Ova and Parasites, Concentrate and Permanent Smear

Test Code
OP (681)

Quest Code
681

CPT Codes
87177, 87209

Includes
Ova and Parasite Concentrate Result, Trichrome Result

Preferred Specimen
10 grams or 10 mL fresh stool preserved in 10% formalin and Polyvinyl Alcohol Transport or single Total-Fix® transport vial

Patient Preparation
Interfering substances: Bismuth, barium (wait 7-10 days), Antimicrobial agents (wait 2 weeks), Gallbladder dye (wait 3 weeks after procedure)

Minimum Volume
5 grams or 5 mL stool • 10 mL urine (unpreserved) • 2 mL sputum or BAL

Other Acceptable Specimens
Parapak SVT transport vial • 25 mL urine collected in a sterile screw-cap container • 10 mL sputum or BAL collected in a sterile screw-cap container or in 10% formalin

Instructions
Note: Tissue samples should be sent to pathology

Stool (preferred): Place fresh stool in 10% formalin transport vial, as well as PVA transport medium or single Total-Fix® vial, within 30 minutes of collection. Add stool to bring the liquid level to the "fill to here" line on the vial. Mix well. Send specimen(s) at room temperature in the same shipping container.
If parasite infestation is strongly suspected, collect at least 3 stool specimens every other day, since a single specimen can be negative. If Giardia is strongly suspected, please see Giardia Antigen, EIA, Stool (Test Code 8625).

Urine (acceptable): Urine may be submitted unpreserved for exam for Schistosoma. Collect at mid-day. Peak egg secretion occurs between noon and 3 p.m. Do not submit first morning specimen. In patients with hematuria, eggs may be found trapped in blood and mucous in the terminal portion (last-voided portion) of the urine specimen.

Sputum (acceptable): The specimen should be a deep expectorated sputum, preferably collected in the early morning. A 24-hour sputum collection is also acceptable. Submit in a sterile screw-capped container, unpreserved or in 10% formalin to increase stability.

Transport Temperature
Stool and sputum (preserved): Room temperature
Urine and sputum (unpreserved): Refrigerated (cold packs)

Specimen Stability
Stool (preserved)
Room temperature: 6 months
Refrigerated: 6 months
Frozen: Unacceptable

Urine, Sputum, BAL (unpreserved)
Room temperature: Unacceptable
Refrigerated: 48 hours
Frozen: Unacceptable

Sputum, BAL (preserved)
Room temperature: 6 months
Refrigerated: Unacceptable
Frozen: Unacceptable

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Unpreserved stool • Specimens containing barium • Stool preserved in medium other than parasitology fixative • Received frozen • Stool submitted in expired transport vial • Preserved urine • Unpreserved sputum and urine received room temperature or frozen • Liver abscess or aspirate • Ecofix Transport vials

Methodology
Microscopic Examination of Concentrate • Permanent Stained Smear

Setup Schedule
Sun-Sat

Reference Range
No ova and parasites seen

Clinical Significance
Diseases caused by human parasites remain on a worldwide basis among the principle causes of morbidity and mortality. Correct diagnosis of intestinal parasitic infection depends on proper collection, transport, detection and identification of parasites in stool specimens. Symptoms range from malaise to death. Treatment is dependent upon examining multiple stool specimens due to the erratic shed rates of some parasites.

Performing Laboratory
Quest Diagnostics Nichols Institute
27027 Tourney Road
Valencia, CA 91355-5386



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.