TEMPLATE, TEST NAME, MODIFIERS (ALL CAPS FOR TESTS PERFORMED IN SYSTEM LABS)

Message
Collect: 
Alternative Specimens: 
Minimum Collection Volume: 
Pediatric (microtainer): 
Stability (Time & Temerpature): 
   Ambient: 
   Refrigerated (2-24°C),: 
   Frozen (-7°C),: 6 months if frozen within 1
hour of collection. 
Collection Remarks: Do not collect through
heparinized line. Must be collected by venipuncture. Blue top tube
must be filled properly to etched line to perform
testing. 
Reject Due To: Tube contaminated with
heparin, gross hemolysis, specimen clotted or not filled
properly. 


Test Code
1463318689


Preferred Specimen
Collect: Alternative Specimens: 


Minimum Volume
Minimum Collection Volume: Pediatric (microtainer): Stability (Time & Temerpature):    Ambient:    Refrigerated (20-24°C),:    Frozen (-70°C),: 6 months if frozen within 1hour of collection. 


Instructions


Instructions: 


Transport Container
Transport Temperature &
aliquotting: 
UML Test Code 
Instructions: 


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Reject Due to: Tube contaminated withheparin, gross hemolysis, specimen clotted or not filledproperly. 


Performing Laboratory
West Virginia University Hopsital, Inc



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.