11DXCL ........................................................................................................................................................................ 11-DEOXYCORTISOL10/27/2017: New: New Test - Replaces 11DXC

11DXC ...................................................................................................................................................... 11-DEOXYCORTISOL (LCMSMS)10/27/2017: Delete: This test is being discontinued. Use the ordercode 11DXCL to order this test.

ABOOBI .......................................................................................................................................................... ABO GROUP AND RH TYPE10/27/2017: Delete: This test is being discontinued. Use the ordercode MABORH to order this test.

ACETAZ (ACETAZ.LCA)............................................................................................................................................... ACETAZOLAMIDE10/27/2017: New

AACHE (AACHE.LCA)

ACETYLCHOLINESTERASE (ACHE), AMNIOTIC FLUID WITH REFLEX TO FETAL HEMOGLOBIN (HB F)10/27/2017: Test Name,Synonyms,Container Type,Supply Item Number,Preferred Volume,Patient Prep,Collection Procedure,SpecimenProcessing,Required Patient Info,Unacceptable Condition,Reference Laboratory,Reference lab Test Code,Test Schedule,TurnaroundTime,Method,Notes,Reflex Condition,Reflex Test Name,Reflex CPT codes,Reflex Billing Codes,Please Note

ADM13L .................................................................................................................................................................... ADAMTS13 ANTIBODY10/27/2017: New: New Test - Replaces ADM13I

ADM13I ................................................................................................................................................................. ADAMTS13 INHIB ASSAY10/27/2017: Delete: This test is being discontinued. Use the ordercode ADM13L to order this test.

HYAALC ........................................................................................................................................... ADDITIONAL ALLERGENS HYPEXL10/27/2017: New: New Test - Replaces HYPEXT

ICABAP .................................................................................................................................... ALLERGIC BRONCH ASPERGIL PANEL10/27/2017: Delete: This test is being discontinued. Use the ordercode HYENLB and ABPNLC to order this test.

ALAUQ (ALA-U) ................................................................................................................................ AMINOLEVULINIC ACID, UR 24HR10/27/2017: Delete: This test is being discontinued. Use the ordercode DVALC to order this test.

AMHPLC (AMHPLC.LCA)........................................................................................................................................ AMOXICILLIN, HPLC10/27/2017: Store and Transport,Preferred Volume,Specimen Processing,Required Patient Info,Room Temp,UnacceptableCondition,Reference Laboratory,Reference lab Test Code,CPT Codes,Test Schedule,Turnaround Time,Method,Please Note

ANTIGA ................................................................................................................................................................................................ ANTI-GA10/27/2017: Delete: This test is being discontinued. Use the ordercode ANTGAL to order this test.

IGREA ................................................................................................................................................................................................... ANTI-IGE10/27/2017: New: New Test - Replaces IGERAB

IGERAB ................................................................................................................................................. ANTI-IGE RECEPTOR ANTIBODY10/27/2017: Delete: This test is being discontinued. Use the ordercode IGREA to order this test.

MYEGF (MYEGF.LCA)....................................................................................... ANTI-MYELIN ASSOCIATED GLYCOPROTEIN IGG10/27/2017: Test Name,Container Type,Supply Item Number,Store and Transport,Preferred Volume,Emergency MinimumVolume,Specimen Processing,Room Temp,Refrigerated,Frozen -20c,Unacceptable Condition,Alternate Specimens,ReferenceLaboratory,Reference lab Test Code,Method

SPEABL ........................................................................................................................................... ANTI-SPERMATOZOA ANTIBODIES10/27/2017: New: New Test - Replaces SPABAG

ARBOV (ARBOV.LCA).............................................................................................................. ARBOVIRUS IGG/IGM PANEL SERUM10/27/2017: Test Name,Store and Transport,Preferred Volume,Emergency Minimum Volume,Specimen Processing,RoomTemp,Refrigerated,Frozen -20c,Reference Laboratory,Reference lab Test Code,Turnaround Time,Method

ABAPNL ................................................................................................................................... ASPERGILLOSIS ALLER BRONCH PNL10/27/2017: Delete: This test is being discontinued. Use the ordercodes ABPNLC and HYPENL to order this test.

BACLQL .............................................................................................................................................. BACLOFEN, SERUM OR PLASMA10/27/2017: New: New Test - Replaces BACLQT

BACLQT ..................................................................................................................................................... BACLOFEN, SERUM/PLASMA10/27/2017: Delete: This test is being discontinued. Use the ordercode BACLQL to order this test.

HYENLB ....................................................................................................................................................... BASIC PNEUMONITIS PANEL10/27/2017: New: New Test - Replaces ICABAP

BPRION .......................................................................................................................................................... BILL ONLY 1433 CSF PRION10/27/2017: Delete: This bill only is being discontinued.

Test Change Alert #462 October 09, 2017

Summary Of Changes

page: 1

HIVDIC ............................................................................................................................................... BILL ONLY HIV AB DIFF, CADAVER10/27/2017: Delete: This bill only is being discontinued.

BOVAB ..................................................................................................................................................... BILL ONLY OVARIAN AB TITER10/27/2017: Delete: This bill only is being discontinued.

BUPRO (BUPROPION)............................................................................................................................................................. BUPROPION10/27/2017: Delete: This test is being discontinued. Use the ordercode BUPROL to order this test.

BUPROL ............................................................................................................................... BUPROPION AND HYDROXYBUPROPION10/27/2017: New: New Test - Replaces BUPRO

CA125 ....................................................................................................................................................................................................... CA 12510/3/2017: Room Temp,Frozen -20c

CAREPL ............................................................................................. CARBAMAZEPINE AND CARBAMAZEPINE-10, 11 EPOXIDE10/27/2017: New: New Test - Replaces CAREPX

CAREPX .......................................................................................................................................... CARBAMAZEPINE EPOXIDE/TOTAL10/27/2017: Delete: This test is being discontinued. Use the ordercode CAREPL to order this test.

CLAXSN (CLAXSN.LCA) ..................................................................................................... CATHARTIC LAXATIVES PROF, STOOL10/27/2017: New

CHAGML ........................................................................................................................................ CHLAMYDIA AB EXPANDED PANEL10/27/2017: New: New Test - Replaces CHLGAM

CHLGAM ........................................................................................................................................ CHLAMYDIA SPECIES DIFF AB PNL10/27/2017: Delete: This test is being discontinued. Use the ordercode CHAGML to order this test.

C5SP (C5SP.LCA) ............................................................................................................................................................ COMPLEMENT C510/27/2017: Synonyms,Store and Transport,Emergency Minimum Volume,Specimen Processing,Room Temp,Refrigerated,Frozen -20c,Unacceptable Condition,Reference Laboratory,Reference lab Test Code,Test Schedule,Turnaround Time,Method,Notes,Please Note

C7SPL ................................................................................................................................................................... COMPLEMENT C7 LEVEL10/27/2017: New: New Test - Replaces C7SP

C8SP .................................................................................................................................................................................... COMPLEMENT C810/27/2017: Delete: This test is being discontinued. Use the ordercode C8SPL to order this test.

C8SPL ................................................................................................................................................................... COMPLEMENT C8 LEVEL10/27/2017: New: New Test - C8SP

C9CSP ................................................................................................................................................................................ COMPLEMENT C910/27/2017: Delete: This test is being discontinued. Use the ordercode CPCSPL to order this test.

CPCSPL .............................................................................................................................................................. COMPLEMENT C9 LEVEL10/27/2017: New: New Test - Replaces C9CSP

C7SP ....................................................................................................................................................................................... COMPONENT C710/27/2017: Delete: This test is being discontinued. Use the ordercode C7SPL to order this test.

CPRPHL ......................................................................................................................................................... COPROPORPHYRIN, URINE10/27/2017: Please Note

COXAAB ........................................................................................................................................................... COXSACKIE A9 VIRUS AB10/27/2017: Delete: This test is being discontinued. Use the ordercode COXAB8 to order this test.

CRTUQL ............................................................................................................................................................... CREATINE, URINE 24 HR10/27/2017: New: New Test - Replaces CRTUQ

CRTUQ (CREATINE-U) ...................................................................................................................................... CREATINE, URINE 24HR10/27/2017: Delete: This test is being discontinued. Use the ordercode CRTUQL to order this test.

FLEX (FLEX.LCA) ............................................................................................................. CYCLOBENZAPRINE, SERUM OR PLASMA10/27/2017: New

CYSAB (CYSAB.LCA)..................................................................................................................................... CYSTICERCOSIS AB, CSF10/27/2017: Delete: This test is being discontinued. Use the ordercode CYSGCF to order this test.

CY2D6L .................................................................................................................................... CYTOCHROME P450 2D6 GENOTYPING10/27/2017: New: New Test - Replaces CYP2D6

Test Change Alert #462 October 09, 2017

Summary Of Changes

page: 2

CYP2D6 ........................................................................................................................................................ CYTOCHROME P450 CYP2D610/27/2017: Delete: This test is being discontinued. Use the ordercode CY2D6L to order this test.

DVALC .................................................................................................................... DELTA-AMINOLEVULINIC ACID, 24-HOUR URINE10/27/2017: New: New Test - Replaces ALAUQ

DEOXCC (DEOXCC.LCA) ..................................................................................................... DEOXYCORTICOSTERONE, LC/MS/MS10/27/2017: Container Type,Supply Item Number,Store and Transport,Specimen Type,Preferred Volume,SpecimenProcessing,Refrigerated,Frozen -20c,Alternate Specimens,Reference Laboratory,Reference lab Test Code,Test Schedule,TurnaroundTime,Method

DIANO ...................................................................................................................................................... DIAZEPAM AND NORDIAZEPAM10/27/2017: Delete: This test is being discontinued. Use the ordercode DIANOL to order this test.

DIANOL ................................................................................................................................................. DIAZEPAM, SERUM OR PLASMA10/27/2017: New: New Test - Replaces DIANO

ESSUL ............................................................................................................................................................................ ESTRONE SULFATE10/27/2017: New: New Test - Replaces ESTRS

ESTRS ............................................................................................................................................................................ ESTRONE SULFATE10/27/2017: Delete: This test is being discontinued. Use the ordercode ESSUL to order this test.

ICFEMA (ICFEMA.LCA) ................................................................................................................................................ FEATHER MIX IGE10/27/2017: Room Temp,Refrigerated,Frozen -20c,Unacceptable Condition,Reference Laboratory,Reference lab Test Code,CPTCodes,Turnaround Time,Please Note

FCELOS ...................................................................................................................................... FECAL LYTES/OSMOLALITY PROFILE10/27/2017: Delete: This test is being discontinued. Use the ordercode LYTST and FECOSA to order this test.

LUVOX (LUVOX.LCA).......................................................................................................................................................... FLUVOXAMINE10/27/2017: New

FDPNG4 ................................................................................................................................................... FOOD ALLERGEN PANEL IGG410/27/2017: Delete: This test is being discontinued. Use the ordercode FAP19L and ICMCG4 to order this test.

GABAPU (GABAPU.LCA)...................................................................................................................................... GABAPENTIN, URINE10/27/2017: Preferred Volume,Room Temp,Unacceptable Condition,Reference Laboratory,Reference lab Test Code,CPTCodes,Turnaround Time,Method,Reference Ranges,Please Note

GM1COM ...................................................................................................................................................................... GM1 COMBINATION10/27/2017: Delete: This test is being discontinued. Use the ordercode NEUPR3 and AGQ1BG to order this test.

AGQ1BG ........................................................................................................................................................ GQ1B ANTIBODY IGG RFLX10/27/2017: New: New Test - Replaces GM1COM Reflex testing provided at no charge.

HIVRSF ....................................................................................................................................................................... HIV 1 RNA QUAL, CSF10/27/2017: Delete: This test is being discontinued. Use the ordercode HIVSFL to order this test.

HIVSFL ..................................................................................................................... HIV 1 RNA, REAL TIME PCR (NON-GRAPH), CSF10/27/2017: New: New Test - Replaces HIVRSF

CDHV12 ............................................................................... HIV-1 AND HIV-2 ANTIBODIES FOR CADAVERIC SPECIMENS RFLX10/27/2017: New: New Test - Replaces HV1CD and HIVDIC

HV1CD .................................................................................. HIV-1 AND HIV-2 ANTIBODIES FOR CADAVERIC SPECIMENS RFLX10/27/2017: Delete: This test is being discontinued. Use the ordercode CDHV12 to order this test.

HLABGT (HLABGT.LCA).................................................................................................................... HLA B ABACAVIR SENSITIVITY10/6/2017: New

HLADP ........................................................................................................................................................................ HLA DP GENOTYPING10/27/2017: Delete: This test is being discontinued. Use the ordercode HLADPL to order this test.

HLADPL ............................................................................................................................ HLA DPA1 + HLA DPB1 HIGH RESOLUTION10/27/2017: New: New Test - Replaces HLADP

HLADRG .................................................................................................................................................................. HLA DR GENOTYPING 10/27/2017: Delete: This test is being discontinued. Use the ordercode HLADRB to order this test.

Test Change Alert #462 October 09, 2017

Summary Of Changes

page: 3

HLADRB ................................................................................................................................................... HLA DRB1 HIGH RESOLUTION10/27/2017: New: New Test - Replaces HLADRG

HLBGT ............................................................................................................................................................................... HLA-B GENOTYPE10/6/2017: Delete: This test is being discontinued. Use the ordercode HLABG to order this test.

HIVDPC (HIVDPC.LCA).................................................... HUMAN IMMUNODEFICIENCY VIRUS 1 (HIV-1), QUALITATIVE, RNA10/27/2017: Test Name,Store and Transport,Specimen Type,Specimen Processing,Room Temp,Refrigerated,Frozen -20c,UnacceptableCondition,Alternate Specimens,Reference Laboratory,Reference lab Test Code,Method,Notes

HUNDML ................................................................................................................................ HUNTINGTON DISEASE (HD) MUTATION10/27/2017: New: New Test - Replaces HUNDUW

HUNDUW ................................................................................................................................... HUNTINGTON DISEASE DNA SCREEN10/27/2017: Delete: This test is being discontinued. Use the ordercode HUNDML to order this test.

PLAQ (PLAQ.LCA)............................................................................................................................................ HYDROXYCHLOROQUINE10/27/2017: New

HYPEXT ....................................................................................................................................................... HYPER PNEUMO EXT PANEL10/27/2017: Delete: This test is being discontinued. Use the ordercode HYPEXL and HYAALC to order this test.

HYPENL ............................................................................................................................................ HYPERSENSITIVITY PNEUMONITIS10/27/2017: New: New Test - Replaces ABAPNL

HYPEXL ...................................................................................................................................... HYPERSENSITIVITY PNEUMONITIS #610/27/2017: New: New Test - Replaces HYPEXT

ANTGAL ............................................................................................................................................................... IGA DEFICIENCY PANEL10/27/2017: New: New Test - Replaces ANTIGA

ABPNLC .................................................................................................................................................................. IGE+ALLERGEN MOLD10/27/2017: New: New Test - Replaces ABAPNL and ICABAP

IGFP1 (IGFP1.LCA) ............................................................................................................................................. IGF BINDING PROTEIN 110/27/2017: Synonyms,Store and Transport,Preferred Volume,Emergency Minimum Volume,Specimen Processing,Refrigerated,Frozen -20c,Unacceptable Condition,Alternate Specimens,Reference Laboratory,Reference lab Test Code,CPT Codes,Test Schedule,TurnaroundTime,Method,Notes,Please Note

FAP19L ...................................................................................................................................................... IGG4 ALLERGENS (19) FOODS10/27/2017: New: New Test - Replaces FDPNG4 Results for this test are for Investigational Purposes Only by the assay's manufacturer. The performance characteristics of this product havenot been established.

INDIC (INDIC.LCA) ............................................................................................................................................... INDICANS, URINE QUAL10/27/2017: Delete: This test is being discontinued.

INHBP (INHBP.LCA)........................................................................................................................................................................ INHIBIN B10/27/2017: Store and Transport,Preferred Volume,Emergency Minimum Volume,Patient Prep,Room Temp,Refrigerated,Frozen -20c,Unacceptable Condition,Alternate Specimens,Reference Laboratory,Reference lab Test Code,CPT Codes,Method,Notes,Please Note

IFBSTL .......................................................................................................................... INTERFERON BETA NEUTRALIZING AB RFLX10/27/2017: New: New Test - Replaces INFBEG

INFBEG ..................................................................................................................................................... INTERFERON BETA, IGG RFLX10/27/2017: Delete: This test is being discontinued. Use the ordercode IFBSTL to order this test.

ISOHTS ........................................................................................................................................................... ISOHEMAGGLUTININ TITER10/27/2017: Delete: This test is being discontinued. Use the ordercode ISOHMT to order this test.

LAPRAT ................................................................................................................................................. LACTATE TO PYRUVATE RATIO10/27/2017: Delete: This test is being discontinued. Use the ordercode LAPRAL to order this test.

LAPRAL ................................................................................................................................................................ LACTIC/PYRUVIC RATIO10/27/2017: New: New Test - Replaces LAPRAT

LIVCY ................................................................................................................................................. LC-1 (LIVER CYTOSOL PROTEIN-1)10/27/2017: New: New Test - Replaces LIVCYT

LDLPSR ........................................................................................................................................................................ LDL PARTICLE SIZE10/27/2017: Delete: This test is being discontinued. Use the ordercode NMRLP to order this test.

Test Change Alert #462 October 09, 2017

Summary Of Changes

page: 4

LIBNO ........................................................................................................................................................... LIBRIUM AND NORDIAZEPAM10/27/2017: Delete: This test is being discontinued due to low utilization.

LIPAU ........................................................................................................................................................................................ LIPASE, URINE10/27/2017: Delete: This test is being discontinued. Use suggested order code AMYUQ, AMYUR, or LIPA to order this test.

LASA (LASA.LCA)............................................................................................................................... LIPID-ASSOCIATED SIALIC ACID10/27/2017: New

LSTCSF (LSTCSF.LCA)................................................................................................................................................ LISTERIA AB, CFS10/27/2017: Reference Laboratory,Reference lab Test Code,CPT Codes,Please Note

LIVCYT ................................................................................................................................................ LIVER CYTOSOL AUTOABS (LC 1)10/27/2017: Delete: This test is being discontinued. Use the ordercode LIVCY to order this test.

MCC ................................................................................................................................................... MATERNAL CELL CONTAMINATION10/27/2017: New: New Test - Replaces MCCMA

MCCMA ........................................................................................................................................... MATERNAL CELL CONTAMINATION10/27/2017: Delete: This test is being discontinued. Use the ordercode MCC to order this test.

RITA (RITA.LCA).......................................................................................................................................................... METHYLPHENIDATE10/27/2017: New

MTCPCR (MTCPCR.LCA).............................................................................................................. MTB COMPLEX, NON RESP (PCR)9/21/2017: Synonyms,Specimen Type,Preferred Volume,Emergency Minimum Volume,Refrigerated,Frozen -20c,UnacceptableCondition,Alternate Specimens,Test Schedule,Turnaround Time

MYAJO1 ......................................................................................................................................... MYOSITIS ASSESS, JO 1 AUTOABS 10/27/2017: Delete: This test is being discontinued. Use the ordercode MYOPII to order this test.

MYOPII ............................................................................................................................................................................. MYOSITIS PANEL II10/27/2017: New: New Test - Replaces MYAJO1

INFBR ............................................................................................................................................ NABFERON NEUTRALIZING AB TEST10/27/2017: Delete: This bill only test is being discontinued.

NEUIGB .............................................................................................................................................................. NEURONAL NUCLEAR AB10/27/2017: Delete: This test is being discontinued. Use the ordercode PARNP1 to order this test.

NEUPR3 ................................................................................................................................................ NEUROPATHY PROFILE III RFLX10/27/2017: New: New Test - Replaces GM1COM Reflex testing provided at no charge.

OBGA ................................................................................................................................................... OCCULT BLOOD, GASTRIC FLUID10/27/2017: Delete: This test is being discontinued. Use the ordercode OCBDLL to order this test.

OCBDLL ............................................................................................................................................. OCCULT BLOOD, GASTRIC FLUID10/27/2017: New: New Test - Replaces OBGA

OVAB .............................................................................................................................................................. OVARIAN AB SCREEN RFLX10/27/2017: Delete: This test is being discontinued. Use the ordercode OVABL to order this test.

OVABL .......................................................................................................................................................... OVARY ANTIBODY IGG RFLX10/27/2017: New: New Test - Replaces OVAB and BOVAB

PAROX (PAROX.LCA)............................................................................................................................................................ PAROXETINE10/27/2017: New

B19ABP (B19ABP.LCA).......................................................................................................................... PARVOVIRUS B19 AB PANEL10/27/2017: Synonyms,Container Type,Supply Item Number,Store and Transport,Specimen Type,Preferred Volume,Emergency MinimumVolume,Specimen Processing,Room Temp,Refrigerated,Frozen -20c,Unacceptable Condition,Reference Laboratory,Reference lab TestCode,Method,Notes

PAPEB (PEMPEB)..................................................................................................................................................... PEMPHIGOID PANEL10/27/2017: Delete: This test is being discontinued. Use the ordercode GLBMAB and BUPHLC to order this test.

ICPWEI ............................................................................................................................................................................ PEPPER WHITE IGE10/27/2017: Delete: This test is being discontinued. Use the ordercode ICFBP to order this test.

PRION (PRION.LCA)..................................................................................................................... PRION PROTEIN (14,3,3), CSF RFLX10/27/2017: Reference Laboratory,Reference lab Test Code,Reflex Condition,Reflex Test Name,Reflex CPT codes,Reflex Billing

Test Change Alert #462 October 09, 2017

Summary Of Changes

page: 5

Codes,Please Note PROPAF (PROPAFENONE)............................................................................................................................................. PROPAFENONE

10/27/2017: Delete: This test is being discontinued due to low utilization. PYRURI (PYRURI.LCA) ............................................................................................................................................... PYRROLES, URINE

10/27/2017: Container Type,Supply Item Number,Preferred Volume,Patient Prep,Specimen Processing,Frozen -20c,UnacceptableCondition,Reference Laboratory,Reference lab Test Code,CPT Codes,Clinical Significance,Please Note

PYACFA (PYACFA.LCA).......................................................................................................................................... PYRUVIC ACID, CSF10/27/2017: New

SILIS (SILIS.LCA)................................................................................................................................................................................ SILICON10/27/2017: New

SMADS ................................................................................................................................................................... SMA DIAGNOSTIC TEST9/27/2017: Delete: This test is being discontinued. Use the ordercode SMACNA to order this test.

SPABAG ..................................................................................................................................................... SPERM ANTIBODY (IGA, IGG)10/27/2017: Delete: This test is being discontinued. Use the ordercode SPEABL to order this test.

SPAU (SPAU.LCA).................................................................................................................. S-PHENYLMERCAPTURIC ACID, URINE10/27/2017: Reference Laboratory,Reference lab Test Code,Reflex CPT codes,Reflex Billing Codes,Please Note

STREPL (STREPL.LCA)..................................................................................................................... STREPTOMYCIN, LEVEL (HPLC)9/21/2017: CPT Codes,Please Note

THYMA .................................................................................................................................... THYMIDINE DETERMINATION - PLASMA10/27/2017: New: New Test - Replaces THYDET

THYDET .................................................................................................................................................... THYMIDINE PHOSPHORYLASE10/27/2017: Delete: This test is being discontinued. Use the ordercode THYMA to order this test.

TOC (TOC.LCA).................................................................................................................................... TOCAINIDE, SERUM OR PLASMA10/27/2017: New

TOXOC .............................................................................................................................................. TOXOCARA (T. CANIS/T. CATA) AB9/21/2017: Delete: This test is being discontinued. Use the ordercode TOXC to order this test.

TRICAB (TRICH)..................................................................................................................................................... TRICHINELLA AB, IGG11/11/2017: Delete: This test is being discontinued.

TCRTA ............................................................................................................................................... TROFILE CO RECEPTOR TROPISM10/27/2017: Delete: This test is being discontinued. Use the ordercode TROFIL to order this test.

TROFIL ...................................................................................................................................................................................... TROFILE®10/27/2017: New: New Test - Replaces TCRTA

VERAPA (VERAPA.LCA)......................................................................................................................................................... VERAPAMIL10/27/2017: New

ICWISI ................................................................................................................................................................................... WINGSCALE IGE10/27/2017: Delete: This test is being discontinued. Use the ordercode ICWSC to order this test.

Test Change Alert #462 October 09, 2017

Summary Of Changes

page: 6

11-DEOXYCORTISOLTest Code 11DXCL

Billing Code 11DXCLEffective 10/27/2017

Synonyms 11-Desoxycortisol; Compound S for Metyrapone Test

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type Serum

Preferred Volume 0.5 mL

EmergencyMinimum Volume

0.2 mL

Patient Prep No isotopes administered 24 hours prior to venipuncture.

SpecimenProcessing

Separate serum from cells within one hour of collection and transfer to a standard PAML aliquot tube. Freezeimmediately and maintain frozen until tested.

Room Temp 1 day

Refrigerated 1 day

Frozen -20c 2 years

UnacceptableCondition

Recently administered isotopes

ReferenceLaboratory

LabCorp

Reference labTest Code

500550

CPT Codes 82634

Test Schedule Mon, Thu

Turnaround Time 4-7 days

Method High-Pressure Liquid Chromatography/Tandem Mass Spectrometry

Notes

Use: Evaluate hypothalamic-pituitary-adrenal axis and pituitary ACTH reserve.

Additional Informaion: 11-Deoxycortisol is the immediate precursor of cortisol and follows the same catabolicpathways as cortisol. The conversion of 11-deoxycortisol to cortisol is inhibited by metyrapone, which acts on 11-beta-hydroxylase. The metyrapone test (see the online Endocrine Appendix: ACTH Stimulation) serves as a reliableand sensitive indicator of pituitary ACTH secretory reserve. The 11-deoxycortisol levels normally increase to 100times the control value following metyrapone administration. Reduced response occurs in patients withhypoadrenalism or with hypopituitarism and in some patients with diseases of the hypothalamus. Patients withmyxedema, some pregnant patients, and those on oral contraceptives respond poorly.

New New Test - Replaces 11DXC

11-DEOXYCORTISOL (LCMSMS)Test Code 11DXC

Billing Code 11DXCEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode 11DXCL to order this test.

ABO GROUP AND RH TYPETest Code ABOOBI

Billing Code ABOOBIEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode MABORH to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 7

ACETAZOLAMIDETest Code ACETAZ

Billing Code ACETAZ.LCAEffective 10/27/2017

Synonyms Diamox

Container Type Red top tube (plain)

Supply ItemNumber

1372

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 1 mL

EmergencyMinimum Volume

0.5 mL

Patient Prep Trough levels are most reproducible.

SpecimenProcessing

Separate serum or plasma from cells and transfer to a standard PAML aliquot tube.

Room Temp 3 days

UnacceptableCondition

Gel barrier tubes

AlternateSpecimens

Green top tube (heparin)

ReferenceLaboratory

LabCorp

Reference labTest Code

811984

CPT Codes 80375, HCPCS G0480

Method High-Pressure Liquid Chromatography with Ultraviolet Detection

Notes Use: Therapeutic drug management

New New Test

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 8

ACETYLCHOLINESTERASE (ACHE), AMNIOTIC FLUID WITH REFLEX TO FETAL HEMOGLOBIN (HBF)

Test Code AACHE

Billing Code AACHE.LCAEffective 10/27/2017

Synonyms AChE; Amniotic Fluid With Reflex to Hb F

Container Type Sterile plastic conical tube

Supply ItemNumber

8671

Preferred Volume 3 mL

Patient Prep The patient should have undergone ultrasound studies to verify fetal viability, detect multiple gestation, confirmgestational age, localize placenta, and detect fetal and uterine pathology.

CollectionProcedure

Avoid contamination of amniotic fluid with maternal or fetal blood. As little as one drop of fetal blood can causefalse-positive results during assay of amniotic fluid. Amniotic fluid should be collected by the attending physician.

SpecimenProcessing

Do not centrifuge specimen. If cytogenetics is also ordered, do not split or pour off specimen; send all specimen toCytogenetics. Complete a cytogenetics form.

Required PatientInfo

The patient's gestational age must be at least 13 weeks for accurate AChE detection. Optimal gestational age is 14to 18 weeks. Include the gestational age by ultrasound and/or last menstrual period (LMP) on the request form.

UnacceptableCondition

Do not use urine containers or tubes with rubber stoppers; rubber is toxic to amniocytes. Specimen found not tobe amniotic fluid; gross contamination of amniotic fluid with maternal or fetal blood; quantity not sufficient foranalysis

ReferenceLaboratory

LabCorp

Reference labTest Code

510354

Test Schedule Set up and reported 2x/week or 3x/week

Turnaround Time 7 days

Method Acrylamide Gel Electrophoresis; Isoelectric Focusing (IEF)

NotesUse: Analysis of midtrimester amniotic fluid for detection of open neural tube defects and ventral wall defectsDetection of AChE. The reflex to fetal hemoglobin (Hb F) will be performed, if necessary, to ascertain falseelevations of amniotic fluid AFP.

Reflex Testing

Reflex Condition Reflex Test Name Reflex CPT codes Reflex Billing Codes

Acetylcholinesterase, Amnio ispositive

Fetal Hemoglobin 83020 FHGB

Please Note Reflex testing performed at no charge.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 9

ADAMTS13 ANTIBODYTest Code ADM13L

Billing Code ADM13LEffective 10/27/2017

Container Type Blue top tube (buffered sodium citrate)

Supply ItemNumber

1072

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type Plasma

Preferred Volume 0.5 mL

EmergencyMinimum Volume

0.3 mL

CollectionProcedure

Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate. Evacuated collection tubesmust be filled to completion to ensure a proper blood-to-anticoagulant ratio. The sample should be mixedimmediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood.

SpecimenProcessing

Centrifuge and carefully remove the plasma using a plastic transfer pipette, being careful not to disturb the cells.Transfer plasma into a standard PAML aliquot tube and freeze immediately. Maintain frozen until tested.

UnacceptableCondition

Nonfrozen sample received; noncitrate plasma received; sample left on cells

LimitationsResults for this test are for research purposes only by the assay's manufacturer. The performance characteristicsof this product have not been established. Results should not be used as a diagnostic procedure withoutconfirmation of the diagnosis by another medically established diagnostic product or procedure.

ReferenceLaboratory

LabCorp

Reference labTest Code

117915

CPT Codes 83520

Method Enzyme-Linked Immunosorbent Assay

ReferenceRanges

Title Ranges Units

ADAMTS13 Antibody < 12 u/mL

Notes Use: Differentiating congenital from autoimmune ADAMTS13 deficiency

New New Test - Replaces ADM13I

Please Note Critical frozen

ADAMTS13 INHIB ASSAYTest Code ADM13I

Billing Code ADM13IEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode ADM13L to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 10

ADDITIONAL ALLERGENS HYPEXLTest Code HYAALC

Billing Code HYAALCEffective 10/27/2017

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 1.8 mL

EmergencyMinimum Volume

1.8 mL

SpecimenProcessing

Separate serum from cells and transfer to a standard PAML aliquot tube.

AlternateSpecimens

Red top tube (plain)

ReferenceLaboratory

LabCorp

Reference labTest Code

605853

CPT Codes 86003 x 3

Method Thermo Fisher ImmunoCAP®

New New Test - Replaces HYPEXT

Fees Fees for this test are being adjusted. Please contact your Sales Representative or Client Services for feeinformation.

ALLERGIC BRONCH ASPERGIL PANELTest Code ICABAP

Billing Code ICABAPEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode HYENLB and ABPNLC to order this test.

Fees Fees for this test are being adjusted. Please contact your Sales Representative or Client Services for feeinformation.

AMINOLEVULINIC ACID, UR 24HRTest Code ALAUQ

Billing Code ALA-UEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode DVALC to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 11

AMOXICILLIN, HPLCTest Code AMHPLC

Billing Code AMHPLC.LCAEffective 10/27/2017

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Preferred Volume 2 mL

SpecimenProcessing

Separate serum from cells within two hours of collection and transfer to a standard PAML aliquot tube and freeze.

Required PatientInfo

Drug dose and frequency, including time of last dose should be indicated on request form.

Room Temp 1 day

UnacceptableCondition

Severe hemolysis; thawed samples for greater than 24 hours

ReferenceLaboratory

LabCorp

Reference labTest Code

816458

CPT Codes 80375

Test Schedule Mon-Fri

Turnaround Time Within 7-8 days

Method Liquid Chromatography/Mass Spectrometry

Please Note Previous CPT Code: 80299

ANTI-GATest Code ANTIGA

Billing Code ANTIGAEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode ANTGAL to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 12

ANTI-IGETest Code IGREA

Billing Code IGREAEffective 10/27/2017

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Ambient (room temperature)

Specimen Type Serum

Preferred Volume 1 mL

EmergencyMinimum Volume

0.1 mL

SpecimenProcessing

Separate serum from cells and transfer to a standard PAML aliquot tube.

Room Temp 2 weeks

ReferenceLaboratory

LabCorp

Reference labTest Code

805243

CPT Codes 83516

Turnaround Time 7-9 days from receipt of specimen

Method ELISA

ComplianceRemarks

This test was developed and its performance characteristics determined by Viracor-IBT Laboratories. It has notbeen cleared or approved by the FDA.

New New Test - Replaces IGERAB

ANTI-IGE RECEPTOR ANTIBODYTest Code IGERAB

Billing Code IGERABEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode IGREA to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 13

ANTI-MYELIN ASSOCIATED GLYCOPROTEIN IGGTest Code MYEGF

Billing Code MYEGF.LCAEffective 10/27/2017

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Preferred Volume 1 mL

EmergencyMinimum Volume

0.5 mL

SpecimenProcessing

Separate serum from cells and transfer to a standard PAML aliquot tube.

Room Temp 2 days

Refrigerated 5 days

Frozen -20c 1 year

UnacceptableCondition

Grossly hemolyzed, lipemic, or icteric specimens

AlternateSpecimens

Red top tube (plain)

ReferenceLaboratory

LabCorp

Reference labTest Code

806387

Method Indirect Immunofluorescence Substrate: primate nerve

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 14

ANTI-SPERMATOZOA ANTIBODIESTest Code SPEABL

Billing Code SPEABLEffective 10/27/2017

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type Serum

Preferred Volume 5 mL

EmergencyMinimum Volume

2 mL

SpecimenProcessing

Separate serum from cells within 2 hours of collection and transfer to a standard PAML aliquot tube and freeze.

Refrigerated 5 days

Frozen -20c 1 year

AlternateSpecimens

Red top tube (plain)

ReferenceLaboratory

LabCorp

Reference labTest Code

808813

CPT Codes 89325

Test Schedule Weekly x 1

Turnaround Time Within one week from the time of specimen receipt

Method Enzyme-linked immunosorbent assay

New New Test - Replaces SPABAG

ARBOVIRUS IGG/IGM PANEL SERUMTest Code ARBOV

Billing Code ARBOV.LCAEffective 10/27/2017

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Preferred Volume 5 mL

EmergencyMinimum Volume

2 mL

SpecimenProcessing

Serum must be separated from cells within 45 minutes of venipuncture. Transfer to a standard PAML aliquot tubeand freeze.

Room Temp 2 days

Refrigerated 1 month

Frozen -20c 1 month; Freeze/thaw cycle: Stable x 3

ReferenceLaboratory

LabCorp

Reference labTest Code

820466

Turnaround Time 7 business days from receipt of sample

Method IFA

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 15

ASPERGILLOSIS ALLER BRONCH PNLTest Code ABAPNL

Billing Code ABAPNLEffective 10/27/2017

Delete This test is being discontinued. Use the ordercodes ABPNLC and HYPENL to order this test.

Fees Fees for this test are being adjusted. Please contact your Sales Representative or Client Services for feeinformation.

BACLOFEN, SERUM OR PLASMATest Code BACLQL

Billing Code BACLQLEffective 10/27/2017

Synonyms Gablofen®; Kemstro®; Lioresal®

Container Type Red top tube (plain)

Supply ItemNumber

1372

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 2 mL

EmergencyMinimum Volume

0.5 mL

Patient Prep Trough levels are most reproducible.

SpecimenProcessing

Separate serum from cells within two hours of collection and transfer to a standard PAML aliquot tube.

Room Temp 3 days

Refrigerated 1 week

Frozen -20c 1 year

UnacceptableCondition

Gel-barrier tubes

AlternateSpecimens

Green top tube (heparin)

ReferenceLaboratory

LabCorp

Reference labTest Code

808300

CPT Codes 80369

Method Liquid Chromatography/Tandem Mass Spectrometry

ComplianceRemarks

This test was developed and its performance characteristics determined by LabCorp. It has not been cleared orapproved by the Food and Drug Administration.

Notes Use: Therapeutic drug management.

New New Test - Replaces BACLQT

BACLOFEN, SERUM/PLASMATest Code BACLQT

Billing Code BACLQTEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode BACLQL to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 16

BASIC PNEUMONITIS PANELTest Code HYENLB

Billing Code HYENLBEffective 10/27/2017

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 1.5 mL

SpecimenProcessing

Separate serum from cells and transfer to a standard PAML aliquot tube.

Room Temp 1 week

Refrigerated 2 weeks

Frozen -20c 2 weeks; Freeze/thaw cycles: Stable x 2

UnacceptableCondition

Excessive hemolysis

AlternateSpecimens

Red top tube (plain)

Limitations A positive test does not establish the diagnosis of hypersensitivity pneumonitis, nor does the absence ofprecipitins eliminate the diagnosis.

ReferenceLaboratory

LabCorp

Reference labTest Code

605852

CPT Codes 86606 x 2

Test Schedule Mon-Fri

Turnaround Time 5-7 days

Method Double diffusion (Ouchterlony)

New New Test - Replaces ICABAP

Fees Fees for this test are being adjusted. Please contact your Sales Representative or Client Services for feeinformation.

BILL ONLY 1433 CSF PRIONTest Code BPRION

Billing Code BPRIONEffective 10/27/2017

Delete This bill only is being discontinued.

BILL ONLY HIV AB DIFF, CADAVERTest Code HIVDIC

Billing Code HIVDICEffective 10/27/2017

Delete This bill only is being discontinued.

BILL ONLY OVARIAN AB TITERTest Code BOVAB

Billing Code BOVABEffective 10/27/2017

Delete This bill only is being discontinued.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 17

BUPROPIONTest Code BUPRO

Billing Code BUPROPIONEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode BUPROL to order this test.

BUPROPION AND HYDROXYBUPROPIONTest Code BUPROL

Billing Code BUPROLEffective 10/27/2017

Synonyms Bupropion and Hydroxybupropion, Serum or Plasma; Wellbutrin®; Zyban®

Container Type Red top tube (plain)

Supply ItemNumber

1372 & 4459

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type Serum

Preferred Volume 3 mL

EmergencyMinimum Volume

0.6 mL

Patient Prep Trough levels are most reproducible.

SpecimenProcessing

Centrifuge within 30 minutes of collection. Transfer separated serum or plasma to the "Transfer for BupropionAnalysis" tube containing sodium citrate monobasic (white powder). Mix well. Freeze immediately.

Room Temp 1 day

Refrigerated 2 weeks

Frozen -20c 2 weeks

UnacceptableCondition

Gel-barrier tubes; specimen received not frozen; sample not received in "Transfer for Bupropion Analysis" tube.

AlternateSpecimens

Green top tube: Heparin

ReferenceLaboratory

LabCorp

Reference labTest Code

811083

CPT Codes 80338

Method Liquid Chromatography with Tandem Mass Spectrometry

ComplianceRemarks

This test was developed and its performance characteristics determined by LabCorp. It has not been cleared orapproved by the Food and Drug Administration.

Notes

Note: Stability applies to the buffered sample

Use: Therapeutic drug management

New New Test - Replaces BUPRO

CA 125Test Code CA125

Billing Code CA125Effective 10/3/2017

Room Temp 8 hours

Frozen -20c 6 months

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 18

CARBAMAZEPINE AND CARBAMAZEPINE-10, 11 EPOXIDETest Code CAREPL

Billing Code CAREPLEffective 10/27/2017

Synonyms Carbamazepine and Carbamazepine-10,11 Epoxide, Serum or Plasma; Carbatrol; Epitol; Tegretol; CBZ; Epoxide

Container Type Red top tube (plain)

Supply ItemNumber

1372

Store andTransport

Refrigerated

Specimen Type 2 mL

Preferred Volume 0.5 mL

Patient Prep Trough levels are most reproducible.

SpecimenProcessing

Separate serum or plasma from cells within two hours of collection and transfer to a standard PAML aliquot tube.

Room Temp 3 days

UnacceptableCondition

Gel barrier tubes

AlternateSpecimens

Green top tube (heparin)

ReferenceLaboratory

LabCorp

Reference labTest Code

803189

CPT Codes 80339

Method High-Pressure Liquid Chromatography with Ultraviolet Detection

ComplianceRemarks

This test was developed and its performance characteristics determined by LabCorp. It has not been cleared orapproved by the Food and Drug Administration.

Notes Use: Therapeutic drug management

New New Test - Replaces CAREPX

CARBAMAZEPINE EPOXIDE/TOTALTest Code CAREPX

Billing Code CAREPXEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode CAREPL to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 19

CATHARTIC LAXATIVES PROF, STOOLTest Code CLAXSN

Billing Code CLAXSN.LCAEffective 10/27/2017

Synonyms Clysodrast®; Dulcolax®; Phenolax®

Container Type Plastic container (acid washed or trace metal-free)

Supply ItemNumber

3132

Store andTransport

Refrigerated

Specimen Type Stool fluid or stool solid

Preferred Volume 20 mL stool fluid or 20 grams stool solid

EmergencyMinimum Volume

10 grams

Room Temp 1 month

Refrigerated 1 month

Frozen -20c 1 month

ReferenceLaboratory

LabCorp

Reference labTest Code

810200

CPT Codes 83735, 84100

Test Schedule Mon-Fri

Turnaround Time Up to 14 days after set up

Method Inductively Coupled Plasma/Optical Emission Spectrometry

New New Test

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 20

CHLAMYDIA AB EXPANDED PANELTest Code CHAGML

Billing Code CHAGMLEffective 10/27/2017

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type Serum

Preferred Volume 1 mL

EmergencyMinimum Volume

0.15 mL

SpecimenProcessing

Separate serum from cells within 45 minutes of collection and transfer to a standard PAML aliquot tube and freeze.

Refrigerated 1 month

Frozen -20c 1 month; Freeze/thaw cycles: Stable x 4

UnacceptableCondition

Hyperlipemic serum; hemolyzed serum; contaminated sera. Greater than four FREEZE thaw cycles; sample isoutside the listed stability range.

ReferenceLaboratory

LabCorp

Reference labTest Code

821218

CPT Codes 86631 x 6, 86632 x 3

Turnaround Time 5-7 days

Method Indirect Fluorescent Antibody

New New Test - Replaces CHLGAM

CHLAMYDIA SPECIES DIFF AB PNLTest Code CHLGAM

Billing Code CHLGAMEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode CHAGML to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 21

COMPLEMENT C5Test Code C5SP

Billing Code C5SP.LCAEffective 10/27/2017

Synonyms C5; C5 Antigen; C5 Level; Fifth component of complement

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

EmergencyMinimum Volume

0.3 mL

SpecimenProcessing

Allow specimen to clot for one hour at room temperature. Separate serum from cells ASAP or within two hours ofcollection. Transfer serum to a standard PAML aliquot tube and freeze immediately. CRITICAL FROZEN.

Room Temp 2 hours

Refrigerated Unacceptable

Frozen -20c 2 weeks

UnacceptableCondition

Non-frozen specimens; specimens exposed to repeated freeze/thaw cycles; specimens left to clot at refrigeratedtemperature.

ReferenceLaboratory

LabCorp

Reference labTest Code

803029

Test Schedule Tue, Fri

Turnaround Time 4-9 days

Method Quantitative Radial Immunodiffusion

Notes Use: Follow-up test for complement activity screening when CH50 and AH50 are low or absent and high suspicionremains for complement deficiency.

Please Note Critical frozen

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 22

COMPLEMENT C7 LEVELTest Code C7SPL

Billing Code C7SPLEffective 10/27/2017

Synonyms Complement (C7 level); Radial Immuno Assay (C7 level)

Container Type Lavender top tube (EDTA)

Supply ItemNumber

1222

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type Plasma

Preferred Volume 1 mL

EmergencyMinimum Volume

250 µL (Pediatric)

CollectionProcedure

After collection gently rotate sample mixing well.

SpecimenProcessing

Centrifuge at room temp within one half hour of collection; preferably immediately after venipuncture. Transfer thecell-free plasma to a standard PAML aliquot tube and freeze immediately on dry ice or at -70°C. CRITICAL FROZEN

Frozen -70c 1 year

UnacceptableCondition

Thawed specimen

ReferenceLaboratory

LabCorp

Reference labTest Code

224427

CPT Codes 86160

Test Schedule Varies

Turnaround Time Up to 4 weeks

Method Radial Immunodiffusion

New New Test - Replaces C7SP

Please Note Critical frozen

COMPLEMENT C8Test Code C8SP

Billing Code C8SPEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode C8SPL to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 23

COMPLEMENT C8 LEVELTest Code C8SPL

Billing Code C8SPLEffective 10/27/2017

Synonyms Complement (C8 Level); Radial Immuno Assay (C8 Level)

Container Type Lavender top tube (EDTA)

Supply ItemNumber

1222

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type Plasma

Preferred Volume 1 mL

EmergencyMinimum Volume

0.5 mL

CollectionProcedure

After collection gently rotate sample mixing well.

SpecimenProcessing

Centrifuge at room temp within one half hour of collection; preferably immediately after venipuncture. Transfer thecell-free plasma to a standard PAML aliquot tube and freeze immediately on dry ice or at -70°C. CRITICAL FROZEN

Frozen -70c 1 year

UnacceptableCondition

Thawed specimen

ReferenceLaboratory

LabCorp

Reference labTest Code

840769

CPT Codes 86160

Test Schedule Varies

Turnaround Time Up to 4 weeks

Method Radial Immunodiffusion

New New Test - C8SP

Please Note Critical frozen

COMPLEMENT C9Test Code C9CSP

Billing Code C9CSPEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode CPCSPL to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 24

COMPLEMENT C9 LEVELTest Code CPCSPL

Billing Code CPCSPLEffective 10/27/2017

Synonyms Complement (C9 Level); Radial Immuno Assay (C9 Level)

Container Type Lavender top tube (EDTA)

Supply ItemNumber

1222

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type Plasma

Preferred Volume 1 mL

EmergencyMinimum Volume

250 uL (Pediatric)

CollectionProcedure

After collection gently rotate sample mixing well.

SpecimenProcessing

Centrifuge at room temp within one half hour of collection; preferably immediately after venipuncture. Transfer thecell-free plasma to a standard PAML aliquot tube and freeze immediately on dry ice or at -70C. CRITICAL FROZEN

Frozen -70c 1 year

UnacceptableCondition

Thawed specimen

ReferenceLaboratory

LabCorp

Reference labTest Code

279053

CPT Codes 86160

Test Schedule Varies

Turnaround Time Up to 4 weeks

Method Radial Immunodiffusion

New New Test - Replaces C9CSP

Please Note Critical frozen

COMPONENT C7Test Code C7SP

Billing Code C7SPEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode C7SPL to order this test.

COPROPORPHYRIN, URINETest Code CPRPHL

Billing Code CPRPHLEffective 10/27/2017

Please Note Please refer to the IMB for important interface updates. New AOE has been added to the test.

COXSACKIE A9 VIRUS ABTest Code COXAAB

Billing Code COXAABEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode COXAB8 to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 25

CREATINE, URINE 24 HRTest Code CRTUQL

Billing Code CRTUQLEffective 10/27/2017

Synonyms CreatU+Crti24

Container Type 24 hour dark plastic urine container, no preservative

Supply ItemNumber

1108

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type Urine, 24 hour

Preferred Volume 3 mL aliquot

EmergencyMinimum Volume

2 mL aliquot

CollectionProcedure

The collection of the 24-hour urine starts with the patient voiding (completely emptying bladder) and discardingthe first urine passed (ie, 8 AM or 8 PM). Then collect all urine including the final specimen voided at the end of the24-hour collection period (ie, 8 AM or 8 PM the following day). Specimen must be kept refrigerated duringcollection.

SpecimenProcessing

Aliquot 3 mL of a well-mixed 24 hour urine collection into a leakproof plastic urine container and freeze. Recordtotal volume and collection period. The specimen should be frozen immediately and maintained frozen until tested.

Required PatientInfo

Patient's sex, 24-hour total volume and collection period on the request form.

Frozen -20c 2 weeks

UnacceptableCondition

Thawed specimen; 6N HCl, boric acid, or alkali added to collection (Acid or alkali preservative will convert creatineto creatinine, falsely lowering creatine values.)

ReferenceLaboratory

LabCorp

Reference labTest Code

204672

CPT Codes 82540, 82570

Test Schedule Tue, Thu

Turnaround Time 3-5 days

Method Enzymatic (creatinase)/Spectrophotometry

Notes

Use: Determine creatinuria; increased urine creatine values may be obtained from diseases that reduce musclemass, including fasting, muscular dystrophy, poliomyelitis, atrophy, inflammatory destructive muscle disease aspolymyositis, hyperthyroidism, as well as corticosteroid induced myopathy.

Additional Information: Creatine is endogenously synthesized in the kidney, liver, and pancreas. It is transported inblood to other organs such as muscle and brain, where it is phosphorylated to phosphocreatine. Interconversionof phosphocreatine and creatine is a unique feature of the metabolic processes of muscle contraction; some of thefree creatine in muscle spontaneously converts to creatinine, its anhydride. Between 1% and 2% of musclecreatine is converted to creatinine daily.

New New Test - Replaces CRTUQ

CREATINE, URINE 24HRTest Code CRTUQ

Billing Code CREATINE-UEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode CRTUQL to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 26

CYCLOBENZAPRINE, SERUM OR PLASMATest Code FLEX

Billing Code FLEX.LCAEffective 10/27/2017

Synonyms Flexeril; Amrix; Fexmid

Container Type Red top tube (plain)

Supply ItemNumber

1372

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 2 mL

EmergencyMinimum Volume

0.5 mL

Patient Prep Trough levels are most reproducible.

SpecimenProcessing

Separate serum or plasma from cells within 2 hours of collection and transfer to a standard PAML aliquot tube.

Room Temp 3 days

UnacceptableCondition

Gel barrier tubes

AlternateSpecimens

Green top tube (heparin)

ReferenceLaboratory

LabCorp

Reference labTest Code

811075

CPT Codes 80369

Method Liquid Chromatography/Tandem Mass Spectrometry

ReferenceRanges

Title Ranges Units

Cyclobenzaprine 10-30 ng/mL

Notes Use: Therapeutic drug management

New New Test

CYSTICERCOSIS AB, CSFTest Code CYSAB

Billing Code CYSAB.LCAEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode CYSGCF to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 27

CYTOCHROME P450 2D6 GENOTYPINGTest Code CY2D6L

Billing Code CY2D6LEffective 10/27/2017

Synonyms DME Genotyping

Container Type Lavender-top tube (EDTA), or yellow-top tube (ACD), or LabCorp buccal swab kit

Supply ItemNumber

1222 or 1055 or 6039 or 1701K

Store andTransport

Maintain specimen at room temperature or refrigerate at 4°C.

Specimen Type Whole blood or LabCorp buccal swab kit (Buccal swab collection kit contains instructions for use of a buccalswab)

Preferred Volume 7 mL whole blood or LabCorp buccal swab kit

EmergencyMinimum Volume

3 mL whole blood or two buccal swabs

UnacceptableCondition

Frozen or hemolyzed specimen; quantity not sufficient for analysis; one buccal swab; improper container; wetbuccal swab

Limitations

This assay does not detect other variants in the CYP2D6 gene that may affect metabolic activity. The metabolismof drugs is also influenced by race, ethnicity, diet, and medications. All factors should be considered prior toinitiating new therapy. This testing does not rule out the possibility of variant alleles in other drug metabolismpathways.

ReferenceLaboratory

LabCorp

Reference labTest Code

511230

CPT Codes 81226

Test Schedule Weekly x 2

Turnaround Time 6-8 days

Method DNA Analysis/Multiplex Polymerase Chain Reaction

Notes

Use: This testing can assist with customizing drug therapy by providing metabolic activity information that mayexplain patient drug responses relevant to CYP2D6 genetic variability. The cytochrome P450 (CYP450) enzymesmetabolize many drugs. Individual genetic differences of cytochrome P450 activity can result in the total absenceof metabolism to ultrafast metabolism of certain drugs.Additional Information: This can lead to adverse drug reactions or a lack of therapeutic effect under standardtherapy conditions. CYP2D6 metabolizes 25% to 30% of all prescribed drugs.Common drugs metabolized by 2D6 include, but are not limited to:Opioids: Codeine, dihydrocodeine, hydrocodone, oxycodone, tramadolBeta-blockers: Carvedilol, S-metoprolol, propafenone, propranolol, timololCardioreactive drugs: Encainide, flecainide, lidocaine, mexiletine, perhexilineAntidepressants: Amitriptyline, clomipramine, desipramine, doxepin (E-isomers), fluoxetine, fluvoxamine,imipramine, maprotiline, nortriptyline, paroxetine, sertraline, venlafaxineAntipsychotics: Aripiprazole, haloperidol, perphenazine, risperidone, thioridazine, zuclopenthixolOthers: Tamoxifen, ondansetron, phenformin

New New Test - Replaces CYP2D6

CYTOCHROME P450 CYP2D6Test Code CYP2D6

Billing Code CYP2D6Effective 10/27/2017

Delete This test is being discontinued. Use the ordercode CY2D6L to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 28

DELTA-AMINOLEVULINIC ACID, 24-HOUR URINETest Code DVALC

Billing Code DVALCEffective 10/27/2017

Synonyms ALA, Delta, 24-Hour Urine

Container Type Urine, 24 hour dark plastic urine container with 30 mL of 30% glacial acetic acid

Supply ItemNumber

4474 and 3131

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type Urine (24-hour), PROTECTED FROM LIGHT

Preferred Volume 3 mL aliquot

EmergencyMinimum Volume

1 mL aliquot

CollectionProcedure

The collection of the 24-hour urine starts with the patient voiding (completely emptying bladder) and discardingthe first urine passed (ie, 8 AM or 8 PM). Then collect all urine including the final specimen voided at the end of the24-hour collection period (ie, 8 AM or 8 PM the following day). Specimen must be kept refrigerated duringcollection.

SpecimenProcessing

Mix well, pH must be < 6. Aliquot 3 mL of a well-mixed 24 hour urine collection into a leakproof amber plastic urinecontainer and freeze. Record total volume and collection period. (Must be portected from light. If amber tubes areunavailable, cover plastic tube completely, top and bottom, with aluminum foil. Identify specimen with patient'sname directly on the container AND on the outside of the aluminum foil. Secure with tape.) The specimen should befrozen immediately and maintained frozen until tested.

Required PatientInfo

Total volume and collection period.

Refrigerated 3 days

Frozen -20c 1 month

UnacceptableCondition

Specimen not protected from light; use of preservative other than 30% glacial acetic acid; use of sodium carbonatepreservative (Urine is not stable preserved with sodium carbonate)

LimitationsALA may be normal during latent period of acute intermittent porphyria, hereditary coproporphyria, porphyriavariegata. For the diagnosis of lead poisoning, measurement of blood and urine lead, and free erythrocyteprotoporphyrin are other available options.

ReferenceLaboratory

LabCorp

Reference labTest Code

096354

CPT Codes 82135

Test Schedule Mon, Wed, Fri

Turnaround Time 3-5 days

Method Column Chromatography; Ehrlich Reagent - Spectrophotometry

ReferenceRanges

Title Ranges Units

Delta ALA Undefined mg/L

Delta ALA 0.5-5.1 mg/24 hr

ComplianceRemarks

This test was developed, and its performance characteristics determined, by LabCorp. It has not been cleared orapproved by the Food and Drug Administration.

Notes

Use: Diagnose porphyrias: Delta-ALA may be increased in attacks of acute intermittent porphyria, hereditarycoproporphyria, and porphyria variegata; evaluation of certain neurological problems with abdominal pain;diagnosis of lead or mercury poisoning. Urinary Delta-ALA is not a sensitive indicator of lead poisoning in childrenbecause it does not increase until blood lead concentration is 40 mcg/dL, well above the recommended level <15mcg/dL. ALA is increased also in tyrosinemia. Porphobilinogen and delta-aminolevulinic acid are the tests ofchoice for acute intermittent porphyria. Recently the molecular lesions have been identified in a severely affectedhomozygote with delta-aminolevulinate dehydratase deficient porphyria.

Additional Information: Conversion of ALA to porphobilinogen is inhibited by lead and mercury; thus, leadpoisoning causes increased urinary Delta-ALA, as well as increases of coproporphyrin and of free erythrocyteprotoporphyrin.

New New Test - Replaces ALAUQ

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 29

DEOXYCORTICOSTERONE, LC/MS/MSTest Code DEOXCC

Billing Code DEOXCC.LCAEffective 10/27/2017

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type Serum (preferred)

Preferred Volume 3 mL

SpecimenProcessing

Separate serum or plasma from cells within one hour of collection. Transfer to a standard PAML aliquot tube andfreeze.

Refrigerated 3 days

Frozen -20c 2 years

AlternateSpecimens

Lavender top tube (EDTA) or green top tube (heparin) or red top tube (plain)

ReferenceLaboratory

LabCorp

Reference labTest Code

500138

Test Schedule Mon, Wed

Turnaround Time 5-9 days

Method High-Pressure Liquid Chromatography/Tandem Mass Spectrometry

DIAZEPAM AND NORDIAZEPAMTest Code DIANO

Billing Code DIANOEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode DIANOL to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 30

DIAZEPAM, SERUM OR PLASMATest Code DIANOL

Billing Code DIANOLEffective 10/27/2017

Synonyms Diastat®; Diastat® AcuDial™; Diazepam Intensol™; Valium®

Container Type Red top tube (plain)

Supply ItemNumber

1372

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 1 mL

EmergencyMinimum Volume

0.4 mL

CollectionProcedure

Oral: peak: one hour after dose; IV: peak: 15 minutes after dose.

SpecimenProcessing

Separate serum or plasma from cells and transfer to a standard PAML aliquot tube.

Room Temp 1 day

Refrigerated 2 weeks

Frozen -20c 2 weeks

UnacceptableCondition

Gel-barrier tube

AlternateSpecimens

Lavender-top tube (EDTA), or green-top tube (heparin)

LimitationsDo not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug bythe gel. Depending on the specimen volume and storage time, the decrease in drug level due to absorption may beclinically significant.

ReferenceLaboratory

LabCorp

Reference labTest Code

007989

CPT Codes 80346

Test Schedule Mon-Fri

Turnaround Time 3-5 days

Method Liquid Chromatography/Tandem Mass Spectrometry

Notes

Use: Diazepam is effective in the management of generalized anxiety disorder and panic disorder in appropriatelyselected patients. Its use prior to endoscopy or cardioversion relieves anxiety and diminishes the patient's recallof the procedure. Preoperative use relieves anxiety and tension and may provide anterograde amnesia. Additionaluses include the treatment of skeletal muscle spasms due to inflammation or trauma, spasticity (eg, multiplesclerosis, cerebral palsy, paraplegia, stiff-man syndrome), seizure disorders (eg, status epilepticus, febrileseizures), and alleviation of abstinence symptoms during alcohol withdrawal.

Additional Information: Diazepam is a muscle relaxant and antianxiety drug. Peak blood levels are achieved withinan hour after oral dose. Half-life in adults is 21 to 37 hours. The major metabolite (nordiazepam) has a half-life inadults of 50 to 99 hours. It is the major metabolite also of clorazepate and prazepam. Minor active metabolites ofdiazepam are temazepam (3-hydroxydiazepam) and oxazepam (3-hydroxy-N-diazepam). Diazepam may exhibitsynergism with barbiturates, tricyclic antidepressants, and amine oxidase inhibitors. Toxicity may be additive withother central nervous system depressants, and ethanol enhances the absorption of diazepam itself. Many cases ofoverdose are seen but few fatalities result from use of this drug alone. A frequent finding is a combination of thisdrug and ethanol.

New New Test - Replaces DIANO

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 31

ESTRONE SULFATETest Code ESSUL

Billing Code ESSULEffective 10/27/2017

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type Serum

Preferred Volume 1 mL

EmergencyMinimum Volume

0.3 mL

SpecimenProcessing

Serum must be separated from cells within 45 minutes of collection. Transfer to a standard PAML aliquot tube andfreeze.

Room Temp 2 days

Refrigerated 2 days

Frozen -20c 2 years

UnacceptableCondition

Urine; whole blood; CSF; specimen beyond stability

AlternateSpecimens

Red top tube (plain)

ReferenceLaboratory

LabCorp

Reference labTest Code

501049

CPT Codes 82679

Test Schedule Mon

Turnaround Time 5-9 days

Method High-Pressure Liquid Chromatography/Tandem Mass Spectrometry

New New Test - Replaces ESTRS

ESTRONE SULFATETest Code ESTRS

Billing Code ESTRSEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode ESSUL to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 32

FEATHER MIX IGETest Code ICFEMA

Billing Code ICFEMA.LCAEffective 10/27/2017

Room Temp 1 month

Refrigerated 1 month

Frozen -20c 1 month

UnacceptableCondition

Lipemic samples may lead to rejection

ReferenceLaboratory

LabCorp

Reference labTest Code

823551

CPT Codes 86003

Turnaround Time 4-5 days

Please Note Previous CPT Code: 86005

FECAL LYTES/OSMOLALITY PROFILETest Code FCELOS

Billing Code FCELOSEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode LYTST and FECOSA to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 33

FLUVOXAMINETest Code LUVOX

Billing Code LUVOX.LCAEffective 10/27/2017

Synonyms Fluvoxamine, Serum or Plasma; Luvox

Container Type Red top tube (plain)

Supply ItemNumber

1372

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 3 mL

EmergencyMinimum Volume

0.6 mL

Patient Prep Trough levels are most reproducible.

SpecimenProcessing

Separate serum or plasma from cells within 2 hours of collection and transfer to a standard PAML aliquot tube.

Room Temp 3 days

UnacceptableCondition

Gel barrier tubes

AlternateSpecimens

Green top tube (heparin)

ReferenceLaboratory

LabCorp

Reference labTest Code

810762

CPT Codes 80332

Method High-Pressure Liquid Chromatography with Ultraviolet Detection

ComplianceRemarks

This test was developed and its performance characteristics determined by LabCorp. It has not been cleared orapproved by the Food and Drug Administration.

Notes Use: Therapeutic drug management

New New Test

FOOD ALLERGEN PANEL IGG4Test Code FDPNG4

Billing Code FDPNG4Effective 10/27/2017

Delete This test is being discontinued. Use the ordercode FAP19L and ICMCG4 to order this test.

Fees Fees for this test are being adjusted. Please contact your Sales Representative or Client Services for feeinformation.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 34

GABAPENTIN, URINETest Code GABAPU

Billing Code GABAPU.LCAEffective 10/27/2017

Preferred Volume 10 mL

Room Temp 3 days

UnacceptableCondition

Urine from preservative tube

ReferenceLaboratory

LabCorp

Reference labTest Code

790394

CPT Codes 80307

Turnaround Time 5-6 days

Method Immunoassay

ReferenceRanges

Title Ranges Units

Gabapentin, Urine Reporting Limit: 10.0 ug/mL

Please Note Previous CPT Code: 80355

GM1 COMBINATIONTest Code GM1COM

Billing Code GM1COMEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode NEUPR3 and AGQ1BG to order this test.

Fees Fees for this test are being adjusted. Please contact your Sales Representative or Client Services for feeinformation.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 35

GQ1B ANTIBODY IGG RFLXTest Code AGQ1BG

Billing Code AGQ1BGEffective 10/27/2017

Synonyms Gangliosides (ASIALO-GM1, GM1, GM2, GD1a, GD1b, GQ1b & sulphatides) Antibodies

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 1 mL

EmergencyMinimum Volume

0.25 mL

SpecimenProcessing

Separate serum from cells and transfer to a standard PAML aliquot tube.

Room Temp 5 days

Refrigerated 5 days

Frozen -20c 1 year

AlternateSpecimens

Red top tube (plain)

ReferenceLaboratory

LabCorp

Reference labTest Code

808602

CPT Codes 83520

Test Schedule Weekly x 1

Turnaround Time Within two weeks from the time of specimen receipt

Method Enzyme-linked immunosorbent assay

ClinicalSignificance

Antibodies against glycolipids (GM1, GD1a, GD1b, GQ1b, Asialo GM1 and sulphatides) are present Guillain-Barrésyndrome (GBS), IgM paraproteinemic neuropathy, and chronic demyelinating polyneuropathy. Antibodies to oneor more glycolipids are present in 60-70% of patients with GBS. The titers of antiglycolipid antibodies are higher inacute phase and decrease with clinical improvement. Antibodies to GM1 and/or GD1b are frequently found in acutephase GBS. The two antibodies together occur in 20% of these cases, anti-GM1 without anti-GD1b antibodies inabout 10% and anti-GD1b without anit-GM1 antibodies in about 10% of GBS patients.Antibodies to GQ1b or IgGisotype are present in 95% of patients with Miller Fisher Syndrome (MFS). The titers of these antibodies fluctuatewith disease activity. IgM paraproteinemia is often associated with peripheral neuropathies. These antibodies arepresent in one half of patients with specificity for SGPG, GD1b and other gangliosides. Anti-GM1 IgM are usuallyassociated with motor dominant or sensorimotor neuropathies. These antibodies are also elevated in multifocalneuropathies such as GBS, CIPD and other immunological diseases

Notes Disease: Neuropathies

Reflex TestingReflex Condition Reflex Test Name Reflex CPT codes Reflex Billing Codes

If GQ1b Ab IgG > = 1:100 Anti GQ1b IgG Titer No Reflex CPT Code AGQ1BT

NewNew Test - Replaces GM1COM

Reflex testing provided at no charge.

Fees Fees for this test are being adjusted. Please contact your Sales Representative or Client Services for feeinformation.

HIV 1 RNA QUAL, CSFTest Code HIVRSF

Billing Code HIVRSFEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode HIVSFL to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 36

HIV 1 RNA, REAL TIME PCR (NON-GRAPH), CSFTest Code HIVSFL

Billing Code HIVSFLEffective 10/27/2017

Container Type CSF sterile plastic tube

Supply ItemNumber

7211

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type Cerebrospinal fluid (CSF)

Preferred Volume 3.5 mL

EmergencyMinimum Volume

1.1 mL

CollectionProcedure

Collect in a sterile screw-capped container.

UnacceptableCondition

Specimen received in "pop-top" or "snap-cap" tube; quantity not sufficient for analysis

ReferenceLaboratory

LabCorp

Reference labTest Code

550410

CPT Codes 87536

Test Schedule Mon-Fri

Turnaround Time 5-6 days

Method COBAS® AmpliPrep/COBAS® TaqMan® HIV-1 Test

Notes

Use: Detect and quantitate HIV-1 in cerebrospinal fluid (CSF)

Assay range: 20-10,000,000 copies/mL Results of this test are for research purposes only by the assay'smanufacturer. The performance characteristics of this product have not been established. Results should not beused as a diagnostic procedure without confirmation of the diagnosis by another medically established diagnosticproduct or procedure.

New New Test - Replaces HIVRSF

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 37

HIV-1 AND HIV-2 ANTIBODIES FOR CADAVERIC SPECIMENS RFLXTest Code CDHV12

Billing Code CDHV12Effective 10/27/2017

Synonyms Donor Panel 139544

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Refrigerated

Specimen Type Serum or cadaveric serum

Preferred Volume 1 mL

EmergencyMinimum Volume

0.1 mL

Refrigerated 1 week

UnacceptableCondition

Plasma specimen

AlternateSpecimens

Red top tube (plain)

ReferenceLaboratory

LabCorp

Reference labTest Code

139544

CPT Codes 86703

Method Enzyme immunoassay

NotesSpecial Instructions: **This test is intended for ViroMed CADAVERIC DONOR** clients only. DONOR testingperformed at ViroMed Laboratories using Genetic Systems HIV-1/HIV-2 plus O kit. If reflex test is performed,additional charges/CPT code(s) may apply.

Reflex Testing

Reflex Condition Reflex Test Name Reflex CPT codes Reflex Billing Codes

If HIV-1/-2 antibody EIA isreactive

HIV Western Blot Cadaver 86689 CDHVWB

New New Test - Replaces HV1CD and HIVDIC

Please Note This test may reflex to additional tests depending upon the results of this test. An additional fee will be added if thereflex test is necessary.

HIV-1 AND HIV-2 ANTIBODIES FOR CADAVERIC SPECIMENS RFLXTest Code HV1CD

Billing Code HV1CDEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode CDHV12 to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 38

HLA B ABACAVIR SENSITIVITYTest Code HLABGT

Billing Code HLABGT.LCAEffective 10/6/2017

Synonyms HLA-B*57:01 for Abacavir Sensitivity; Abacavir Hypersensitivity Genotyping; Abacavir Sensitivity; HLA-B 5701Genotype, Abacavir Hypersensitivity, Saliva

Container Type Lavender top tube (EDTA)

Supply ItemNumber

1222

Store andTransport

Refrigerated

Specimen Type Whole blood

Preferred Volume 7 mL

EmergencyMinimum Volume

3 mL

Required PatientInfo

Counseling and informed consent are recommended for genetic testing.

Room Temp 3 days

Refrigerated 2 weeks

Frozen -20c 1 month

UnacceptableCondition

Plasma or serum; heparinized specimens

AlternateSpecimens

Pink (K2EDTA) or yellow (ACD solution A or B)

ReferenceLaboratory

LabCorp

Reference labTest Code

006926

CPT Codes 81381

Method Polymerase Chain Reaction/Fluorescence Monitoring

Notes

Ordering Recommendation:

Standard of care prior to abacavir therapy per FDA. Screening test to determine susceptibility to abacavirhypersensitivity syndrome.

New New Test

HLA DP GENOTYPINGTest Code HLADP

Billing Code HLADPEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode HLADPL to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 39

HLA DPA1 + HLA DPB1 HIGH RESOLUTIONTest Code HLADPL

Billing Code HLADPLEffective 10/27/2017

Synonyms HLA DPA1 (HR)+HLA DPB1 (HR)

Container Type Lavender top tube (EDTA)

Supply ItemNumber

1867

Store andTransport

Ambient (room temperature)

Specimen Type Whole blood

Preferred Volume 8.0 mL

EmergencyMinimum Volume

3 mL

SpecimenProcessing

Maintain specimen at room temperature; protect from extreme heat or cold. Do not freeze.

UnacceptableCondition

Hemolyzed specimen; clotted specimen; wrong specimen container

ReferenceLaboratory

LabCorp

Reference labTest Code

236951

CPT Codes 86160 x 2, 86038, 86431, 86200

Method Sequence-Based Typing (SBT), SequenceSpecific Oligonucleotide Probes (SSOP), and/or Sequence-SpecificPrimers (SSP)

ComplianceRemarks

This test was developed, and its performance characteristics determined, by LabCorp. It has not been cleared orapproved by the US Food and Drug Administration (FDA).

NotesUse: DPA1/DPB1 antigens may be correlated with certain disease states or other clinical conditions. Also used forscreening of transplant candidates and potential donors, transfusion of specifically compatible blood products,among others. This test is for single locus typing at high resolution.

New New Test - Replaces HLADP

HLA DR GENOTYPINGTest Code HLADRG

Billing Code HLADRGEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode HLADRB to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 40

HLA DRB1 HIGH RESOLUTIONTest Code HLADRB

Billing Code HLADRBEffective 10/27/2017

Container Type Lavender top tube (EDTA)

Supply ItemNumber

1867

Store andTransport

Ambient (room temperature)

Specimen Type Whole blood

Preferred Volume 7 mL

EmergencyMinimum Volume

3 mL

SpecimenProcessing

Maintain specimen at room temperature; protect from extreme heat or cold. Do not freeze.

UnacceptableCondition

Hemolyzed specimen; clotted specimen; wrong specimen container.

ReferenceLaboratory

LabCorp

Reference labTest Code

167167

CPT Codes 81382

Method Sequence-Based Typing, Sequence-Specific Oligonucleotide Probes, and/or Sequence-Specific Primers

ComplianceRemarks

This test was developed, and its performance characteristics determined, by LabCorp. It has not been cleared orapproved by the US Food and Drug Administration (FDA).

Notes

Use: High resolution HLA typing is preferred for matching of bone marrow transplant donors and recipients. Otherclinical indications may require high resolution typing to rule out alternative allele combinations.

High resolution typing for DRB1 will meet the following criteria: All ambiguities within exon 2, which defines theantigen recognition site, will be resolved. Those ambiguities that remain will be reported as an allele code. Thistest is for single locus typing at high resolution.

New New Test - Replaces HLADRG

HLA-B GENOTYPETest Code HLBGT

Billing Code HLBGTEffective 10/6/2017

Delete This test is being discontinued. Use the ordercode HLABG to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 41

HUMAN IMMUNODEFICIENCY VIRUS 1 (HIV-1), QUALITATIVE, RNATest Code HIVDPC

Billing Code HIVDPC.LCAEffective 10/27/2017

Store andTransport

Refrigerated

Specimen Type Plasma

SpecimenProcessing

Separate plasma from cells and transfer to a standard PAML aliquot tube.

Room Temp 3 days

Refrigerated 2 weeks

Frozen -20c 6 months; Freeze/thaw cycles: Stable x 5

UnacceptableCondition

Specimen grossly hemolyzed; received outside of specimen and/or storage requirements

AlternateSpecimens

Yellow-top (ACD) tube, red-top tube, or gel-barrier tube

ReferenceLaboratory

LabCorp

Reference labTest Code

139350

Method Transcription-mediated amplification (TMA)

Notes

This test is intended for use as an aid in the diagnosis of HIV-1 infection, including acute or primary infection.Presence of HIV-1 RNA in the plasma of patients without antibodies to HIV-1 is indicative of acute or primary HIV-1infection. This assay may also be used as an additional test, when it is reactive, to confirm HIV-1 infection in anindividual whose specimen is repeatedly reactive for HIV-1 antibodies. This assay is not intended for use in donortesting.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 42

HUNTINGTON DISEASE (HD) MUTATIONTest Code HUNDML

Billing Code HUNDMLEffective 10/27/2017

Synonyms Huntington's Chorea; HD Genetic Testing; HTT Genetic Testing

Container Type Lavender top tube (EDTA)

Supply ItemNumber

1222

Store andTransport

Refrigerated

Specimen Type Whole blood

Preferred Volume 5 mL

EmergencyMinimum Volume

3 mL

Required PatientInfo

REQUIRED - Huntington Disease Consent Form

Room Temp 3 days

Refrigerated 1 week

Frozen -20c 1 month

AlternateSpecimens

Yellow top tube (ACD Solution A or B) or pink top tube (K2 EDTA)

Limitations

A completed HD specific consent form, signed by the patient (or legal guardian) and physician, is required for allspecimens. Testing for patients under the age of 18 years or fetal specimens is not offered. Presymptomaticpatients are strongly encouraged to be tested through a counseling program approved by the Huntington DiseaseSociety of America at (800) 345-4372. Clients must call ARUP's genetics counselor at 800-242-2787, extension 2141before submitting specimens.A DNA isolation Fee will be charged if this procedure is canceled at the clientsrequest after receipt of the sample by ARUP.

ReferenceLaboratory

LabCorp

Reference labTest Code

829044

CPT Codes 81401

Test Schedule Varies

Turnaround Time 8-12 days after receipt of fully completed HD consent form

Method Polymerase Chain Reaction/Fragment Analysis

ComplianceRemarks

The performance characteristics of this test were validated by ARUP Laboratories. The U.S. Food and DrugAdministration (FDA) has not approved or cleared this test. However, FDA approval or clearance is currently notrequired for clinical use of this test. The results are not intended to be used as the sole means for clinicaldiagnosis or patient management decisions. ARUP is authorized under Clinical Laboratory ImprovementAmendments (CLIA) and by all states to perform high-complexity testing. Counseling and informed consent arerecommended for genetic testing. Consent forms are available online.

Notes Use: Diagnostic confirmation for Huntington disease (HD) in a symptomatic individual. Presymptomatic testing foradults with a family history of HD.

New New Test - Replaces HUNDUW

Please Note REQUIRED - Huntington Disease Consent Form

HUNTINGTON DISEASE DNA SCREENTest Code HUNDUW

Billing Code HUNDUWEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode HUNDML to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 43

HYDROXYCHLOROQUINETest Code PLAQ

Billing Code PLAQ.LCAEffective 10/27/2017

Synonyms Oxychloroquine; Plaquenil®

Container Type Red top tube (plain)

Supply ItemNumber

1372

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 1 mL

EmergencyMinimum Volume

0.4 mL

SpecimenProcessing

Separate serum or plasm from cells within 2 hours of collection and transfer to a standard PAML aliquot tube.

Room Temp 1 month

Refrigerated 1 month

Frozen -20c 1 month

UnacceptableCondition

Polymer gel separation tube (sst or PST)

AlternateSpecimens

Lavender top tube (EDTA)

ReferenceLaboratory

LabCorp

Reference labTest Code

802576

CPT Codes 80375

Test Schedule Thu

Turnaround Time 4-8 days

Method High Performance Liquid Chromatography/Tandem Mass Spectrometry

New New Test

HYPER PNEUMO EXT PANELTest Code HYPEXT

Billing Code HYPEXTEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode HYPEXL and HYAALC to order this test.

Fees Fees for this test are being adjusted. Please contact your Sales Representative or Client Services for feeinformation.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 44

HYPERSENSITIVITY PNEUMONITISTest Code HYPENL

Billing Code HYPENLEffective 10/27/2017

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 1.5 mL

SpecimenProcessing

Separate serum from cells and transfer to a standard PAML aliquot tube.

Room Temp 1 week

Refrigerated 2 weeks

Frozen -20c 2 weeks; Freeze/thaw cycles: Stable x 2

UnacceptableCondition

Excessive hemolysis

AlternateSpecimens

Red top tube (plain)

Limitations A positive test does not establish the diagnosis of hypersensitivity pneumonitis, nor does the absence ofprecipitins eliminate the diagnosis.

ReferenceLaboratory

LabCorp

Reference labTest Code

605856

CPT Codes 86606 x 8

Test Schedule Mon-Fri

Turnaround Time 5-7 days

Method Double diffusion (Ouchterlony)

New New Test - Replaces ABAPNL

Fees Fees for this test are being adjusted. Please contact your Sales Representative or Client Services for feeinformation.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 45

HYPERSENSITIVITY PNEUMONITIS #6Test Code HYPEXL

Billing Code HYPEXLEffective 10/27/2017

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 1.0 mL

EmergencyMinimum Volume

1.0 mL

SpecimenProcessing

Separate serum from cells and transfer to a standard PAML aliquot tube.

Room Temp 1 week

Refrigerated 2 weeks

Frozen -20c 2 weeks; Freeze/thaw cycles: Stable x 2

UnacceptableCondition

Excessive hemolysis

AlternateSpecimens

Red top tube (plain)

ReferenceLaboratory

LabCorp

Reference labTest Code

660663

CPT Codes 86671 x 12

Test Schedule Mon-Fri

Turnaround Time 4-7 days

Method Double diffusion (Ouchterlony)

Notes

Clinical Limitation: A positive test does not establish the diagnosis of hypersensitivity pneumonitis, nor does theabsence of precipitins eliminate the diagnosis.

Use/Additional Details: Confirm the presence of precipitating antibodies associated with hypersensitivitypneumonitis Hypersensitivity pneumonitis (HP), also referred to as extrinsic allergic alveolitis (EAA), is aninflammatory lung disease resulting from the inhalation and subsequent sensitization to a wide variety of inhaledorganic dusts. HP is not mediated by IgE. HP is associated with progressive pulmonary disability, irreversible lungdamage and mortality in some occupation settings. Patients often present with intermittent chills, fever, cough,and shortness of breath that begin 4 to 8 hours after exposure to the offending dust. No single laboratory test isdiagnostic for HP. Diagnosis is based on a complete environmental history supported by result of chest x-ray,spirometry and in vitro immunologic tests. Identification of the causative agent is important to allow avoidance ofexposure. Double diffusion (Ouchterlony) assays are typically used to determine antigen specific IgG antibodies.The appearance of precipitin arcs confirms the presence of precipitating antibodies to specific antigens. Theseantibodies may also be present in individuals not afflicted with HP. The presence of antibodies to the offendingdust or antigen confirms exposure but is not diagnostic of HP. However, upon repeated or prolonged exposures,high levels of precipitating IgG antibodies are typically observed.

New New Test - Replaces HYPEXT

Fees Fees for this test are being adjusted. Please contact your Sales Representative or Client Services for feeinformation.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 46

IGA DEFICIENCY PANELTest Code ANTGAL

Billing Code ANTGALEffective 10/27/2017

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 2 mL

EmergencyMinimum Volume

2 mL

SpecimenProcessing

Separate serum from cells within two hours of collection and transfer to a standard PAML aliquot tube.

Room Temp 2 days

Refrigerated 1 week

Frozen -20c 2 weeks

UnacceptableCondition

Lipemic specimens

AlternateSpecimens

Red top tube (plain)

ReferenceLaboratory

LabCorp

Reference labTest Code

818624

CPT Codes 82784, 83520

Turnaround Time 8-10 days

Method Enzyme-Linked Immunosorbent Assay/ Radial Immunodiffusion

ClinicalSignificance

For the evaluation of patients with recurrent infection for the possibility of IgA deficiency (IgAD). Patients with IgAdeficiency may develop antibodies against IgA that make them susceptible to adverse reactions to blood productsincluding intravenous immunoglobulin. IgAD has also been reported to progress to Common VariableImmunodeficiency (CVID).

ComplianceRemarks

This test was developed and its performance characteristics determined by Viracor-IBT Laboratories. It has notbeen cleared or approved by the U.S. Food and Drug Administration.

New New Test - Replaces ANTIGA

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 47

IGE+ALLERGEN MOLDTest Code ABPNLC

Billing Code ABPNLCEffective 10/27/2017

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 2.2 mL

SpecimenProcessing

Separate serum from cells and transfer to a standard PAML aliquot tube.

Room Temp 2 weeks

Refrigerated 2 weeks

Frozen -20c 3 months; Freeze/thaw cycles: Stable x 3

UnacceptableCondition

Gross hemolysis

AlternateSpecimens

Red top tube (plain)

ReferenceLaboratory

LabCorp

Reference labTest Code

605851

CPT Codes 86003

Method Electrochemiluminescence Immunoassay; Thermo Fisher ImmunoCAP®

New New Test - Replaces ABAPNL and ICABAP

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 48

IGF BINDING PROTEIN 1Test Code IGFP1

Billing Code IGFP1.LCAEffective 10/27/2017

Synonyms Insulin-Like Growth Factor-Binding Protein 1 (IGFBP-1)

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Preferred Volume 0.5 mL

EmergencyMinimum Volume

0.1 mL

SpecimenProcessing

Separate serum from cells and transfer to a standard PAML aliquot tube and freeze immediately. Maintain frozenuntil tested.

Refrigerated 2 days

Frozen -20c 16 months

UnacceptableCondition

Plasma specimens

AlternateSpecimens

Red top tube (plain)

ReferenceLaboratory

LabCorp

Reference labTest Code

140822

CPT Codes 83520

Test Schedule Mon, Thu

Turnaround Time 4-8 days

Method Immunochemiluminometric Assay

Notes

Use: Identify women who are at high risk for developing preëclampsia.

Additional Information: Insulin-like growth factor-binding protein 1 is a member of the family of structurallyhomologous proteins that specifically binds and modulates the activities of IGF-1 and IGF-2. IGFBP-1 is a 25kilodalton protein that is produced predominantly by hepatocytes and decidualized ovarian endometrium. Serumlevels of IGFBP-1 exhibit considerable diurnal variation with levels highest early in the morning and lowest in theevening. Serum IGFBP-1 levels are controlled by insulin with the postprandial increase in insulin levels producinga four- to fivefold decrease in IGFBP-1 levels relative to fasting levels.1 IGFBP-1 levels have been shown to beelevated in type 1 diabetics and in patients with insulin resistance syndromes. Type 2 diabetics tend to have lowserum IGFBP-1 levels. Patients with growth hormone deficiency tend to have elevated IGFBP-1 levels. Low levelsare observed in acromegaly, Cushing disease, and polycystic ovary syndrome. IGFBP-1 is the predominant IGF-binding protein in amniotic fluid and in fetal and maternal circulation. The levels are high in the fetus and newborn,but decline steadily until puberty. In a recent study of women in the second trimester of pregnancy, IGFBP-1 levelswere higher in women who subsequently developed preëclampsia than in matched controls who did not developthe syndrome.

Please Note Previous CPT Code: 83519

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 49

IGG4 ALLERGENS (19) FOODSTest Code FAP19L

Billing Code FAP19LEffective 10/27/2017

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 1.5 mL

SpecimenProcessing

Separate serum from cells and transfer to a standard PAML aliquot tube.

AlternateSpecimens

Red top tube (plain)

ReferenceLaboratory

LabCorp

Reference labTest Code

605828

CPT Codes 86001 x 19

Method Thermo Fisher ImmunoCAP®

NotesResults for this test are for Investigational Purposes Only by the assay's manufacturer. The performancecharacteristicsof this product have not been established. Results should not be used as a diagnostic procedurewithout confirmation of the diagnosis by another medically established diagnosticproduct or procedure.

New

New Test - Replaces FDPNG4

Results for this test are for Investigational Purposes Only by the assay's manufacturer. The performancecharacteristics of this product have not been established.

Fees Fees for this test are being adjusted. Please contact your Sales Representative or Client Services for feeinformation.

INDICANS, URINE QUALTest Code INDIC

Billing Code INDIC.LCAEffective 10/27/2017

Delete This test is being discontinued.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 50

INHIBIN BTest Code INHBP

Billing Code INHBP.LCAEffective 10/27/2017

Store andTransport

Refrigerated

Preferred Volume 0.6 mL

EmergencyMinimum Volume

0.3 mL

Patient Prep

Special Instructions: This test may exhibit interference when sample is collected from a person who is consuming asupplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It isrecommended to ask all patients who may be indicated for this test about biotin supplementation. Patients shouldbe cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.

Room Temp 1 week

Refrigerated 3 weeks

Frozen -20c 3 weeks; Freeze/thaw cycles: Stable x 3

UnacceptableCondition

Nonserum sample received

AlternateSpecimens

Red top tube (plain)

ReferenceLaboratory

LabCorp

Reference labTest Code

146795

CPT Codes 83520

Method Enzyme immunoassay

Notes Use: Assess the function of the antral follicles of the ovaries in women or the Sertoli cells of the testes in men.

Please Note

Previous CPT Code: 82397

This procedure may be considered by Medicare and other carriers as investigational and, therefore, may not bepayable as a covered benefit for patients.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 51

INTERFERON BETA NEUTRALIZING AB RFLXTest Code IFBSTL

Billing Code IFBSTLEffective 10/27/2017

Synonyms INF-Beta Neutralizing Ab Rflx

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 1 mL

EmergencyMinimum Volume

0.3 mL

Patient PrepCollect specimens before Interferon beta treatment, or more than 48 hours following the most recent dose. Patientshould not be on steroid therapy in excess of 10 mg prednisolone (or equivalent) daily. High endogenous levels ofInterferon beta, alpha, or gamma may interfere with this assay.

SpecimenProcessing

Separate serum from cells within 45 minutes of collection and transfer to a standard PAML aliquot tube.

Room Temp 2 days

Refrigerated 2 weeks

Frozen -20c 1 year (avoid repeated freeze/thaw cycles)

UnacceptableCondition

Contaminated, hemolyzed, icteric, or lipemic specimen.

ReferenceLaboratory

LabCorp

Reference labTest Code

819067

CPT Codes 82397

Test Schedule Mon

Turnaround Time 3-16 days

Method Cell Culture/Chemiluminescent Immunoassay

Notes Use: Aids in management of individuals treated with interferon beta.

Reflex Testing

Reflex Condition Reflex Test Name Reflex CPT codes Reflex Billing Codes

If Interferon Beta NeutralizingAB Screen result is positive

Interferon Beta Neutralizing ABTiter

82397 IFBRFL

New New Test - Replaces INFBEG

Please Note This test may reflex to additional tests depending upon the results of this test. An additional fee will be added if thereflex test is necessary.

INTERFERON BETA, IGG RFLXTest Code INFBEG

Billing Code INFBEGEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode IFBSTL to order this test.

ISOHEMAGGLUTININ TITERTest Code ISOHTS

Billing Code ISOHTSEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode ISOHMT to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 52

LACTATE TO PYRUVATE RATIOTest Code LAPRAT

Billing Code LAPRATEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode LAPRAL to order this test.

LACTIC/PYRUVIC RATIOTest Code LAPRAL

Billing Code LAPRALEffective 10/27/2017

Container Type Gray top tube (potassium oxalate/sodium fluoride)

Supply ItemNumber

7357

Store andTransport

Refrigerated

Specimen Type Plasma

Preferred Volume 1 mL

EmergencyMinimum Volume

0.5 mL

Patient Prep Patient should not be on any intravenous infusion that would affect the acid-base balance. Patient should be in afasting and resting state (should not exercise).

CollectionProcedure

Keep gray-top tube on ice. Draw blood in gray-top tube. Mix well by gentle inversion at least six times. Return toice bath to cool. Avoid hand-clenching and, if possible, avoid use of a tourniquet. A tourniquet with patientclenching and unclenching hand will lead to high potassium and lactic acid buildup from the hand muscles, andpH will decrease. It is best to avoid a tourniquet for electrolytes and lactic acid or to release it after blood begins toflow into the tube. If the tourniquet is released before blood is drawn, wait about a minute before drawing.

SpecimenProcessing

Within 15 minutes of draw, separate the plasma from blood by centrifugation for 10 minutes. Immediately transferthe plasma portion of the sample to a labeled plastic transport tube. Avoid excessive forces that contribute tohemolysis.

Room Temp 2 weeks after separation

Refrigerated 2 weeks after separation

Frozen -20c 2 weeks after separation; Freeze/thaw cycles: Stable x 3

UnacceptableCondition

Specimen not separated from cells within 15 minutes of draw; marked hemolysis; slight or moderate turbidity;perchloric acid supernatant; serum specimen

LimitationsGross hemolysis elevates plasma results. Intravenous injections, or infusions which modify acid-base balance,may cause alterations in lactate levels. Epinephrine and exercise elevate lactate, as may IV sodium bicarbonate,glucose, or hyperventilation. False-low values may be found with a high LD (LDH) value.

ReferenceLaboratory

LabCorp

Reference labTest Code

120543

CPT Codes 83605, 84210

Test Schedule Mon-Fri

Turnaround Time 3-5 days

Method Lactate-pyruvate; Spectrophotometry

New New Test - Replaces LAPRAT

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 53

LC-1 (LIVER CYTOSOL PROTEIN-1)Test Code LIVCY

Billing Code LIVCYEffective 10/27/2017

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type Serum

Preferred Volume 1 mL

EmergencyMinimum Volume

0.5 mL

SpecimenProcessing

Separate serum from cells and transfer to a standard PAML aliquot tube and freeze.

Room Temp 2 days

Refrigerated 5 days

Frozen -20c 1 year

UnacceptableCondition

Grossly hemolyzed, lipemic, or icteric specimens

AlternateSpecimens

Red top tube (plain)

ReferenceLaboratory

LabCorp

Reference labTest Code

806396

CPT Codes 86376

Test Schedule Weekly x 1

Turnaround Time Within one week of specimen receipt

Method Indirect Immunofluorescence

New New Test - Replaces LIVCYT

LDL PARTICLE SIZETest Code LDLPSR

Billing Code LDLPSREffective 10/27/2017

Delete This test is being discontinued. Use the ordercode NMRLP to order this test.

LIBRIUM AND NORDIAZEPAMTest Code LIBNO

Billing Code LIBNOEffective 10/27/2017

Delete This test is being discontinued due to low utilization.

LIPASE, URINETest Code LIPAU

Billing Code LIPAUEffective 10/27/2017

Delete This test is being discontinued. Use suggested order code AMYUQ, AMYUR, or LIPA to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 54

LIPID-ASSOCIATED SIALIC ACIDTest Code LASA

Billing Code LASA.LCAEffective 10/27/2017

Synonyms Lipid-bound Sialic Acid

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Ambient (room temperature)

Specimen Type Serum

Preferred Volume 2 mL

EmergencyMinimum Volume

0.1 mL

SpecimenProcessing

Separate serum from cells and transfer to a standard PAML aliquot tube.

Room Temp 2 weeks

Refrigerated 2 weeks

Frozen -20c 2 weeks; Freeze/thaw cycles: Stable x 3

AlternateSpecimens

Red-top tube or lavender-top (EDTA) tube

ReferenceLaboratory

LabCorp

Reference labTest Code

100313

CPT Codes 84275

Test Schedule Tue, Thu

Turnaround Time 3-8 days

Method Spectrophotometry

ComplianceRemarks

Results for this test are for investigational purposes only by the assay's manufacturer. The performancecharacteristics of this product have not been established. Results should not be used as a diagnostic procedurewithout confirmation of the diagnosis by another medically established diagnostic product or procedure.

Notes LASA is a useful adjunct in the management of a variety of malignancies. It is generally used in conjunction withother tumor markers.

New New Test

LISTERIA AB, CFSTest Code LSTCSF

Billing Code LSTCSF.LCAEffective 10/27/2017

ReferenceLaboratory

LabCorp

Reference labTest Code

272685

CPT Codes 86723

Please Note Previous CPT Code: 86609

LIVER CYTOSOL AUTOABS (LC 1)Test Code LIVCYT

Billing Code LIVCYTEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode LIVCY to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 55

MATERNAL CELL CONTAMINATIONTest Code MCC

Billing Code MCCEffective 10/27/2017

Container Type 1222 or 1701K; 1055 or 6039

Store andTransport

Ambient (room temperature)

Specimen Type Whole blood or buccal swab kit, amniotic fluid, OR chorionic villus sample (CVS) (Submission of maternal blood isrequired for fetal testing.)

Preferred Volume 7 mL whole blood or buccal swab kit, 10 mL amniotic fluid OR 20 mg CVS

EmergencyMinimum Volume

3 mL whole blood or two buccal swabs, 5 mL amniotic fluid OR 10 mg CVS

SpecimenProcessing

If a prenatal specimen (CVS or amniotic fluid) has not already been submitted to LabCorp for other testing, it mustnow be provided to complete maternal cell contamination (MCC) analysis.

UnacceptableCondition

Frozen or hemolyzed specimen; quantity not sufficient for analysis; improper container

AlternateSpecimens

Yellow top tube (ACD) or buccal swab kit, sterile plastic conical tube, or two confluent T-25 flasks for fetal testing

ReferenceLaboratory

LabCorp

Reference labTest Code

511402

CPT Codes 81265

Method See Notes

ComplianceRemarks

Results of this test are for investigational purposes only. The performance characteristics of this assay have beendetermined by LabCorp. The result should not be used as a diagnostic procedure without confirmation of thediagnosis by another medically established diagnostic product or procedure.

Notes

Method - Analysis of short tandem repeat markers by polymerase chain reaction (PCR) and capillaryelectrophoresis.

Use - Quality assurance for interpretation of prenatal molecular genetic test results. This test is not applicable innonmaternity contexts.

New New Test - Replaces MCCMA

MATERNAL CELL CONTAMINATIONTest Code MCCMA

Billing Code MCCMAEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode MCC to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 56

METHYLPHENIDATETest Code RITA

Billing Code RITA.LCAEffective 10/27/2017

Synonyms Methylphenidate, Serum or Plasma; Ritalin

Container Type Red top tube (plain)

Supply ItemNumber

1372

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type Serum

Preferred Volume 2 mL

EmergencyMinimum Volume

1.1 mL

CollectionProcedure

Collect specimen as a peak level one to two hours after dosing.

SpecimenProcessing

Separate serum or plasma from cells and transfer to a standard PAML aliquot tube and freeze.

Room Temp Unacceptable

Refrigerated Unacceptable

Frozen -20c 6 months

UnacceptableCondition

Gel barrier tube; thawed specimen

AlternateSpecimens

Green top tube (heparin) or gray top tube (sodium fluoride)

ReferenceLaboratory

LabCorp

Reference labTest Code

715300

CPT Codes 80360

Test Schedule Tue, Thu, Fri

Turnaround Time 3-4 days

Method Liquid Chromatography/Tandem Mass Spectrometry

Notes

Additional Information: Methylphenidate is an oral central nervous system stimulant used to treat attention deficithyperactivity disorders (ADHD) in children and ADD in adults. Methylphenidate is a derivative of phenethylamine,and its CNS actions are similar to the amphetamines. The exact mechanism of action is not fully understood. Thedrug is rapidly and well absorbed from the GI tract, achieving peak blood levels in 60 to 120 minutes. Somepreparations of methylphenidate will exhibit a bimodal plasma concentration-time profile with half-lives varyingfrom 2.5 to 8.4 hours and about 80% of a dose is excreted in the urine in 24 hours. The major metabolite, ritalinicacid (pharmacologically inactive), is formed by hydrolysis of the methyl ester linkage. This takes placeenzymatically and nonenzymatically in alkaline conditions during storage of serum or plasma. The use of EDTA asan anticoagulant reduces hydrolytic loss. After a 0.3 mg/kg oral dose of methylphenidate, peak plasmaconcentrations typically do not go much above 20 ng/mL, but they can reach as high as 70 ng/mL on a higher doseof 0.6 mg/kg. The common side effects of methylphenidate are due mainly to its adrenergic activity, includinginsomnia, anorexia, headache, and tachycardia.

New New Test

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 57

MTB COMPLEX, NON RESP (PCR)Test Code MTCPCR

Billing Code MTCPCR.LCAEffective 9/21/2017

Synonyms MTB Complex PCR Non-Respirator; M. tuberculosis Complex PCR, Non Respiratory; Mycobacterium TuberculosisComplex PCR, Non-Respiratory; MTB; TB

Specimen Type CSF or Urine are preferred: (Urine: first void clean catch or urine with no preservative)

Preferred Volume 3 mL CSF or 10 mL urine collected in a sterile, leak-proof container

EmergencyMinimum Volume

1 mL CSF or 5 mL urine

Refrigerated 5 days

Frozen -20c 1 month

UnacceptableCondition

Un-neutralized gastric lavage

AlternateSpecimens

Gastric lavage: Collect 10 mL (5 mL minimum) of an early morning specimen, before food or water intake, in asterile container without preservative. Adjust to normal pH with 100 mg of sodium bicarbonate, within 4 hours ofcollection, and mix thoroughly.Non-neutralized specimens are not acceptable. Separate specimens collected on 3 consecutive days arerecommended.

Pericardial fluid, peritoneal fluid, pleural fluid: 5 mL (2 mL minimum) collected in a sterile leak-proof container.

Fresh (unfixed) tissue: 2 grams collected in a sterile leak-proof container. Specimen must be kept moist with saline.Specimens should not be frozen if sample is to be shared with AFB culture.

Whole blood: 3 mL (1 mL minimum) collected in an EDTA (lavender-top tube) or ACD (yellow-top tube).

Test Schedule Daily

Turnaround Time 3-4 days

MYOSITIS ASSESS, JO 1 AUTOABSTest Code MYAJO1

Billing Code MYAJO1Effective 10/27/2017

Delete This test is being discontinued. Use the ordercode MYOPII to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 58

MYOSITIS PANEL IITest Code MYOPII

Billing Code MYOPIIEffective 10/27/2017

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 4 mL

EmergencyMinimum Volume

0.5 mL

SpecimenProcessing

Separate serum from cells and transfer to a standard PAML aliquot tube.

Refrigerated 5 days

Frozen -20c 1 year

UnacceptableCondition

Specimens other than serum. Grossly hemolyzed, lipemic, or icteric samples.

ReferenceLaboratory

LabCorp

Reference labTest Code

840020

CPT Codes 86235 x 8

Method Western Blot/Line Blot

New New Test - Replaces MYAJO1

NABFERON NEUTRALIZING AB TESTTest Code INFBR

Billing Code INFBREffective 10/27/2017

Delete This bill only test is being discontinued.

NEURONAL NUCLEAR ABTest Code NEUIGB

Billing Code NEUIGBEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode PARNP1 to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 59

NEUROPATHY PROFILE III RFLXTest Code NEUPR3

Billing Code NEUPR3Effective 10/27/2017

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 3 mL

EmergencyMinimum Volume

1 mL

SpecimenProcessing

Separate serum from cells and transfer to a standard PAML aliquot tube.

Room Temp 5 days

Refrigerated 5 days

Frozen -20c 1 year

AlternateSpecimens

Red top tube (plain)

ReferenceLaboratory

LabCorp

Reference labTest Code

808977

CPT Codes 83520 x 8, 86255

Test Schedule Weekly x 1

Turnaround Time Within two weeks from the time of specimen receipt

Method Enzyme-linked immunosorbent assay

ClinicalSignificance

Antibodies against glycolipids (GM1, GD1a, GD1b, GQ1b, Asialo GM1 and sulphatides) are present Guillain-Barrésyndrome (GBS), IgM paraproteinemic neuropathy, and chronic demyelinating polyneuropathy. Antibodies to oneor more glycolipids are present in 60-70% of patients with GBS. The titers of antiglycolipid antibodies are higher inacute phase and decrease with clinical improvement. Antibodies to GM1 and/or GD1b are frequently found in acutephase GBS. The two antibodies together occur in 20% of these cases, anti-GM1 without anti-GD1b antibodies inabout 10% and anti-GD1b without anit-GM1 antibodies in about 10% of GBS patients.Antibodies to GQ1b or IgGisotype are present in 95% of patients with Miller Fisher Syndrome (MFS). The titers of these antibodies fluctuatewith disease activity. IgM paraproteinemia is often associated with peripheral neuropathies. These antibodies arepresent in one half of patients with specificity for SGPG, GD1b and other gangliosides. Anti-GM1 IgM are usuallyassociated with motor dominant or sensorimotor neuropathies. These antibodies are also elevated in multifocalneuropathies such as GBS, CIPD and other immunological diseases.

Reflex Testing

Reflex Condition Reflex Test Name Reflex CPT codes Reflex Billing Codes

If Anti GM1 (IgM) is > = 1:100 Anti GM1 IgM Titer No Reflex CPT Code AGM1IM

If Anti GM1 (IgG) is > = 1:100 Anti GM1 IgG Titer No Reflex CPT Code AGM1GT

If Anti GD1a (IgM) is > = 1:100 Anti GD1a IgM Titer No Reflex CPT Code AGDAMT

If Anti GD1a (IgG) is > = 1:100 Anti GD1a IgG Titer No Reflex CPT Code AGDAGT

Reflex Testingcontinued

If Anti GD1b (IgM) is > = 1:100 Anti GD1b IgM Titer No Reflex CPT Code AGDBMT

If Anti GD1b (IgG) is > = 1:100 Anti GD1b IgG Titer No Reflex CPT Code AGDBGT

If Asialo GM1 Antibody, IgM is> = 1:100

Anti Asialo GM1 IgM Titer No Reflex CPT Code AAG1MT

If Asialo GM1 Antibody, IgG is> = 1:100

Anti Asialo GM1 IgG Titer No Reflex CPT Code AAG1GT

If Anti Myelin Glyco IgM Rflx is> = 1:100

Anti MAG Abs (Western Blot) No Reflex CPT Code AMAGWB

NewNew Test - Replaces GM1COM

Reflex testing provided at no charge.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 60

NEUROPATHY PROFILE III RFLXFees Fees for this test are being adjusted. Please contact your Sales Representative or Client Services for fee

information.

OCCULT BLOOD, GASTRIC FLUIDTest Code OBGA

Billing Code OBGAEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode OCBDLL to order this test.

OCCULT BLOOD, GASTRIC FLUIDTest Code OCBDLL

Billing Code OCBDLLEffective 10/27/2017

Container Type Sterile leakproof container with screw-cap

Supply ItemNumber

1387

Store andTransport

Ambient (room temperature)

Specimen Type Gastric fluid

Preferred Volume 5 mL

Patient Prep

Patient should not receive vitamin C(ascorbic acid) for 3 days prior to occult blood testing by guaiac. Vitamin Cdoesnot affect the HemoQuant test. Antacids may cause false-neg-ative guaiac test. A high bulk, red meat free dietwith res-triction of peroxidase-rich vegetables(turnips, horseradish,artichokes, mushrooms, radishes, broccoli,bean sprouts, cauliflower, apples, oranges, bananas, cantaloupes, grapes),has been recommended for 72 hoursprior to guaiac testing, and during testing, to decrease the incidence of false- positives. Therapeutic iron causesfalse-positives with guaica with guaiac tests in over half of healthy subjects. Alcohol and aspirin, especiallytogether,and other gastric irritants steroids, rauwolfia derivatives, all nonsteroidal anti-inflammatory drugs,colchicine) should also be avoided.

ReferenceLaboratory

LabCorp

Reference labTest Code

182196

CPT Codes 82271

Test Schedule Mon-Fri

Turnaround Time 3-5 days

Method Guaiac

New New Test - Replaces OBGA

OVARIAN AB SCREEN RFLXTest Code OVAB

Billing Code OVABEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode OVABL to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 61

OVARY ANTIBODY IGG RFLXTest Code OVABL

Billing Code OVABLEffective 10/27/2017

Container Type Serum separator tube (gold, brick, SST, or corvac)

Supply ItemNumber

1467

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type Serum

Preferred Volume 1 mL

EmergencyMinimum Volume

0.25 mL

SpecimenProcessing

Separate serum from cells and transfer to a standard PAML aliquot tube and freeze.

Room Temp 5 days

Refrigerated 5 days

Frozen -20c 1 year

AlternateSpecimens

Red top tube (plain)

ReferenceLaboratory

LabCorp

Reference labTest Code

808616

CPT Codes 86255

Test Schedule Weekly x 1

Turnaround Time Within 1 week of specimen receipt

Method Indirect Immunofluorescence

Reflex Testing

Reflex Condition Reflex Test Name Reflex CPT codes Reflex Billing Codes

If ovary antibody IGG ispositive

Anti Ovary Ab Pattern No Reflex CPT Code OVABLT

New New Test - Replaces OVAB and BOVAB

Please Note Reflex testing provided at no charge.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 62

PAROXETINETest Code PAROX

Billing Code PAROX.LCAEffective 10/27/2017

Synonyms Paroxetine, Serum or Plasma; Paxil; Pexeva

Container Type Red top tube (plain)

Supply ItemNumber

1372

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 1 mL

EmergencyMinimum Volume

0.5 mL

Patient Prep Trough levels are most reproducible.

SpecimenProcessing

Separate serum or plasma from cells within 2 hours of collection and transfer to a standard PAML aliquot tube.

Room Temp 3 days

UnacceptableCondition

Gel barrier tubes

AlternateSpecimens

Green top tube (heparin)

ReferenceLaboratory

LabCorp

Reference labTest Code

811133

CPT Codes 80332

Method Liquid Chromatography/Tandem Mass Spectrometry

ComplianceRemarks

This test was developed and its performance characteristics determined by LabCorp. It has not been cleared orapproved by the Food and Drug Administration.

Notes Use: Therapeutic drug management

New New Test

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 63

PARVOVIRUS B19 AB PANELTest Code B19ABP

Billing Code B19ABP.LCAEffective 10/27/2017

Synonyms Human Parvovirus B19, IgG, IgM; Fifth Disease; Parvo; B19

Container Type Serum separator tube (gold, brick, SST, or corvac) and lavender top tube (EDTA)

Supply ItemNumber

1467 and 1222

Store andTransport

Refrigerated

Specimen Type Serum and whole blood

Preferred Volume Serum: 1.0 mL; whole blood: 1.0 mL

EmergencyMinimum Volume

Serum: 0.5 mL; whole blood: 0.5 mL

SpecimenProcessing

Separate serum from cells and transfer to a standard PAML aliquot tube.

Room Temp Serum: 2 weeks; whole blood: 1 week

Refrigerated Serum: 2 weeks; whole blood: 1 week

Frozen -20c Serum: 2 weeks; freeze/thaw cycles: Stable x 3; whole blood: unacceptable

UnacceptableCondition

Hemolysis; lipemia; gross bacterial contamination; frozen whole blood

ReferenceLaboratory

LabCorp

Reference labTest Code

236956

Method Enzyme Immunoassay/Real-Time Polymerase Chain Reaction

Notes

Use: Differential diagnosis of acute or recent infection from past infection with human parvovirus associated witherythema infectiosum (fifth disease), aplastic crisis, and fetal infection.

Additional Information: IgM antibodies are detectable two weeks after exposure. IgG antibody production usuallyoccurs 18 to 24 days after exposure. The presence of IgM antibodies to parvovirus B19 provide definite evidence ofrecent infection.

PEMPHIGOID PANELTest Code PAPEB

Billing Code PEMPEBEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode GLBMAB and BUPHLC to order this test.

PEPPER WHITE IGETest Code ICPWEI

Billing Code ICPWEIEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode ICFBP to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 64

PRION PROTEIN (14,3,3), CSF RFLXTest Code PRION

Billing Code PRION.LCAEffective 10/27/2017

ReferenceLaboratory

LabCorp

Reference labTest Code

081695

Reflex Testing

Reflex Condition Reflex Test Name Reflex CPT codes Reflex Billing Codes

CSF samples with tau levels >= 500 pg/ml

RT QulC (CSF) 87798 PRIORL

Please Note This test may reflex to additional tests depending upon the results of this test. An additional fee will be added if thereflex test is necessary.

PROPAFENONETest Code PROPAF

Billing Code PROPAFENONEEffective 10/27/2017

Delete This test is being discontinued due to low utilization.

PYRROLES, URINETest Code PYRURI

Billing Code PYRURI.LCAEffective 10/27/2017

Container Type Leakproof plastic urine container and amber plastic transport tube

Supply ItemNumber

1387 and 3415

Preferred Volume 10 mL

Patient PrepIf first time testing for pyrroles, discontinue taking any B6 or Zinc one week prior to collecting specimen. If undertreatment for pyrroluria, continue taking vitamin B6 and Zinc. Female patients: DO NOT collect specimen duringmenstrual cycle.

SpecimenProcessing

Add approximately 8 mL of urine to an amber plastic tube containing 500 mg of ascorbic acid. Mix and freeze. Mustbe protected from light. (Wrap tube in foil for light protection if amber tube is not available). Tubes are available throughPAML Supply #3415.

Frozen -20c 1 month (kept fozen)

UnacceptableCondition

Ascorbic acid not used to maintain specimen stability; received not frozen; not protected from light

ReferenceLaboratory

LabCorp

Reference labTest Code

823054

CPT Codes 84999

ClinicalSignificance

A urine test for diagnosis and monitoring severe physiological or psychological stress. Pyrroles appear in theurine of patients undergoing severe physiological or psychological stress. The presence of urinary pyrroles(mauve factor) was first reported in patients with LSD psychosis. Later, high levels of pyrroles were found in theurine of schizophrenic patients. The chemical structure is a 2,4 dimethyl-3-ethylpyrrole. It is also calledkryptopyrrole. Kryptos comes from the Greek word "hidden."

Please Note Previous CPT Code: 84311

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 65

PYRUVIC ACID, CSFTest Code PYACFA

Billing Code PYACFA.LCAEffective 10/27/2017

Container Type Sterile CSF plastic tube

Supply ItemNumber

4448

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type CSF

Preferred Volume 1 mL

EmergencyMinimum Volume

1 mL

Patient Prep Patient should be at complete rest.

SpecimenProcessing

1. Immediately after CSF is drawn, add exactly 1 mL CSF to a chilled pyruvate collection tube containing 2 mL 8percent (w/v) perchloric acid

2. Mix well for 30 seconds then place in an ice bath for 10 minutes.

3. Centrifuge for 10 minutes at 1500 x g.

4. Decant 2 mL supernatant to a PAML Standard Transport Tube and freeze.

Room Temp Unacceptable

Refrigerated 2 days

Frozen -20c 1 month

UnacceptableCondition

If less than 1 mL of CSF is added to collection tube, pH of the supernatant will be too low for testing.

ReferenceLaboratory

LabCorp

Reference labTest Code

216834

CPT Codes 84210

Test Schedule Daily

Turnaround Time 2-4 days

Method Enzymatic

ReferenceRanges

Title Ranges Units

Pyruvic Acid, CSF 0.060-0.190 mmol/L

Notes Useful for investigating possible disorders of mitochondrial metabolism, particularly when used in conjunctionwith CSF lactate.

New New Test

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 66

SILICONTest Code SILIS

Billing Code SILIS.LCAEffective 10/27/2017

Synonyms Silicon, Serum/Plasma

Container Type Royal Blue top tube (Trace metal-free; EDTA)

Supply ItemNumber

9734

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 2 mL

EmergencyMinimum Volume

0.7 mL

SpecimenProcessing

Separate plasma or serum from cells within 45 minutes of collection and transfer into an acid washed plastic screwcapped vial.

Room Temp 2 weeks

Refrigerated 3 weeks

Frozen -20c 2 weeks

UnacceptableCondition

Glass container. Polymer gel separation tube (SST or PST).

AlternateSpecimens

Royal Blue top tube (Trace metal-free; No additive)

ReferenceLaboratory

LabCorp

Reference labTest Code

823579

CPT Codes 83018

Test Schedule Mon

Turnaround Time 8-10 days

Method Inductively Coupled Plasma/Optical Emission Spectrometry

Notes

Exposure Monitoring/Investigation; This test assesses the presence of Silicon and does NOT measure Silica orSilicone. Silica is silicon dioxide (SiO2), which is found in quartz and sand. Silicones are inert syntheticorganosilicon compounds used in adhesives, sealants, lubricants, medical applications, insulation and cookingutensils.

New New Test

SMA DIAGNOSTIC TESTTest Code SMADS

Billing Code SMADSEffective 9/27/2017

Delete This test is being discontinued. Use the ordercode SMACNA to order this test.

SPERM ANTIBODY (IGA, IGG)Test Code SPABAG

Billing Code SPABAGEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode SPEABL to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 67

S-PHENYLMERCAPTURIC ACID, URINETest Code SPAU

Billing Code SPAU.LCAEffective 10/27/2017

ReferenceLaboratory

LabCorp

Reference labTest Code

823562

Reflex Testing

Reflex Condition Reflex Test Name Reflex CPT codes Reflex Billing Codes

Creatinine is > = 5000 or < = 200 Specific Gravity Confirmation,Urine

No Reflex CPT Code SGSPAU

Please Note Reflex testing performed at no charge.

STREPTOMYCIN, LEVEL (HPLC)Test Code STREPL

Billing Code STREPL.LCAEffective 9/21/2017

CPT Codes 80299

Please Note Previous CPT Code: 82492

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 68

THYMIDINE DETERMINATION - PLASMATest Code THYMA

Billing Code THYMAEffective 10/27/2017

Synonyms Thymidine phosphorylase

Container Type Green top tube (sodium heparin)

Supply ItemNumber

1398

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type Plasma

Preferred Volume 2 mL

EmergencyMinimum Volume

1 mL

SpecimenProcessing

Promptly separate plasma from cells and transfer to a standard PAML aliquot tube and freeze.

Room Temp Unacceptable

Refrigerated Unacceptable

Frozen -20c 1 week

ReferenceLaboratory

LabCorp

Reference labTest Code

823567

CPT Codes 83789

Turnaround Time 15-21 days

Method Tandem Mass Spectroscopy

ComplianceRemarks

This test was developed and its performance charactistics determined by Baylor Miraca Genetics LaboratoriesDBA Baylor Genetics It has not been cleared or approved by the FDA. The laboratory is regulated under CLIA asqualified to perform high-complexity testing. This test is used for clinical purposes. It should not be regarded asinvestigational or for research.

NotesThis test provides quantitative analysis of Thymidine in Plasma. This test is useful for evaluation of patientssuspected of MNGIE Disease. Results from this test are not useful for Carrier Testing. Please note, carriers mayhave Thymidine levels in the normal range.

New New Test - Replaces THYDET

THYMIDINE PHOSPHORYLASETest Code THYDET

Billing Code THYDETEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode THYMA to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 69

TOCAINIDE, SERUM OR PLASMATest Code TOC

Billing Code TOC.LCAEffective 10/27/2017

Synonyms Tonocard®

Container Type Red top tube (plain)

Supply ItemNumber

1372

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 1 mL

EmergencyMinimum Volume

0.5 mL

SpecimenProcessing

Separate serum from cells within 2 hours of collection and transfer to a standard PAML aliquot tube.

Room Temp 3 days - beyond three days, specimen should be refrigerated or frozen.

UnacceptableCondition

Gel-barrier tubes

AlternateSpecimens

Green-top (heparin) tube

ReferenceLaboratory

LabCorp

Reference labTest Code

811372

CPT Codes 80299

Method Liquid chromatography/tandem mass spectrometry (LC/MS-MS)

ComplianceRemarks

This test was developed and its performance characteristics determined by LabCorp. It has not been cleared orapproved by the Food and Drug Administration.

New New Test

TOXOCARA (T. CANIS/T. CATA) ABTest Code TOXOC

Billing Code TOXOCEffective 9/21/2017

Delete This test is being discontinued. Use the ordercode TOXC to order this test.

TRICHINELLA AB, IGGTest Code TRICAB

Billing Code TRICHEffective 11/11/2017

Delete This test is being discontinued.

TROFILE CO RECEPTOR TROPISMTest Code TCRTA

Billing Code TCRTAEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode TROFIL to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 70

TROFILE®Test Code TROFIL

Billing Code TROFILEffective 10/27/2017

Synonyms HIV; Tropism, Co-Receptor Tropism (phenotypic); Monogram Biosciences; CCR5; CXCR4; Chemokine co-receptortropism Trofile®; Human Immunodeficiency Virus (HIV) co-receptor tropism phenotype

Container Type Two lavender top tubes (EDTA)

Supply ItemNumber

1222

Store andTransport

Frozen - Separate samples must be submitted when multiple tests are ordered.

Specimen Type Plasma

Preferred Volume 3 mL

EmergencyMinimum Volume

3 mL

CollectionProcedure

Collect specimen in 2 lavender-top (EDTA) tubes or 2 PPT(TM) tubes. Do NOT use green-top (heparin) tubes.

SpecimenProcessing

Separate plasma from cells within 6 hours of collection. Transfer plasma to a standard PAML aliquot tube andfreeze immediately. CRITICAL FROZEN

Room Temp Unacceptable

Refrigerated Unacceptable

UnacceptableCondition

PPT not centrifuged; insufficient volume; heparinized plasma; non frozen specimens

AlternateSpecimens

Two plasma preparation tubes (PPT)

Limitations Provide patient's most recent viral load and viral load collection date. Procedure should be used for patients withdocumented HIV-1 infection and viral loads greater than 1000 copies/mL.

ReferenceLaboratory

LabCorp

Reference labTest Code

550220

CPT Codes 87999

Test Schedule Varies

Turnaround Time 3-4 weeks

Method Polymerase Chain Reaction Amplification and Viral Culture

Notes

Use/Additonal Details: Detect HIV-1 co-receptor tropism, determine eligibility for CCR5 antagonist therapy such asSelzentry(TM) (maraviroc).

Trofile® is a trademark of Monogram Biosciences®.

New New Test - Replaces TCRTA

Please Note Critical frozen

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 71

PAML Web Test Directory Link

VERAPAMILTest Code VERAPA

Billing Code VERAPA.LCAEffective 10/27/2017

Synonyms Calan; Isoptin; Verelan

Container Type Red top tube (plain)

Supply ItemNumber

1372

Store andTransport

Refrigerated

Specimen Type Serum

Preferred Volume 3 mL

EmergencyMinimum Volume

1.2 mL

SpecimenProcessing

Separate serum or plasma from cells within 2 hours of collection and transfer to a standard PAML aliquot tube.

Room Temp 2 weeks

Refrigerated 1 month

Frozen -20c 18 months

UnacceptableCondition

Polymer gel separation tube (SST or PST)

AlternateSpecimens

Lavender top tube (EDTA)

ReferenceLaboratory

LabCorp

Reference labTest Code

829873

CPT Codes 80375

Test Schedule Mon-Fri

Turnaround Time 4-5 days

Method Gas Chromatography

New New Test

WINGSCALE IGETest Code ICWISI

Billing Code ICWISIEffective 10/27/2017

Delete This test is being discontinued. Use the ordercode ICWSC to order this test.

Test Change Alert #462 October 09, 2017

The following tables reflect revisions only; other existing data remain unchanged.

page: 72