PlexEBV™

Test Code
12774


CPT Codes
85032, 86353, 88184, 88185 (x5), 88187<br>This test is not available for New York patient testing<br>Restricted Client Code

Preferred Specimen
Children: 3 mL whole blood collected in a sodium heparin (green-top) tube
Adults: 5 mL whole blood


Minimum Volume
Children: 3 mL
Adults: 5 mL


Instructions

1.) Samples should be drawn between the hours of 5:00 am and 10:00 am. This time frame increases the chances that the sample will arrive at Plexision during normal operating hours when staff is available to test it immediately. Sample collection time and date must be noted on the sample label and the Pleximark Test Requisition Form, or the sample will not be accepted.

2.) To permit identification of a specimen, the specimen label must have at least two patient identifiers, (e.g., date of birth, patient unique identifier assigned by collection center/hospital, name, etc.).

3.) Complete the Pleximark Test Requisition Form (form attached with email). Complete the form by filling in all required information. Also include patient information for billing along with the doctor ordering the test. Confirm that the patient information on the form matches the information provided on the specimen label.

4.) Fax a copy of the requisition form of Plexision at (412) 224-2776 by 4:00 PM (EST) on the day of the shipment.

5.) Patient blood sample should be shipped to Plexision's laboratory at 4424 Penn Ave. Suite 202, Pittsburgh, PA 15224 via overnight priority shipping (FEDEX, UPS, or other overnight shipping vendor). Package and label the samples in compliance with applicable federal regulation covering the transport of clinical samples and etiological agents. Blood samples will be tested as soon as possible arrival.

Room temperature, ship priority overnight, the sample must get to Plexision within 30 hours of the phlebotomy.



Transport Temperature
Room temperature


Specimen Stability
Room temperature: 30 hours
Refrigerated: Unacceptable
Frozen: Unacceptable


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Hemolysis • Transport time more than 30 hours from the phlebotomy • Lithium heparin (green-top) tube or ACD (yellow-top) tube • Clotted • Broken vacutainer seal


Methodology
Stimulation of peripheral blood leukocytes with EBV lysate • Flow Cytometry

Setup Schedule
Set up: Daily; Report available: 30 hours of receiving the blood sample


Reference Range
See Laboratory Report


Clinical Significance
To measure cell-mediated immunity to the Epstein-Barr virus (EBV).




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.