Neutrophil Function, Oxidative Burst

Test Code
37523

CPT Codes
82657

Preferred Specimen
3 mL whole blood collected in a sodium heparin (green-top) tube
--and--

2nd specimen (Control): 3 mL whole blood in sodium heparin (green-top) tube

Minimum Volume
2 mL

Instructions
Specimen must arrive at the referral laboratory within 72 hours of collection in order to meet sample stability requirements. Specimens are accepted <72 hours post collection. No other preservatives are acceptable. Specify time of day specimen was collected. Clients may send 4 mL whole blood in sodium heparin from a healthy donor unrelated to the patient, drawn at the same time as the patient sample to run in parallel with the patient's specimen. The outermost label of the tube must be clearly labeled as "Transport Control". If the draw date is not indicated on the specimen, the client must be called and this information obtained.

Clients: Contact the lab prior to ordering for special logistics arrangements.

PSC:
Follow Short Stability Protocol.

Test available by prior arrangement only. Special sample collection and transportation arrangements must be made prior to ordering the test. Contact your local Customer Service Department and request to speak to someone in Referral Testing Department for specific instructions.

Submit Monday through Thursday only. Do not draw day before a holiday. Draw the specimens prior to the last FedEx pick up. Make arrangements with FedEx in advance for same day pick up. Collect and label the specimen(s) according to test requirements. Place the specimen(s) and paperwork into the short stability specimen kit. Use one kit per patient. Use the pre-printed FedEx shipping airbill (provided with the kit) for FedEx Express overnight shipment to Quest Diagnostics Nichols Institute in San Juan Capistrano, CA.

Request item #170903

Samples received > 72 hours after collection will be rejected. Date and time of draw are required and must be provided.

Transport Temperature
Room temperature

Specimen Stability
Room temperature: 72 hours
Refrigerated: Unacceptable
Frozen: Unacceptable

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Hemolysis • Lipemia • Icterus • Clotted specimens • Refrigerated and frozen specimens

Methodology
Flow Cytometry (FC)

Setup Schedule
Set up: Daily a.m.; Report available: 2-3 days

Reference Range
%Oxidation Pos Neutrophils
24 Hours ≥93%
48 Hours ≥83%
72 Hours ≥82%


Clinical Significance
This assay measures the capability of neutrophils (PMN) to undergo oxidative metabolism to produce superoxide anion and hydrogen peroxide, as detected by oxidation of dihydrorhodamine (DHR). Patients with chronic granulomatous disease (CGD) are unable to oxidize DHR due to defects in oxidative capacity slowly decreases as the specimen age (hours post collection) increases. It is thus important that the reference range value appropriate for the specimen age be utilized when assessing the reported results.

Performing Laboratory
Quest Diagnostics Nichols Inst San Juan Capistrano
33608 Ortega Highway
San Juan Capistrano, CA 92690-6130



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.