSCOPIC
CPT CODE:
88108
SPECIMEN REQUIREMENT:
10 m L f r o m a random, first morning clean catch mid - stream
or catheterized specimen.
METHOD:
Automated digital microscopic examination of urine sediment or
manual microscopy
LAB SECTION
PERFORMING TEST:
Urinalysis
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:
Same shift testing.
Results of STAT specimens will be reported within 30
minutes of receipt in the laboratory.
GENERAL USE OF TEST:
Detection of increased and/or abnormal formed elements.
LIMITATIONS:
This test is included in a routine urinalysis when
abnormal dipstick readings are present.
SPECIMEN PREPARATION:
Submit a random, clean catch mid-stream urine sample or a
catheterized sample in a labeled sealed container. Aliquot to a
yellow tube.
STORAGE REQUIREMENTS:
 Refrigerate up to 24 hours before analysis.
 Specimens left at room temperature more than 2 hours
are unacceptable for assay.
Revised 07/14
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URINE REDUCING SUBSTANCES
TEST NAME:
URINE REDUCING SUBSTANCES
CODE:
81099
SPECIMEN REQUIREMENT:
10 mL from fresh random urine.
REFERENCE RANGE:
Negative
METHOD:
Benedict’s copper reduction reaction.
LAB SECTION PERFORMING TEST:
Urinalysis
AVAILABILITY:
Daily or STAT
Only performed on children < 1 month old
TURNAROUND TIME:

Same shift testing.

Results of STAT specimens will be reported within 30
minutes of receipt in the laboratory.
GENERAL USE OF TEST:
The presence of reducing substances in urine can be an
indication of certain metabolic disorders.
LIMITATIONS:

The test is routinely performed on all pediatric
patients up to 1 month of age.
STORAGE REQUIREMENTS:
Refrigerate for 24 hours if sample cannot be tested
immediately.
Revised 07/14.
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VANCOMYCIN (VANCOCIN HC1)
TEST NAME:
VANCOMYCIN
(VANCOCIN HC1)
CPT CODE:
80202 Random Trough
Peak
SPECIMEN REQUIREMENT:
0.5 mL serum from a gold top tube (SST).
REFERENCE RANGE:
Vancomycin 5- 40 g/mL
Vancomycin Trough 5 - 20g/mL
Vancomycin Peak 30 - 40g/mL
CRITICAL VALUE:
Vancomycin 51g/mL
Vancomycin Trough 51g/mL
Vancomycin Peak 51g/mL
METHOD:
Immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily or STAT
TURNAROUND TIME:
Same shift testing
GENERAL USE OF TEST:
Monitor therapeutic drug levels.
PATIENT PREPARATION:
Trough: 30 minutes to immediately prior to next dose.
Peak: Draw 2 hours after infusion complete.
SPECIMEN PREPARATION:

Collect specimen using standard lab procedures.

Centrifuge specimen; separate serum from cells within 2
hours of collection.
STORAGE REQUIREMENTS:


Refrigerate at 2 - 8C up to 48 hours.
to C for prolonged storage prior to analysis.

Samples will be capped and held for 5 days after
testing.
Revised 07/14
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VITAMIN B12
TEST NAME:
VITAMIN B12
CPT CODE:
82607
SPECIMEN REQUIREMENT:
1 mL plasma from a green top tube (heparin) OR
1 mL serum from a gold top tube (SST)
REFERENCE RANGE:
180-914 pg/mL
METHOD:
Chemiluminescent immunoassay
LAB SECTION PERFORMING TEST:
Chemistry
AVAILABILITY:
Daily
TURNAROUND TIME:
Same shift testing
GENERAL USE OF TEST:
Megalobastic anemia, dietary deficiency.
PATIENT PREPARATION:
Fasting is preferred.
LIMITATIONS:
Patients who have been regularly exposed to animals or
immunoglobulin fragments may produce antibodies that
interfere with immunoassays.
SPECIMEN PREPARATION:
Centrifuge and separate serum or plasma from cells
immediately after collection.
STORAGE REQUIREMENTS:

Store at 2 - 8C for up to 24 hours.

Samples will be held for at least 5 days after testing.
Revised 07/14
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VITAMIN D
TEST NAME:
VITAMIN D
CPT CODE:
82306
SPECIMEN REQUIREMENT:
1 mL plasma from a green Lithium Heparin OR
1 mL serum from a gold top tube (SST)
REFERENCE RANGE:
>29 ng/mL
METHOD:
Chemiluminescent immunoassay
LAB SECTION PERFORMING TEST:
Send Outs/Chemistry
AVAILABILITY:
Weekdays
TURNAROUND TIME:
Same day if received before 5:00 pm.
GENERAL USE OF TEST:
Vitamin D is important for general bone health. Vitamin D
deficiency (less than 10 ng/mL) is characterized by muscle
weakness, bone pain and fragility fractures.
PATIENT PREPARATION:
None
LIMITATIONS:
The effect of heterophilic antibodies on this assay’s
performance has not been evaluated.
SPECIMEN PREPARATION:
Centrifuge and separate serum from cells immediately after
collection.
STORAGE REQUIREMENTS:

Store at 2 - 8C for up to 24 hours.

Samples will be held for at least 5 days after testing.
Revised 07/14.
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WASHING / LAVAGE CYTOLOGY: BRONCHIAL, TRACHEAL OR ESOPHAGEAL
TEST NAME:
WASHING / LAVAGE CYTOLOGY:
BRONCHIAL, TRACHEAL OR ESOPHAGEAL
CPT CODE:
88112 - Washing
88104 - Smears
88305 – Cell Block
SPECIMEN REQUIREMENT:

Washing obtained by physician during endoscopy.

lavage, washings, bronchial-received fresh, no fixative
REFERENCE RANGE:
Negative for malignant cells.
METHOD:
Modified Papanicolaou
LAB SECTION PERFORMING TEST:
Cytology
AVAILABILITY:
Monday through Friday, 0800 to 1600
TURNAROUND TIME:
24 to 72 hours
GENERAL USE OF TEST:
To establish the presence of primary or metastatic
neoplasm.
LIMITATIONS:
Washings are considered non-diagnostic if epithelium
lining the site of the wash is not present.
STORAGE REQUIREMENTS:
Refrigerate
Revised 07/14.
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MICROBIOLOGY
TEST DIRECTORY
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REMARKABLE MEDICINE. REMARKABLE CARE.
SJMO LABORATORY
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ACID FAST CULTURE WITH STAIN
TEST NAME
ACID FAST CULTURE WITH STAIN
Sputum
3- .
Urine
Gastric
40 ml
Blood in
SPS* or
Mycolytic F
Feces
1
gram
Bronchial washings,
Bronchoalveolar lavage,
Tissue, Pleural fluid, other
body fluids, wounds, biopsy
SPECIMEN REQUIRED/
MINIMUM VOLUME
First morning specimen required for gastric, urine.
REJECTION CRITERIA
24 hour or pooled sputum or urine is not acceptable for culture.
For sputum, 3 specimens are recommended. The specimens should be collected 8 24 hours apart; at least one of 3 specimens must be a first morning collection.
Low volume sputum, urine.
Feces in non-immunocompromised patient.
Multiple samples less than 8 hours apart. Saliva and swabs will not be tested.
TRANSPORT TIME/TEMP
COLLECTION/TRANSPORT
CONTAINER
< 1 hour, Room temperature. Refrigerate for longer storage/transport times.
Sterile Container
STABILITY
24 hours, Refrigerated. Specimens transported from off-site locations will be accepted
up to 72 hours.
REPLICA LIMITS
1/day/same site
PERFORMED
Sunday-Saturday
METHODOLOGY
Fluorescent Stain and Culture
TEST TURN AROUND TIME
Smear within 24 hours.
Culture: 6-8 weeks.
CLINICAL USE AND
INTERPRETATION
Used to diagnose tuberculosis and other mycobacterial infections. AFB smear without
culture will be used to monitor therapy in smear- positive patients.
COMMENTS
Organisms accumulate in the bladder and lungs overnight, so first morning specimen
provides the best yield. Specimens collected at other times are dilute and are not
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optimal but will be accepted.
SPS** tube for Acid-fast culture of blood can be obtained from Microbiology.
Urine specimens of <40 ml are not acceptable unless a larger volume is not obtainable.
Call Microbiology the day before collection of a gastric specimen.
Antimicrobial susceptibility automatically performed on M. tuberculosis isolates by
Michigan Department of community Health. Microbiology must be notified if sensitivity
is required on Mycobacterium species other than M. tuberculosis. AFB susceptibility is
a send out test.
CHG =*Chlorhexidene gluconate
SPS = sodium polyanethiol sulfonate
Revised 07/14
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ANAEROBIC CULTURE
TEST NAME
ANAEROBIC CULTURE
SPECIMEN REQUIRED/
MINIMUM VOLUME
Acceptable specimens include aspirated pus, tissue, body fluids, suprapubic
urine, transtracheal aspirate (TTA) and lung aspirates. Tissues fluids and
aspirates are always preferred over swab samples.
REJECTION CRITERIA
Aerobic culture swabs.
Specimens which have been refrigerated.
Throat, NP swabs, sputum, gastric contents, feces, swabs from decubitus
ulcers, skin, voided urine, stool, prostatic or seminal fluid, I.U.D., vaginal or
cervical swabs are unacceptable for anaerobic culture.
TRANSPORT TIME/TEMP
1 hour, Room temperature. DO NOT REFRIGERATE.
COLLECTION TRANSPORT
CONTAINER
Anaerobic Swab
STABILITY
Stable for 24 hours at room temperature.
REPLICA LIMITS
1/day/same site
PERFORMED
Sunday-Saturday
METHODOLOGY
Culture
TEST TURN AROUND TIME
4-6 Days
CLINICAL USE AND
INTERPRETATION
Used to diagnose anaerobic infection in appropriate specimens.
COMMENTS
CAUTION: Glass tube is fragile. Use bubble wrap/cushioned packaging for
transport in pneumatic tube.
Revised 07/14.
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ARTHOPOD INSECT ID (ARTHID)
TEST NAME
ARTHOPOD/ INSECT ID (ARTHID)
SPECIMEN REQUIRED/
MINIMUM VOLUME
Submit arthropod/insect in tightly capped container. Submit patient history.
For tick, submit location (state, county) of tick bite.
REJECTION CRITERIA
Insects/arthropods other than those associated with human infection. Spiders
are not identified.
TRANSPORT TIME/TEMP
Room temperature, 1 day.
COLLECTION TRANSPORT
CONTAINER
Clean or Sterile Container
STABILITY
Room temperature 1-3 days
REPLICA LIMITS
NA
PERFORMED
Monday-Friday, Saturday & Sunday for inpatients only.
METHODOLOGY
Direct Examination
TEST TURN AROUND TIME
1-7 days
CLINICAL USE AND
INTERPRETATION
Used for identification of common human ectoparasites.
COMMENTS
Some ticks, insects and arthropods will be referred.
Revised 07/14.
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BACTERIAL ANTIGEN GROUP B STREP
TEST NAME
BACTERIAL ANTIGEN GROUP B STREP
SPECIMEN REQUIRED/
MINIMUM VOLUME
Cerebrospinal fluid (CSF), 0.5 mL. Tube 2 preferred
REJECTION CRITERIA
Urine and serum are not accepted for testing. Test must be ordered in
conjunction with CSF culture.
TRANSPORT TIME/TEMP
Room temperature 1 hour
COLLECTION/TRANSPORT
CONTAINER
LP tube 2.
STABILITY
24 hours refrigerated
REPLICA LIMITS
1/day
PERFORMED
Sunday-Saturday
METHODOLOGY
Latex Agglutination
TEST TURN AROUND TIME
24 hours
CLINICAL USE AND
INTERPRETATION
Use as an aid in diagnosis of meningitis due to Streptococcus agalactiae,
especially in patients previously treated with antibiotics. It will also be used in
patients with laboratory data and clinical history suggestive of meningitis when
gram stain is negative.
COMMENTS
Urine for antigen not accepted because of low sensitivity and predictive value.
Requests for CSF bacterial antigen for other organisms must be sent to a
reference laboratory.
Revised 07/14.
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BACTERICIDAL LEVEL
TEST NAME
BACTERICIDAL LEVEL
SPECIMEN REQUIRED/
MINIMUM VOLUME
Serum Peak 1.0 ml
Serum Trough 1.0 ml
CONTACT MICROBIOLOGY PRIOR TO AND AFTER COLLECTION. MUST BE
COLLECTED BETWEEN 0600 and 1800 hours.
Test requires collection of peak and trough sera.
TROUGH: Trough specimen should be collected immediately before (1-30 minutes)
antibiotic dose.
PEAK: Peak specimen should be collected 30-60 minutes after completion of the
antibiotic dose. (Recommend end of 30 minute IV infusion, or 15 minutes after a 60
minute IV infusion or 60 minutes after IM dose.)
Indicate antibiotics being administered, dosing schedule and bacterium to be tested.
REJECTION CRITERIA
Specimens collected at times other than those described or those with prolonged
transport times will be rejected.
TRANSPORT TIME/TEMP
Transport < 1 hour, room temperature. NOTE: Deliver specimen to Microbiology.
COLLECTION/TRANSPORT
CONTAINER
Red Top Vacutainer x 2 (1 peak, 1 trough)
STABILITY
Indicate antibiotics being administered, dosing schedule and bacterium to be tested.
REPLICA LIMITS
1/day
PERFORMED
Variable, performed at reference laboratory.
METHODOLOGY
Serum dilution
TEST TURN AROUND TIME
Variable
CLINICAL USE AND
INTERPRETATION
Used as an aid in treatment of infections.
COMMENTS
This test is sent to a Reference Laboratory.
NOTE: Peak and trough sera usually collected after third or fourth dose of antibiotic.
Revised 07/14.
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BLOOD CULTURE
TEST NAME
BLOOD CULTURE
SPECIMEN
REQUIRED/
MINIMUM
VOLUME
COLLECTION:
SKIN ANTISEPSIS IS CRITICAL!
Two sets should be collected from two separate venipunctures to
detect suspected bacteremia/fungemia.
Draw prior to initiating antibiotic therapy if possible.
Contact Microbiology if Brucella or other special pathogens suspected.
Submit aerobic and anaerobic bottle on adults or peds bottle on
pediatric patients.
Recommend collection of Myco Lytic F for detection of yeast mold in blood culture. See Fungus
Blood Culture.
Collect Myco-Lytic F for detection of acid-fast bacilli in blood. Order Acid-Fast Culture, Blood.
REJECTION
CRITERIA
Submission in bottles other than those compatible with Bactec System. Delay in transport to
Laboratory >48 hours.
STABILITY
48 hours, Room Temperature.
REPLICA LIMITS
LIMIT: 2/day unless diagnosis is Subacute Bacterial Endocarditis. Order for >2 sets/day in
other diagnoses requires Pathology approval.
PERFORMED
Sunday-Saturday
METHODOLOGY
Bactec Continuous Monitoring System/CO2 Detection
TEST TURN
AROUND TIME
5 days negatives, 1-5 days for positives. Positive blood culture is a critical value.
CLINICAL USE
AND
INTERPRETATION
For diagnosis of sepsis due to bacteria, yeasts.
COMMENTS
Contact Laboratory if Brucella suspect; extended incubation required.
Most true positives are detected within 48 hours.
DELAY IN TRANSPORT WILL INCREASE TIME TO DETECTION IN POSITIVE CULTURES.
SEE HOSPITAL BLOOD CULTURE POLICY FOR COMPLETE DETAILS.
Revised 07/14.
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BODY FLUID CULTURE/BODY FLUID CULTURE WITH GRAM STAIN
BODY FLUID CULTURE
BODY FLUID CULTURE WITH GRAM STAIN
SPECIMEN REQUIRED/
MINIMUM VOLUME
Sterile, leakproof container (Abdominal, Ascites, Bile, Joint, Pericardial, Peritoneal,
Pleural, Synovial)
REJECTION CRITERIA
Specimens on swabs will not be accepted.
TRANSPORT TIME/TEMP
1 hour, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Sterile Container
Red top Vacutainer will be accepted.
STABILITY
4 Hours, Room Temperature.
24 hours, Refrigerated.
REPLICA LIMITS
1/day/same source.
PERFORMED
Sunday-Saturday
METHODOLOGY
Gram stain (if ordered)
Culture
TEST TURN AROUND TIME
1-3 Days
CLINICAL USE AND
INTERPRETATION
Used as an aid to diagnosis of infection in various body fluids.
COMMENTS
When volume permits, fluid inoculated in blood culture bottles will be submitted as a
supplement to the specimen in the sterile container.
Order Anaerobic Culture, Fungus Culture, Acid fast Culture or Viral Culture separately
if these pathogens suspect.
Revised 07/14
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BONE MARROW CULTURE
TEST NAME
BONE MARROW CULTURE
(ORDER AS BODY FLUID CULTURE)
SPECIMEN REQUIRED/
MINIMUM VOLUME
1-3 ml bone marrow in SPS (preferred)
REJECTION CRITERIA
Other Anticoagulants, such as citrate, oxalate, EDTA, are not suitable because
of their toxicity for some bacteria.
TRANSPORT TIME/TEMP
30 minutes, Room temperature.
COLLECTION/TRANSPORT
CONTAINER
SPS-Vacutainer Tube
STABILITY
24 hours, Room temperature.
REPLICA LIMITS
None
PERFORMED
Sunday-Saturday
METHODOLOGY
Gram stain (if ordered)
Culture
TEST TURN AROUND TIME
3 days
CLINICAL USE AND
INTERPRETATION
Used for diagnosis of infection due to several organisms.
COMMENTS
Small yellow-top vacutainer tubes containing sodium polyaniethol sulfonate
(SPS) are designed for a maximum 3.0 ml draw. SPS required for Acid fast
and Fungus. Heparin will be used for routine culture only.
Revised 07/14.
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Bordetella pertussis DETECTION BY PCR
TEST NAME
Bordetella pertussis DETECTION BY PCR
SPECIMEN REQUIRED/
MINIMUM VOLUME
Nasopharyngeal swab in M4-RT Transport medium. Transport media can be
obtained from Microbiology - 86256.
REJECTION CRITERIA
24 hours, Room temperature.
TRANSPORT TIME/TEMP
1/day/same source
LLECTION/TRANSPORT
CONTAINER
M4-RT Transport
STABILITY
Room temperature 3 days, Refrigerated 2 weeks.
REPLICA LIMITS
1/day
PERFORMED
Monday – Friday
METHODOLOGY
Polymerase Chain Reaction (PCR)
TEST TURN AROUND TIME
1-3 days
CLINICAL USE AND
INTERPRETATION
Used for diagnosis of whooping cough/ Bordetella pertussis.
COMMENTS
Agents causing a Whooping Cough Syndrome include: B pertussis,
parapertussis, B. bronchiseptica and Adenovirus. If PCR for pertussis
negative, respiratory culture and viral culture will detect the other agents, which
will cause whooping cough syndrome.
Specimen sent in charcoal transport media will be submitted to Michigan
Department of Community Health for testing.
Revised 07/14.
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CATHETER, I.V. CULTURE
TEST NAME
CATHETER, I.V. CULTURE
SPECIMEN REQUIRED/ MINIMUM
VOLUME
2 inch segment of catheter tip
REJECTION CRITERIA
Catheter in non-sterile container. Catheter with attached tubing.
Catheter submitted without 2 sets of blood cultures will be rejected.
TRANSPORT TIME/TEMP
1 hour, Room temperature.
COLLECTION/TRANSPORT
CONTAINER
Sterile Container
STABILITY
4 hours, Room temperature.
REPLICA LIMITS
None
PERFORMED
Sunday-Saturday
METHODOLOGY
Semi-quantitative Maki technique
TEST TURN AROUND TIME
2-3 days
CLINICAL USE AND
INTERPRETATION
Used in conjunction with blood cultures for detection of line-related
sepsis.
COMMENTS
Acceptable IV catheters: Central, CVP, Hickman, Boric, Peripheral,
Arterial, Umbilical, Hyperal, and Swan Ganz.
Blood cultures X2 MUST be collected within 24 hours of catheter tip
culture. Catheter tip culture will be rejected if blood cultures are
not collected.
Revised 07/14.
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CEREBROSPINAL FLUID
TEST NAME
CEREBROSPINAL FLUID
SPECIMEN REQUIRED/
MINIMUM VOLUME
CSF, 0.5 mL2 - 0.5 mL
REJECTION CRITERIA
CSF submitted on ice, QNS for culture
TRANSPORT TIME/TEMP
< 1 hour, Room temperature for bacterial agents. For viral agents, send on ice.
COLLECTION/TRANSPORT
CONTAINER
Tube 2, preferred
STABILITY
2 hours, Room temperature for bacterial.
GRAM STAIN IS PERFORMED ON ALL CSF FOR CULTURE.
72 hours viral, Refrigerated.
REPLICA LIMITS
1/day
PERFORMED
Sunday-Saturday
METHODOLOGY
Culture with Gram Stain
TEST TURN AROUND TIME
1-3 days
CLINICAL USE AND
INTERPRETATION
Used for diagnosis of bacterial meningitis.
COMMENTS
Viral culture/Viral agent PCR must be ordered separately.
DO NOT SUBMIT ON ICE OR REFRIGERATE
Revised 07/14.
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CHLAMYDIA CULTURE
TEST NAME
CHLAMYDIA CULTURE
SPECIMEN REQUIRED/
MINIMUM VOLUME
Acceptable specimens include cervix, urethra, eye, nasopharyngeal aspirate,
throat, and rectal swab or bronchoalveolar lavage.
REJECTION CRITERIA
Specimens submitted in transport media other than M4-RT.
TRANSPORT TIME/TEMP
1/day/same source
COLLECTION/TRANSPORT
CONTAINER
Chlamydia/Viral Transport (M4-RT)
STABILITY
24 hours, Refrigerated
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Friday
METHODOLOGY
Tissue culture for Chlamydia
TEST TURN AROUND TIME
Variable
CLINICAL USE AND
INTERPRETATION
Used for diagnosis of respiratory infections, ocular infections and genital tract
infections due to Chlamydia species.
COMMENTS
CSF or Semen are not acceptable specimens.
Do NOT use CALGISWABS
Detects Chlamydia trachomatis and Chlamydia pneumoniae.
Serology/PCR optimal for detection of Chlamydia psittaci.
Revised 07/14.
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CHLAMYDIA DFA (MICRO-TRAK)
TEST NAME
CHLAMYDIA DFA (MICRO-TRAK)
SPECIMEN REQUIRED/
MINIMUM VOLUME
Ocular swab inoculated to Microtrak slide.
REJECTION CRITERIA
Specimens submitted in transport media. Unfixed smears.
TRANSPORT TIME/TEMP
Room Temperature
COLLECTION/TRANSPORT
CONTAINER
Chlamydia Micro Trak
STABILITY
3 days, Room temperature.
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Friday
METHODOLOGY
Direct Fluorescent Antibody
TEST TURN AROUND TIME
1-3 days
CLINICAL USE AND
INTERPRETATION
Used for diagnosis of ocular infections due to Chlamydia species.
COMMENTS
Sent to Reference Laboratory.
Revised 07/14.
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CHLAMYDIA PROBE
TEST NAME
CHLAMYDIA PROBE
SPECIMEN REQUIRED/
MINIMUM VOLUME
Cervix or urethral specimen on Aptima unisex swab.
REJECTION CRITERIA
Specimens submitted with white swab only, specimens submitted with two
swabs ( white plus blue), specimens submitted with no swabs and specimens
submitted with swabs other than those supplied with the kit will be rejected.
For urine first void specimen is required. Clean catch mid-stream specimens
are not acceptable.
Ocular specimens are not acceptable.
TRANSPORT TIME/TEMP
1/day/same source
COLLECTIONRANSPORT
CONTAINER
STABILITY
30 days, unisex swab 60 days in urine transport
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Friday
METHODOLOGY
Transcription Mediated Amplification
TEST TURN AROUND TIME
1-3 days
CLINICAL USE AND
INTERPRETATION
Used for diagnosis of genital tract infections due to Chlamydia trachomatis.
COMMENTS
For ocular specimens, order Chlamydia Culture or Chlamydia DFA. Test is
performed at a Reference Laboratory.
Revised 07/14.
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CLOSTRIDIUM DIFFICILE TOXIN, MOLECULAR
TEST NAME
CLOSTRIDIUM DIFFICILE TOXIN, MOLECULAR
SPECIMEN REQUIRED/
MINIMUM VOLUME
Soft or liquid stool required.
REJECTION CRITERIA
TRANSPORT TIME/TEMP
(Soft/liquid stool is defined as stool sample assuming the shape of its container.)
Formed stool will be rejected. Stool in preservative will be rejected.
Stool with delay in transport to lab > 1 hour if not cold during transport.
1 hour, Room temperature.
24 hours, Refrigerated.
Sterile Container. Transfer of liquid/soft stool directly into container.
COLLECTION/TRANSPORT
CONTAINER
STABILITY
REPLICA LIMITS
1 hour, Room temperature
24 hours, Refrigerated
Testing repeated after 7 days if negative.
Testing repeated after 10 days if positive.
Routine Test, Sunday-Saturday
Twice daily weekdays(Approx.10 AM and 6 PM)
TEST SCHEDULE
Once per day on weekends and holidays (Approx. 3PM)
.Additional test runs may be performed if there is a critical need; contact Microbiology.
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Illumigene C. difficile Toxin assay. Isothermal nucleic acid amplification test uses LAMP
methodology.
METHODOLOGY
Sensitivity*
95.2%
Specificity*
95.3%
* From package insert
TEST TURN AROUND TIME
24 hours
CLINICAL USE AND
INTERPRETATION
Used as in aid to diagnosis of pseudomembranous colitis and C difficile infection
NOTE: ADHERENCE TO TRANSPORT CONDITIONS IS CRITCAL.
C. difficile assays should not be ordered as a test of cure.
COMMENTS
Infants and cystic fibrosis patients have high colonization rates, positive results should be
interpreted with caution.
The test does not distinguish between viable and non-viable organisms.
Revised 07/14.
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Corynebacterium diphtheriae CULTURE
TEST NAME
Corynebacterium diphtheriae CULTURE
SPECIMEN REQUIRED/
MINIMUM VOLUME
Throat swab, naspharyngeal and or skin swab
REJECTION CRITERIA
Specimen other than aerobic culture swab
TRANSPORT TIME/TEMP
2-12hours, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Aerobic Swab Use Minitip wire for NP.
STABILITY
24 hours, Refrigerated
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Saturday
METHODOLOGY
Culture
TEST TURN AROUND TIME
1-5 days
CLINICAL USE AND
INTERPRETATION
Use to detect diphtheria
COMMENTS
Isolates of possible C diphtheriae must be submitted to Michigan Department of
Community Health for ID and determination of toxin production. Order as Respiratory
Screen culture; indicate C. diphtheriae.
Revised 07/14.
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CRYPTOCOCCAL ANTIGEN – CSF/ SERUM
TEST NAME
SPECIMEN
REQUIRED/
MINIMUM
VOLUME
CRYPTOCOCCAL ANTIGEN – CSF/ SERUM
0.5 mL serum or cerebrospinal fluid
REJECTION
CRITERIA
Plasma cannot be tested.
TRANSPORT
TIME/TEMP
1 hour, Room temperature
COLLECTION
TRANSPORT
COTAINER
Lumbar Puncture tube (CSF)
STABILITY
24 hours, refrigerated
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Saturday
METHODOLOGY
Latex Agglutination
TEST TURN
AROUND TIME
24 hours
CLINICAL USE
AND
INTERPRETATION
Used for diagnosis of Cryptococcal neoformans infections. Normal: Negative. Positive
specimen is reported as a titer.
COMMENTS
Titer will be used to monitor therapy. Decrease in titer correlates with clinical improvement.
Red Top Vacutainer (Serum)
Revised 07/14.
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CRYPTOSPORIDIUM STAIN
TEST NAME
CRYPTOSPORIDIUM STAIN
CRYPTODPORIDIUM ANTIGEN
PARASITE ANTIGEN
SPECIMEN REQUIRED/
MINIMUM VOLUME
Stool in sterile container. Stool in Formalin/PVA preservative kit. Follow instructions
for collection of fecal specimen for ova and parasite exam. Approximately of stool.
REJECTION CRITERIA
Specimens obtained with barium, bismuth, mineral oil or magnesium is not
acceptable. Patient must wait 7-10 days to clear these compounds.
TRANSPORT TIME/TEMP
<60 minutes unpreserved. <1 day if preserved
COLLECTION/TRANSPORT
CONTAINER
Formalin/PVA Vials or Sterile Container
STABILITY
1 hour, unpreserved. 7 days preserved.
REPLICA LIMITS
1/day
PERFORMED
Monday-Friday
METHODOLOGY
Acid Fast Stain
TEST TURN AROUND TIME
1-3 Days
CLINICAL USE AND
INTERPRETATION
Used for diagnosis of Cryptosporidium parvum infections.
COMMENTS
Diagnosis can also be made by detection of Cryptosporidium antigen.
Revised 07/14.
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DIRECT SMEAR/GRAM STAIN ONLY
TEST NAME
GRAM STAIN ONLY
SPECIMEN REQUIRED/
MINIMUM VOLUME
Variable
REJECTION CRITERIA
Separate order must be placed for gram stain (in addition to culture order) for all sites
other than CSF, respiratory culture and wounds.
TRANSPORT TIME/TEMP
See culture instructions by anatomic site.
COLLECTION /TRANSPORT
CONTAINER
Sterile Container
STABILITY
NA
REPLICA LIMITS
NA
PERFORMED
Sunday-Saturday
METHODOLOGY
Gram Stain
TEST TURN AROUND TIME
<60 minutes for STAT orders.
24 hours for other samples.
CLINICAL USE AND
INTERPRETATION
Used as an aid in diagnosing infection.
COMMENTS
All CSF gram stains are read as STATS. Sensitivity of gram stain is approximately
10,000 CFU***/ml of fluid or per gram of tissue.
***CFU =Colony Forming Units
Revised 07/14.
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EAR CULTURE (INNER AND OUTER EAR)
EAR CULTURE OR
EAR CULTURE WITH GRAM STAIN
TEST NAME
EAR CULTURE (INNER AND OUTER EAR)
EAR CULTURE OR
EAR CULTURE WITH GRAM STAIN
SPECIMEN REQUIRED/
MINIMUM VOLUME
Sterile tube OR Aerobic Swab
Include anaerobic transport for aspirate and biopsy.
REJECTION CRITERIA
Delay in transport to Laboratory.
Submission in viral transport media.
TRANSPORT TIME/TEMP
1-4 hours, Room temperature
COLLECTION/TRANSPORT
COTAINER
Aerobic Swab
STABILITY
12 hours, Room temperature
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Saturday
METHODOLOGY
Culture or Gram stain with Culture.
Sensitivity performed on pathogens isolated.
TEST TURN AROUND TIME
1-3 days
CLINICAL USE AND
INTERPRETATION
Used for diagnosis of otitis externa and otitis media.
Normal skin flora: Coagulase negative staphylococcus, diphtheroids.
Common pathogens: Pseudomonas aeruginosa, Streptococcus pneumoniae,
Haemophilus influenzae, Moraxella catarrhalis.
COMMENTS
If aspirate or biopsy, use anaerobic transport system and transport. Throat or
nasopharyngeal cultures are not predictive of agents responsible for otitis media.
For otitis externa, vigorous swabbing is required since surface swabbing will miss
streptococcal cellulites.
Place additional order for anaerobic culture (AC) if required.
Revised 07/14.
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EYE – CONJUNCTIVA CULTURE
EYE CULTURE
EYE CULTURE WITH GRAM STAIN
TEST NAME
EYE – CONJUNCTIVA CULTURE
EYE CULTURE
EYE CULTURE WITH GRAM STAIN
SPECIMEN REQUIRED/
MINIMUM VOLUME
Conjunctiva or corneal scrapings
REJECTION CRITERIA
Swab other than aerobic swab
TRANSPORT TIME/TEMP
Swabs: 12 hours, Room temperature.
Plates: 30 minutes, Room temperature.
COLLECTION/TRANSPORT
CONTAINER
Aerobic swab (Mini-tip preferred)
STABILITY
24 hours, Room temperature
REPLICA LIMITS
None
PERFORMED
Sunday-Saturday
METHODOLOGY
Gram stain (if ordered)
Culture
TEST TURN AROUND TIME
1-3 days
CLINICAL USE AND
INTERPRETATION
Conjunctiva must be sampled to determine indigenous microflora. It is
generally recommended that swabs for culture be taken prior to anesthetic
application, whereas corneal scrapings should be obtained after anesthetic
application.
COMMENTS
Revised 07/14.
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FECAL OCCULT BLOOD
FECAL OCCULT BLOOD DIAGNOSTIC
FECAL OCCULT BLOOD IMMUNOLOGIC
TEST NAME
FECAL OCCULT BLOOD
FECAL OCCULT BLOOD DIAGNOSTIC
FECAL OCCULT BLOOD IMMUNOLOGIC
SPECIMEN REQUIRED/
MINIMUM VOLUME
Stool smear on card or inoculated into collection tube
REJECTION CRITERIA
Stool in preservative Immunologic sample received more than 15 days after
collection
TRANSPORT TIME/TEMP
48-72 hours, Room Temperature
COLLECTION/TRANSPORT
CONTAINER FECAL
OCCULT BLOOD
FECAL OCCULT BLOOD
SCREENING/DIAGNOSTIC
STABILITY
7 days, Room temperature
REPLICA LIMITS
1/day
PERFORMED
Sunday-Saturday
METHODOLOGY
Guaic or immunologic
TEST TURN AROUND TIME
1-3 days
CLINICAL USE AND
INTERPRETATION
Fecal occult blood and fecal occult blood screening can be used to detect
occult bleeding in both the upper and lower GI tract. These tests are prone to
false positive test from medications and diet if not carefully controlled.
COMMENTS
The fecal occult blood immunologic detects only occult bleeds in the colon and
is used to detect bleeding which will be related to colon cancer. This test is
specific for human hemoglobin and is not affected by the patient’s diet. For
outpatients label with name, date of birth and date of collection.
Revised 07/14.
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TEST/ TEST CODE
FUNGAL CULTURE
HAIR SKIN OR NAIL
HAIR SKIN, NAIL WITH KOH PREP
SPECIMEN REQUIRED/
MINIMUM VOLUME
Approximately 10 hairs
Skin: enough scrapings to cover the head of a thumbtack
Nail: 3-4 pieces of nail
REJECTION CRITERIA
Quantity not sufficient; swabs
TRANSPORT TIME/TEMP
24 hours, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Sterile Container
STABILITY
24 hours, Room temperature
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Saturday
METHODOLOGY
KOH direct examination (if ordered)
Fungal culture
TEST TURN AROUND TIME
1-4 weeks
CLINICAL USE AND
INTERPRETATION
Used for diagnosis of infections with dermatophytes and other fungi causing
human skin infections.
COMMENTS
Scales, if present, should be collected along with scrapings of active borders of
lesions. Note any antifungal therapy taken recently.
Revised 07/14.
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TEST/ TEST CODE
FUNGAL CULTURE
SPECIMEN OTHER THAN HAIR, SKIN, OR NAIL
SPCIMEN OTHER THAN HAIR, SKIN, NAIL WITH KOH PREP
SPECIMEN REQUIRED/
MINIMUM VOLUME
Body Fluids, CSF, Eye, Abscess/drainage, Sputum, Tissue, Bone Marrow
Urine
REJECTION CRITERIA
Quantity not sufficient; swabs
TRANSPORT TIME/TEMP
24 hours, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Sterile Container
STABILITY
24 hours, Room temperature
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Saturday
METHODOLOGY
Fungal Culture
KOH direct examination (if ordered)
Fungal culture
TEST TURN AROUND TIME
1-4 weeks
CLINICAL USE AND
INTERPRETATION
Used for diagnosis of fungal infections in a variety of specimen sources.
COMMENTS
Molds identified on routine bacterial culture are reflexed to Mycology for
identification.
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FUNGAL CULTURE, BLOOD
TEST NAME
FUNGAL CULTURE, BLOOD
SPECIMEN REQUIRED/
MINIMUM VOLUME
2 yellow SPS tubes, 3 ml draw, Total 2 ml required
REJECTION CRITERIA
Quantity not sufficient; swabs
TRANSPORT TIME/TEMP
24 hours, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Yellow SPS Vacutainer (Obtain from Microbiology Laboratory)
STABILITY
24 hours, Room temperature
REPLICA LIMITS
2/day/same source
CLINICAL USE AND
INTERPRETATION
Used for diagnosis of fungal infection of the blood stream.
COMMENTS
Bacterial isolates may also be recovered.
Revised 07/14.
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GASTRIC OCCULT BLOOD
TEST NAME
GASTRIC OCCULT BLOOD
SPECIMEN REQUIRED/
MINIMUM VOLUME
Gastric aspirate or emesis
REJECTION CRITERIA
15 minutes, Room temperature
TRANSPORT TIME/TEMP
24 hours, Refrigerate
COLLECTION/TRANSPORT
CONTAINER
Sterile Container
STABLITY
24 hours
REPLICA LIMITS
1/day
PERFORMED
Sunday-Saturday
METHODOLOGY
Gastrocult/Guaic
TEST TURN AROUND TIME
1-2 days
CLINICAL USE AND
INTERPRETATION
Used for diagnosis of occult bleeding in the stomach.
COMMENTS
Revised 07/14.
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GC SCREEN
TEST NAME
GC SCREEN
SPECIMEN REQUIRED/
MINIMUM VOLUME
Cervical, urethral, ocular or throat specimen submitted in aerobic culture swab
REJECTION CRITERIA
Delay in transport or refrigerated specimen
TRANSPORT TIME/TEMP
12-18 hours, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Aerobic swab (Use Mini-tip for male urethral)
STABILITY
18 hours, Room temperature
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Saturday
METHODOLOGY
Culture
TEST TURN AROUND TIME
1-3 Days
CLINICAL USE AND
INTERPRETATION
Used to screen for gonococcal infections.
COMMENTS
DO NOT REFRIGERATE. Amplified Probe recommended for urine, cervix,
and urethra.
Revised 07/14.
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GENITAL CULTURE / VAGINA, CERVIX, URETHRA, PROSTATE
GENITAL CULTURE GENITAL CULTURE WITH GRAM STAIN
TEST NAME
GENITAL CULTURE / VAGINA, CERVIX, URETHRA, PROSTATE
SPECIMEN REQUIRED/
MINIMUM VOLUME
Vaginal, cervical, urethral or prostate specimen
REJECTION CRITERIA
Refrigerated sample; specimen other than aerobic swab
TRANSPORT TIME/TEMP
12 hours, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Aerobic Swab
STABILITY
12 hours in aerobic swab
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Saturday
METHODOLOGY
Gram stain (if ordered)
GENITAL CULTURE GENITAL CULTURE WITH GRAM STAIN
Culture
TEST TURN AROUND TIME
1- 3 days
CLINICAL USE AND
INTERPRETATION
Used as an aid in diagnosis of vaginitis, cervicitis, urethritis and prostatitis.
COMMENTS
Includes evaluation for Neisseria gonorrhoeae, Group B beta streptococcus, Candida
albicans and Gardnerella vaginitis. Amplified probe for gonorrhea and Chlamydia is
recommended for cervix and urethra in lieu of culture.
Revised 07/14.
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GENITALCULTURE - FEMALE - BARTHOLIN, CUL-DE-SAC, ENDOMETRIUM, OVARIES, FALLOPIAN TUBE,
PLACENTA, IUD
GENITAL CULTURE GENITAL CUTURE WITH GRAM STAIN
TEST NAME
GENITAL CULTURE - FEMALE - BARTHOLIN, CUL-DE-SAC,
ENDOMETRIUM, OVARIES, FALLOPIAN TUBE, PLACENTA,UD
GENITAL CULTURE GENITAL CUTURE WITH GRAM STAIN
SPECIMEN REQUIRED/
MINIMUM VOLUME
Swab or aspirate in sterile container. Tissues and fluids are superior to swab
specimens.
REJECTION CRITERIA
Refrigerated specimen
TRANSPORT TIME/TEMP
2 hours, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Sterile container or Aerobic swab
STABILITY
2 hours, Room temperature
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Saturday
METHODOLOGY
Gram Stain (if ordered)
Culture
TEST TURN AROUND TIME
1-5 days
CLINICAL USE AND
INTERPRETATION
Used as an aid in diagnosis.
COMMENTS
Lochia should not be processed.
Viral, fungal, Mycoplasma and Ureaplasma must be ordered separately and will
require additional samples.
ANAEROBIC CULTURE: Order anaerobic culture in addition to genital culture if
anaerobes suspect.
Please Note: Bartholin gland, fallopian tube, IUD, ovary, placenta via C-section, and
endometrial aspiration are the only acceptable genital specimens for anaerobes.
Revised 07/14.
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GIARDIA LAMBLIA ANTIGEN / CRYPTOSPORIDIUM PARVUM ANTIGEN (PARASITE ANTIGEN)
TEST NAME
GIARDIA LAMBLIA ANTIGEN / CRYPTOSPORIDIUM PARVUM
ANTIGEN (PARASITE ANTIGEN)
SPECIMEN REQUIRED/
MINIMUM VOLUME
Stool in sterile container
REJECTION CRITERIA
Follow collection guidelines for Ova and Parasite exam. Fresh specimen in sterile cup
accepted if delivered to Lab within 1 hour of collection.
TRANSPORT TIME/TEMP
Fresh specimen accepted if delivered to Lab within 1 hour of collection for liquid stool
or two hours if soft or formed. Formalin PVA specimens also acceptable, Room
temperature Fresh 30 minutes – 1 hour.
COLLECTION/TRANSPORT
CONTAINER
Stool in Formalin vial + PVA vial
Formalin PVA vials
STABILITY
7 days, room temperature
REPLICA LIMITS
1/day
PERFORMED
Sunday-Saturday
METHODOLOGY
EIA
TEST TURN AROUND TIME
1-2 days
CLINICAL USE AND
INTERPRETATION
Use for detection of two common protozoan infections associated with diarrhea:
Giardia lamblia and Cryptosporidium parvum. Recommend at least two specimens to
rule out infection.
COMMENTS
Specimens saved for 7 days.
Revised 07/14.
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GROUP B BETA STREP SCREEN
GROUP B BETA STREP SCREEN WITH SENSITIVITY
TEST NAME
GROUP B BETA STREP SCREEN
GROUP B BETA STREP SCREEN WITH SENSITIVITY
SPECIMEN REQUIRED/ MINIMUM
VOLUME
Rectal vaginal swab collected at 35-37 weeks
REJECTION CRITERIA
Specimens submitted in viral transport media
TRANSPORT TIME/TEMP
12 hours, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Aerobic Swab
STABILITY
4 days, Room temperature
REPLICA LIMITS
1/day
PERFORMED
Sunday-Saturday
METHODOLOGY
Culture
TEST TURN AROUND TIME
1-3 Days
CLINICAL USE AND INTERPRETATION
Used to detect colonization with Group B strep in pregnant patients.
COMMENTS
Vaginal or cervical swab are not sufficient to detect carrier status.
Group B strep (Streptococcus agalactiae) is susceptible to penicillin and
ampicillin. Antimicrobial susceptibility testing is performed only upon
request in patients with Penicillin allergy.
Revised 07/14.
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Herpes simplex DETECTION by PCR (Replaces Herpes Culture)
TEST NAME
Herpes Simplex DETECTION by PCR (Replaces Herpes Culture)
SPECIMEN REQUIRED/
MINIMUM VOLUME
CSF, cervical, vaginal urethral specimen, skin lesion, ocular sample in M4-RT
REJECTION CRITERIA
Specimens submitted in transport media other than M4-RT
TRANSPORT TIME/TEMP
1 hour, Refrigerated
COLLECTION/TRANSPORT
CONTAINER
M4-RT Transport Medium
STABILITY
3 days, Refrigerated
REPLICA LIMITS
1/day/same source
PERFORMED
Monday-Friday
METHODOLOGY
Polymerase Chain Reaction
TEST TURN AROUND TIME
1-3 days
CLINICAL USE AND
INTERPRETATION
Used to diagnose Herpes Simplex I and II infections in a variety of sources.
COMMENTS
This test is performed at a reference laboratory.
Revised 07/14.
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INFLUENZA ANTIGEN (INFLUENZA A + B)
TEST NAME
INFLUENZA ANTIGEN (INFLUENZA A + B)
SPECIMEN REQUIRED/
MINIMUM VOLUME
Nasopharyngeal swab in M4- RT vial transport medium or saline
Nasopharyngeal aspirate
Nasopharyngeal washing
REJECTION CRITERIA
Specimen submitted in viral transport medium other than M4-RT
Specimen submitted without ice/room temperature
Specimen other than nasopharynx
TRANSPORT TIME/TEMP
<1 hour, cold
COLLECTION/TRANSPORT
CONTAINER
Chlamydia/Viral Transport Media (M4-Rt). Use Mini-Tip Swab only.
STABILITY
24 hours, Refrigerated
REPLICA LIMITS
1/day
PERFORMED
Sunday-Saturday
Performed as STAT for ER, LD Triage and Pediatrics patients
METHODOLOGY
Membrane EIA
TEST TURN AROUND TIME
1 hour -24 hours
CLINICAL USE AND
INTERPRETATION
Used to diagnose infection due to Influenza A and B viruses.
COMMENTS
Nasopharyngeal washes are the most sensitive specimens. Rapid influenza test will
not detect Novel Influenza virus infections such as those due to H1N1. Testing for
Novel influenza virus available thru MDCH^ or reference laboratory. Specimens
saved for 7 days in case additional testing is required.
^MDCH =Michigan Department of Community Health
Revised 07/14.
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KOH PREPARATION
KOH PREPARATION
TEST NAME
SPECIMEN REQUIRED/
MINIMUM VOLUME
Skin scrapings, hair, nail, respiratory fluid, or genital specimen.
REJECTION CRITERIA
Specimen QNS for testing. Some specimen sites submitted on swabs.
TRANSPORT TIME/TEMP
2 hours, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Sterile Container
STABILITY
24 hours, Room temperature
REPLICA LIMITS
1/day/same site
PERFORMED
Sunday-Saturday
METHODOLOGY
Direct Examination
TEST TURN AROUND TIME
24 Hours
CLINICAL USE AND
INTERPRETATION
Used for detection of fungus in keratinized samples.
COMMENTS
Revised 07/14.
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LEGIONELLA URINARY ANTIGEN
LEGIONELLA URINARY ANTIGEN
TEST NAME
SPECIMEN REQUIRED/
MINIMUM VOLUME
Urine, First morning
REJECTION CRITERIA
Specimen other than urine
TRANSPORT TIME/TEMP
2 hours, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Sterile Container
STABILITY
24 hours, Refrigerated
REPLICA LIMITS
1/day
PERFORMED
Sunday-Saturday
METHODOLOGY
Membrane EIA
TEST TURN AROUND TIME
24 hours
CLINICAL USE AND
INTERPRETATION
Used to detect soluble urinary antigen in patients infected with Legionella
pneumophila serogroup one. A positive result indicates infection with this
organism.
COMMENTS
This test detects only L. pneumophila serogroup 1. Legionella culture of
respiratory samples and Legionella PCR or serology should be ordered if the
urinary antigen test is negative and clinical history is suggestive of legionellosis
Revised 07/14.
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LEGIONELLA CULTURE
TEST NAME
LEGIONELLA CULTURE
SPECIMEN REQUIRED/
MINIMUM VOLUME
Acceptable specimens: Lung biopsies, pleural fluid, bronchial washings,
bronchial brushings, induced sputum and postmortem tissues. Culture of
expectorated/aspirated sputum is discouraged because yield is negligible.
REJECTION CRITERIA
Specimens other than those listed
TRANSPORT TIME/TEMP
1 hour, Room Temperature
COLLECTION/TRANSPORT
CONTAINER
Sterile Container
STABILITY
24 hours, Refrigerated
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Saturday
METHODOLOGY
Culture
TEST TURN AROUND TIME
7-14 days
CLINICAL USE AND
INTERPRETATIN
Used to detect Legionella species in a variety of respiratory specimens.
COMMENTS
Order Legionella urine antigen for rapid diagnosis of L. pneumophila
serogroup 1. This organism is difficult to culture. Consider Legionella PCR or
serology for diagnosis.
Revised 07/14.
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MALARIA SMEAR
TEST NAME
MALARIA SMEAR
SPECIMEN REQUIRED/
MINIMUM VOLUME
Blood, Minimum 2.0 ml collected when patient has fever spikes
REJECTION CRITERIA
Serum or anticoagulant other than EDTA.
TRANSPORT TIME/TEMP
6 hours, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Lavender (EDTA) Vacutainer
STABILITY
24 hours, Refrigerated.
REPLICA LIMITS
1/day
PERFORMED
Sunday-Saturday
METHODOLOGY
Thin and Thick film examination
TEST TURN AROUND TIME
1 -2 days
CLINICAL USE AND
INTERPRETATION
Used to detect infection with Plasmodium species. This test will also be used to
detect other blood parasites including: Trypanosomes, Leishmania, Microfilaria,
Babesia, and Ehrlichia.
COMMENTS
Slides should be made and stained within 1 hour of collection for best
visualization of Shuffner’s dots.
Revised 07/14.
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MRSA SCREEN
TEST NAME
MRSA SCREEN
SPECIMEN REQUIRED/
MINIMUM VOLUME
Nasal swab, skin, groin, urine sputum
REJECTION CRITERIA
Rayon swab; swab submitted in transport media other than Armies or Stuarts
TRANSPORT TIME/TEMP
1-12 hours, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Aerobic Swab
STABILITY
24 hours Room Temperature
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Saturday
METHODOLOGY
Culture screen
TEST TURN AROUND TIME
1-2 Days
CLINICAL USE AND
INTERPRETATION
Used to detect patients colonized with MRSA.
COMMENTS
Susceptibility is not reported for screening cultures.
Revised 07/14.
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MYCOPLASMA/ UREAPLASMA CULTURE
TEST/ TESTCODE
MYCOPLASMA/ UREAPLASMA CULTURE
SPECIMEN REQUIRED/
MINIMUM VOLUME
GENITAL MYCOPLASMA/UREAPLASMA: cervical or urethral swab;
RESPIRATORY SECRETIONS. Contact Laboratory for additional
specimen sources.
REJECTION CRITERIA
Specimens other than those listed above
Specimens submitted in transport media other than UTM%.
TRANSPORT TIME/TEMP
COLLECTION/TRANSPORT
CONTAINER
STABILITY
Refrigerate/keep cold
UTM or Sterile container
< 1 Day. Refrigerate after collection.
REPLICA LIMITS
1/day/ same source
PERFORMED
Sunday-Friday
METHODOLOGY
Culture
TEST TURN AROUND TIME
1-7 days
CLINICAL USE AND
INTERPRETATION
Used as in aid in diagnosis of non-specific cervicitis/urethritis.
COMMENTS
UTM=Universal Transport Medium
Revised 07/14.
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Neisseria gonorrhoeae PROBE
TEST NAME
Neisseria gonorrhoeae PROBE
SPECIMEN REQUIRED/
MINIMUM VOLUME
Cervix or urethral specimen on Aptima unisex swab.
REJECTION CRITERIA
Specimens submitted with white swab only, specimens submitted with
two swabs (white plus blue), specimens submitted with no swabs and
specimens submitted with swabs other than those supplied with the kit
will be rejected.
For urine, first void specimen is required. Clean catch mid-stream
specimens are not acceptable.
Ocular specimens are not acceptable.
TRANSPORT TIME/TEMP
1/day/same source
COLLECTION/TRANSPORT
CONTAINER
STABILITY
30 days, unisex swab 60 days in urine transport
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Friday
METHODOLOGY
Transcription mediated amplification
TEST TURN AROUND TIME
1-3 days
COLLECTION/TRANSPORT
CONTAINER
Used for diagnosis of genital tract infections due to Chlamydia
trachomatis.
CLINICAL USE AN
INTERPRETATION
For ocular specimens, order eye culture for detection of N.
gonorrhoeae.
COMMENTS
Revised 07/14.
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OVA AND PARASITE EXAM
TEST NAME
OVA AND PARASITE EXAM
SPECIMEN REQUIRED/
MINIMUM VOLUME
Stool, walnut sized piece if fresh. Ova and parasite collection vials, both filled
to line on vial
Parasite/worm for Identification
Duodenal aspirate
Urine, Sputum
REJECTION CRITERIA
Stool and Duodenal Aspirates, unpreserved received >-30 minutes after
collection
Specimens with barium, bismuth or other anti-diarrheal medications. Presence
of other compounds which will obscure parasites on microscopic exam
TRANSPORT TIME/TEMP
Unpreserved: 30-60 minutes, Room temperature
Preserved: 12 hours, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Formalin and PVA vials. Fill to line. Do not
overfill. Multiple collections will be used to fill vial
if necessary. Note date and time of collection on
each vial.
STABILITY
Unpreserved stool: 30-60 minutes, Room temperature.
Preserved stool: 7 days
Urine, sputum: 1 day, Refrigerated
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Saturday
METHODOLOGY
Microscopic Examination
TEST TURN AROUND TIME
1-3 days
CLINICAL USE AND
INTERPRETATION
COMMENTS
Giardia cryptosporidium performed as reflex test if no history provided. (Fall 2014)
Revised 07/14.
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PINWORM EXAMINATION
TEST NAME
PINWORM EXAMINATION
SPECIMEN REQUIRED/
MINIMUM VOLUME
Sticky paddle or scotch tape sample of area around anus. Collect specimen
during the night or first thing in the morning prior to bathing or using the toilet.
REJECTION CRITERIA
Specimens collected at times other than those recommended. Note:
Transparent tape must be used. Magic or other nontransparent tape is
unacceptable. If using scotch tape technique contact Microbiology for
instructions.
TRANSPORT TIME/TEMP
1 day, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Pinworm Paddle. Contact Laboratory
for instructions for scotch tape
technique.
STABILITY
3 days, Room temperature
REPLICA LIMITS
1/day
PERFORMED
Monday-Friday
METHODOLOGY
Direct Examination of scotch tape preparation or Pinworm paddle
TEST TURN AROUND TIME
1-2 Days
CLINICAL USE AND
INTERPRETATION
Used to diagnose infection with the pinworm (Enterobius vermicularis.)
COMMENTS
Pinworm cannot be reliably detected in stools samples. Ova and parasite exam
should not be ordered to rule out this parasite.
Revised 07/14.
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RAPID STREP SCREEN
TEST NAME
RAPID STREP SCREEN
SPECIMEN REQUIRED/
MINIMUM VOLUME
Throat swab
REJECTION CRITERIA
Specimen other than aerobic culture sab
TRANSPORT TIME/TEMP
2-24 hours, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Aerobic Swab
STABILITY
24 hours, Room Temperature
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Saturday
METHODOLOGY
Membrane Enzyme Immunoassay
TEST TURN AROUND TIME
1 hour - 1 day
CLINICAL USE AND
INTERPRETATION
Used for diagnosis of pharyngitis due to Group A beta streptococcus
(Streptococcus pharyngitis)
COMMENTS
Sensitivity is approximately 90%. American Academy of Pediatrics
recommends throat culture for pediatric patients negative in rapid strep A
antigen screens. Culture backup will be performed on negative rapid strep
screens.
Revised 07/14.
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RESPIRATORY CULTURE WITH GRAM STAIN BRONCHOALVEOLAR LAVAGE, BRONCIAL BRUSH
OR WASH OR TRACHEAL ASPIRATE
TEST NAME
RESPIRATORY CULTURE WITH GRAM STAIN
BRONCHOALVEOLAR LAVAGE, BRONCIAL BRUSH OR
WASH OR TRACHEAL ASPIRATE
SPECIMEN REQUIRED/
MINIMUM VOLUME
> 1ml sample
REJECTION CRITERIA
Delay in transport to Laboratory; leaking specimens
TRANSPORT TIME/TEMP
2 hours, Room temperature
COLLECTION/TRANSPORT
CONTAINER
*If mycobacterial cultures requested, at least required. See Acid Fast Culture.
Sterile Container
Lukens tube acceptable. Hand carry to lab if tubing attached.
Lukens samples with pneumatic tube transport cap (no tubing) can be
sent through the pneumatic tube system.
STABILITY
2 Hours, Room temperature
24 hours, Refrigerated
REPLICA LIMITS
None
PERFORMED
Sunday-Saturday
METHODOLOGY
Gram Stain with Culture
TEST TURN AROUND TIME
1-3 days
CLINICAL USE AND
INTERPRETATION
Use for diagnosis of lower respiratory tract infections.
COMMENTS
Fungal, AFB and viral cultures require additional orders and will require additional
samples. Specimens will be assessed for quality by gram stain. H. capsulatum and
B. dermatitidis survive for only short periods of time once a specimen is obtained.
Streptococcus pneumoniae, Haemophilus pneumoniae and Neisseria meningitidis
will not survive in refrigerated samples.
Revised 07/14.
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RESPIRATORY CULTURE WITH GRAM STAIN \
SPUTUM, EXPECTORATED
TEST NAME
RESPIRATORY CULTURE WITH GRAM STAIN \
SPUTUM, EXPECTORATED
SPECIMEN REQUIRED/
MINIMUM VOLUME
Sputum, >1 ml
REJECTION CRITERIA
Sputum with excessive oropharyngeal contamination by gram stain. Repeat
specimen and order will be requested.
TRANSPORT TIME/TEMP
2 hours, Room temperature (preferred)
24 hours, Refrigerated
COLLECTION/TRANSPORT
CONTAINER
Sterile Container
STABILITY
24 hours, Refrigerated
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Saturday
METHODOLOGY
Gram stain with Culture
TEST TURN AROUND TIME
1-3 days
CLINICAL USE AND
INTERPRETATION
Used for diagnosis of pneumonia bronchitis and other lower respiratory tract
infections due to bacterial agents.
COMMENTS
Fungal, acid fast and viral culture require additional orders and specimen.
Streptococcus pneumoniae, Haemophilus influenzae and Neisseria
meningitidis may not survive in refrigerated samples.
Revised 07/14.
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RESPIRATORY CULTURE WITH GRAM STAIN
SPUTUM, INDUCED
TEST NAME
RESPIRATORY CULTURE WITH GRAM STAIN
SPUTUM, INDUCED
SPECIMEN REQUIRED/
MINIMUM VOLUME
Sterile Container >
REJECTION CRITERIA
Delay in transport to Laboratory
TRANSPORT TIME/TEMP
2 hours, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Sterile Container
STABILITY
24 hours, Refrigerated
REPLICA LIMITS
1/day/ same source
PERFORMED
Sunday-Saturday
METHODOLOGY
Gram stain and Culture
TEST TURN AROUND TIME
1-3 days
CLINICAL USE AND
INTERPRETATION
Use for detection of lower respiratory tract specimens. Used in patients who
cannot produce specimen by coughing. Specimen of choice for detection of
Pneumocystis.
COMMENTS
H. capsulatum and B. dermatitidis survive for only short periods of time once a
specimen is obtained. Streptococcus pneumoniae, Haemophilus pneumoniae
and Neisseria meningitidis may not survive in refrigerated samples.
Revised 07/14.
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RESPIRATORY SCREEN
TEST NAME
RESPIRATORY SCREEN
SPECIMEN REQUIRED/ MINIMUM VOLUME
Nasal specimen for MRSA
Nasopharyngeal specimen for Group A strep, Neisseria
meningitidis or Bordetella pertussis
Throat swab for Corynebacterium diphtheriae, Neisseria
gonorrhoeae or Yeast
Specify organism in test order.
REJECTION CRITERIA
Specimens other than those described above
Delay in transport to Laboratory
TRANSPORT TIME/TEMP
12 hours, Room temperature
COLLECTION/TRANPORT CONTAINER
Aerobic swab for MRSA Group A strep, C.
diphtheriae, yeast and GC
Collect nasopharyngeal swab for Neisseria
meningitidis
See Bordetella pertussis Culture/PCR for
specimen collection requirements.
STABILITY
1/day/same source
REPLICA LIMITS
Anterior nose cultures are reserved for detecting
staphylococcal and streptococcal carriers or for nasal
lesions.
PERFORMED
Sunday-Saturday
METHODOLOGY
Culture
TEST TURN AROUND TIME
1-3 days
CLINICAL USE AND INTERPRETATION
Use to detect colonization of MRSA, Group A Strep and
Neisseria meningitidis in patients or contacts.
Used for detection of C. diphtheriae or B. pertussis in
symptomatic patients. Testing for both organisms is
referred to MDCH or Reference Laboratory.
COMMENTS
Revised 07/14.
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ROTAVIRUS ANTIGEN
TEST NAME
ROTAVIRUS ANTIGEN
SPECIMEN REQUIRED/
MINIMUM VOLUME
Stool, pea-walnut sized piece
REJECTION CRITERIA
Stool in preservative
Delay in transport
Unrefrigerated sample
TRANSPORT TIME/TEMP
Sterile Container
COLLECTION/TRANSPORT
CONTAINER
1-24 hours, Refrigerate or on ice
STABILITY
24 hours, Refrigerated
REPLICA LIMITS
1/day
PERFORMED
Sunday-Saturday
METHODOLOGY
Membrane EIA
TEST TURN AROUND TIME
1 day
CLINICAL USE AND
INTERPRETATION
Used to detect gastroenteritis due to Rotavirus.
COMMENTS
Most infections occur in the winter months and in children.
Revised 07/14.
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RSV ANTIGEN
TEST NAME
RSV ANTIGEN
SPECIMEN REQUIRED/
MINIMUM VOLUME
Nasopharyngeal swab in M4 RT, Nasopharyngeal aspirate or Nasopharyngeal
wash
REJECTION CRITERIA
Specimens submitted in transport media other than those approved
Patients >5 years of age
TRANSPORT TIME/TEMP
1-2 hours, Refrigerated or on ice
COLLECTION/TRANSPORT
CONTAINER
M4-RT transport medium or Saline
STABILITY
24 hours, Refrigerated
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Saturday
Performed as a STAT procedure for ER and in-house pediatric patients
METHODOLOGY
Membrane EIA for antigen detection
TEST TURN AROUND TIME
1 hour - 1 day
CLINICAL USE AND
INTERPRETATION
Used as an aid in respiratory tract infection due to Respiratory Synclinal virus in
children <= 5 years old.
COMMENTS
Methodology is approved for detection of RSV in young children. Alternate
methodology such as culture or DFA is recommended or detection of RSV in
older children and adults.
Revised 07/14.
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SPORE CHECK /STERILITY CULTURE
TEST NAME
SPORE CHECK /STERILITY CULTURE
SPECIMEN REQUIRED/
MINIMUM VOLUME
Attest Spore Ampoule, Spore strip or other spore indicator system
REJECTION CRITERIA
Attest or Spore strip submitted without control sample
TRANSPORT TIME/TEMP
1 - 2 days, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Attest Spore Ampoule or Spore Strips
STABILITY
1 - 2 days, Room temperature
REPLICA LIMITS
NA
PERFORMED
Sunday-Saturday
METHODOLOGY
Culture
TEST TURN AROUND TIME
2 days
CLINICAL USE AND
INTERPRETATION
Used to verify proper functioning of autoclave.
COMMENTS
If control vial/ test is positive, sterility has not been achieved. Recall/ re-sterilization
should be performed and the spore test repeated.
Revised 07/14.
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STOOL CULTURE
TEST NAME
STOOL CULTURE
SPECIMEN REQUIRED/
MINIMUM VOLUME
Stool pea-walnut sized piece, unpreserved. Stool to fill line in preservative vial.
REJECTION CRITERIA
Stool, unpreserved > 4 hours after collection
Rectal swab
Stool, preserved > 48 hour delay to lab
Stool in fixative such as Formalin
TRANSPORT TIME/TEMP
COLLECTION/TRANSPORT
CONTAINER
STABILITY
1-2 Hours, Room temperature, unpreserved
Sterile Container or Enteric Plus Transport
48 hours, Room temperature in preservative
1 - 2hours, Room temperature unpreserved
24 Hours, Refrigerated
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Saturday
METHODOLOGY
Culture
TEST TURN AROUND TIME
2-3 days
CLINICAL USE AND
INTERPRETATION
Used as an aid in diagnosis of bacterial gastroenteritis.
COMMENTS
Stool culture will be rejected for patients hospitalized for > 3 days. Clostridium difficile
is most commonly responsible for diarrhea in these patients. Rectal swab reserved
for detecting GC, Shigella, HSV, and anal carriage of S. pyogenes OR for patients
unable to pass a stool specimen. Detects Salmonella, Shigella, Campylobacter and
Enterohemorrhagic E. Coli. Notify Microbiology if Yersinia, Vibrio or other pathogens
suspected.
Revised 07/14.
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THROAT FOR GROUP A STREP
TEST NAME
THROAT FOR GROUP A STREP
SPECIMEN REQUIRED/
MINIMUM VOLUME
Throat swab
REJECTION CRITERIA
Specimen other than aerobic culture swab; dry swab
TRANSPORT TIME/TEMP
2 - 24 hours, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Aerobic Swab
STABILITY
24 hours, Room temperature
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Saturday
METHODOLOGY
Culture
TEST TURN AROUND TIME
1-2 days
CLINICAL USE AND
INTERPRETATION
Use to detect bacterial pharyngitis due to Group A beta streptococci.
COMMENTS
Sensitivity of culture for Group A Strep: Good Specimen = 90% Poor Specimen =
30%
Throat cultures are contraindicated for patients with an inflamed epiglottis.
Note: Throat Specimens are routinely processed for the recovery of beta-hemolytic
streptococci only. Antimicrobial susceptibility tests are not performed on bacterial
isolates from throat cultures unless specifically requested due to penicillin allergy. If
organisms other than beta-hemolytic streptococci are suspected, the laboratory must
be notified.
Notify Microbiology if special agents of pharyngitis are suspected: Yeast,
Arcanobacterium haemolyticum, Corynebacterium diphtheriae, Vincent’s angina.
If ordering Rapid strep screen plus throat culture, submission of a dual swab is
optimal.
Revised 07/14.
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TISSUE CULTURE
TISSUE CULTURE
TISSUE CULTURE WITH GRAM STAIN
TEST NAME
TISSUE CULTURE
TISSUE CULTURE
TISSUE CULTURE WITH GRAM STAIN
SPECIMEN REQUIRED/
MINIMUM VOLUME
Piece of tissue
REJECTION CRITERIA
Delay in transport >2 hours
Specimens submitted on swabs
Specimens submitted in preservatives such as Formalin or alcohol.
TRANSPORT TIME/TEMP
2-4 hours, Room temperature for bacterial and mycobacterial agents. For viral
agents, refrigerate 72 hours.
COLLECTION/TRANSPORT
CONTAINER
Sterile Container
STABILITY
2 - 4 hours, Room temperature
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Saturday
METHODOLOGY
Gram Stain (if ordered)
Culture
TEST TURN AROUND TIME
3 days
CLINICAL USE AND
INTERPRETATION
Used as an aid in diagnosis of infection in a variety of tissues and organs.
COMMENTS
Always submit as much tissue as possible. NEVER submit a swab that has
simply been rubbed over the surface.
Specimens submitted in formalin are unacceptable for culture.
Revised 07/14.
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TISSUE CULTURE QUANTITATIVE
TEST NAME
TISSUE CULTURE QUANTITATIVE
SPECIMEN REQUIRED/
MINIMUM VOLUME
Piece of tissue, 0.5 mL2 gm minimum, 0.5 mL5 grams or greater preferred
REJECTION CRITERIA
Delay in transport to Laboratory > 1 Hour
TRANSPORT TIME/TEMP
1 hour, Room Temperature. CONTACT MICROBIOLOGY PRIOR TO
SUBMISSION.
COLLECTION/TRANSPORT
CONTAINER
Sterile Container. DO NOT ADD FIXATIVES OR
PRESERVATIVES.
STABILITY
1-2 hours, Room temperature
Specimen in preservatives
4 hours, Refrigerated
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Saturday
METHODOLOGY
Culture
TEST TURN AROUND TIME
3 days
CLINICAL USE AND
INTERPRETATION
Used as in aid in diagnosis of infection, especially with skin grafts and burn
sites.
COMMENTS
Always submit as much tissue as possible. NEVER submit a swab that has
simply been rubbed over the surface.
Specimens submitted in formalin are unacceptable for culture.
Revised 07/14.
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URINE CULTURE
TEST NAME
URINE CULTURE
SPECIMEN REQUIRED/
MINIMUM VOLUME
Clean-catch, indwelling catheter, pediatric urine collection, straight catheter,
suprapubic or cystoscopic. Indicate method of collection.
REJECTION CRITERIA
Unpreserved urine at room temperature > 2 hours
Refrigerated, Unpreserved urine> 2 hours
Urine in gray top preservative >48 hours
Urine previously processed for urinalysis
TRANSPORT TIME/TEMP
Unpreserved: 2 hours, Room temperature
Preserved (gray top): 48 hours
COLLECTION/TRANSPORT
CONTAINER
STABILITY
BD Vacutainer Collection Gray top for Culture OR Sterile container
Unpreserved: 2 hours, Room temperature
Unpreserved: 24 hours, Refrigerated
Gray top Preserved: 48 hours, Room temperature
REPLICA LIMITS
1/day/same source/same method of collection
PERFORMED
Sunday-Saturday
METHODOLOGY
Culture with colony count
TEST TURN AROUND TIME
1-3 days.
CLINICAL USE AND
INTERPRETATION
Used as an aid in diagnosis of urinary tract infections.
COMMENTS
Urine taken directly from a Foley catheter bag is not acceptable.
Collect suprapubic urine and submit order for urine culture plus anaerobic
culture when anaerobic UTI is suspected.
Revised 07/14.
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VAGINITIS SCREEN
TEST NAME
VAGINITIS SCREEN
SPECIMEN REQUIRED/
MINIMUM VOLUME
Vaginal swab or secretions collected on Affirm swab
REJECTION CRITERIA
Specimens other than vaginal specimens
Specimens submitted with swabs other than the AFFIIRM swab
TRANSPORT TIME/TEMP
1 - 7 hours, Room Temperature
COLLECTION/TRANSPORT
CONTAINER
Affirm Collection Kit
STABILITY
72 hours, Room temperature when preservative is added
1 hour, Room temperature for unpreserved specimens
REPLICA LIMITS
1/day
PERFORMED
Sunday-Saturday
Specimens from ER & LD Triage performed as STATS
METHODOLOGY
AFFIRM Molecular Probe
TEST TURN AROUND TIME
1 hour- 1 day
CLINICAL USE AND
INTERPRETATION
Used as an aid in diagnosis of vaginitis due to Trichomonas vaginalis, Gardnerella
vaginalis and Candida species.
COMMENTS
Specimen collection kits available for Microbiology/Laboratory.
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Revised 07/14.
VIRAL CULTURE
TEST NAME
VIRAL CULTURE
SPECIMEN REQUIRED/
MINIMUM VOLUME
Throat, nasopharyngeal swab, nasopharyngeal aspirate or wash, bronchial
washings, Broncho alveolar lavage, CSF, body fluids, Urine, Stool, Tissues,
Swabs, Blood
REJECTION CRITERIA
Specimens other than those sited; improper transport medium; dry swabs
TRANSPORT TIME/TEMP
1 - 4 Hours, Refrigerated
COLLECTION/TRANSPORT
CONTAINER
M4-RT Transport Media
STABILITY
Variable, most 1 day, Refrigerated
REPLICA LIMITS
1/day/same source
PERFORMED
Sunday-Friday
METHODOLOGY
Rapid shell vial or viral culture, DFA, PCR, variable with virus
TEST TURN AROUND TIME
1-7 days
CLINICAL USE AND
INTERPRETATION
Used for diagnosis of a variety of viral infections.
COMMENTS
See Visual Aids portion of manual for specimen selection for viral diagnosis.
Revised 07/14.
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WOUND CULTURE
TEST NAME
WOUND CULTURE
SPECIMEN REQUIRED/
MINIMUM VOLUME
Cellulitis, oral abscess, open or closed abscess, decubitus ulcer
GRAM STAIN IS PERFORMED ON ALL WOUND/ABSCESS SPECIMENS.
REJECTION CRITERIA
Capped Luer-tip Syringe OR Sterile Tube OR Swab Transport OR Anaerobic
Swab
TRANSPORT TIME/TEMP
2 hours, Room temperature
COLLECTION/TRANSPORT
CONTAINER
Aerobic swab
STABILITY
12-18 Hours, Room Temperature
REPLICA LIMITS
None
PERFORMED
Sunday-Saturday
METHODOLOGY
Gram Stain with Culture
TEST TURN AROUND TIME
1- 5 days
CLINICAL USE AND
INTERPRETATION
Used for diagnosis of wound and abscess infections.
COMMENTS





Cellulitis: Yield of potential pathogens is only 25-35 % (when aspirates,
blood cultures and skin biopsies have been obtained.)
A decubitus swab provides little clinical information and its collection should
be discouraged; tissue biopsy or needle aspirates are the specimens of
choice.
Periodontal lesions should be processed only by reference laboratories
equipped to provide specialized techniques for the detection and
enumeration of specific agents.
Sampling of superficial tissue for bacterial is discouraged; tissue Biopsy or
needle aspirates are specimens of choice.
Anaerobic culture requires separate order and anaerobic transport swab.
Revised 07/14.
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