PARASITE EXAM, BLOOD

Test Code

8185

CPT Codes
87207

Preferred Specimen

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Smears made from fresh whole capillary (fingerstick) blood and/or capillary blood in EDTA (Microtainer™), or 3-5 mL fresh whole venous blood in EDTA
"

Minimum Volume

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Films (two thin and two thick) or 3-5 mL fresh whole venous blood in EDTA
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Transport Container

"Glass slide, lavender-top (EDTA) tube
"

Transport Temperature

room temperature

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

"Specimen clotted; improper labeling
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Methodology
"Wright stain; microscopic examination of thick and thin peripheral blood smears stained with Romanovsky dye (in particular Giemsa). Thick films are more difficult to interpret but greatly increase sensitivity (by concentrating cells and organisms). Thick smears require considerable experience with malaria, as they increase the number of cells examined in a given time period by a factor of about 12.1 "

Limitations

"One negative result does not rule out the possibility of parasitic infestation. If protozoal, filarial, or trypanosomal infection is strongly suspected, test should be performed at least three times with samples obtained at different times in the fever cycle.
"

Clinical Significance

"Proper therapy depends upon identification of the specific variety of malaria parasite. Release of trophozoites and RBC debris results in a febrile response. Periodicity of fever correlates with type of malaria (see table). Organisms are most likely to be detected just before onset of fever, which is predictable in many cases. Sampling immediately upon onset of fever is the most desirable time to obtain blood. Alternatively in cases negative by these means but with a strong clinical history, multiple sampling at different times in the fever cycle may prove successful. Malarial parasites are destroyed in AS and SS patients. The cause of parasite death in AS cells is potassium loss, in SS cells Hb S aggregates destroy the parasites by physical penetration.2
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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.