GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
UPDATED 11/15/10
Test NameGHS
CODESpecimen Type CPT
17-Hydroxyprogesterone, neonatal is in test description test code in Sunquest is 17654
17HP
RED.Separate serum after clotting and spinning. Refrigerated.
83498
ABO-Rh Type (including Du) ABRHRED. 1 LAVENDER OR PINK. Refrigerated.
86900
Acetaminophen ACETGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
82003
Acetone ACESGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
82009
Aerobic Wound Culture AWD
CULTURETTE (crush ampule/ provide specimen source/site) Room Temperature.
87070
Albumin ALBGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
82040
Alcohol (ETOS) chain of custody
ETOS
GRAY: Use Betadine to clean venipuncture site. Follow chain of custody collection procedure. Refrigerated.
82055
Alcohol (ETOH) medical nonchain of custody
ETOHGRAY: Use Betadine to clean venipuncture site. Refrigerated.
82055nonchain of custody venipuncture site. Refrigerated.
Adrenocorticotrophic Hormone ACTH
LAVENDER. Centrifuge and separate plasma specimens from cells. Transfer 1.5 mLs to a plastic, transport tube. Label Sample with "Plasma" sticker. Do not thaw. Frozen.
82024
Aldolase ALDGOLD, RED OR SPECKLED. Refrigerated.
82085
Aldosterone ALDSGOLD, RED OR SPECKLED. Refrigerated.
82088
Alkaline Phosphatase APGOLD, RED OR SPECKLED. Refrigerated.
84080
Alpha 1 Antitrypsin A1ATGOLD, RED OR SPECKLED. Refrigerated.
82103
Alpha 1 Acid Glycoprotein A1AGGOLD, RED OR SPECKLED. Refrigerated.
82985
Alphafetoprotein AFPT, tumor marker
AFPTGOLD,RED OR SPECKLED. Refrigerated.
82105
Page 1
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Alphafetoprotein AFP, Maternal pregnancy screen2.0
AFP
GOLD, RED OR SPECKLED SEND 3.0 (1.5 MIN) mL serum FROZEN. Icteric or grossly hemolyzed specimens are not acceptable. Split serum into two tubes. Must include gestational age, LMP, weight, race, insulin dependent, number of fetuses and initial or repeat screening. Call Lab for Gestational worksheet: 678.312.4731.
82105
Alphafetoprotein AFP, Maternal pregnancy screen, Triple screen
AFP3
AFPS
GOLD, RED OR SPECKLED SEND 3.0 (1.5 MIN) mL serum FROZEN. Icteric or grossly hemolyzed specimens are not acceptable. Split serum into two tubes. Must include gestational age, LMP, weight, race, insulin dependent, number of fetuses and initial or repeat screening. Call Lab for Gestational worksheet: 678.312.4731.
82105, 82677, 84702
Ammonia GREEN place on ice and tranport to Ammonia (Not recommended for off site collection, as testing must be performed within 30 minutes)
AMM
GREEN place on ice and tranport to Laboratory within 30 min. Refrigerated.Do not freeze.
82140
Amylase, 24 hr. Urine A24
24 HOUR URINE CONTAINER/ NO PRESERVATIVE. 24 hour Urine collection. Refrigerate during collection.
82150
Amylase, Serum AMYGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
82150
ANA positive/negative only ANAGOLD, RED OR SPECKLED. Refrigerated.
86038
ANA with Reflex AANAGOLD, RED OR SPECKLED. Refrigerated.
86038
Anaerobic Wound Culture ANWD
PORT-A-CUL AND CULTURETTE. Requires two swabs: 1 submitted in Culturette *AND* 1 swab placed in anaerobic (Port-a-cul) transport media. Room Temperature.
87075
Page 2
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Anafranil (aka Clominpramine aka Placil)
CLPN
LAVENDER (plasma), DARK NAVY BLUE (red label, serum), or RED (serum) tube. Centrifuge and immediately separate serum or plasma from the cells. Refrigerate.
80299
Anemia Profile ANEM
GOLD, Refrigerated. 1 LAVENDER, Refrigerated and 1 LAVENDER, Frozen.
82728, 83550, 85025, 82607, 82747, 85014
Angiotensin Converting Enzyme, ACE, ATCE
ATCEGOLD, RED OR SPECKLED. Refrigerated.
82164
Antibody Screen (Indirect Antiglobulin test)
ASRED OR LAVENDER OR PINK. Refrigerated.
86885
Anti Cardiolipin (Profile) Antibody
CARPGOLD, RED OR SPECKLED. Refrigerated.
86147
Anti CCP, Cyclic Citrullinated Peptide AB, IgG
CCPGOLD, RED OR SPECKLED. Refrigerated.
86200
Anti Mitochondrial Antibodies (AMA)
AMCAGOLD, RED OR SPECKLED. Refrigerated.
86256
10- BLUE. (Recommend sending to Laboratory for collection. Plasma must be Platelet poor). Centrifuge, pipette off plasma without disturbing 86146 (3),
Anti Phospholipin Panel MSC
must be Platelet poor). Centrifuge, pipette off plasma without disturbing "buffy coat" into plastic pour off tubes. Centrifuge Plastic pour off tubes, pipette all but button on the bottom into a new plastic pour off tube. Refrigerated.
86146 (3), 86147 (3), 86148 (3)
Anti Smooth Muscle Ab. (aka Actin antibody, IgG)
SMUAGOLD, RED OR SPECKLED. Refrigerated.
86256
Arthritis Profile RAP1
2- GOLD and 1- LAVENDER(Sed rate must be tested within 4 hours) Refrigerated.
86038, 86431, 80053,85652
ASO (Streptozyme) ASO GOLD, RED OR SPECKLED. Frozen. 86063
AST (SGOT) ASTGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84450
Auto Immune Panel AIPGOLD, RED OR SPECKLED. Refrigerated.
82340
Bacterial Antigen Panel BAGPGOLD, RED OR SPECKLED, OR 1 ml of CSF. Frozen.
86403
Page 3
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Beta-2 microglobulin B2MSGOLD, RED OR SPECKLED. Room Temperature.
82232
Beta Strep Group B Culture BSCCulterette (crush ampule on bottom). Room Temperature.
87077
BHCG, beta subunit For cancer monitoring
BHCG GOLD, RED OR SPECKLED. Frozen. 84702
Bilirubin, Direct DB
GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED or Green Pediatric bullet. Refrigerated.
82248
Bilirubin, Neonatal TBP
GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED or Green Pediatric bullet. Refrigerated.
82247
Bilirubin, Total TBA
GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED or Green Pediatric bullet. Refrigerated.
82247
Blood Culture*** sensitivity-no charge
BLDC
BACTEC BOTTLES, Anaerobic and Aerobic. Use Aseptic TechniqueRoom Temperature.
87040
Blood Urea Nitrogen (BUN) BUNGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84520
B-Natriuretic (BNP) BNP LAVENDER OR PINK. Refrigerated. 83880B-Natriuretic (BNP) BNP LAVENDER OR PINK. Refrigerated. 83880
Bordetella pertussis IgG and IgA
MSC
17825X
GOLD, RED OR SPECKLED. Refrigerated.
86615-90 (4)
Bordetella pertussis, IgGMSC
17826X
GOLD, RED OR SPECKLED. Refrigerated.
86615-90 (2)
C Reactive Protein CRPGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
86140
C-Terminal Peptide CPPT GOLD, RED OR SPECKLED. Frozen. 84681
Calcium CAGOLD,GREEN LITH-HEP, RED OR SPECKLED. Refrigerated.
82310
Cancer Antigen 19 (CARBOHYDRATE ANTIGEN 19-9)
CA19GOLD,RED OR SPECKLED. Refrigerated.
86316
Cancer Antigen 125 C125
GOLD, RED OR SPECKLED. Grossly hemolyzed samples are unacceptable. Refrigerated.
86316
Cancer Antigen 27.29 CA27
GOLD, RED OR SPECKLED. Grossly hemolyzed samples are unacceptable. Room Temperature.
Page 4
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Candida Albicans IgG, IgM, IgA (Quest test code 30440X)
MSC
RED. Centrifuge and separate serum, pipette into plastic pour off tube, write RED SERUM on plastic tube. Room Temperature.
86628x 3
Candida albicans Antigen and Antibody Detection Panel (Quest test code 6643)
MSC
RED. Centrifuge and separate serum, pipette into plastic pour off tube, write RED SERUM on plastic tube. Refrigerated.
86403, 86628
Cannabinoids CANBURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated.
G0431
Carbamazepine(Tegretol) CRMZGOLD,GREEN LITH-HEP, RED OR SPECKLED. Refrigerated.
80156
Cardiac Profile CARDGREEN LITH. HEPARIN. Refrigerated.
82550, 83615, 84450
Cardiolipin Antibody CARPGOLD, RED OR SPECKLED OR BLUE. Refrigerated.
86147
CBC (includes platelets/differential if abnormal)
CBC LAVENDER. Refrigerated. 85025abnormal)
CEA, EIA CEAGOLD, RED OR SPECKLED. Refrigerated.
82378
Celiac Disease Panel CELGOLD, RED OR SPECKLED. Refrigerated.
82784
Ceruloplasmin CRPMGOLD, RED OR SPECKLED. Refrigerated.
82390
Cervical Biopsy PATHCervical sample in FORMALIN CONTAINER. Room Temperature
88305
Chem 7 (BMP-Basic Metabolic Panel)
CH7GOLD,GREEN LITH-HEP, RED OR SPECKLED. Refrigerated.
80048
Chlamydia/Chlamydophila Ab Panel 3 (IgG,IgA,IgM)
CHLM
GOLD, RED OR SPECKLED. Refrigerated. Testing includes: C. pneumoniae IgM, IgA, IgGC. trachomatis IgM, IgA, IgGC. psittaci IgM, IgA, IgG
86631x6, 86632x3
Page 5
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Chlamydia culture (legal cases, abuse) any site
CHC
DACRON/RAYON SWAB from endocervix, urethra, conjunctiva, rectal mucosa (without feces) fluid aspirate, tissue, nasopharynx or throat in MICROTEST (M4) microbe
transport tube. Do not use wood
swabs or cotton swab.
Specimens should befrozen -70 degrees C or colder Frozen.
Stability:-Room Temperature NO-Refrigerated: 72 hours-Frozen: 30 days (-70c)
87110, 87140
Air dried Conjunctival SLIDE or Endocervical SLIDE or Urethral SLIDE or Rectal SLIDE or Nasopharyngeal SLIDE or useMICRO TRAK(R) Chlamydia trachomatis Direct SpecimenCollection kit. Collection instructions: Before
Chlamydia Direct FA, rectum, throat, eyes
CFA
Collection instructions: Before specimen collection, removeand discard mucous and exudates/pus to preventinterference with assay performance.Rejection criteria:Vaginal or penile specimens will be rejected. Specimensidentified nonspecifically as genital will be rejected.Transport Container: Slide HolderTransport Temperature: Room TemperatureFrozen: unacceptable
87270
Chlamydia and GC DNA Probe GCCP
BLUE DNA CULTURETTE (Male) PINK DNA CULTURETTE (Female). Room Temperature.
87491, 87591
Chlamydia DNA probe CDNA
BLUE DNA CULTURETTE (Male) PINK DNA CULTURETTE (Female). Room Temperature.
87491
Page 6
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Chlamydia/GC Urine APTIMA MSC
URINE. Room Temperature: The patient should not have urinated for at least one hour prior to specimen collection. Direct patient to provide a first-catch urine into a urine collection cup, the rest of the void in the toilet. Collection of larger volumes of urine may result in specimen dilution that may reduce test sensitivity. Female patients should not cleanse the labial area prior to providing the specimen. Minimum: 2 mL
87491, 87591
Chlamydia Urine, APTIMA MSC
URINE. Room Temperature: The patient should not have urinated for at least one hour prior to specimen collection. Direct patient to provide a first-catch urine into a urine collection cup, the rest of the void in the toilet. Collection of larger volumes of urine may result in specimen dilution that may reduce test sensitivity. Female patients should not cleanse the labial area prior to providing the specimen.
87491
area prior to providing the specimen. Minimum: 2 mL
Cholesterol, Total CHOGOLD,GREEN LITH-HEP, RED OR SPECKLED. Refrigerated.
82465
Clomipramine (aka Anafranil aka Placil)
CLPN
DARK NAVY BLUE, LAVENDER OR RED. Centrifuge and pipette the plasma or serum (carefully) from the red cells, pipette into plastic pour off tube. Refrigerated.
80299
Clostridium Toxin Difficile CLOT
PLASTIC, LEAK PROOF CONTAINER (must receive in 30 minutes or Refrigerate)
87230
Clozapine/norclozapine CLOZ
GREEN SODIUM HEPARIN, LAVENDER OR RED**Do not use gel barrier tubes. Grossly hemolytic or lipemic samples are unacceptable. Centrifuge and immediately separate plasma or serumfrom the cells into a plastic, screw-capped vial. Frozen.
80154
Page 7
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Cofactor 5 Leiden Assay COF5LAVENDER, whole blood. Important: keep Room Temperature.
85220
Complement C3 C3CS
GOLD, RED, SPECKLED. Avoid hemolysis. Centrifuge serum specimens within 1 hour of collection. Immediately pipette serum into sterile, plastic, screw-capped vial(s) and freeze. Do not allow samples to thaw. Frozen.
86161
Complement C4 C4CS
GOLD, RED, SPECKLED. Avoid hemolysis. Centrifuge serum specimens within 1 hour of collection. Immediately pipette serum into sterile, plastic, screw-capped vial(s) and freeze. Do not allow samples to thaw. Frozen.
86161
C3 and C4 complement group MSC
GOLD, RED, SPECKLED. Avoid hemolysis. Centrifuge serum specimens within 1 hour of collection. Immediately pipette serum into sterile, plastic, screw-capped vial(s) and freeze. Do not allow samples to thaw. Frozen.
86161 x 2
Complement , total (50) CH50
GOLD, RED, SPECKLED. Avoid hemolysis. Centrifuge serum specimens within 1 hour of collection. Immediately pipette serum into sterile, plastic, screw-capped vial(s) and freeze. Do not allow samples to thaw. Frozen.
86162
Comprehensive Metabolic Panel (CMP)
CMPGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
80053
Copper CU
DARK BLUE NAVY (RED LABEL OR PURPLE LABEL). Refrigerated.Patient should refrain from taking vitamins, mineral or herbal supplements for at least 1 week prior to sample collection.Centrifuge and immediately separate serum or plasma from the cells into a pour-off plastic (trace metal free, element free tube). Contact laboratory for the special pour off tube.
82525
Page 8
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Cortisol AM CORAGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
82533
Cortisol PM CORPGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
82533
CPK, Total CKGREEN LITH. HEPARIN. Refrigerated.
82550
Creatinine Clearance, 24 hr. Urine
CRCL
GOLD and 24 HOUR URINE CONTAINER/ NO PRESERVATIVE. 24 hour Urine collection. Refrigerate during collection. Document Total Volume. Keep refrigerated during collection.
82570
Creatinine, Serum CREGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
82565
Cryptosporidium Specific Antigen
CSASStool in SAF (Yellow) TRANSPORT container. Room Temperature.
87328
Cryptococcal Antigen, Serum CCASGOLD, RED OR SPECKLED. Refrigerated.
86403
Cryptococcal Antigen Titer CRATGOLD, RED OR SPECKLED. Refrigerated.
86171
Cyclic Citrullinated Peptide AB, Anti CCP CCP
GOLD, RED, SPECKLED. Refrigerated.
86200Anti CCP CCPRefrigerated.
86200
Cystic Fibrosis Screen MSC
2- LAVENDER, whole blood. Room Temperature. Instructions: Please indicate the ethnicity of the patient. Specimen stability is crucial. Send immediately. Do not freeze.
83891, 83900, 83901x13,
83909, 83912, 83914x32
Cytoplasmic neutrophil antibody
CYNE
GOLD OR RED. Patient must be fasting. Centrifuge and transfer serum specimens to pour-off tubes. Refrigerated or Frozen.
86021
D Dimer QDIM
BLUE. Refrigerated. Blood should fill to the black error on side of tube. Gently invert tube 6 times.
85379
Depakote aka Depakene aka Valproic Acid
VAP
GOLD,GREEN LITH-HEP, RED OR SPECKLED. Refrigerated. Recommended collection 30 min prior to dose
80164
DHEA, unconjugate DHEU
RED. Centrifuge, pipette serum into plastic pour off tube. Place "Serum" sticker on pour off tube. Frozen
82626
Page 9
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Dhea Sulfate DHEAGOLD, RED, SPECKLED. Refrigerated.
82627
Digoxin DIGGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
80162
Dilantin DILGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
80185
Drug Screen, Urine Chain of custody 6 panel
IDP6
CHAIN CUSTODY URINE: Follow chain of custody collection procedure.This includes testing for the following with auto GC/MSconfirmation and integrity check: amphetamines, barbs, benzo's, Cannabinoids (THC), cocaine, opiates.
80100
Drug Screen, Urine Chain of custody 12 panel
ID12
CHAIN CUSTODY URINE: Follow chain of custody collection procedure.This includes testing for the following with auto GC/MS confirmation and integrity check: amphetamines, barbs, benzo's, Cannabinoids (THC), cocaine, fentanyls, meperidine, oxycodones, phencyclidines,
80100
oxycodones, phencyclidines, propoxyphene, methadone, opiates, tramodol. Room Temperature.
Drug Screen, Urine (Medical) UTOX
UTOXURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated.
80100
Drug Screen, Serum (Medical) BTOXGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
80100
Ear Culture *** sensitivity-no charge
EARCCULTURETTE or NP Swab. Room Temperature.
87070
Electrolytes LYTEGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
80051
Electrolytes, Urine LYTUURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated.
80051
EOS Count, Total EOST LAVENDER. Refrigerated. 85048
EOS Smear EOSS
SMEAR ON GLASS SLIDE. Urine, Sputum, or Nasal Smear. Refrigerated.
89190
Epstein Barr Virus Ab EBRGOLD, RED, SPECKLED. Refrigerated.
86665
Page 10
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Estradiol ES17GOLD, RED OR SPECKLED. Refrigerated.
82670
Estrogen ETTSGOLD, RED OR SPECKLED. Refrigerated.
82672
Ethanol (ETOS) chain of custody
ETOS
CHAIN OF CUSTODY. GRAY Must Use BETADINE to cleanse the venipuncture site. DO NOT USE ALCOHOL. Room Temperature.
82055
Ethanol (blood alcohol), non chain of custody
ETOH
GREEN LITHIUM HEPARIN or GOLD. Use BETADINE to cleanse the venipuncture site. DO NOT USE ALCOHOL. Room Temperature.
82055
ENAA ( Antibodies to extractable nuclear antigens: Anti Smith (SM) and Anti U1RNP
ENAAGOLD, RED OR SPECKLED. Refrigerated.
86235
Eye Culture ***sensitivity-no charge
EYECCULTURETTE (crush ampule). Room Temperature
87070
2 -LIGHT BLUE. Frozen. Blood should fill to the black error on side of tube. Gently invert tube 6 times. Centrifuge, then pipette plasma
Factor VIII (8) Activity (Collection by Laboratory recommended)
F8AC
times. Centrifuge, then pipette plasma (without disturbing red cells) into plastic pour-off tube. Centrifuge plastic pour-off tube and, again, pipette plasma (leaving button on bottom) into new plastic pour-off tube. Place "Plasma" label on pour off tube. Frozen.
85240
Factor VIII (8) Antigen (von Willebrand Factor antigen) (Collection by Laboratory recommended)
F8AG
2 -LIGHT BLUE. Frozen. Blood should fill to the black error on side of tube. Gently invert tube 6 times. Centrifuge, then pipette plasma (without disturbing red cells) into plastic pour-off tube. Centrifuge plastic pour-off tube and, again, pipette plasma (leaving button on bottom) into new plastic pour-off tube. Place "Plasma" label on pour off tube. Frozen.
85246
Fecal Occult Blood x 3 OCBLHemoccult Card x 3. Room Temperature.
82270
Page 11
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Feces Culture ***sensitivity-no charge
FECC
Feces Transport vial (Orange) add stool until liquid rises to black line on side of transport vial. Room Temperature.
87045
Ferritin FERRGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
82728
Fibrinogen FIBR
BLUE. Refrigerated. Blood should fill to the black error on side of tube. Gently invert tube 6 times.
85384
Fluid, Albumin FALB RED. Refrigerated. 82042
Fluid, Amylase FAMY RED. Refrigerated. 82150
Fluid, AST FAST RED. Refrigerated. 84450
Fluid, Cell Count and Differential
FLDA RED. Refrigerated. 89051
Fluid, Cell Count and Differential (Synovial)
SYNA RED. Refrigerated. 89051
Fluid, Chloride FCL RED. Refrigerated. 82438
Fluid, Creatinine FCRE RED. Refrigerated. 82570
Fluid, Glucose FGLU RED. Refrigerated. 82947
Fluid, Hematocrit FHCT LAVENDER. Refrigerated. 85014
Fluid, LDH FLDH RED. Refrigerated. 83615
Fluid, PH FPH RED. Refrigerated. 83986
Fluid, Specific Gravity FSPG RED. Refrigerated. 84315
Fluid, Total Protein FTP RED. Refrigerated. 84155
Fluid, Uric Acid FURA RED. Refrigerated. 84560
Fluid, Triglycerides FTGL RED. Refrigerated. 84478
Fluids, Culture ***sensitivity-no charge
BF RED. Room Temperature. 87070
Folate, RBC & Vitamin B12 (MAPS profile)
MAPS
GOLD and 1 LAVENDER Refrigerated and 1 LAVENDER Frozen, whole blood.
82747, 82607
Folate, Serum FOLSGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
82746
Page 12
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Free Kappa Lambda light chain with ration
FKLR
GOLD, RED OR SPECKLEDSpecimen Rejection Criterion: Grossly hemolyzed samples or grossly lipemic samples are unacceptable. Refrigerated.
83883 (2)
Free and Total Prostatic Specific Antigen
FPRS
GOLD, RED OR SPECKLED. Centrifuge, pour into plastic pour-off tube. Place "Serum" sticker on pour off rube. Rejection criterion: Gross hemolysis, gross lipemia, or gross icterus. Frozen..
84153, 84154
Fructosamine FRUCGOLD, RED OR SPECKLED. Refrigerated.
82985
FSH FSHGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
83001
FTA antibodies (Treponema Pallidum)
FTAAGOLD, RED OR SPECKLED. Refrigerated.
86780
Fungus Culture ***sensitivity-no charge
FUNG
STERILE CONTAINER or CULTURETTE (Crush Ampule). Room Temperature.
87107
G6PD G6PDLAVENDER, whole blood.
82955G6PD G6PDLAVENDER, whole blood. Refrigerated.
82955
Gabapentin level GABA
LAVENDER. Draw sample two hours after last dose at steady-state. Do not use gel barrier tubes. Centrifuge, pipette plasma from cells as soon as possible. Pipette into plastic pour off tube. Place "Plasma" label on pour off tube.Transport at room temperature.
80299
Gamma-glutamyl Trans (GGTP)
GGTGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
82977
GC Screen GCCULTURETTE (crush ampule). Refrigerated.
80299
GC and Chlamydia DNA Probe GCCP
BLUE DNA CULTURETTE (Male) PINK DNA CULTURETTE (Female). Room Temperature.
87491, 87591
GC DNA Probe GDNA
BLUE DNA CULTURETTE (Male) PINK DNA CULTURETTE (Female). Room Temperature.
87591
Page 13
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
GC/Chlamydia Urine APTIMA MSC
URINE. Room Temperature: The patient should not have urinated for at leastone hour prior to specimen collection. Direct patient toprovide a first-catch urine into a urine collection cup, the rest of the void in the toilet. Collection of larger volumes of urine may result in specimen dilution that may reduce test sensitivity. Female patients should not cleanse thelabial area prior to providing the specimen. Minimum: 2 mL
87491, 87591
GC Urine, APTIMA MSC
URINE. Room Temperature: The patient should not have urinated for at leastone hour prior to specimen collection. Direct patient toprovide a first-catch urine into a urine collection cup, the rest of the void in the toilet. Collection of larger volumes of urine may result in specimen
87591
of urine may result in specimen dilution that may reduce test sensitivity. Female patients should not cleanse thelabial area prior to providing the specimen. Minimum: 2 mL
Genital Culture ***sensitivity-no charge
GENCCULTURETTE (crush ampule). Room Temperature.
87070
Gentamycin, Random GENRGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
80170
GGTP (GGT) GGTGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
82977
Giardia Specific AG, Stool GSASStool in SAF (Yellow) transport container. Room Temperature.
87329
Glucose GLU
GOLD, GREEN LITHIUM HEPARIN, RED, GRAY OR SPECKLED. Refrigerated.
82947
Glucose, Post -Prandial GLUP
GOLD, GREEN LITHIUM HEPARIN, RED, GRAY OR SPECKLED. Refrigerated.
82950
Page 14
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Glucose-6-Phos Dehydrogenase
G6PDLAVENDER, whole blood. Refrigerated.
82955
Glyco Hemoglobin A1C HBG1 LAVENDER. Refrigerated. 83036
Gram Stain GSBCULTURETTE (crush ampule) or Air-dried smear. Room Temperature.
87205
HCG, pregnancy test reflects to quantitation if positive, at no charge
HCGCGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84702
HCG, pregnancy test urine UHCGURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated.
81025
HCG, Beta (for neoplasm not pregnancy)
BHCGGOLD, RED OR SPECKLED. Refrigerated.
84702
HEA4, Ovarian Cancer Monitoring
MSC
RED. Frozen. Centrifuge, pipette serum into plastic pour-off tube. Place "Serum" label on pour-off tube.Instructions: Rejection criterion: Specimens exhibiting lipemia,
86305
2- GOLD and 1 LAVENDER. Refrigerated.
Use all Codes 85025,80053,84443,Health Profile 01 HEAL
Refrigerated. Includes: CBC, TSH, LIPP, IRON, FERR, CMP, URA
84443,80061,83540,82728,84550
Health Profile 02 HEA2
2 -GOLD and 1 -LAVENDER. Refrigerated. Includes: CMP, CBC, LIPP, FERR
Use all Codes 85025, 80061, 82728, 80053
Health Profile 03 HEA3GOLD and LAVENDER. Refrigerated.Includes: FERR, CBC
Use all Codes 80053, 82728
Health Profile 04 HEA42 - GOLD. Refrigerated.Includes: LIPP, TIBC, MAG, CMP. Refrigerated.
Use all Codes 80053, 80061, 83735, 83550
Heavy Metal, blood: arsenic, lead, mercury
HMB
DARK NAVY BLUE, whole blood. Refrigerated. Patient should refrain from eating seafood, or taking mineral and herbal supplements for at least 3 days before specimen collection. To avoid contamination, use powderless gloves.
83015
Page 15
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Heavy Metal, 24 hr urine: arsenic, lead, mercury, creatinine
HMS
24 hour urine collection in Acid Washed, Metal Free Container (Call the Laboratory for this collection container). Refrigerated. Keep Refrigerated during collection. Fish, shellfish, and kelp should not be consumed for at least one week before specimen collection. Please specify on the request form and on The urine container the total 24-hour urine volume.
83015
Heavy Metal 19, 24 hr urine: nickel, arsenic, lead, mercury, zinc, copper, chromium, creatinine cadmium
HM19
24 hour urine collection in Acid Washed, Metal Free Container (Call the Laboratory for this collection container). Refrigerated. Keep Refrigerated during collection. Fish, shellfish, and kelp should not beconsumed for at least one week before specimen collection. Please specify on the request form and onthe urine container the total 24-hour urine volume.
82175, 82300, 82495, 82525, 82570, 83655, 83825, 83885,
84630
Hematocrit, Micro MHCTLAVENDER PEDIATRIC BULLET. Refrigerated.
85014Refrigerated.
Hemochromatosis DNA HCHR LAVENDER. Room Temperature. 83890
Hemoglobin & Hematocrit HH LAVENDER. Refrigerated.85014,85018
Hemoglobin A1C HGB1 LAVENDER. Refrigerated. 83036
Hemoglobin Electrophoresis (EVALUATION)
HGBE LAVENDER. Refrigerated. 83020
Hepatitis A Antibody, IGM HAABGOLD, RED OR SPECKLED. Refrigerated.
86708
Hepatitis B Antibody HBABGOLD, RED OR SPECKLED. Refrigerated.
86706
Hepatitis B Core AB HBCGGOLD, RED OR SPECKLED. Refrigerated.
86704
Hepatitis B Surface Antigen HBAGGOLD, RED OR SPECKLED. Refrigerated.
87340
Hepatitis Be Antibody BEAGOLD, RED OR SPECKLED. Refrigerated.
86707
Hepatitis Be antigen & antibody (HBV Infectivity profile)
HBVPGOLD, RED OR SPECKLED. Refrigerated.
86707, 87350
Page 16
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Hepatitis B Virus drug resistance
MSCWHITE PPT TUBE (EDTA), Centrifuge and Freeze entire tube.
83891, 83894, 83900,
83904 x4, 83912
Hepatitis B Virus DNA ultraquant
HBVDGOLD, RED OR SPECKLED. Refrigerated.
87517
Hepatitis C Antibody NON-A,B)
HEPCGOLD, RED OR SPECKLED. Refrigerated.
86302
Hepatitis C genotype by PCR (must perform HCV Hepatitis C Virus RNA along with this test)*
HCVGWHITE PPT TUBE (EDTA), Centrifuge and Freeze entire tube.
87902
Hepatitis C Virus RNA Ultraquant by PCR*
HCVWHITE PPT TUBE (EDTA), Centrifuge and Freeze entire tube.
87522
Hepatitis (D) Delta AB HBDAGOLD, RED OR SPECKLED. Refrigerated.
86692
Hepatitis Profile HEPPGOLD, RED OR SPECKLED. Refrigerated.
80059
Herpes Simplex Culture HSCRED CAP VIRAL transport media. Refrigerated.
87255
GOLD, RED OR SPECKLED. Herpes Simplex DNA by PCR HDNA
GOLD, RED OR SPECKLED. Refrigerated.
87529
Herpes Simplex Virus1&2, IgG HSABGOLD, RED OR SPECKLED. Refrigerated.
86695-90, if (+) reflects
to 86696-90
HIV DNA by PCR HIVDLAVENDER, whole blood. Room Temperature.
83898
HIV 1 by RNA by PCR, ultraquant
HIVP
LAVENDER. Centrifuge, pipette plasma (gently) without disturbing red cells, pipette plasma into plastic pour off tube. Place "Plasma" label on pour off tube. Frozen.
83898
HIV Antibodies (HTLV3) HIVGOLD, RED OR SPECKLED. Refrigerated.
86703
HLA A,B,C PHENOTYPE PROFILE
HLAPACD CANARY YELLOW tube, whole blood. Room Temperature.
86813
HLA B 27, DNA typing H27B
ACD CANARY YELLOW tube, whole blood or 1 Lavender (whole blood). Room Temperature.
86812
Page 17
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Homocysteine level HMCS
RED, GOLD, OR SPECKLED1 mL SerumInstructions: Place the specimen in a refrigerator bath for 30 minutes after collection. Centrifuge the specimen as soon as possible after complete clot formation has taken place. Refrigerated.
83090
H-pylori (helicobacter pylori antibody)
HPYGOLD, RED OR SPECKLED. Refrigerated.
86677
H-pylori (stool) HPYS
Random Stool in a PLASTIC, LEAK PROOF CONTAINER. Frozen.Instructions: Patients should be off Proton Pump Inhibitors (PPI), antibiotics, or bismuth for two weeksbefore specimen collection.
87339
Human Chorionic Gonadotropin (HCG), Beta, for pregnancy (POS + reflexes to quantitation)
HCGCGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84702
Human Chorionic Gonadotropin (HCG), Beta, for BHCG
GOLD, RED OR SPECKLED. 84702Gonadotropin (HCG), Beta, for
neoplasm not pregnancy
BHCGGOLD, RED OR SPECKLED. Refrigerated.
84702
Hypersensitivity Pneumonitis Panel
HPNPGOLD, RED OR SPECKLED. Refrigerated.
86329
IGF Binding Protein 1 MSC
GOLD, RED OR SPECKLED. Instructions: Overnight fasting is preferred. Room Temperature.
83519
IGF Binding Protein 2 MSC
GOLD, RED OR SPECKLED. Instructions: Overnight fasting is preferred. Room Temperature.
83519
IGF Binding Protein 3 MSC
GOLD, RED OR SPECKLED. Instructions: Overnight fasting is preferred. Room Temperature.
83519
IGF I, (Insulin Like Growth Hormone)Electrochemiluminescence
INGF
GOLD, RED OR SPECKLED. Refrigerated.Instructions: Rejection Criteria:Gross hemolysis; Gross lipemia;Slightly, moderately, and grossly icteric samples.
84305
Page 18
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Imipramine/Desipramine aka Tofranil
IMDE
LAVENDER, GRAY, GREEN SODIUM HEPARIN, RED. Room Temperature. Do not use gel separator tubes. Collect just before next dose or at least 12 hours after last dose.
80174
Immune Status Panel, MMR MMRGOLD, RED OR SPECKLED. Refrigerated.
86735, 86762, 86765
Immunoglobulin A (IgA) IGAGOLD, RED OR SPECKLED. Refrigerated.
82784
Immunoglobulin E (IgE) IGEGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
86785
Immunoglobulin G (IgG) IGGGOLD, RED OR SPECKLED. Refrigerated.
82784
Immunoglobulin M (IgM) IGMGOLD, RED OR SPECKLED. Refrigerated.
82784
Immunoglobulin, quant. (IgA, IgG, IgM )
IGB
GOLD, RED OR SPECKLEDInstructions: Overnight fasting is preferred. Serum should beseparated immediately from clot.Centrifuge within 1 hour of collection and transfer serum specimens to sterile, plastic, screw-capped vial(s).
82784x3
sterile, plastic, screw-capped vial(s). Refrigerated.
Inflammatory Bowel Disease Differentiation Panel: Includes C-ANCA titer; P-ANCA titer; Atypical P-ANCA titer;PROTEINASE-3 ANTIBODY; Myeloperoxidase Antibody; ANCA Screen with Reflex to ANCA Titer; Saccharomyces cerevisiae Antibody (ASCA) IgA; Saccharomyces cerevisiae Antibody (ASCA) IgG;
MSC
6- GOLD, RED OR SPECKLED. Instructions: Patient must be fasting. Centrifuge and transfer serum specimens to clean, plastic, screw-capped vial(s). Refrigerated.
86021x3, 86671x2
Influenza A and B FLU
NASAL SWABS, NASOPHARYNGEAL SWAB OR WASHINGS. Room Temperature. No charcoal, gel swabs or viral transport media accepted.
87400 x 2
Insulin Level INSSGOLD, RED OR SPECKLED. Refrigerated.
83525
Page 19
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Insulin Like Growth Factor IGF I, Electrochemiluminescence
INGF
GOLD, RED OR SPECKLED. Refrigerated.Instructions: Rejection Criteria:Gross hemolysis; Gross lipemia;Slightly, moderately, and grossly icteric samples.
84305
Iron Profile, Total TIBCGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84466,83540
Iron, Serum IRONGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
83540
Keppra level (Levetiracetam) KPRA
RED, LAVENDER or GREEN SODIUM HEPARIN. Centrifuge and transfer serum or plasma to pour-off tube. Frozen.
80299
KOH Prep KOH
STERILE CONTAINER. Specify source on requisition. Room Temperature.
87220
Lamotrigine (Lamictal) LAMT
RED. Refrigerated. Recommendation: Draw 1/2 to 1 hour before next dose at steady-state.
87449
LDH LDGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
83615RED OR SPECKLED. Refrigerated.
Lead levels LB
For Adults: DARK NAVY BLUE, whole blood. Refrigerated.For children: LAVENDER Pediatric bullet. Follow Lead collection procedure.
83655
Legionella Antigen, urine LAGU
Instructions: Refrigerate urine immediately aftercollection. Store refrigerated 2-8 degrees C for up to14 days. For longer periods, store frozen -20 degrees C.Transport refrigerated urine samples refrigerated (coldpacks) to the laboratory.
87449
Levetiracetam (Keppra) KPRA
RED, LAVENDER or GREEN SODIUM HEPARIN. Centrifuge and transfer serum or plasma to pour-off tube. Frozen.
80299
LH(Luteinizing hormone) LHGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
83002
Page 20
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Lipase LIPSGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
83690
Lipid Profile LIPPGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
80061
Lithium LITHGOLD, RED OR SPECKLED. Refrigerated.
80178
Liver Kidney Microsome Ab. IgG (LKM-1)
ALKMGOLD, RED OR SPECKLED. Refrigerated.
86376
Liver Profile LIVRGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
80076
Lupus Like Anticoagulant LUPU
6 -BLUE. Blood should fill to the black error on side of tube. Gently invert tube 6 times. Centrifuge, then pipette plasma (without disturbing red cells) into plastic pour-off tube. Centrifuge plastic pour-off tube and, again, pipette plasma (leaving button on bottom) into new plastic pour-off tube. Place "Plasma" label on pour off tube. Frozen.
80500, 85610, 85613. If
reflexed to additional
testing, add: 85210,85220,85230,85240,85
250, 85260, 85270,85280,8
5597x2, 85611, 85635, 85670,85732
Frozen. 85611, 85635, 85670,85732
Lyme IgG and IgM antibodies LYGM
GOLD, RED OR SPECKLED. Refrigerated.Rejection criterion: Gross hemolysis or gross lipemia is unacceptable.
86618
Lymphocyte CD4 helper/inducer Subset Panel 4
LTHSLAVENDER, whole blood, important keep room temperature
88182
Lymphocyte Subset Panel 5 CD4MLAVENDER, whole blood, important keep room temperature
86361
Lysozyme Muramindase LYSS
GOLD, RED OR SPECKLED.Centrifuge serum specimens within 1 hour of collection. Transfer serum to sterile, plastic,screw-capped vial(s). Refrigerated.
85549
Macrocytic Anemia Profile MAPS
GOLD, Refrigerated. 1 LAVENDER, Refrigerated and 1 LAVENDER, Frozen.
82747, 82607
Magnesium MAGGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
83735
Page 21
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
MAIC Blood Cul-X MAIC
GREEN SODIUM HEPARIN, whole blood. Room Temperature or Specimen (list source) in a STERILE, LEAK PROOF CONTAINER. Room Temperature.
87116
Malaria Workup MALW LAVENDER. Refrigerated. 87207
Mercury level MRY
DARK NAVY BLUE (EDTA purple label), whole blood. Refrigerated. Patient should refrain from eating seafood, or taking mineral and herbal supplements for at least 3 days before specimen collection. To avoid contamination, use powderless gloves.
83825
Methylmalonic Acid MMA
RED. Centrifuge and pipette serum into plastic pour-off tubes. Place "Serum" label on pour off tube. Frozen.
82131
Micro albumin/creatinine ration, urine
MALUURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated.
82043
Add $20.00 to any miscellaneous test Miscellaneous Test
Add $20.00 to any miscellaneous test price quoted by GMC-Laboratory
MMR (Measles, mumps, rubella immune status)
MMR2 -GOLD, 2 -RED OR 2 -SPECKLED. Refrigerated.
86762
Monospot MSPTGOLD, RED OR SPECKLED. Refrigerated.
86403
Myasthenia Gravis Profile MGP
RED. Centrifuge, pipette serum into plastic pour-off tube. Place "Serum" Label on pour-off tube. Frozen.
83519
Mycoplasma Pneumonia Ab, IgG and IgM
MYCOGOLD, RED OR SPECKLED. Refrigerated.
86738
Myoglobin, Serum baseline MGBSGREEN LITH. HEPARIN. Refrigerated.
83874
Myoglobin, Urine MGBUURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated.
83874
Nasal Culture ***sensitivity-no charge
NASACULTURETTE (crush ampule). Room Temperature.
87077
Page 22
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Neisseria Gonorrhoeae RNA Urine use Aptima ™ urine collect kit
MSC
URINE. Room Temperature: The patient should not have urinated for at leastone hour prior to specimen collection. Direct patient toprovide a first-catch urine into a urine collection cup, the rest of the void in the toilet. Collection of larger volumes of urine may result in specimen dilution that may reduce test sensitivity. Female patients should not cleanse thelabial area prior to providing the specimen. Minimum: 2 mL
87591
Nicotine (continine), urine COTURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated.
83887
Nortryptyline/Amitriptyline aka Pamelor
AN
RED. Room Temperature.Collect just before next dose or at least 12 hours after last dose. Do not use serum separator (gel barrier) tubes.
80152
RED. Room Temperature.
Nortriptyline only NORT
RED. Room Temperature.Collect just before next dose or at least 12 hours after last dose. Do not use serum separator (gel barrier) tubes.
80182
Occult Blood x 3 OCBL Hemoccult Card x 3 82270
Osmolality, Serum OSMSGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
83930
Osmolality, Urine UOSMURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated.
83935
Ova and Parasites OPSStool in SAF (Yellow) transport container. Room Temperature.
87177
Package 15 (OB panel) includes: CBC, RPR, RUB,HBAG, TYSC
PK152 -LAVENDER and 3 -GOLD. Refrigerated.
85025, 86592, 86762, 87340, 86885, 86900
Parathyroid hormone, INTACT PTHGOLD, RED OR SPECKLED. Refrigerated.
83970
PH, Stool SPHRandom Stool in PLASTIC, LEAK PROOF CONTAINER. Frozen.
83986
Page 23
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Phenobarbital PHENGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
80184
Phosphorus PHOGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84100
Pin Worm Prep PWP Scotch Tape/Slide Prep. 87172
Placil, (aka Anafranil aka Clomipramine)
CLPN
LAVENDER (plasma), DARK NAVY BLUE( red label, serum), or RED (serum) tube. Refrigerate. Centrifuge and immediately separate serum or plasma from the cells.
80299
Platelet PLT LAVENDER. Refrigerated. 85049
Platelet Function Study CEPI
2 -BLUE. Refrigerated. Blood should fill to the black error on side of tube. Gently invert tube 6 times.
85576 x 2
Poliovirus Antibody, (Neutralization) Titer
MSCGOLD, RED OR SPECKLED. Refrigerated.
86382x3
Potassium KGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84132
Prealbumin PALBGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84134
Pregnancy test, reflexes to Pregnancy test, reflexes to quantitation if positive at no charge
HCGCGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84702
Procainamide & N. Acetyl Procainamide (Pronestyl)
PCM RED. Refrigerated. 80192
Progesterone PGTRGOLD, RED OR SPECKLED. Refrigerated.
84144
Prograf (Tacrolimas level) PRGF
LAVENDER, whole blood. Room Temperature.Instructions: Drug regimens, time and date of drug administration are to be noted on requisition.Therapeutic range applies to trough specimens drawn justbefore a.m. dose. Optimal time to draw specimen: 0.5-1 hour before next oral dose. Rejection criterion: Clotted specimens or gel barrier tubes.
80197
Prolactin PRLAGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84146
Page 24
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Prostatic Specific Antigen, Free and Total
FPRS
GOLD, RED OR SPECKLED. Centrifuge, pour into plastic pour-off tube. Place "Serum" sticker on pour off rube. Rejection criterion: Gross hemolysis, gross lipemia, or gross icterus. Frozen.
84153, 84154
Prostatic Specific Antigen PRSAGOLD, RED OR SPECKLED. Refrigerated.
84152
Protein C and S Activity CSAC
2- BLUE. Centrifuge, carefully pipette plasma (without disturbing the red cells) into pour off tube. Label with "Plasma" label. Frozen.
85303, 85306
Protein Electrophoresis SPE
GOLD, RED OR SPECKLED. Refrigerated. Fasting sample preferred.
84155, 84165
Protein, Total TPGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84155
Protein, Total (24 h Urine) TPU
24 hr. Urine Container (document volume and total hours collected). Refrigerated.
84156
Protime with INR PTI
BLUE. Refrigerated. Blood should fill to the black error on side of tube. Gently invert tube 6 times.
85610Gently invert tube 6 times.
PTT PTT
BLUE. Refrigerated. Blood should fill to the black error on side of tube. Gently invert tube 6 times.
85730
Quetiapine (Seroquel) serum or plasma
MTS
Lavender, spin and pipette plasma into plastic pour off tube (write 'plasma') orRed top tube, spin and pipette serum into pour off tube (write 'serum'). Refrigerated.
80299
Quinidine QN
RED, Centrifuge and transfer serum or plasma to a polypropylene or polyethylene transport tube. Frozen.
80194
Rabies Titer RABTGOLD, RED OR SPECKLED. Refrigerated.
86317
Rapid Strep Screen RSSCULTURETTE (crush ampule). Refrigerated.
87430
Rast Individual Allergens MSCGOLD, RED OR SPECKLED. Refrigerated.
86003 x number of allergens
Page 25
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Reducing Substance, Stool STRDRandom Stool in PLASTIC, LEAK PROOF CONTAINER. Frozen.
81005
Renal Function Panel/Profile RENLGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
80069
Renin Activity REN
LAVENDER. Centrifuge, pipette plasma (gently) without disturbing red cells, pipette plasma into plastic pour off tube. Place "Plasma" label on pour off tube. Frozen.
84244
Respiratory Culture ***sensitivity-no charge
RESPSTERILE CONTAINER. Room Temperature.
87070
Respiratory Syncytial Virus RESY RSV Collect Kit. Room Temperature. 87280
Retic Count RET LAVENDER. Refrigerated. 85044
Rheumatoid Arthritis Factor RAGOLD, RED OR SPECKLED. Refrigerated.
86430
Rotavirus Antigen, Stool ROAN
Random Stool in PLASTIC, LEAK PROOF CONTAINER. Refrigerate immediately.
87425
RPR RPRGOLD, RED OR SPECKLED. Refrigerated.
86592Refrigerated.
RSV, Respiratory Sync Virus RESY
Collect nasopharyngeal specimen (wash or swab). Submit in saline or viral transport media. Do not send culturette swabs. Room Temperature.
87280
Rubella RUBGOLD, RED OR SPECKLED. Refrigerated.
86762
Salicylate, Serum SALIGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
80196
Salmonella and/or Shigella (order Stool culture)
FECC
Feces Transport vial (Orange) add stool until liquid rises to black line on side of transport vial. Room Temperature.
87045
Sed Rate, Westergren ESR LAVENDER. Refrigerated. 85652
Semen Analysis SMAN
PLASTIC, LEAK PROOF CONTAINER (must receive within 30 min. of collection). Critical to keep sample wrapped in towel next to the body.
89320
Page 26
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Seroquel (Quetiapine), serum or plasma
MTS
LAVENDER, spin and pipette plasma into plastic pour off tube, place "Plasma" label on pour off tube orRed top tube, spin and pipette serum into pour off tube, place "Serum" label on pour-off tube. Refrigerate.
80299
Sickle Cell (Hemoglobin Electrophoresis)
HGBE LAVENDER. Refrigerated. 83020
Sickle Cell Screen, positive/negative only
SIKL LAVENDER. Refrigerated. 85660
Sodium, Serum NAGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84295
Sputum Culture ***sensitivity-no charge
RESPSputum in STERILE CONTAINER. Room Temperature.
87070
Sputum for AFB QAFBSputum in STERILE CONTAINER. Room Temperature.
87015
Staph Screen STAPCULTURETTE (crush ampule). Room Temperature.
87081
LAVENDER, whole blood. Room Temperature.Instructions: Drug regimens, time and
Tacrolimus (Prograf) level PRGF
Instructions: Drug regimens, time and date of drug administration are to be noted on requisition.Therapeutic range applies to trough specimens drawn just before a.m. dose. Optimal time to draw specimen: 0.5-1 hour before next oral dose. Rejection criterion: Clotted specimens or gel barriertubes.
80197
T3, Free (SEND-OUT) aka triiodothyronine, free
T3FGOLD, RED OR SPECKLED. Refrigerated.
84481
T3, Total T3GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84480
T3, Uptake (SEND-OUT) T3UGOLD, RED OR SPECKLED. Refrigerated.
84479
T4, Free FT4 GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84439
T4, Total T4GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84436
Page 27
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Tegretol (aka Carbamazepine) CRMZGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
80156
Testosterone- need red top tube
TEST
RED. Refrigerated.Unacceptable Specimens:Samples exhibiting gross hemolysis and samples collected in any gel-separator tubes are unacceptable.
84403
Testosterone group, free & total
TG
RED. Refrigerated.Unacceptable Specimens:Samples exhibiting gross hemolysis and samples collected in any gel-separator tubes are unacceptable.
84402, 84403
Theophylline THEOGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
80198
Throat Culture ***sensitivity-no charge
THRCULTURETTE (crush ampule). Room Temperature.
87077
Thyroglobulin Ab TRGNGOLD, RED OR SPECKLED. Refrigerated.
86800
Thyroid Peroxidase TPAGOLD, RED OR SPECKLED. Refrigerated.
86376
Thyroid Profile- TSH preformed reflexes if abnormal- TSH
GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84443preformed reflexes if abnormal-n/c
TSHRED OR SPECKLED. Refrigerated.
84443
Thyroid Stimulating Immunoglobulin (TSI)
TSIG
GOLD, RED OR SPECKLED. Refrigerated. Rejection Criteria: Gross hemolysis, gross lipemia or gross icterus
83516
Thyroxine Binding Globulin TBGGOLD, RED OR SPECKLED. Refrigerated.
84442
Tissue Transglutaminase IgG TTRGGOLD, RED OR SPECKLED. Refrigerated.
83516
Tobramycin, Random TOBRGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
80200
Tofranil aka Imipramine and Desipramine
IMDE
LAVENDER, GRAY, GREEN SODIUM HEPARIN, RED. Room Temperature. Do not use gel separator tubes. Collect just before next dose or at least 12 hours after last dose.
80174
Total Iron Profile TIBCGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84466,83540
Page 28
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Total Protein, 24 hr Urine TPU
24 HOUR URINE CONTAINER/ NO PRESERVATIVE. 24 hour Urine collection. Refrigerate during collection. (document volume and total hours collected)
84156
Total Protein/Creatinine Ratio TPCRURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated
84156,82570
Toxoplama IGM TXPMGOLD, RED OR SPECKLED. Refrigerated.
86778
Toxoplasma IGG TXPGOLD, RED OR SPECKLED. Refrigerated.
86777
Transferrin TFNGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84466
Tricyclics Class, Serum TRIGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
80102
Triglycerides TGLGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84478RED OR SPECKLED. Refrigerated.
TSH, third generation 3TSHGOLD, RED OR SPECKLED. Refrigerated.
84443
TSH, Thyroid Stimulating Hormone reflexes if abnormal- n/c
TSHGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84443
Type and Rh, blood ABRHLAVENDER, PINK OR RED. Refrigerated.
86900
Uric Acid URAGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
84550
Urinalysis- reflexes to microscopic (n/c) if abnormal
UMACUrine Cylinder Transport Tube. Refrigerated.
81001
Urine Culture ***sensitivity-no charge
URCUrine Culture Transport (Vacutainer). Room Temperature.
87086
Urine for Micro albumin/creatinine ration
MALUURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated
82043, 82570
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GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Urine for Chlamydia/GC APTIMA
MSC
URINE. Room Temperature: The patient should not have urinated for at leastone hour prior to specimen collection. Direct patient toprovide a first-catch urine into a urine collection cup, the rest of the void in the toilet. Collection of larger volumes of urine may result in specimen dilution that may reduce test sensitivity. Female patients should not cleanse thelabial area prior to providing the specimen. Minimum: 2 mL
87491, 87591
Urine Porphyrins PQ
24 HOUR URINE COLLECTION. ** MUST PROTECT FROM LIGHT**. Indicate total volume on the transport container. Pour off 50 mL into a leak rook, screw top container. Document Total volume on the 50 mL aliquot. Frozen.
84120
UTOX, Urine (medical - no UTOX
URINE OR WHITE URINE 80100
UTOX, Urine (medical - no chain of custody)
UTOXURINE OR WHITE URINE TRANSPORT TUBE. Refrigerated.
80100
Valproic Acid (Depakene) VAPGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
80164
Vancomycin VANRGOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
80202
Varicella Zoster, IgG VZGOLD, RED OR SPECKLED. Refrigerated.
86787
Vitamin B12 (only) VB12GOLD, GREEN LITHIUM HEPARIN, RED OR SPECKLED. Refrigerated.
82607
Vitamin D 25-Hydroxy VD
RED. Fasting specimen is preferred, but not required. Collectblood into plain red top tube without anticoagulant. Allow blood toclot at room temperature for 30 minutes prior to spinning. Spin for 20 minutes and pipette the serum from the cells immediately. Place "Serum" label on pour-off tube. Room Temperature.
82306
Page 30
GHS LABORATORY OUTREACH TEST CODES AND SPECIMEN REQUIREMENTS
Test NameGHS
CODESpecimen Type CPT
Vitamin D,1, 25 dihydroxy D125
RED. Fasting specimen is preferred, but not required. Collectblood into plain red top tube without anticoagulant. Allow blood toclot at room temperature for 30 minutes prior to spinning. Spin for 20 minutes and pipette the serum from the cells immediately. Place "Serum" label on pour-off tube. Room Temperature.
82652
WBC (stool) include yeast WBY
Feces Transport vial (Orange) add stool until liquid rises to black line on side of transport vial. Room
87205side of transport vial. Room Temperature.
Zinc, serum ZNCS
DARK NAVY BLUE, red labeled metal free; pipette into metal free plastic pour off tube. Call laboratory for metal free supplies: 678.312.4731. Refrigerated.
84630
Adjustments/Updates made 11/15/10
Page 31
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