Microsoft word - dlo final september 2012 qls lab update.doc

Table of Contents

Summary of Test Changes . 3

New Test Offerings . 4

Test Changes . 5
Plasminogen Activator Inhibitor-1 (PAI-1) 4G/5G . 12 Herpesvirus 7 IgG and IgM Antibody Panel, IFA . 12 The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the bil ing party. Please direct any questions regarding coding to the payor being bil ed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.
Redirects .14

Discontinued Tests.15
Ristocetin Cofactor with Reflex to von Wil ebrand Factor Activity (ELISA) . 15 Summary of Test Changes
perature
tability
nalytic Tim
Test Name
ejection C
eference R
ethodology
ther (see listing)
Transport Tem
New Test Offerings
The fol owing tests wil be available through Quest Diagnostics on the dates indicated MSH6 Gene Deletion or Duplication
Clinical Significance:
This assay detects large deletions/duplications in the MSH6 gene in HNPCC patients. It can be used as part of the molecular diagnostic workup in HNPCC patients. It can also be used to detect familial large deletions/duplications in relatives of HNPCC Effective Date:
October 8, 2012
83891; 83900; 83901 (x16); 83909; 83912, or 81300*
*The 2012 AMA CPT codebook contains Tier 1 and Tier 2
Molecular Pathology Procedures as well as Molecular
Pathology Procedures to be coded by procedure rather than
analyte. Please direct any questions regarding coding to the
payor being billed.
Specimen Requirements: 5 mL whole blood collected in an EDTA (purple-top) tube with
sodium metabisulfite
Whole blood: normal phlebotomy procedure. Specimen
stability is crucial. Store and ship ambient immediately. Do
not freeze.
Room temperature
Room temperature and Refrigerated: 8 days
Frozen: Unacceptable
Accompanies report
Semi-quantitative Fluorescent PCR
Quest Diagnostics Nichols Institute, San Juan Capistrano
Test Changes
The fol owing test changes wil be effective on the dates indicated below. Please note that only the information that is changing appears in this update. Former test codes and test names have been italicized. Bordetella pertussis/parapertussis
Effective Date:
October 8, 2012
Gel Amies
Quest Diagnostics Nichols Institute Focus Diagnostics, Inc. Aluminum
Effective Date:
October 15, 2012
Draw one royal blue top tube of blood and discard. Draw
second royal blue top tube. Allow to clot in an upright
position. Centrifuge and pour (do not pipette) the serum or
plasma into an acid washed or metal-free vial.
Dialysis Patient: < 40 mcg/L
Inductively-Coupled Plasma/Mass Spectrometry
This test previously performed at Quest Diagnostics Nichols
Institute, San Juan Capistrano will now be performed at
Quest Diagnostics Nichols Institute, Valencia.
Arsenic, Blood
Effective Date:
October 15, 2012
Specimen Requirements: 4 mL whole blood col ected in an EDTA (royal blue-top) tube (2
mL minimum) preferred. Sodium heparin (royal blue-top tube) is
Collection Instructions: Carefully clean skin prior to
venipuncture. Avoid worksite collection. Avoid seafood
consumption for 48 hrs prior to sample collection.
Room temperature and Refrigerated: 10 days
Frozen: Unacceptable
This test previously performed at Quest Diagnostics Nichols
Institute, San Juan Capistrano will now be performed at
Quest Diagnostics Nichols Institute, Valencia and Chantil y
Please note this test is included in the fol owing group code: Bismuth, Blood
Effective Date:
October 15, 2012
Specimen Requirements: 4 mL whole blood col ected in an EDTA (royal blue-top) tube (2 mL minimum). Sodium heparin (royal blue-top) tube is
acceptable.
Collection Instructions: Avoid taking bismuth preparations
such as Pepto-Bismol for at least 1 week prior to collection
Gross hemolysis, Clotted
Refrigerated
Room temperature: 48 hours
Refrigerated: 7 days
Frozen: Unacceptable
Nonexposed: <0.5 mcg/L
Therapeutic: 4-30 mcg/L
Toxic: > 50 mcg/L
This test previously performed at Quest Diagnostics Nichols
Institute, San Juan Capistrano will now be performed at
Quest Diagnostics Nichols Institute, Valencia
Cadmium, Blood
Effective Date:
October 15, 2012
Specimen Requirements: 4 mL whole blood collected in an EDTA (royal blue-top) tube
(2 mL minimum). Sodium heparin (royal blue-top) tube is
Collection Instructions: Avoid worksite collection.
Phlebotomist should wear powderless gloves.
Room temperature, Refrigerated and Frozen: 14 days
Adults, Non-Smokers: < or = 1.7 mcg/L
Adults, Smokers: < or = 5.0 mcg/L
OSHA Reference Range: < or = 5.0 mcg/L
Toxic Concentration: Early signs of toxicity have been
observed at 30 mcg/L
This test previously performed at Quest Diagnostics Nichols
Institute, San Juan Capistrano will now be performed at
Quest Diagnostics Nichols Institute, Valencia and Chantil y
Please note this test is included in the fol owing group code: Chromium, Blood
Effective Date:
October 15, 2012
Specimen Requirements: 4 mL whole blood col ected in an EDTA (royal blue-top) tube (0.7 mL minimum)
Collection Instructions: Patient should refrain from taking
mineral supplements and multivitamin three days before
specimen collection. To avoid contamination, use powderless
gloves. Draw one royal blue top tube of blood and discard.
Draw second royal blue top tube, label tube with patient
This test previously performed at Quest Diagnostics Nichols
Institute, San Juan Capistrano will now be performed at
Quest Diagnostics Nichols Institute, Valencia and Chantil y
The fol owing test code is also affected: Chromium, Plasma
Effective Date:
October 15, 2012
Specimen Requirements: 2 mL plasma col ected in an EDTA (royal blue-top) tube (1 mL minimum). Sodium heparin (royal blue-top) tube is acceptable.
Collection Instructions: Draw one royal blue-top tube of
blood and discard. Draw second royal blue-top tube.
Centrifuge and pour (do not pipette) the plasma into a metal-
free tube.
Current reject criteria will be removed
Room temperature: 5 days
Refrigerated: 10 days
Frozen: 21 days
Inductively-Coupled Plasma/Mass Spectrometry
This test previously performed at Quest Diagnostics Nichols
Institute, San Juan Capistrano will now be performed at
Quest Diagnostics Nichols Institute, Valencia
Chromium, Serum
Effective Date:
October 15, 2012
Specimen Requirements: 2 mL serum col ected in no additive (royal blue-top) tube (1 mL Draw one royal blue-top tube of blood and discard. Draw
second royal blue-top tube. Allow blood to clot in an upright
position. Centrifuge and pour (do not pipette) the serum into
a metal-free tube
Current reject criteria will be removed
Room temperature: 5 days
Refrigerated: 10 days
Frozen: 21 days
Inductively-Coupled Plasma/Mass Spectrometry
This test previously performed at Quest Diagnostics Nichols
Institute, San Juan Capistrano will now be performed at
Quest Diagnostics Nichols Institute, Valencia and Chantil y
Cobalt, Blood
Effective Date:
October 15, 2012
Specimen Requirements: 4 mL whole blood col ected in an EDTA (royal blue-top) tube (2 mL minimum). Sodium heparin (royal blue-top) tube is
acceptable.
Collection Instructions: Avoid worksite collection. To avoid
contamination, use powderless gloves. Do not aliquot
specimens. Patient should refrain from taking mineral
supplements, vitamin B12, or vitamin B complex three days
before specimen collection.
Current reject criteria will be removed
This test previously performed at Quest Diagnostics Nichols
Institute, San Juan Capistrano will now be performed at
Quest Diagnostics Nichols Institute, Valencia and Chantil y
The fol owing test code is also affected: Copper
Effective Date:
October 15, 2012
Specimen Requirements: 2 mL serum col ected in a no additive (royal blue-top) trace element tube preferred (0.7 mL minimum). 2 mL plasma col ected in an EDTA or Sodium heparin (royal
blue-top) tube (0.7 mL minimum)
Separate serum or plasma from cells within two hours.
Transfer separated serum/plasma to a plastic acid washed or
metal free vial. Alternately, transfer separated serum or
plasma to a second non-additive royal blue-top tube for
transport.
Hemolysis; serum or plasma not separated from cells;
samples submitted in non-trace metal or non acid washed
containers.
This test previously performed at Quest Diagnostics Nichols
Institute, San Juan Capistrano will now be performed at
Quest Diagnostics Nichols Institute, Valencia and Chantil y
Heavy Metals Panel, Blood
Effective Date:
October 15, 2012
Specimen Requirements: 4 mL whole blood collected in an EDTA (royal blue-top) tube.
Sodium heparin (royal blue-top) tube is acceptable.
Collection Intsructions: Carefully clean skin prior to
venipuncture. Avoid worksite collection. Avoid seafood
consumption for 48 hrs prior to sample collection
Room temperature: 5 days
Refrigerated: 7 days
Frozen: Unacceptable
Arsenic: < 23 mcg/L
Whole Blood Arsenic level >100 mcg/L is indicative of
acute/chronic exposure. Urine is usual y the best specimen for
the analysis of arsenic in body fluids. Blood levels tend to be low even when urine concentrations are high. Mercury: < or = 10 mcg/L
Lead: Birth to 6 years: <5 mcg/dL
Blood lead levels in the range of 5-9 mcg/dL have been associated with adverse health effects in children aged 6 years Patient management varies by age and CDC Blood Lead Level Refer to the CDC website regarding Lead Publications/Case Management for recommended interventions. This test previously performed at Quest Diagnostics Nichols
Institute, San Juan Capistrano will now be performed at
Quest Diagnostics Nichols Institute, Valencia and Chantil y
Lead, Blood (OSHA)
Effective Date:
October 15, 2012
Specimen Requirements: 3 mL whole blood collected in a K2 EDTA (tan-top) tube (0.5
mL minimum) Sodium heparin lead-free (tan-top), EDTA (royal
blue-top) and Sodium heparin (royal blue-top) tubes are
acceptable.
Collection Instructions: Collection material such as alcohol
swabs should be lead-free. Avoid work site collection.
Room temperature: 5 days
Refrigerated: 14 days
Frozen: 60 days
Industrial Exposure: <40 mcg/dL
mcg/dL = mcg/100g for OSHA
(Refer to current governmental regulations for exposure
criteria.)
Atomic Spectroscopy/Inductively-Coupled Plasma/Mass
Spectrometry
This test previously performed at Quest Diagnostics Nichols
Institute, San Juan Capistrano will now be performed at
Quest Diagnostics Nichols Institute, Valencia and Chantil y.
Manganese
Effective Date:
October 15, 2012
Specimen Requirements: 2 mL serum col ected in a no additive (royal blue-top) tube (0.7
mL minimum).
2 mL plasma col ected in an EDTA (royal blue-top) or Sodium
heparin (royal blue-top) tube is acceptable (0.7 mL minimum).
Sodium heparin lead-free (tan top) tube is unacceptable.
Collection Instructions: Carefully clean skin prior to
venipuncture. Avoid hemolysis. Avoid worksite collection.
For serum samples, blood may be drawn into royal blue-top
evacuated tube without additive, allow to clot and centrifuge
within 4 hours of collection. Pour off plasma/serum into an
acid washed metal free tube for transportation. Use
powderless gloves. For plasma samples, follow the above
instructions except the sample does not go through the
clotting process.
Hemolysis; Sodium heparin lead-free (tan-top) tube
Room temperature: 7 days
Refrigerated: 30 days
Frozen: 60 days
Inductively-Coupled Plasma/Mass Spectrometry
This test previously performed at Quest Diagnostics Nichols
Institute, San Juan Capistrano will now be performed at
Quest Diagnostics Nichols Institute, Valencia
Manganese, Blood
Effective Date:
October 15, 2012
Specimen Requirements: 2 mL whole blood collected in an EDTA (royal blue-top) tube
(1 mL minimum). Sodium heparin (royal blue-top) tube is
acceptable. Sodium heparin lead-free (tan top) tube is
unacceptable.
Collection Instructions: Carefully clean skin prior to
venipuncture. Avoid worksite collection
Sodium heparin lead-free (tan-top) tube
Refrigerated
Room temperature: 4 hours
Frozen: 60 days
7-16 mcg/L
This test previously performed at Quest Diagnostics Nichols
Institute, San Juan Capistrano will now be performed at
Quest Diagnostics Nichols Institute, Valencia
Mercury, Blood
Effective Date:
October 15, 2012
Specimen Requirements: 4 mL whole blood collected in an EDTA (royal blue-top) tube
(2 mL minimum).
Collection Instructions: Carefully clean skin prior to
venipuncture. Avoid worksite collection. Avoid seafood
consumption for 48 hrs prior to sample collection.
Room temperature: 5 days
Refrigerated: 7 days
Frozen: Unacceptable
This test previously performed at Quest Diagnostics Nichols
Institute, San Juan Capistrano will now be performed at
Quest Diagnostics Nichols Institute, Valencia and Chantil y
Please note this test is included in the fol owing group code: Thallium, Blood
Effective Date:
October 15, 2012
Specimen Requirements: 4 mL whole blood col ected in an EDTA (royal blue-top) tube (2 mL minimum). Sodium heparin (royal blue-top) tube is
acceptable.
Collection Instructions: Carefully clean skin prior to
venipuncture. Avoid worksite collection.
Current reject criteria will be removed
This test previously performed at Quest Diagnostics Nichols
Institute, San Juan Capistrano will now be performed at
Quest Diagnostics Nichols Institute, Valencia
Zinc
Effective Date:
October 15, 2012
Specimen Requirements: 2 mL plasma collected in an EDTA (royal blue-top) tube (0.7
mL minimum). 2 mL serum col ected in a no additive (royal blue-
top) tube is acceptable (0.7 mL minimum). Collection Instructions: Separate plasma or serum from cells
within two hours. Transfer separated plasma/serum to a
plastic acid washed or metal free vial. Alternately, transfer
separated plasma or serum to a second non-additive royal
blue-top tube for transport.
Hemolysis; Plasma/Serum not separated from cells within 2
hours; samples submitted in non-trace metal or non acid
washed containers.
Inductively-Coupled Plasma/Mass Spectrometry
This test previously performed at Quest Diagnostics Nichols
Institute, San Juan Capistrano will now be performed at
Quest Diagnostics Nichols Institute, Valencia and Chantil y
Plasminogen Activator Inhibitor-1 (PAI-1) 4G/5G
Effective Date:
October 22, 2012
83891, 83900, 83909, 83912 or 81400*
*The 2012 AMA CPT codebook contains Tier 1 and Tier 2
Molecular Pathology Procedures as well as Molecular
Pathology Procedures to be coded by procedure rather than
analyte. Please direct any questions regarding coding to the
payor being billed.
Polymerase Chain Reaction
Quest Diagnostics Nichols Institute, San Juan Capistrano
Herpesvirus 7 IgG and IgM Antibody Panel, IFA
Effective Date:
October 29, 2012
Room temperature
Room temperature: 7 days
Refrigerated: 14 days
Frozen: 30 days
IgG <1:320
Laboratory Developed Test
Herpesvirus 8 IgG Antibody, IFA
Effective Date:
October 29, 2012
Room temperature
Room temperature: 7 days
Refrigerated: 14 days
Frozen: 30 days
Laboratory Developed Test
Redirects
Effective October 22, 2012 the fol owing test performed at Athena Diagnostics wil now also be performed at Quest Diagnostics, Nichols Institute, San Juan Capistrano. SMA Diagnostic Test
Effective Date:
October 22, 2012
Specimen Requirements: 4mL whole blood col ected in EDTA (lavender-top) tube. For prenatal diagnosis with a fetal specimen:
1) parents must be documented carriers of one of the
mutations tested;
2) maternal blood or DNA must be available to rule out
maternal cell contamination (order test code 10262);
3) contact the laboratory genetic counselor before
submission.
Amniotic Fluid: Normal collection procedure. Specimen
stability is crucial. Store and ship ambient immediately. Do
not refrigerate or freeze.
Amniocyte culture: Two sterile T25 flasks, filled with culture
medium. Specimen stability is crucial. Store and ship ambient
immediately. Do not refrigerate or freeze.
Dissected chorionic villus (CVS) biopsy: 10-20 mg dissected
chorionic villi collected in sterile tube filled with sterile
culture medium or two sterile T25 flasks. Specimen stability
is crucial. Store and ship ambient immediately. Do not
refrigerate or freeze.
Accompanies Report
This test performed at Athena Diagnostics will now also be
performed at Quest Diagnostics Nichols Institute, San Juan
Capistrano
Discontinued Tests
Bovine Thrombin Inhibitor Panel
Effective Date:
October 8, 2012
Mixed Feathers (EX71) IgE
Effective Date:
October 8, 2012
• 2539 - Al ergen (IgE), ImmunoCap- Turkey Feathers Maprotiline
Effective Date:
October 15, 2012
Propranolol (Inderal)
Effective Date:
October 15, 2012
Trimipramine (Surmontil)
Effective Date:
October 15, 2012
Strontium, Blood
Effective Date:
October 15, 2012
Ristocetin Cofactor with Reflex to von Willebrand Factor Activity (ELISA)
Effective Date:
October 22, 2012
von Willebrand Factor Activity
Effective Date:
October 22, 2012

Source: http://www.dlolab.com/sites/dlo2/uploads/documents/lab_updates/2012/DLO-SEPTEMBER-2012-LAB-UPDATE.pdf