Prometheus® IBD sgi Diagnostic®

Test Code

90807

CPT Codes
81599<br>**This test is only available for Kaiser-Nor Cal and client 54277**

Preferred Specimen

2 mL serum collected in a red-top tube (no gel) and 2 mL whole blood collected in EDTA (lavender-top)

Minimum Volume

Serum: 1 mL
Whole blood: 1 mL

Other Acceptable Specimens

Serum in an SST (serum separator tube)

Instructions

2 mL whole blood and 2 mL serum (specimens must be shipped together).
Shipment same day as collection and storage at or below room temperature is recommended.
Do not freeze.
Include patient's name and collection date on sample and request form.

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

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

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

Improperly labeled specimens • Whole blood and serum not drawn/received together

Methodology
Enzyme-Linked Immunosorbent Assay • Indirect Immunofluorescence Assay • Chemiluminescent Assay

FDA Status
This test was developed and its performance characteristics determined by Prometheus Laboratories Inc. It has not been cleared or approved by the U.S. Food and Drug Administration. Prometheus Laboratories Inc. is a CAP- accredited CLIA laboratory.

Setup Schedule

Sets up 5 days a week.

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.