Prometheus® IBD sgi Diagnostic®

Test Code
90807


CPT Codes
81599<br>Restricted Client Code

Includes
ASCA IgA, ELISA, ASCA IgG, ELISA, Anti-OmpC IgA, ELISA, Anti-CBir1, ELISA; IBD specific pANCA Autoantibody, ELISA; Anti-A4-Fla2 IgG, ELISA, Anti-FlaX IgG, ELISA; ICAM-1, VCAM-1, VEGF, CRP; ATG16L 1 SNP (rs2241880); NKX2-3 SNP (rs10883365); EMC1 SNP (rs3737240); STAT3 SNP (rs744166); SAA; IBD Specific pANCA IFA Perinuclear Pattern; IBD Specific pANCA IFA DNAse; Sensitivity; SNP 8 (R702W), SNP 12 G908R), SNP 13 (1007fs); Anti-I2 ELISA

When ordering IBD sgi, please note that if results of IBD sgi testing are pattern consistent with Crohn's disease, at physicians request Crohn's Prognostic, will be added at additional charge (CPT codes: 81401, 83520 (x5), 86036, 86255).


Preferred Specimen
2 mL serum and 2 mL whole blood collected in an EDTA (lavender-top) tube


Instructions
Draw 2 mL whole blood and 2 mL serum (specimens must be shipped together).
Shipment within 7 days of collection and storage at or below room temperature is recommended. (Minimum specimen volume for genetic testing may vary based on WBC). Do not freeze specimen. Specimens will be rejected if whole blood and serum are not drawn and received together.


Transport Temperature
Refrigerated (cold packs)


Specimen Stability
Room temperature: 7 days
Refrigerated: 21 days
Frozen: Unacceptable


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Improper sample type • Improper sample conditions • Improper labeling (specimens must be labeled with patient's name and date of collection; unlabeled specimens will not be accepted for testing.)


Methodology
Enzyme-Linked Immunosorbent Assay (ELISA) • Indirect Immunofluorescence Assay (IFA)

Setup Schedule
Set up: Mon-Fri; Report available: 6 days


Reference Range
See Laboratory Report


Clinical Significance
This test will aid healthcare providers to differentiate IBD versus Non-IBD and CD versus UC in one comprehensive blood test.




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.