Donor, Stem Cell Panel

Test Code

901753

CPT Codes
86644, 86703, 86704, 86753, 86780, 86790, 86803, 87340, 87798, 87801<br>Restricted Client Code

Includes

Donor, HIV-1/HIV-2 plus O Antibody Screen
Donor, Hepatitis B Surface Antigen Refl to Confirm
Donor, Hep B core Total Ab
Donor, Hepatitis C Antibody (Anti-HCV)
Donor, HTLV-I/II Antibody Screen
Donor, Cytomegalovirus Antibody, Total
Donor, HIV/HCV/HBV NAT Procleix® with Reflexes
Donor, West Nile Virus NAT
Donor, Syphilis IgG Antibody
Donor, Chagas Screen

Preferred Specimen

6 mL serum collected in each of two red-top tubes (no gel), or serum separator tubes, and
6 mL plasma collected in each of two EDTA (lavender-top) tubes

Minimum Volume

6 mL

Instructions

Please note: This test is to be used for the screening of DONORS of human cells, tissues, and cellular and tissue-based products for infectious diseases.

Label the tubes according to your standard operating procedure, making sure that each tube has at least two unique patient identifiers.

Note: Please include serum, Red-top (no gel) for CMV portion of testing.

If transport temperature will be frozen, centrifuge the red/lavender top tube and transfer the serum/plasma into a plastic screw cap vial. The plastic screw cap vial (aliquot tube) containing serum or plasma must be labeled with the specimen type (serum or plasma) and at least two unique patient identifiers. Aliquot tubes must be processed and labeled at the original collection site. If aliquot tubes are submitted, do not send the original red/lavender-top tube. Room temperature transport is acceptable. Do not store at room temperature.

Transport Container

Plastic screw-cap vial

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Room temperature: See instructions
Refrigerated: 7 days
Frozen: 30 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Heparinized samples • CMV samples submitted in Gel tubes (Serum separator tubes) • Syphilis sample not marked serum • Gross hemolysis • Grossly lipemic • Grossly icteric

Methodology
Immunoassay • Hemagglutination • Nucleic Acid Amplification (NAT) • Enzyme Immunoassay • Enzyme-Linked Immunosorbent Assay (ELISA)

Setup Schedule

Set up and Report available: See individual assays

Reference Range

See Laboratory Report

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.