Spreadsheet: 634ba0b0-e58b-4710-8e92-7243043e63f1
Sheet: Sheet1

Test ID | Type | Published Name | Reporting Name | CPT Units | CPT Code | Always Performed | Orderable Separately | Testing Algorithm
19701 | Test | Biliary Tract Malignancy, FISH Only | Biliary Tract Malignancy, FISH Only | 1 |  |  |  | When this test is ordered, 19229 / Biliary Tract Malignancy, FISH will be performed.
19229 | [NAME] | Biliary Tract Malignancy, FISH ([NAME] Only) | Biliary Tract Malignancy, FISH | 4 | 88368 | Yes | No
2D6CB | Test | Cytochrome P450 2D6 (CYP2D6) [NAME], Blood | CYP2D6 [NAME], B | 1 | 81226 |  |  | This test will always include CYP2D6 genotype testing via [NAME] (tier 1). [NAME] testing will be performed as appropriate and at an additional charge and will include CYP2D6 copy number variation. If additional testing is needed, any or all of the following tier 3 testing will be performed at an additional charge: CYP2D6 full gene sequencing, CYP2D6-2D7 gene sequencing, CYP2D7-2D6 gene sequencing, CYP2D6 duplication sequence A, CYP2D6 duplication sequence B, and CYP2D6 duplication sequence C. The results of the reflex tests will be incorporated into the interpretation of this test.
2D6R | [NAME] | CYP2D7-2D6 Gene Sequencing, B ([NAME] Only) | CYP2D7-2D6 Gene Sequencing, B | 1 | 81479 | No | No
2D6FG | [NAME] | CYP2D6 [NAME], B ([NAME] Only) | CYP2D6 [NAME], B | 1 | 81479 | No | No
2D6DC | [NAME] | CYP2D6 [NAME], B ([NAME] Only) | CYP2D6 [NAME], B | 1 | 81479 | No | No
2D6DB | [NAME] | CYP2D6 [NAME] B, B ([NAME] Only) | CYP2D6 [NAME] B, B | 1 | 81479 | No | No
2D6DA | [NAME] | CYP2D6 [NAME] A, B ([NAME] Only) | CYP2D6 [NAME] A, B | 1 | 81479 | No | No
2D6N | [NAME] | CYP2D6-2D7 Gene  Sequencing, B ([NAME] Only) | CYP2D6-2D7 Gene Sequencing, B | 1 | 81479 | No | No
2D6CN | [NAME] | CYP2D6 [NAME], B ([NAME] Only) | CYP2D6 [NAME], B | 1 | 81479 | No | No
4339 | Test | DermPath Consultation, Wet Tissue | DermPath Consultation, Wet Tissue | 1 |  |  |  | When this test is ordered, 1 of the 3 reflex tests will be performed and charged. Appropriate additional stains and other ancillary testing may be performed to determine a diagnosis. These stains and tests will be charged separately.
50033 | [NAME] | Level II Surg Path Gross and Micro Exam | Level II Surg Path w/Gross,Micro Ex | 1 | 88302 | No | No
50034 | [NAME] | Level III Surg Path | Level III Surg Path | 1 | 88304 | No | No
88305 | [NAME] | Level IV Surg Path | Level IV Surg Path | 1 | 88305 | No | No
60198 | Test | HER2, Gastric/Esophageal, Semi-Quantitative Immunohistochemistry, Manual | [NAME], Manual | 1 | 88360 |  |  | Cases that are equivocal (2+) by immunohistochemical stain will reflex to HER2 FISH at an additional charge.
[NAME] | [NAME] | HER2 Amplification Associated with Gastroesophageal Cancer, FISH, Tissue | [NAME], Gastroesophageal FISH |  | PROFILE | No | Yes
60694 | Test | FOXL2 Mutation (C402G) Analysis by PCR and Pyrosequencing | FOXL2 Mutation (C402G) Analysis | 1 | 81479 |  |  | This test is performed in conjunction with 60254 / AP Special Studies Review and 70011 / Slide Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / AP Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
70011 | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
60714 | Test | USP6 (17p13), [NAME] and Nodular Fasciitis, FISH | USP6 (17p13), FISH | 1 | 88368 |  |  | This test is performed in conjunction with 60254 / AP Special Studies Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / AP Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
61207 | Test | IDH1/IDH2 Mutation Analysis by Pyrosequencing, Paraffin | IDH1/IDH2 Genes, Known Mutations | 2 | 81403 |  |  | This test is performed in conjunction with 60254 / AP Special Studies Review and 70011 / Slide Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / AP Special Studies Review could be changed to 70012 / Pathology Consultation if they determine this is more appropriate.
70011 | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
61210 | Test | Beta-Catenin, Fibromatosis, Mutation Analysis | Beta-Catenin, Mutation Analysis | 1 | 81403 |  |  | This test is performed in conjunction with 60254 / Anatomic Pathology Special Studies Review and 70011 / Slide Review. Additional testing may be performed after review by pathologist. Upon approval from requesting clinician, 60254 / Anatomic Pathology Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
70011 | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
61219 | Test | [NAME] (11q21), Mucoepidermoid Carcinoma (MEC) | [NAME] (11q21), FISH | 1 | 88368 |  |  | This test is performed in conjunction with 60254 / Anatomic Pathology Special Studies Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / Anatomic Pathology Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
62512 | Test | Small Lymphocytic Lymphoma, FISH, Tissue | SLL, FISH, Ts |  | PROFILE |  |  | This test does not include a pathology consult. If a pathology consult is requested, 70012 / Pathology Consultation should be ordered and the appropriate FISH test will be ordered and performed at an additional charge.     The number of probes ordered will determine the price of the testing. When this test is ordered, a charge for 2 FISH probes and interpretation is included. If additional probes or the entire panel are ordered, they will be performed at an additional charge.
62512 | Component |  | CYTO/MOLECULAR REPORT | 1 | 88291 | No | No
62512 | Component |  | CYTOGENETICS 100-300 | 1 | 88275 | No | No
62512 | Component |  | CYTOGENETICS DNA PROBE | 2 | 88271 | No | No
19862 | [NAME] | Twenty Additional FISH Probes ([NAME] Only) | Twenty Additional FISH Probes |  | PROFILE | No | No
19860 | [NAME] | Eighteen Additional FISH Probes ([NAME] Only) | Eighteen Additional FISH Probes |  | PROFILE | No | No
19169 | [NAME] | One Additional FISH Probe ([NAME] Only) | One Additional FISH Probe |  | PROFILE | No | No
19857 | [NAME] | Fifteen Additional FISH Probes ([NAME] Only) | Fifteen Additional FISH Probes |  | PROFILE | No | No
19437 | [NAME] | Nine Additional FISH Probes ([NAME] Only) | Nine Additional FISH Probes |  | PROFILE | No | No
19440 | [NAME] | Twelve Additional FISH Probes ([NAME] Only) | Twelve Additional FISH Probes |  | PROFILE | No | No
19855 | [NAME] | Thirteen Additional FISH Probes ([NAME] Only) | Thirteen Additional FISH Probes |  | PROFILE | No | No
19856 | [NAME] | Fourteen Additional FISH Probes ([NAME] Only) | Fourteen Additional FISH Probes |  | PROFILE | No | No
19438 | [NAME] | Ten Additional FISH Probes ([NAME] Only) | Ten Additional FISH Probes |  | PROFILE | No | No
19171 | [NAME] | Four Additional FISH Probes ([NAME] Only) | Four Additional FISH Probes |  | PROFILE | No | No
19435 | [NAME] | Seven Additional FISH Probes ([NAME] Only) | Seven Additional FISH Probes |  | PROFILE | No | No
19439 | [NAME] | Eleven Additional FISH Probes ([NAME] Only) | Eleven Additional FISH Probes |  | PROFILE | No | No
19170 | [NAME] | Two Additional FISH Probes ([NAME] Only) | Two Additional FISH Probes |  | PROFILE | No | No
19434 | [NAME] | Six Additional FISH Probes ([NAME] Only) | Six Additional FISH Probes |  | PROFILE | No | No
19432 | [NAME] | Three Additional FISH Probes ([NAME] Only) | Three Additional FISH Probes |  | PROFILE | No | No
19861 | [NAME] | Nineteen Additional FISH Probes ([NAME] Only) | Nineteen Additional FISH Probes |  | PROFILE | No | No
19436 | [NAME] | Eight Additional FISH Probes ([NAME] Only) | Eight Additional FISH Probes |  | PROFILE | No | No
19433 | [NAME] | Five Additional FISH Probes ([NAME] Only) | Five Additional FISH Probes |  | PROFILE | No | No
19858 | [NAME] | Sixteen Additional FISH Probes ([NAME] Only) | Sixteen Additional FISH Probes |  | PROFILE | No | No
19859 | [NAME] | Seventeen Additional FISH Probes ([NAME] Only) | Seventeen Additional FISH Probes |  | PROFILE | No | No
6MAMX | Test | 6-Monoacetylmorphine (6-MAM), Chain of Custody, Urine | 6-MAM Confirmation, CoC, U | 1 | 83925 |  |  | Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
70012 | Test | Pathology Consultation | Pathology Consultation | 1 |  |  |  | This request will be processed as a consultation case. An interpretation, which includes an evaluation of the specimen and determination of a
62366 | [NAME] | Renal Pathology Consult, with [NAME] ([NAME] Only) | RenalPath Consult, w/USS Prof | 1 | 88323 | No | No
62472 | [NAME] | [NAME], Outside Slide ([NAME] Only) | AnatPath Consult, Outside Slide | 1 | 88321 | No | No
62196 | [NAME] | Renal Pathology Consultation, Outside Slide ([NAME] Only) | RenalPath Consult, Outside Slide | 1 | 88321 | No | No
62466 | [NAME] | [NAME], Outside Slide ([NAME] Only) | [NAME], Outside Slide | 1 | 88321 | No | No
62374 | [NAME] | [NAME], with [NAME] ([NAME] Only) | [NAME], w/USS Prof | 1 | 88323 | No | No
62467 | [NAME] | [NAME], w/Slide Prep ([NAME] Only) | [NAME], w/Slide Prep | 1 | 88323 | No | No
61125 | [NAME] | [NAME], with Comprehensive Review of History ([NAME] Only) | [NAME], w/Comp Rvw of His | 1 | 88325 | No | No
62197 | [NAME] | Renal Pathology Consult, with Slide Prep ([NAME] Only) | RenalPath Consult, w/Slide Prep | 1 | 88323 | No | No
62198 | [NAME] | Renal Pathology Consult, with Complete Review of History ([NAME] Only) | RenalPath Consult, w/Comp Rvw of His | 1 | 88325 | No | No
62373 | [NAME] | [NAME], with [NAME] ([NAME] Only) | [NAME], w/USS Prof | 1 | 88323 | No | No
62474 | [NAME] | AnatPath Consult, w/Comp Rvw of His | AnatPath Consult, w/Comp Rvw of His | 1 | 88325 | No | No
61123 | [NAME] | [NAME], Outside Slide ([NAME] Only) | [NAME], Outside Slide | 1 | 88321 | No | No
61124 | [NAME] | [NAME], with Slide Prep ([NAME] Only) | [NAME], w/Slide Prep | 1 | 88323 | No | No
62376 | [NAME] | Anatomic Pathology Consult, with [NAME] ([NAME] Only) | AnatPath Consult, w/USS Prof | 1 | 88323 | No | No
62202 | [NAME] | [NAME], w/Comp Review of History ([NAME] Only) | [NAME], w/Comp Rvw of His | 1 | 88325 | No | No
62473 | [NAME] | [NAME], w/Slide Prep ([NAME] Only) | AnatPath Consult, w/Slide Prep | 1 | 88323 | No | No
70015 | Test | Anatomic Pathology Consultation, Wet Tissue | AnatPath Consultation, Wet Tissue | 1 |  |  |  | An interpretation will be provided by Mayo staff pathologists within a formal pathology report which is sent to the referring pathologist.
5201 | [NAME] | Surgical Path, Level 1, Gross Exam | Surgical Path, Level 1, Gross Exam | 1 | 88300 | No | No
62473 | [NAME] | [NAME], w/Slide Prep ([NAME] Only) | AnatPath Consult, w/Slide Prep | 1 | 88323 | No | No
5204 | [NAME] | Surgical Pathology, Level IV, [NAME] and [NAME], Wet Tissue | [NAME], Level IV, Wet Ts | 1 | 88305 | No | No
5205 | [NAME] | Surgical Pathology, Level V, [NAME] and [NAME], Wet Tissue | [NAME], Level V, Wet Ts | 1 | 88307 | No | No
62474 | [NAME] | AnatPath Consult, w/Comp Rvw of His | AnatPath Consult, w/Comp Rvw of His | 1 | 88325 | No | No
5203 | [NAME] | Surgical Pathology, Level III, [NAME] and [NAME], Wet Tissue | [NAME], Level III, Wet Ts | 1 | 88304 | No | No
5202 | [NAME] | Surgical Pathology, Level II, [NAME] and [NAME], Wet Tissue | [NAME], Level II, Wet Ts | 1 | 88302 | No | No
5206 | [NAME] | Surgical Pathology, Level VI, [NAME] and [NAME], Wet Tissue | [NAME], Level VI, Wet Ts | 1 | 88309 | No | No
62472 | [NAME] | [NAME], Outside Slide ([NAME] Only) | AnatPath Consult, Outside Slide | 1 | 88321 | No | No
70016 | Test | Hematopathology Consultation, Wet Tissue | HemePath Consultation, Wet Tissue | 1 |  |  |  | This request will be processed as a consultation case. An interpretation, which includes an evaluation of the specimen and determination of a
82972 | [NAME] | Peripheral Blood Smear Examination ([NAME] Only) | Peripheral Blood Smear Examination |  | PROFILE | No | No
61124 | [NAME] | [NAME], with Slide Prep ([NAME] Only) | [NAME], w/Slide Prep | 1 | 88323 | No | No
61662 | [NAME] | HemePath, Level IV, Wet Tissue ([NAME] Only) | HemePath, Level IV, Wet Tissue | 1 | 88305 | No | No
61649 | [NAME] | HemePath, Level II, Wet Tissue ([NAME] Only) | HemePath, Level II, Wet Tissue | 1 | 88302 | No | No
61648 | [NAME] | HemePath, Level I, Gross Exam ([NAME] Only) | HemePath, Level I, Gross Exam | 1 | 88300 | No | No
61125 | [NAME] | [NAME], with Comprehensive Review of History ([NAME] Only) | [NAME], w/Comp Rvw of His | 1 | 88325 | No | No
61663 | [NAME] | HemePath, Level V, Wet Tissue ([NAME] Only) | HemePath, Level V, Wet Tissue | 1 | 88307 | No | No
61664 | [NAME] | HemePath, Level VI, Wet Tissue ([NAME] Only) | HemePath, Level VI, Wet Tissue | 1 | 88309 | No | No
61123 | [NAME] | [NAME], Outside Slide ([NAME] Only) | [NAME], Outside Slide | 1 | 88321 | No | No
9196 | [NAME] | Bone Marrow Aspirate ([NAME] Only) | Bone Marrow Aspirate | 1 | 85097 | No | No
61661 | [NAME] | HemePath, Level III, Wet Tissue ([NAME] Only) | HemePath, Level III, Wet Tissue | 1 | 88304 | No | No
9172 | [NAME] | Bone Marrow Biopsy ([NAME] Only) | Bone [NAME] |  | PROFILE | No | No
62373 | [NAME] | [NAME], with [NAME] ([NAME] Only) | [NAME], w/USS Prof | 1 | 88323 | No | No
70064 | Test | Renal Pathology Consultation, Wet Tissue | RenalPath Consultation, Wet Tissue | 1 |  |  |  | The Renal Pathology Consultation is performed by a Mayo Clinic renal pathologist and entails the performance of appropriate procedures and stains based on the material received, patient information and specific findings on the case in order to determine a diagnosis. Optimal/standard diagnostic interpretation of a medical kidney biopsy requires integration of the light microscopy, immunofluorescence, and electron microscopy findings together with the clinical and laboratory data for the patient. We follow published standards by the Renal Pathology Society (Chang, A., et [NAME]. Clin J American Society of Nephrology, 2012; 7:1365-1368) for the diagnostic evaluation and reporting of non-neoplastic renal disease.
60331 | [NAME] | IgG4 Immunofluorescent Stain, Renal | IgG4 IF, Renal | 1 | 88346 | No | No
4986 | [NAME] | [NAME], Electron Microscopy | [NAME], Electron Microscopy | 1 | 88348 | No | No
60303 | [NAME] | IgM Immunofluorescent Stain, Renal | IgM IF, Renal | 1 | 88346 | No | No
62198 | [NAME] | Renal Pathology Consult, with Complete Review of History ([NAME] Only) | RenalPath Consult, w/Comp Rvw of His | 1 | 88325 | No | No
60290 | [NAME] | Kappa Paraffin Immunofluorescent Stain, Renal | Kappa Paraffin IF, Renal | 1 | 88346 | No | No
60287 | [NAME] | IgA Paraffin Immunofluorescent Stain, Renal | IgA Paraffin IF, Renal | 1 | 88346 | No | No
84226 | [NAME] | C4d Stain, Renal Allograft Biopsies, Immunofluorescent | Immunofluorescent C4d Stain | 1 | 88347 | No | No
60285 | [NAME] | C1q Paraffin Immunofluorescent Stain, Renal | C1q Paraffin IF, Renal | 1 | 88346 | No | No
62197 | [NAME] | Renal Pathology Consult, with Slide Prep ([NAME] Only) | RenalPath Consult, w/Slide Prep | 1 | 88323 | No | No
60289 | [NAME] | IgM Paraffin Immunofluorescent Stain, Renal | IgM Paraffin IF, Renal | 1 | 88346 | No | No
60309 | [NAME] | Fibrinogen Immunofluorescent Stain, Renal | Fibrinogen IF, Renal | 1 | 88346 | No | No
60301 | [NAME] | IgA Immunofluorescent Stain, Renal | IgA IF, Renal | 1 | 88346 | No | No
62196 | [NAME] | Renal Pathology Consultation, Outside Slide ([NAME] Only) | RenalPath Consult, Outside Slide | 1 | 88321 | No | No
60329 | [NAME] | IgG2 Immunofluorescent Stain, Renal | IgG2 IF, Renal | 1 | 88346 | No | No
9828 | [NAME] | [NAME]'s Trichrome Stain for Connective Tissue | Masson's Trichrome ST for Conn Ts | 1 | 88313 | No | No
20500 | [NAME] | Renal Pathology, Level IV, Wet Tissue ([NAME] Only) | RenalPath, Level IV, Wet Ts | 1 | 88305 | No | No
60308 | [NAME] | Albumin Immunofluorescent Stain, Renal | Albumin IF, Renal | 1 | 88346 | No | No
60330 | [NAME] | IgG3 Immunofluorescent Stain, Renal | IgG3 IF, Renal | 1 | 88346 | No | No
60305 | [NAME] | Kappa Immunofluorescent Stain, Renal | Kappa IF, Renal | 1 | 88346 | No | No
60328 | [NAME] | IgG1 Immunofluorescent Stain, Renal | IgG1 IF, Renal | 1 | 88346 | No | No
60302 | [NAME] | IgG Immunofluorescent Stain, Renal | IgG IF, Renal | 1 | 88346 | No | No
60304 | [NAME] | Lambda Immunofluorescent Stain, Renal | Lambda IF, Renal | 1 | 88346 | No | No
60306 | [NAME] | C1q, Immunofluorescent Stain, Renal | C1q IF, Renal | 1 | 88346 | No | No
9840 | [NAME] | Periodic Acid-Schiff (PAS) Stain | Periodic Acid-Schiff (PAS) ST | 1 | 88313 | No | No
60291 | [NAME] | Lambda Paraffin Immunofluorescent Stain, Renal | Lambda Paraffin IF, Renal | 1 | 88346 | No | No
60288 | [NAME] | IgG Paraffin Immunofluorescent Stain, Renal | IgG Paraffin IF, Renal | 1 | 88346 | No | No
9889 | [NAME] | Jones' Methenamine Silver Stain | Jones' [NAME] | 1 | 88313 | No | No
60307 | [NAME] | [NAME], Renal | [NAME], Renal | 1 | 88346 | No | No
800050 | Test |  |  | 1 | 87340 |  |  | If HBs antigen screen is reactive with S/CO ratio of 1.00 to 50.0, then HBsAg confirmation will be performed at an additional charge.
HBGNT | [NAME] | Hepatitis B Surface Antigen Confirmation, Serum | HBs Antigen Confirmation, S | 1 | 87341 | No | No
80027 | Test | B-Cell Lymphoma, FISH, Tissue | B-Cell Lymphoma, FISH, Ts |  | PROFILE |  |  | This test does not include a pathology consultation. If a pathology consultation is requested, 70012 / Pathology Consultation should be ordered and the appropriate FISH test will be ordered and performed at an additional charge.
80027 | Component |  | Analyze 100-300 cells | 1 | 88275 | No | No
80027 | Component |  | Cyto & Mol Cyto, interp | 1 | 88291 | No | No
80027 | Component |  | [NAME], DNA probe, each | 2 | 88271 | No | No
19861 | [NAME] | Nineteen Additional FISH Probes ([NAME] Only) | Nineteen Additional FISH Probes |  | PROFILE | No | No
19435 | [NAME] | Seven Additional FISH Probes ([NAME] Only) | Seven Additional FISH Probes |  | PROFILE | No | No
19862 | [NAME] | Twenty Additional FISH Probes ([NAME] Only) | Twenty Additional FISH Probes |  | PROFILE | No | No
19858 | [NAME] | Sixteen Additional FISH Probes ([NAME] Only) | Sixteen Additional FISH Probes |  | PROFILE | No | No
19857 | [NAME] | Fifteen Additional FISH Probes ([NAME] Only) | Fifteen Additional FISH Probes |  | PROFILE | No | No
19859 | [NAME] | Seventeen Additional FISH Probes ([NAME] Only) | Seventeen Additional FISH Probes |  | PROFILE | No | No
19436 | [NAME] | Eight Additional FISH Probes ([NAME] Only) | Eight Additional FISH Probes |  | PROFILE | No | No
19860 | [NAME] | Eighteen Additional FISH Probes ([NAME] Only) | Eighteen Additional FISH Probes |  | PROFILE | No | No
19437 | [NAME] | Nine Additional FISH Probes ([NAME] Only) | Nine Additional FISH Probes |  | PROFILE | No | No
19438 | [NAME] | Ten Additional FISH Probes ([NAME] Only) | Ten Additional FISH Probes |  | PROFILE | No | No
19855 | [NAME] | Thirteen Additional FISH Probes ([NAME] Only) | Thirteen Additional FISH Probes |  | PROFILE | No | No
19439 | [NAME] | Eleven Additional FISH Probes ([NAME] Only) | Eleven Additional FISH Probes |  | PROFILE | No | No
19433 | [NAME] | Five Additional FISH Probes ([NAME] Only) | Five Additional FISH Probes |  | PROFILE | No | No
19434 | [NAME] | Six Additional FISH Probes ([NAME] Only) | Six Additional FISH Probes |  | PROFILE | No | No
19169 | [NAME] | One Additional FISH Probe ([NAME] Only) | One Additional FISH Probe |  | PROFILE | No | No
19440 | [NAME] | Twelve Additional FISH Probes ([NAME] Only) | Twelve Additional FISH Probes |  | PROFILE | No | No
19171 | [NAME] | Four Additional FISH Probes ([NAME] Only) | Four Additional FISH Probes |  | PROFILE | No | No
19170 | [NAME] | Two Additional FISH Probes ([NAME] Only) | Two Additional FISH Probes |  | PROFILE | No | No
19432 | [NAME] | Three Additional FISH Probes ([NAME] Only) | Three Additional FISH Probes |  | PROFILE | No | No
19856 | [NAME] | Fourteen Additional FISH Probes ([NAME] Only) | Fourteen Additional FISH Probes |  | PROFILE | No | No
81504 | Test | HER2, Breast, Quantitative Immunohistochemistry, Automated | HER2, [NAME], Automated | 1 | 88361 |  |  | Cases that are equivocal (2+) by immunohistochemical stain will reflex to HER2 FISH at an additional charge.
[NAME] | [NAME] | HER2 Amplification Associated with Breast Cancer, FISH, Tissue | [NAME], Breast Cancer, FISH |  | PROFILE | No | Yes
82037 | Test | ThinPrep Screen, Without Physician Interpretation | [NAME], w/o [NAME] | 1 | 88142
82100 | [NAME] | Physician Interpretation of ThinPrep, PAP | [NAME] of ThinPrep, PAP | 1 | 88141 | No | No
82039 | Test | ThinPrep Diagnostic Without Physician Interpretation | ThinPrep Diagn., w/o [NAME] | 1 | 88142
82100 | [NAME] | Physician Interpretation of ThinPrep, PAP | [NAME] of ThinPrep, PAP | 1 | 88141 | No | No
82091 | Test | Amyloid Protein Identification, Paraffin, LC MS/MS | Amyloid Protein ID, Par, LC-MS/MS |  | PROFILE |  |  | When this test is ordered, Congo red stain will always be performed at an additional charge.
82091 | Component |  | Mass and tandem mass spectrometry | 1 | 88380 | No | No
82091 | Component |  | MASS SPECTROMETRY QUAL | 1 | 83788 | No | No
61124 | [NAME] | [NAME], with Slide Prep ([NAME] Only) | [NAME], w/Slide Prep | 1 | 88323 | No | No
61125 | [NAME] | [NAME], with Comprehensive Review of History ([NAME] Only) | [NAME], w/Comp Rvw of His | 1 | 88325 | No | No
62197 | [NAME] | Renal Pathology Consult, with Slide Prep ([NAME] Only) | RenalPath Consult, w/Slide Prep | 1 | 88323 | No | No
62198 | [NAME] | Renal Pathology Consult, with Complete Review of History ([NAME] Only) | RenalPath Consult, w/Comp Rvw of His | 1 | 88325 | No | No
62473 | [NAME] | [NAME], w/Slide Prep ([NAME] Only) | AnatPath Consult, w/Slide Prep | 1 | 88323 | No | No
62474 | [NAME] | AnatPath Consult, w/Comp Rvw of His | AnatPath Consult, w/Comp Rvw of His | 1 | 88325 | No | No
89054 | [NAME] | Congo Red, Stain | Congo Red, Stain | 1 | 88313 | Yes | No
83342 | Test | ThinPrep Screen with Human Papillomavirus (HPV) Reflex | ThinPrep Screen with HPV Reflex | 1 | 88142 |  |  | When this test is ordered, a ThinPrep Pap screen will be performed. If the results include the criteria below, a high-risk HPV test will be performed:   -Atypical cells of undetermined significance (ASCUS), and the patient is > or =21 years old   -Atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) and the patient is > or =21 years old   -Low-grade squamous intraepithelial lesion ([NAME]), and the patient is > or =50 years old   -Inadequate endocervical/transformation zone component, negative for intraepithelial lesion or malignancy, and the patient is > or =30 years old
70099 | [NAME] | High Risk HPV with [NAME] ([NAME] Only) | High Risk HPV with Genotyping | 1 | 87621 | No | Yes
82100 | [NAME] | Physician Interpretation of ThinPrep, PAP | [NAME] of ThinPrep, PAP | 1 | 88141 | No | No
83343 | Test | ThinPrep Diagnostic with Human Papillomavirus (HPV) Reflex | ThinPrep Diagnostic with HPV Reflex | 1 | 88142 |  |  | When this test is ordered, a ThinPrep Pap diagnostic test will be performed. If the results include the criteria below, a high-risk HPV test will be performed:   -Atypical cells of undetermined significance (ASCUS), and the patient is > or =21 years old   -Atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) and the patient is > or =21 years old   -Low-grade squamous intraepithelial lesion ([NAME]), and the patient is > or =50 years old   -Inadequate endocervical/transformation zone component, negative for intraepithelial lesion or malignancy, and the patient is > or =30 years old
70099 | [NAME] | High Risk HPV with [NAME] ([NAME] Only) | High Risk HPV with Genotyping | 1 | 87621 | No | Yes
88141 | [NAME] | Physician Interpretation of Diagnostic PAP ([NAME] Only) | [NAME] of Diag PAP | 1 | 88141 | No | No
83361 | Test | Synovial Sarcoma by Reverse Transcriptase PCR (RT-PCR), Paraffin | Synovial Sarcoma, RT-PCR, Paraffin | 2 | 81401 |  |  | This test is performed in conjunction with 60254 / AP Special Studies Review and 70011 / Slide Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / AP Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
70011 | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
FSYT | [NAME] | Synovial Sarcoma (SS), 18q11.2 (SS18 or SYT) Rearrangement, FISH, Tissue | SS18 (SYT), 18q11.2, FISH |  | PROFILE | No | Yes
83363 | Test | Ewing Sarcoma/Primitive Neuroectodermal Tumors (ES/PNET) by Reverse Transcriptase PCR (RT-PCR), Paraffin | Ewings Sarcoma, RT-PCR, Paraffin | 2 | 81401 |  |  | This test is performed in conjunction with 60254 / AP Special Studies Review and 70011 / Slide Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / AP Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
FEWS | [NAME] | Ewing Sarcoma (EWS) 22q12 Rearrangement, FISH, Tissue | EWSR1, 22q12, FISH |  | PROFILE | No | Yes
70011 | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
83365 | Test | Desmoplastic Small Round-Cell Tumor (DSRCT) by Reverse Transcriptase PCR (RT-PCR), Paraffin | DSRCT, RT-PCR, Paraffin | 1 | 81401 |  |  | This test is performed in conjunction with 60254 / AP Special Studies Review and 70011 / Slide Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / AP Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
70011 | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
FEWS | [NAME] | Ewing Sarcoma (EWS) 22q12 Rearrangement, FISH, Tissue | EWSR1, 22q12, FISH |  | PROFILE | No | Yes
83367 | Test | Alveolar Rhabdomyosarcoma (ARMS) by Reverse Transcriptase PCR (RT-PCR), Paraffin | [NAME], RT-PCR,PF | 2 | 81401 |  |  | This test is performed in conjunction with 60254 / AP Special Studies Review and 70011 / Slide Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / AP Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
70011 | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
FKHR | [NAME] | Alveolar Rhabdomyosarcoma (ARMS), 13q14 ([NAME] or FKHR) Rearrangement, FISH, Tissue | [NAME] (FKHR), 13q14, FISH |  | PROFILE | No | Yes
84357 | Test | Biliary Tract Malignancy, Cytology and Molecular Testing | Biliary Tract Malignancy | 1 | 88112 |  |  | When this test is ordered, biliary tract malignancy testing by FISH will always be performed at an additional charge.
19229 | [NAME] | Biliary Tract Malignancy, FISH ([NAME] Only) | Biliary Tract Malignancy, FISH | 4 | 88368 | Yes | No
88905 | Test | PDGFB, 22q13, for Dermatofibrosarcoma Protuberans/Giant Cell Fibroblastoma, FISH | PDGFB, 22q13, FISH | 1 | 88368 |  |  | This test is performed in conjunction with 60254 / Anatomic Pathology Special Studies Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / Anatomic Pathology Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
88955 | Test | KIT, Mutation Analysis, Exon 8 | KIT, Mutation Analysis, Ex8 | 1 | 81404 |  |  | This test is performed in conjunction with 60254 / Anatomic Pathology Special Studies Review and 70011 / Slide Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / Anatomic Pathology Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
70011 | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
88956 | Test | KIT, Mutation Analysis, Exon 13 | KIT, Mutation Analysis, Ex13 | 1 | 81404 |  |  | This test is performed in conjunction with 60254 / Anatomic Pathology Special Studies Review and 70011 / Slide Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / Anatomic Pathology Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
70011 | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
88957 | Test | KIT, Mutation Analysis, Exon 17 | KIT, Mutation Analysis, Ex17 | 1 | 81404 |  |  | This test is performed in conjunction with 60254 / Anatomic Pathology Special Studies Review and 70011 / Slide Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / Anatomic Pathology Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
70011 | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
88958 | Test | PDGFRA, Mutation Analysis, Exon 14 | PDGFRA, Mutation Analysis, Ex14 | 1 | 81404 |  |  | This test is performed in conjunction with 60254 / Anatomic Pathology Special Studies Review and 70011 / Slide Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / Anatomic Pathology Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
70011 | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
89041 | Test | T-Cell Lymphoma, FISH, Tissue | T-Cell Lymphoma, FISH, Ts |  | PROFILE |  |  | This panel includes a mini-pathology consultation to evaluate appropriate FISH probes and translocations to investigate. Panel includes testing for the following anomalies via the probes listed:
89041 | Component |  | Interpretation and Report | 1 | 88291 | No | No
89041 | Component |  | Interphase in situ hybridztn, 100-300 | 1 | 88275 | No | No
89041 | Component |  | DNA Probe, each | 2 | 88271 | No | No
19440 | [NAME] | Twelve Additional FISH Probes ([NAME] Only) | Twelve Additional FISH Probes |  | PROFILE | No | No
19855 | [NAME] | Thirteen Additional FISH Probes ([NAME] Only) | Thirteen Additional FISH Probes |  | PROFILE | No | No
19438 | [NAME] | Ten Additional FISH Probes ([NAME] Only) | Ten Additional FISH Probes |  | PROFILE | No | No
19860 | [NAME] | Eighteen Additional FISH Probes ([NAME] Only) | Eighteen Additional FISH Probes |  | PROFILE | No | No
19859 | [NAME] | Seventeen Additional FISH Probes ([NAME] Only) | Seventeen Additional FISH Probes |  | PROFILE | No | No
19856 | [NAME] | Fourteen Additional FISH Probes ([NAME] Only) | Fourteen Additional FISH Probes |  | PROFILE | No | No
19857 | [NAME] | Fifteen Additional FISH Probes ([NAME] Only) | Fifteen Additional FISH Probes |  | PROFILE | No | No
19170 | [NAME] | Two Additional FISH Probes ([NAME] Only) | Two Additional FISH Probes |  | PROFILE | No | No
19439 | [NAME] | Eleven Additional FISH Probes ([NAME] Only) | Eleven Additional FISH Probes |  | PROFILE | No | No
19862 | [NAME] | Twenty Additional FISH Probes ([NAME] Only) | Twenty Additional FISH Probes |  | PROFILE | No | No
19435 | [NAME] | Seven Additional FISH Probes ([NAME] Only) | Seven Additional FISH Probes |  | PROFILE | No | No
19861 | [NAME] | Nineteen Additional FISH Probes ([NAME] Only) | Nineteen Additional FISH Probes |  | PROFILE | No | No
19437 | [NAME] | Nine Additional FISH Probes ([NAME] Only) | Nine Additional FISH Probes |  | PROFILE | No | No
19436 | [NAME] | Eight Additional FISH Probes ([NAME] Only) | Eight Additional FISH Probes |  | PROFILE | No | No
19169 | [NAME] | One Additional FISH Probe ([NAME] Only) | One Additional FISH Probe |  | PROFILE | No | No
19434 | [NAME] | Six Additional FISH Probes ([NAME] Only) | Six Additional FISH Probes |  | PROFILE | No | No
19432 | [NAME] | Three Additional FISH Probes ([NAME] Only) | Three Additional FISH Probes |  | PROFILE | No | No
19171 | [NAME] | Four Additional FISH Probes ([NAME] Only) | Four Additional FISH Probes |  | PROFILE | No | No
19858 | [NAME] | Sixteen Additional FISH Probes ([NAME] Only) | Sixteen Additional FISH Probes |  | PROFILE | No | No
19433 | [NAME] | Five Additional FISH Probes ([NAME] Only) | Five Additional FISH Probes |  | PROFILE | No | No
89045 | Test | BRAF Mutation (T1799A) Analysis by PCR and Sequencing, Thyroid | BRAF Mutation (T1799A) Analysis | 1 | 81210 |  |  | This test is performed in conjunction with 60254 / Anatomic Pathology Special Studies Review and 70011 / Slide Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / Anatomic Pathology Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
70011 | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
89118 | Test | ThinPrep Screen with HPV for Women 30 Years and [NAME] | ThinPrep Screen W/HPV>=30yr | 1 | 88142 |  |  | When this test is ordered, a ThinPrep Pap cytology screen and human papillomavirus high-risk DNA detection with genotyping by PCR test will be performed. If [NAME] results are abnormal, a pathologist will review the case at an additional charge.
70099 | [NAME] | High Risk HPV with [NAME] ([NAME] Only) | High Risk HPV with Genotyping | 1 | 87621 | Yes | Yes
82100 | [NAME] | Physician Interpretation of ThinPrep, PAP | [NAME] of ThinPrep, PAP | 1 | 88141 | No | No
89119 | Test | ThinPrep Diagnostic with Human Papillomavirus (HPV) for Women 30 Years and [NAME] | ThinPrep Diag w/HPV>=30yr | 1 | 88142 |  |  | When this test is ordered, a ThinPrep Pap cytology diagnostic and human papillomavirus high-risk DNA detection with genotyping by PCR test will be performed. If [NAME] results are abnormal, a pathologist will review the case at an additional charge.
70099 | [NAME] | High Risk HPV with [NAME] ([NAME] Only) | High Risk HPV with Genotyping | 1 | 87621 | Yes | Yes
88141 | [NAME] | Physician Interpretation of Diagnostic PAP ([NAME] Only) | [NAME] of Diag PAP | 1 | 88141 | No | No
89366 | Test | CPM, 12q15, for Well-Differentiated Liposarcoma/Atypical Lipomatous Tumor, FISH | CPM, 12q15, FISH | 2 | 88368 |  |  | This test is performed in conjunction with 60254 / Anatomic Pathology Special Studies Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / Anatomic Pathology Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
89669 | Test | KIT, Mutation Analysis, Exon 9 | KIT, Mutation Analysis, Ex9 | 1 | 81404 |  |  | This test is performed in conjunction with 60254 / AP Special Studies Review and 70011 / Slide Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / AP Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
70011 | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
89670 | Test | KIT, Mutation Analysis, Exon 11 | KIT, Mutation Analysis, Ex11 | 1 | 81404 |  |  | This test is performed in conjunction with 60254 / AP Special Studies Review and 70011 / Slide Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / AP Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
70011 | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
89671 | Test | PDGFRA, Mutation Analysis, Exon 12 | PDGFRA, [NAME], Ex12 | 1 | 81404 |  |  | This test is performed in conjunction with 60254 / AP Special Studies Review and 70011 / Slide Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / AP Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
70011 | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
89672 | Test | PDGFRA, Mutation Analysis, Exon 18 | PDGFRA, Mutation Analysis, Ex18 | 1 | 81404 |  |  | This test is performed in conjunction with 60254 / AP Special Studies Review and 70011 / Slide Review. Additional testing may be performed after review by pathologist. Upon approval from the requesting clinician, 60254 / AP Special Studies Review could be changed to 70012 / Pathology Consultation, if determined to be more appropriate.
70011 | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
60254 | [NAME] | Anatomic Pathology Special Studies Review | AP Special Studies Review | 1 |  | Yes | No
[NAME] | Test | Alpha-1-Antitrypsin Proteotype S/Z by LC-MS/MS, Serum | A1AT Proteotype S/Z, LC-MS/MS, S |  | PROFILE |  |  | If the mass spectrometry proteotype and quantitative serum level are discordant, then phenotyping will be added and performed at an additional charge.
A1ASZ | Component | Alpha-1-Antitrypsin Proteotype S/Z, LC-MS/MS | A1AT Proteotype S/Z, LC-MS/MS | 1 | 82544 | Yes | No
AATP | Component | Alpha-1-Antitrypsin (A1A), Serum | Alpha-1-Antitrypsin, S | 1 | 82103 | Yes | Yes
A1APR | [NAME] | Alpha-1-Antitrypsin Phenotyping, Serum | Alpha-1-Antitrypsin Phenotype, S | 1 | 82104 | No | Yes
A1ATR | Test | Alpha-1-Antitrypsin Deficiency Profile | A1AT Deficiency Profile |  | PROFILE |  |  | If the genotyping and quantitative serum level are discordant, then alpha-1-antitrypsin phenotyping, will be added and performed at an additional charge.
A1AT | Component | Alpha-1-Antitrypsin Genotyping, Blood | Alpha-1-Antitrypsin Genotyping, B | 1 | 81332 | Yes | No
AATQ | Component | Alpha-1-Antitrypsin (A1A), Serum | Alpha-1-Antitrypsin, S | 1 | 82103 | Yes | Yes
A1ATP | [NAME] | Alpha-1-Antitrypsin (A1A) Phenotyping, Serum | A1AT Phenotype, S | 1 | 82104 | No | Yes
ABID2 | Test | Antibody Identification, [NAME] | Antibody Identification, RBC | 1 | 86870 |  |  | The following tests may also be ordered and performed as part of antibody identification: special red cell antigen typing, antibody elution, antibody absorption, direct Coombs, and monospecific direct Coombs. These additional tests will determine or confirm antibody specificity and allo- vs. autoantibody.
DCTM | [NAME] | Direct Coombs, Blood | Direct Coombs, B | 1 | 86880 | No | Yes
SPAG | [NAME] | Special Red Cell Antigen Typing | Special Red Cell Ag Typing | 1 | 86905 | No | Yes
MDCG | [NAME] | Monospecific Direct Coombs IgG, Blood | Monospecific Direct Coombs IgG, B | 1 | 86880 | No | Yes
ABAB | [NAME] | Antibody Absorption | Antibody Absorption | 1 | 86978 | No | No
MDCC3 | [NAME] | Monospecific Direct Coombs C3, Blood | Monospecific Direct Coombs C3, B | 1 | 86880 | No | Yes
ABEL | [NAME] | Antibody Elution | Antibody Elution | 1 | 86860 | No | No
[NAME] | Test | Antibody Screen, [NAME] | [NAME], RBC | 1 | 86850 |  |  | If the antibody screen is positive, then antibody identification will be performed.   The following tests may also be ordered and performed as part of antibody identification: monospecific direct Coombs, special red cell antigen typing, antibody elution, and antibody absorption.
ABAB | [NAME] | Antibody Absorption | Antibody Absorption | 1 | 86978 | No | No
ABEL | [NAME] | Antibody Elution | Antibody Elution | 1 | 86860 | No | No
ABID2 | [NAME] | Antibody Identification, [NAME] | Antibody Identification, RBC | 1 | 86870 | No | Yes
DCTM | [NAME] | Direct Coombs, Blood | Direct Coombs, B | 1 | 86880 | No | Yes
MDCC3 | [NAME] | Monospecific Direct Coombs C3, Blood | Monospecific Direct Coombs C3, B | 1 | 86880 | No | Yes
MDCG | [NAME] | Monospecific Direct Coombs IgG, Blood | Monospecific Direct Coombs IgG, B | 1 | 86880 | No | Yes
SPAG | [NAME] | Special Red Cell Antigen Typing | Special Red Cell Ag Typing | 1 | 86905 | No | Yes
ABTIH | Test | [NAME], [NAME] | [NAME], RBC |  | PROFILE |  |  | The initial test performed is an antibody identification. If the antibody problem identified is not relevant in hemolytic disease of the newborn, or if titrations are not helpful, the titer will be cancelled and will be replaced by the antibody identification test. Depending upon the antibody identification results, additional tests, ie, monospecific direct Coombs, antibody elution, antibody absorption, and red cell antigen typing may be added and charged. A consultation service is offered, at no charge, regarding the clinical relevance of red cell antibodies.
ABTIH | Component |  | Antibody Titer | 1 | 86886 | No | No
ABTIH | Component |  | Antibody Ident, Erythro | 1 | 86870 | No | No
DCTM | [NAME] | Direct Coombs, Blood | Direct Coombs, B | 1 | 86880 | No | Yes
ABEL | [NAME] | Antibody Elution | Antibody Elution | 1 | 86860 | No | No
ABID2 | [NAME] | Antibody Identification, [NAME] | Antibody Identification, RBC | 1 | 86870 | No | Yes
MDCG | [NAME] | Monospecific Direct Coombs IgG, Blood | Monospecific Direct Coombs IgG, B | 1 | 86880 | No | Yes
ABAB | [NAME] | Antibody Absorption | Antibody Absorption | 1 | 86978 | No | No
SPAG | [NAME] | Special Red Cell Antigen Typing | Special Red Cell Ag Typing | 1 | 86905 | No | Yes
MDCC3 | [NAME] | Monospecific Direct Coombs C3, Blood | Monospecific Direct Coombs C3, B | 1 | 86880 | No | Yes
ACASM | Test | [NAME] | [NAME] | 1 | 82607 |  |  | If vitamin [NAME] is <150 ng/L, then intrinsic factor blocking antibody (IFBA) is performed. If IFBA is negative or indeterminate, then gastrin is performed.     If vitamin B12 is 150 to 400 ng/L, then methylmalonic acid (MMA) is performed. If MMA is >0.40 nmol/mL, then IFBA is performed.
GASTR | [NAME] | Gastrin, Serum | Gastrin, S | 1 | 82941 | No | Yes
IFBPA | [NAME] | Intrinsic Factor Blocking Antibody, Serum | Intrinsic Factor Blocking Ab, S | 1 | 86340 | No | Yes
MMAPA | [NAME] | Methylmalonic Acid (MMA), Quantitative, Serum | Methylmalonic Acid, QN, S | 1 | 83921 | No | Yes
ACT | Test | Actinomyces Culture | Actinomyces Culture | 1 | 87075 |  |  | When this test is ordered, the reflex tests may be performed and charged.
ANAID | [NAME] | Anaerobe Ident (Bill Only) | Anaerobe Ident | 1 | 87076 | No | No
ISAN | [NAME] | Anaerobe Ident by Sequencing ([NAME] Only) | Anaerobe Ident by Sequencing | 1 | 87153 | No | No
TISSR | [NAME] | Tissue Processing ([NAME] Only) | Tissue Processing | 1 | 87176 | No | No
ADE | Test | Autoimmune Dysautonomia Evaluation, Serum | Autoimmune Dysautonomia Eval, S |  | PROFILE |  |  | If indirect immunofluorescence assay (IFA) (ANN1S) patterns are indeterminate, then paraneoplastic autoantibody Western blot is performed at an additional charge.   If IFA patterns suggest CRMP-5-IgG, then CRMS and/or CRMP-5-IgG Western blot is performed at an additional charge.   If IFA patterns suggest amphiphysin antibody, then AMPHS and/or amphiphysin Western blot is performed at an additional charge.   If IFA (ANN1S) pattern suggests antineuronal nuclear antibody type 2 or type 3, Purkinje cell cytoplasmic antibody type 1, type 2, or type trace, [NAME]-glial nuclear antibody type 1, then ANN2S, ANN3S, PCABP, PCAB2, PCATR, and/or AGN1S is performed at an additional charge.   If IFA pattern suggests NMO/AQP4-IgG, then NMO/AQP4-IgG CBA is performed at an additional charge.   If IFA pattern suggests NMDA-R, then NMDA-R CBA and/or NMDA-R titer is performed at an additional charge.   If IFA pattern suggests AMPA-R, then AMPA-R CBA and/or AMPA-R titer is performed at an additional charge.   If IFA pattern suggests GABA-B-R, then GABA-B-R CBA and/or GABA-B-R titer is performed at an additional charge.   If acetylcholine ([NAME]) receptor binding antibody is >0.02, then ACh receptor [NAME] antibodies and CRMP-5-IgG Western blot are performed at an additional charge.
ANN1S | Component | Antineuronal Nuclear Antibody-Type 1 (ANNA-1), Serum | Anti-Neuronal Nuclear Ab, Type 1 | 1 | 86256 | Yes | No
PAINT | Component | Interpretive Comments | Interpretive Comments |  |  | Yes | No
VGKC | Component | Neuronal Voltage-Gated Potassium Channel (VGKC) Autoantibody, Serum | Neuronal (V-G) K+ Channel Ab, S | 1 | 83519 | Yes | No
GD65S | Component | Glutamic Acid Decarboxylase (GAD65) Antibody Assay, Serum | GAD65 Ab Assay, S | 1 | 86341 | Yes | Yes
GANG | Component | Ganglionic Acetylcholine Receptor (Alpha3) Autoantibody, Serum | [NAME], S | 1 | 83519 | Yes | No
CCPQ | Component | P/Q-Type Calcium Channel Antibody, Serum | P/Q-Type Calcium Channel Ab | 1 | 83519 | Yes | No
ARBI | Component | Acetylcholine Receptor ([NAME]) [NAME], Serum | ACh Receptor ([NAME]) Binding Ab | 1 | 83519 | Yes | Yes
CCN | Component | N-Type Calcium Channel Antibody, Serum | N-Type Calcium Channel Ab | 1 | 83519 | Yes | No
STR | Component | Striational (Striated Muscle) Antibodies, Serum | Striational (Striated Muscle) Ab, S | 1 | 83520 | Yes | Yes
AGN1S | [NAME] | Anti-Glial/Neuronal Nuclear Antibody-Type 1 (AGNA-1), Serum | Anti-Glial Nuclear Ab, Type 1 | 1 | 86256 | No | No
ANN2S | [NAME] | Antineuronal Nuclear Antibody-Type 2 (ANNA-2), Serum | Anti-Neuronal Nuclear Ab, Type 2 | 1 | 86256 | No | No
NMDCS | [NAME] | NMDA-Receptor Antibody by CBA, Serum | NMDA-R Ab CBA, S | 1 | 86255 | No | No
ABLOT | [NAME] | Amphiphysin Antibody Western Blot, Serum | Amphiphysin Western Blot, S | 1 | 84182 | No | No
CRMS | [NAME] | [NAME] Protein-5 Neuronal (CRMP-5-IgG), Serum | CRMP-5-IgG, S | 1 | 86256 | No | No
PCAB2 | [NAME] | Purkinje Cell Cytoplasmic Antibody, Type 2 (PCA-2), Serum | Purkinje Cell Cytoplasmic Ab Type 2 | 1 | 86256 | No | No
AMPCS | [NAME] | AMPA-Receptor Antibody by CBA, Serum | AMPA-R Ab CBA, S | 1 | 86255 | No | No
PCABP | [NAME] | Purkinje Cell Cytoplasmic Antibody, Type 1 (PCA-1), Serum | Purkinje Cell Cytoplasmic Ab Type 1 | 1 | 86256 | No | No
NMOCS | [NAME] | Neuromyelitis Optica (NMO)/Aquaporin-4-IgG Cell-Binding Assay, Serum | NMO/AQP4-IgG CBA, S | 1 | 86255 | No | No
GABIS | [NAME] | GABA-B-Receptor Antibody Titer Assay by Immunofluorescence, Serum | GABA-B-R Ab IF Titer Assay, S | 1 | 86256 | No | No
ARMO | [NAME] | Acetylcholine Receptor ([NAME]) [NAME], Serum | ACh Receptor ([NAME]) [NAME] | 1 | 83519 | No | No
AMPIS | [NAME] | AMPA-Receptor Antibody Titer Assay by Immunofluorescence, Serum | AMPA-R Ab IF Titer Assay, S | 1 | 86256 | No | No
PCATR | [NAME] | Purkinje Cell Cytoplasmic Antibody, Type Tr (PCA-Tr), Serum | Purkinje Cell Cytoplasmic Ab Type Tr | 1 | 86256 | No | No
CRMWS | [NAME] | [NAME] Protein-5-IgG (CRMP-5-IgG) Western Blot, Serum | CRMP-5-IgG Western Blot, S | 1 | 84182 | No | No
NMDIS | [NAME] | NMDA-Receptor Antibody Titer Assay by Immunofluorescence, Serum | NMDA-R Ab IF Titer Assay, S | 1 | 86256 | No | No
ANN3S | [NAME] | Antineuronal Nuclear Antibody-Type 3 (ANNA-3), Serum | Anti-Neuronal Nuclear Ab, Type 3 | 1 | 86256 | No | No
GABCS | [NAME] | GABA-B-Receptor Antibody by CBA, Serum | GABA-B-R Ab CBA, S | 1 | 86255 | No | No
AMPHS | [NAME] | Amphiphysin Antibody Assay, Serum | [NAME], S | 1 | 86256 | No | No
WBN | [NAME] | [NAME], Western Blot Confirmation, Serum | Paraneoplastic Autoantibody WBlot,S | 1 | 84182 | No | No
ADHP | Test | Familial Hypercholesterolemia/Autosomal Dominant Hypercholesterolemia Genetic Testing Reflex Panel | FH/ADH Genetic Reflex Panel | 1 | 81479 |  |  | If APOB genotype is negative, LDLSP / Familial Hypercholesterolemia, LDLR Full Gene Sequencing will be performed at an additional charge.
APOBP | Component | Apolipoprotein B-100 Molecular Analysis, R3500Q and R3500W | APOB Genotype | 1 | 81479 | Yes | Yes
ADHI | Component | Familial Hypercholesterolemia/Autosomal Dominant Hypercholesterolemia Genetic Interpretation | FH/ADH Genetic Interpretation | 1 |  | Yes | No
LDLSP | [NAME] | Familial Hypercholesterolemia, LDLR Full Gene Sequencing | [NAME], Full Gene Sequence | 1 | 81406 | No | Yes
[NAME] | [NAME] | Familial Hypercholesterolemia, LDLR Large Deletion/Duplication, Molecular Analysis | [NAME] | 1 | 81405 | No | Yes
ADLTX | Test | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
ADM13 | Test | ADAMTS13 Activity and Inhibitor Profile | ADAMTS13 Activity and Inhibitor Profile | 1 | 85397 |  |  | Testing begins with ADAMTS13 activity assay to evaluate the percent activity. If the ADAMTS13 activity assay is <30%, an inhibitor screen will be performed to look for specific ADAMTS13 inhibition. If specific inhibition is apparent, the titer of the inhibitor will be determined.
ADMIN | Component | ADAMTS13 Interpretation | ADAMTS13 Interpretation |  |  | Yes | No
ADMFX | Component | ADAMTS13 Activity Assay | ADAMTS13 Activity Assay | 1 | 85397 | Yes | No
[NAME] | [NAME] | ADAMTS13 Inhibitor Bethesda Titer | ADAMTS13 Inhibitor Bethesda Titer | 1 | 85335 | No | No
ADMIS | [NAME] | ADAMTS13 Inhibitor Screen Assay | ADAMTS13 Inhibitor Screen | 1 | 85335 | No | No
AFPA | Test | Alpha-Fetoprotein, Amniotic Fluid | [NAME], AF | 1 | 82106 |  |  | If alpha-fetoprotein (AFP) is positive, then acetylcholinesterase (AChE) will be performed at an additional charge. Because false-positive AChE may occur from a bloody tap, specimens with positive AChE results will also be tested for the presence of fetal hemoglobin at no additional charge.
ACHE_ | [NAME] | Acetylcholinesterase, [NAME] (AChE-AF), [NAME] | Acetylcholinesterase, AF | 1 | 82013 | No | Yes
AGIDE | Test | Autoimmune Gastrointestinal Dysmotility Evaluation, Serum | Autoimmune GI Dysmotility Eval, S |  | PROFILE |  |  | If indirect immunofluorescence assay (IFA) (ANN1S) pattern is indeterminate, then WBN is performed at an additional charge.   If IFA pattern suggests CRMP-5-IgG, then CRMS and/or CRMWS are performed at an additional charge.   If IFA pattern suggests amphiphysin antibody, then AMPHS and/or ABLOT are performed at an additional charge.   If IFA (ANN1S) pattern suggests antineuronal nuclear antibody, type 2; antineuronal nuclear antibody, type 3; Purkinje cell cytoplasmic antibody, type 1; Purkinje cell cytoplasmic antibody, type 2; Purkinje cell cytoplasmic antibody, type Tr; [NAME]-glial nuclear antibody, type 1; then ANN2S, ANN3S, PCABP, PCAB2, PCATR, and/or AGN1S are performed at an additional charge.   If IFA pattern suggests NMO/AQP4-IgG, then NMOCS is performed at an additional charge.   If IFA pattern suggests NMDA-R, then NMDCS and/or NMDIS are performed at an additional charge.   If IFA pattern suggests AMPA-R, then AMPCS and/or AMPIS are performed at an additional charge.   If IFA pattern suggests GABA-B-R, then GABCS and/or GABIS are performed at an additional charge.   If ACh receptor binding antibody is >0.02, then ARMO and CRMWS are performed at an additional charge.
ANN1S | Component | Antineuronal Nuclear Antibody-Type 1 (ANNA-1), Serum | Anti-Neuronal Nuclear Ab, Type 1 | 1 | 86256 | Yes | No
CCN | Component | N-Type Calcium Channel Antibody, Serum | N-Type Calcium Channel Ab | 1 | 83519 | Yes | No
PAINT | Component | Interpretive Comments | Interpretive Comments |  |  | Yes | No
GANG | Component | Ganglionic Acetylcholine Receptor (Alpha3) Autoantibody, Serum | [NAME], S | 1 | 83519 | Yes | No
GD65S | Component | Glutamic Acid Decarboxylase (GAD65) Antibody Assay, Serum | GAD65 Ab Assay, S | 1 | 86341 | Yes | Yes
VGKC | Component | Neuronal Voltage-Gated Potassium Channel (VGKC) Autoantibody, Serum | Neuronal (V-G) K+ Channel Ab, S | 1 | 83519 | Yes | No
STR | Component | Striational (Striated Muscle) Antibodies, Serum | Striational (Striated Muscle) Ab, S | 1 | 83520 | Yes | Yes
ARBI | Component | Acetylcholine Receptor ([NAME]) [NAME], Serum | ACh Receptor ([NAME]) Binding Ab | 1 | 83519 | Yes | Yes
AMPCS | [NAME] | AMPA-Receptor Antibody by CBA, Serum | AMPA-R Ab CBA, S | 1 | 86255 | No | No
PCATR | [NAME] | Purkinje Cell Cytoplasmic Antibody, Type Tr (PCA-Tr), Serum | Purkinje Cell Cytoplasmic Ab Type Tr | 1 | 86256 | No | No
ABLOT | [NAME] | Amphiphysin Antibody Western Blot, Serum | Amphiphysin Western Blot, S | 1 | 84182 | No | No
AGN1S | [NAME] | Anti-Glial/Neuronal Nuclear Antibody-Type 1 (AGNA-1), Serum | Anti-Glial Nuclear Ab, Type 1 | 1 | 86256 | No | No
ARMO | [NAME] | Acetylcholine Receptor ([NAME]) [NAME], Serum | ACh Receptor ([NAME]) [NAME] | 1 | 83519 | No | No
ANN2S | [NAME] | Antineuronal Nuclear Antibody-Type 2 (ANNA-2), Serum | Anti-Neuronal Nuclear Ab, Type 2 | 1 | 86256 | No | No
GABCS | [NAME] | GABA-B-Receptor Antibody by CBA, Serum | GABA-B-R Ab CBA, S | 1 | 86255 | No | No
PCABP | [NAME] | Purkinje Cell Cytoplasmic Antibody, Type 1 (PCA-1), Serum | Purkinje Cell Cytoplasmic Ab Type 1 | 1 | 86256 | No | No
ANN3S | [NAME] | Antineuronal Nuclear Antibody-Type 3 (ANNA-3), Serum | Anti-Neuronal Nuclear Ab, Type 3 | 1 | 86256 | No | No
NMDIS | [NAME] | NMDA-Receptor Antibody Titer Assay by Immunofluorescence, Serum | NMDA-R Ab IF Titer Assay, S | 1 | 86256 | No | No
CRMS | [NAME] | [NAME] Protein-5 Neuronal (CRMP-5-IgG), Serum | CRMP-5-IgG, S | 1 | 86256 | No | No
AMPIS | [NAME] | AMPA-Receptor Antibody Titer Assay by Immunofluorescence, Serum | AMPA-R Ab IF Titer Assay, S | 1 | 86256 | No | No
NMOCS | [NAME] | Neuromyelitis Optica (NMO)/Aquaporin-4-IgG Cell-Binding Assay, Serum | NMO/AQP4-IgG CBA, S | 1 | 86255 | No | Yes
AMPHS | [NAME] | Amphiphysin Antibody Assay, Serum | [NAME], S | 1 | 86256 | No | No
PCAB2 | [NAME] | Purkinje Cell Cytoplasmic Antibody, Type 2 (PCA-2), Serum | Purkinje Cell Cytoplasmic Ab Type 2 | 1 | 86256 | No | No
NMDCS | [NAME] | NMDA-Receptor Antibody by CBA, Serum | NMDA-R Ab CBA, S | 1 | 86255 | No | No
GABIS | [NAME] | GABA-B-Receptor Antibody Titer Assay by Immunofluorescence, Serum | GABA-B-R Ab IF Titer Assay, S | 1 | 86256 | No | No
CRMWS | [NAME] | [NAME] Protein-5-IgG (CRMP-5-IgG) Western Blot, Serum | CRMP-5-IgG Western Blot, S | 1 | 84182 | No | No
WBN | [NAME] | [NAME], Western Blot Confirmation, Serum | Paraneoplastic Autoantibody WBlot,S | 1 | 84182 | No | No
AGPB | Test | Alpha-Globin Gene Analysis | Alpha-Globin Gene Analysis | 1 | 81257 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
AGXKM | Test | AGXT Gene, Known Mutation | AGXT Gene, Known Mutation | 1 | 81479 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
AHEPR | Test | Acute Hepatitis Profile with Hepatitis C Virus Reflex | Acute Hepatitis Prof w/HCV Reflex |  | PROFILE |  |  | If hepatitis B surface antigen (HBsAg) is reactive, then HBsAg confirmation will be performed at an additional charge.   If hepatitis C virus (HCV) antibody screen is reactive, then HCV RNA detection and quantification will be performed at an additional charge.
HAVM | Component | Hepatitis A IgM Antibody, Serum | Hepatitis A IgM Ab, S | 1 | 86709 | Yes | Yes
HBAG | Component | Hepatitis B Surface Antigen, Serum | HBs Antigen, S | 1 | 87340 | Yes | Yes
HBIM | Component | Hepatitis B Core Antibody, IgM, Serum | HBc IgM Ab, S | 1 | 86705 | Yes | Yes
HCPCR | Component | Hepatitis C Antibody Screen with Reflex to HCV RNA by PCR, Serum | HCV [NAME] w/Reflex to HCV PCR, S | 1 | 86803 | Yes | Yes
HBGNT | [NAME] | Hepatitis B Surface Antigen Confirmation, Serum | HBs Antigen Confirmation, S | 1 | 87341 | No | No
HCVQU | [NAME] | Hepatitis C Virus (HCV) RNA Detection and Quantification by Real-Time Reverse Transcription-PCR (RT-PCR), Serum | HCV RNA Detect/Quant, S | 1 | 87522 | No | Yes
AHPS | Test | Acute Hepatitis Profile | Acute Hepatitis Profile |  | PROFILE |  |  | If hepatitis B surface (HBs) antigen is reactive, then HBs antigen confirmation will be performed at an additional charge.
HBAG | Component | Hepatitis B Surface Antigen, Serum | HBs Antigen, S | 1 | 87340 | Yes | Yes
HCV | Component | Hepatitis C Antibody Screen, Serum | HCV Ab Screen, S | 1 | 86803 | Yes | Yes
HAVM | Component | Hepatitis A IgM Antibody, Serum | Hepatitis A IgM Ab, S | 1 | 86709 | Yes | Yes
HBIM | Component | Hepatitis B Core Antibody, IgM, Serum | HBc IgM Ab, S | 1 | 86705 | Yes | Yes
HBGNT | [NAME] | Hepatitis B Surface Antigen Confirmation, Serum | HBs Antigen Confirmation, S | 1 | 87341 | No | No
AHPS | Test | Acute Hepatitis Profile | Acute Hepatitis Profile |  | PROFILE |  |  | If hepatitis B surface (HBs) antigen is reactive, then HBs antigen confirmation will be performed at an additional charge.
HBIM | Component | Hepatitis B Core Antibody, IgM, Serum | HBc IgM Ab, S | 1 | 86705 | Yes | Yes
HCV | Component | Hepatitis C Antibody Screen, Serum | HCV Ab Screen, S | 1 | 86803 | Yes | Yes
HAVM | Component | Hepatitis A IgM Antibody, Serum | Hepatitis A IgM Ab, S | 1 | 86709 | Yes | Yes
HBAG | Component | Hepatitis B Surface Antigen, Serum | HBs Antigen, S | 1 | 87340 | Yes | Yes
HBGNT | [NAME] | Hepatitis B Surface Antigen Confirmation, Serum | HBs Antigen Confirmation, S | 1 | 87341 | No | No
AJPWO | Test | Ashkenazi Jewish Mutation Analysis Panel Without Cystic Fibrosis (CF) | Ashkenazi Jewish Panel Without CF |  | PROFILE |  |  | When this test is ordered, hexosaminidase A and total, white blood cells will always be performed at an additional charge.
AJPWO | Component |  | [NAME] | 1 | 81200 | No | No
AJPWO | Component |  | SMPD1 GENE COMMON VARIANTS | 1 | 81330 | No | No
AJPWO | Component |  | MCOLN1 GENE | 1 | 81290 | No | No
AJPWO | Component |  | IKBKAP GENE | 1 | 81260 | No | No
AJPWO | Component |  | HEXA GENE | 1 | 81255 | No | No
AJPWO | Component |  | GBA GENE | 1 | 81251 | No | No
AJPWO | Component |  | FANCC GENE | 1 | 81242 | No | No
AJPWO | Component |  | BLM GENE | 1 | 81209 | No | No
23425 | [NAME] | Hexosaminidase A and Total, Leukocytes/Ashkenazi Jewish ([NAME] Only) | Hexosaminidase A and Tot, WBC/AJ | 2 | 83080 | Yes | No
ALCX | Test | Ethanol, Chain of Custody, Blood | Ethanol, CoC, B | 1 | 82055
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
AMPHX | Test | Amphetamines Confirmation, Chain of Custody, [NAME] | Amphetamines Confirmation, CoC, U | 1 | 82145 |  |  | Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
[NAME] | Test | Amphetamine-Type Stimulants Confirmation, Chain of Custody, Meconium | Amphetamines Confirmation, CoC, M | 1 | 82145
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
ANAE | Test | Bacterial Culture, Anaerobic | Bacterial Culture, Anaerobic | 1 | 87075 |  |  | When this test is ordered, the reflex tests may be performed and charged.
BLA | [NAME] | Beta Lactamase ([NAME] Only) | Beta Lactamase | 1 | 87185 | No | No
ISAN | [NAME] | Anaerobe Ident by Sequencing ([NAME] Only) | Anaerobe Ident by Sequencing | 1 | 87153 | No | No
RMALA | [NAME] | Id MALDI-TOF Mass Spec Anaerobe ([NAME] Only) | Id MALDI-TOF Mass Spec Anaerobe | 1 | 87076 | No | No
TISSR | [NAME] | Tissue Processing ([NAME] Only) | Tissue Processing | 1 | 87176 | No | No
ANAH2 | Test | Antinuclear Antibodies (ANA), [NAME], Serum | Antinuclear Ab, HEp-2 Substrate, S | 1 | 86038 |  |  | If ANA HEp-2 substrate screen is positive, then ANA (multiple) will be performed at an additional charge.
ANAB | [NAME] | Antinuclear Antibody (Multiple), Serum | Antinuclear Antibody (Multiple), S | 1 | 86039 | No | No
ANAR | Test | Antinuclear Antibodies (ANA), IFA with [NAME] to Connective Tissue Disease Antibodies | [NAME] to CTD Ab, S | 1 | 86038 |  |  | If ANA HEp-2 substrate screen is positive, then ANAB will be performed at an additional charge. If the ANAB contains a titer of <1:160 or a centromere pattern the cascade will stop and results will be reported. A titer > or =1:160 will cause ADNA, RIB, and ENAE tests to be performed at an additional charge.
ANAH2 | Component | Antinuclear Antibodies (ANA), [NAME], Serum | Antinuclear Ab, HEp-2 Substrate, S | 1 | 86038 | Yes | Yes
ENAE | [NAME] | Antibody to Extractable Nuclear Antigen Evaluation, Serum | Ab to Extractable Nuclear Ag Eval,S |  | PROFILE | No | Yes
ADNA | [NAME] | DNA Double-Stranded (dsDNA) Antibodies, IgG, Serum | DNA Double-Stranded Ab, IgG, S | 1 | 86225 | No | Yes
RIB | [NAME] | Ribosome P Antibodies, IgG, Serum | Ribosome P Ab, IgG, S | 1 | 83520 | No | Yes
ANAB | [NAME] | Antinuclear Antibody (Multiple), Serum | Antinuclear Antibody (Multiple), S | 1 | 86039 | No | No
ANAT | Test | Alpha-N-Acetylglucosaminidase, Fibroblasts | A-N-Acetylglucosaminidase, Fibro | 1 | 82657 |  |  | When this test is ordered, a fibroblast culture and cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple lysosomal enzyme assays on a patient utilizing fibroblast culture, only 1 culture is required regardless of the number of enzyme assays ordered. If viable cells are not obtained within 10 days, client will be notified.
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
FIBR | [NAME] | Fibroblast Culture | Fibroblast Culture | 1 | 88233 | Yes | Yes
ANIDE | Test | Organism Referred for Identification, Anaerobic Bacteria | Organism Ref for ID, Anaerobic Bact | 1 | 87076 |  |  | When this test is ordered, the reflex tests may be performed and charged.
ISAN | [NAME] | Anaerobe Ident by Sequencing ([NAME] Only) | Anaerobe Ident by Sequencing | 1 | 87153 | No | No
BLA | [NAME] | Beta Lactamase ([NAME] Only) | Beta Lactamase | 1 | 87185 | No | No
RMALA | [NAME] | Id MALDI-TOF Mass Spec Anaerobe ([NAME] Only) | Id MALDI-TOF Mass Spec Anaerobe | 1 | 87076 | No | No
ARPKD | Test | Autosomal Recessive Polycystic Kidney Disease (ARPKD), Full Gene Analysis | ARPKD Mutation Screen | 1 | 81408 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
ARPKM | Test | Autosomal Recessive Polycystic Kidney Disease (ARPKD), Known Mutation | ARPKD Known Mutation | 1 | 81403 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
ARSAK | Test | ARSA Gene, Known Mutation | ARSA Gene, Known Mutation | 1 | 81403 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.   For prenatal specimens only: If amniotic fluid (nonconfluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (nonconfluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
ARSAS | Test | ARSA Gene, Full Gene Analysis | ARSA Gene, Full Gene Analysis | 1 | 81405 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
ARSB | Test | Arylsulfatase B, Fibroblasts | Arylsulfatase B, Fibroblasts | 1 | 82657 |  |  | When this test is ordered, a fibroblast culture and cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple lysosomal enzyme assays on a patient utilizing fibroblast culture, only 1 culture is required regardless of the number of enzyme assays ordered. If viable cells are not obtained within 10 days, client will be notified.
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
FIBR | [NAME] | Fibroblast Culture | Fibroblast Culture | 1 | 88233 | Yes | Yes
ARST | Test | Arylsulfatase A, Fibroblasts | Arylsulfatase A, Fibroblasts | 1 | 82657 |  |  | When this test is ordered, a fibroblast culture and cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple lysosomal enzyme assays on a patient utilizing fibroblast culture, only 1 culture is required regardless of the number of enzyme assays ordered. If viable cells are not obtained within 10 days, client will be notified.
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
FIBR | [NAME] | Fibroblast Culture | Fibroblast Culture | 1 | 88233 | Yes | Yes
AXINS | Test | [NAME], Full Gene Analysis | [NAME], Full Gene Analysis | 1 | 81479 |  |  | When this test is ordered, COLDB / Hereditary Colon Cancer CGH Array will always be performed at an additional charge.
COLDB | [NAME] | Hereditary Colon Cancer CGH Array | Hereditary Colon Cancer CGH Array | 1 | 81228 | Yes | Yes
BARBX | Test | [NAME], Chain of Custody, [NAME] | [NAME], CoC, U | 1 | 82205 |  |  | Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
BBLD | Test | Bacterial Culture, Blood | Bacterial Culture, Blood | 1 | 87040 |  |  | When this test is ordered, the reflex tests may be performed and charged.
[NAME] | [NAME] | KPC and NDM PCR ([NAME] Only) | KPC and NDM PCR |  |  | No | No
BLA | [NAME] | Beta Lactamase ([NAME] Only) | Beta Lactamase | 1 | 87185 | No | No
REFID | [NAME] | Additional Identification Procedure (Bill Only) | Additional Identification Procedure | 1 | 87077 | No | No
STRP | [NAME] | Identification Streptococcus (Bill Only) | Identification Streptococcus | 1 | 87077 | No | No
STAP | [NAME] | Identification Staphylococcus ([NAME] Only) | Identification Staphylococcus | 1 | 87077 | No | No
SHIG | [NAME] | Serologic Agglut Method 3 Ident (Bill Only) | Serologic Agglut Method 3 Ident | 1 | 87147 | No | No
HODGB | [NAME] | Carbapenemase-Modified Hodge Test ([NAME] Only) | Carbapenamase-Modified Hodge Test | 1 | 87185 | No | No
SALS | [NAME] | Serologic Agglut Method 1 Ident (Bill Only) | Serologic Agglut Method 1 Ident | 1 | 87147 | No | No
ISAE | [NAME] | Aerobe Ident by Sequencing ([NAME] Only) | Aerobe Ident by Sequencing | 1 | 87153 | No | No
GID | [NAME] | [NAME] ([NAME] Only) | [NAME] | 1 | 87077 | No | No
RMALD | [NAME] | Ident by MALDI-TOF Mass Spec ([NAME] Only) | Ident by MALDI-TOF mass spec | 1 | 87077 | No | No
COMM | [NAME] | Identification, [NAME] | Identification [NAME] | 1 | 87077 | No | No
EC | [NAME] | Serologic Agglut Method 2 Ident (Bill Only) | Serologic Agglut Method 2 Ident | 1 | 87147 | No | No
BDIAL | Test | Bleeding Diathesis Profile, Limited | Bleeding Diath Prof, Limited |  | PROFILE |  |  | Initial testing includes: prothrombin time (PT), activated partial thromboplastin time, thrombin time (bovine), fibrinogen, D-dimer, soluble fibrin monomer, coagulation factor VIII activity assay, [NAME] factor antigen, [NAME] factor activity, factor [NAME] screen, and special coagulation interpretation.
DIRM | Component | D-Dimer, Plasma | D-Dimer, P | 1 | 85379 | Yes | Yes
CCC | Component | Special Coagulation Interpretation | Special Coagulation Interpretation | 1 | 85390 | Yes | No
FIBC | Component | Fibrinogen, Plasma | Fibrinogen, P | 1 | 85384 | Yes | Yes
PTC | Component | Prothrombin Time (PT), Plasma | Prothrombin Time (PT), P | 1 | 85610 | Yes | Yes
APTTB | Component | Activated Partial Thromboplastin Time (APTT), Plasma | Activated Partial Thrombopl Time, P | 1 | 85730 | Yes | Yes
TT | Component | Thrombin Time (Bovine), Plasma | Thrombin Time (Bovine), P | 1 | 85670 | Yes | Yes
FXIII | Component | Factor [NAME] (13), Screen | Factor XIII(13),Scrn | 1 | 85291 | Yes | No
F8A | Component | Coagulation Factor VIII Activity Assay, Plasma | Coag Factor VIII Activity Assay, P | 1 | 85240 | Yes | Yes
VWAG | Component | von Willebrand Factor [NAME], Plasma | von Willebrand Factor Ag, P | 1 | 85246 | Yes | Yes
SFM | Component | Soluble [NAME] | Soluble [NAME] | 1 | 85366 | Yes | No
VWFX | Component | von Willebrand Factor Activity, Plasma | von Willebrand Factor Activity, P | 1 | 85397 | Yes | Yes
PNP | [NAME] | Platelet Neutralization Procedure | Platelet Neutralization Procedure | 1 | 85597 | No | No
10_IS | [NAME] | Factor X Inhibitor Screen | Factor X Inhib Scrn | 1 | 85335 | No | No
F_7 | [NAME] | Coagulation Factor VII Activity Assay, Plasma | Coag Factor VII Assay, P | 1 | 85230 | No | Yes
PTMX | [NAME] | PT Mix 1:1 | PT Mix 1:1 | 1 | 85611 | No | No
VWFM | [NAME] | von Willebrand Factor Multimer Analysis, Plasma | von Willebrand Factor Multimer, P | 1 | 85247 | No | Yes
11_IS | [NAME] | Factor XI Inhibitor Screen | Factor [NAME] Scrn | 1 | 85335 | No | No
F5_IS | [NAME] | Factor V Inhibitor Screen | Factor V Inhib Scrn | 1 | 85335 | No | No
F7_IS | [NAME] | Factor VII Inhibitor Screen | Factor [NAME] | 1 | 85335 | No | No
APTTM | [NAME] | APTT Mix 1:1 | APTT Mix 1:1 | 1 | 85732 | No | No
DRVTM | [NAME] | DRVVT Mix | DRVVT Mix | 1 | 85613 | No | No
STLA | [NAME] | Staclot Lupus Anticoagulant, Plasma | Staclot LA, P | 1 | 85598 | No | No
F8IS | [NAME] | Coagulation Factor VIII Inhibitor Screen, Plasma | Coag Factor VIII Assay [NAME],P | 1 | 85335 | No | No
RIST | [NAME] | [NAME], Plasma | [NAME], P | 1 | 85245 | No | No
IBETH | [NAME] | Bethesda Units | Bethesda Units | 1 | 85335 | No | No
F9_IS | [NAME] | Factor IX Inhibitor Screen | Factor IX Inhib Scrn | 1 | 85335 | No | No
FACTV | [NAME] | Coagulation Factor V Activity Assay, Plasma | Coag Factor V Assay, P | 1 | 85220 | No | Yes
RPTL | [NAME] | Reptilase Time, Plasma | Reptilase Time, P | 1 | 85635 | No | Yes
APSM | [NAME] | [NAME], Plasma | [NAME], P | 1 | 85410 | No | Yes
F_9 | [NAME] | Coagulation Factor IX Activity Assay, Plasma | Coag Factor IX Assay, P | 1 | 85250 | No | Yes
F_2 | [NAME] | Coagulation Factor II Activity Assay, Plasma | Coag Factor II Assay, P | 1 | 85210 | No | Yes
DRVTC | [NAME] | DRVVT Confirmation | DRVVT Confirmation | 1 | 85613 | No | No
F_10 | [NAME] | Coagulation Factor X Activity Assay, Plasma | Coag Factor X Assay, P | 1 | 85260 | No | Yes
DRVT | [NAME] | [NAME] Viper Venom Time (DRVVT), Plasma | Dilute Russells Viper Venom Time, P | 1 | 85613 | No | No
F2_IS | [NAME] | Factor II Inhibitor Screen | Factor II Inhib Scrn | 1 | 85335 | No | No
F_11 | [NAME] | Coagulation Factor XI Activity Assay, Plasma | Coag Factor XI Assay, P | 1 | 85270 | No | Yes
F_12 | [NAME] | Coagulation Factor XII Activity Assay, Plasma | Coag Factor XII Assay, P | 1 | 85280 | No | Yes
BENZX | Test | Benzodiazepines Confirmation, Chain of Custody, [NAME] | [NAME], CoC, U | 1 | 80154 |  |  | Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
BGAT | Test | Beta-Galactosidase, Fibroblasts | Beta-Galactosidase, Fibroblasts | 1 | 82657 |  |  | When this test is ordered, a fibroblast culture and cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple lysosomal enzyme assays on a patient utilizing fibroblast culture, only 1 culture is required regardless of the number of enzyme assays ordered. If viable cells are not obtained within 10 days, client will be notified.
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
FIBR | [NAME] | Fibroblast Culture | Fibroblast Culture | 1 | 88233 | Yes | Yes
BGLR | Test | Beta-Glucuronidase, Fibroblasts | Beta-Glucuronidase, Fibroblasts | 1 | 82657 |  |  | When this test is ordered, a fibroblast culture and cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple lysosomal enzyme assays on a patient utilizing fibroblast culture, only 1 culture is required regardless of the number of enzyme assays ordered. If viable cells are not obtained within 10 days, client will be notified.
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
FIBR | [NAME] | Fibroblast Culture | Fibroblast Culture | 1 | 88233 | Yes | Yes
[NAME] | Test | Beta-Glucosidase, Fibroblasts | Beta-Glucosidase, Fibroblasts | 1 | 82657 |  |  | When this test is ordered, a fibroblast culture and cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple lysosomal enzyme assays on a patient utilizing fibroblast culture, only 1 culture is required regardless of the number of enzyme assays ordered. If viable cells are not obtained within 10 days, client will be notified.
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
FIBR | [NAME] | Fibroblast Culture | Fibroblast Culture | 1 | 88233 | Yes | Yes
BLM | Test | Bloom Syndrome, Mutation Analysis, 2281del6/ins7 | Bloom Syndrome, Mutation Analysis | 1 | 81209 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
BMPMS | Test | [NAME], Full Gene Analysis | [NAME], Full Gene Analysis | 1 | 81479 |  |  | When this test is ordered, CGH array will always be performed at an additional charge.
COLDB | [NAME] | Hereditary Colon Cancer CGH Array | Hereditary Colon Cancer CGH Array | 1 | 81228 | Yes | Yes
BRAF | Test | BRAF Mutation Analysis (V600E), Tumor | BRAF Mutation Analysis(V600E),Tumor | 1 | 81210 |  |  | When this test is ordered, slide review will always be performed at an additional charge.
SLRVW | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
BRAFM | Test | BRAF Mutation Analysis (V600), Melanoma | BRAF Mutation AnalysisV600 Melanoma | 1 | 81210 |  |  | When this test is ordered, slide review will always be performed at an additional charge.
SLRVW | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
BRUGM | Test | [NAME], IgG and IgM, Serum | [NAME], IgG and IgM, S |  | PROFILE |  |  | If [NAME] antibody screen, IgG and IgM is positive or equivocal, then BRUTA / Brucella Total Antibody Confirmation, Agglutination, Serum will be performed at an additional charge.
BRUGM | Component |  | [NAME], IgG, S | 1 | 86622 | No | No
BRUGM | Component |  | [NAME], IgM, S | 1 | 86622 | No | No
BRUTA | [NAME] | Brucella Total Antibody Confirmation, Agglutination, Serum | [NAME], Agglutination, S | 1 | 86622 | No | Yes
BTDKM | Test | Biotinidase Deficiency, [NAME], Known Mutation | [NAME], Known Mutation | 1 | 81403 |  |  | For prenatal specimens only: If amniotic fluid (nonconfluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (nonconfluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
BWSRS | Test | Beckwith-Wiedemann Syndrome (BWS)/Russell-Silver Syndrome (RSS) Molecular Analysis | BWS/RSS Molecular Analysis | 2 | 81401 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.   For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
C2 | Test | C2 Complement, Functional, with [NAME], Serum | C2 Complement,Functional,w/Reflex,S | 1 | 86161 |  |  | If the C2 result is <15 U/mL, then [NAME] and C4 will be performed at an additional charge.
[NAME] | [NAME] | [NAME], Serum | [NAME], S | 1 | 86160 | No | Yes
C4 | [NAME] | [NAME], Serum | [NAME], S | 1 | 86160 | No | Yes
C9OR | Test | C9orf72 Hexanucleotide Repeat, Molecular Analysis | C9orf72, Molecular Analysis | 1 | 81479 |  |  | When this test is ordered follow-up analysis testing will be performed and charged dependent upon on the GGGGCC hexanucleotide repeat alleles of the C9ORF72 gene found by PCR analysis.
C9OFU | [NAME] | C9orf72, Follow Up Analysis | C9orf72, Follow Up Analysis | 1 | 81479 | No | No
CACTK | Test | Carnitine-Acylcarnitine Translocase Deficiency, Known Mutation | SLC25A20 Gene, Known Mutation | 1 | 81403 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
CACTS | Test | Carnitine-Acylcarnitine Translocase Deficiency, Full Gene Analysis | SLC25A20 Gene, Full Gene Analysis | 1 | 81405 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and changed separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
CAMPY | Test | Helicobacter pylori Culture | Helicobacter pylori Culture | 1 | 87081
GID | [NAME] | [NAME] ([NAME] Only) | [NAME] | 1 | 87077 | No | No
TISSR | [NAME] | Tissue Processing ([NAME] Only) | Tissue Processing | 1 | 87176 | No | No
CANCP | Test | [NAME] Cancer Gene Panel by Next Generation Sequencing | Solid Tumor Targeted Cancer Panel |  | PROFILE |  |  | When this test is ordered, slide review will always be performed at an additional charge.
CANCP | Component |  | BRAF GENE | 1 | 81210 | No | No
CANCP | Component |  | KRAS GENE | 1 | 81275 | No | No
CANCP | Component |  | JAK2 GENE | 1 | 81270 | No | No
CANCP | Component |  | FLT3 GENE | 1 | 81245 | No | No
CANCP | Component |  | EGFR GENE COM VARIANTS | 1 | 81235 | No | No
CANCP | Component |  | NPM1 GENE | 1 | 81310 | No | No
CANCP | Component |  | UNLISTED MOLECULAR PATHOLOGY | 1 | 81479 | No | No
CANCP | Component |  | MOPATH PROCEDURE LEVEL 6 | 1 | 81405 | No | No
CANCP | Component |  | MOPATH PROCEDURE LEVEL 5 | 7 | 81404 | No | No
CANCP | Component |  | MOPATH PROCEDURE LEVEL 4 | 7 | 81403 | No | No
SLRVW | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
CANW | Test | Canavan Disease, Mutation Analysis, ASPA | Canavan Disease, Mutation Analysis | 1 | 81200 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
CARNP | Test | Carbapenemase Detection-Carba NP Test | Carbapenemase-Carba NP Test | 1 | 87185
CARNB | [NAME] | Carbapenemase Detection-Carba NP Test ([NAME] Only) | Carbapenemase-Carba NP Test | 1 | 87185 | Yes | No
CBC | Test | CBC with Differential, Blood | CBC with Differential, B | 1 | 85025 |  |  | For Mayo patients:   A morphology evaluation is performed when the automated 5-part differential is invalid and/or when abnormal results are identified upon microscopic examination.
CE | [NAME] | Consultant Evaluation | Consultant Eval. |  |  | No | No
DIFFR | [NAME] | Morphology Eval (Special Smear) | Morphology Eval (special Smear) | 1 | 85007 | No | No
CBGT | Test | Galactocerebrosidase, Fibroblasts | Galactocerebrosidase,Fibro | 1 | 82658 |  |  | When this test is ordered, a fibroblast culture and cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple lysosomal enzyme assays on a patient utilizing fibroblast culture, only 1 culture is required regardless of the number of enzyme assays ordered. If viable cells are not obtained within 10 days, client will be notified.
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
FIBR | [NAME] | Fibroblast Culture | Fibroblast Culture | 1 | 88233 | Yes | Yes
CDA5X | Test | Drug Abuse Survey with Confirmation, Panel 5, Chain of Custody, Urine | Confirmed Drug Abuse Panel5, CoC, U | 1 | 80104 |  |  | Testing begins with immunoassay screen. Positives are confirmed and quantitated by gas chromatography-mass spectrometry at an additional charge.
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
OPATX | [NAME] | Opiates Confirmation, Chain of Custody, [NAME] | Opiate Confirmation, CoC, U | 1 | 83925 | No | Yes
COKEX | [NAME] | Cocaine and Metabolite Confirmation, Chain of Custody, [NAME] | Cocaine and metabolite [NAME], CoC, U | 1 | 82520 | No | Yes
THCX | [NAME] | Carboxy-Tetrahydrocannabinol (THC) Confirmation, Chain of Custody, [NAME] | Carboxy-THC Confirmation, CoC, U | 1 | 80299 | No | Yes
AMPHX | [NAME] | Amphetamines Confirmation, Chain of Custody, [NAME] | Amphetamines Confirmation, CoC, U | 1 | 82145 | No | Yes
PCPX | [NAME] | Phencyclidine Confirmation, Chain of Custody, [NAME] | Phencyclidine Confirmation, CoC, U | 1 | 83992 | No | Yes
CDA7X | Test | Drug Abuse Survey with Confirmation, Panel 9, Chain of Custody, Urine | Confirmed Drug Abuse Panel9, CoC, U | 1 | 80104 |  |  | Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods (gas chromatography-flame ionization detector for ethanol; gas chromatography-mass spectrometry for amphetamines, barbiturates, benzodiazepines, cocaine and metabolites, methadone, opiates, phencyclidine, propoxyphene, and [NAME]) at an additional charge.
PCPX | [NAME] | Phencyclidine Confirmation, Chain of Custody, [NAME] | Phencyclidine Confirmation, CoC, U | 1 | 83992 | No | Yes
MTDNX | [NAME] | Methadone Confirmation, Chain of Custody, [NAME] | Methadone Confirmation, CoC, U | 1 | 83840 | No | Yes
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
THCX | [NAME] | Carboxy-Tetrahydrocannabinol (THC) Confirmation, Chain of Custody, [NAME] | Carboxy-THC Confirmation, CoC, U | 1 | 80299 | No | Yes
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
BARBX | [NAME] | [NAME], Chain of Custody, [NAME] | [NAME], CoC, U | 1 | 82205 | No | Yes
AMPHX | [NAME] | Amphetamines Confirmation, Chain of Custody, [NAME] | Amphetamines Confirmation, CoC, U | 1 | 82145 | No | Yes
ETOHX | [NAME] | Ethanol, Chain of Custody, [NAME] | Ethanol, CoC, U | 1 | 82055 | No | Yes
OPATX | [NAME] | Opiates Confirmation, Chain of Custody, [NAME] | Opiate Confirmation, CoC, U | 1 | 83925 | No | Yes
COKEX | [NAME] | Cocaine and Metabolite Confirmation, Chain of Custody, [NAME] | Cocaine and metabolite [NAME], CoC, U | 1 | 82520 | No | Yes
BENZX | [NAME] | Benzodiazepines Confirmation, Chain of Custody, [NAME] | [NAME], CoC, U | 1 | 80154 | No | Yes
CDAU | Test | Drug Abuse Survey with Confirmation, [NAME] | Confirmed Drug Abuse Panel, U | 1 | 80104 |  |  | Testing begins with screening assays. If alcohol (ethanol) screen is positive, then the gas chromatography-flame ionization detector confirmation with quantification will be performed at an additional charge. If amphetamines, barbiturates, benzodiazepines, cocaine and metabolites, phencyclidine, or tetrahydrocannabinol metabolite screen is positive, then the gas chromatography-mass spectrometry confirmation with quantification will be performed at an additional charge. Opiates that screen positive will be quantified with liquid chromatography-tandem mass spectrometry at an additional charge.
BARBU | [NAME] | [NAME], [NAME] | [NAME], U | 1 | 82205 | No | Yes
THCU | [NAME] | Carboxy-Tetrahydrocannabinol (THC) Confirmation, [NAME] | Carboxy-THC Confirmation, U | 1 | 80299 | No | Yes
AMPHU | [NAME] | Amphetamines Confirmation, [NAME] | [NAME], U | 1 | 82145 | No | Yes
[NAME] | [NAME] | Ethanol, [NAME] | Ethanol, U | 1 | 82055 | No | No
BENZU | [NAME] | Benzodiazepines Confirmation, [NAME] | Benzodiazepines Confirmation, U | 1 | 80154 | No | Yes
COKEU | [NAME] | Cocaine and Metabolite Confirmation, [NAME] | Cocaine and metabolite [NAME], U | 1 | 82520 | No | Yes
PCPU | [NAME] | Phencyclidine Confirmation, [NAME] | Phencyclidine Confirmation, U | 1 | 83992 | No | Yes
OPATU | [NAME] | Opiates Confirmation, [NAME] | Opiate Confirmation, U | 1 | 83925 | No | Yes
CDAU5 | Test | Drug Abuse Survey with Confirmation, Panel 5, [NAME] | Confirmed Drug Abuse Panel 5, U | 1 | 80104 |  |  | Testing begins with immunoassay screen. Positives are confirmed and quantitated by gas chromatography-mass spectrometry or liquid chromatography-tandem mass spectrometry at an additional charge.
AMPHU | [NAME] | Amphetamines Confirmation, [NAME] | [NAME], U | 1 | 82145 | No | Yes
COKEU | [NAME] | Cocaine and Metabolite Confirmation, [NAME] | Cocaine and metabolite [NAME], U | 1 | 82520 | No | Yes
OPATU | [NAME] | Opiates Confirmation, [NAME] | Opiate Confirmation, U | 1 | 83925 | No | Yes
PCPU | [NAME] | Phencyclidine Confirmation, [NAME] | Phencyclidine Confirmation, U | 1 | 83992 | No | Yes
THCU | [NAME] | Carboxy-Tetrahydrocannabinol (THC) Confirmation, [NAME] | Carboxy-THC Confirmation, U | 1 | 80299 | No | Yes
CDAU7 | Test | Drug Abuse Survey with Confirmation, Panel 9, [NAME] | Confirmed Drug Abuse Panel 9, U | 1 | 80104 |  |  | Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods (gas chromatography-flame ionization detector for ethanol; gas chromatography-mass spectrometry for amphetamines, barbiturates, benzodiazepines, cocaine and metabolites, methadone, phencyclidine, and [NAME]) at an additional charge. Opiates that screen positive will be quantified with liquid chromatography-tandem mass spectrometry at an additional charge.
AMPHU | [NAME] | Amphetamines Confirmation, [NAME] | [NAME], U | 1 | 82145 | No | Yes
BARBU | [NAME] | [NAME], [NAME] | [NAME], U | 1 | 82205 | No | Yes
BENZU | [NAME] | Benzodiazepines Confirmation, [NAME] | Benzodiazepines Confirmation, U | 1 | 80154 | No | Yes
COKEU | [NAME] | Cocaine and Metabolite Confirmation, [NAME] | Cocaine and metabolite [NAME], U | 1 | 82520 | No | Yes
[NAME] | [NAME] | Ethanol, [NAME] | Ethanol, U | 1 | 82055 | No | No
MTDNU | [NAME] | Methadone Confirmation, [NAME] | Methadone Confirmation, U | 1 | 83840 | No | Yes
OPATU | [NAME] | Opiates Confirmation, [NAME] | Opiate Confirmation, U | 1 | 83925 | No | Yes
PCPU | [NAME] | Phencyclidine Confirmation, [NAME] | Phencyclidine Confirmation, U | 1 | 83992 | No | Yes
THCU | [NAME] | Carboxy-Tetrahydrocannabinol (THC) Confirmation, [NAME] | Carboxy-THC Confirmation, U | 1 | 80299 | No | Yes
CDAUX | Test | Drug Abuse Panel with Confirmation, Chain of Custody, [NAME] | Confirmed Drug Abuse Panel, CoC, U | 1 | 80104 |  |  | Testing begins with screening assays. If alcohol (ethanol) screen is positive, then the gas chromatography-flame ionization detector confirmation with quantification will be performed at an additional charge. If amphetamines, barbiturates, benzodiazepines, cocaine and metabolites, opiates, phencyclidine, or tetrahydrocannabinol metabolite screen is positive, then the gas chromatography-mass spectrometry confirmation with quantification will be performed at an additional charge.
BENZX | [NAME] | Benzodiazepines Confirmation, Chain of Custody, [NAME] | [NAME], CoC, U | 1 | 80154 | No | Yes
COKEX | [NAME] | Cocaine and Metabolite Confirmation, Chain of Custody, [NAME] | Cocaine and metabolite [NAME], CoC, U | 1 | 82520 | No | Yes
THCX | [NAME] | Carboxy-Tetrahydrocannabinol (THC) Confirmation, Chain of Custody, [NAME] | Carboxy-THC Confirmation, CoC, U | 1 | 80299 | No | Yes
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
ETOHX | [NAME] | Ethanol, Chain of Custody, [NAME] | Ethanol, CoC, U | 1 | 82055 | No | Yes
PCPX | [NAME] | Phencyclidine Confirmation, Chain of Custody, [NAME] | Phencyclidine Confirmation, CoC, U | 1 | 83992 | No | Yes
BARBX | [NAME] | [NAME], Chain of Custody, [NAME] | [NAME], CoC, U | 1 | 82205 | No | Yes
OPATX | [NAME] | Opiates Confirmation, Chain of Custody, [NAME] | Opiate Confirmation, CoC, U | 1 | 83925 | No | Yes
AMPHX | [NAME] | Amphetamines Confirmation, Chain of Custody, [NAME] | Amphetamines Confirmation, CoC, U | 1 | 82145 | No | Yes
CDCOM | Test | Celiac Disease Comprehensive Cascade | Celiac Disease Comprehensive Casc |  | PROFILE |  |  | If [NAME] is age-specified normal, then tissue transglutaminase (tTG) IgA will be performed at an additional charge.     If tTG IgA is equivocal, then endomysial antibodies IgA and deamidated gliadin antibody IgA will be performed at an additional charge.     If [NAME] is > or =1.0 mg/dL but lower than age-specified normal, then tTG IgA, tTG IgG, deamidated gliadin IgA, and deamidated gliadin IgG will be performed at an additional charge.     If IgA is below detection (<1.0 mg/[NAME]), then tTG IgG and deamidated gliadin IgG will be performed at an additional charge.
CDCOM | Component |  | HLA II TYPING 1 LOCUS LR | 2 | 81376 | No | No
IGA | Component | Immunoglobulin A (IgA), Serum | Immunoglobulin A (IgA), S | 1 | 82784 | Yes | Yes
CELI2 | Component | HLA-DQ Typing | HLA-DQ Typing | 2 | 81376 | Yes | Yes
CDCM1 | Component | Celiac Disease Interpretation | Celiac Disease Interpretation |  |  | Yes | No
TTGG | [NAME] | Tissue Transglutaminase (tTG) Antibody, IgG, Serum | Tissue Transglutaminase Ab, IgG, S | 1 | 83516 | No | Yes
DGGL | [NAME] | Gliadin (Deamidated) Antibody, IgG, Serum | Gliadin(Deamidated) Ab, IgG, S | 1 | 83516 | No | Yes
DAGL | [NAME] | Gliadin (Deamidated) Antibody, IgA, Serum | Gliadin(Deamidated) Ab, IgA, S | 1 | 83516 | No | Yes
EMA | [NAME] | Endomysial Antibodies (IgA), Serum | Endomysial Abs, S (IgA) | 1 | 86255 | No | Yes
TTGA | [NAME] | Tissue Transglutaminase (tTG) Antibody, IgA, Serum | Tissue Transglutaminase Ab, IgA, S | 1 | 83516 | No | Yes
CDGF | Test | [NAME] | [NAME] | 2 | 81376 |  |  | If HLA-DQ typing is positive or equivocal for DQ2 or DQ8, then IgA, tissue transglutaminase (tTG) IgA and IgG, and deamidated gliadin IgA and IgG will be performed at an additional charge.
CDGF1 | Component | Celiac Disease Interpretation | Celiac Disease Interpretation |  |  | Yes | No
CELI2 | Component | HLA-DQ Typing | HLA-DQ Typing | 2 | 81376 | Yes | Yes
TTGG | [NAME] | Tissue Transglutaminase (tTG) Antibody, IgG, Serum | Tissue Transglutaminase Ab, IgG, S | 1 | 83516 | No | Yes
DGGL | [NAME] | Gliadin (Deamidated) Antibody, IgG, Serum | Gliadin(Deamidated) Ab, IgG, S | 1 | 83516 | No | Yes
TTGA | [NAME] | Tissue Transglutaminase (tTG) Antibody, IgA, Serum | Tissue Transglutaminase Ab, IgA, S | 1 | 83516 | No | Yes
IGA | [NAME] | Immunoglobulin A (IgA), Serum | Immunoglobulin A (IgA), S | 1 | 82784 | No | Yes
DAGL | [NAME] | Gliadin (Deamidated) Antibody, IgA, Serum | Gliadin(Deamidated) Ab, IgA, S | 1 | 83516 | No | Yes
CDH1S | Test | CDH1 Gene, Full Gene Analysis | CDH1 Gene, Full Gene Analysis | 1 | 81406 |  |  | When this test is ordered, CGH array will always be performed at an additional charge.
COLDB | [NAME] | Hereditary Colon Cancer CGH Array | Hereditary Colon Cancer CGH Array | 1 | 81228 | Yes | No
CDKKM | Test | CDKN1C Gene, Known Mutation | CDKN1C Gene, Known Mutation | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
CDKMS | Test | CDKN1C Gene, Full Gene Analysis | CDKN1C Gene, Full Gene Analysis | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
CDSP | Test | Celiac Disease Serology Cascade | Celiac Disease Serology Cascade | 1 | 82784 |  |  | If [NAME] is age-specified normal, then tissue transglutaminase (tTG) IgA will be performed at an additional charge.   If tTG IgA is equivocal, then endomysial antibodies IgA and deamidated gliadin antibody IgA will be performed at an additional charge.   If [NAME] is > or =1.0 mg/dL but lower than age-specified normal, then tTG IgA, tTG IgG, deamidated gliadin IgA, and deamidated gliadin IgG will be performed at an additional charge.   If [NAME] is below detection (<1.0 mg/[NAME]), then tTG IgG and deamidated gliadin IgG will be performed at an additional charge.
IGA | Component | Immunoglobulin A (IgA), Serum | Immunoglobulin A (IgA), S | 1 | 82784 | Yes | Yes
CDSP1 | Component | Celiac Disease Interpretation | Celiac Disease Interpretation |  |  | Yes | No
TTGG | [NAME] | Tissue Transglutaminase (tTG) Antibody, IgG, Serum | Tissue Transglutaminase Ab, IgG, S | 1 | 83516 | No | Yes
DAGL | [NAME] | Gliadin (Deamidated) Antibody, IgA, Serum | Gliadin(Deamidated) Ab, IgA, S | 1 | 83516 | No | Yes
DGGL | [NAME] | Gliadin (Deamidated) Antibody, IgG, Serum | Gliadin(Deamidated) Ab, IgG, S | 1 | 83516 | No | Yes
EMA | [NAME] | Endomysial Antibodies (IgA), Serum | Endomysial Abs, S (IgA) | 1 | 86255 | No | Yes
TTGA | [NAME] | Tissue Transglutaminase (tTG) Antibody, IgA, Serum | Tissue Transglutaminase Ab, IgA, S | 1 | 83516 | No | Yes
CFPB | Test | Cystic Fibrosis Mutation Analysis, 106-Mutation Panel | Cystic Fibrosis Mutation Panel | 1 | 81220 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
CFRC | Test | Bacterial Culture, Cystic Fibrosis, Respiratory | Bacterial Culture, Cystic Fibrosis | 1 | 87070 |  |  | When this test is ordered, the reflex tests may be performed and charged.
GID | [NAME] | [NAME] ([NAME] Only) | [NAME] | 1 | 87077 | No | No
HODGB | [NAME] | Carbapenemase-Modified Hodge Test ([NAME] Only) | Carbapenamase-Modified Hodge Test | 1 | 87185 | No | No
[NAME] | [NAME] | KPC and NDM PCR ([NAME] Only) | KPC and NDM PCR |  |  | No | No
STAP | [NAME] | Identification Staphylococcus ([NAME] Only) | Identification Staphylococcus | 1 | 87077 | No | No
STRP | [NAME] | Identification Streptococcus (Bill Only) | Identification Streptococcus | 1 | 87077 | No | No
EC | [NAME] | Serologic Agglut Method 2 Ident (Bill Only) | Serologic Agglut Method 2 Ident | 1 | 87147 | No | No
SHIG | [NAME] | Serologic Agglut Method 3 Ident (Bill Only) | Serologic Agglut Method 3 Ident | 1 | 87147 | No | No
BLA | [NAME] | Beta Lactamase ([NAME] Only) | Beta Lactamase | 1 | 87185 | No | No
SALS | [NAME] | Serologic Agglut Method 1 Ident (Bill Only) | Serologic Agglut Method 1 Ident | 1 | 87147 | No | No
REFID | [NAME] | Additional Identification Procedure (Bill Only) | Additional Identification Procedure | 1 | 87077 | No | No
RMALD | [NAME] | Ident by MALDI-TOF Mass Spec ([NAME] Only) | Ident by MALDI-TOF mass spec | 1 | 87077 | No | No
ISAE | [NAME] | Aerobe Ident by Sequencing ([NAME] Only) | Aerobe Ident by Sequencing | 1 | 87153 | No | No
COMM | [NAME] | Identification, [NAME] | Identification [NAME] | 1 | 87077 | No | No
CFTRK | Test | CFTR Gene, Known Mutation | CFTR Gene, Known Mutation | 1 | 81221 |  |  | For prenatal specimens only: If amniotic fluid (nonconfluent cultured cells) is received, amniotic fluid culture will be added and charged separately. If chorionic villus specimen (nonconfluent cultured cells) is received, fibroblast culture will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
CHEKS | Test | CHEK2 Gene, Full Gene Analysis | CHEK2 Gene, Full Gene Analysis | 1 | 81479 |  |  | When this test is ordered, CGH array will always be performed at an additional charge.
COLDB | [NAME] | Hereditary Colon Cancer CGH Array | Hereditary Colon Cancer CGH Array | 1 | 81228 | Yes | Yes
CHEP | Test | Chimerism-Recipient Engraftment (Post) | Chimerism-Recipient Engraft |  |  |  |  | Initial Chimerism Testing:   Complete chimerism analysis requires 3 specimens. These specimens should be submitted when collected. An interpretive report will be provided once all specimens are received.
CHMT | [NAME] | Chimerism-Recipient Engraftment (Post) ([NAME] Only) | Chimerism Analysis | 1 | 81267 | No | No
PCS1 | [NAME] | Post Cell Sort, 1 (Bill Only) | Post Cell Sort, 1 |  |  | No | No
PCS2 | [NAME] | Post Cell Sort, 2 ([NAME] Only) | Post Cell Sort, 2 |  |  | No | No
ADDO | [NAME] | Additional Donor (Bill Only) | Additional Donor |  |  | No | No
CHOU | Test | Carbohydrate, [NAME] | Carbohydrate, U | 1 | 84377 |  |  | Testing begins with CHOU / Carbohydrate, [NAME]. If qualitative results are normal, or abnormal but not indicative of galactose or glucose, testing is complete.     If qualitative results indicate the presence of galactose, GALU / Galactose, Quantitative, [NAME] will be performed at an additional charge.      If qualitative results indicate the presence of glucose, RGLUR / Glucose, Random, [NAME] will be performed at an additional charge.
GALU | [NAME] | Galactose, Quantitative, [NAME] | Galactose, QN, U | 1 | 82760 | No | Yes
RGLUR | [NAME] | Glucose, Random, [NAME] | Glucose, Random, U | 1 | 82945 | No | Yes
CHSBP | Test | Chronic Hepatitis Profile (Type B) | Chronic Hepatitis Profile (Type B) |  | PROFILE |  |  | If HBs antigen is reactive, then HBs antigen confirmation will be performed at an additional charge.
HEAB | Component | [NAME], Serum | [NAME], S | 1 | 86707 | Yes | Yes
HBAG | Component | Hepatitis B Surface Antigen, Serum | HBs Antigen, S | 1 | 87340 | Yes | Yes
EAG | Component | [NAME], Serum | Hepatitis Be Ag, S | 1 | 87350 | Yes | Yes
HBGNT | [NAME] | Hepatitis B Surface Antigen Confirmation, Serum | HBs Antigen Confirmation, S | 1 | 87341 | No | No
CHSUP | Test | Chronic Hepatitis Profile (Type Unknown) | Chronic Hepatitis Prof (Unknown) |  | PROFILE |  |  | If hepatitis B surface antigen (HBsAg) is reactive, then HBsAg confirmation will be performed at an additional charge.
HBAG | Component | Hepatitis B Surface Antigen, Serum | HBs Antigen, S | 1 | 87340 | Yes | Yes
HCV | Component | Hepatitis C Antibody Screen, Serum | HCV Ab Screen, S | 1 | 86803 | Yes | Yes
HBAB | Component | Hepatitis B Surface Antibody, Qualitative/Quantitative, Serum | [NAME], S | 1 | 86706 | Yes | Yes
HBC | Component | Hepatitis B Core Total Antibodies, Serum | HBc Total Ab, S | 1 | 86704 | Yes | Yes
HBGNT | [NAME] | Hepatitis B Surface Antigen Confirmation, Serum | HBs Antigen Confirmation, S | 1 | 87341 | No | No
CHSUP | Test | Chronic Hepatitis Profile (Type Unknown) | Chronic Hepatitis Prof (Unknown) |  | PROFILE |  |  | If hepatitis B surface antigen (HBsAg) is reactive, then HBsAg confirmation will be performed at an additional charge.
HCV | Component | Hepatitis C Antibody Screen, Serum | HCV Ab Screen, S | 1 | 86803 | Yes | Yes
HBAG | Component | Hepatitis B Surface Antigen, Serum | HBs Antigen, S | 1 | 87340 | Yes | Yes
HBAB | Component | Hepatitis B Surface Antibody, Qualitative/Quantitative, Serum | [NAME], S | 1 | 86706 | Yes | Yes
HBC | Component | Hepatitis B Core Total Antibodies, Serum | HBc Total Ab, S | 1 | 86704 | Yes | Yes
HBGNT | [NAME] | Hepatitis B Surface Antigen Confirmation, Serum | HBs Antigen Confirmation, S | 1 | 87341 | No | No
CKELR | Test | [NAME], Serum | [NAME], S | 1 | 82550 |  |  | Testing begins with total creatine kinase analysis (CK). If the total CK activity is <100 U/L testing is complete. CK isoenzyme electrophoresis (CKE) testing will not be performed. If the total CK activity is > or =100 U/L, CK isoenzyme electrophoresis (CKE) will be performed at an additional charge.
CK | Component | [NAME] (CK), Serum | [NAME] (CK), S | 1 | 82550 | Yes | Yes
CKER | Component | CK Isoenzyme Elec, [NAME] Only | CK Isoenzyme Elec, [NAME] Only |  |  | Yes | No
CKE | [NAME] | CK Isoenzyme Electrophoresis, Serum | CK Isoenzyme Electrophoresis, S | 1 | 82552 | No | No
CLFA | Test | Cryptococcus Antigen Screen with Titer, [NAME] | Cryptococcus Ag Screen w/Titer, CSF | 1 | 87899 |  |  | If result is positive, Cryptococcus titer will be performed at an additional charge.
CLFAT | [NAME] | [NAME], LFA, Spinal Fluid | Cryptococcus Ag Titer, LFA, CSF | 1 | 87899 | No | Yes
CLFA | Test | Cryptococcus Antigen Screen with Titer, [NAME] | Cryptococcus Ag Screen w/Titer, CSF | 1 | 87899 |  |  | If result is positive, Cryptococcus titer will be performed at an additional charge.
CLFAT | [NAME] | [NAME], LFA, Spinal Fluid | Cryptococcus Ag Titer, LFA, CSF | 1 | 87899 | No | Yes
CLLM | Test | CLL Monitoring, MRD Detection, Blood | CLL Monitoring, MRD Detection, B |  | PROFILE |  |  | When this test is ordered, flow cytometry interpretation, 2 to 8 markers will always be performed at an additional charge.
CLLM | Component |  | Flow Cytometry, first marker | 1 | 88184 | No | No
CLLM | Component |  | Each additional marker | 6 | 88185 | No | No
88465 | [NAME] | Flow Cytometry Interpretation, 2 to 8 Markers ([NAME] Only) | Flow Cytometry Interp, 2-8 Markers | 1 | 88187 | Yes | No
CLYME | Test | Lyme Disease Serology, Spinal Fluid | Lyme Disease Serology, CSF | 1 | 86618 |  |  | If Lyme disease serology is positive, then immunoblot testing will be performed at an additional charge.
CLYWB | [NAME] | Lyme Disease Antibody, Immunoblot, Spinal Fluid | Lyme Disease Ab, Immunoblot, CSF | 2 | 86617 | No | Yes
COKEX | Test | Cocaine and Metabolite Confirmation, Chain of Custody, [NAME] | Cocaine and metabolite [NAME], CoC, U | 1 | 82520 |  |  | Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
COKMX | Test | Cocaine and Metabolite Confirmation, Chain of Custody, Meconium | Cocaine and metabolite [NAME], CoC, M | 1 | 82520
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
CORAB | Test | Hepatitis B Core Total Antibodies, with [NAME] to Hepatitis B Core Antibody, IgM, Serum | HBc [NAME], w/Reflex, S | 1 | 86704 |  |  | If hepatitis B core total antibodies is positive, then hepatitis B core antibody IgM is performed at an additional charge.
HBIM | [NAME] | Hepatitis B Core Antibody, IgM, Serum | HBc IgM Ab, S | 1 | 86705 | No | Yes
CORAB | Test | Hepatitis B Core Total Antibodies, with [NAME] to Hepatitis B Core Antibody, IgM, Serum | HBc [NAME], w/Reflex, S | 1 | 86704 |  |  | If hepatitis B core total antibodies is positive, then hepatitis B core antibody IgM is performed at an additional charge.
HBIM | [NAME] | Hepatitis B Core Antibody, IgM, Serum | HBc IgM Ab, S | 1 | 86705 | No | Yes
COXIC | Test | [NAME] with [NAME], Spinal Fluid | [NAME] w/ Reflex, CSF | 1 | 86635 |  |  | If result is positive, Coccidioides by complement fixation and immunodiffusion will be performed at an additional charge.
RCCOC | [NAME] | [NAME], Complement Fixation and Immunodiffusion, Spinal Fluid | [NAME], CF/ID, CSF | 3 | 86635 | No | No
COXIS | Test | [NAME] with [NAME], Serum | [NAME] w/ Reflex, S | 1 | 86635 |  |  | If result is positive, then Coccidioides by complement fixation and immunodiffusion will be performed at an additional charge.
RSCOC | [NAME] | [NAME], Complement Fixation and Immunodiffusion, Serum | [NAME], CF/ID, S | 3 | 86635 | No | No
CPOXK | Test | CPOX Gene, Known Mutation | CPOX Gene, Known Mutation | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
CPOXS | Test | CPOX Gene, Full Gene Analysis | CPOX Gene, Full Gene Analysis | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
CPTKM | Test | Carnitine Palmitoyltransferase II Deficiency, Known Mutation | CPT2 Gene, Known Mutation | 1 | 81403 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
CPTMS | Test | Carnitine Palmitoyltransferase II Deficiency, Full Gene Analysis | CPT2 Gene, Full Gene Analysis | 1 | 81404 |  |  | If skin biopsy is received, fibroblast culture will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
CRDPU | Test | [NAME], [NAME] | [NAME], U |  |  |  |  | CRDPU / Creatine Disorders Panel, [NAME] is a single test that carries the results for the panel. When the test is resulted, the following procedures are billed:   23466 [NAME], ([NAME] Only), [NAME]     23467 Creatinine, ([NAME] Only), [NAME]     23468 Guanidinoacetate, ([NAME] Only), [NAME]
23466 | [NAME] | [NAME], [NAME] ([NAME] Only) | [NAME], ([NAME] Only), U | 1 | 82540 | Yes | No
23467 | [NAME] | Creatinine, [NAME] ([NAME] Only) | Creatinine, ([NAME] Only), U | 1 | 82570 | Yes | No
23468 | [NAME] | Guanidinoacetate, [NAME] ([NAME] Only) | Guanidinoacetate, ([NAME] Only), U | 1 | 83789 | Yes | No
CRGSP | Test | Cryoglobulin and Cryofibrinogen Panel, Serum and Plasma | Cryo Panel, S and P |  | PROFILE |  |  | If cryoglobulin has a result other than negative, then immunofixation will be performed at an additional charge. Positive cryoglobulins of > or =0.1 mL of precipitate will be typed once.
CRY_P | Component | Cryofibrinogen, Plasma | Cryofibrinogen, P | 1 | 82585 | Yes | No
CRY_S | Component | Cryoglobulin, Serum | Cryoglobulin, S | 1 | 82595 | Yes | Yes
IMFXC | [NAME] | Immunofixation Cryoglobulin | Immunofixation Cryoglobulin | 1 | 86334 | No | No
CRY_S | Test | Cryoglobulin, Serum | Cryoglobulin, S | 1 | 82595 |  |  | If cryoglobulin has a result other than negative, then iImmunofixation will be performed at an additional charge. Positive cryoglobulins of > or =0.1 mL of precipitate will be typed once.
IMFXC | [NAME] | Immunofixation Cryoglobulin | Immunofixation Cryoglobulin | 1 | 86334 | No | No
CTB | Test | Mycobacterial Culture | Mycobacterial Culture | 1 | 87116 |  |  | When this test is ordered, the reflex test may be performed and charged.
ISMY | [NAME] | Mycobact Ident by Sequencing ([NAME] Only) | Mycology Ident by Sequencing | 1 | 87153 | No | No
TISSR | [NAME] | Tissue Processing ([NAME] Only) | Tissue Processing | 1 | 87176 | No | No
RTBSP | [NAME] | Identification Mycobacterium tuberculosis Complex Speciation, PCR ([NAME] Only) | Id, Mtb Speciation, PCR | 1 | 87150 | No | No
TBMP | [NAME] | Mycobacteria Probe Ident Solid ([NAME] Only) | Mycobacteria Probe Ident | 1 | 87150 | No | No
TBPB | [NAME] | Mycobacteria Probe Ident Broth ([NAME] Only) | Mycobacteria Probe Ident Broth | 1 | 87150 | No | No
TBT | [NAME] | Mycobacteria Culture, Concentration ([NAME] Only) | Mycobacteria Culture, Conc | 1 | 87015 | No | No
RMALM | [NAME] | Id MALDI-TOF Mass Spec AFB (Bill Only) | Id MALDI-TOF Mass Spec AFB | 1 | 87118 | No | No
LCMC | [NAME] | Identification, M.chelonae and M.abscessus,PCR ([NAME] Only) | Id,M.chelonae and M.abcessus,PCR | 1 | 87149 | No | No
CTBBL | Test | Mycobacterial Culture, Blood | Mycobacterial Culture, B | 1 | 87116
TBMP | [NAME] | Mycobacteria Probe Ident Solid ([NAME] Only) | Mycobacteria Probe Ident | 1 | 87150 | No | No
TBPB | [NAME] | Mycobacteria Probe Ident Broth ([NAME] Only) | Mycobacteria Probe Ident Broth | 1 | 87150 | No | No
LCMC | [NAME] | Identification, M.chelonae and M.abscessus,PCR ([NAME] Only) | Id,M.chelonae and M.abcessus,PCR | 1 | 87149 | No | No
RMALM | [NAME] | Id MALDI-TOF Mass Spec AFB (Bill Only) | Id MALDI-TOF Mass Spec AFB | 1 | 87118 | No | No
RTBSP | [NAME] | Identification Mycobacterium tuberculosis Complex Speciation, PCR ([NAME] Only) | Id, Mtb Speciation, PCR | 1 | 87150 | No | No
ISMY | [NAME] | Mycobact Ident by Sequencing ([NAME] Only) | Mycology Ident by Sequencing | 1 | 87153 | No | No
CTBID | Test | Culture Referred for Identification, Mycobacterium | Culture Refer for ID, Mycobacterium | 1 | 0 |  |  | When this test is ordered, the reflex test may be performed and charged.
TBPB | [NAME] | Mycobacteria Probe Ident Broth ([NAME] Only) | Mycobacteria Probe Ident Broth | 1 | 87150 | No | No
RTBSP | [NAME] | Identification Mycobacterium tuberculosis Complex Speciation, PCR ([NAME] Only) | Id, Mtb Speciation, PCR | 1 | 87150 | No | No
ISMY | [NAME] | Mycobact Ident by Sequencing ([NAME] Only) | Mycology Ident by Sequencing | 1 | 87153 | No | No
LCMC | [NAME] | Identification, M.chelonae and M.abscessus,PCR ([NAME] Only) | Id,M.chelonae and M.abcessus,PCR | 1 | 87149 | No | No
RMALM | [NAME] | Id MALDI-TOF Mass Spec AFB (Bill Only) | Id MALDI-TOF Mass Spec AFB | 1 | 87118 | No | No
TBMP | [NAME] | Mycobacteria Probe Ident Solid ([NAME] Only) | Mycobacteria Probe Ident | 1 | 87150 | No | No
CTDC | Test | Connective Tissue Diseases Cascade, Serum | Connective Tissue Disease Cascade,S |  | PROFILE |  |  | If antinuclear antibodies are > or =3.0 U, then antibodies to double-stranded DNA (ds-DNA), extractable nuclear antigen evaluation, ribosome P, and centromere are performed at an additional charge.
ANA2 | Component | Antinuclear Antibodies (ANA), Serum | Antinuclear Ab, S | 1 | 86038 | Yes | Yes
CCP | Component | Cyclic Citrullinated Peptide Antibodies, IgG, Serum | Cyclic Citrullinated Peptide Ab, S | 1 | 86200 | Yes | Yes
IM_01 | Component | Interpretation | Interpretation |  |  | Yes | No
ADNA | [NAME] | DNA Double-Stranded (dsDNA) Antibodies, IgG, Serum | DNA Double-Stranded Ab, IgG, S | 1 | 86225 | No | Yes
CASMT | [NAME] | [NAME] | [NAME] |  |  | No | No
CMA | [NAME] | Centromere Antibodies, IgG, Serum | [NAME], IgG, S | 1 | 83516 | No | Yes
ENAE | [NAME] | Antibody to Extractable Nuclear Antigen Evaluation, Serum | Ab to Extractable Nuclear Ag Eval,S |  | PROFILE | No | Yes
RIB | [NAME] | Ribosome P Antibodies, IgG, Serum | Ribosome P Ab, IgG, S | 1 | 83520 | No | Yes
CYCMS | Test | 21-Hydroxylase Gene (CYP21A2), Full Gene Analysis, Prenatal | CYP21A2 Full Gene Analysis,Prenatal |  | PROFILE |  |  | If amniotic fluid (nonconfluent cultured cells) is received, amniotic fluid culture/genetic test will be added per laboratory protocol and charged separately.
CYCMS | Component |  | MOPATH PROCEDURE LEVEL 6 | 1 | 81405 | No | No
CYCMS | Component |  | MOPATH PROCEDURE LEVEL 3 | 1 | 81402 | No | No
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
DAAMP | Test | Drug of Abuse, Amphetamine Screen with GC-MS Confirmation, [NAME] | Drug of Abuse, Amphetamine, U | 1 | 80101 |  |  | If the amphetamines screen is >499 ng/mL then amphetamines confirmation is performed at an additional charge.
DAUAM | [NAME] | Drug of Abuse, Amphetamines GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME], U | 2 | 82145 | No | Yes
DABAR | Test | Drug of Abuse, Barbiturate Screen with GC-MS Confirmation, [NAME] | Drug of Abuse, Barbiturate, U | 1 | 80101 |  |  | If the barbituate screen is > or =200 ng/mL then barbiturate confirmation is performed at an additional charge.
MSBR | [NAME] | Drug of Abuse, [NAME], [NAME] | Drug of Abuse, Barbiturate Conf, U | 1 | 82205 | No | Yes
DABZO | Test | Drug of Abuse, Benzodiazepine Screen with GC-MS Confirmation, [NAME] | Drug of Abuse, Benzodiazepine, U | 1 | 80101 |  |  | If the benzodiazepine screen is > or =200 ng/mL, then benzodiazepine confirmation is performed at an additional charge.
DAUBZ | [NAME] | Drug of Abuse, Benzodiazepines GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 80154 | No | Yes
DASM4 | Test | Drugs of Abuse Screen, Meconium 4 | Drugs of Abuse Screen, Meconium 4 | 1 | 80104 |  |  | Testing begins with immunoassay screen. Positives are confirmed and quantitated by liquid-chromatography/tandem-mass spectrometry (LC-MS/MS) at an additional charge.
AMPHM | [NAME] | Amphetamine-Type Stimulants, Confirmation, Meconium | Amphetamines, Confirmation, M | 2 | 82145 | No | Yes
COKEM | [NAME] | Cocaine and Metabolites Confirmation, Meconium | Cocaine and [NAME], Confirm, M | 1 | 82520 | No | Yes
OPATM | [NAME] | Opiate Confirmation, Meconium | Opiate Confirmation, M | 1 | 83925 | No | Yes
THCM | [NAME] | 11-nor-Delta-9-Tetrahydrocannabinol-9-Carboxylic Acid (Carboxy-THC), Confirmation, Meconium | Carboxy-THC Confirmation, M | 1 | 80299 | No | Yes
DASM5 | Test | Drugs of Abuse Screen, Meconium 5 | Drugs of Abuse Screen, Meconium 5 | 1 | 80104 |  |  | Testing begins with immunoassay screen. Positives are confirmed and quantitated by liquid-chromatography/tandem-mass spectrometry (LC-MS/MS) at an additional charge.
AMPHM | [NAME] | Amphetamine-Type Stimulants, Confirmation, Meconium | Amphetamines, Confirmation, M | 2 | 82145 | No | Yes
COKEM | [NAME] | Cocaine and Metabolites Confirmation, Meconium | Cocaine and [NAME], Confirm, M | 1 | 82520 | No | Yes
OPATM | [NAME] | Opiate Confirmation, Meconium | Opiate Confirmation, M | 1 | 83925 | No | Yes
PCPMC | [NAME] | Phencyclidine Confirmation, Meconium | PCP Confirmation, Meconium | 1 | 83992 | No | Yes
THCM | [NAME] | 11-nor-Delta-9-Tetrahydrocannabinol-9-Carboxylic Acid (Carboxy-THC), Confirmation, Meconium | Carboxy-THC Confirmation, M | 1 | 80299 | No | Yes
DAU | Test | Drug of Abuse Screen, DAU10, [NAME] | Drugs of Abuse, Clin, DAU10, U | 1 | 80104 |  |  | When this test is ordered, a immunoassay screen for multiple drugs of abuse (qualitative) and ethanol (quantitative) is performed.  If the cocaine screen is >149 ng/mL then cocaine confirmation is performed at an additional charge.   If the THC screen is >49 ng/mL then THC confirmation is performed at an additional charge.   If the opiate screen is >299 ng/mL then opiate confirmation is performed at an additional charge.   If the barbiturate screen is >199 ng/mL then barbiturate confirmation is performed at an additional charge.   If the benzodiazepine screen is >199 ng/mL then benzodiazepine confirmation is performed at an additional charge.   If the phencyclidine screen is >24 ng/mL then phencyclidine confirmation is performed at an additional charge.   If the amphetamines screen is >499 ng/mL then amphetamines confirmation is performed at an additional charge.   If the methadone screen is >299 ng/mL then methadone confirmation is performed at an additional charge.   If the propoxyphene screen is >299 ng/mL then propoxyphene confirmation is performed at an additional charge.
MSTHC | [NAME] | Drug of Abuse, Tetrahydrocannabinol GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 80299 | No | Yes
MSBR | [NAME] | Drug of Abuse, [NAME], [NAME] | Drug of Abuse, Barbiturate Conf, U | 1 | 82205 | No | Yes
DAUAM | [NAME] | Drug of Abuse, Amphetamines GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME], U | 2 | 82145 | No | Yes
DAUBZ | [NAME] | Drug of Abuse, Benzodiazepines GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 80154 | No | Yes
MSOP | [NAME] | Drug of Abuse, Opiates Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 83925 | No | Yes
MSCO | [NAME] | Drug of Abuse, [NAME], [NAME] | Drug of Abuse, [NAME], U | 1 | 82520 | No | Yes
MSPCP | [NAME] | Drug of Abuse, Phencyclidine GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME] | 1 | 83992 | No | Yes
MSMT | [NAME] | Drug of Abuse, Methadone Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 83840 | No | Yes
DAU7 | Test | Drugs of Abuse Screen, DAU7, [NAME] | Drug of Abuse, Clin, DAU7, U | 1 | 80104 |  |  | Testing begins with screening tests for drugs of abuse. Positives are confirmed and quantitated by gas chromatography-mass spectrometry for amphetamines, barbiturates, benzodiazepines, cocaine and metabolites, methadone, opiates, phencyclidine, propoxyphene, and [NAME], at an additional charge.
DAUAM | [NAME] | Drug of Abuse, Amphetamines GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME], U | 2 | 82145 | No | Yes
DAUBZ | [NAME] | Drug of Abuse, Benzodiazepines GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 80154 | No | Yes
MSBR | [NAME] | Drug of Abuse, [NAME], [NAME] | Drug of Abuse, Barbiturate Conf, U | 1 | 82205 | No | Yes
MSCO | [NAME] | Drug of Abuse, [NAME], [NAME] | Drug of Abuse, [NAME], U | 1 | 82520 | No | Yes
MSOP | [NAME] | Drug of Abuse, Opiates Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 83925 | No | Yes
MSPCP | [NAME] | Drug of Abuse, Phencyclidine GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME] | 1 | 83992 | No | Yes
MSTHC | [NAME] | Drug of Abuse, Tetrahydrocannabinol GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 80299 | No | Yes
DAU8 | Test | Drugs of Abuse Screen, DAU8, [NAME] | Drugs of Abuse, Clin, DAU8, U | 7 | 80101 |  |  | Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods, gas chromatography-mass spectrometry for amphetamines, barbiturates, benzodiazepines, cocaine and metabolites, methadone, opiates, phencyclidine, propoxyphene, and [NAME] at an additional charge.
MSOP | [NAME] | Drug of Abuse, Opiates Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 83925 | No | Yes
MSPCP | [NAME] | Drug of Abuse, Phencyclidine GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME] | 1 | 83992 | No | Yes
MSBR | [NAME] | Drug of Abuse, [NAME], [NAME] | Drug of Abuse, Barbiturate Conf, U | 1 | 82205 | No | Yes
DAUAM | [NAME] | Drug of Abuse, Amphetamines GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME], U | 2 | 82145 | No | Yes
MSTHC | [NAME] | Drug of Abuse, Tetrahydrocannabinol GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 80299 | No | Yes
MSCO | [NAME] | Drug of Abuse, [NAME], [NAME] | Drug of Abuse, [NAME], U | 1 | 82520 | No | Yes
DAUBZ | [NAME] | Drug of Abuse, Benzodiazepines GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 80154 | No | Yes
DAU9 | Test | Drugs of Abuse Screen, DAU9, [NAME] | Drug of Abuse, Clin, DAU9, U | 1 | 80104 |  |  | If the cocaine screen is >149 ng/mL then cocaine confirmation is performed at an additional charge.   If the THC screen is >49 ng/mL then THC confirmation is performed at an additional charge.   If the opiate screen is >299 ng/mL then opiate confirmation is performed at an additional charge.   If the barbiturate screen is >199 ng/mL then barbiturate confirmation is performed at an additional charge.   If the benzodiazepine screen is >199 ng/mL then benzodiazepine confirmation is performed at an additional charge.   If the phencyclidine screen is >24 ng/mL then phencyclidine confirmation is performed at an additional charge.   If the amphetamines screen is >499 ng/mL then amphetamines confirmation is performed at an additional charge.   If the methadone screen is >299 ng/mL then methadone confirmation is performed at an additional charge.   If the propoxyphene screen is >299 ng/mL then propoxyphene confirmation is performed at an additional charge.
DAUAM | [NAME] | Drug of Abuse, Amphetamines GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME], U | 2 | 82145 | No | Yes
DAUBZ | [NAME] | Drug of Abuse, Benzodiazepines GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 80154 | No | Yes
MSBR | [NAME] | Drug of Abuse, [NAME], [NAME] | Drug of Abuse, Barbiturate Conf, U | 1 | 82205 | No | Yes
MSCO | [NAME] | Drug of Abuse, [NAME], [NAME] | Drug of Abuse, [NAME], U | 1 | 82520 | No | Yes
MSMT | [NAME] | Drug of Abuse, Methadone Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 83840 | No | Yes
MSOP | [NAME] | Drug of Abuse, Opiates Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 83925 | No | Yes
MSPCP | [NAME] | Drug of Abuse, Phencyclidine GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME] | 1 | 83992 | No | Yes
MSTHC | [NAME] | Drug of Abuse, Tetrahydrocannabinol GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 80299 | No | Yes
DAUCO | Test | Drug of Abuse, Cocaine Screen with GC-MS Confirmation, [NAME] | Drug of Abuse, Cocaine, U | 1 | 80101 |  |  | If the cocaine screen is >149 ng/mL then cocaine confirmation is performed at an additional charge.
MSCO | [NAME] | Drug of Abuse, [NAME], [NAME] | Drug of Abuse, [NAME], U | 1 | 82520 | No | Yes
DEMEC | Test | Dementia, Autoimmune Evaluation, Spinal Fluid | Dementia-Autoimmune Evaluation, CSF |  | PROFILE |  |  | If indirect immunofluorescence assay (IFA) (ANNA-1, ANNA-2, ANNA-3, PCA-2, PCA-Tr, Amphiphysin, CRMP-5-IgG, AGNA-1)) is indeterminate, paraneoplastic autoantibody Western blot is performed at an additional charge.   If client requests or if IFA patterns suggest CRMP-5-IgG, CRMP-5-IgG Western blot is performed at an additional charge.   If IFA patterns suggest amphiphysin antibody, amphiphysin Western blot is performed at an additional charge.   If IFA pattern suggest NMO/AQP4-IgG, NMO/AQP4-IgG CBA is performed at an additional charge.   If IFA pattern suggest AMPA-Receptor antibody and AMPA-Receptor antibody CBA is positive, AMPA-Receptor antibody IF titer assay is performed at an additional charge.   If IFA pattern suggest GABA-B-Receptor antibody and GABA-B-R Receptor Ab antibody is positive, GABA-B-R Receptor Ab antibody IF titer assay is performed at an additional charge.   If IFA pattern suggest NMDA-Receptor antibody and NMDA-Receptor Ab antibody CBA is positive, NMDA-Receptor Ab antibody IF titer assay is performed at an additional charge.   If IFA patterns suggest PCA-1, Purkinje Cell Cytoplasmic antibody Type 1 assay is performed at an additional charge.
ANN3C | Component | Antineuronal Nuclear Antibody-Type 3 (ANNA-3), [NAME] | Anti-Neuronal Nuclear Ab, Type 3 | 1 | 86256 | Yes | No
GABCC | Component | GABA-B-Receptor Antibody by CBA, Spinal Fluid | GABA-B-R Ab CBA, CSF | 1 | 86255 | Yes | No
NMDCC | Component | NMDA-Receptor Antibody by CBA, Spinal Fluid | NMDA-R Ab CBA, CSF | 1 | 86255 | Yes | No
VGKCC | Component | Neuronal Voltage-Gated Potassium Channel-Complex Autoantibody, Spinal Fluid | VGKC-complex Ab IPA, CSF | 1 | 83519 | Yes | No
ANN2C | Component | Antineuronal Nuclear Antibody-Type 2 (ANNA-2), [NAME] | Anti-Neuronal Nuclear Ab, Type 2 | 1 | 86256 | Yes | No
AGN1C | Component | Anti-Glial/Neuronal Nuclear Antibody-Type 1 (AGNA-1), [NAME] | Anti-Glial Nuclear Ab, Type 1 | 1 | 86256 | Yes | No
PCA2C | Component | Purkinje Cell Cytoplasmic Antibody, Type 2 (PCA-2), [NAME] | Purkinje Cell Cytoplasmic Ab Type 2 | 1 | 86256 | Yes | No
PCTRC | Component | Purkinje Cell Cytoplasmic Antibody, Type Tr (PCA-Tr), [NAME] | Purkinje Cell Cytoplasmc Ab Type Tr | 1 | 86256 | Yes | No
CRMC | Component | [NAME] Protein-5 Neuronal (CRMP-5-IgG), [NAME] | CRMP-5-IgG, CSF | 1 | 86256 | Yes | No
AMPHC | Component | Amphiphysin Antibody Assay, Spinal Fluid | [NAME], CSF | 1 | 86256 | Yes | No
ANN1C | Component | Antineuronal Nuclear Antibody-Type 1 (ANNA-1), [NAME] | Anti-Neuronal Nuclear Ab, Type 1 | 1 | 86256 | Yes | No
AMPCC | Component | AMPA-Receptor Antibody by CBA, Spinal Fluid | AMPA-R Ab CBA, CSF | 1 | 86255 | Yes | No
GD65C | Component | Glutamic Acid Decarboxylase (GAD65) Antibody Assay, Spinal Fluid | GAD65 Ab Assay, CSF | 1 | 86341 | Yes | Yes
ADMCI | Component | Dementia, Autoimmune Interpretation, Spinal Fluid | Dementia, Interpretation, CSF |  |  | Yes | No
GABIC | [NAME] | GABA-B-Receptor Antibody Titer Assay by Immunofluorescence, Spinal Fluid | GABA-B-R Ab IF Titer Assay, CSF | 1 | 86256 | No | No
ABLTC | [NAME] | Amphiphysin Antibody Western Blot, [NAME] | Amphiphysin Western Blot, CSF | 1 | 84182 | No | No
PCA1C | [NAME] | Purkinje Cell Cytoplasmic Antibody, Type 1 (PCA-1), [NAME] | Purkinje Cell Cytoplasmic Ab Type 1 | 1 | 86256 | No | No
CRMWC | [NAME] | [NAME] Protein-5-IgG (CRMP-5-IgG) Western Blot, [NAME] | CRMP-5-IgG Western Blot, CSF | 1 | 84182 | No | No
NMDIC | [NAME] | NMDA-Receptor Antibody Titer Assay by Immunofluorescence, Spinal Fluid | NMDA-R Ab IF Titer Assay, CSF | 1 | 86256 | No | No
NMOCC | [NAME] | Neuromyelitis Optica (NMO)/Aquaporin-4-IgG Cell-Binding Assay, CSF | NMO/AQP4-IgG CBA, CSF | 1 | 86255 | No | Yes
AMPIC | [NAME] | AMPA-Receptor Antibody Titer Assay by Immunofluorescence, Spinal Fluid | AMPA-R Ab IF Titer Assay, CSF | 1 | 86256 | No | No
WBNC | [NAME] | [NAME], Western Blot Confirmation, Spinal Fluid | [NAME],CSF | 1 | 84182 | No | No
[NAME] | Test | Dementia, Autoimmune Evaluation, Serum | Dementia Autoimmune Eval, S |  | PROFILE |  |  | If indirect immunofluorescence assay (IFA) (ANNA-1, ANNA-2, ANNA-3, PCA-2, PCA-Tr, Amphiphysin, CRMP-5-IgG, AGNA-1)) is indeterminate, paraneoplastic autoantibody Western blot is performed at an additional charge.   If client requests or if IFA patterns suggest CRMP-5-IgG, CRMP-5-IgG Western blot is performed at an additional charge.   If IFA patterns suggest amphiphysin antibody, amphiphysin Western blot is performed at an additional charge.   If IFA pattern suggest NMO/AQP4-IgG, NMO/AQP4-IgG CBA is performed at an additional charge.   If IFA pattern suggest AMPA-Receptor antibody and AMPA-Receptor antibody CBA is positive, AMPA-Receptor antibody IF titer assay is performed at an additional charge.   If IFA pattern suggest GABA-B-Receptor antibody and GABA-B-R Receptor Ab antibody is positive, GABA-B-R Receptor Ab antibody IF titer assay is performed at an additional charge.   If IFA pattern suggest NMDA-Receptor antibody and NMDA-Receptor Ab antibody CBA is positive, NMDA-Receptor Ab antibody IF titer assay is performed at an additional charge.   If IFA patterns suggest PCA-1, Purkinje Cell Cytoplasmic antibody Type 1 assay is performed at an additional charge.
CRMS | Component | [NAME] Protein-5 Neuronal (CRMP-5-IgG), Serum | CRMP-5-IgG, S | 1 | 86256 | Yes | No
PCAB2 | Component | Purkinje Cell Cytoplasmic Antibody, Type 2 (PCA-2), Serum | Purkinje Cell Cytoplasmic Ab Type 2 | 1 | 86256 | Yes | No
PCATR | Component | Purkinje Cell Cytoplasmic Antibody, Type Tr (PCA-Tr), Serum | Purkinje Cell Cytoplasmic Ab Type Tr | 1 | 86256 | Yes | No
AMPHS | Component | Amphiphysin Antibody Assay, Serum | [NAME], S | 1 | 86256 | Yes | No
CCN | Component | N-Type Calcium Channel Antibody, Serum | N-Type Calcium Channel Ab | 1 | 83519 | Yes | No
ARBI | Component | Acetylcholine Receptor ([NAME]) [NAME], Serum | ACh Receptor ([NAME]) Binding Ab | 1 | 83519 | Yes | Yes
GANG | Component | Ganglionic Acetylcholine Receptor (Alpha3) Autoantibody, Serum | [NAME], S | 1 | 83519 | Yes | No
CCPQ | Component | P/Q-Type Calcium Channel Antibody, Serum | P/Q-Type Calcium Channel Ab | 1 | 83519 | Yes | No
ADMSI | Component | Dementia, Autoimmune Interpretation, Serum | Dementia, Interpretation, S |  |  | Yes | No
NMDCS | Component | NMDA-Receptor Antibody by CBA, Serum | NMDA-R Ab CBA, S | 1 | 86255 | Yes | No
VGKC | Component | Neuronal Voltage-Gated Potassium Channel (VGKC) Autoantibody, Serum | Neuronal (V-G) K+ Channel Ab, S | 1 | 83519 | Yes | No
GD65S | Component | Glutamic Acid Decarboxylase (GAD65) Antibody Assay, Serum | GAD65 Ab Assay, S | 1 | 86341 | Yes | Yes
GABCS | Component | GABA-B-Receptor Antibody by CBA, Serum | GABA-B-R Ab CBA, S | 1 | 86255 | Yes | No
AMPCS | Component | AMPA-Receptor Antibody by CBA, Serum | AMPA-R Ab CBA, S | 1 | 86255 | Yes | No
ANN1S | Component | Antineuronal Nuclear Antibody-Type 1 (ANNA-1), Serum | Anti-Neuronal Nuclear Ab, Type 1 | 1 | 86256 | Yes | No
ANN2S | Component | Antineuronal Nuclear Antibody-Type 2 (ANNA-2), Serum | Anti-Neuronal Nuclear Ab, Type 2 | 1 | 86256 | Yes | No
AGN1S | Component | Anti-Glial/Neuronal Nuclear Antibody-Type 1 (AGNA-1), Serum | Anti-Glial Nuclear Ab, Type 1 | 1 | 86256 | Yes | No
ANN3S | Component | Antineuronal Nuclear Antibody-Type 3 (ANNA-3), Serum | Anti-Neuronal Nuclear Ab, Type 3 | 1 | 86256 | Yes | No
ABLOT | [NAME] | Amphiphysin Antibody Western Blot, Serum | Amphiphysin Western Blot, S | 1 | 84182 | No | No
NMOCS | [NAME] | Neuromyelitis Optica (NMO)/Aquaporin-4-IgG Cell-Binding Assay, Serum | NMO/AQP4-IgG CBA, S | 1 | 86255 | No | Yes
AMPIS | [NAME] | AMPA-Receptor Antibody Titer Assay by Immunofluorescence, Serum | AMPA-R Ab IF Titer Assay, S | 1 | 86256 | No | No
GABIS | [NAME] | GABA-B-Receptor Antibody Titer Assay by Immunofluorescence, Serum | GABA-B-R Ab IF Titer Assay, S | 1 | 86256 | No | No
NMDIS | [NAME] | NMDA-Receptor Antibody Titer Assay by Immunofluorescence, Serum | NMDA-R Ab IF Titer Assay, S | 1 | 86256 | No | No
CRMWS | [NAME] | [NAME] Protein-5-IgG (CRMP-5-IgG) Western Blot, Serum | CRMP-5-IgG Western Blot, S | 1 | 84182 | No | No
PCABP | [NAME] | Purkinje Cell Cytoplasmic Antibody, Type 1 (PCA-1), Serum | Purkinje Cell Cytoplasmic Ab Type 1 | 1 | 86256 | No | No
WBN | [NAME] | [NAME], Western Blot Confirmation, Serum | Paraneoplastic Autoantibody WBlot,S | 1 | 84182 | No | No
[NAME] | Test | Drug of Abuse, Methadone Screen with GC-MS Confirmation, [NAME] | Drug of Abuse, Methadone, U | 1 | 80101 |  |  | If the methadone screen is > or =300 ng/mL then methadone confirmation is performed at an additional charge.
MSMT | [NAME] | Drug of Abuse, Methadone Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 83840 | No | Yes
DPCP | Test | Drug of Abuse, Phencyclidine Screen With GC-MS Confirmation, [NAME] | Drug of Abuse, Phencyclidine, U | 1 | 80101 |  |  | If the phencyclidine screen is 25 ng/mL or greater, then phencyclidine confirmation is performed at an additional charge.
MSPCP | [NAME] | Drug of Abuse, Phencyclidine GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME] | 1 | 83992 | No | Yes
DSM4X | Test | Drugs of Abuse Screen 4, Chain of Custody, Meconium | Drugs of Abuse Screen 4, CoC, M | 1 | 80104 |  |  | Testing begins with immunoassay screen. Positives are confirmed and quantitated by liquid-chromatography/tandem-mass spectrometry (LC-MS/MS) at an additional charge.
THCMX | [NAME] | 11-nor-Delta-9-Tetrahydrocannabinol-9-Carboxylic Acid (Carboxy-THC) Confirmation, Chain of Custody, Meconium | Carboxy-THC Confirmation, CoC, M | 1 | 80299 | No | Yes
[NAME] | [NAME] | Amphetamine-Type Stimulants Confirmation, Chain of Custody, Meconium | Amphetamines Confirmation, CoC, M | 1 | 82145 | No | Yes
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
COKMX | [NAME] | Cocaine and Metabolite Confirmation, Chain of Custody, Meconium | Cocaine and metabolite [NAME], CoC, M | 1 | 82520 | No | Yes
OPTMX | [NAME] | Opiate Confirmation, Chain of Custody, Meconium | Opiate Confirmation, CoC, M | 1 | 83925 | No | Yes
DSM5X | Test | Drugs of Abuse Screen 5, Chain of Custody, Meconium | Drugs of Abuse Screen 5, CoC, M | 1 | 80104 |  |  | Testing begins with immunoassay screen. Positives are confirmed and quantitated by liquid-chromatography/tandem-mass spectrometry (LC-MS/MS) at an additional charge.
[NAME] | [NAME] | Amphetamine-Type Stimulants Confirmation, Chain of Custody, Meconium | Amphetamines Confirmation, CoC, M | 1 | 82145 | No | Yes
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
COKMX | [NAME] | Cocaine and Metabolite Confirmation, Chain of Custody, Meconium | Cocaine and metabolite [NAME], CoC, M | 1 | 82520 | No | Yes
OPTMX | [NAME] | Opiate Confirmation, Chain of Custody, Meconium | Opiate Confirmation, CoC, M | 1 | 83925 | No | Yes
PCPMX | [NAME] | Phencyclidine Confirmation, Chain of Custody, Meconium | Phencyclidine Confirmation, CoC, M | 1 | 83992 | No | Yes
THCMX | [NAME] | 11-nor-Delta-9-Tetrahydrocannabinol-9-Carboxylic Acid (Carboxy-THC) Confirmation, Chain of Custody, Meconium | Carboxy-THC Confirmation, CoC, M | 1 | 80299 | No | Yes
DSSX | Test | Drug Screen, Prescription/OTC, Chain of Custody, Serum | [NAME], Prescription/OTC, CoC, S | 1 | 80100
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
DTHC | Test | Drug of Abuse, Tetrahydrocannabinol Screen with GC-MS Confirmation, [NAME] | Drug of Abuse, THC, U | 1 | 80101 |  |  | If the tetrahydrocannabinol screen is > or =50 ng/mL, then THC confirmation is performed at an additional charge.
MSTHC | [NAME] | Drug of Abuse, Tetrahydrocannabinol GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 80299 | No | Yes
EEEVP | Test | Red Blood Cell (RBC) Enzyme Evaluation | RBC Enzyme Evaluation |  | PROFILE |  |  | This is a consultative evaluation in which the case will be evaluated at Mayo Medical Laboratories, the appropriate tests performed at an additional charge, and the results interpreted.   Note: RBCE / Reflexed RBC Enzymes, Blood includes: adenosine deaminase, adenylate kinase, phosphofructokinase, phosphoglycerate kinase, triosephosphate isomerase, and pyrimidine 5'nucleotidase.
EEEV | Component | Red Blood Cell (RBC) Enzyme Interpretation | Erythrocyte Enzyme Interpretation | 1 | 0 | Yes | No
PK | Component | [NAME], [NAME] | [NAME], RBC | 1 | 84220 | Yes | Yes
HEXK | Component | Hexokinase, Blood | Hexokinase, B | 1 | 82657 | Yes | No
GPI | Component | [NAME], [NAME] | [NAME], B | 1 | 84087 | Yes | Yes
G6PD | Component | Glucose-6-Phosphate Dehydrogenase (G-6-PD), Quantitative, Erythrocytes | G-6-PD, QN, RBC | 1 | 82955 | Yes | Yes
RBCE | [NAME] | Reflexed RBC Enzymes, Blood | Reflexed RBC Enzymes |  | PROFILE | No | No
GLTI | [NAME] | Glutathione, Blood | Glutathione, B | 1 | 82978 | No | No
EGFR | Test | [NAME], 29 Mutation Panel, Tumor | [NAME], Tumor | 1 | 81235 |  |  | When this test is ordered, slide review will always be performed at an additional charge.
SLRVW | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
EGFRX | Test | [NAME], EGFR with [NAME], Tumor | [NAME], EGFR with [NAME] | 1 | 81235 |  |  | When this test is ordered, [NAME], 29 Mutation Panel, Tumor, will always be performed. All specimens without an EGFR mutation will be automatically reflexed for ALK (2p23) FISH testing.   When this test is ordered, SLRVW / Slide Review ([NAME] Only) will always be performed at an additional charge.
FLCA | [NAME] | [NAME], ALK (2p23) Rearrangement, FISH, Tissue | [NAME], ALK (2p23), FISH, Ts |  | PROFILE | No | Yes
SLRVW | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
ENCEC | Test | Encephalopathy, Autoimmune Evaluation, Spinal Fluid | Encephalopathy-Autoimmune Eval, CSF |  | PROFILE |  |  | If indirect immunofluorescence assay (IFA) (ANN1C, ANN2C, ANN3C, [NAME], PCA2C, PCTRC, AMPHC, CRMC) is indeterminate, then WBNC is performed at an additional charge.   If client requests or if IFA patterns suggest CRMP-5-IgG, then CRMWC is performed at an additional charge.   If IFA pattern suggest amphiphysin antibody, then ABLTC is performed at an additional charge.   If IFA pattern suggest NMO/AQP4-IgG, then NMOCC is performed at an additional charge.   If IFA pattern suggest AMPA-R Ab and AMPCC is positive, then AMPIC is performed at an additional charge.   If IFA pattern suggest GABA-B-R Ab and GABCC is positive, then GABIC is performed at an additional charge.   If IFA pattern suggest NMDA-R Ab and NMDCC is positive, then NMDIC is performed at an additional charge.
AMPCC | Component | AMPA-Receptor Antibody by CBA, Spinal Fluid | AMPA-R Ab CBA, CSF | 1 | 86255 | Yes | No
ANN3C | Component | Antineuronal Nuclear Antibody-Type 3 (ANNA-3), [NAME] | Anti-Neuronal Nuclear Ab, Type 3 | 1 | 86256 | Yes | No
NMDCC | Component | NMDA-Receptor Antibody by CBA, Spinal Fluid | NMDA-R Ab CBA, CSF | 1 | 86255 | Yes | No
VGKCC | Component | Neuronal Voltage-Gated Potassium Channel-Complex Autoantibody, Spinal Fluid | VGKC-complex Ab IPA, CSF | 1 | 83519 | Yes | No
AGN1C | Component | Anti-Glial/Neuronal Nuclear Antibody-Type 1 (AGNA-1), [NAME] | Anti-Glial Nuclear Ab, Type 1 | 1 | 86256 | Yes | No
PCA1C | Component | Purkinje Cell Cytoplasmic Antibody, Type 1 (PCA-1), [NAME] | Purkinje Cell Cytoplasmic Ab Type 1 | 1 | 86256 | Yes | No
PCTRC | Component | Purkinje Cell Cytoplasmic Antibody, Type Tr (PCA-Tr), [NAME] | Purkinje Cell Cytoplasmc Ab Type Tr | 1 | 86256 | Yes | No
AMPHC | Component | Amphiphysin Antibody Assay, Spinal Fluid | [NAME], CSF | 1 | 86256 | Yes | No
CRMC | Component | [NAME] Protein-5 Neuronal (CRMP-5-IgG), [NAME] | CRMP-5-IgG, CSF | 1 | 86256 | Yes | No
PCA2C | Component | Purkinje Cell Cytoplasmic Antibody, Type 2 (PCA-2), [NAME] | Purkinje Cell Cytoplasmic Ab Type 2 | 1 | 86256 | Yes | No
ANN2C | Component | Antineuronal Nuclear Antibody-Type 2 (ANNA-2), [NAME] | Anti-Neuronal Nuclear Ab, Type 2 | 1 | 86256 | Yes | No
GD65C | Component | Glutamic Acid Decarboxylase (GAD65) Antibody Assay, Spinal Fluid | GAD65 Ab Assay, CSF | 1 | 86341 | Yes | Yes
GABCC | Component | GABA-B-Receptor Antibody by CBA, Spinal Fluid | GABA-B-R Ab CBA, CSF | 1 | 86255 | Yes | No
ANN1C | Component | Antineuronal Nuclear Antibody-Type 1 (ANNA-1), [NAME] | Anti-Neuronal Nuclear Ab, Type 1 | 1 | 86256 | Yes | No
AEECI | Component | Encephalopathy, Autoimmune Interpretation, Spinal Fluid | Encephalopathy, Interpretation, CSF |  |  | Yes | No
AMPIC | [NAME] | AMPA-Receptor Antibody Titer Assay by Immunofluorescence, Spinal Fluid | AMPA-R Ab IF Titer Assay, CSF | 1 | 86256 | No | No
NMOCC | [NAME] | Neuromyelitis Optica (NMO)/Aquaporin-4-IgG Cell-Binding Assay, CSF | NMO/AQP4-IgG CBA, CSF | 1 | 86255 | No | Yes
NMDIC | [NAME] | NMDA-Receptor Antibody Titer Assay by Immunofluorescence, Spinal Fluid | NMDA-R Ab IF Titer Assay, CSF | 1 | 86256 | No | No
ABLTC | [NAME] | Amphiphysin Antibody Western Blot, [NAME] | Amphiphysin Western Blot, CSF | 1 | 84182 | No | No
WBNC | [NAME] | [NAME], Western Blot Confirmation, Spinal Fluid | [NAME],CSF | 1 | 84182 | No | No
CRMWC | [NAME] | [NAME] Protein-5-IgG (CRMP-5-IgG) Western Blot, [NAME] | CRMP-5-IgG Western Blot, CSF | 1 | 84182 | No | No
GABIC | [NAME] | GABA-B-Receptor Antibody Titer Assay by Immunofluorescence, Spinal Fluid | GABA-B-R Ab IF Titer Assay, CSF | 1 | 86256 | No | No
ENCES | Test | Encephalopathy, Autoimmune Evaluation, Serum | Encephalopathy-Autoimmune Eval, S |  | PROFILE |  |  | If indirect immunofluorescence assay (IFA) suggests ANN1S, ANN2S, ANN3S, PCAB2, PCATR, AMPHS, CRMS, or AGN1S is indeterminate, then paraneoplastic autoantibody Western blot is performed at an additional charge.   If client requests, or if IFA patterns suggests CRMP-5-IgG, then CRMP-5-IgG Western blot is performed at an additional charge.   If IFA patterns suggest amphiphysin antibody, then amphiphysin Western blot is performed at an additional charge.   If IFA pattern suggest NMO/AQP4-IgG, then NMO/AQP4-IgG CBA is performed at an additional charge.   If IFA pattern suggest NMDA-R antibody and NMDA-R antibody CBA is positive, then NMDA-R titer is performed at an additional charge.   If IFA pattern suggest AMPA-R antibody and AMPA-R antibody CBA is positive, then AMPA-R titer is performed at an additional charge.   If IFA pattern suggest GABA-B-R antibody and GABA-B-R antibody CBA is positive, then GABA-B-R titer is performed at an additional charge.
AEESI | Component | Encephalopathy, Autoimmune Interpretation, Serum | Encephalopathy, Interpretation, S |  |  | Yes | No
PCABP | Component | Purkinje Cell Cytoplasmic Antibody, Type 1 (PCA-1), Serum | Purkinje Cell Cytoplasmic Ab Type 1 | 1 | 86256 | Yes | No
NMDCS | Component | NMDA-Receptor Antibody by CBA, Serum | NMDA-R Ab CBA, S | 1 | 86255 | Yes | No
VGKC | Component | Neuronal Voltage-Gated Potassium Channel (VGKC) Autoantibody, Serum | Neuronal (V-G) K+ Channel Ab, S | 1 | 83519 | Yes | No
GD65S | Component | Glutamic Acid Decarboxylase (GAD65) Antibody Assay, Serum | GAD65 Ab Assay, S | 1 | 86341 | Yes | Yes
GABCS | Component | GABA-B-Receptor Antibody by CBA, Serum | GABA-B-R Ab CBA, S | 1 | 86255 | Yes | No
AMPCS | Component | AMPA-Receptor Antibody by CBA, Serum | AMPA-R Ab CBA, S | 1 | 86255 | Yes | No
ANN1S | Component | Antineuronal Nuclear Antibody-Type 1 (ANNA-1), Serum | Anti-Neuronal Nuclear Ab, Type 1 | 1 | 86256 | Yes | No
GANG | Component | Ganglionic Acetylcholine Receptor (Alpha3) Autoantibody, Serum | [NAME], S | 1 | 83519 | Yes | No
CRMS | Component | [NAME] Protein-5 Neuronal (CRMP-5-IgG), Serum | CRMP-5-IgG, S | 1 | 86256 | Yes | No
CCPQ | Component | P/Q-Type Calcium Channel Antibody, Serum | P/Q-Type Calcium Channel Ab | 1 | 83519 | Yes | No
CCN | Component | N-Type Calcium Channel Antibody, Serum | N-Type Calcium Channel Ab | 1 | 83519 | Yes | No
AMPHS | Component | Amphiphysin Antibody Assay, Serum | [NAME], S | 1 | 86256 | Yes | No
ANN3S | Component | Antineuronal Nuclear Antibody-Type 3 (ANNA-3), Serum | Anti-Neuronal Nuclear Ab, Type 3 | 1 | 86256 | Yes | No
AGN1S | Component | Anti-Glial/Neuronal Nuclear Antibody-Type 1 (AGNA-1), Serum | Anti-Glial Nuclear Ab, Type 1 | 1 | 86256 | Yes | No
ANN2S | Component | Antineuronal Nuclear Antibody-Type 2 (ANNA-2), Serum | Anti-Neuronal Nuclear Ab, Type 2 | 1 | 86256 | Yes | No
PCAB2 | Component | Purkinje Cell Cytoplasmic Antibody, Type 2 (PCA-2), Serum | Purkinje Cell Cytoplasmic Ab Type 2 | 1 | 86256 | Yes | No
PCATR | Component | Purkinje Cell Cytoplasmic Antibody, Type Tr (PCA-Tr), Serum | Purkinje Cell Cytoplasmic Ab Type Tr | 1 | 86256 | Yes | No
ARBI | Component | Acetylcholine Receptor ([NAME]) [NAME], Serum | ACh Receptor ([NAME]) Binding Ab | 1 | 83519 | Yes | Yes
WBN | [NAME] | [NAME], Western Blot Confirmation, Serum | Paraneoplastic Autoantibody WBlot,S | 1 | 84182 | No | No
CRMWS | [NAME] | [NAME] Protein-5-IgG (CRMP-5-IgG) Western Blot, Serum | CRMP-5-IgG Western Blot, S | 1 | 84182 | No | No
ABLOT | [NAME] | Amphiphysin Antibody Western Blot, Serum | Amphiphysin Western Blot, S | 1 | 84182 | No | No
GABIS | [NAME] | GABA-B-Receptor Antibody Titer Assay by Immunofluorescence, Serum | GABA-B-R Ab IF Titer Assay, S | 1 | 86256 | No | No
NMOCS | [NAME] | Neuromyelitis Optica (NMO)/Aquaporin-4-IgG Cell-Binding Assay, Serum | NMO/AQP4-IgG CBA, S | 1 | 86255 | No | Yes
AMPIS | [NAME] | AMPA-Receptor Antibody Titer Assay by Immunofluorescence, Serum | AMPA-R Ab IF Titer Assay, S | 1 | 86256 | No | No
NMDIS | [NAME] | NMDA-Receptor Antibody Titer Assay by Immunofluorescence, Serum | NMDA-R Ab IF Titer Assay, S | 1 | 86256 | No | No
ENFD | Test | Epidermal Nerve Fiber Density Consult | Epidermal Nerve Fiber Density |  |  |  |  | When this test is ordered, 1 of the 3 ENFD consult tests will be performed and charged for each biopsied site. Each additional stain will be charged separately.   Note: Special stains performed outside Mayo Medical Laboratories and included with the case may be repeated and charged at the reviewing neuropathologist's discretion. In addition, testing requested by referring physician (immunostains, molecular studies, etc) may not be performed if deemed unnecessary by the Mayo neuropathologist. For all requested consultations, auxiliary testing is ordered at the discretion of the Mayo neuropathologist.
ENFDC | [NAME] | Epidermal Nerve Fiber Density Consult, Tissue | [NAME], Tissue | 1 | 88323 | No | No
MORAN | [NAME] | [NAME] | [NAME] | 1 | 88356 | Yes | No
CRED | [NAME] | Congo Red, Nrv ST | Congo Red, Nrv ST | 1 | 88313 | No | No
PGP95 | [NAME] | PGP 9.5 Immunostain | PGP 9.5 Immunostain | 1 | 88342 | No | No
EROSB | [NAME] | Epidermal Nerve Fiber Density, Review of Outside Slides/Block | ENFD, Review Outside Slides/Block | 1 | 88325 | No | No
EOSPS | [NAME] | Epidermal Nerve Fiber Density, Outside Slides-PGP Stained | ENFD, Outside Slides-PGP Stained | 1 | 88321 | No | No
EPIEC | Test | Epilepsy, Autoimmune Evaluation, Spinal Fluid | Epilepsy-Autoimmune Evaluation, CSF |  | PROFILE |  |  | If indirect immunofluorescence assay (IFA) (ANN1C, ANN2C, ANN3C, PCA2C, PCTRC, AMPHC, CRMC, [NAME]) is indeterminate, then paraneoplastic autoantibody Western blot is performed at an additional charge.   If client requests or if IFA patterns suggest CRMP-5-IgG, then CRMP-5-IgG Western blot is performed at an additional charge.   If IFA patterns suggest amphiphysin antibody, then amphiphysin Western blot is performed at an additional charge.   If IFA pattern suggest NMO/AQP4-IgG, then NMO/AQP4-IgG CBA is performed at an additional charge.   If IFA pattern suggest AMPA-Receptor antibody and AMPA-Receptor antibody CBA is positive, then AMPA-Receptor antibody IF titer assay is performed at an additional charge.   If IFA pattern suggest GABA-B-Receptor antibody and GABA-B-R Receptor Ab antibody is positive, then GABA-B-R Receptor Ab antibody IF titer assay is performed at an additional charge.   If IFA pattern suggest NMDA-Receptor antibody and NMDA-Receptor Ab antibody CBA is positive, then NMDA-Receptor Ab antibody IF titer assay is performed at an additional charge.   If IFA patterns suggest PCA-1, then Purkinje Cell Cytoplasmic antibody Type 1 assay is performed at an additional charge.
NMDCC | Component | NMDA-Receptor Antibody by CBA, Spinal Fluid | NMDA-R Ab CBA, CSF | 1 | 86255 | Yes | No
VGKCC | Component | Neuronal Voltage-Gated Potassium Channel-Complex Autoantibody, Spinal Fluid | VGKC-complex Ab IPA, CSF | 1 | 83519 | Yes | No
GD65C | Component | Glutamic Acid Decarboxylase (GAD65) Antibody Assay, Spinal Fluid | GAD65 Ab Assay, CSF | 1 | 86341 | Yes | Yes
GABCC | Component | GABA-B-Receptor Antibody by CBA, Spinal Fluid | GABA-B-R Ab CBA, CSF | 1 | 86255 | Yes | No
PCTRC | Component | Purkinje Cell Cytoplasmic Antibody, Type Tr (PCA-Tr), [NAME] | Purkinje Cell Cytoplasmc Ab Type Tr | 1 | 86256 | Yes | No
AMPHC | Component | Amphiphysin Antibody Assay, Spinal Fluid | [NAME], CSF | 1 | 86256 | Yes | No
CRMC | Component | [NAME] Protein-5 Neuronal (CRMP-5-IgG), [NAME] | CRMP-5-IgG, CSF | 1 | 86256 | Yes | No
PCA2C | Component | Purkinje Cell Cytoplasmic Antibody, Type 2 (PCA-2), [NAME] | Purkinje Cell Cytoplasmic Ab Type 2 | 1 | 86256 | Yes | No
AEPCI | Component | Epilepsy, Autoimmune Interpretation, Spinal Fluid | Epilepsy, Interpretation, CSF |  |  | Yes | No
AMPCC | Component | AMPA-Receptor Antibody by CBA, Spinal Fluid | AMPA-R Ab CBA, CSF | 1 | 86255 | Yes | No
ANN1C | Component | Antineuronal Nuclear Antibody-Type 1 (ANNA-1), [NAME] | Anti-Neuronal Nuclear Ab, Type 1 | 1 | 86256 | Yes | No
AGN1C | Component | Anti-Glial/Neuronal Nuclear Antibody-Type 1 (AGNA-1), [NAME] | Anti-Glial Nuclear Ab, Type 1 | 1 | 86256 | Yes | No
ANN3C | Component | Antineuronal Nuclear Antibody-Type 3 (ANNA-3), [NAME] | Anti-Neuronal Nuclear Ab, Type 3 | 1 | 86256 | Yes | No
ANN2C | Component | Antineuronal Nuclear Antibody-Type 2 (ANNA-2), [NAME] | Anti-Neuronal Nuclear Ab, Type 2 | 1 | 86256 | Yes | No
WBNC | [NAME] | [NAME], Western Blot Confirmation, Spinal Fluid | [NAME],CSF | 1 | 84182 | No | No
PCA1C | [NAME] | Purkinje Cell Cytoplasmic Antibody, Type 1 (PCA-1), [NAME] | Purkinje Cell Cytoplasmic Ab Type 1 | 1 | 86256 | No | No
GABIC | [NAME] | GABA-B-Receptor Antibody Titer Assay by Immunofluorescence, Spinal Fluid | GABA-B-R Ab IF Titer Assay, CSF | 1 | 86256 | No | No
AMPIC | [NAME] | AMPA-Receptor Antibody Titer Assay by Immunofluorescence, Spinal Fluid | AMPA-R Ab IF Titer Assay, CSF | 1 | 86256 | No | No
CRMWC | [NAME] | [NAME] Protein-5-IgG (CRMP-5-IgG) Western Blot, [NAME] | CRMP-5-IgG Western Blot, CSF | 1 | 84182 | No | No
NMDIC | [NAME] | NMDA-Receptor Antibody Titer Assay by Immunofluorescence, Spinal Fluid | NMDA-R Ab IF Titer Assay, CSF | 1 | 86256 | No | No
ABLTC | [NAME] | Amphiphysin Antibody Western Blot, [NAME] | Amphiphysin Western Blot, CSF | 1 | 84182 | No | No
NMOCC | [NAME] | Neuromyelitis Optica (NMO)/Aquaporin-4-IgG Cell-Binding Assay, CSF | NMO/AQP4-IgG CBA, CSF | 1 | 86255 | No | Yes
EPIES | Test | Epilepsy, Autoimmune Evaluation, Serum | Epilepsy-Autoimmune Evaluation, S |  | PROFILE |  |  | If indirect immunofluorescence assay (IFA) patterns suggest PCA-1, then Purkinje cell cytoplasmic antibody type 1 is performed at an additional charge.   If IFA suggests ANN1S, ANN2S, ANN3S, PCAB2, PCATR, AMPHS, CRMS, AGN1S, or is indeterminate, then paraneoplastic autoantibody Western blot is performed at an additional charge.   If client requests, or if IFA patterns suggest CRMP-5-IgG, then CRMP-5-IgG Western blot is performed at an additional charge.   If IFA patterns suggest amphiphysin antibody, then amphiphysin Western blot is performed at an additional charge.   If IFA pattern suggest NMO/AQP4-IgG, then NMO/AQP4-IgG CBA is performed at an additional charge.   If IFA pattern suggest NMDA-R antibody and NMDA-R antibody CBA is positive, then NMDA-R titer is performed at an additional charge.   If IFA pattern suggest AMPA-R antibody and AMPA-R antibody CBA is positive, then AMPA-R titer is performed at an additional charge.   If IFA pattern suggest GABA-B-R antibody and GABA-B-R antibody CBA is positive, then GABA-B-R titer is performed at an additional charge.
ANN3S | Component | Antineuronal Nuclear Antibody-Type 3 (ANNA-3), Serum | Anti-Neuronal Nuclear Ab, Type 3 | 1 | 86256 | Yes | No
NMDCS | Component | NMDA-Receptor Antibody by CBA, Serum | NMDA-R Ab CBA, S | 1 | 86255 | Yes | No
VGKC | Component | Neuronal Voltage-Gated Potassium Channel (VGKC) Autoantibody, Serum | Neuronal (V-G) K+ Channel Ab, S | 1 | 83519 | Yes | No
GD65S | Component | Glutamic Acid Decarboxylase (GAD65) Antibody Assay, Serum | GAD65 Ab Assay, S | 1 | 86341 | Yes | Yes
GABCS | Component | GABA-B-Receptor Antibody by CBA, Serum | GABA-B-R Ab CBA, S | 1 | 86255 | Yes | No
AMPCS | Component | AMPA-Receptor Antibody by CBA, Serum | AMPA-R Ab CBA, S | 1 | 86255 | Yes | No
ANN1S | Component | Antineuronal Nuclear Antibody-Type 1 (ANNA-1), Serum | Anti-Neuronal Nuclear Ab, Type 1 | 1 | 86256 | Yes | No
ANN2S | Component | Antineuronal Nuclear Antibody-Type 2 (ANNA-2), Serum | Anti-Neuronal Nuclear Ab, Type 2 | 1 | 86256 | Yes | No
AGN1S | Component | Anti-Glial/Neuronal Nuclear Antibody-Type 1 (AGNA-1), Serum | Anti-Glial Nuclear Ab, Type 1 | 1 | 86256 | Yes | No
PCAB2 | Component | Purkinje Cell Cytoplasmic Antibody, Type 2 (PCA-2), Serum | Purkinje Cell Cytoplasmic Ab Type 2 | 1 | 86256 | Yes | No
PCATR | Component | Purkinje Cell Cytoplasmic Antibody, Type Tr (PCA-Tr), Serum | Purkinje Cell Cytoplasmic Ab Type Tr | 1 | 86256 | Yes | No
CCPQ | Component | P/Q-Type Calcium Channel Antibody, Serum | P/Q-Type Calcium Channel Ab | 1 | 83519 | Yes | No
AMPHS | Component | Amphiphysin Antibody Assay, Serum | [NAME], S | 1 | 86256 | Yes | No
CCN | Component | N-Type Calcium Channel Antibody, Serum | N-Type Calcium Channel Ab | 1 | 83519 | Yes | No
ARBI | Component | Acetylcholine Receptor ([NAME]) [NAME], Serum | ACh Receptor ([NAME]) Binding Ab | 1 | 83519 | Yes | Yes
GANG | Component | Ganglionic Acetylcholine Receptor (Alpha3) Autoantibody, Serum | [NAME], S | 1 | 83519 | Yes | No
CRMS | Component | [NAME] Protein-5 Neuronal (CRMP-5-IgG), Serum | CRMP-5-IgG, S | 1 | 86256 | Yes | No
AEPSI | Component | Epilepsy, Autoimmune Interpretation, Serum | Epilepsy, Interpretation, S |  |  | Yes | No
AMPIS | [NAME] | AMPA-Receptor Antibody Titer Assay by Immunofluorescence, Serum | AMPA-R Ab IF Titer Assay, S | 1 | 86256 | No | No
GABIS | [NAME] | GABA-B-Receptor Antibody Titer Assay by Immunofluorescence, Serum | GABA-B-R Ab IF Titer Assay, S | 1 | 86256 | No | No
CRMWS | [NAME] | [NAME] Protein-5-IgG (CRMP-5-IgG) Western Blot, Serum | CRMP-5-IgG Western Blot, S | 1 | 84182 | No | No
NMOCS | [NAME] | Neuromyelitis Optica (NMO)/Aquaporin-4-IgG Cell-Binding Assay, Serum | NMO/AQP4-IgG CBA, S | 1 | 86255 | No | Yes
ABLOT | [NAME] | Amphiphysin Antibody Western Blot, Serum | Amphiphysin Western Blot, S | 1 | 84182 | No | No
PCABP | [NAME] | Purkinje Cell Cytoplasmic Antibody, Type 1 (PCA-1), Serum | Purkinje Cell Cytoplasmic Ab Type 1 | 1 | 86256 | No | No
WBN | [NAME] | [NAME], Western Blot Confirmation, Serum | Paraneoplastic Autoantibody WBlot,S | 1 | 84182 | No | No
NMDIS | [NAME] | NMDA-Receptor Antibody Titer Assay by Immunofluorescence, Serum | NMDA-R Ab IF Titer Assay, S | 1 | 86256 | No | No
EPU | Test | Electrophoresis, Protein, 24 Hour, [NAME] | Electrophoresis, Protein, U |  | PROFILE |  |  | If a discrete electrophoresis band is identified, the laboratory will evaluate the urine protein electrophoresis and, if necessary, perform immunofixation at an additional charge.
PEU | Component | Electrophoresis, Protein, 24 Hour, [NAME] | Protein Electrophoresis, U | 1 | 84166 | Yes | No
PTU | Component | Protein, Total, 24 Hour, [NAME] | Protein, Total, U | 1 | 84156 | Yes | Yes
IFXU | [NAME] | Immunofixation, 24 Hour, [NAME] | Immunofixation, U | 1 | 86335 | No | No
F10IS | Test | Coagulation Factor X Inhibitor Screen, Plasma | Coag Factor X Inhibitor Scrn, P |  | PROFILE |  |  | If appropriate, a Bethesda titer will be performed at an additional charge to quantify the inhibitor.
10_IS | Component | Factor X Inhibitor Screen | Factor X Inhib Scrn | 1 | 85335 | Yes | No
F_10 | Component | Coagulation Factor X Activity Assay, Plasma | Coag Factor X Assay, P | 1 | 85260 | Yes | Yes
IBETH | [NAME] | Bethesda Units | Bethesda Units | 1 | 85335 | No | No
F11IS | Test | Coagulation Factor XI Inhibitor Screen, Plasma | Coag Factor XI Inhibitor Scrn, P |  | PROFILE |  |  | If appropriate, a Bethesda titer will be performed at an additional charge to quantify the inhibitor.
F_11 | Component | Coagulation Factor XI Activity Assay, Plasma | Coag Factor XI Assay, P | 1 | 85270 | Yes | Yes
11_IS | Component | Factor XI Inhibitor Screen | Factor [NAME] Scrn | 1 | 85335 | Yes | No
IBETH | [NAME] | Bethesda Units | Bethesda Units | 1 | 85335 | No | No
F2IS | Test | Coagulation Factor II Inhibitor Screen, Plasma | Coag Factor II Inhibitor Scrn, P |  | PROFILE |  |  | If appropriate, a Bethesda titer will be performed at an additional charge to quantify the inhibitor.
F2_IS | Component | Factor II Inhibitor Screen | Factor II Inhib Scrn | 1 | 85335 | Yes | No
F_2 | Component | Coagulation Factor II Activity Assay, Plasma | Coag Factor II Assay, P | 1 | 85210 | Yes | Yes
IBETH | [NAME] | Bethesda Units | Bethesda Units | 1 | 85335 | No | No
F2ISO | Test | F2-Isoprostanes, [NAME] | F2-Isoprostanes, U | 1 | 83789 |  |  | When F2-Isoprostanes testing is performed, urine creatinine will always be performed at no additional charge.
AACT | [NAME] | Creatinine, [NAME] | Creatinine, U |  |  | Yes | No
F5IS | Test | Coagulation Factor V Inhibitor Screen, Plasma | Coag Factor V Inhibitor Scrn, P |  | PROFILE |  |  | If appropriate, a Bethesda titer will be performed at an additional charge to quantify the inhibitor.
FACTV | Component | Coagulation Factor V Activity Assay, Plasma | Coag Factor V Assay, P | 1 | 85220 | Yes | Yes
F5_IS | Component | Factor V Inhibitor Screen | Factor V Inhib Scrn | 1 | 85335 | Yes | No
IBETH | [NAME] | Bethesda Units | Bethesda Units | 1 | 85335 | No | No
F7IS | Test | Coagulation Factor VII Inhibitor Screen, Plasma | Coag Factor VII Inhibitor Scrn, P |  | PROFILE |  |  | If appropriate, a Bethesda titer will be performed at an additional charge to quantify the inhibitor.
F_7 | Component | Coagulation Factor VII Activity Assay, Plasma | Coag Factor VII Assay, P | 1 | 85230 | Yes | Yes
F7_IS | Component | Factor VII Inhibitor Screen | Factor [NAME] | 1 | 85335 | Yes | No
IBETH | [NAME] | Bethesda Units | Bethesda Units | 1 | 85335 | No | No
F81B | Test | Hemophilia A F8 Gene, Intron 1 Inversion Known Mutation, [NAME] | HA F8 Intron 1 Inversion KM, B | 1 | 81403 |  |  | Maternal cell contamination testing will be performed for all cord blood specimens. A maternal whole blood sample is required to perform this test.
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
F81P | Test | Hemophilia A F8 Gene, Intron 1 Inversion Known Mutation Analysis, [NAME] or Chorionic Villus Sampling | HA F8 Intron 1 Inversion, AF or CVS | 1 | 81403 |  |  | If amniotic fluid is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added. A maternal whole blood sample is required to perform this test.
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
F822B | Test | Hemophilia A F8 Gene, Intron 22 Inversion Known Mutation, [NAME] | HA F8 Intron 22 Inversion KM, B | 1 | 81403 |  |  | Maternal cell contamination testing will be performed for all cord blood specimens. A maternal whole blood sample is required to perform this test.
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
F822P | Test | Hemophilia A F8 Gene, Intron 22 Inversion Mutation Analysis, [NAME] or Chorionic Villus Sampling | HA F8 Int22 Inversion KM, AF or CVS | 1 | 81403 |  |  | If amniotic fluid is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added. A maternal whole blood sample is required to perform this test.
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
F8INH | Test | Factor VIII Inhibitor Evaluation | Factor 8 Inhib Prof | 1 | 85240 |  |  | Testing begins with coagulation factor VIII activity assay with dilutions to evaluate assay inhibition; if the factor VIII activity assay is decreased, an inhibitor screen will be performed to look for specific factor VIII inhibition. If specific inhibition is apparent, the titer of the inhibitor will be determined.
F8A | Component | Coagulation Factor VIII Activity Assay, Plasma | Coag Factor VIII Activity Assay, P | 1 | 85240 | Yes | Yes
CCCR | [NAME] | Special Coagulation Interpretation | Special Coagulation Interpretation | 1 | 85390 | No | No
IBETH | [NAME] | Bethesda Units | Bethesda Units | 1 | 85335 | No | No
F8IS | [NAME] | Coagulation Factor VIII Inhibitor Screen, Plasma | Coag Factor VIII Assay [NAME],P | 1 | 85335 | No | No
F8INP | Test | Hemophilia A F8 Gene, Intron 1 and 22 Inversion Mutation Analysis, [NAME] or Chorionic Villus Sampling | HA F8 Int 1/22 Inversion, AF or CVS | 1 | 81403 |  |  | If amniotic fluid is received, amniotic fluid culture for genetic testing will be added and charged separately. If chorionic villus specimen is received, fibroblast culture for genetic testing will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added. A maternal whole blood sample is required to perform this test.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
F8INV | Test | Hemophilia A F8 Gene, Intron 1 and 22 Inversion Mutation Analysis, [NAME] | HA F8 Intron 1/22 Inversion, B | 1 | 81403 |  |  | Maternal cell contamination testing will be performed for all cord blood specimens. A maternal whole blood sample is required to perform this test.
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
F9INH | Test | Factor IX Inhibitor Evaluation | Factor IX Inhib Profile | 1 | 85250 |  |  | Testing begins with coagulation factor IX activity assay with dilutions to evaluate assay inhibition; if the factor IX activity assay is decreased, an inhibitor will be performed to look for specific factor IX inhibition. If specific inhibition is apparent, it will be titered.
F_9 | Component | Coagulation Factor IX Activity Assay, Plasma | Coag Factor IX Assay, P | 1 | 85250 | Yes | Yes
CCCR | [NAME] | Special Coagulation Interpretation | Special Coagulation Interpretation | 1 | 85390 | No | No
IBETH | [NAME] | Bethesda Units | Bethesda Units | 1 | 85335 | No | No
F9_IS | [NAME] | Factor IX Inhibitor Screen | Factor IX Inhib Scrn | 1 | 85335 | No | No
FABI | Test | Alcohol Biomarkers, [NAME] | Alcohol Biomarkers | 1 | 80101 |  |  | If the Ethyl Glucuronide is positive, then FABIC "Alcohol Biomarkers Confirmation" will be performed at no additional charge.
FABIC | [NAME] | Alcohol Biomarkers Confirmation | Alcohol Biomarkers Confirmation | 1 | 82542 | No | No
FABKM | Test | [NAME], Known Mutation | [NAME] | 1 | 81403 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
FAML | Test | Acute [NAME] (AML), FISH | AML, FISH |  | PROFILE |  |  | See Acute Promyelocytic Leukemia: Guideline to Diagnosis and Follow-up in Special Instructions.
18FP | [NAME] | Eighteen Additional FISH Probes ([NAME] Only) | Eighteen Additional FISH Probes |  | PROFILE | No | No
ADD6F | [NAME] | Six Additional FISH Probes ([NAME] Only) | Six Additional FISH Probes |  | PROFILE | No | No
14FP | [NAME] | Fourteen Additional FISH Probes ([NAME] Only) | Fourteen Additional FISH Probes |  | PROFILE | No | No
30FP | [NAME] | Thirty Additional FISH Probes ([NAME] Only) | Thirty Additional FISH Probes |  | PROFILE | No | No
23FP | [NAME] | Twenty Three Additional FISH Probes ([NAME] Only) | Twenty Three Additional FISH Probes |  | PROFILE | No | No
24FP | [NAME] | Twenty Four Additional FISH Probes ([NAME] Only) | Twenty Four Additional FISH Probes |  | PROFILE | No | No
17FP | [NAME] | Seventeen Additional FISH Probes ([NAME] Only) | Seventeen Additional FISH Probes |  | PROFILE | No | No
ADD11 | [NAME] | Eleven Additional FISH Probes ([NAME] Only) | Eleven Additional FISH Probes |  | PROFILE | No | No
ADD5F | [NAME] | Five Additional FISH Probes ([NAME] Only) | Five Additional FISH Probes |  | PROFILE | No | No
27FP | [NAME] | Twenty Seven Additional FISH Probes ([NAME] Only) | Twenty Seven Additional FISH Probes |  | PROFILE | No | No
16FP | [NAME] | Sixteen Additional FISH Probes ([NAME] Only) | Sixteen Additional FISH Probes |  | PROFILE | No | No
ADD7F | [NAME] | Seven Additional FISH Probes ([NAME] Only) | Seven Additional FISH Probes |  | PROFILE | No | No
ADD4F | [NAME] | Four Additional FISH Probes ([NAME] Only) | Four Additional FISH Probes |  | PROFILE | No | No
13FP | [NAME] | Thirteen Additional FISH Probes ([NAME] Only) | Thirteen Additional FISH Probes |  | PROFILE | No | No
ADD8F | [NAME] | Eight Additional FISH Probes ([NAME] Only) | Eight Additional FISH Probes |  | PROFILE | No | No
20FP | [NAME] | Twenty Additional FISH Probes ([NAME] Only) | Twenty Additional FISH Probes |  | PROFILE | No | No
ADD12 | [NAME] | Twelve Additional FISH Probes ([NAME] Only) | Twelve Additional FISH Probes |  | PROFILE | No | No
ADD9F | [NAME] | Nine Additional FISH Probes ([NAME] Only) | Nine Additional FISH Probes |  | PROFILE | No | No
19FP | [NAME] | Nineteen Additional FISH Probes ([NAME] Only) | Nineteen Additional FISH Probes |  | PROFILE | No | No
21FP | [NAME] | Twenty One Additional FISH Probes ([NAME] Only) | Twenty One Additional FISH Probes |  | PROFILE | No | No
ADD10 | [NAME] | Ten Additional FISH Probes ([NAME] Only) | Ten Additional FISH Probes |  | PROFILE | No | No
ADD3F | [NAME] | Three Additional FISH Probes ([NAME] Only) | Three Additional FISH Probes |  | PROFILE | No | No
ADD1F | [NAME] | One Additional FISH Probe ([NAME] Only) | One Additional FISH Probe |  | PROFILE | No | No
29FP | [NAME] | Twenty Nine Additional FISH Probes ([NAME] Only) | Twenty Nine Additional FISH Probes |  | PROFILE | No | No
26FP | [NAME] | Twenty Six Additional FISH Probes ([NAME] Only) | Twenty Six Additional FISH Probes |  | PROFILE | No | No
15FP | [NAME] | Fifteen Additional FISH Probes ([NAME] Only) | Fifteen Additional FISH Probes |  | PROFILE | No | No
25FP | [NAME] | Twenty Five Additional FISH Probes ([NAME] Only) | Twenty Five Additional FISH Probes |  | PROFILE | No | No
ADD2F | [NAME] | Two Additional FISH Probes ([NAME] Only) | Two Additional FISH Probes |  | PROFILE | No | No
28FP | [NAME] | Twenty Eight Additional FISH Probes ([NAME] Only) | Twenty Eight Additional FISH Probes |  | PROFILE | No | No
22FP | [NAME] | Twenty Two Additional FISH Probes ([NAME] Only) | Twenty Two Additional FISH Probes |  | PROFILE | No | No
FANCA | Test | Fanconi Anemia C Mutation Analysis, IVS4(+4)A->T and 322delG | [NAME], Mutation Analysis | 1 | 81242 |  |  | For prenatal specimens only: If amniotic fluid (nonconfluent cultured cells) is received, amniotic fluid culture will be added and charged separately. If chorionic villus specimen (nonconfluent cultured cells) is received, fibroblast culture will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
FAO | Test | Fatty Acid Oxidation Probe Assay, Fibroblast Culture | Fatty Acid Ox Probe Assay, Fibro | 1 | 82017 |  |  | When this test is ordered, a fibroblast culture and cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple assays on a patient utilizing fibroblast culture, only 1 culture is required regardless of the number of assays ordered. If viable cells are not obtained within 10 days, client will be notified.
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
FIBR | [NAME] | Fibroblast Culture | Fibroblast Culture | 1 | 88233 | Yes | Yes
FBALL | Test | B-Cell Acute Lymphoblastic Leukemia (ALL), FISH | ALL (B-Cell), FISH |  | PROFILE |  |  | We recommend the following testing algorithm for patients with B-Cell Acute Lymphoblastic Leukemia (B-ALL):   -At diagnosis, conventional cytogenetic studies (BM / Chromosome Analysis, [NAME], Bone Marrow) and a complete B-ALL FISH panel should be performed.   -At follow-up, conventional cytogenetic studies (BM / Chromosome Analysis, [NAME], Bone Marrow) and targeted B-ALL FISH probes based on the abnormalities identified in the diagnostic study can be evaluated.   -If the patient clinically relapses, a conventional chromosome study is useful to identify cytogenetic changes in the neoplastic clone or the possible emergence of a new therapy-related myeloid clone.
13FP | [NAME] | Thirteen Additional FISH Probes ([NAME] Only) | Thirteen Additional FISH Probes |  | PROFILE | No | No
14FP | [NAME] | Fourteen Additional FISH Probes ([NAME] Only) | Fourteen Additional FISH Probes |  | PROFILE | No | No
15FP | [NAME] | Fifteen Additional FISH Probes ([NAME] Only) | Fifteen Additional FISH Probes |  | PROFILE | No | No
16FP | [NAME] | Sixteen Additional FISH Probes ([NAME] Only) | Sixteen Additional FISH Probes |  | PROFILE | No | No
17FP | [NAME] | Seventeen Additional FISH Probes ([NAME] Only) | Seventeen Additional FISH Probes |  | PROFILE | No | No
18FP | [NAME] | Eighteen Additional FISH Probes ([NAME] Only) | Eighteen Additional FISH Probes |  | PROFILE | No | No
19FP | [NAME] | Nineteen Additional FISH Probes ([NAME] Only) | Nineteen Additional FISH Probes |  | PROFILE | No | No
20FP | [NAME] | Twenty Additional FISH Probes ([NAME] Only) | Twenty Additional FISH Probes |  | PROFILE | No | No
21FP | [NAME] | Twenty One Additional FISH Probes ([NAME] Only) | Twenty One Additional FISH Probes |  | PROFILE | No | No
22FP | [NAME] | Twenty Two Additional FISH Probes ([NAME] Only) | Twenty Two Additional FISH Probes |  | PROFILE | No | No
23FP | [NAME] | Twenty Three Additional FISH Probes ([NAME] Only) | Twenty Three Additional FISH Probes |  | PROFILE | No | No
24FP | [NAME] | Twenty Four Additional FISH Probes ([NAME] Only) | Twenty Four Additional FISH Probes |  | PROFILE | No | No
25FP | [NAME] | Twenty Five Additional FISH Probes ([NAME] Only) | Twenty Five Additional FISH Probes |  | PROFILE | No | No
26FP | [NAME] | Twenty Six Additional FISH Probes ([NAME] Only) | Twenty Six Additional FISH Probes |  | PROFILE | No | No
27FP | [NAME] | Twenty Seven Additional FISH Probes ([NAME] Only) | Twenty Seven Additional FISH Probes |  | PROFILE | No | No
28FP | [NAME] | Twenty Eight Additional FISH Probes ([NAME] Only) | Twenty Eight Additional FISH Probes |  | PROFILE | No | No
29FP | [NAME] | Twenty Nine Additional FISH Probes ([NAME] Only) | Twenty Nine Additional FISH Probes |  | PROFILE | No | No
30FP | [NAME] | Thirty Additional FISH Probes ([NAME] Only) | Thirty Additional FISH Probes |  | PROFILE | No | No
ADD10 | [NAME] | Ten Additional FISH Probes ([NAME] Only) | Ten Additional FISH Probes |  | PROFILE | No | No
ADD11 | [NAME] | Eleven Additional FISH Probes ([NAME] Only) | Eleven Additional FISH Probes |  | PROFILE | No | No
ADD12 | [NAME] | Twelve Additional FISH Probes ([NAME] Only) | Twelve Additional FISH Probes |  | PROFILE | No | No
ADD1F | [NAME] | One Additional FISH Probe ([NAME] Only) | One Additional FISH Probe |  | PROFILE | No | No
ADD2F | [NAME] | Two Additional FISH Probes ([NAME] Only) | Two Additional FISH Probes |  | PROFILE | No | No
ADD3F | [NAME] | Three Additional FISH Probes ([NAME] Only) | Three Additional FISH Probes |  | PROFILE | No | No
ADD4F | [NAME] | Four Additional FISH Probes ([NAME] Only) | Four Additional FISH Probes |  | PROFILE | No | No
ADD5F | [NAME] | Five Additional FISH Probes ([NAME] Only) | Five Additional FISH Probes |  | PROFILE | No | No
ADD6F | [NAME] | Six Additional FISH Probes ([NAME] Only) | Six Additional FISH Probes |  | PROFILE | No | No
ADD7F | [NAME] | Seven Additional FISH Probes ([NAME] Only) | Seven Additional FISH Probes |  | PROFILE | No | No
ADD8F | [NAME] | Eight Additional FISH Probes ([NAME] Only) | Eight Additional FISH Probes |  | PROFILE | No | No
ADD9F | [NAME] | Nine Additional FISH Probes ([NAME] Only) | Nine Additional FISH Probes |  | PROFILE | No | No
FBL | Test | Fungal Culture, Blood | Fungal Culture, Blood |  | PROFILE |  |  | When this test is ordered, the reflex test may be performed and charged.
FBL | Component |  | Blood | 1 | 87103 | No | No
FBL | Component |  | Concentration | 1 | 87015 | No | No
[NAME] | [NAME] | Yeast Ident Panel B ([NAME] Only) | Yeast Ident panel B | 1 | 87106 | No | No
RMALY | [NAME] | Id MALDI-TOF Mass Spec Yeast ([NAME] Only) | Id MALDI-TOF Mass Spec Yeast | 1 | 87106 | No | No
RRU | [NAME] | Yeast Ident Panel D (Bill Only) | Yeast Ident Panel D | 1 | 87106 | No | No
API | [NAME] | Yeast Ident Panel C | Yeast Ident Panel C | 1 | 87106 | No | No
CNP | [NAME] | [NAME], Fungus Indent | Microbial Probe Fungus Ident | 1 | 87150 | No | No
RMALF | [NAME] | ID MALDI-TOF Mass Spec Fungi ([NAME] Only) | Id MALDI-TOF Mass Spec Fungi | 1 | 87107 | No | No
D2F | [NAME] | Fungal Sequencing Identification | D2 Fungal Sequencing Identification | 1 | 87153 | No | No
[NAME] | [NAME] | Id, Histoplasma/Blastomyces PCR ([NAME] Only) | Id, Histoplasma/Blastomyces PCR | 2 | 87150 | No | No
LCCI | [NAME] | Ident Rapid PCR Coccidioides ([NAME] Only) | Ident Rapid [NAME] | 1 | 87150 | No | No
GT | [NAME] | Yeast Ident Panel A (Bill Only) | Yeast Ident Panel A | 1 | 87106 | No | No
FUNB | [NAME] | Fungal Ident Panel B ([NAME] Only) | Fungal Ident Panel B | 1 | 87107 | No | No
FUNA | [NAME] | Fungal Ident Panel A (Bill Only) | Fungal Ident Panel A | 1 | 87107 | No | No
FBLP | Test | B-Cell Lymphoma, FISH, Blood or Bone Marrow | B-Cell Lymphoma, FISH, B/BM |  | PROFILE |  |  | The number of probes ordered will determine the price of the testing. When this test is ordered, a charge for 2 FISH probes and interpretation is included. If additional probes or the entire panel are ordered, additional probes charges will be added.
ADD8F | [NAME] | Eight Additional FISH Probes ([NAME] Only) | Eight Additional FISH Probes |  | PROFILE | No | No
ADD7F | [NAME] | Seven Additional FISH Probes ([NAME] Only) | Seven Additional FISH Probes |  | PROFILE | No | No
23FP | [NAME] | Twenty Three Additional FISH Probes ([NAME] Only) | Twenty Three Additional FISH Probes |  | PROFILE | No | No
ADD11 | [NAME] | Eleven Additional FISH Probes ([NAME] Only) | Eleven Additional FISH Probes |  | PROFILE | No | No
25FP | [NAME] | Twenty Five Additional FISH Probes ([NAME] Only) | Twenty Five Additional FISH Probes |  | PROFILE | No | No
ADD6F | [NAME] | Six Additional FISH Probes ([NAME] Only) | Six Additional FISH Probes |  | PROFILE | No | No
ADD1F | [NAME] | One Additional FISH Probe ([NAME] Only) | One Additional FISH Probe |  | PROFILE | No | No
ADD9F | [NAME] | Nine Additional FISH Probes ([NAME] Only) | Nine Additional FISH Probes |  | PROFILE | No | No
19FP | [NAME] | Nineteen Additional FISH Probes ([NAME] Only) | Nineteen Additional FISH Probes |  | PROFILE | No | No
14FP | [NAME] | Fourteen Additional FISH Probes ([NAME] Only) | Fourteen Additional FISH Probes |  | PROFILE | No | No
24FP | [NAME] | Twenty Four Additional FISH Probes ([NAME] Only) | Twenty Four Additional FISH Probes |  | PROFILE | No | No
28FP | [NAME] | Twenty Eight Additional FISH Probes ([NAME] Only) | Twenty Eight Additional FISH Probes |  | PROFILE | No | No
ADD10 | [NAME] | Ten Additional FISH Probes ([NAME] Only) | Ten Additional FISH Probes |  | PROFILE | No | No
15FP | [NAME] | Fifteen Additional FISH Probes ([NAME] Only) | Fifteen Additional FISH Probes |  | PROFILE | No | No
29FP | [NAME] | Twenty Nine Additional FISH Probes ([NAME] Only) | Twenty Nine Additional FISH Probes |  | PROFILE | No | No
26FP | [NAME] | Twenty Six Additional FISH Probes ([NAME] Only) | Twenty Six Additional FISH Probes |  | PROFILE | No | No
21FP | [NAME] | Twenty One Additional FISH Probes ([NAME] Only) | Twenty One Additional FISH Probes |  | PROFILE | No | No
ADD12 | [NAME] | Twelve Additional FISH Probes ([NAME] Only) | Twelve Additional FISH Probes |  | PROFILE | No | No
13FP | [NAME] | Thirteen Additional FISH Probes ([NAME] Only) | Thirteen Additional FISH Probes |  | PROFILE | No | No
ADD3F | [NAME] | Three Additional FISH Probes ([NAME] Only) | Three Additional FISH Probes |  | PROFILE | No | No
16FP | [NAME] | Sixteen Additional FISH Probes ([NAME] Only) | Sixteen Additional FISH Probes |  | PROFILE | No | No
27FP | [NAME] | Twenty Seven Additional FISH Probes ([NAME] Only) | Twenty Seven Additional FISH Probes |  | PROFILE | No | No
20FP | [NAME] | Twenty Additional FISH Probes ([NAME] Only) | Twenty Additional FISH Probes |  | PROFILE | No | No
22FP | [NAME] | Twenty Two Additional FISH Probes ([NAME] Only) | Twenty Two Additional FISH Probes |  | PROFILE | No | No
ADD5F | [NAME] | Five Additional FISH Probes ([NAME] Only) | Five Additional FISH Probes |  | PROFILE | No | No
18FP | [NAME] | Eighteen Additional FISH Probes ([NAME] Only) | Eighteen Additional FISH Probes |  | PROFILE | No | No
ADD4F | [NAME] | Four Additional FISH Probes ([NAME] Only) | Four Additional FISH Probes |  | PROFILE | No | No
ADD2F | [NAME] | Two Additional FISH Probes ([NAME] Only) | Two Additional FISH Probes |  | PROFILE | No | No
30FP | [NAME] | Thirty Additional FISH Probes ([NAME] Only) | Thirty Additional FISH Probes |  | PROFILE | No | No
17FP | [NAME] | Seventeen Additional FISH Probes ([NAME] Only) | Seventeen Additional FISH Probes |  | PROFILE | No | No
FBORE | Test | Bordetella pertussis Antibodies, IgG and IgM by ELISA with Reflex to Immunoblot | B. pertussis Abs, IgG, IgM w/Reflex | 2 | 86615 |  |  | If Bordetella pertussis Antibody, IgG by ELISA is 1.0 U/mL or greater, then B. pertussis [NAME], IgG Immunoblot testing will be performed at an additional charge.   If Bordetella pertussis Antibody IgM by ELISA is 1.2 U/mL or greater, then B. pertussis Ab, IgM Immunoblot testing will be performed at an additional charge.
FBAMI | [NAME] | Bordetella pertussis Antibody, IgM by Immunoblot | B. pertussis Ab, IgM Immunoblot | 1 | 86615 | No | No
FBAGI | [NAME] | Bordetella pertussis Antibody, IgG by Immunoblot | B. pertussis [NAME], IgG Immunoblot | 1 | 86615 | No | No
FBPTS | Test | Bordetella pertussis Antibodies, IgA, IgG and IgM by ELISA with Reflex to Immunoblot | B. pertussis [NAME], M, A w/Reflex | 3 | 86615 |  |  | If Bordetella pertussis Antibody, IgA by ELISA is 1.2 U/mL or greater, then B. pertussis Ab, IgA Immunoblot testing will be performed at an additional charge.   If Bordetella pertussis Antibody, IgG by ELISA is 1.0 U/mL or greater, then B. pertussis [NAME], IgG Immunoblot testing will be performed at an additional charge.   If Bordetella pertussis Antibody, IgM by ELISA is 1.2 U/mL or greater, then B. pertussis Ab, IgM Immunoblot testing will be performed at an additional charge.
FBAGI | [NAME] | Bordetella pertussis Antibody, IgG by Immunoblot | B. pertussis [NAME], IgG Immunoblot | 1 | 86615 | No | No
FBAMI | [NAME] | Bordetella pertussis Antibody, IgM by Immunoblot | B. pertussis Ab, IgM Immunoblot | 1 | 86615 | No | No
FBAAI | [NAME] | Bordetella pertussis Antibody, IgA by Immunoblot | B. pertussis Ab, IgA Immunoblot | 1 | 86615 | No | No
FCABL | Test | Cocaine Analysis-Whole Blood | Cocaine Analysis-Whole Blood | 1 | 80101 |  |  | If the Cocaine Analysis, whole blood is positive, then the Cocaine, Confirmation (FCOCO) will be performed at no additional charge.
FCOCO | [NAME] | Cocaine, GC/MS Confirmation | Cocaine, Confirmation | 1 | 82542 | No | No
FCART | Test | Chikungunya Antibodies with Reflex(es) to [NAME] | [NAME] w/Reflex to [NAME] | 2 | 86790 |  |  | If Z4120 "Chikungunya IgG Screen" is positive, then FCGT "Chikungunya IgG Titration" will be performed at an additional charge.
FCMT | [NAME] | Chikungunya IgM Titration | Chikungunya IgM Titration | 1 | 86790 | No | No
FCGT | [NAME] | Chikungunya IgG Titration | Chikungunya IgG Titration | 1 | 86790 | No | No
FCAWB | Test | Cannabinoid Analysis, [NAME] | Cannabinoid Analysis, [NAME] | 1 | 80101 |  |  | If the Cannabinoid Analysis, [NAME] is positive, then the THC, GC/MS Confirmation (FFTCB) will be performed at no additional charge.
FFTCB | [NAME] | THC, GC/MS Confirmation | THC, GC/MS Confirmation | 1 | 82542 | No | No
FCGHP | Test | [NAME] (aCGH) Parental Testing, FISH | aCGH Parental Testing, FISH |  | PROFILE |  |  | When this test is ordered, 1 to 4 FISH probes will be added at an additional charge.
FCGHP | Component |  | DNA probe, each | 2 | 88271 | No | No
FCGHP | Component |  | Chromosomal in situ hybridization | 1 | 88273 | No | No
FCGHP | Component |  | Interpretation and Report | 1 | 88291 | No | No
ADD1F | [NAME] | One Additional FISH Probe ([NAME] Only) | One Additional FISH Probe |  | PROFILE | No | No
ADD2F | [NAME] | Two Additional FISH Probes ([NAME] Only) | Two Additional FISH Probes |  | PROFILE | No | No
ADD3F | [NAME] | Three Additional FISH Probes ([NAME] Only) | Three Additional FISH Probes |  | PROFILE | No | No
ADD4F | [NAME] | Four Additional FISH Probes ([NAME] Only) | Four Additional FISH Probes |  | PROFILE | No | No
FCLL | Test | Chronic Lymphocytic Leukemia (CLL), FISH | CLL, FISH |  | PROFILE |  |  | When this test is ordered, a charge for 2 FISH probes and interpretation is included. If additional probes or the entire panel are ordered, additional probe charges will be added.
13FP | [NAME] | Thirteen Additional FISH Probes ([NAME] Only) | Thirteen Additional FISH Probes |  | PROFILE | No | No
14FP | [NAME] | Fourteen Additional FISH Probes ([NAME] Only) | Fourteen Additional FISH Probes |  | PROFILE | No | No
15FP | [NAME] | Fifteen Additional FISH Probes ([NAME] Only) | Fifteen Additional FISH Probes |  | PROFILE | No | No
16FP | [NAME] | Sixteen Additional FISH Probes ([NAME] Only) | Sixteen Additional FISH Probes |  | PROFILE | No | No
17FP | [NAME] | Seventeen Additional FISH Probes ([NAME] Only) | Seventeen Additional FISH Probes |  | PROFILE | No | No
18FP | [NAME] | Eighteen Additional FISH Probes ([NAME] Only) | Eighteen Additional FISH Probes |  | PROFILE | No | No
19FP | [NAME] | Nineteen Additional FISH Probes ([NAME] Only) | Nineteen Additional FISH Probes |  | PROFILE | No | No
20FP | [NAME] | Twenty Additional FISH Probes ([NAME] Only) | Twenty Additional FISH Probes |  | PROFILE | No | No
21FP | [NAME] | Twenty One Additional FISH Probes ([NAME] Only) | Twenty One Additional FISH Probes |  | PROFILE | No | No
22FP | [NAME] | Twenty Two Additional FISH Probes ([NAME] Only) | Twenty Two Additional FISH Probes |  | PROFILE | No | No
23FP | [NAME] | Twenty Three Additional FISH Probes ([NAME] Only) | Twenty Three Additional FISH Probes |  | PROFILE | No | No
24FP | [NAME] | Twenty Four Additional FISH Probes ([NAME] Only) | Twenty Four Additional FISH Probes |  | PROFILE | No | No
25FP | [NAME] | Twenty Five Additional FISH Probes ([NAME] Only) | Twenty Five Additional FISH Probes |  | PROFILE | No | No
26FP | [NAME] | Twenty Six Additional FISH Probes ([NAME] Only) | Twenty Six Additional FISH Probes |  | PROFILE | No | No
27FP | [NAME] | Twenty Seven Additional FISH Probes ([NAME] Only) | Twenty Seven Additional FISH Probes |  | PROFILE | No | No
28FP | [NAME] | Twenty Eight Additional FISH Probes ([NAME] Only) | Twenty Eight Additional FISH Probes |  | PROFILE | No | No
29FP | [NAME] | Twenty Nine Additional FISH Probes ([NAME] Only) | Twenty Nine Additional FISH Probes |  | PROFILE | No | No
30FP | [NAME] | Thirty Additional FISH Probes ([NAME] Only) | Thirty Additional FISH Probes |  | PROFILE | No | No
ADD10 | [NAME] | Ten Additional FISH Probes ([NAME] Only) | Ten Additional FISH Probes |  | PROFILE | No | No
ADD11 | [NAME] | Eleven Additional FISH Probes ([NAME] Only) | Eleven Additional FISH Probes |  | PROFILE | No | No
ADD12 | [NAME] | Twelve Additional FISH Probes ([NAME] Only) | Twelve Additional FISH Probes |  | PROFILE | No | No
ADD1F | [NAME] | One Additional FISH Probe ([NAME] Only) | One Additional FISH Probe |  | PROFILE | No | No
ADD2F | [NAME] | Two Additional FISH Probes ([NAME] Only) | Two Additional FISH Probes |  | PROFILE | No | No
ADD3F | [NAME] | Three Additional FISH Probes ([NAME] Only) | Three Additional FISH Probes |  | PROFILE | No | No
ADD4F | [NAME] | Four Additional FISH Probes ([NAME] Only) | Four Additional FISH Probes |  | PROFILE | No | No
ADD5F | [NAME] | Five Additional FISH Probes ([NAME] Only) | Five Additional FISH Probes |  | PROFILE | No | No
ADD6F | [NAME] | Six Additional FISH Probes ([NAME] Only) | Six Additional FISH Probes |  | PROFILE | No | No
ADD7F | [NAME] | Seven Additional FISH Probes ([NAME] Only) | Seven Additional FISH Probes |  | PROFILE | No | No
ADD8F | [NAME] | Eight Additional FISH Probes ([NAME] Only) | Eight Additional FISH Probes |  | PROFILE | No | No
ADD9F | [NAME] | Nine Additional FISH Probes ([NAME] Only) | Nine Additional FISH Probes |  | PROFILE | No | No
FCSP | Test | Chromosome Anomalies, [NAME] with Chromosome-Specific FISH [NAME] | Chromosome Anomalies, [NAME], FISH |  | PROFILE |  |  | When this test is ordered, 2 FISH probes are included. If further probes are needed, they will be added at an additional charge.
ADD12 | [NAME] | Twelve Additional FISH Probes ([NAME] Only) | Twelve Additional FISH Probes |  | PROFILE | No | No
27FP | [NAME] | Twenty Seven Additional FISH Probes ([NAME] Only) | Twenty Seven Additional FISH Probes |  | PROFILE | No | No
19FP | [NAME] | Nineteen Additional FISH Probes ([NAME] Only) | Nineteen Additional FISH Probes |  | PROFILE | No | No
ADD4F | [NAME] | Four Additional FISH Probes ([NAME] Only) | Four Additional FISH Probes |  | PROFILE | No | No
ADD9F | [NAME] | Nine Additional FISH Probes ([NAME] Only) | Nine Additional FISH Probes |  | PROFILE | No | No
24FP | [NAME] | Twenty Four Additional FISH Probes ([NAME] Only) | Twenty Four Additional FISH Probes |  | PROFILE | No | No
ADD7F | [NAME] | Seven Additional FISH Probes ([NAME] Only) | Seven Additional FISH Probes |  | PROFILE | No | No
15FP | [NAME] | Fifteen Additional FISH Probes ([NAME] Only) | Fifteen Additional FISH Probes |  | PROFILE | No | No
23FP | [NAME] | Twenty Three Additional FISH Probes ([NAME] Only) | Twenty Three Additional FISH Probes |  | PROFILE | No | No
ADD11 | [NAME] | Eleven Additional FISH Probes ([NAME] Only) | Eleven Additional FISH Probes |  | PROFILE | No | No
ADD10 | [NAME] | Ten Additional FISH Probes ([NAME] Only) | Ten Additional FISH Probes |  | PROFILE | No | No
25FP | [NAME] | Twenty Five Additional FISH Probes ([NAME] Only) | Twenty Five Additional FISH Probes |  | PROFILE | No | No
17FP | [NAME] | Seventeen Additional FISH Probes ([NAME] Only) | Seventeen Additional FISH Probes |  | PROFILE | No | No
13FP | [NAME] | Thirteen Additional FISH Probes ([NAME] Only) | Thirteen Additional FISH Probes |  | PROFILE | No | No
26FP | [NAME] | Twenty Six Additional FISH Probes ([NAME] Only) | Twenty Six Additional FISH Probes |  | PROFILE | No | No
18FP | [NAME] | Eighteen Additional FISH Probes ([NAME] Only) | Eighteen Additional FISH Probes |  | PROFILE | No | No
ADD2F | [NAME] | Two Additional FISH Probes ([NAME] Only) | Two Additional FISH Probes |  | PROFILE | No | No
22FP | [NAME] | Twenty Two Additional FISH Probes ([NAME] Only) | Twenty Two Additional FISH Probes |  | PROFILE | No | No
ADD5F | [NAME] | Five Additional FISH Probes ([NAME] Only) | Five Additional FISH Probes |  | PROFILE | No | No
29FP | [NAME] | Twenty Nine Additional FISH Probes ([NAME] Only) | Twenty Nine Additional FISH Probes |  | PROFILE | No | No
28FP | [NAME] | Twenty Eight Additional FISH Probes ([NAME] Only) | Twenty Eight Additional FISH Probes |  | PROFILE | No | No
ADD3F | [NAME] | Three Additional FISH Probes ([NAME] Only) | Three Additional FISH Probes |  | PROFILE | No | No
20FP | [NAME] | Twenty Additional FISH Probes ([NAME] Only) | Twenty Additional FISH Probes |  | PROFILE | No | No
16FP | [NAME] | Sixteen Additional FISH Probes ([NAME] Only) | Sixteen Additional FISH Probes |  | PROFILE | No | No
21FP | [NAME] | Twenty One Additional FISH Probes ([NAME] Only) | Twenty One Additional FISH Probes |  | PROFILE | No | No
14FP | [NAME] | Fourteen Additional FISH Probes ([NAME] Only) | Fourteen Additional FISH Probes |  | PROFILE | No | No
ADD8F | [NAME] | Eight Additional FISH Probes ([NAME] Only) | Eight Additional FISH Probes |  | PROFILE | No | No
30FP | [NAME] | Thirty Additional FISH Probes ([NAME] Only) | Thirty Additional FISH Probes |  | PROFILE | No | No
ADD1F | [NAME] | One Additional FISH Probe ([NAME] Only) | One Additional FISH Probe |  | PROFILE | No | No
ADD6F | [NAME] | Six Additional FISH Probes ([NAME] Only) | Six Additional FISH Probes |  | PROFILE | No | No
FD | Test | Familial Dysautonomia, Mutation Analysis, IVS20(+6T->C) and R696P | Familial Dysautonomia, Mutation | 1 | 81260 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
FDERM | Test | Fungal Culture, Dermal | Fungal Culture, Dermal | 1 | 87101 |  |  | When this test is ordered, the reflex test may be performed and charged.
RMALY | [NAME] | Id MALDI-TOF Mass Spec Yeast ([NAME] Only) | Id MALDI-TOF Mass Spec Yeast | 1 | 87106 | No | No
RRU | [NAME] | Yeast Ident Panel D (Bill Only) | Yeast Ident Panel D | 1 | 87106 | No | No
RMALF | [NAME] | ID MALDI-TOF Mass Spec Fungi ([NAME] Only) | Id MALDI-TOF Mass Spec Fungi | 1 | 87107 | No | No
[NAME] | [NAME] | Yeast Ident Panel B ([NAME] Only) | Yeast Ident panel B | 1 | 87106 | No | No
FUNA | [NAME] | Fungal Ident Panel A (Bill Only) | Fungal Ident Panel A | 1 | 87107 | No | No
FUNB | [NAME] | Fungal Ident Panel B ([NAME] Only) | Fungal Ident Panel B | 1 | 87107 | No | No
GT | [NAME] | Yeast Ident Panel A (Bill Only) | Yeast Ident Panel A | 1 | 87106 | No | No
LCCI | [NAME] | Ident Rapid PCR Coccidioides ([NAME] Only) | Ident Rapid [NAME] | 1 | 87150 | No | No
[NAME] | [NAME] | Id, Histoplasma/Blastomyces PCR ([NAME] Only) | Id, Histoplasma/Blastomyces PCR | 2 | 87150 | No | No
D2F | [NAME] | Fungal Sequencing Identification | D2 Fungal Sequencing Identification | 1 | 87153 | No | No
CNP | [NAME] | [NAME], Fungus Indent | Microbial Probe Fungus Ident | 1 | 87150 | No | No
API | [NAME] | Yeast Ident Panel C | Yeast Ident Panel C | 1 | 87106 | No | No
FDS9R | Test | Drug Screen 9 Panel, Serum or Plasma-Immunoassay Screen with Reflex to Mass Spectrometry Confirmation/Quantitation | Drug Screen 9 Pnl, with [NAME] | 9 | 80101 |  |  | If screen is positive, specimens are automatically confirmed by GC/MS and/or LC/MS/MS at an additional charge.
FCANN | [NAME] | Cannabinoids, Confirmation | Cannabinoids, Confirmation | 1 | 82542 | No | No
FOPCQ | [NAME] | Opiates - Confirmation/Quantitation, Serum or [NAME] | Opiates, Confirm/Quantitation, S/P | 1 | 83925 | No | No
FCOCF | [NAME] | Cocaine, Confirmation | Cocaine, Confirmation | 1 | 82520 | No | No
FDS92 | [NAME] | Benzodiazepines, Confirmation | Benzodiazepine, Confirmation | 1 | 80154 | No | No
[NAME] | [NAME] | Barbiturates, Confirmation | Barbiturates, Confirmation | 1 | 82205 | No | No
[NAME] | [NAME] | Propoxyphene, Confirmation | Propoxyphene, Confirmation | 1 | 80299 | No | No
FDS91 | [NAME] | Amphetamine, Confirmation | Amphetamine, Confirmation | 1 | 82145 | No | No
FDS93 | [NAME] | Phencyclidine, Confirmation | Phencyclidine, Confirmation | 1 | 83992 | No | No
[NAME] | [NAME] | Methadone and Metabolite Confirm | Methadone and Metabolite Confirm | 1 | 83840 | No | No
FEAGR | Test | [NAME] (IgG), EIA with Reflex to Western Blot | [NAME] [NAME] to WB | 1 | 86682 |  |  | If [NAME], EIA is positive, then Echinococcus IgG Western Blot will be performed at an additional charge.
FEGWB | [NAME] | [NAME] (IgG), Western Blot | [NAME], WB | 1 | 86682 | No | No
FENAB | Test | Encephalitis Antibody Panel (CSF) | Encephalitis Antibody Panel (CSF) |  | PROFILE |  |  | If HSV 1 IgM Screen is Positive, then HSV 1 IgM Titer (FMTR1) will be performed at an additional charge.    If HSV 2 IgM Screen is Positive, then HSV 2 IgM Titer (FMTR2) will be performed at an additional charge.
FENAB | Component |  | LYMPH CHORIOMENINGITIS AB | 2 | 86727 | No | No
FENAB | Component |  | RUBEOLA ANTIBODY | 2 | 86765 | No | No
FENAB | Component |  | MUMPS ANTIBODY | 2 | 86735 | No | No
FENAB | Component |  | VARICELLA-ZOSTER ANTIBODY | 2 | 86787 | No | No
FENAB | Component |  | HERPES SIMPLEX TEST | 1 | 86695 | No | No
FENAB | Component |  | HERPES SIMPLEX TYPE 2 | 1 | 86696 | No | No
FENAB | Component |  | HERPES SIMPLEX TEST | 1 | 86695 | No | No
FENAB | Component |  | HERPES SIMPLEX TYPE 2 | 1 | 86696 | No | No
FENAB | Component |  | WEST NILE VIRUS AB IGM | 1 | 86788 | No | No
FENAB | Component |  | WEST NILE VIRUS ANTIBODY | 1 | 86789 | No | No
FHSGC | Component | HSV 1/2 (IgG) Type-Specific Ab, CSF | HSV 1/2 (IgG) Type-Specific Ab, CSF |  | PROFILE | Yes | No
FHSMC | Component | Herpes Simplex Virus 1/2 IgM Ab, CSF | Herpes Simplex Virus 1/2 IgM Ab,CSF |  | PROFILE | Yes | No
FLCAC | Component | LCM Virus Ab, IFA (CSF) | LCM Virus Ab, IFA CSF | 2 | 86727 | Yes | No
[NAME] | Component | Mumps Antibody Panel, IFA (CSF) | Mumps Antibody Panel, IFA (CSF) | 2 | 86735 | Yes | No
FMGMC | Component | Measles (Rubeola) G/M Ab, IFA CSF | Measles (Rubeola) G/M Ab, IFA CSF | 2 | 86765 | Yes | No
FVZTC | Component | Varicella-Zoster, Total/IgM Ab, CSF | Varicella-Zoster, Total/IgM Ab, CSF | 2 | 86787 | Yes | No
FWNAB | Component | West Nile Virus Antibodies (IgG, IgM), CSF | West Nile Virus Ab (IgG, IgM), CSF |  | PROFILE | Yes | No
FMTR1 | [NAME] | HSV 1 IgM Titer | HSV 1 IgM Titer |  | PROFILE | No | No
FMTR2 | [NAME] | HSV 2 IgM Titer | HSV 2 IgM Titer | 1 | 86696 | No | No
FENTX | Test | [NAME] with Metabolite Confirmation, Chain of Custody, [NAME] | [NAME] w/metabolite Conf, CoC, U | 1 | 80299 |  |  | Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
FFAPL | Test | Febrile Antibodies Panel | Febrile Antibodies Panel |  | PROFILE |  |  | If RMSF IgG is Detected, then FRMFG RMSF IgG Titer will be performed at an additional charge.   If RMSF IgM is Detected, then FRMFM RMSF IgM Titer will be performed at an additional charge.   If [NAME] IgG is Detected, then FRTG R. Typhi IgG Titer will be performed at an additional charge.   If R. Typhi IgM is Detected, then FRTM R. Typhi IgM Titer will be performed at an additional charge.   If Brucella IgM is > or =1.10, then FBRAG Brucella Agglutination will be performed at an additional charge.
FFAPL | Component |  | BRUCELLA ANTIBODY | 2 | 86622 | No | No
FFAPL | Component |  | SALMONELLA ANTIBODY | 5 | 86768 | No | No
FFAPL | Component |  | RICKETTSIA ANTIBODY | 4 | 86757 | No | No
FBRAG | [NAME] | Brucella Agglutination | Brucella Agglutination | 1 | 86622 | No | No
FRTM | [NAME] | R. Typhi IgM Titer | R. Typhi IgM Titer | 1 | 86757 | No | No
FRMFM | [NAME] | Rickettsia (RMSF) IgM Titer | RMSF IgM Titer | 1 | 86757 | No | No
FRMFG | [NAME] | Rickettsia (RMSF) [NAME] | RMSF IgG Titer | 1 | 86757 | No | No
FRTG | [NAME] | R. Typhi IgG Titer | R. Typhi IgG Titer | 1 | 86757 | No | No
FGEN | Test | Fungal Culture, Routine | Fungal Culture, Routine | 1 | 87102 |  |  | When this test is ordered, the reflex tests may be performed and charged.
TISSR | [NAME] | Tissue Processing ([NAME] Only) | Tissue Processing | 1 | 87176 | No | No
RMALY | [NAME] | Id MALDI-TOF Mass Spec Yeast ([NAME] Only) | Id MALDI-TOF Mass Spec Yeast | 1 | 87106 | No | No
RMALF | [NAME] | ID MALDI-TOF Mass Spec Fungi ([NAME] Only) | Id MALDI-TOF Mass Spec Fungi | 1 | 87107 | No | No
RRU | [NAME] | Yeast Ident Panel D (Bill Only) | Yeast Ident Panel D | 1 | 87106 | No | No
[NAME] | [NAME] | Id, Histoplasma/Blastomyces PCR ([NAME] Only) | Id, Histoplasma/Blastomyces PCR | 2 | 87150 | No | No
[NAME] | [NAME] | Yeast Ident Panel B ([NAME] Only) | Yeast Ident panel B | 1 | 87106 | No | No
LCCI | [NAME] | Ident Rapid PCR Coccidioides ([NAME] Only) | Ident Rapid [NAME] | 1 | 87150 | No | No
GT | [NAME] | Yeast Ident Panel A (Bill Only) | Yeast Ident Panel A | 1 | 87106 | No | No
FUNB | [NAME] | Fungal Ident Panel B ([NAME] Only) | Fungal Ident Panel B | 1 | 87107 | No | No
D2F | [NAME] | Fungal Sequencing Identification | D2 Fungal Sequencing Identification | 1 | 87153 | No | No
FUNA | [NAME] | Fungal Ident Panel A (Bill Only) | Fungal Ident Panel A | 1 | 87107 | No | No
CNP | [NAME] | [NAME], Fungus Indent | Microbial Probe Fungus Ident | 1 | 87150 | No | No
API | [NAME] | Yeast Ident Panel C | Yeast Ident Panel C | 1 | 87106 | No | No
FHAN | Test | Hantavirus Antibodies (IgG, IgM) with Reflex to Confirmation | [NAME], IgM w/Rfl | 2 | 86790 |  |  | If [NAME] is >=2.00 and Hantavirus IgM is >=2.00 (FSING) Sin Nombre Virus IgG Confirmation will be performed at an additional charge.
FSING | [NAME] | Sin Nombre Virus IgG Confirmation, IBL | Sin Nombre Virus IgG Confirmation | 1 | 86790 | No | No
FSINM | [NAME] | Sin Nombre Virus IgM Confirmation, ELISA | Sin Nombre Virus IgM Confirmation | 1 | 86790 | No | No
FHEAB | Test | Heroin Analysis, [NAME] | Heroin Analysis, Blood | 1 | 80101 |  |  | If the Heroin Analysis is positive, then the 6-Acetylmorphine, Confirm (FMOR6) and [NAME] (FMORC) will be performed at no additional charge.
FMOR6 | [NAME] | 6-Acetylmorphine, GC/MS Confirmation | 6-Acetylmorphine Confirm |  |  | No | No
FMORC | [NAME] | [NAME] | [NAME], unconjugated |  |  | No | No
FHSAB | Test | Herpes Simplex Virus 1/2 Antibody (IgM), IFA with [NAME] to [NAME], Serum | HSV 1/2 IgM Ab IFA Reflex to [NAME] |  | PROFILE
FHSAB | Component |  | HERPES SIMPLEX TEST | 1 | 86695 | No | No
FHSAB | Component |  | HERPES SIMPLEX TYPE 2 | 1 | 86696 | No | No
FHSI | [NAME] | HSV 1 IgM Titer | HSV 1 IgM Titer | 1 | 86695 | No | No
FHSII | [NAME] | HSV 2 IgM Titer | HSV 2 IgM Titer | 1 | 86696 | No | No
FIBR | Test | Fibroblast Culture | Fibroblast Culture | 1 | 88233 |  |  | When this test is ordered, cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple assays on a patient utilizing the ordered fibroblast culture, only 1 culture is required regardless of the number of assays ordered. If viable cells are not obtained within 30 days, client will be notified.
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
FIMRG | Test | Imatinib Mesylate Responsive Genes, Locus Anomalies, FISH | Imatinib [NAME], FISH |  | PROFILE |  |  | Panel includes testing for the following anomalies via the probes listed:
13FP | [NAME] | Thirteen Additional FISH Probes ([NAME] Only) | Thirteen Additional FISH Probes |  | PROFILE | No | No
14FP | [NAME] | Fourteen Additional FISH Probes ([NAME] Only) | Fourteen Additional FISH Probes |  | PROFILE | No | No
15FP | [NAME] | Fifteen Additional FISH Probes ([NAME] Only) | Fifteen Additional FISH Probes |  | PROFILE | No | No
16FP | [NAME] | Sixteen Additional FISH Probes ([NAME] Only) | Sixteen Additional FISH Probes |  | PROFILE | No | No
17FP | [NAME] | Seventeen Additional FISH Probes ([NAME] Only) | Seventeen Additional FISH Probes |  | PROFILE | No | No
18FP | [NAME] | Eighteen Additional FISH Probes ([NAME] Only) | Eighteen Additional FISH Probes |  | PROFILE | No | No
19FP | [NAME] | Nineteen Additional FISH Probes ([NAME] Only) | Nineteen Additional FISH Probes |  | PROFILE | No | No
20FP | [NAME] | Twenty Additional FISH Probes ([NAME] Only) | Twenty Additional FISH Probes |  | PROFILE | No | No
21FP | [NAME] | Twenty One Additional FISH Probes ([NAME] Only) | Twenty One Additional FISH Probes |  | PROFILE | No | No
22FP | [NAME] | Twenty Two Additional FISH Probes ([NAME] Only) | Twenty Two Additional FISH Probes |  | PROFILE | No | No
23FP | [NAME] | Twenty Three Additional FISH Probes ([NAME] Only) | Twenty Three Additional FISH Probes |  | PROFILE | No | No
24FP | [NAME] | Twenty Four Additional FISH Probes ([NAME] Only) | Twenty Four Additional FISH Probes |  | PROFILE | No | No
25FP | [NAME] | Twenty Five Additional FISH Probes ([NAME] Only) | Twenty Five Additional FISH Probes |  | PROFILE | No | No
26FP | [NAME] | Twenty Six Additional FISH Probes ([NAME] Only) | Twenty Six Additional FISH Probes |  | PROFILE | No | No
27FP | [NAME] | Twenty Seven Additional FISH Probes ([NAME] Only) | Twenty Seven Additional FISH Probes |  | PROFILE | No | No
28FP | [NAME] | Twenty Eight Additional FISH Probes ([NAME] Only) | Twenty Eight Additional FISH Probes |  | PROFILE | No | No
29FP | [NAME] | Twenty Nine Additional FISH Probes ([NAME] Only) | Twenty Nine Additional FISH Probes |  | PROFILE | No | No
30FP | [NAME] | Thirty Additional FISH Probes ([NAME] Only) | Thirty Additional FISH Probes |  | PROFILE | No | No
ADD10 | [NAME] | Ten Additional FISH Probes ([NAME] Only) | Ten Additional FISH Probes |  | PROFILE | No | No
ADD11 | [NAME] | Eleven Additional FISH Probes ([NAME] Only) | Eleven Additional FISH Probes |  | PROFILE | No | No
ADD12 | [NAME] | Twelve Additional FISH Probes ([NAME] Only) | Twelve Additional FISH Probes |  | PROFILE | No | No
ADD1F | [NAME] | One Additional FISH Probe ([NAME] Only) | One Additional FISH Probe |  | PROFILE | No | No
ADD2F | [NAME] | Two Additional FISH Probes ([NAME] Only) | Two Additional FISH Probes |  | PROFILE | No | No
ADD3F | [NAME] | Three Additional FISH Probes ([NAME] Only) | Three Additional FISH Probes |  | PROFILE | No | No
ADD4F | [NAME] | Four Additional FISH Probes ([NAME] Only) | Four Additional FISH Probes |  | PROFILE | No | No
ADD5F | [NAME] | Five Additional FISH Probes ([NAME] Only) | Five Additional FISH Probes |  | PROFILE | No | No
ADD6F | [NAME] | Six Additional FISH Probes ([NAME] Only) | Six Additional FISH Probes |  | PROFILE | No | No
ADD7F | [NAME] | Seven Additional FISH Probes ([NAME] Only) | Seven Additional FISH Probes |  | PROFILE | No | No
ADD8F | [NAME] | Eight Additional FISH Probes ([NAME] Only) | Eight Additional FISH Probes |  | PROFILE | No | No
ADD9F | [NAME] | Nine Additional FISH Probes ([NAME] Only) | Nine Additional FISH Probes |  | PROFILE | No | No
FKMS | Test | Ketamine and Metabolite Screen, Serum/Plasma | Ketamine and Metabolite Screen | 1 | 80100 |  |  | If [NAME] and Metabolite Screen is positive, then [NAME] and Metabolite Confirm (FKMSC) will be performed at an additional charge.
FKMSC | [NAME] | Ketamine and Metabolite Confirmation | Ketamine and Metabolite Confirm | 1 | 82542 | No | No
FLGA | Test | [NAME], Mutation Analysis | [NAME], Mutation Analysis | 1 | 81401 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
FLUPV | Test | Lupus Anticoagulant Evaluation with Reflex | Lupus Anticoagulant Eval w/Reflexes |  | PROFILE |  |  | If the PTT-LA is >40, then the Hexagonal Phase Confirmation (FHEXC) will be performed at an additional charge.   If the Hexagonal Phase Confirm is positive or weakly positive, a Thrombin Clotting Time (FCLOT) will be performed at an additional charge.    If the DRVVT Screen is >45 then the DRVVT Confirmation (FDVTC) will be performed at an additional charge.   If the DRVVT Confirmation is positive, then the DRVVT 1:1 Mix (FDVTX) will be performed at an additional charge.
FLUPV | Component |  | DRVVT Screen | 1 | 85613 | No | No
FLUPV | Component |  | Lupus Anticoagulant | 1 | 85730 | No | No
FDVTC | [NAME] | DRVVT Confirm | DRVVT Confirm | 1 | 85597 | No | No
FCLOT | [NAME] | Thrombin Clotting Time | Thrombin Clotting Time | 1 | 85670 | No | No
FDVTX | [NAME] | DRVVT 1:1 Mix | DRVVT 1:1 Mix | 1 | 85613 | No | No
FHEXC | [NAME] | Hexagonal Phase Confirm | Hexagonal Phase Confirm | 1 | 85598 | No | No
FMCPL | Test | [NAME], CSF | Meningoencephalitis Comp Panel, CSF |  | PROFILE |  |  | If HSV 1 IgM Screen is Positive, then HSV 1 IgM Titer (FMTR1) will be performed at an additional charge.    If HSV 2 IgM Screen is Positive, then HSV 2 IgM Titer (FMTR2) will be performed at an additional charge.
FMGMA | Component | Measles (Rubeola) G/M Ab, IFA CSF | Measles (Rubeola) G/M Ab, IFA CSF | 2 | 86765 | Yes | No
FMABC | Component | Mumps Antibody Panel, IFA CSF | Mumps Antibody Panel, IFA CSF | 2 | 86735 | Yes | No
FWNIL | Component | West Nile Virus Antibodies (IgG, IgM), CSF | West Nile Virus Ab (IgG, IgM), CSF |  | PROFILE | Yes | No
FHSAC | Component | HSV 1/2 IgG Type-Specific Ab, CSF | HSV 1/2 IgG Type-Specific Ab, CSF |  | PROFILE | Yes | No
FEEQC | Component | [NAME], IFA CSF | [NAME], IFA CSF | 2 | 86652 | Yes | No
FMCPL | Component |  | ENCEPHALITIS ANTIBODY | 2 | 86653 | No | No
FMCPL | Component |  | ENCEPHALITIS ANTIBODY | 2 | 86652 | No | No
FMCPL | Component |  | [NAME] ANTIBODY | 1 | 86603 | No | No
FMCPL | Component |  | LYMPH CHORIOMENINGITIS AB | 2 | 86727 | No | No
FMCPL | Component |  | INFLUENZA VIRUS ANTIBODY | 2 | 86710 | No | No
FMCPL | Component |  | MUMPS ANTIBODY | 2 | 86735 | No | No
FMCPL | Component |  | VARICELLA-ZOSTER ANTIBODY | 1 | 86787 | No | No
FMCPL | Component |  | RUBEOLA ANTIBODY | 2 | 86765 | No | No
FCEVC | Component | Calif Enceph Virus Ab Pnl, IFA CSF | Calif Enceph Virus Ab Pnl, IFA CSF | 2 | 86651 | Yes | No
FSTLE | Component | St. Louis Enceph Virus Ab, IFA CSF | St. Louis Enceph Virus Ab, IFA CSF | 2 | 86653 | Yes | No
FADAC | Component | [NAME], CSF | [NAME], CSF | 1 | 86603 | Yes | No
[NAME] | Component | Coxsackie A Antibodies, CSF | Coxsackie A Antibodies, CSF | 6 | 86658 | Yes | No
FCBAC | Component | [NAME] (1-6) Antibodies, CSF | [NAME] (1-6) Antibodies, CSF | 6 | 86658 | Yes | No
FMCPL | Component |  | ENTEROVIRUS ANTIBODY | 6 | 86658 | No | No
FCMGA | Component | [NAME], ELISA CSF | [NAME], ELISA CSF | 1 | 86644 | Yes | No
FMCPL | Component |  | ENTEROVIRUS ANTIBODY | 6 | 86658 | No | No
FMCPL | Component |  | HERPES SIMPLEX TYPE 2 | 1 | 86696 | No | No
FMCPL | Component |  | HERPES SIMPLEX TEST | 1 | 86695 | No | No
FMCPL | Component |  | WEST NILE VIRUS ANTIBODY | 1 | 86789 | No | No
FMCPL | Component |  | ENCEPHALITIS ANTIBODY | 2 | 86651 | No | No
FMCPL | Component |  | HERPES SIMPLEX TYPE 2 | 1 | 86696 | No | No
FMCPL | Component |  | WEST NILE VIRUS AB IGM | 1 | 86788 | No | No
FMCPL | Component |  | CMV ANTIBODY | 1 | 86644 | No | No
FMCPL | Component |  | ENCEPHALITIS ANTIBODY | 2 | 86654 | No | No
FEASF | Component | Echovirus Antibodies, CSF | Echovirus Antibodies, CSF | 5 | 86658 | Yes | No
FWEQC | Component | [NAME], IFA CSF | [NAME], IFA CSF | 2 | 86654 | Yes | No
FHERM | Component | HSV 1/2 IgM Ab IFA Reflex to [NAME] | HSV 1/2 IgM Ab IFA Reflex to [NAME] |  | PROFILE | Yes | No
FVZVA | Component | Varicella-Zoster Virus Antibody, CSF | Varicella-Zoster Virus Antibody, CSF | 1 | 86787 | Yes | No
FLCHV | Component | Lymphocytic [NAME], CSF | Lymphocytic [NAME], CSF | 2 | 86727 | Yes | No
FMCPL | Component |  | CMV ANTIBODY IGM | 1 | 86645 | No | No
FMCPL | Component |  | ENTEROVIRUS ANTIBODY | 5 | 86658 | No | No
FCMVM | Component | Cytomegalovirus IgM Ab, ELISA CSF | Cytomegalovirus IgM Ab, ELISA CSF | 1 | 86645 | Yes | No
FMCPL | Component |  | HERPES SIMPLEX TEST | 1 | 86695 | No | No
FITAB | Component | Influenza Virus A and B Ab, CSF | Influenza Virus A and B Ab, CSF | 2 | 86710 | Yes | No
FMTR2 | [NAME] | HSV 2 IgM Titer | HSV 2 IgM Titer | 1 | 86696 | No | No
FMTR1 | [NAME] | HSV 1 IgM Titer | HSV 1 IgM Titer |  | PROFILE | No | No
FMDS | Test | Myelodysplastic Syndrome (MDS), FISH | MDS, FISH |  | PROFILE |  |  | Chromosome analysis is recommended as first-tier testing for this disorder; FISH should be used if chromosomes are not successful.
28FP | [NAME] | Twenty Eight Additional FISH Probes ([NAME] Only) | Twenty Eight Additional FISH Probes |  | PROFILE | No | No
13FP | [NAME] | Thirteen Additional FISH Probes ([NAME] Only) | Thirteen Additional FISH Probes |  | PROFILE | No | No
30FP | [NAME] | Thirty Additional FISH Probes ([NAME] Only) | Thirty Additional FISH Probes |  | PROFILE | No | No
20FP | [NAME] | Twenty Additional FISH Probes ([NAME] Only) | Twenty Additional FISH Probes |  | PROFILE | No | No
19FP | [NAME] | Nineteen Additional FISH Probes ([NAME] Only) | Nineteen Additional FISH Probes |  | PROFILE | No | No
ADD7F | [NAME] | Seven Additional FISH Probes ([NAME] Only) | Seven Additional FISH Probes |  | PROFILE | No | No
ADD11 | [NAME] | Eleven Additional FISH Probes ([NAME] Only) | Eleven Additional FISH Probes |  | PROFILE | No | No
15FP | [NAME] | Fifteen Additional FISH Probes ([NAME] Only) | Fifteen Additional FISH Probes |  | PROFILE | No | No
24FP | [NAME] | Twenty Four Additional FISH Probes ([NAME] Only) | Twenty Four Additional FISH Probes |  | PROFILE | No | No
26FP | [NAME] | Twenty Six Additional FISH Probes ([NAME] Only) | Twenty Six Additional FISH Probes |  | PROFILE | No | No
ADD10 | [NAME] | Ten Additional FISH Probes ([NAME] Only) | Ten Additional FISH Probes |  | PROFILE | No | No
ADD3F | [NAME] | Three Additional FISH Probes ([NAME] Only) | Three Additional FISH Probes |  | PROFILE | No | No
21FP | [NAME] | Twenty One Additional FISH Probes ([NAME] Only) | Twenty One Additional FISH Probes |  | PROFILE | No | No
14FP | [NAME] | Fourteen Additional FISH Probes ([NAME] Only) | Fourteen Additional FISH Probes |  | PROFILE | No | No
29FP | [NAME] | Twenty Nine Additional FISH Probes ([NAME] Only) | Twenty Nine Additional FISH Probes |  | PROFILE | No | No
23FP | [NAME] | Twenty Three Additional FISH Probes ([NAME] Only) | Twenty Three Additional FISH Probes |  | PROFILE | No | No
17FP | [NAME] | Seventeen Additional FISH Probes ([NAME] Only) | Seventeen Additional FISH Probes |  | PROFILE | No | No
22FP | [NAME] | Twenty Two Additional FISH Probes ([NAME] Only) | Twenty Two Additional FISH Probes |  | PROFILE | No | No
16FP | [NAME] | Sixteen Additional FISH Probes ([NAME] Only) | Sixteen Additional FISH Probes |  | PROFILE | No | No
ADD5F | [NAME] | Five Additional FISH Probes ([NAME] Only) | Five Additional FISH Probes |  | PROFILE | No | No
27FP | [NAME] | Twenty Seven Additional FISH Probes ([NAME] Only) | Twenty Seven Additional FISH Probes |  | PROFILE | No | No
25FP | [NAME] | Twenty Five Additional FISH Probes ([NAME] Only) | Twenty Five Additional FISH Probes |  | PROFILE | No | No
ADD9F | [NAME] | Nine Additional FISH Probes ([NAME] Only) | Nine Additional FISH Probes |  | PROFILE | No | No
ADD2F | [NAME] | Two Additional FISH Probes ([NAME] Only) | Two Additional FISH Probes |  | PROFILE | No | No
ADD12 | [NAME] | Twelve Additional FISH Probes ([NAME] Only) | Twelve Additional FISH Probes |  | PROFILE | No | No
18FP | [NAME] | Eighteen Additional FISH Probes ([NAME] Only) | Eighteen Additional FISH Probes |  | PROFILE | No | No
ADD8F | [NAME] | Eight Additional FISH Probes ([NAME] Only) | Eight Additional FISH Probes |  | PROFILE | No | No
ADD6F | [NAME] | Six Additional FISH Probes ([NAME] Only) | Six Additional FISH Probes |  | PROFILE | No | No
ADD4F | [NAME] | Four Additional FISH Probes ([NAME] Only) | Four Additional FISH Probes |  | PROFILE | No | No
ADD1F | [NAME] | One Additional FISH Probe ([NAME] Only) | One Additional FISH Probe |  | PROFILE | No | No
FMECM | Test | Meconium Methadone Screen | Meconium Methadone Screen | 1 | 80101 |  |  | If test is positive, then the Meconium Methadone Confirmation (FMMC) will be performed at no additional charge.
FMMC | [NAME] | Meconium Methadone Confirmation | Meconium Methadone Conf. | 1 | 82542 | No | No
FMEPL | Test | Meningoencephalitis (Encephalitis) Panel, CSF | Meningoencephalitis Panel CSF |  | PROFILE |  |  | If positive HSV 1 IgM Screen, reflex to titer (FMTR1) will be performed at an additional charge.   If positive HSV 2 IgM Screen, reflex to titer (FMTR2) will be performed at an additional charge.
FCEVP | Component | Calif Enceph Virus Ab Pnl, IFA CSF | California Encephalitis Ab Panel, CSF | 1 | 86651 | Yes | No
FEEEV | Component | [NAME], IFA CSF | [NAME], IFA CSF | 2 | 86652 | Yes | No
FHSV | Component | HSV 1/2 IgG Type-Specific Ab, CSF | HSV 1/2 IgG Type-Specific Ab, CSF |  | PROFILE | Yes | No
FHSVA | Component | HSV 1/2 IgM Ab IFA Reflex to [NAME] | HSV 1/2 IgM Ab IFA Reflex to [NAME] |  | PROFILE | Yes | No
FLCVC | Component | LCM Virus Ab, IFA CSF | LCM Virus Ab, IFA CSF | 2 | 86727 | Yes | No
FMAPC | Component | Mumps Antibody Panel, IFA CSF | Mumps Antibody Panel, IFA CSF | 2 | 86735 | Yes | No
FMEPL | Component |  | ENCEPHALITIS ANTIBODY | 2 | 86651 | No | No
FMEPL | Component |  | ENCEPHALITIS ANTIBODY | 2 | 86652 | No | No
FMEPL | Component |  | HERPES SIMPLEX TEST | 1 | 86695 | No | No
FMEPL | Component |  | HERPES SIMPLEX TYPE 2 | 1 | 86696 | No | No
FMEPL | Component |  | LYMPH CHORIOMENINGITIS AB | 2 | 86727 | No | No
FMEPL | Component |  | MUMPS ANTIBODY | 2 | 86735 | No | No
FMEPL | Component |  | ENCEPHALITIS ANTIBODY | 2 | 86653 | No | No
FMEPL | Component |  | ENCEPHALITIS ANTIBODY | 2 | 86654 | No | No
FMEPL | Component |  | HERPES SIMPLEX TEST | 1 | 86695 | No | No
FMEPL | Component |  | HERPES SIMPLEX TYPE 2 | 1 | 86696 | No | No
FMEPL | Component |  | WEST NILE VIRUS AB IGM | 1 | 86788 | No | No
FMEPL | Component |  | WEST NILE VIRUS ANTIBODY | 1 | 86789 | No | No
FSLEV | Component | St. Louis Encephalitis Ab, IFA CSF | St Louis Encephalitis Ab, IFA (CSF) | 2 | 86653 | Yes | No
FWEQE | Component | [NAME], IFA CSF | [NAME], IFA CSF | 2 | 86654 | Yes | No
[NAME] | Component | West Nile Virus Antibodies (IgG, IgM), CSF | West Nile Virus Ab (IgG, IgM), CSF |  | PROFILE | Yes | No
FMTR1 | [NAME] | HSV 1 IgM Titer | HSV 1 IgM Titer |  | PROFILE | No | No
FMTR2 | [NAME] | HSV 2 IgM Titer | HSV 2 IgM Titer | 1 | 86696 | No | No
FMFC | Test | Myeloma, FISH, Fixed Cells | Myeloma, FISH, Fixed Cells |  | PROFILE |  |  | This test is designed for diagnostic specimens. The test panel includes analysis for the disease-associated abnormalities using the probes listed below:
ADD11 | [NAME] | Eleven Additional FISH Probes ([NAME] Only) | Eleven Additional FISH Probes |  | PROFILE | No | No
17FP | [NAME] | Seventeen Additional FISH Probes ([NAME] Only) | Seventeen Additional FISH Probes |  | PROFILE | No | No
25FP | [NAME] | Twenty Five Additional FISH Probes ([NAME] Only) | Twenty Five Additional FISH Probes |  | PROFILE | No | No
ADD7F | [NAME] | Seven Additional FISH Probes ([NAME] Only) | Seven Additional FISH Probes |  | PROFILE | No | No
ADD9F | [NAME] | Nine Additional FISH Probes ([NAME] Only) | Nine Additional FISH Probes |  | PROFILE | No | No
ADD1F | [NAME] | One Additional FISH Probe ([NAME] Only) | One Additional FISH Probe |  | PROFILE | No | No
18FP | [NAME] | Eighteen Additional FISH Probes ([NAME] Only) | Eighteen Additional FISH Probes |  | PROFILE | No | No
ADD6F | [NAME] | Six Additional FISH Probes ([NAME] Only) | Six Additional FISH Probes |  | PROFILE | No | No
22FP | [NAME] | Twenty Two Additional FISH Probes ([NAME] Only) | Twenty Two Additional FISH Probes |  | PROFILE | No | No
29FP | [NAME] | Twenty Nine Additional FISH Probes ([NAME] Only) | Twenty Nine Additional FISH Probes |  | PROFILE | No | No
21FP | [NAME] | Twenty One Additional FISH Probes ([NAME] Only) | Twenty One Additional FISH Probes |  | PROFILE | No | No
ADD4F | [NAME] | Four Additional FISH Probes ([NAME] Only) | Four Additional FISH Probes |  | PROFILE | No | No
ADD10 | [NAME] | Ten Additional FISH Probes ([NAME] Only) | Ten Additional FISH Probes |  | PROFILE | No | No
23FP | [NAME] | Twenty Three Additional FISH Probes ([NAME] Only) | Twenty Three Additional FISH Probes |  | PROFILE | No | No
28FP | [NAME] | Twenty Eight Additional FISH Probes ([NAME] Only) | Twenty Eight Additional FISH Probes |  | PROFILE | No | No
26FP | [NAME] | Twenty Six Additional FISH Probes ([NAME] Only) | Twenty Six Additional FISH Probes |  | PROFILE | No | No
20FP | [NAME] | Twenty Additional FISH Probes ([NAME] Only) | Twenty Additional FISH Probes |  | PROFILE | No | No
ADD2F | [NAME] | Two Additional FISH Probes ([NAME] Only) | Two Additional FISH Probes |  | PROFILE | No | No
27FP | [NAME] | Twenty Seven Additional FISH Probes ([NAME] Only) | Twenty Seven Additional FISH Probes |  | PROFILE | No | No
19FP | [NAME] | Nineteen Additional FISH Probes ([NAME] Only) | Nineteen Additional FISH Probes |  | PROFILE | No | No
ADD8F | [NAME] | Eight Additional FISH Probes ([NAME] Only) | Eight Additional FISH Probes |  | PROFILE | No | No
13FP | [NAME] | Thirteen Additional FISH Probes ([NAME] Only) | Thirteen Additional FISH Probes |  | PROFILE | No | No
ADD5F | [NAME] | Five Additional FISH Probes ([NAME] Only) | Five Additional FISH Probes |  | PROFILE | No | No
14FP | [NAME] | Fourteen Additional FISH Probes ([NAME] Only) | Fourteen Additional FISH Probes |  | PROFILE | No | No
16FP | [NAME] | Sixteen Additional FISH Probes ([NAME] Only) | Sixteen Additional FISH Probes |  | PROFILE | No | No
24FP | [NAME] | Twenty Four Additional FISH Probes ([NAME] Only) | Twenty Four Additional FISH Probes |  | PROFILE | No | No
15FP | [NAME] | Fifteen Additional FISH Probes ([NAME] Only) | Fifteen Additional FISH Probes |  | PROFILE | No | No
ADD12 | [NAME] | Twelve Additional FISH Probes ([NAME] Only) | Twelve Additional FISH Probes |  | PROFILE | No | No
30FP | [NAME] | Thirty Additional FISH Probes ([NAME] Only) | Thirty Additional FISH Probes |  | PROFILE | No | No
ADD3F | [NAME] | Three Additional FISH Probes ([NAME] Only) | Three Additional FISH Probes |  | PROFILE | No | No
FMGA | Test | [NAME]. [NAME] (MAG) Antibody w/Reflex to MAG-SGPG & MAG, EIA | MAG w/Reflex MAG-SGPG and MAG, EIA | 1 | 84181 |  |  | If FMGA is Positive, then FMGS (MAG EIA Reflex) will be performed at an additional charge.
FMGS | [NAME] | MAG EIA Reflex | MAG EIA Reflex |  | PROFILE | No | No
FMMM | Test | Mephedrone, MDPV and Methylone, [NAME] | Mephedrone, MDPV, Methylone | 1 | 80101 |  |  | If the Mephedrone, MDPV, Methylone is positive, then the Mephedrone and MDPV Confirm (FMMCF) and Methylone Confirm (FMEYL) will be performed at an additional charge.
FMEYL | [NAME] | Methylone Confirmation | Methylone Confirm | 1 | 82542 | No | No
FMMCF | [NAME] | Mephedrone & MDPV Confirmation | Mephedrone and MDPV Confirm | 1 | 82542 | No | No
FMST | Test | Myeloid [NAME], FISH, Tissue | Myeloid [NAME], FISH, Ts |  | PROFILE |  |  | This test does not include a pathology consult. If a pathology consultation is requested, 70012 Pathology Consultation should be ordered and the appropriate FISH test will be ordered and performed at an additional charge.
FMST | Component |  | CYTO/MOLECULAR REPORT | 1 | 88291 | No | No
FMST | Component |  | CYTOGENETICS 100-300 | 1 | 88275 | No | No
FMST | Component |  | CYTOGENETICS DNA PROBE | 2 | 88271 | No | No
15FP | [NAME] | Fifteen Additional FISH Probes ([NAME] Only) | Fifteen Additional FISH Probes |  | PROFILE | No | No
ADD4F | [NAME] | Four Additional FISH Probes ([NAME] Only) | Four Additional FISH Probes |  | PROFILE | No | No
ADD7F | [NAME] | Seven Additional FISH Probes ([NAME] Only) | Seven Additional FISH Probes |  | PROFILE | No | No
13FP | [NAME] | Thirteen Additional FISH Probes ([NAME] Only) | Thirteen Additional FISH Probes |  | PROFILE | No | No
17FP | [NAME] | Seventeen Additional FISH Probes ([NAME] Only) | Seventeen Additional FISH Probes |  | PROFILE | No | No
14FP | [NAME] | Fourteen Additional FISH Probes ([NAME] Only) | Fourteen Additional FISH Probes |  | PROFILE | No | No
19FP | [NAME] | Nineteen Additional FISH Probes ([NAME] Only) | Nineteen Additional FISH Probes |  | PROFILE | No | No
18FP | [NAME] | Eighteen Additional FISH Probes ([NAME] Only) | Eighteen Additional FISH Probes |  | PROFILE | No | No
ADD12 | [NAME] | Twelve Additional FISH Probes ([NAME] Only) | Twelve Additional FISH Probes |  | PROFILE | No | No
ADD6F | [NAME] | Six Additional FISH Probes ([NAME] Only) | Six Additional FISH Probes |  | PROFILE | No | No
20FP | [NAME] | Twenty Additional FISH Probes ([NAME] Only) | Twenty Additional FISH Probes |  | PROFILE | No | No
ADD8F | [NAME] | Eight Additional FISH Probes ([NAME] Only) | Eight Additional FISH Probes |  | PROFILE | No | No
ADD11 | [NAME] | Eleven Additional FISH Probes ([NAME] Only) | Eleven Additional FISH Probes |  | PROFILE | No | No
ADD10 | [NAME] | Ten Additional FISH Probes ([NAME] Only) | Ten Additional FISH Probes |  | PROFILE | No | No
16FP | [NAME] | Sixteen Additional FISH Probes ([NAME] Only) | Sixteen Additional FISH Probes |  | PROFILE | No | No
ADD9F | [NAME] | Nine Additional FISH Probes ([NAME] Only) | Nine Additional FISH Probes |  | PROFILE | No | No
ADD2F | [NAME] | Two Additional FISH Probes ([NAME] Only) | Two Additional FISH Probes |  | PROFILE | No | No
ADD1F | [NAME] | One Additional FISH Probe ([NAME] Only) | One Additional FISH Probe |  | PROFILE | No | No
ADD5F | [NAME] | Five Additional FISH Probes ([NAME] Only) | Five Additional FISH Probes |  | PROFILE | No | No
FNTSX | Test | [NAME] and [NAME], Chain of Custody, Serum | [NAME] and metabolite, CoC, S | 1 | 80299
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
FPLAS | Test | [NAME] Proliferative Disorder, FISH, Tissue | Plasma Cell Prolif, FISH, Ts |  | PROFILE |  |  | This test does not include a pathology consult. If a pathology consult is requested, order 70012 / Pathology Consultation and the appropriate FISH test will be ordered and performed at an additional charge.
FPLAS | Component |  | CYTOGENETICS DNA PROBE | 2 | 88271 | No | No
FPLAS | Component |  | CYTOGENETICS 100-300 | 1 | 88275 | No | No
FPLAS | Component |  | CYTO/MOLECULAR REPORT | 1 | 88291 | No | No
13FP | [NAME] | Thirteen Additional FISH Probes ([NAME] Only) | Thirteen Additional FISH Probes |  | PROFILE | No | No
14FP | [NAME] | Fourteen Additional FISH Probes ([NAME] Only) | Fourteen Additional FISH Probes |  | PROFILE | No | No
15FP | [NAME] | Fifteen Additional FISH Probes ([NAME] Only) | Fifteen Additional FISH Probes |  | PROFILE | No | No
16FP | [NAME] | Sixteen Additional FISH Probes ([NAME] Only) | Sixteen Additional FISH Probes |  | PROFILE | No | No
17FP | [NAME] | Seventeen Additional FISH Probes ([NAME] Only) | Seventeen Additional FISH Probes |  | PROFILE | No | No
18FP | [NAME] | Eighteen Additional FISH Probes ([NAME] Only) | Eighteen Additional FISH Probes |  | PROFILE | No | No
19FP | [NAME] | Nineteen Additional FISH Probes ([NAME] Only) | Nineteen Additional FISH Probes |  | PROFILE | No | No
20FP | [NAME] | Twenty Additional FISH Probes ([NAME] Only) | Twenty Additional FISH Probes |  | PROFILE | No | No
21FP | [NAME] | Twenty One Additional FISH Probes ([NAME] Only) | Twenty One Additional FISH Probes |  | PROFILE | No | No
22FP | [NAME] | Twenty Two Additional FISH Probes ([NAME] Only) | Twenty Two Additional FISH Probes |  | PROFILE | No | No
23FP | [NAME] | Twenty Three Additional FISH Probes ([NAME] Only) | Twenty Three Additional FISH Probes |  | PROFILE | No | No
24FP | [NAME] | Twenty Four Additional FISH Probes ([NAME] Only) | Twenty Four Additional FISH Probes |  | PROFILE | No | No
25FP | [NAME] | Twenty Five Additional FISH Probes ([NAME] Only) | Twenty Five Additional FISH Probes |  | PROFILE | No | No
26FP | [NAME] | Twenty Six Additional FISH Probes ([NAME] Only) | Twenty Six Additional FISH Probes |  | PROFILE | No | No
27FP | [NAME] | Twenty Seven Additional FISH Probes ([NAME] Only) | Twenty Seven Additional FISH Probes |  | PROFILE | No | No
28FP | [NAME] | Twenty Eight Additional FISH Probes ([NAME] Only) | Twenty Eight Additional FISH Probes |  | PROFILE | No | No
29FP | [NAME] | Twenty Nine Additional FISH Probes ([NAME] Only) | Twenty Nine Additional FISH Probes |  | PROFILE | No | No
30FP | [NAME] | Thirty Additional FISH Probes ([NAME] Only) | Thirty Additional FISH Probes |  | PROFILE | No | No
ADD10 | [NAME] | Ten Additional FISH Probes ([NAME] Only) | Ten Additional FISH Probes |  | PROFILE | No | No
ADD11 | [NAME] | Eleven Additional FISH Probes ([NAME] Only) | Eleven Additional FISH Probes |  | PROFILE | No | No
ADD12 | [NAME] | Twelve Additional FISH Probes ([NAME] Only) | Twelve Additional FISH Probes |  | PROFILE | No | No
ADD1F | [NAME] | One Additional FISH Probe ([NAME] Only) | One Additional FISH Probe |  | PROFILE | No | No
ADD2F | [NAME] | Two Additional FISH Probes ([NAME] Only) | Two Additional FISH Probes |  | PROFILE | No | No
ADD3F | [NAME] | Three Additional FISH Probes ([NAME] Only) | Three Additional FISH Probes |  | PROFILE | No | No
ADD4F | [NAME] | Four Additional FISH Probes ([NAME] Only) | Four Additional FISH Probes |  | PROFILE | No | No
ADD5F | [NAME] | Five Additional FISH Probes ([NAME] Only) | Five Additional FISH Probes |  | PROFILE | No | No
ADD6F | [NAME] | Six Additional FISH Probes ([NAME] Only) | Six Additional FISH Probes |  | PROFILE | No | No
ADD7F | [NAME] | Seven Additional FISH Probes ([NAME] Only) | Seven Additional FISH Probes |  | PROFILE | No | No
ADD8F | [NAME] | Eight Additional FISH Probes ([NAME] Only) | Eight Additional FISH Probes |  | PROFILE | No | No
ADD9F | [NAME] | Nine Additional FISH Probes ([NAME] Only) | Nine Additional FISH Probes |  | PROFILE | No | No
FRDP | Test | Rickettsial Disease Panel | Rickettsial Disease Panel |  | PROFILE |  |  | If R. Typhi IgG is Detected - FRTG Rickettsia (Typhus Fever) [NAME] will be performed at an additional charge.   If R. Typhi IgM is Detected - FRTM Rickettsia (Typhus Fever) IgM Titer will be performed at an additional charge.   If RMSF IgG is Detected - FRMFG Rickettsia (RMSF) [NAME] will be performed at an additional charge.   If RMSF IgM is Detected - FRMFM Rickettsia (RMSF) IgM Titer will be performed at an additional charge.   If Q Fever IgG Phase I (FQGI) is Positive – FQFG1 Q Fever IgG Phase I Titer will be performed at an additional charge.    If Q Fever IgM Phase I (FQMI) is Positive – FQFG2 Q Fever IgM Phase I Titer will be performed at an additional charge.    If Q Fever IgG Phase II (FQG2S) is Positive – FQFM1 Q Fever IgG Phase II Titer will be performed at an additional charge.   If Q Fever IgM Phase II (FQM2S) is Positive – FQFM2 Q Fever IgM Phase II Titer will be performed at an additional charge.
FRDP | Component |  | RICKETTSIA ANTIBODY | 2 | 86757 | No | No
FQMI | Component | Q Fever IgM Phase I Screen | Q Fever IgM Phase I Screen | 1 | 86638 | Yes | No
FRDP | Component |  | RICKETTSIA ANTIBODY | 2 | 86757 | No | No
FQGI | Component | Q Fever IgG Phase I Screen | Q Fever IgG Phase I Screen | 1 | 86638 | Yes | No
FRMGM | Component | RMSF IgG/IgM Reflex to Titers | RMSF IgG/IgM Reflex to Titers | 2 | 86757 | Yes | No
FQG2S | Component | Q Fever IgG Phase II Screen | Q Fever IgG Phase II Screen | 1 | 86638 | Yes | No
FRTGM | Component | [NAME]/IgM Reflex to Titers | [NAME]/IgM Reflex to Titers | 2 | 86757 | Yes | No
FQM2S | Component | Q Fever IgM Phase II Screen | Q Fever IgM Phase II Screen | 1 | 86638 | Yes | No
FRMFG | [NAME] | Rickettsia (RMSF) [NAME] | RMSF IgG Titer | 1 | 86757 | No | No
FQFG2 | [NAME] | Q Fever IgG Phase II Titer | Q Fever IgG Phase II Titer | 1 | 86638 | No | No
FRMFM | [NAME] | Rickettsia (RMSF) IgM Titer | RMSF IgM Titer | 1 | 86757 | No | No
FQFM1 | [NAME] | Q Fever IgM Phase I Titer | Q Fever IgM Phase I Titer | 1 | 86638 | No | No
FQFG1 | [NAME] | Q Fever IgG Phase I Titer | Q Fever IgG Phase I Titer | 1 | 86638 | No | No
FRTG | [NAME] | R. Typhi IgG Titer | R. Typhi IgG Titer | 1 | 86757 | No | No
FRTM | [NAME] | R. Typhi IgM Titer | R. Typhi IgM Titer | 1 | 86757 | No | No
FQFM2 | [NAME] | Q Fever IgM Phase II Titer | Q Fever IgM Phase II Titer | 1 | 86638 | No | No
FRTAL | Test | T-Cell Acute Lymphoblastic Leukemia (T-ALL), FISH | ALL (T-Cell), FISH |  | PROFILE |  |  | We recommend the following testing algorithm for patients with T-cell acute lymphoblastic leukemia (T-ALL):   -At diagnosis, conventional cytogenetic studies (BM / Chromosome Analysis, [NAME], Bone Marrow) and a complete T-ALL FISH panel (FRTAL / T-Cell Acute Lymphoblastic Leukemia [T-ALL], FISH) should be performed.   -At follow-up, conventional cytogenetic studies (BM / Chromosome Analysis, [NAME], Bone Marrow) and targeted T-ALL FISH probes based on the abnormalities identified in the diagnostic study can be evaluated.   -If the patient clinically relapses, a conventional chromosome study is useful to identify cytogenetic changes in the neoplastic clone or the possible emergence of a new therapy-related myeloid clone.
30FP | [NAME] | Thirty Additional FISH Probes ([NAME] Only) | Thirty Additional FISH Probes |  | PROFILE | No | No
ADD6F | [NAME] | Six Additional FISH Probes ([NAME] Only) | Six Additional FISH Probes |  | PROFILE | No | No
16FP | [NAME] | Sixteen Additional FISH Probes ([NAME] Only) | Sixteen Additional FISH Probes |  | PROFILE | No | No
28FP | [NAME] | Twenty Eight Additional FISH Probes ([NAME] Only) | Twenty Eight Additional FISH Probes |  | PROFILE | No | No
25FP | [NAME] | Twenty Five Additional FISH Probes ([NAME] Only) | Twenty Five Additional FISH Probes |  | PROFILE | No | No
24FP | [NAME] | Twenty Four Additional FISH Probes ([NAME] Only) | Twenty Four Additional FISH Probes |  | PROFILE | No | No
ADD10 | [NAME] | Ten Additional FISH Probes ([NAME] Only) | Ten Additional FISH Probes |  | PROFILE | No | No
29FP | [NAME] | Twenty Nine Additional FISH Probes ([NAME] Only) | Twenty Nine Additional FISH Probes |  | PROFILE | No | No
22FP | [NAME] | Twenty Two Additional FISH Probes ([NAME] Only) | Twenty Two Additional FISH Probes |  | PROFILE | No | No
18FP | [NAME] | Eighteen Additional FISH Probes ([NAME] Only) | Eighteen Additional FISH Probes |  | PROFILE | No | No
13FP | [NAME] | Thirteen Additional FISH Probes ([NAME] Only) | Thirteen Additional FISH Probes |  | PROFILE | No | No
ADD4F | [NAME] | Four Additional FISH Probes ([NAME] Only) | Four Additional FISH Probes |  | PROFILE | No | No
15FP | [NAME] | Fifteen Additional FISH Probes ([NAME] Only) | Fifteen Additional FISH Probes |  | PROFILE | No | No
ADD11 | [NAME] | Eleven Additional FISH Probes ([NAME] Only) | Eleven Additional FISH Probes |  | PROFILE | No | No
27FP | [NAME] | Twenty Seven Additional FISH Probes ([NAME] Only) | Twenty Seven Additional FISH Probes |  | PROFILE | No | No
ADD12 | [NAME] | Twelve Additional FISH Probes ([NAME] Only) | Twelve Additional FISH Probes |  | PROFILE | No | No
ADD7F | [NAME] | Seven Additional FISH Probes ([NAME] Only) | Seven Additional FISH Probes |  | PROFILE | No | No
17FP | [NAME] | Seventeen Additional FISH Probes ([NAME] Only) | Seventeen Additional FISH Probes |  | PROFILE | No | No
ADD2F | [NAME] | Two Additional FISH Probes ([NAME] Only) | Two Additional FISH Probes |  | PROFILE | No | No
14FP | [NAME] | Fourteen Additional FISH Probes ([NAME] Only) | Fourteen Additional FISH Probes |  | PROFILE | No | No
ADD5F | [NAME] | Five Additional FISH Probes ([NAME] Only) | Five Additional FISH Probes |  | PROFILE | No | No
ADD9F | [NAME] | Nine Additional FISH Probes ([NAME] Only) | Nine Additional FISH Probes |  | PROFILE | No | No
23FP | [NAME] | Twenty Three Additional FISH Probes ([NAME] Only) | Twenty Three Additional FISH Probes |  | PROFILE | No | No
ADD8F | [NAME] | Eight Additional FISH Probes ([NAME] Only) | Eight Additional FISH Probes |  | PROFILE | No | No
ADD3F | [NAME] | Three Additional FISH Probes ([NAME] Only) | Three Additional FISH Probes |  | PROFILE | No | No
26FP | [NAME] | Twenty Six Additional FISH Probes ([NAME] Only) | Twenty Six Additional FISH Probes |  | PROFILE | No | No
20FP | [NAME] | Twenty Additional FISH Probes ([NAME] Only) | Twenty Additional FISH Probes |  | PROFILE | No | No
ADD1F | [NAME] | One Additional FISH Probe ([NAME] Only) | One Additional FISH Probe |  | PROFILE | No | No
21FP | [NAME] | Twenty One Additional FISH Probes ([NAME] Only) | Twenty One Additional FISH Probes |  | PROFILE | No | No
19FP | [NAME] | Nineteen Additional FISH Probes ([NAME] Only) | Nineteen Additional FISH Probes |  | PROFILE | No | No
FRTLP | Test | T-Cell Lymphoma, FISH, Blood or Bone Marrow | T-Cell Lymphoma, FISH, B/BM |  | PROFILE |  |  | This panel includes testing for the following anomalies via the probes listed:
ADD12 | [NAME] | Twelve Additional FISH Probes ([NAME] Only) | Twelve Additional FISH Probes |  | PROFILE | No | No
14FP | [NAME] | Fourteen Additional FISH Probes ([NAME] Only) | Fourteen Additional FISH Probes |  | PROFILE | No | No
ADD10 | [NAME] | Ten Additional FISH Probes ([NAME] Only) | Ten Additional FISH Probes |  | PROFILE | No | No
23FP | [NAME] | Twenty Three Additional FISH Probes ([NAME] Only) | Twenty Three Additional FISH Probes |  | PROFILE | No | No
15FP | [NAME] | Fifteen Additional FISH Probes ([NAME] Only) | Fifteen Additional FISH Probes |  | PROFILE | No | No
29FP | [NAME] | Twenty Nine Additional FISH Probes ([NAME] Only) | Twenty Nine Additional FISH Probes |  | PROFILE | No | No
21FP | [NAME] | Twenty One Additional FISH Probes ([NAME] Only) | Twenty One Additional FISH Probes |  | PROFILE | No | No
ADD8F | [NAME] | Eight Additional FISH Probes ([NAME] Only) | Eight Additional FISH Probes |  | PROFILE | No | No
13FP | [NAME] | Thirteen Additional FISH Probes ([NAME] Only) | Thirteen Additional FISH Probes |  | PROFILE | No | No
26FP | [NAME] | Twenty Six Additional FISH Probes ([NAME] Only) | Twenty Six Additional FISH Probes |  | PROFILE | No | No
16FP | [NAME] | Sixteen Additional FISH Probes ([NAME] Only) | Sixteen Additional FISH Probes |  | PROFILE | No | No
25FP | [NAME] | Twenty Five Additional FISH Probes ([NAME] Only) | Twenty Five Additional FISH Probes |  | PROFILE | No | No
24FP | [NAME] | Twenty Four Additional FISH Probes ([NAME] Only) | Twenty Four Additional FISH Probes |  | PROFILE | No | No
20FP | [NAME] | Twenty Additional FISH Probes ([NAME] Only) | Twenty Additional FISH Probes |  | PROFILE | No | No
18FP | [NAME] | Eighteen Additional FISH Probes ([NAME] Only) | Eighteen Additional FISH Probes |  | PROFILE | No | No
ADD5F | [NAME] | Five Additional FISH Probes ([NAME] Only) | Five Additional FISH Probes |  | PROFILE | No | No
17FP | [NAME] | Seventeen Additional FISH Probes ([NAME] Only) | Seventeen Additional FISH Probes |  | PROFILE | No | No
ADD9F | [NAME] | Nine Additional FISH Probes ([NAME] Only) | Nine Additional FISH Probes |  | PROFILE | No | No
ADD7F | [NAME] | Seven Additional FISH Probes ([NAME] Only) | Seven Additional FISH Probes |  | PROFILE | No | No
ADD11 | [NAME] | Eleven Additional FISH Probes ([NAME] Only) | Eleven Additional FISH Probes |  | PROFILE | No | No
ADD6F | [NAME] | Six Additional FISH Probes ([NAME] Only) | Six Additional FISH Probes |  | PROFILE | No | No
22FP | [NAME] | Twenty Two Additional FISH Probes ([NAME] Only) | Twenty Two Additional FISH Probes |  | PROFILE | No | No
19FP | [NAME] | Nineteen Additional FISH Probes ([NAME] Only) | Nineteen Additional FISH Probes |  | PROFILE | No | No
27FP | [NAME] | Twenty Seven Additional FISH Probes ([NAME] Only) | Twenty Seven Additional FISH Probes |  | PROFILE | No | No
30FP | [NAME] | Thirty Additional FISH Probes ([NAME] Only) | Thirty Additional FISH Probes |  | PROFILE | No | No
28FP | [NAME] | Twenty Eight Additional FISH Probes ([NAME] Only) | Twenty Eight Additional FISH Probes |  | PROFILE | No | No
ADD4F | [NAME] | Four Additional FISH Probes ([NAME] Only) | Four Additional FISH Probes |  | PROFILE | No | No
ADD3F | [NAME] | Three Additional FISH Probes ([NAME] Only) | Three Additional FISH Probes |  | PROFILE | No | No
ADD2F | [NAME] | Two Additional FISH Probes ([NAME] Only) | Two Additional FISH Probes |  | PROFILE | No | No
ADD1F | [NAME] | One Additional FISH Probe ([NAME] Only) | One Additional FISH Probe |  | PROFILE | No | No
FS | Test | Fungal Smear | Fungal Smear | 1 | 87206 |  |  | When this test is ordered, the reflex test may be performed and charged.
TISSR | [NAME] | Tissue Processing ([NAME] Only) | Tissue Processing | 1 | 87176 | No | No
FSAA | Test | Amphetamines Analysis, Serum | Serum Amphetamine Analysis | 1 | 80101 |  |  | If the Serum Amphetamine Analysis is positive, then the Amphetamines, GC/MS Confirm (FSAC) will be performed at no additional charge.
FSAC | [NAME] | Amphetamines, GC/MS Confirm | Amphetamines, GC/MS Confirm | 1 | 82145 | No | No
FSCMB | Test | Synthetic Cannabinoids (K2, Spice), Expanded Panel, urine, qualitative | Synthetic Cannabinoids Scrn, UR QL | 1 | 82541 |  |  | If the Synthetic Cannabinoids Scrn, UR QL is positive, then the Synthetic Cannabinoids Confirm (FSYCC) will be performed at an additional charge.
FSYCC | [NAME] | Synthetic Cannabinoids Confirmation | Synthetic Cannabinoids Confirm | 1 | 82541 | No | No
FSED | Test | Sedative Hypnotic Panel, Urine-Forensic | Sedative Hypnotic Panel, [NAME] |  | PROFILE |  |  | If screen is positive, confirmation(s) will be done at no additional charge.
FSED | Component |  | single drug class method | 3 | 80101 | No | No
FSED | Component |  | Alcohol (ethanol) | 1 | 82055 | No | No
FSED | Component |  | Chromatography, quantitative, column | 1 | 82491 | No | No
FSED | Component |  | Column chromatography | 1 | 82541 | No | No
FBARB | [NAME] | Barbiturate Confirmation, Quantitative, [NAME] | Barbiturate Confirmation, UR |  |  | No | No
FBENU | [NAME] | Benzodiazepine Confirmation, Quantitative, [NAME] | Benzodiazepine Confirmation, UR |  |  | No | No
FFTZU | [NAME] | Flunitrazepam (Rohypnol) Confirmation, [NAME] | Flunitrazepam ([NAME]), [NAME] |  |  | No | No
FMETA | [NAME] | Alcohol, Ethyl-urine | Ethyl Alcohol Confirmation, UR |  |  | No | No
FSTSC | Test | [NAME] with [NAME] to [NAME] | Streptozyme Screen w/[NAME] | 1 | 86403 |  |  | If the Streptozyme Screen is "Positive" then the Streptozyme Titer will be performed at an additional charge (CPT code 86406).
FSTTI | [NAME] | [NAME] | [NAME] | 1 | 86406 | No | No
FUCT | Test | Alpha-Fucosidase, Fibroblasts | Alpha-Fucosidase, Fibroblasts | 1 | 82657 |  |  | When this test is ordered, a fibroblast culture and cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple lysosomal enzyme assays on a patient utilizing fibroblast culture, only 1 culture is required regardless of the number of enzyme assays ordered. If viable cells are not obtained within 10 days, client will be notified.
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
FIBR | [NAME] | Fibroblast Culture | Fibroblast Culture | 1 | 88233 | Yes | Yes
FUNID | Test | Culture Referred for Identification, Fungus | Culture Referred for ID, Fungus | 1 | 0 |  |  | When this test is ordered, the reflex tests may be performed and charged.
LCCI | [NAME] | Ident Rapid PCR Coccidioides ([NAME] Only) | Ident Rapid [NAME] | 1 | 87150 | No | No
CNP | [NAME] | [NAME], Fungus Indent | Microbial Probe Fungus Ident | 1 | 87150 | No | No
D2F | [NAME] | Fungal Sequencing Identification | D2 Fungal Sequencing Identification | 1 | 87153 | No | No
RMALY | [NAME] | Id MALDI-TOF Mass Spec Yeast ([NAME] Only) | Id MALDI-TOF Mass Spec Yeast | 1 | 87106 | No | No
[NAME] | [NAME] | Id, Histoplasma/Blastomyces PCR ([NAME] Only) | Id, Histoplasma/Blastomyces PCR | 2 | 87150 | No | No
[NAME] | [NAME] | Yeast Ident Panel B ([NAME] Only) | Yeast Ident panel B | 1 | 87106 | No | No
GT | [NAME] | Yeast Ident Panel A (Bill Only) | Yeast Ident Panel A | 1 | 87106 | No | No
RMALF | [NAME] | ID MALDI-TOF Mass Spec Fungi ([NAME] Only) | Id MALDI-TOF Mass Spec Fungi | 1 | 87107 | No | No
FUNA | [NAME] | Fungal Ident Panel A (Bill Only) | Fungal Ident Panel A | 1 | 87107 | No | No
FUNB | [NAME] | Fungal Ident Panel B ([NAME] Only) | Fungal Ident Panel B | 1 | 87107 | No | No
RRU | [NAME] | Yeast Ident Panel D (Bill Only) | Yeast Ident Panel D | 1 | 87106 | No | No
API | [NAME] | Yeast Ident Panel C | Yeast Ident Panel C | 1 | 87106 | No | No
FVAG | Test | Fungal Culture, Vaginal | Fungal Culture, Vaginal | 1 | 87102 |  |  | When this test is ordered, the reflex tests may be performed and charged.
API | [NAME] | Yeast Ident Panel C | Yeast Ident Panel C | 1 | 87106 | No | No
RMALY | [NAME] | Id MALDI-TOF Mass Spec Yeast ([NAME] Only) | Id MALDI-TOF Mass Spec Yeast | 1 | 87106 | No | No
RRU | [NAME] | Yeast Ident Panel D (Bill Only) | Yeast Ident Panel D | 1 | 87106 | No | No
[NAME] | [NAME] | Yeast Ident Panel B ([NAME] Only) | Yeast Ident panel B | 1 | 87106 | No | No
[NAME] | [NAME] | Id, Histoplasma/Blastomyces PCR ([NAME] Only) | Id, Histoplasma/Blastomyces PCR | 2 | 87150 | No | No
LCCI | [NAME] | Ident Rapid PCR Coccidioides ([NAME] Only) | Ident Rapid [NAME] | 1 | 87150 | No | No
GT | [NAME] | Yeast Ident Panel A (Bill Only) | Yeast Ident Panel A | 1 | 87106 | No | No
FUNA | [NAME] | Fungal Ident Panel A (Bill Only) | Fungal Ident Panel A | 1 | 87107 | No | No
RMALF | [NAME] | ID MALDI-TOF Mass Spec Fungi ([NAME] Only) | Id MALDI-TOF Mass Spec Fungi | 1 | 87107 | No | No
D2F | [NAME] | Fungal Sequencing Identification | D2 Fungal Sequencing Identification | 1 | 87153 | No | No
FUNB | [NAME] | Fungal Ident Panel B ([NAME] Only) | Fungal Ident Panel B | 1 | 87107 | No | No
CNP | [NAME] | [NAME], Fungus Indent | Microbial Probe Fungus Ident | 1 | 87150 | No | No
FX13M | Test | Factor [NAME], Qualitative, with [NAME] to Factor [NAME] 1:1 Mix | Factor [NAME], Qual, w/[NAME] 1:1 Mix | 1 | 85291 |  |  | If Factor XIII 1:1 has a result of Lysis, then Factor XIII, 1:1 Mix will be performed at an additional charge.
F13BO | [NAME] | Factor XIII 1:1, [NAME] Only | Factor XIII 1:1, [NAME] Only | 1 | 85291 | No | No
FXPB | Test | Fragile X Syndrome, Molecular Analysis | Fragile X Syndrome, [NAME]. Analysis | 1 | 81243 |  |  | When this test is ordered, fragile X follow-up analysis testing will be performed and charged dependent upon on the size of the CGG repeat found by PCR analysis.   For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
FXFU | [NAME] | Fragile X, Follow up Analysis | Fragile X, Follow Up Analysis | 1 | 81244 | No | No
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
FYABS | Test | [NAME] with [NAME] to [NAME] and Western Blot | [NAME]. w/Reflex to [NAME] and WB | 1 | 86255 |  |  | If [NAME], IFA is positive, [NAME], Western Blot, FYABW, will be performed at an additional charge.    If [NAME], Western Blot is positive, [NAME], FYABT, will be performed at an additional charge.
FYABW | [NAME] | [NAME], Western Blot | [NAME], Western Blot | 1 | 84181 | No | No
FYABT | [NAME] | [NAME], [NAME] | [NAME] Titer | 1 | 86256 | No | No
G6ST | Test | N-Acetylgalactosamine-6-Sulfate Sulfatase, Fibroblasts | N-Acetylgalactosamine 6 Slft, Fibro | 1 | 82657 |  |  | When this test is ordered, a fibroblast culture and cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple lysosomal enzyme assays on a patient utilizing fibroblast culture, only 1 culture is required regardless of the number of enzyme assays ordered. If viable cells are not obtained within 10 days, client will be notified.
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
FIBR | [NAME] | Fibroblast Culture | Fibroblast Culture | 1 | 88233 | Yes | Yes
GAAKM | Test | Pompe Disease, Known Mutation | Pompe Disease, Known Mutation | 1 | 81403 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
GAAMS | Test | Pompe Disease, Full Gene Sequencing | Pompe Disease, Full Gene Sequencing | 1 | 81406 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
GALCK | Test | Krabbe Disease, Known Mutation | Krabbe Disease, Known Mutation | 1 | 81403 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
GALCS | Test | Krabbe Disease, Full Gene Analysis and Large (30 kb) Deletion, PCR | Krabbe Disease, Full Gene Analysis | 1 | 81406 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
GALTK | Test | Galactosemia Gene Analysis, Known Mutation | Galactosemia Known Mutation | 1 | 81403 |  |  | For prenatal specimens only: If amniotic fluid (nonconfluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (nonconfluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
GALTP | Test | Galactose-1-Phosphate Uridyltransferase Biochemical Phenotyping, [NAME] | Gal-1-Phos Urdyltrns Phenotype,RBC | 1 | 82664 |  |  | A quantitative galactose-1-phosphate uridyltransferase (GALT) level (GALT / Galactose-1-Phosphate Uridyltransferase [GALT], Blood) is used in addition to the isoelectric focusing for accurate interpretation. If recent GALT test results are not provided, GALT will be automatically performed at an additional charge. However, if previous GALT results are provided, GALT testing will be cancelled and not charged.
GALT | [NAME] | Galactose-1-Phosphate Uridyltransferase (GALT), Blood | Gal-1-P Uridyltransferase, RBC | 1 | 82775 | Yes | Yes
GAUW | Test | Gaucher Disease, Mutation Analysis, GBA | Gaucher Disease, Mutation Analysis | 1 | 81251 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
GBAKM | Test | Gaucher Disease, Known Mutation | Gaucher Disease, Known Mutation | 1 | 81403 |  |  | If skin biopsy is received, fibroblast culture will be added and charged separately.   For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
GBAMS | Test | Gaucher Disease, Full Gene Analysis | Gaucher Disease, Full Gene Analysis | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
GCT | Test | [NAME], Blood | [NAME], B | 1 | 82775 |  |  | Testing begins with galactose-1-phosphate uridyltransferase (GALT) enzyme analysis. If GALT is > or =24.5 nmol/h/mg of hemoglobin, testing is complete. No molecular test will be performed. If GALT is <24.5 nmol/h/mg of hemoglobin, GAL6 / Galactosemia Gene Analysis (6-Mutation Panel) will be performed at an additional charge.
GAL6 | [NAME] | Galactosemia Gene Analysis (6-Mutation Panel) | Galactosemia Gene Analysis | 1 | 81401 | No | Yes
GEN | Test | Bacterial Culture, Aerobic | Bacterial Culture, Aerobic | 1 | 87070 |  |  | When this test is ordered, the reflex tests may be performed and charged.
HODGE | [NAME] | Carbapenemase Detection, Modified Hodge Test | Carbapenamase-Modified Hodge Test | 1 | 87185 | No | Yes
STAP | [NAME] | Identification Staphylococcus ([NAME] Only) | Identification Staphylococcus | 1 | 87077 | No | No
SHIG | [NAME] | Serologic Agglut Method 3 Ident (Bill Only) | Serologic Agglut Method 3 Ident | 1 | 87147 | No | No
EC | [NAME] | Serologic Agglut Method 2 Ident (Bill Only) | Serologic Agglut Method 2 Ident | 1 | 87147 | No | No
STRP | [NAME] | Identification Streptococcus (Bill Only) | Identification Streptococcus | 1 | 87077 | No | No
KPNRP | [NAME] | KPC (blaKPC) and NDM (blaNDM) in Gram-Negative Bacilli, Molecular Detection, PCR | KPC and NDM PCR | 2 | 87798 | No | Yes
RMALD | [NAME] | Ident by MALDI-TOF Mass Spec ([NAME] Only) | Ident by MALDI-TOF mass spec | 1 | 87077 | No | No
GID | [NAME] | [NAME] ([NAME] Only) | [NAME] | 1 | 87077 | No | No
ISAE | [NAME] | Aerobe Ident by Sequencing ([NAME] Only) | Aerobe Ident by Sequencing | 1 | 87153 | No | No
TISSR | [NAME] | Tissue Processing ([NAME] Only) | Tissue Processing | 1 | 87176 | No | No
BLA | [NAME] | Beta Lactamase ([NAME] Only) | Beta Lactamase | 1 | 87185 | No | No
SALS | [NAME] | Serologic Agglut Method 1 Ident (Bill Only) | Serologic Agglut Method 1 Ident | 1 | 87147 | No | No
REFID | [NAME] | Additional Identification Procedure (Bill Only) | Additional Identification Procedure | 1 | 87077 | No | No
COMM | [NAME] | Identification, [NAME] | Identification [NAME] | 1 | 87077 | No | No
GFDKM | Test | [NAME], Known Mutation | [NAME], Known Mutation | 1 | 81479
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
GFDMS | Test | [NAME], Full Gene Analysis | [NAME], Full Gene Analysis | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
GRHKM | Test | GRHPR Gene, Known Mutation | GRHPR Gene, Known Mutation | 1 | 81479 |  |  | For prenatal specimens only: If amniotic fluid (nonconfluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (nonconfluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal sample that is received, maternal cell contamination studies maternal cell contamination studies will be added.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
HAEVP | Test | Hemolytic Anemia Evaluation | Hemolytic Anemia Evaluation |  | PROFILE |  |  | This is a consultative evaluation in which the case will be evaluated and appropriate tests performed, at an additional charge, and the results interpreted.   Note: RBCE / Reflexed RBC Enzymes, Blood includes: adenosine deaminase, adenylate kinase, phosphofructokinase, phosphoglycerate kinase, triosephosphate isomerase, and pyrimidine 5' nucleotidase.
SCTRL | Component | Sex of Control Vial | Sex of Control Vial |  |  | Yes | No
G6PD | Component | Glucose-6-Phosphate Dehydrogenase (G-6-PD), Quantitative, Erythrocytes | G-6-PD, QN, RBC | 1 | 82955 | Yes | Yes
FRAGO | Component | Osmotic Fragility | Osmotic Fragility |  |  | Yes | No
HAEVP | Component |  | Osmotic Fragility, RBC | 1 | 85557 | No | No
HEXK | Component | Hexokinase, Blood | Hexokinase, B | 1 | 82657 | Yes | No
A2F | Component | [NAME] and F, Blood | [NAME] and F | 1 | 83021 | Yes | Yes
HBEL | Component | [NAME], Blood | [NAME], B | 1 | 83020 | Yes | No
PBSM | Component | Morphology Review | Morphology Review | 1 | 85060 | Yes | No
GPI | Component | [NAME], [NAME] | [NAME], B | 1 | 84087 | Yes | Yes
UNHB | Component | Unstable Hemoglobin, Blood | Unstable Hemoglobin, B | 1 | 83068 | Yes | Yes
PK | Component | [NAME], [NAME] | [NAME], RBC | 1 | 84220 | Yes | Yes
HAEV | Component | Hemolytic Anemia Interpretation | Hemolytic Anemia Interpretation |  |  | Yes | No
HGBMO | [NAME] | [NAME], Molecular | HGB Electrophoresis, Molecular |  | PROFILE | No | No
BND3 | [NAME] | Band 3 Fluorescence Staining | Band 3 [NAME], RBC | 1 | 88184 | No | No
MASS | [NAME] | [NAME] by Mass Spectrometry | [NAME] by [NAME], B | 1 | 83789 | No | No
IEF | [NAME] | IEF Confirms | IEF Confirms | 1 | 82664 | No | No
HPFH | [NAME] | [NAME], Red Cell Distribution, Blood | [NAME], Red Cell Distrib, B | 1 | 88184 | No | Yes
RBCE | [NAME] | Reflexed RBC Enzymes, Blood | Reflexed RBC Enzymes |  | PROFILE | No | No
GLTI | [NAME] | Glutathione, Blood | Glutathione, B | 1 | 82978 | No | No
SDEX | [NAME] | [NAME], Screen, Blood | [NAME], Scrn, B | 1 | 85660 | No | Yes
HAVAB | Test | Hepatitis A Total Antibodies, with [NAME] to Hepatitis A IgM Antibody, Serum | Hepatitis A Total Ab, w/Reflex, S | 1 | 86708 |  |  | If hepatitis A total antibodies is positive, then hepatitis A IgM antibody is performed at an additional charge.
HAVM | [NAME] | Hepatitis A IgM Antibody, Serum | Hepatitis A IgM Ab, S | 1 | 86709 | No | Yes
HAVAB | Test | Hepatitis A Total Antibodies, with [NAME] to Hepatitis A IgM Antibody, Serum | Hepatitis A Total Ab, w/Reflex, S | 1 | 86708 |  |  | If hepatitis A total antibodies is positive, then hepatitis A IgM antibody is performed at an additional charge.
HAVM | [NAME] | Hepatitis A IgM Antibody, Serum | Hepatitis A IgM Ab, S | 1 | 86709 | No | Yes
HBAG | Test | Hepatitis B Surface Antigen, Serum | HBs Antigen, S | 1 | 87340 |  |  | If hepatitis B surface antigen (HBsAg) screen is reactive with S/CO ratio in the range of 1.00 to 50.0, then HBsAg confirmation will be performed at an additional charge.
HBGNT | [NAME] | Hepatitis B Surface Antigen Confirmation, Serum | HBs Antigen Confirmation, S | 1 | 87341 | No | No
HBAG | Test | Hepatitis B Surface Antigen, Serum | HBs Antigen, S | 1 | 87340 |  |  | If hepatitis B surface antigen (HBsAg) screen is reactive with S/CO ratio in the range of 1.00 to 50.0, then HBsAg confirmation will be performed at an additional charge.
HBGNT | [NAME] | Hepatitis B Surface Antigen Confirmation, Serum | HBs Antigen Confirmation, S | 1 | 87341 | No | No
HBAGP | Test | Hepatitis B Surface Antigen Prenatal, Serum | HBs Antigen Prenatal, S | 1 | 87340 |  |  | If hepatitis B surface antigen (HBsAg) prenatal is reactive, then HBsAg confirmation prenatal will be performed at an additional charge.
HBNTP | [NAME] | Hepatitis B Surface Antigen Confirmation Prenatal, Serum | HBs Ag Confirmation Prenatal, S | 1 | 87341 | No | No
HBAGP | Test | Hepatitis B Surface Antigen Prenatal, Serum | HBs Antigen Prenatal, S | 1 | 87340 |  |  | If hepatitis B surface antigen (HBsAg) prenatal is reactive, then HBsAg confirmation prenatal will be performed at an additional charge.
HBNTP | [NAME] | Hepatitis B Surface Antigen Confirmation Prenatal, Serum | HBs Ag Confirmation Prenatal, S | 1 | 87341 | No | No
HBELC | Test | Hemoglobin Electrophoresis Cascade, Blood | HGB Electrophoresis Cascade |  | PROFILE |  |  | Hemoglobin electrophoresis cascade will always include [NAME]) and F and hemoglobin electrophoresis.
HBEL | Component | [NAME], Blood | [NAME], B | 1 | 83020 | Yes | No
A2F | Component | [NAME] and F, Blood | [NAME] and F | 1 | 83021 | Yes | Yes
UNHB | [NAME] | Unstable Hemoglobin, Blood | Unstable Hemoglobin, B | 1 | 83068 | No | Yes
HPFH | [NAME] | [NAME], Red Cell Distribution, Blood | [NAME], Red Cell Distrib, B | 1 | 88184 | No | Yes
HGBMO | [NAME] | [NAME], Molecular | HGB Electrophoresis, Molecular |  | PROFILE | No | No
IEF | [NAME] | IEF Confirms | IEF Confirms | 1 | 82664 | No | No
SDEX | [NAME] | [NAME], Screen, Blood | [NAME], Scrn, B | 1 | 85660 | No | Yes
MASS | [NAME] | [NAME] by Mass Spectrometry | [NAME] by [NAME], B | 1 | 83789 | No | No
HBGCD | Test | [NAME] (HBsAg) for Cadaveric or Hemolyzed Specimens, Serum | HBsAg Cadaver/Hemolyzed, S | 1 | 87340 |  |  | All reactive HBsAg EIA results are confirmed by HBsAg neutralization at an additional charge.
BNTCD | [NAME] | Hepatitis B Surface Antigen Confirmation for Cadaveric or Hemolyzed Specimens, Serum | HBsAg Confirm Cadav/Hemol, S | 1 | 87341 | No | No
HBIS | Test | Hepatitis B Immune Status Profile, Serum | Hepatitis B Immune Status Prof, S |  | PROFILE |  |  | Confirmatory testing will be performed at an extra charge on all reactive hepatitis B surface antigen prenatal specimens as well as all other reactive specimens that have a signal-to-cutoff ratio (S/CO) of < or =50.0. Specimens with an S/CO of >50.0 that are not prenatal specimens do not require confirmation.
CORAB | Component | Hepatitis B Core Total Antibodies, with [NAME] to Hepatitis B Core Antibody, IgM, Serum | HBc [NAME], w/Reflex, S | 1 | 86704 | Yes | Yes
HBAB | Component | Hepatitis B Surface Antibody, Qualitative/Quantitative, Serum | [NAME], S | 1 | 86706 | Yes | Yes
EAG | Component | [NAME], Serum | Hepatitis Be Ag, S | 1 | 87350 | Yes | Yes
HBAG | Component | Hepatitis B Surface Antigen, Serum | HBs Antigen, S | 1 | 87340 | Yes | Yes
HEAB | Component | [NAME], Serum | [NAME], S | 1 | 86707 | Yes | Yes
HBGNT | [NAME] | Hepatitis B Surface Antigen Confirmation, Serum | HBs Antigen Confirmation, S | 1 | 87341 | No | No
HBIM | [NAME] | Hepatitis B Core Antibody, IgM, Serum | HBc IgM Ab, S | 1 | 86705 | No | Yes
HCH | Test | [NAME], [NAME], Bone Marrow or /Peripheral Blood | Heme Chromosome Hold, B/BM | 1 | 81479 |  |  | This test is designed to hold the specimen but delay chromosome preparation and analysis while preliminary morphologic assessment is in process.
BM | [NAME] | Chromosome Analysis, [NAME], Bone Marrow | Chromosomes, Hematolog, Bone Marrow |  | PROFILE | No | Yes
HBL | [NAME] | Chromosome Analysis, [NAME], Blood | Chromosomes, [NAME], Blood |  | PROFILE | No | Yes
HCPCR | Test | Hepatitis C Antibody Screen with Reflex to HCV RNA by PCR, Serum | HCV [NAME] w/Reflex to HCV PCR, S | 1 | 86803 |  |  | If hepatitis C virus (HCV) antibody screen by chemiluminescence immunoassay is reactive, then HCV RNA by RT-PCR will be performed at an additional charge.
HCVQU | [NAME] | Hepatitis C Virus (HCV) RNA Detection and Quantification by Real-Time Reverse Transcription-PCR (RT-PCR), Serum | HCV RNA Detect/Quant, S | 1 | 87522 | No | Yes
HCPCR | Test | Hepatitis C Antibody Screen with Reflex to HCV RNA by PCR, Serum | HCV [NAME] w/Reflex to HCV PCR, S | 1 | 86803 |  |  | If hepatitis C virus (HCV) antibody screen by chemiluminescence immunoassay is reactive, then HCV RNA by RT-PCR will be performed at an additional charge.
HCVQU | [NAME] | Hepatitis C Virus (HCV) RNA Detection and Quantification by Real-Time Reverse Transcription-PCR (RT-PCR), Serum | HCV RNA Detect/Quant, S | 1 | 87522 | No | Yes
HCVPS | Test | Hepatitis C Antibody Screen Patient Source, Serum | HCV Ab Screen Patient Source, S | 1 | 86803 |  |  | If hepatitis C virus antibody screen is reactive, then HCV RNA will be performed at an additional charge.
PHCPS | [NAME] | Hepatitis C Virus (HCV) RNA [NAME], Serum | HCV RNA Pt Source, S | 1 | 87521 | No | Yes
HELIS | Test | Helicobacter pylori Culture with Antimicrobial Susceptibilities | Helicobacter pylori Culture + Susc | 1 | 87081 |  |  | When this test is ordered, the reflex tests may be performed and charged.   When Helicobacter pylori is isolated, identification and susceptibility testing will be performed. Routine susceptibility panel consists of amoxicillin, ciprofloxacin, clarithromycin, metronidazole, and tetracycline.
MIC | [NAME] | Sensitivity, MIC ([NAME] Only) | Sensitivity, MIC | 1 | 87186 | No | No
SUS | [NAME] | Susceptibility ([NAME] Only) | Susceptibility | 1 | 87181 | No | No
TISSR | [NAME] | Tissue Processing ([NAME] Only) | Tissue Processing | 1 | 87176 | No | No
GID | [NAME] | [NAME] ([NAME] Only) | [NAME] | 1 | 87077 | No | No
HEMP | Test | Hereditary Erythrocytosis Mutations | Hereditary Erythrocytosis Mut, B | 1 | 81479 |  |  | This evaluation is recommended for patients presenting with lifelong erythrocytosis, usually with a positive family history of similar symptoms. Polycythemia vera should be excluded prior to testing as it is much more common than hereditary erythrocytosis, and can be present even in young patients. A JAK2 V617F or JAK2 exon 12 mutation should not be present. Additionally, p50 testing should be performed and a normal result confirmed before ordering this test. For a complete evaluation including p50 testing, hemoglobin electrophoresis testing, and hereditary erythrocytosis mutation analysis in an algorithmic fashion, order REVP / Erythrocytosis Evaluation. Please note that this test (HEMP) is a reflex test for REVP and should not be ordered if REVP is ordered.
HIF2A | Component | Hypoxia-inducible Factor [NAME] (EPAS1/HIF2A) Gene, Exon 12 Sequencing | HIF2A Gene, Mutation Analysis, B | 1 | 81479 | Yes | No
PHD2 | Component | [NAME] Domain-2 (PHD2/EGLN1) [NAME] | PHD2 Gene, Mutation Analysis, B | 1 | 81479 | Yes | No
EPOR | Component | Erythropoietin Receptor (EPOR) Gene, Exon 8 Sequencing | [NAME], Mutation Analysis, B | 1 | 81479 | Yes | No
MINT | Component | Molecular Interpretation | Molecular Interpretation | 1 | 81479 | Yes | No
VHLSP | [NAME] | [NAME] (VHL) Gene, Full Gene Analysis | VHL Full Gene Analysis | 1 | 81404 | No | Yes
HEPB | Test | Hepatitis B Profile, Serum | Hepatitis B Profile, S |  | PROFILE |  |  | Confirmatory testing will be performed at an extra charge on all reactive hepatitis B surface antigen prenatal specimens as well as all other reactive specimens that have a signal-to-cutoff ratio (S/CO) of < or =50.0. Specimens with an S/CO of >50.0 that are not prenatal specimens do not require confirmation.
HBAG | Component | Hepatitis B Surface Antigen, Serum | HBs Antigen, S | 1 | 87340 | Yes | Yes
CORAB | Component | Hepatitis B Core Total Antibodies, with [NAME] to Hepatitis B Core Antibody, IgM, Serum | HBc [NAME], w/Reflex, S | 1 | 86704 | Yes | Yes
HBAB | Component | Hepatitis B Surface Antibody, Qualitative/Quantitative, Serum | [NAME], S | 1 | 86706 | Yes | Yes
HBIM | [NAME] | Hepatitis B Core Antibody, IgM, Serum | HBc IgM Ab, S | 1 | 86705 | No | Yes
HBGNT | [NAME] | Hepatitis B Surface Antigen Confirmation, Serum | HBs Antigen Confirmation, S | 1 | 87341 | No | No
HEPP | Test | Hepatitis Profile, Serum | Hepatitis Profile, S |  | PROFILE |  |  | Confirmatory testing will be performed at an extra charge on all reactive hepatitis B surface antigen prenatal specimens as well as all other reactive specimens that have a signal-to-cutoff ratio (S/CO) of < or =50.0. Specimens with an S/CO of >50.0 that are not prenatal specimens do not require confirmation.
HAVAB | Component | Hepatitis A Total Antibodies, with [NAME] to Hepatitis A IgM Antibody, Serum | Hepatitis A Total Ab, w/Reflex, S | 1 | 86708 | Yes | Yes
HBAG | Component | Hepatitis B Surface Antigen, Serum | HBs Antigen, S | 1 | 87340 | Yes | Yes
CORAB | Component | Hepatitis B Core Total Antibodies, with [NAME] to Hepatitis B Core Antibody, IgM, Serum | HBc [NAME], w/Reflex, S | 1 | 86704 | Yes | Yes
HBAB | Component | Hepatitis B Surface Antibody, Qualitative/Quantitative, Serum | [NAME], S | 1 | 86706 | Yes | Yes
HAVM | [NAME] | Hepatitis A IgM Antibody, Serum | Hepatitis A IgM Ab, S | 1 | 86709 | No | Yes
HBGNT | [NAME] | Hepatitis B Surface Antigen Confirmation, Serum | HBs Antigen Confirmation, S | 1 | 87341 | No | No
HBIM | [NAME] | Hepatitis B Core Antibody, IgM, Serum | HBc IgM Ab, S | 1 | 86705 | No | Yes
HEPS | Test | Hepatitis Screening Panel, Serum | Hepatitis Screening Panel, S |  | PROFILE |  |  | Confirmatory testing will be performed at an extra charge on all reactive hepatitis B surface antigen prenatal specimens as well as all other reactive specimens that have a signal-to-cutoff ratio (S/CO) of < or =50.0. Specimens with an S/CO of >50.0 that are not prenatal specimens do not require confirmation.
HBAG | Component | Hepatitis B Surface Antigen, Serum | HBs Antigen, S | 1 | 87340 | Yes | Yes
CORAB | Component | Hepatitis B Core Total Antibodies, with [NAME] to Hepatitis B Core Antibody, IgM, Serum | HBc [NAME], w/Reflex, S | 1 | 86704 | Yes | Yes
HAVAB | Component | Hepatitis A Total Antibodies, with [NAME] to Hepatitis A IgM Antibody, Serum | Hepatitis A Total Ab, w/Reflex, S | 1 | 86708 | Yes | Yes
HCV | Component | Hepatitis C Antibody Screen, Serum | HCV Ab Screen, S | 1 | 86803 | Yes | Yes
HBAB | Component | Hepatitis B Surface Antibody, Qualitative/Quantitative, Serum | [NAME], S | 1 | 86706 | Yes | Yes
HAVM | [NAME] | Hepatitis A IgM Antibody, Serum | Hepatitis A IgM Ab, S | 1 | 86709 | No | Yes
HBGNT | [NAME] | Hepatitis B Surface Antigen Confirmation, Serum | HBs Antigen Confirmation, S | 1 | 87341 | No | No
HBIM | [NAME] | Hepatitis B Core Antibody, IgM, Serum | HBc IgM Ab, S | 1 | 86705 | No | Yes
HEVM | Test | Hepatitis E Virus IgM Antibody Screen with Reflex to Confirmation, Serum | HEV IgM Ab Screen, S | 1 | 86790 |  |  | If hepatitis E virus (HEV) IgM antibody screen is reactive or borderline, HEV IgM antibody confirmation will be performed.
HEVML | [NAME] | Hepatitis E Virus IgM Antibody Confirmation, Serum | HEV IgM Ab Confirmation, S | 1 | 86790 | No | Yes
HEXKM | Test | Tay-Sachs Disease, HEXA Gene, Known Mutation | HEXA Gene, Known Mutation | 1 | 81403 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
HFH | Test | [NAME], Fluorescence In Situ Hybridization (FISH) Hold, Bone Marrow or Peripheral Blood | Heme FISH Hold, B/BM | 1 | 81479 |  |  | This test is designed to hold the sample but delay FISH testing while preliminary morphologic assessment or flow cytometry testing is in process. When ordering this test, a FISH test must be indicated when prompted. Based on the morphologic assessment, the FISH test originally indicated may be changed. If a different test or specific probes are needed, the client can call the laboratory and modify the requested probes (see cancellation policy below).
ADD2F | [NAME] | Two Additional FISH Probes ([NAME] Only) | Two Additional FISH Probes |  | PROFILE | No | No
ADD8F | [NAME] | Eight Additional FISH Probes ([NAME] Only) | Eight Additional FISH Probes |  | PROFILE | No | No
FBLP | [NAME] | B-Cell Lymphoma, FISH, Blood or Bone Marrow | B-Cell Lymphoma, FISH, B/BM |  | PROFILE | No | Yes
ADD12 | [NAME] | Twelve Additional FISH Probes ([NAME] Only) | Twelve Additional FISH Probes |  | PROFILE | No | No
FCLL | [NAME] | Chronic Lymphocytic Leukemia (CLL), FISH | CLL, FISH |  | PROFILE | No | Yes
19FP | [NAME] | Nineteen Additional FISH Probes ([NAME] Only) | Nineteen Additional FISH Probes |  | PROFILE | No | No
ADD5F | [NAME] | Five Additional FISH Probes ([NAME] Only) | Five Additional FISH Probes |  | PROFILE | No | No
ADD4F | [NAME] | Four Additional FISH Probes ([NAME] Only) | Four Additional FISH Probes |  | PROFILE | No | No
FCSP | [NAME] | Chromosome Anomalies, [NAME] with Chromosome-Specific FISH [NAME] | Chromosome Anomalies, [NAME], FISH |  | PROFILE | No | Yes
28FP | [NAME] | Twenty Eight Additional FISH Probes ([NAME] Only) | Twenty Eight Additional FISH Probes |  | PROFILE | No | No
13FP | [NAME] | Thirteen Additional FISH Probes ([NAME] Only) | Thirteen Additional FISH Probes |  | PROFILE | No | No
22FP | [NAME] | Twenty Two Additional FISH Probes ([NAME] Only) | Twenty Two Additional FISH Probes |  | PROFILE | No | No
16FP | [NAME] | Sixteen Additional FISH Probes ([NAME] Only) | Sixteen Additional FISH Probes |  | PROFILE | No | No
30FP | [NAME] | Thirty Additional FISH Probes ([NAME] Only) | Thirty Additional FISH Probes |  | PROFILE | No | No
23FP | [NAME] | Twenty Three Additional FISH Probes ([NAME] Only) | Twenty Three Additional FISH Probes |  | PROFILE | No | No
ADD7F | [NAME] | Seven Additional FISH Probes ([NAME] Only) | Seven Additional FISH Probes |  | PROFILE | No | No
27FP | [NAME] | Twenty Seven Additional FISH Probes ([NAME] Only) | Twenty Seven Additional FISH Probes |  | PROFILE | No | No
FMDS | [NAME] | Myelodysplastic Syndrome (MDS), FISH | MDS, FISH |  | PROFILE | No | Yes
29FP | [NAME] | Twenty Nine Additional FISH Probes ([NAME] Only) | Twenty Nine Additional FISH Probes |  | PROFILE | No | No
FBALL | [NAME] | B-Cell Acute Lymphoblastic Leukemia (ALL), FISH | ALL (B-Cell), FISH |  | PROFILE | No | Yes
ADD6F | [NAME] | Six Additional FISH Probes ([NAME] Only) | Six Additional FISH Probes |  | PROFILE | No | No
FBMT | [NAME] | XX/XY in Opposite Sex Bone Marrow Transplantation, FISH | XX/XY in Opposite Sex BMT, FISH |  | PROFILE | No | Yes
17FP | [NAME] | Seventeen Additional FISH Probes ([NAME] Only) | Seventeen Additional FISH Probes |  | PROFILE | No | No
14FP | [NAME] | Fourteen Additional FISH Probes ([NAME] Only) | Fourteen Additional FISH Probes |  | PROFILE | No | No
21FP | [NAME] | Twenty One Additional FISH Probes ([NAME] Only) | Twenty One Additional FISH Probes |  | PROFILE | No | No
ADD3F | [NAME] | Three Additional FISH Probes ([NAME] Only) | Three Additional FISH Probes |  | PROFILE | No | No
ADD10 | [NAME] | Ten Additional FISH Probes ([NAME] Only) | Ten Additional FISH Probes |  | PROFILE | No | No
25FP | [NAME] | Twenty Five Additional FISH Probes ([NAME] Only) | Twenty Five Additional FISH Probes |  | PROFILE | No | No
FRTAL | [NAME] | T-Cell Acute Lymphoblastic Leukemia (T-ALL), FISH | ALL (T-Cell), FISH |  | PROFILE | No | Yes
20FP | [NAME] | Twenty Additional FISH Probes ([NAME] Only) | Twenty Additional FISH Probes |  | PROFILE | No | No
F512 | [NAME] | PDGFRB/TEL Translocation (5;12) for Chronic Myelomonocytic Leukemia, FISH | PDGFRB/TEL, FISH |  | PROFILE | No | Yes
FIMRG | [NAME] | Imatinib Mesylate Responsive Genes, Locus Anomalies, FISH | Imatinib [NAME], FISH |  | PROFILE | No | Yes
ADD11 | [NAME] | Eleven Additional FISH Probes ([NAME] Only) | Eleven Additional FISH Probes |  | PROFILE | No | No
18FP | [NAME] | Eighteen Additional FISH Probes ([NAME] Only) | Eighteen Additional FISH Probes |  | PROFILE | No | No
ADD9F | [NAME] | Nine Additional FISH Probes ([NAME] Only) | Nine Additional FISH Probes |  | PROFILE | No | No
MBCR | [NAME] | BCR/ABL, Translocation 9;22, FISH (D-FISH) | BCR/ABL, FISH |  | PROFILE | No | Yes
ADD1F | [NAME] | One Additional FISH Probe ([NAME] Only) | One Additional FISH Probe |  | PROFILE | No | No
26FP | [NAME] | Twenty Six Additional FISH Probes ([NAME] Only) | Twenty Six Additional FISH Probes |  | PROFILE | No | No
FGFR1 | [NAME] | FGFR1, 8p11.2 Rearrangement, FISH | FGFR1 8p11.2, FISH |  | PROFILE | No | Yes
FRTLP | [NAME] | T-Cell Lymphoma, FISH, Blood or Bone Marrow | T-Cell Lymphoma, FISH, B/BM |  | PROFILE | No | Yes
FMFC | [NAME] | Myeloma, FISH, Fixed Cells | Myeloma, FISH, Fixed Cells |  | PROFILE | No | Yes
24FP | [NAME] | Twenty Four Additional FISH Probes ([NAME] Only) | Twenty Four Additional FISH Probes |  | PROFILE | No | No
FMNB | [NAME] | Neuroblastoma, 2p24 (MYCN) Amplification, FISH, Blood or Bone Marrow | MYCN, 2p24, FISH, B/BM |  | PROFILE | No | Yes
FCHIC | [NAME] | CHIC2, 4q12 Deletion (FIP1L1 and PDGFRA Fusion), FISH | CHIC2, 4q12 Deletion, FISH |  | PROFILE | No | Yes
FAML | [NAME] | Acute [NAME] (AML), FISH | AML, FISH |  | PROFILE | No | Yes
15FP | [NAME] | Fifteen Additional FISH Probes ([NAME] Only) | Fifteen Additional FISH Probes |  | PROFILE | No | No
HISTO | Test | Histoplasma capsulatum [NAME], Serum | [NAME], S | 1 | 86698 |  |  | If result is equivocal or positive, SHSTO / Histoplasma Antibody, Serum will be ordered at an additional charge.
SHSTO | [NAME] | [NAME], Serum | [NAME], S | 3 | 86698 | No | Yes
HIV | Test | HIV-1 and HIV-2 Antigen and Antibody Fourth Generation Screen, Serum | HIV-1/-2 [NAME] and [NAME] Gen, S |  | PROFILE |  |  | This test begins with HIV-1/-2 antigen and antibody screen by the immunochromatographic membrane assay. If HIV-1/-2 screen result is reactive, then HIV-1/-2 antibody differentiation test (by membrane immunoconcentration method) is performed at an additional charge. Depending on the HIV-1 and HIV-2 antibody results of this differentiation test, subsequent reflex tests such as HIV-1 antibody confirmation by Western blot and HIV-2 antibody confirmation by line immunoassay will be performed when appropriate and at an additional charge.
HIV | Component |  | HIV-1 AGENT NOS ASSAY W/OPTIC | 1 | 87899 | No | No
HIV | Component |  | HIV-1/HIV-2 1 RESULT ANTBDY | 1 | 86703 | No | No
HV1WB | [NAME] | HIV-1 Antibody Confirmation by Western Blot, Serum | HIV-1 Ab Confirm by Western Blot, S | 1 | 86689 | No | Yes
HIVDI | [NAME] | HIV-1 and HIV-2 Antibody Differentiation, Serum | HIV-1/-2 [NAME], S |  | PROFILE | No | Yes
HIV2L | [NAME] | HIV-2 Antibody Confirmation, Serum | HIV-2 Ab Confirmation, S | 1 | 86689 | No | Yes
HIV2 | Test | HIV-2 Antibody Evaluation, Serum | HIV-2 Ab Eval, S | 1 | 86702 |  |  | If HIV-2 antibody by EIA is repeatedly reactive, then HIV-2 antibody confirmation for confirmatory/supplemental testing will be added at an additional charge.
HIV2L | [NAME] | HIV-2 Antibody Confirmation, Serum | HIV-2 Ab Confirmation, S | 1 | 86689 | No | Yes
HIV2M | Test | HIV-2 Antibody Screen, Serum | HIV-2 Ab Screen, S | 1 | G0432 |  |  | If HIV-2 antibody by EIA is repeatedly reactive, then HIV-2 antibody confirmation for confirmatory/supplemental testing will be added at an additional charge.
HIV2L | [NAME] | HIV-2 Antibody Confirmation, Serum | HIV-2 Ab Confirmation, S | 1 | 86689 | No | Yes
HIVCO | Test | HIV-1 and HIV-2 Antigen and Antibody Evaluation, Serum | HIV-1/-2 [NAME] and [NAME], S | 1 | 87389 |  |  | This test begins with HIV-1/-2 antigen and antibody screen by the chemiluminescence immunoassay method. If HIV-1/-2 screen result is reactive, then HIV-1/-2 antibody differentiation test (by membrane immunoconcentration method) is performed at an additional charge. Depending on the HIV-1 and HIV-2 antibody results of this differentiation test, subsequent reflex tests such as HIV-1 antibody confirmation by Western blot and HIV-2 antibody confirmation by line immunoassay will be performed when appropriate and at an additional charge.
HIVDI | [NAME] | HIV-1 and HIV-2 Antibody Differentiation, Serum | HIV-1/-2 [NAME], S |  | PROFILE | No | Yes
HV1WB | [NAME] | HIV-1 Antibody Confirmation by Western Blot, Serum | HIV-1 Ab Confirm by Western Blot, S | 1 | 86689 | No | Yes
HIV2L | [NAME] | HIV-2 Antibody Confirmation, Serum | HIV-2 Ab Confirmation, S | 1 | 86689 | No | Yes
HIVDI | Test | HIV-1 and HIV-2 Antibody Differentiation, Serum | HIV-1/-2 [NAME], S |  | PROFILE |  |  | This HIV-1 and HIV-2 antibody differentiation test begins with the Bio-Rad Multispot HIV-1/HIV-2 Rapid Test, with the following reflex testing. Specimens with indeterminate HIV-1 antibody but negative HIV-2 antibody results then HIV-1 antibody confirmation by Western blot is performed at an additional charge. Specimens with reactive or unreadable results for both HIV-1 and HIV-2 antibodies then HIV-1 antibody confirmation by Western blot and HIV-2 antibody confirmation are performed at additional charges. Specimens with negative HIV-1 antibody but reactive HIV-2 antibody results then HIV-2 antibody confirmation is performed at an additional charge.
HIV2L | [NAME] | HIV-2 Antibody Confirmation, Serum | HIV-2 Ab Confirmation, S | 1 | 86689 | No | Yes
HV1WB | [NAME] | HIV-1 Antibody Confirmation by Western Blot, Serum | HIV-1 Ab Confirm by Western Blot, S | 1 | 86689 | No | Yes
HIVDI | Test | HIV-1 and HIV-2 Antibody Differentiation, Serum | HIV-1/-2 [NAME], S |  | PROFILE |  |  | This HIV-1 and HIV-2 antibody differentiation test begins with the Bio-Rad Multispot HIV-1/HIV-2 Rapid Test, with the following reflex testing. Specimens with indeterminate HIV-1 antibody but negative HIV-2 antibody results then HIV-1 antibody confirmation by Western blot is performed at an additional charge. Specimens with reactive or unreadable results for both HIV-1 and HIV-2 antibodies then HIV-1 antibody confirmation by Western blot and HIV-2 antibody confirmation are performed at additional charges. Specimens with negative HIV-1 antibody but reactive HIV-2 antibody results then HIV-2 antibody confirmation is performed at an additional charge.
HIVDI | Component |  | HIV-2 ANTIBODY | 1 | 86702 | No | No
HIVDI | Component |  | HIV-1ANTIBODY | 1 | 86701 | No | No
HIV2L | [NAME] | HIV-2 Antibody Confirmation, Serum | HIV-2 Ab Confirmation, S | 1 | 86689 | No | Yes
HV1WB | [NAME] | HIV-1 Antibody Confirmation by Western Blot, Serum | HIV-1 Ab Confirm by Western Blot, S | 1 | 86689 | No | Yes
HIVQR | Test | HIV-1 RNA Quantification with [NAME] to HIV-1 Genotypic Drug Resistance Mutation Analysis, Plasma | HIV-1 Quant with [NAME] to Genotype, P | 1 | 87536 |  |  | If HIV-1 RNA titer is > or =1,000 copies/mL, then HIV-1 genotypic drug resistance mutations will be determined at an additional charge.
GHIV | [NAME] | HIV-1 Genotypic Drug Resistance Mutation Analysis, Plasma | HIV-1 Genotypic Drug Resistance, P | 1 | 87901 | No | Yes
HLLFH | Test | [NAME], Leukemia/Lymphoma; Flow Hold Varies | Heme Leukemia/Lymphoma; Flow Hold V |  |  |  |  | This test is designed to delay the start of leukemia/lymphoma immunophenotyping until the preliminary assessment is completed. Specimens are held in the laboratory until noon (12 p.m. CST) 2 days after the collection date. For testing to be cancelled, the client must call Mayo Medical Laboratories at [PHONE]. The testing process will be initiated and fully charged if no notification is received within this time period. To expedite the beginning of testing, please call Mayo Medical Laboratories at [PHONE].
88465 | [NAME] | Flow Cytometry Interpretation, 2 to 8 Markers ([NAME] Only) | Flow Cytometry Interp, 2-8 Markers | 1 | 88187 | No | No
88467 | [NAME] | Flow Cytometry Interpretation, 16 or More Markers ([NAME] Only) | Flow Cytometry Interp,16 or greater | 1 | 88189 | No | No
88466 | [NAME] | Flow Cytometry Interpretation, 9 to 15 Markers ([NAME] Only) | Flow Cytometry Interp, 9-15 Markers | 1 | 88188 | No | No
81047 | [NAME] | Flow Cytometry, Cell Surface, Additional (Bill Only) | Flow Cytometry, Cell Surface, [NAME] | 1 | 88185 | No | No
80997 | [NAME] | Flow Cytometry, Cell Surface, First (Bill Only) | Flow Cytometry, Cell Surface, First | 1 | 88184 | No | No
HMBSK | Test | [NAME], Known Mutation | [NAME], Known Mutation | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
HMBSS | Test | [NAME], Full Gene Analysis | [NAME], Full Gene Analysis | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
HNPCC | Test | Hereditary Nonpolyposis Colorectal Cancer (HNPCC) Screen | HNPCC Screen | 1 | 81301 |  |  | When this test is ordered, SLRVW / Slide Review, MLH1, [NAME], MSH6, and PMS2 stains will always be performed at an additional charge.
IHCO | Component | [NAME] (MMR) Protein Immunohistochemistry Only, Tumor | MMR Protein, IHC Only, Tumor |  |  | Yes | Yes
TUMSI | Component | Microsatellite Instability (MSI), Tumor | Microsatellite Instability, Tumor | 1 | 81301 | Yes | Yes
MSH2B | [NAME] | MSH-2, Immunostain (Bill Only) | MSH-2, Immunostain | 1 | 88342 | Yes | No
PMS2B | [NAME] | PMS-2, Immunostain (Bill Only) | PMS-2, Immunostain | 1 | 88342 | Yes | No
MLH1B | [NAME] | MLH-1, Immunostain (Bill Only) | MLH-1, Immunostain | 1 | 88342 | Yes | No
SLRVW | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
MSH6B | [NAME] | MSH-6, Immunostain (Bill Only) | MSH-6, Immunostain | 1 | 88342 | Yes | No
HODGE | Test | Carbapenemase Detection, Modified Hodge Test | Carbapenamase-Modified Hodge Test | 1 | 87185
HODGB | [NAME] | Carbapenemase-Modified Hodge Test ([NAME] Only) | Carbapenamase-Modified Hodge Test | 1 | 87185 | Yes | No
HPFH | Test | [NAME], Red Cell Distribution, Blood | [NAME], Red Cell Distrib, B | 1 | 88184 |  |  | The percent of the patient’s hemoglobin F is very important to the clinical utility of this test. If this value is not provided, HBF / Hemoglobin F, Blood will be performed at an additional charge to determine if [NAME], Red Cell Distribution testing is warranted. If provided hemoglobin F value or results from HBF / Hemoglobin F, Blood are normal for age or if value is <5% the HPFH / Hemoglobin F, Red Cell Distribution, Blood will not be performed. Samples with hemoglobin F (Hb F) levels >35% will be accepted but are discouraged due to decreased test specificity. For these markedly elevated Hb F levels, a hemoglobin electrophoresis profile with request for beta globin gene molecular testing for elevated Hb F levels is recommended.
HBF | [NAME] | [NAME], Blood | [NAME], B | 1 | 83021 | No | Yes
HSEP | Test | Hereditary Spherocytosis Evaluation | Hereditary Spherocytosis Evaluation | 1 | 85557 |  |  | If the osmotic fragility test has 2 or more tubes with increased lysis, then band 3 fluorescence staining will be performed at an additional charge. If band 3 testing is desired regardless of osmotic fragility results, submit the Hereditary Spherocytosis Patient Information Sheet.
HSEV | Component | Spherocytosis Interpretation | Spherocytosis Interpretation |  |  | Yes | No
SCTRL | Component | Sex of Control Vial | Sex of Control Vial |  |  | Yes | No
FRAGO | Component | Osmotic Fragility | Osmotic Fragility |  |  | Yes | No
BND3 | [NAME] | Band 3 Fluorescence Staining | Band 3 [NAME], RBC | 1 | 88184 | No | No
HSV | Test | Herpes Simplex Virus (HSV) Type 1- and Type 2-Specific Antibodies, Serum | HSV Types 1 and 2 Ab, S |  | PROFILE |  |  | If herpes simplex virus (HSV) antibody screen is reactive, then HSV antibody by immunofluorescence assay will be performed at an additional charge.
HS1G | Component | Herpes Simplex Virus (HSV) Type 1-Specific Antibodies, Serum | HSV Type 1 Ab, IgG, S | 1 | 86695 | Yes | No
HS2G | Component | Herpes Simplex Virus (HSV) Type 2-Specific Antibodies, Serum | HSV Type 2 Ab, IgG, S | 1 | 86696 | Yes | No
MHSV | Component | Herpes Simplex Virus (HSV) Antibody Screen, IgM, by EIA, Serum | HSV Ab Screen, IgM, S by EIA | 1 | 86694 | Yes | Yes
HSMR | [NAME] | Herpes Simplex Virus (HSV) Antibody, IgM, by Immunofluorescence Assay (IFA), Serum | HSV Ab, IgM, S by IFA | 1 | 86694 | No | No
HSV | Test | Herpes Simplex Virus (HSV) Type 1- and Type 2-Specific Antibodies, Serum | HSV Types 1 and 2 Ab, S |  | PROFILE |  |  | If herpes simplex virus (HSV) antibody screen is reactive, then HSV antibody by immunofluorescence assay will be performed at an additional charge.
HS2G | Component | Herpes Simplex Virus (HSV) Type 2-Specific Antibodies, Serum | HSV Type 2 Ab, IgG, S | 1 | 86696 | Yes | No
MHSV | Component | Herpes Simplex Virus (HSV) Antibody Screen, IgM, by EIA, Serum | HSV Ab Screen, IgM, S by EIA | 1 | 86694 | Yes | Yes
HS1G | Component | Herpes Simplex Virus (HSV) Type 1-Specific Antibodies, Serum | HSV Type 1 Ab, IgG, S | 1 | 86695 | Yes | No
HSMR | [NAME] | Herpes Simplex Virus (HSV) Antibody, IgM, by Immunofluorescence Assay (IFA), Serum | HSV Ab, IgM, S by IFA | 1 | 86694 | No | No
HTLVI | Test | Human T-Cell Lymphotropic Virus Types I and II (HTLV-I/-II) Antibody Screen with Confirmation, Serum | HTLV-I/-II Ab Screen, S | 1 | 86687 |  |  | If HTLV-I/-II antibody by EIA is reactive, HTLV-I/-II antibody confirmation by line immunoassay will be performed at an additional charge.
HTLVL | [NAME] | Human T-Cell Lymphotropic Virus Types I and II (HTLV-I/-II) Antibody Confirmation, Serum | HTLV-I/-II Ab Confirmation, S | 1 | 86689 | No | Yes
HUNTK | Test | [NAME], Known Mutation | [NAME], Known Mutation | 1 | 81403 |  |  | This test is for known mutations in the IDS gene. If a familial mutation has not been identified, this known mutation test cannot be performed. To identify a familial mutation, order HUNTS / Hunter Syndrome, Full Gene Analysis.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
HUNTS | Test | [NAME], Full Gene Analysis | [NAME], Full Gene Analysis | 1 | 81405 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.   The recommended first-tier test for mucopolysaccharidosis type II is biochemical testing that measures iduronate 2-sulfatase enzyme activity in fibroblasts: IDNS / Iduronate Sulfatase, Fibroblasts. Individuals with decreased or absent enzyme activity are more likely to have a mutation in the IDS gene identifiable by this test.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
HURLK | Test | Hurler Syndrome, Known Mutation | Hurler Syndrome, Known Mutation | 1 | 81403 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
HURLS | Test | Hurler Syndrome, Full Gene Analysis | Hurler Syndrome, Full Gene Analysis | 1 | 81406 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
HV1CD | Test | HIV-1 and HIV-2 Antibodies for Cadaveric or Hemolyzed Specimens, Serum | HIV-1/-2 Cadaver/Hemolyzed, S | 1 | 86703 |  |  | This test begins with HIV-1/-2 antibody EIA. If HIV-1/-2 antibody EIA is reactive, then HIV-1/-2 antibody differentiation is performed at an additional charge. HIV-1 and HIV-2 antibody differentiation test begins with the Bio-Rad Multispot HIV-1/HIV-2 Rapid Test, with the following reflex testing. Specimens with indeterminate HIV-1 antibody but negative HIV-2 antibody results then HIV-1 antibody confirmation by Western blot is performed at an additional charge. Specimens with reactive or unreadable results for both HIV-1 and HIV-2 antibodies then HIV-1 antibody confirmation by Western blot and HIV-2 antibody confirmation are performed at additional charges. Specimens with negative HIV-1 antibody but reactive HIV-2 antibody results then HIV-2 antibody confirmation is performed at an additional charge.
HIV2L | [NAME] | HIV-2 Antibody Confirmation, Serum | HIV-2 Ab Confirmation, S | 1 | 86689 | No | Yes
HIVDI | [NAME] | HIV-1 and HIV-2 Antibody Differentiation, Serum | HIV-1/-2 [NAME], S |  | PROFILE | No | Yes
HV1WB | [NAME] | HIV-1 Antibody Confirmation by Western Blot, Serum | HIV-1 Ab Confirm by Western Blot, S | 1 | 86689 | No | Yes
HV1CM | Test | HIV-1 and HIV-2 Antibody Screen for Hemolyzed Specimens, Serum | HIV-1/-2 Ab Screen Hemolyzed, S | 1 | 86703 |  |  | This test begins with HIV-1/-2 antibody EIA. If HIV-1/-2 antibody EIA is reactive, then HIV-1/-2 antibody differentiation is performed at an additional charge. HIV-1 and HIV-2 antibody differentiation test begins with the Bio-Rad Multispot HIV-1/HIV-2 Rapid Test, with the following reflex testing. In specimens with indeterminate HIV-1 antibody but negative HIV-2 antibody results, HIV-1 antibody confirmation by Western blot is performed at an additional charge. In specimens with reactive or unreadable results for both HIV-1 and HIV-2 antibodies, HIV-1 antibody confirmation by Western blot and HIV-2 antibody confirmation are performed at additional charges. In specimens with negative HIV-1 antibody but reactive HIV-2 antibody results, HIV-2 antibody confirmation is performed at an additional charge.
HIV2L | [NAME] | HIV-2 Antibody Confirmation, Serum | HIV-2 Ab Confirmation, S | 1 | 86689 | No | Yes
HV1WB | [NAME] | HIV-1 Antibody Confirmation by Western Blot, Serum | HIV-1 Ab Confirm by Western Blot, S | 1 | 86689 | No | Yes
HIVDI | [NAME] | HIV-1 and HIV-2 Antibody Differentiation, Serum | HIV-1/-2 [NAME], S |  | PROFILE | No | Yes
IABCS | Test | B-Cell Phenotyping Profile for Immunodeficiency and Immune Competence Assessment, Blood | Immune Assessment B Cell Subsets, B |  | PROFILE |  |  | If immune assessment B-cell subsets test is abnormal, then common variable immunodeficiency (CVID) confirmation flow panel will be performed at an additional charge.
IABC | Component | B-Cell Phenotyping Screen for Immunodeficiency and Immune Competence Assessment, Blood | Immune Assessment B Cell Subsets, B |  | PROFILE | Yes | No
IABCS | Component |  | T-cells total count | 1 | 86359 | No | No
IABCS | Component |  | Absolute CD4/CD8 Count | 1 | 86360 | No | No
IABCS | Component |  | B cells, total count | 1 | 86355 | No | No
IABCS | Component |  | Natural killer cells | 1 | 86357 | No | No
TBBS | Component | T- and B-Cell Quantitation by Flow Cytometry | T- and B-Cell QN by Flow Cytometry |  | PROFILE | No | Yes
IABCS | Component |  | Each additional marker | 7 | 88185 | No | No
IABCS | Component |  | Flow Cytometry first mark | 1 | 88184 | No | No
CVID | [NAME] | Common Variable Immunodeficiency Confirmation Flow Panel | CVID Confirmation Flow Panel |  | PROFILE | No | Yes
IDENT | Test | Organism Referred for Identification, [NAME] | Organism Refer for ID, Aerobic Bact | 1 | 87077 |  |  | When this test is ordered, the reflex tests may be performed and charged.
RMALD | [NAME] | Ident by MALDI-TOF Mass Spec ([NAME] Only) | Ident by MALDI-TOF mass spec | 1 | 87077 | No | No
GID | [NAME] | [NAME] ([NAME] Only) | [NAME] | 1 | 87077 | No | No
ISAE | [NAME] | Aerobe Ident by Sequencing ([NAME] Only) | Aerobe Ident by Sequencing | 1 | 87153 | No | No
SHIG | [NAME] | Serologic Agglut Method 3 Ident (Bill Only) | Serologic Agglut Method 3 Ident | 1 | 87147 | No | No
REFID | [NAME] | Additional Identification Procedure (Bill Only) | Additional Identification Procedure | 1 | 87077 | No | No
STRP | [NAME] | Identification Streptococcus (Bill Only) | Identification Streptococcus | 1 | 87077 | No | No
STAP | [NAME] | Identification Staphylococcus ([NAME] Only) | Identification Staphylococcus | 1 | 87077 | No | No
EC | [NAME] | Serologic Agglut Method 2 Ident (Bill Only) | Serologic Agglut Method 2 Ident | 1 | 87147 | No | No
COMM | [NAME] | Identification, [NAME] | Identification [NAME] | 1 | 87077 | No | No
SALS | [NAME] | Serologic Agglut Method 1 Ident (Bill Only) | Serologic Agglut Method 1 Ident | 1 | 87147 | No | No
IDST | Test | Alpha-L-Iduronidase, Fibroblasts | Alpha-L-Iduronidase, Fibroblasts | 1 | 82657 |  |  | When this test is ordered, a fibroblast culture and cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple lysosomal enzyme assays on a patient utilizing fibroblast culture, only 1 culture is required regardless of the number of enzyme assays ordered. If viable cells are not obtained within 10 days, client will be notified.
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
FIBR | [NAME] | Fibroblast Culture | Fibroblast Culture | 1 | 88233 | Yes | Yes
IHCO | Test | [NAME] (MMR) Protein Immunohistochemistry Only, Tumor | MMR Protein, IHC Only, Tumor |  |  |  |  | When this test is ordered, MLH1, [NAME], MSH6, and PMS2 stains will always be performed at an additional charge.
MLH1B | [NAME] | MLH-1, Immunostain (Bill Only) | MLH-1, Immunostain | 1 | 88342 | Yes | No
MSH2B | [NAME] | MSH-2, Immunostain (Bill Only) | MSH-2, Immunostain | 1 | 88342 | Yes | No
MSH6B | [NAME] | MSH-6, Immunostain (Bill Only) | MSH-6, Immunostain | 1 | 88342 | Yes | No
PMS2B | [NAME] | PMS-2, Immunostain (Bill Only) | PMS-2, Immunostain | 1 | 88342 | Yes | No
KETAX | Test | Ketamine and Metabolite Confirmation, Chain of Custody, [NAME] | [NAME], CoC, U | 1 | 80299 |  |  | Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
KRAS7 | Test | KRAS Mutation Analysis, 7 Mutation Panel, Colorectal | KRAS Mutation Analysis, Colorectal | 1 | 81275 |  |  | When this test is ordered, SLRVW / Slide Review will always be performed at an additional charge.
SLRVW | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
KRASA | Test | KRAS Mutation Analysis, 7 Mutation Panel, Other (Non-Colorectal) | KRAS Mutation Analysis, Other | 1 | 81275 |  |  | When this test is ordered, slide review will always be performed at an additional charge.
SLRVW | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
LBCR | Test | [NAME], Amniotic Fluid | [NAME], AF | 1 | 83664 |  |  | If lamellar body count is indeterminate (between 15,000-50,000/mcL), then FLP / Fetal Lung Profile, [NAME] (includes lecithin/sphingomyelin ratio and phosphatidylglycerol) is performed, at an additional charge, to aid in the risk assessment for respiratory distress syndrome.
LBC | Component | [NAME], Amniotic Fluid | [NAME], AF | 1 | 83664 | Yes | Yes
FLP | [NAME] | [NAME], Amniotic Fluid | [NAME], AF |  | PROFILE | No | Yes
LCMS | Test | Leukemia/Lymphoma Immunophenotyping by Flow Cytometry | Leukemia/Lymphoma, Phenotype |  |  |  |  | When a blood, bone marrow, or fluid test is ordered, a screening panel and a professional interpretation will always be charged. The screening panel will be charged based on number of markers tested (80997 for first marker, 81047 for each additional marker). The interpretation will be based on markers tested in increments of 2 to 8, 9 to 15, or 16 and greater. In addition, reflex testing may occur to fully characterize a disease state or clarify any abnormalities from the screening test. Reflex tests will be performed at an additional charge (81047) for each marker tested.
80997 | [NAME] | Flow Cytometry, Cell Surface, First (Bill Only) | Flow Cytometry, Cell Surface, First | 1 | 88184 | Yes | No
81047 | [NAME] | Flow Cytometry, Cell Surface, Additional (Bill Only) | Flow Cytometry, Cell Surface, [NAME] | 1 | 88185 | Yes | No
88465 | [NAME] | Flow Cytometry Interpretation, 2 to 8 Markers ([NAME] Only) | Flow Cytometry Interp, 2-8 Markers | 1 | 88187 | No | No
88466 | [NAME] | Flow Cytometry Interpretation, 9 to 15 Markers ([NAME] Only) | Flow Cytometry Interp, 9-15 Markers | 1 | 88188 | No | No
88467 | [NAME] | Flow Cytometry Interpretation, 16 or More Markers ([NAME] Only) | Flow Cytometry Interp,16 or greater | 1 | 88189 | No | No
VBETA | [NAME] | T-Cell Clonality by Flow Cytometry of TCR V-Beta | TCR V-BETA |  | PROFILE | No | No
LFACX | Test | [NAME] with [NAME], [NAME], Spinal Fluid | Cryptococcus Ag w/Reflex, LFA, CSF | 1 | 87899 |  |  | If result is positive, Cryptococcus antigen titer will be performed at an additional charge.
CLFA | Component | Cryptococcus Antigen Screen with Titer, [NAME] | Cryptococcus Ag Screen w/Titer, CSF | 1 | 87899 | Yes | Yes
CLFAT | [NAME] | [NAME], LFA, Spinal Fluid | Cryptococcus Ag Titer, LFA, CSF | 1 | 87899 | No | Yes
FGENC | [NAME] | Fungal Culture, Spinal Fluid | Fungal Culture, CSF | 1 | 87102 | No | Yes
LFACX | Test | [NAME] with [NAME], [NAME], Spinal Fluid | Cryptococcus Ag w/Reflex, LFA, CSF | 1 | 87899 |  |  | If result is positive, Cryptococcus antigen titer will be performed at an additional charge.
CLFA | Component | Cryptococcus Antigen Screen with Titer, [NAME] | Cryptococcus Ag Screen w/Titer, CSF | 1 | 87899 | Yes | Yes
CLFAT | [NAME] | [NAME], LFA, Spinal Fluid | Cryptococcus Ag Titer, LFA, CSF | 1 | 87899 | No | Yes
FGENC | [NAME] | Fungal Culture, Spinal Fluid | Fungal Culture, CSF | 1 | 87102 | No | Yes
LLPT | Test | Leukemia/Lymphoma Immunophenotyping by Flow Cytometry, Tissue | Leukemia Lymphoma Phenotype, Tissue |  |  |  |  | When this test is ordered, a screening panel and a professional interpretation will always be charged. The screening panel will be charged based on number of makers tested (80997 for first marker, 81047 for each additional marker). The interpretation will be set based on markers tested in increments of 9 to 15, or 16 and greater. In addition, reflex testing may occur to fully characterize a disease state or clarify any abnormalities from the screening test. Reflex tests will be performed at an additional charge for each marker tested (80997 if applicable, 81047 if applicable).
80997 | [NAME] | Flow Cytometry, Cell Surface, First (Bill Only) | Flow Cytometry, Cell Surface, First | 1 | 88184 | No | No
81047 | [NAME] | Flow Cytometry, Cell Surface, Additional (Bill Only) | Flow Cytometry, Cell Surface, [NAME] | 1 | 88185 | No | No
88465 | [NAME] | Flow Cytometry Interpretation, 2 to 8 Markers ([NAME] Only) | Flow Cytometry Interp, 2-8 Markers | 1 | 88187 | No | No
88466 | [NAME] | Flow Cytometry Interpretation, 9 to 15 Markers ([NAME] Only) | Flow Cytometry Interp, 9-15 Markers | 1 | 88188 | No | No
88467 | [NAME] | Flow Cytometry Interpretation, 16 or More Markers ([NAME] Only) | Flow Cytometry Interp,16 or greater | 1 | 88189 | No | No
LLTOF | Test | Leukemia and Lymphoma Phenotyping, Technical Only | Leukemia/Lymphoma; [NAME] Only Flow |  |  |  |  | Note: This test is only available to clients who have MayoAccess
VBETA | [NAME] | T-Cell Clonality by Flow Cytometry of TCR V-Beta | TCR V-BETA |  | PROFILE | No | No
80997 | [NAME] | Flow Cytometry, Cell Surface, First (Bill Only) | Flow Cytometry, Cell Surface, First | 1 | 88184 | Yes | No
81047 | [NAME] | Flow Cytometry, Cell Surface, Additional (Bill Only) | Flow Cytometry, Cell Surface, [NAME] | 1 | 88185 | Yes | No
88466 | [NAME] | Flow Cytometry Interpretation, 9 to 15 Markers ([NAME] Only) | Flow Cytometry Interp, 9-15 Markers | 1 | 88188 | No | No
88467 | [NAME] | Flow Cytometry Interpretation, 16 or More Markers ([NAME] Only) | Flow Cytometry Interp,16 or greater | 1 | 88189 | No | No
88465 | [NAME] | Flow Cytometry Interpretation, 2 to 8 Markers ([NAME] Only) | Flow Cytometry Interp, 2-8 Markers | 1 | 88187 | No | No
LPA3P | Test | Lymphocyte Proliferation to Anti-CD3/Anti-CD28 and Anti-CD3/Interleukin-2 (IL-2) by Flow Cytometry | [NAME], aCD3 | 2 | 86353 |  |  | Testing with 2 stimulants will always be performed. When adequate specimen is available, a third stimulant will be performed and billed separately. If isolated patient’s peripheral blood mononuclear cells (PBMCs) have a low WBC, selected dilutions or stimulants may not be used at the discretion of the laboratory to ensure the most reliable results.
ADSTM | [NAME] | Additional Flow Stimulant ([NAME] Only) | Additional Flow Stimulant | 1 | 86353 | No | No
[NAME] | Test | Lysergic Acid Diethylamide (LSD) Confirmation, Chain of Custody, [NAME] | LSD Confirmation, CoC, U | 1 | 80299 |  |  | Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
[NAME] | Test | [NAME], [NAME] | [NAME], U | 1 | 83789 |  |  | When leukotriene E4 testing is performed, urine creatinine will always be performed at no additional charge.
AACT | [NAME] | Creatinine, [NAME] | Creatinine, U |  |  | Yes | No
LUPPR | Test | Lupus Anticoagulant Profile | [NAME] |  | PROFILE |  |  | Initial testing includes: prothrombin time (PT), activated partial thromboplastin time (APTT), and dilute [NAME]'s viper venom time (DRVVT).     If the PT, APTT, and DRVVT are normal, a computer-generated interpretive comment indicating no evidence of a lupus anticoagulant will be provided.     If PT is > or =14 seconds, PT mix will be performed.     If APTT is >36 seconds, APTT mix will be performed.     If APTT mix is >36 seconds with no evidence of heparin in sample, platelet neutralization procedure (PNP) will be performed.     If DRVVT ratio is > or =1.2, DRVVT mix will be performed.     If DRVVT mix ratio is > or =1.2, DRVVT confirm will be performed.     If PT, APTT, or DRVVT are prolonged, thrombin time (TT) will be performed.     If TT is >23 seconds, reptilase will be performed.      If appropriate, coagulation factor assays, [NAME], D-dimer, [NAME], and soluble fibrin monomer will be performed to clarify a significant abnormality in the screening clotting times.      If factor VIII result is <55%, the factor VIII inhibitor screen may be performed along with the Bethesda titering assay, if indicated.   If any test results are abnormal, all results will be reviewed by a coagulation consultant and a Special Coagulation Consultant Interpretation will be provided.
APTTB | Component | Activated Partial Thromboplastin Time (APTT), Plasma | Activated Partial Thrombopl Time, P | 1 | 85730 | Yes | Yes
CCC1 | Component | Interpretation | Interpretation |  |  | Yes | No
DRVT | Component | [NAME] Viper Venom Time (DRVVT), Plasma | Dilute Russells Viper Venom Time, P | 1 | 85613 | Yes | No
PTC | Component | Prothrombin Time (PT), Plasma | Prothrombin Time (PT), P | 1 | 85610 | Yes | Yes
APTTM | [NAME] | APTT Mix 1:1 | APTT Mix 1:1 | 1 | 85732 | No | No
CCC2 | [NAME] | Special Coagulation Interpretation | Special Coagulation Interpretation | 1 | 85390 | No | No
DIRM | [NAME] | D-Dimer, Plasma | D-Dimer, P | 1 | 85379 | No | Yes
DRVTC | [NAME] | DRVVT Confirmation | DRVVT Confirmation | 1 | 85613 | No | No
DRVTM | [NAME] | DRVVT Mix | DRVVT Mix | 1 | 85613 | No | No
F8A | [NAME] | Coagulation Factor VIII Activity Assay, Plasma | Coag Factor VIII Activity Assay, P | 1 | 85240 | No | Yes
F8IS | [NAME] | Coagulation Factor VIII Inhibitor Screen, Plasma | Coag Factor VIII Assay [NAME],P | 1 | 85335 | No | No
FACTV | [NAME] | Coagulation Factor V Activity Assay, Plasma | Coag Factor V Assay, P | 1 | 85220 | No | Yes
FIBC | [NAME] | Fibrinogen, Plasma | Fibrinogen, P | 1 | 85384 | No | Yes
F_10 | [NAME] | Coagulation Factor X Activity Assay, Plasma | Coag Factor X Assay, P | 1 | 85260 | No | Yes
F_11 | [NAME] | Coagulation Factor XI Activity Assay, Plasma | Coag Factor XI Assay, P | 1 | 85270 | No | Yes
F_12 | [NAME] | Coagulation Factor XII Activity Assay, Plasma | Coag Factor XII Assay, P | 1 | 85280 | No | Yes
F_2 | [NAME] | Coagulation Factor II Activity Assay, Plasma | Coag Factor II Assay, P | 1 | 85210 | No | Yes
F_7 | [NAME] | Coagulation Factor VII Activity Assay, Plasma | Coag Factor VII Assay, P | 1 | 85230 | No | Yes
F_9 | [NAME] | Coagulation Factor IX Activity Assay, Plasma | Coag Factor IX Assay, P | 1 | 85250 | No | Yes
IBETH | [NAME] | Bethesda Units | Bethesda Units | 1 | 85335 | No | No
PNP | [NAME] | Platelet Neutralization Procedure | Platelet Neutralization Procedure | 1 | 85597 | No | No
PTMX | [NAME] | PT Mix 1:1 | PT Mix 1:1 | 1 | 85611 | No | No
RPTL | [NAME] | Reptilase Time, Plasma | Reptilase Time, P | 1 | 85635 | No | Yes
SFM | [NAME] | Soluble [NAME] | Soluble [NAME] | 1 | 85366 | No | No
STLA | [NAME] | Staclot Lupus Anticoagulant, Plasma | Staclot LA, P | 1 | 85598 | No | No
TT | [NAME] | Thrombin Time (Bovine), Plasma | Thrombin Time (Bovine), P | 1 | 85670 | No | Yes
LYME | Test | Lyme Disease Serology, Serum | Lyme Disease Serology, S | 1 | 86618 |  |  | If Lyme disease serology is positive, then Lyme disease antibody confirmation (by Western blot) will be performed at an additional charge.
LYWB | [NAME] | Lyme Disease Antibody, Immunoblot, Serum | Lyme Disease Ab, Immunoblot, S | 2 | 86617 | No | Yes
LYME | Test | Lyme Disease Serology, Serum | Lyme Disease Serology, S | 1 | 86618 |  |  | If Lyme disease serology is positive, then Lyme disease antibody confirmation (by Western blot) will be performed at an additional charge.
LYWB | [NAME] | Lyme Disease Antibody, Immunoblot, Serum | Lyme Disease Ab, Immunoblot, S | 2 | 86617 | No | Yes
MAHKM | Test | Methylmalonic Aciduria and [NAME], cblC Type, Known Mutation | [NAME], Known Mutation | 1 | 81403 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
MAHMS | Test | Methylmalonic Aciduria and [NAME], cblC Type, Full Gene Analysis | [NAME], Full Gene Analysis | 1 | 81404 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MAMMX | Test | 6-Monoacetylmorphine (6-MAM) Confirmation, Chain of Custody, Meconium | 6-MAM Confirmation, CoC, M | 1 | 83925
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
MANT | Test | Alpha-Mannosidase, Fibroblasts | Alpha-Mannosidase, Fibroblasts | 1 | 82657 |  |  | When this test is ordered, a fibroblast culture and cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple lysosomal enzyme assays on a patient utilizing fibroblast culture, only 1 culture is required regardless of the number of enzyme assays ordered. If viable cells are not obtained within 10 days, client will be notified.
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
FIBR | [NAME] | Fibroblast Culture | Fibroblast Culture | 1 | 88233 | Yes | Yes
MCADS | Test | Medium-Chain Acyl-CoA Dehydrogenase (MCAD) Deficiency Mutation Screen | MCAD Mutation Screen | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCDKM | Test | MLYCD Gene, Known Mutation | MLYCD Gene, Known Mutation | 1 | 81479 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
MCDMS | Test | MLYCD Gene, Full Gene Analysis | MLYCD Gene, Full Gene Analysis | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCIV | Test | Mucolipidosis IV, Mutation Analysis, IVS3(-2)A->G and del6.4kb | Mucolipidosis IV, Mutation Analysis | 1 | 81290 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
ME2KM | Test | MECP2 Gene, Known Mutation | MECP2 Gene, Known Mutation | 1 | 81303 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
MEVP | Test | Methemoglobinemia Evaluation | Methemoglobinemia Evaluation |  | PROFILE |  |  | This is a consultative evaluation in which the case will be evaluated at Mayo Medical Laboratories, the appropriate tests performed at an additional charge, and the results interpreted.
SULF | Component | [NAME], Blood | [NAME], B | 1 | 83060 | Yes | Yes
[NAME] | Component | [NAME], Blood | [NAME], B | 1 | 83050 | Yes | Yes
MEV | Component | Methemoglobinemia Interpretation | Methemoglobinemia Interpretation |  |  | Yes | No
METR | Component | [NAME], Blood | [NAME], B | 1 | 82657 | Yes | Yes
HBEL | Component | [NAME], Blood | [NAME], B | 1 | 83020 | Yes | No
A2F | Component | [NAME] and F, Blood | [NAME] and F | 1 | 83021 | Yes | Yes
SDEX | [NAME] | [NAME], Screen, Blood | [NAME], Scrn, B | 1 | 85660 | No | Yes
UNHB | [NAME] | Unstable Hemoglobin, Blood | Unstable Hemoglobin, B | 1 | 83068 | No | Yes
HGBMO | [NAME] | [NAME], Molecular | HGB Electrophoresis, Molecular |  | PROFILE | No | No
MASS | [NAME] | [NAME] by Mass Spectrometry | [NAME] by [NAME], B | 1 | 83789 | No | No
HPFH | [NAME] | [NAME], Red Cell Distribution, Blood | [NAME], Red Cell Distrib, B | 1 | 88184 | No | Yes
IEF | [NAME] | IEF Confirms | IEF Confirms | 1 | 82664 | No | No
[NAME] | Test | [NAME] (MG) Evaluation, [NAME] | MG Evaluation, [NAME] |  | PROFILE |  |  | If acetylcholine receptor (AChR) modulating antibodies are > or =90% and striational antibodies are > or =1:120, then AChR ganglionic neuronal autoantibody, glutamic acid decarboxylase autoantibody, neuronal voltage-gated potassium channel autoantibody, and collapsin response-mediated response-5-IgG Western blot will be performed at an additional charge.
ARBI | Component | Acetylcholine Receptor ([NAME]) [NAME], Serum | ACh Receptor ([NAME]) Binding Ab | 1 | 83519 | Yes | Yes
ARMO | Component | Acetylcholine Receptor ([NAME]) [NAME], Serum | ACh Receptor ([NAME]) [NAME] | 1 | 83519 | Yes | No
STR | Component | Striational (Striated Muscle) Antibodies, Serum | Striational (Striated Muscle) Ab, S | 1 | 83520 | Yes | Yes
CRMWS | [NAME] | [NAME] Protein-5-IgG (CRMP-5-IgG) Western Blot, Serum | CRMP-5-IgG Western Blot, S | 1 | 84182 | No | No
GANG | [NAME] | Ganglionic Acetylcholine Receptor (Alpha3) Autoantibody, Serum | [NAME], S | 1 | 83519 | No | No
GD65S | [NAME] | Glutamic Acid Decarboxylase (GAD65) Antibody Assay, Serum | GAD65 Ab Assay, S | 1 | 86341 | No | Yes
VGKC | [NAME] | Neuronal Voltage-Gated Potassium Channel (VGKC) Autoantibody, Serum | Neuronal (V-G) K+ Channel Ab, S | 1 | 83519 | No | No
MGLES | Test | [NAME] (MG)/Lambert-Eaton Syndrome (LES) Evaluation | MG/LES Evaluation |  | PROFILE |  |  | If acetylcholine receptor (AChR) modulating antibodies are > or =90% and striational antibodies are > or =1:120, then AChR ganglionic neuronal antibody and CRMP-5-IgG Western blot will be performed at an additional charge.
CCN | Component | N-Type Calcium Channel Antibody, Serum | N-Type Calcium Channel Ab | 1 | 83519 | Yes | No
ARMO | Component | Acetylcholine Receptor ([NAME]) [NAME], Serum | ACh Receptor ([NAME]) [NAME] | 1 | 83519 | Yes | No
ARBI | Component | Acetylcholine Receptor ([NAME]) [NAME], Serum | ACh Receptor ([NAME]) Binding Ab | 1 | 83519 | Yes | Yes
STR | Component | Striational (Striated Muscle) Antibodies, Serum | Striational (Striated Muscle) Ab, S | 1 | 83520 | Yes | Yes
CCPQ | Component | P/Q-Type Calcium Channel Antibody, Serum | P/Q-Type Calcium Channel Ab | 1 | 83519 | Yes | No
CRMWS | [NAME] | [NAME] Protein-5-IgG (CRMP-5-IgG) Western Blot, Serum | CRMP-5-IgG Western Blot, S | 1 | 84182 | No | No
GANG | [NAME] | Ganglionic Acetylcholine Receptor (Alpha3) Autoantibody, Serum | [NAME], S | 1 | 83519 | No | No
MHDKM | Test | Methylmalonic Aciduria and Homocystinuria, cblD Type, Known Mutation | MMADHC Gene, Known Mutation | 1 | 81479 |  |  | For prenatal specimens only: If amniotic fluid (nonconfluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (nonconfluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
MHDMS | Test | Methylmalonic Aciduria and Homocystinuria, cblD Type, Full Gene Analysis | MMADHC Gene, Full Gene Analysis | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MHSV | Test | Herpes Simplex Virus (HSV) Antibody Screen, IgM, by EIA, Serum | HSV Ab Screen, IgM, S by EIA | 1 | 86694 |  |  | If herpes simplex virus (HSV) antibody screen, IgM by EIA is reactive, then HSV antibody, IgM by immunofluorescence assay will be performed at an additional charge.
HSMR | [NAME] | Herpes Simplex Virus (HSV) Antibody, IgM, by Immunofluorescence Assay (IFA), Serum | HSV Ab, IgM, S by IFA | 1 | 86694 | No | No
MHSV | Test | Herpes Simplex Virus (HSV) Antibody Screen, IgM, by EIA, Serum | HSV Ab Screen, IgM, S by EIA | 1 | 86694 |  |  | If herpes simplex virus (HSV) antibody screen, IgM by EIA is reactive, then HSV antibody, IgM by immunofluorescence assay will be performed at an additional charge.
HSMR | [NAME] | Herpes Simplex Virus (HSV) Antibody, IgM, by Immunofluorescence Assay (IFA), Serum | HSV Ab, IgM, S by IFA | 1 | 86694 | No | No
ML23K | Test | GNPTAB Gene, Known Mutation | GNPTAB Gene, Known Mutation | 1 | 81479 |  |  | This test is for known mutations in the GNPTAB gene. If a familial mutation has not been identified, this known mutation test cannot be performed. To identify a familial mutation, order ML23S / GNPTAB Gene, Full Gene Analysis.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
ML23S | Test | GNPTAB Gene, Full Gene Analysis | GNPTAB Gene, Full Gene Analysis | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MLBRF | Test | MLH1 Hypermethylation and BRAF Mutation Analyses, Tumor | MLH1 Hypermethylation/BRAF Mutation |  | PROFILE |  |  | When this test is ordered, slide review will always be performed at an additional charge.
BRAFP | Component | BRAF Mutation ([NAME] Only) | BRAF Mutation Analysis (V600E) |  | PROFILE | Yes | Yes
MLBRF | Component |  | UNLISTED MOLECULAR PATHOLOGY | 1 | 81479 | No | No
MBPIN | Component | MLH1 Hypermethylation/BRAF (V600E) Mutation Interpretation ([NAME] Only) | MLH1 Hyp/BRAF (V600E) Mut Interp |  | PROFILE | Yes | No
MLHHM | Component | MLH1 Hypermethylation ([NAME] Only) | MLH1 Hypermethylation |  | PROFILE | Yes | Yes
MLBRF | Component |  | BRAF GENE | 1 | 81210 | No | No
SLRVW | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
MLH1H | Test | MLH1 Hypermethylation Analysis, Tumor | MLH1 [NAME], Tumor | 1 | 81479 |  |  | When this test is ordered, slide review will always be performed at an additional charge.
SLRVW | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
MLH3S | Test | [NAME], Full Gene Analysis | [NAME], Full Gene Analysis | 1 | 81479 |  |  | When this test is ordered, CGH array will always be performed at an additional charge.
COLDB | [NAME] | Hereditary Colon Cancer CGH Array | Hereditary Colon Cancer CGH Array | 1 | 81228 | Yes | Yes
MMLNS | Test | Antimicrobial Susceptibility, Nocardia species | Susceptibility, Nocardia species | 1 |  |  |  | When this test is ordered, Susceptibility Nocardia species will be performed and charged.
SSNS | [NAME] | Susceptibility Nocardia species ([NAME] Only) | Susceptibility Nocardia species | 1 | 87186 | Yes | No
MMLRG | Test | Antimicrobial Susceptibility, Acid-Fast Bacilli, Rapidly Growing | Susceptibility, AFB, Rapid Grower | 1 |  |  |  | When this test is ordered, Susceptibility Rapid Grower will be performed and charged.
SRG | [NAME] | Susceptibility Rapid Grower ([NAME] Only) | Susceptibility Rapid Grower | 1 | 87186 | Yes | No
[NAME] | Test | Antimicrobial Susceptibility, [NAME], MIC | Susceptibility, Anaerobic, MIC | 3 | 87181 |  |  | When this test is ordered, Anaerobe [NAME] will be performed at an additional charged.   If fewer than 3 antibiotics will be reported, then Anaerobe Suscep Battery will be canceled and [NAME] per agent will be charged per antibiotic.   Based on susceptibility criteria, Beta Lactamase and/or Anaerobe Suscep per agent may be performed at an additional charge.
BLA | [NAME] | Beta Lactamase ([NAME] Only) | Beta Lactamase | 1 | 87185 | No | No
SANA | [NAME] | Anaerobe Suscep per Agent ([NAME] Only) | Anaerobe Suscep per agent | 1 | 87181 | No | No
BATTA | [NAME] | Anaerobe [NAME] (Bill Only) | Anaerobe Suscep Battery | 3 | 87181 | Yes | No
MMLSG | Test | Antimicrobial Susceptibility, Acid-Fast Bacilli, Slowly Growing | Susceptibility, AFB, Slow Grower | 1 |  |  |  | When this test is ordered, the reflex test will be performed and charged.
RSLG | [NAME] | Susceptibility [NAME] ([NAME] Only) | Susceptibility [NAME] | 1 | 87186 | Yes | No
MMLYP | Test | Antimicrobial Susceptibility Panel, Yeast | Susceptibility Panel, Yeast | 1 | 87186 |  |  | When this test is ordered, Susceptibility Yeast Panel will be performed and charged.
SYP | [NAME] | Susceptibility Yeast Panel ([NAME] Only) | Susceptibility Yeast Panel | 1 | 87186 | Yes | No
MP3AK | Test | Mucopolysaccharidosis IIIA, Known Mutation | MPS IIIA, Known Mutation | 1 | 81479 |  |  | This test is for known mutations in the SGSH gene. If a familial mutation has not been identified, this known mutation test cannot be performed. To identify a familial mutation, order MP3AS / Mucopolysaccharidosis IIIA, Full Gene Analysis.   If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
MP3AS | Test | Mucopolysaccharidosis IIIA, Full Gene Analysis | MPS IIIA, Full Gene Analysis | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MP3BK | Test | Mucopolysaccharidosis IIIB, Known Mutation | MPS IIIB, Known Mutation | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and changed separately.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
MP3BS | Test | Mucopolysaccharidosis IIIB, Full Gene Analysis | MPS IIIB, Full Gene Analysis | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and changed separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MPS6K | Test | Mucopolysaccharidosis VI, Known Mutation | MPSVI, Known Mutation | 1 | 81479 |  |  | This test is for known mutations in the ARSB gene. If a familial mutation has not been identified, this known mutation test cannot be performed. To identify a familial mutation, order MPS6S / Mucopolysaccharidosis VI, Full Gene Analysis.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
MPS6S | Test | Mucopolysaccharidosis VI, Full Gene Analysis | MPSVI, Full Gene Analysis | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MSIO | Test | Microsatellite Instability (MSI), Tumor | Microsatellite Instability, Tumor | 1 | 81301 |  |  | When this test is ordered, slide review for molecular genetics will always be performed at an additional charge.
TUMSI | Component | Microsatellite Instability (MSI), Tumor | Microsatellite Instability, Tumor | 1 | 81301 | Yes | No
SLRVW | [NAME] | Slide Review ([NAME] Only) | Slide Review | 1 | 88381 | Yes | No
MTBPZ | Test | Mycobacterium tuberculosis Complex, Pyrazinamide Resistance by pncA DNA Sequencing | Mtb PZA Resistance, pncA Sequencing | 1 | 87153 |  |  | When this test is ordered, the reflex test may be performed and charged.
MTBVP | [NAME] | Mtb PZA Confirmation, [NAME] ([NAME] Only) | Mtb PZA Confirmation, pnc A Sequence | 1 | 87153 | No | No
MTBRP | Test | Mycobacterium tuberculosis Complex, Molecular Detection, PCR | M tuberculosis Complex PCR | 1 | 87556 |  |  | When this test is ordered, the reflex test may be performed and charged.
TBT | [NAME] | Mycobacteria Culture, Concentration ([NAME] Only) | Mycobacteria Culture, Conc | 1 | 87015 | No | No
MTDNX | Test | Methadone Confirmation, Chain of Custody, [NAME] | Methadone Confirmation, CoC, U | 1 | 83840 |  |  | Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
MYCPN | Test | Mycoplasma pneumoniae Antibodies, IgG and IgM, Serum | M. [NAME], IgG and IgM, S |  | PROFILE |  |  | If [NAME] pneumoniae antibodies, IgM is positive or equivocal, then Mycoplasma pneumoniae antibodies, IgM by indirect immunofluorescence assay (IFA) will be performed at an additional charge.
MYCG | Component | Mycoplasma pneumoniae Antibodies, IgG, Serum | M. [NAME], IgG, S | 1 | 86738 | Yes | No
MYCM | Component | Mycoplasma pneumoniae Antibodies, IgM, Serum | M. pneumoniae Ab, IgM, S | 1 | 86738 | Yes | No
MMYCO | [NAME] | Mycoplasma pneumoniae Antibodies, IgM, Serum by Indirect Immunofluorescence Assay (IFA) | M. pneumoniae Ab, IgM, S by IFA | 1 | 86738 | No | No
NAGR | Test | Hexosaminidase A and Total, Leukocytes/Molecular Reflex | Hexosaminidase A and Tot, WBC/Mole | 2 | 83080 |  |  | If hexosaminidase A is <63%, then TSD / Tay-Sachs Disease, Mutation Analysis, HEXA will be added and performed at an additional charge.
TSD | [NAME] | Tay-Sachs Disease, Mutation Analysis, HEXA | Tay-Sachs, Mutation Analysis | 1 | 81255 | No | Yes
NEURF | Test | Neuraminidase, Fibroblasts | Neuraminidase, Fibroblasts | 1 | 82657 |  |  | When this test is ordered, a fibroblast culture and cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple lysosomal enzyme assays on a patient utilizing fibroblast culture, only 1 culture is required regardless of the number of enzyme assays ordered. If viable cells are not obtained within 10 days, client will be notified.
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
FIBR | [NAME] | Fibroblast Culture | Fibroblast Culture | 1 | 88233 | Yes | Yes
NIEM | Test | Niemann-Pick Type C Detection, Fibroblasts | Niemann-Pick Type C, Fibro | 1 | 82658 |  |  | When this test is ordered, a fibroblast culture and cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple lysosomal enzyme assays on a patient utilizing fibroblast culture, only 1 culture is required regardless of the number of enzyme assays ordered. If viable cells are not obtained within 10 days, client will be notified.
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
FIBR | [NAME] | Fibroblast Culture | Fibroblast Culture | 1 | 88233 | Yes | Yes
NPAIN | Test | Pain Clinic Drug Screen, [NAME] | Pain Clinic Drug Screen, U |  | PROFILE |  |  | Ethanol is performed using an immunoassay and provides a quantitative result. Screening immunoassay is performed to detect the above drugs of abuse, followed by confirmation and quantification of screen-positive specimens as follows, with the exception of opiate confirmation, which is performed as part of the profile.    If the cocaine screen is >149 ng/mL then cocaine confirmation is performed at an additional charge.   If the THC screen is >49 ng/mL then THC confirmation is performed at an additional charge.   If the barbiturate screen is >199 ng/mL then barbiturate confirmation is performed at an additional charge.   If the benzodiazepine screen is >199 ng/mL then benzodiazepine confirmation is performed at an additional charge.   If the phencyclidine screen is >24 ng/mL then phencyclidine confirmation is performed at an additional charge.   If the amphetamines screen is >499 ng/mL then amphetamines confirmation is performed at an additional charge.   If the methadone screen is >299 ng/mL then methadone confirmation is performed at an additional charge.   If the propoxyphene screen is >299 ng/mL then propoxyphene confirmation is performed at an additional charge.
NPAIN | Component |  | Drugs of Abuse,Cl,DAU10,U | 1 | 80104 | No | No
MSOP | Component | Drug of Abuse, Opiates Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 83925 | Yes | Yes
DAU | Component | Drug of Abuse Screen, DAU10, [NAME] | Drugs of Abuse, Clin, DAU10, U | 1 | 80104 | Yes | Yes
MSPCP | [NAME] | Drug of Abuse, Phencyclidine GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME] | 1 | 83992 | No | Yes
DAUBZ | [NAME] | Drug of Abuse, Benzodiazepines GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 80154 | No | Yes
MSCO | [NAME] | Drug of Abuse, [NAME], [NAME] | Drug of Abuse, [NAME], U | 1 | 82520 | No | Yes
MSMT | [NAME] | Drug of Abuse, Methadone Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 83840 | No | Yes
DAUAM | [NAME] | Drug of Abuse, Amphetamines GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME], U | 2 | 82145 | No | Yes
MSBR | [NAME] | Drug of Abuse, [NAME], [NAME] | Drug of Abuse, Barbiturate Conf, U | 1 | 82205 | No | Yes
MSTHC | [NAME] | Drug of Abuse, Tetrahydrocannabinol GC-MS Confirmation, [NAME] | Drug of Abuse, [NAME], U | 1 | 80299 | No | Yes
NPCKM | Test | Niemann-Pick Type C Disease, Known Mutation | NPC Known Mutation | 1 | 81403 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
NPCMS | Test | Niemann-Pick Type C, Full Gene Analysis | NPC Mutation Screen |  | PROFILE |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
NPCMS | Component |  | MOPATH PROCEDURE LEVEL 5 | 1 | 81404 | No | No
NPCMS | Component |  | MOPATH PROCEDURE LEVEL 7 | 1 | 81406 | No | No
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
NPD | Test | Niemann-Pick Disease, Types A and B, Mutation Analysis | Niemann-Pick Disease, Types A and B | 1 | 81330 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal sample that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
NPDKM | Test | Niemann-Pick Disease, Types A and B, Known Mutation | Niemann-Pick A-B, Known Mutation | 1 | 81403 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.   For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
NPDMS | Test | Niemann-Pick Disease, Types A and B, Full Gene Analysis | Niemann-Pick A-B Full Gene Analysis | 1 | 81479
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
OLITC | Test | Oligosaccharidoses Screen, Fibroblasts | Oligosaccharidoses Screen, Fibro | 1 | 82657 |  |  | When this test is ordered, a fibroblast culture and cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple lysosomal enzyme assays on a patient utilizing fibroblast cultures, only 1 culture is required regardless of the number of enzyme assays ordered. If viable cells are not obtained within 10 days, client will be notified.
FIBR | [NAME] | Fibroblast Culture | Fibroblast Culture | 1 | 88233 | Yes | Yes
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
OPATX | Test | Opiates Confirmation, Chain of Custody, [NAME] | Opiate Confirmation, CoC, U | 1 | 83925 |  |  | Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
OPTMX | Test | Opiate Confirmation, Chain of Custody, Meconium | Opiate Confirmation, CoC, M | 1 | 83925
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
OXYCX | Test | Oxycodone with Metabolite Confirmation, Chain of Custody, [NAME] | Oxycodone w/metabolite Conf, CoC, U | 1 | 83925 |  |  | Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
OXYSU | Test | Oxycodone Screen, [NAME] | Oxycodone Screen, U | 1 | 80101 |  |  | Testing begins with screening assay. If oxycodone screen is positive, then the liquid chromatography-tandem mass spectrometry confirmation with quantification will be performed at an additional charge.
[NAME] | [NAME] | Oxycodone with Metabolite Confirmation, [NAME] | Oxycodone w/metabolite Conf, U | 1 | 83925 | No | Yes
OXYSX | Test | Oxycodone Screen, Chain of Custody, [NAME] | Oxycodone Screen, CoC, U | 1 | 80101 |  |  | Testing begins with screening assay. If oxycodone screen is positive, then the liquid chromatography-tandem mass spectrometry confirmation with quantification will be performed at an additional charge.
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
OXYCX | [NAME] | Oxycodone with Metabolite Confirmation, Chain of Custody, [NAME] | Oxycodone w/metabolite Conf, CoC, U | 1 | 83925 | No | Yes
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
P53CA | Test | [NAME], TP53 Somatic Mutation, DNA Sequencing Exons 4-9 | TP53 gene somatic mutation analysis | 1 | 81405 |  |  | Flow cytometry CKP53 / CKP53 Protocol, Blood may be performed on peripheral blood samples to verify diagnosis of chronic lymphocytic leukemia (CLL) and determine the % B-cells in the sample prior to TP53 testing. See TP53 Sequencing Testing Algorithm in Special Instructions.
CKP53 | [NAME] | CKP53 Protocol, Blood | CKP53 Protocol, B |  | PROFILE | No | No
P53MS | Test | TP53 Gene, Full Gene Analysis | TP53 Gene, Full Gene Analysis | 1 | 81405 |  |  | When this test is ordered, CGH array will always be performed at an additional charge.
COLDB | [NAME] | Hereditary Colon Cancer CGH Array | Hereditary Colon Cancer CGH Array | 1 | 81228 | Yes | Yes
PAINO | Test | Pain Clinic Survey 10, [NAME] | Pain Clinic Survey 10, U | 1 | 80104 |  |  | If immunoassay screen is positive, confirmation is performed. Confirmation with quantification of positives for amphetamines, barbiturates, benzodiazepines, cocaine and metabolites, methadone, opiates, phencyclidine, and [NAME] will be performed at an additional charge. If only oxycodone screen positive, only confirmation of oxycodone w/metabolite will be performed. Any other opiate-positive screen will result in the full opiate confirmation being performed.
PN_10 | Component | Pain Clinic Survey 10 | Pain Clinic Survey 10 | 1 | 80104 | Yes | No
OXYSU | Component | Oxycodone Screen, [NAME] | Oxycodone Screen, U | 1 | 80101 | Yes | Yes
PCPU | [NAME] | Phencyclidine Confirmation, [NAME] | Phencyclidine Confirmation, U | 1 | 83992 | No | Yes
COKEU | [NAME] | Cocaine and Metabolite Confirmation, [NAME] | Cocaine and metabolite [NAME], U | 1 | 82520 | No | Yes
MTDNU | [NAME] | Methadone Confirmation, [NAME] | Methadone Confirmation, U | 1 | 83840 | No | Yes
[NAME] | [NAME] | Oxycodone with Metabolite Confirmation, [NAME] | Oxycodone w/metabolite Conf, U | 1 | 83925 | No | Yes
OPATU | [NAME] | Opiates Confirmation, [NAME] | Opiate Confirmation, U | 1 | 83925 | No | Yes
THCU | [NAME] | Carboxy-Tetrahydrocannabinol (THC) Confirmation, [NAME] | Carboxy-THC Confirmation, U | 1 | 80299 | No | Yes
BENZU | [NAME] | Benzodiazepines Confirmation, [NAME] | Benzodiazepines Confirmation, U | 1 | 80154 | No | Yes
BARBU | [NAME] | [NAME], [NAME] | [NAME], U | 1 | 82205 | No | Yes
AMPHU | [NAME] | Amphetamines Confirmation, [NAME] | [NAME], U | 1 | 82145 | No | Yes
PANOX | Test | Pain Clinic Survey 10, Chain of Custody, [NAME] | Pain Clinic Survey 10, CoC, U | 1 | 80104 |  |  | If immunoassay screen is positive, then gas chromatography-mass spectrometry (GC-MS) confirmation is performed. GC-MS confirmation with quantification of positives for amphetamines, barbiturates, benzodiazepines, cocaine and metabolites, methadone, phencyclidine, and [NAME] will be performed at an additional charge.   Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
[NAME] | Component | Pain Clinic Survey 10, Chain of Custody | Pain Clinic Survey 10, CoC | 1 | 80104 | Yes | No
OXYSX | Component | Oxycodone Screen, Chain of Custody, [NAME] | Oxycodone Screen, CoC, U | 1 | 80101 | Yes | Yes
AMPHX | [NAME] | Amphetamines Confirmation, Chain of Custody, [NAME] | Amphetamines Confirmation, CoC, U | 1 | 82145 | No | Yes
OPATX | [NAME] | Opiates Confirmation, Chain of Custody, [NAME] | Opiate Confirmation, CoC, U | 1 | 83925 | No | Yes
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
PCPX | [NAME] | Phencyclidine Confirmation, Chain of Custody, [NAME] | Phencyclidine Confirmation, CoC, U | 1 | 83992 | No | Yes
THCX | [NAME] | Carboxy-Tetrahydrocannabinol (THC) Confirmation, Chain of Custody, [NAME] | Carboxy-THC Confirmation, CoC, U | 1 | 80299 | No | Yes
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
BENZX | [NAME] | Benzodiazepines Confirmation, Chain of Custody, [NAME] | [NAME], CoC, U | 1 | 80154 | No | Yes
OXYCX | [NAME] | Oxycodone with Metabolite Confirmation, Chain of Custody, [NAME] | Oxycodone w/metabolite Conf, CoC, U | 1 | 83925 | No | Yes
COKEX | [NAME] | Cocaine and Metabolite Confirmation, Chain of Custody, [NAME] | Cocaine and metabolite [NAME], CoC, U | 1 | 82520 | No | Yes
BARBX | [NAME] | [NAME], Chain of Custody, [NAME] | [NAME], CoC, U | 1 | 82205 | No | Yes
MTDNX | [NAME] | Methadone Confirmation, Chain of Custody, [NAME] | Methadone Confirmation, CoC, U | 1 | 83840 | No | Yes
PARID | Test | Parasite Identification | Parasite Identification | 1 | 0 |  |  | When this test is ordered, 1 of the 2 reflex tests will be performed and charged.
[NAME] | [NAME] | Parasite Identification ([NAME] Only) | Parasite Identification | 1 | 87169 | No | No
BUG | [NAME] | [NAME] ([NAME] Only) | [NAME] | 1 | 87168 | No | No
PAVAL | Test | Paraneoplastic Autoantibody Evaluation, Serum | Paraneoplastic Autoantibody Eval, S |  | PROFILE |  |  | If IFA (ANN1S, ANN2S, ANN3S, PCABP, PCAB2, PCATR, AMPHS, CRMS, AGN1S) patterns are indeterminate, paraneoplastic autoantibody Western blot is performed at an additional charge.   If client requests or if IFA patterns suggest CRMP-5-IgG, CRMP-5-IgG Western blot is performed at an additional charge.   If IFA pattern suggest NMO/AQP4-IgG, NMO/AQP4-IgG CBA is performed at an additional charge.   If IFA patterns suggest amphiphysin antibody, amphiphysin Western blot is performed at an additional charge.   If IFA patterns suggest GAD65 antibody, GAD65 antibody radioimmunoassay is performed at an additional charge.   If IFA pattern suggest NMDA-R, NMDA-R Ab CBA and/or NMDA-R Ab IF Titer Assay is performed at an additional charge.   If IFA pattern suggest AMPA-R, AMPA-R Ab CBA and/or AMPA-R Ab IF Titer Assay is performed at an additional charge.   If IFA pattern suggest GABA-B-R, GABA-B-R Ab CBA and/or GABA-B-R Ab IF Titer Assay is performed at an additional charge.   If ACh receptor binding antibody is >0.02, ACh receptor modulating antibodies and CRMP-5-IgG Western blot are performed at an additional charge.   CRMP-5-IgG Western blot is also performed by specific request for more sensitive detection of CRMP-5-IgG. Testing should be requested in cases of subacute basal [NAME] (chorea, Parkinsonism), cranial neuropathies (especially loss of vision, taste, or smell) and myelopathies.
CCN | Component | N-Type Calcium Channel Antibody, Serum | N-Type Calcium Channel Ab | 1 | 83519 | Yes | No
AMPHS | Component | Amphiphysin Antibody Assay, Serum | [NAME], S | 1 | 86256 | Yes | No
CRMS | Component | [NAME] Protein-5 Neuronal (CRMP-5-IgG), Serum | CRMP-5-IgG, S | 1 | 86256 | Yes | No
AGN1S | Component | Anti-Glial/Neuronal Nuclear Antibody-Type 1 (AGNA-1), Serum | Anti-Glial Nuclear Ab, Type 1 | 1 | 86256 | Yes | No
VGKC | Component | Neuronal Voltage-Gated Potassium Channel (VGKC) Autoantibody, Serum | Neuronal (V-G) K+ Channel Ab, S | 1 | 83519 | Yes | No
ARBI | Component | Acetylcholine Receptor ([NAME]) [NAME], Serum | ACh Receptor ([NAME]) Binding Ab | 1 | 83519 | Yes | Yes
PAINT | Component | Interpretive Comments | Interpretive Comments |  |  | Yes | No
ANN3S | Component | Antineuronal Nuclear Antibody-Type 3 (ANNA-3), Serum | Anti-Neuronal Nuclear Ab, Type 3 | 1 | 86256 | Yes | No
CCPQ | Component | P/Q-Type Calcium Channel Antibody, Serum | P/Q-Type Calcium Channel Ab | 1 | 83519 | Yes | No
PCATR | Component | Purkinje Cell Cytoplasmic Antibody, Type Tr (PCA-Tr), Serum | Purkinje Cell Cytoplasmic Ab Type Tr | 1 | 86256 | Yes | No
STR | Component | Striational (Striated Muscle) Antibodies, Serum | Striational (Striated Muscle) Ab, S | 1 | 83520 | Yes | Yes
ANN2S | Component | Antineuronal Nuclear Antibody-Type 2 (ANNA-2), Serum | Anti-Neuronal Nuclear Ab, Type 2 | 1 | 86256 | Yes | No
PCABP | Component | Purkinje Cell Cytoplasmic Antibody, Type 1 (PCA-1), Serum | Purkinje Cell Cytoplasmic Ab Type 1 | 1 | 86256 | Yes | No
GANG | Component | Ganglionic Acetylcholine Receptor (Alpha3) Autoantibody, Serum | [NAME], S | 1 | 83519 | Yes | No
ANN1S | Component | Antineuronal Nuclear Antibody-Type 1 (ANNA-1), Serum | Anti-Neuronal Nuclear Ab, Type 1 | 1 | 86256 | Yes | No
PCAB2 | Component | Purkinje Cell Cytoplasmic Antibody, Type 2 (PCA-2), Serum | Purkinje Cell Cytoplasmic Ab Type 2 | 1 | 86256 | Yes | No
ABLOT | [NAME] | Amphiphysin Antibody Western Blot, Serum | Amphiphysin Western Blot, S | 1 | 84182 | No | No
AMPIS | [NAME] | AMPA-Receptor Antibody Titer Assay by Immunofluorescence, Serum | AMPA-R Ab IF Titer Assay, S | 1 | 86256 | No | No
NMOCS | [NAME] | Neuromyelitis Optica (NMO)/Aquaporin-4-IgG Cell-Binding Assay, Serum | NMO/AQP4-IgG CBA, S | 1 | 86255 | No | Yes
WBN | [NAME] | [NAME], Western Blot Confirmation, Serum | Paraneoplastic Autoantibody WBlot,S | 1 | 84182 | No | No
ARMO | [NAME] | Acetylcholine Receptor ([NAME]) [NAME], Serum | ACh Receptor ([NAME]) [NAME] | 1 | 83519 | No | No
GD65S | [NAME] | Glutamic Acid Decarboxylase (GAD65) Antibody Assay, Serum | GAD65 Ab Assay, S | 1 | 86341 | No | Yes
GABIS | [NAME] | GABA-B-Receptor Antibody Titer Assay by Immunofluorescence, Serum | GABA-B-R Ab IF Titer Assay, S | 1 | 86256 | No | No
GABCS | [NAME] | GABA-B-Receptor Antibody by CBA, Serum | GABA-B-R Ab CBA, S | 1 | 86255 | No | No
NMDCS | [NAME] | NMDA-Receptor Antibody by CBA, Serum | NMDA-R Ab CBA, S | 1 | 86255 | No | No
AMPCS | [NAME] | AMPA-Receptor Antibody by CBA, Serum | AMPA-R Ab CBA, S | 1 | 86255 | No | No
CRMWS | [NAME] | [NAME] Protein-5-IgG (CRMP-5-IgG) Western Blot, Serum | CRMP-5-IgG Western Blot, S | 1 | 84182 | No | No
NMDIS | [NAME] | NMDA-Receptor Antibody Titer Assay by Immunofluorescence, Serum | NMDA-R Ab IF Titer Assay, S | 1 | 86256 | No | No
PCDSO | Test | Pain Clinic Drug Screen, [NAME] | Pain Clinic Drug Screen, U |  | PROFILE |  |  | Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods (gas chromatography-flame ionization detector for ethanol; gas chromatography-mass spectrometry for amphetamines, barbiturates, benzodiazepines, cocaine and metabolites, methadone, phencyclidine, and [NAME]; liquid chromatography-tandem mass spectrometry for opiates) at an additional charge. If only oxycodone screens positive, only confirmation of oxycodone w/metabolite will be performed. Any other opiate- positive screen will result in the full opiate confirmation being performed.
OXYSU | Component | Oxycodone Screen, [NAME] | Oxycodone Screen, U | 1 | 80101 | Yes | Yes
PCDSO | Component |  | DRUG SCREEN QUALITATE/MULTI | 1 | 80100 | No | No
PCDSO | Component |  | DRUG SCRN 1+ CLASS NONCHROMO | 1 | 80104 | No | No
CDAU7 | Component | Drug Abuse Survey with Confirmation, Panel 9, [NAME] | Confirmed Drug Abuse Panel 9, U | 1 | 80104 | Yes | Yes
PDSU | Component | Drug Screen, Prescription/OTC, [NAME] | Drug Screen, Prescription/OTC, U | 1 | 80100 | Yes | Yes
[NAME] | [NAME] | Oxycodone with Metabolite Confirmation, [NAME] | Oxycodone w/metabolite Conf, U | 1 | 83925 | No | Yes
PCPU | [NAME] | Phencyclidine Confirmation, [NAME] | Phencyclidine Confirmation, U | 1 | 83992 | No | Yes
BENZU | [NAME] | Benzodiazepines Confirmation, [NAME] | Benzodiazepines Confirmation, U | 1 | 80154 | No | Yes
OPATU | [NAME] | Opiates Confirmation, [NAME] | Opiate Confirmation, U | 1 | 83925 | No | Yes
[NAME] | [NAME] | Ethanol, [NAME] | Ethanol, U | 1 | 82055 | No | No
MTDNU | [NAME] | Methadone Confirmation, [NAME] | Methadone Confirmation, U | 1 | 83840 | No | Yes
BARBU | [NAME] | [NAME], [NAME] | [NAME], U | 1 | 82205 | No | Yes
THCU | [NAME] | Carboxy-Tetrahydrocannabinol (THC) Confirmation, [NAME] | Carboxy-THC Confirmation, U | 1 | 80299 | No | Yes
COKEU | [NAME] | Cocaine and Metabolite Confirmation, [NAME] | Cocaine and metabolite [NAME], U | 1 | 82520 | No | Yes
AMPHU | [NAME] | Amphetamines Confirmation, [NAME] | [NAME], U | 1 | 82145 | No | Yes
PCLLM | Test | CLL Monitoring, MRD Detection FLIP, see CLLM | CLL Monitoring, MRD Detection, BM |  | PROFILE |  |  | When this test is ordered, flow cytometry interpretation, 2 to 8 markers will always be performed at an additional charge.
PCLLM | Component |  | FLOWCYTOMETRY/TC ADD-ON | 6 | 88185 | No | No
PCLLM | Component |  | FLOWCYTOMETRY/ TC 1 MARKER | 1 | 88184 | No | No
88465 | [NAME] | Flow Cytometry Interpretation, 2 to 8 Markers ([NAME] Only) | Flow Cytometry Interp, 2-8 Markers | 1 | 88187 | Yes | No
PCPMX | Test | Phencyclidine Confirmation, Chain of Custody, Meconium | Phencyclidine Confirmation, CoC, M | 1 | 83992
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
PCPRO | Test | [NAME], Bone Marrow | [NAME], Marrow |  | PROFILE |  |  | See Laboratory Screening Tests for Suspected Multiple Myeloma in Special Instructions.
PCPRO | Component |  | CELL MARKER STUDY | 1 | 88182 | No | No
PCPRO | Component |  | FLOWCYTOMETRY/ TC 1 MARKER | 1 | 88184 | No | No
PCPRO | Component |  | FLOWCYTOMETRY/TC ADD-ON | 5 | 88185 | No | No
88465 | [NAME] | Flow Cytometry Interpretation, 2 to 8 Markers ([NAME] Only) | Flow Cytometry Interp, 2-8 Markers | 1 | 88187 | Yes | No
PCPX | Test | Phencyclidine Confirmation, Chain of Custody, [NAME] | Phencyclidine Confirmation, CoC, U | 1 | 83992 |  |  | Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
PDSOX | Test | Pain Clinic Drug Screen, Chain of Custody, [NAME] | Pain Clinic Drug Screen, CoC, U |  | PROFILE |  |  | Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods (gas chromatography-flame ionization detector for ethanol; gas chromatography-mass spectrometry for amphetamines, barbiturates, benzodiazepines, cocaine and metabolites, methadone, phencyclidine, and [NAME]; liquid chromatography-tandem mass spectrometry for opiates) at an additional charge. If only oxycodone screens positive, only confirmation of oxycodone with metabolite will be performed. Any other opiate positive screen will result in the full opiate confirmation being performed.
OXYSX | Component | Oxycodone Screen, Chain of Custody, [NAME] | Oxycodone Screen, CoC, U | 1 | 80101 | Yes | Yes
PDSOX | Component |  | DRUG SCREEN QUALITATE/MULTI | 1 | 80100 | No | No
PDSOX | Component |  | DRUG SCRN 1+ CLASS NONCHROMO | 1 | 80104 | No | No
CDA7X | Component | Drug Abuse Survey with Confirmation, Panel 9, Chain of Custody, Urine | Confirmed Drug Abuse Panel9, CoC, U | 1 | 80104 | Yes | Yes
PDSUX | Component | Drug Screen, Prescription/OTC, Chain of Custody, [NAME] | [NAME], Prescription/OTC, CoC, U | 1 | 80100 | Yes | Yes
COKEX | [NAME] | Cocaine and Metabolite Confirmation, Chain of Custody, [NAME] | Cocaine and metabolite [NAME], CoC, U | 1 | 82520 | No | Yes
OXYCX | [NAME] | Oxycodone with Metabolite Confirmation, Chain of Custody, [NAME] | Oxycodone w/metabolite Conf, CoC, U | 1 | 83925 | No | Yes
PCPX | [NAME] | Phencyclidine Confirmation, Chain of Custody, [NAME] | Phencyclidine Confirmation, CoC, U | 1 | 83992 | No | Yes
MTDNX | [NAME] | Methadone Confirmation, Chain of Custody, [NAME] | Methadone Confirmation, CoC, U | 1 | 83840 | No | Yes
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
THCX | [NAME] | Carboxy-Tetrahydrocannabinol (THC) Confirmation, Chain of Custody, [NAME] | Carboxy-THC Confirmation, CoC, U | 1 | 80299 | No | Yes
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
AMPHX | [NAME] | Amphetamines Confirmation, Chain of Custody, [NAME] | Amphetamines Confirmation, CoC, U | 1 | 82145 | No | Yes
BARBX | [NAME] | [NAME], Chain of Custody, [NAME] | [NAME], CoC, U | 1 | 82205 | No | Yes
ETOHX | [NAME] | Ethanol, Chain of Custody, [NAME] | Ethanol, CoC, U | 1 | 82055 | No | No
BENZX | [NAME] | Benzodiazepines Confirmation, Chain of Custody, [NAME] | [NAME], CoC, U | 1 | 80154 | No | Yes
OPATX | [NAME] | Opiates Confirmation, Chain of Custody, [NAME] | Opiate Confirmation, CoC, U | 1 | 83925 | No | Yes
PDSUX | Test | Drug Screen, Prescription/OTC, Chain of Custody, [NAME] | [NAME], Prescription/OTC, CoC, U | 1 | 80100
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
PEE | Test | Porphyrins Evaluation, [NAME] | Porphyrins Evaluation, WB | 1 | 84311 |  |  | Testing begins with total RBC porphyrins. If the result is <80 mcg/[NAME], it is normal and testing is complete. If the total RBC porphyrin value is >80 mcg/dL, fractionation assays will be performed at an additional charge to identify the porphyrin involved. The protoporphyrin fractionation yields free protoporphyrin and zinc-complexed protoporphyrin. Depending on this result, porphyrins fractionation may be added, which fractionates and individually quantitates RBC porphyrins (uroporphyrin, coproporphyrin, and protoporphyrin).
PPFR | [NAME] | Protoporphyrins, Fractionation, [NAME] | Protoporphyrins, Fractionation | 1 | 84202 | No | Yes
PFR | [NAME] | Porphyrins, Fractionation, [NAME] | Porphyrins, Fractionation | 1 | 82492 | No | No
PEL | Test | Electrophoresis, Protein, Serum | Electrophoresis, Protein, S |  | PROFILE |  |  | If a discrete electrophoresis band is identified, the laboratory will evaluate the serum protein electrophoresis and, if necessary, perform immunofixation at an additional charge.
ELP | Component | Protein Electrophoresis | Protein Electrophoresis | 1 | 84165 | Yes | No
TPE | Component | Total Protein | Total Protein | 1 | 84155 | Yes | Yes
IMFX | [NAME] | Immunofixation, Serum | Immunofixation | 1 | 86334 | No | No
PEWE | Test | Porphyrins Evaluation, Washed Erythrocytes | [NAME], RBC | 1 | 84311 |  |  | Testing begins with total RBC porphyrins. If the result is <80 mcg/[NAME], it is normal and testing is complete. If the total RBC porphyrin value is >80 mcg/dL, fractionation assays will be performed at an additional charge to identify the porphyrin involved. The protoporphyrin fractionation yields free protoporphyrin and zinc-complexed protoporphyrin. Depending on this result, porphyrins fractionation may be added, which fractionates and individually quantitates RBC porphyrins (uroporphyrin, coproporphyrin, and protoporphyrin).
PPFR | [NAME] | Protoporphyrins, Fractionation, [NAME] | Protoporphyrins, Fractionation | 1 | 84202 | No | Yes
PFR | [NAME] | Porphyrins, Fractionation, [NAME] | Porphyrins, Fractionation | 1 | 82492 | No | No
PHESP | Test | Previous Hepatitis Exposure Profile | Previous Hepatitis Exposure Profile |  | PROFILE |  |  | If hepatitis B surface antigen (HBsAg) is reactive, then HBsAg confirmation will be performed at an additional charge.
HCV | Component | Hepatitis C Antibody Screen, Serum | HCV Ab Screen, S | 1 | 86803 | Yes | Yes
HBC | Component | Hepatitis B Core Total Antibodies, Serum | HBc Total Ab, S | 1 | 86704 | Yes | Yes
HBAB | Component | Hepatitis B Surface Antibody, Qualitative/Quantitative, Serum | [NAME], S | 1 | 86706 | Yes | Yes
HAV | Component | Hepatitis A Total Antibodies, Serum | Hepatitis A Total Ab, S | 1 | 86708 | Yes | Yes
HBAG | Component | Hepatitis B Surface Antigen, Serum | HBs Antigen, S | 1 | 87340 | Yes | Yes
HBGNT | [NAME] | Hepatitis B Surface Antigen Confirmation, Serum | HBs Antigen Confirmation, S | 1 | 87341 | No | No
PHESP | Test | Previous Hepatitis Exposure Profile | Previous Hepatitis Exposure Profile |  | PROFILE |  |  | If hepatitis B surface antigen (HBsAg) is reactive, then HBsAg confirmation will be performed at an additional charge.
HCV | Component | Hepatitis C Antibody Screen, Serum | HCV Ab Screen, S | 1 | 86803 | Yes | Yes
HBC | Component | Hepatitis B Core Total Antibodies, Serum | HBc Total Ab, S | 1 | 86704 | Yes | Yes
HBAB | Component | Hepatitis B Surface Antibody, Qualitative/Quantitative, Serum | [NAME], S | 1 | 86706 | Yes | Yes
HBAG | Component | Hepatitis B Surface Antigen, Serum | HBs Antigen, S | 1 | 87340 | Yes | Yes
HAV | Component | Hepatitis A Total Antibodies, Serum | Hepatitis A Total Ab, S | 1 | 86708 | Yes | Yes
HBGNT | [NAME] | Hepatitis B Surface Antigen Confirmation, Serum | HBs Antigen Confirmation, S | 1 | 87341 | No | No
PHSP | Test | Prenatal Hepatitis Evaluation | Prenatal Hepatitis Evaluation | 1 | 87340 |  |  | If hepatitis B surface antigen (HBsAg) prenatal is reactive, then HBsAg confirmation prenatal will be performed at an additional charge. If HBsAg confirmation is positive, then hepatitis Be antigen and hepatitis Be antibody tests will be performed at an additional charge.
HBAGP | Component | Hepatitis B Surface Antigen Prenatal, Serum | HBs Antigen Prenatal, S | 1 | 87340 | Yes | Yes
HEAB | [NAME] | [NAME], Serum | [NAME], S | 1 | 86707 | No | Yes
EAG | [NAME] | [NAME], Serum | Hepatitis Be Ag, S | 1 | 87350 | No | Yes
HBNTP | [NAME] | Hepatitis B Surface Antigen Confirmation Prenatal, Serum | HBs Ag Confirmation Prenatal, S | 1 | 87341 | No | No
PLINK | Test | PNH, PI-Linked Antigen, Blood | PNH, PI-Linked AG, B |  | PROFILE
PLINK | Component |  | FLOWCYTOMETRY/ TC 1 MARKER | 2 | 88184 | No | No
PLINK | Component |  | FLOWCYTOMETRY/TC ADD-ON | 7 | 88185 | No | No
88466 | [NAME] | Flow Cytometry Interpretation, 9 to 15 Markers ([NAME] Only) | Flow Cytometry Interp, 9-15 Markers | 1 | 88188 | Yes | No
PLSD | Test | Lysosomal and Peroxisomal Storage Disorders Screen, Blood Spot | Lysosomal/Peroxisomal D/O Scrn, BS | 1 | 83789 |  |  | If C26 lysophosphatidylcholine is >0.30, then lysophosphatidylcholines will be performed at an additional charge.
LPCBS | [NAME] | Lysophosphatidylcholines by Liquid Chromatography Tandem Mass Spectrometry ([NAME]), Blood Spot | LysoPC by LC MS/MS ([NAME]), BS | 1 | 83789 | No | No
PMMIF | Test | Phosphomannomutase (PMM) and [NAME] (PMI), Fibroblasts | PMM-PMI, Fibroblasts | 1 | 82657 |  |  | When this test is ordered, a fibroblast culture and cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple lysosomal enzyme assays on a patient utilizing fibroblast culture, only 1 culture is required regardless of the number of enzyme assays ordered. If viable cells are not obtained within 10 days, client will be notified.
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
FIBR | [NAME] | Fibroblast Culture | Fibroblast Culture | 1 | 88233 | Yes | Yes
PNEFC | Test | Neuroimmunology Antibody Follow-up, Spinal Fluid | Neuroimmunology Ab Follow-up, CSF
AGN1C | [NAME] | Anti-Glial/Neuronal Nuclear Antibody-Type 1 (AGNA-1), [NAME] | Anti-Glial Nuclear Ab, Type 1 | 1 | 86256 | No | No
AMPCC | [NAME] | AMPA-Receptor Antibody by CBA, Spinal Fluid | AMPA-R Ab CBA, CSF | 1 | 86255 | No | No
AMPHC | [NAME] | Amphiphysin Antibody Assay, Spinal Fluid | [NAME], CSF | 1 | 86256 | No | No
AMPIC | [NAME] | AMPA-Receptor Antibody Titer Assay by Immunofluorescence, Spinal Fluid | AMPA-R Ab IF Titer Assay, CSF | 1 | 86256 | No | No
ANN1C | [NAME] | Antineuronal Nuclear Antibody-Type 1 (ANNA-1), [NAME] | Anti-Neuronal Nuclear Ab, Type 1 | 1 | 86256 | No | No
ANN2C | [NAME] | Antineuronal Nuclear Antibody-Type 2 (ANNA-2), [NAME] | Anti-Neuronal Nuclear Ab, Type 2 | 1 | 86256 | No | No
ANN3C | [NAME] | Antineuronal Nuclear Antibody-Type 3 (ANNA-3), [NAME] | Anti-Neuronal Nuclear Ab, Type 3 | 1 | 86256 | No | No
CRMC | [NAME] | [NAME] Protein-5 Neuronal (CRMP-5-IgG), [NAME] | CRMP-5-IgG, CSF | 1 | 86256 | No | No
GABCC | [NAME] | GABA-B-Receptor Antibody by CBA, Spinal Fluid | GABA-B-R Ab CBA, CSF | 1 | 86255 | No | No
GABIC | [NAME] | GABA-B-Receptor Antibody Titer Assay by Immunofluorescence, Spinal Fluid | GABA-B-R Ab IF Titer Assay, CSF | 1 | 86256 | No | No
NMDCC | [NAME] | NMDA-Receptor Antibody by CBA, Spinal Fluid | NMDA-R Ab CBA, CSF | 1 | 86255 | No | No
NMDIC | [NAME] | NMDA-Receptor Antibody Titer Assay by Immunofluorescence, Spinal Fluid | NMDA-R Ab IF Titer Assay, CSF | 1 | 86256 | No | No
NMOCC | [NAME] | Neuromyelitis Optica (NMO)/Aquaporin-4-IgG Cell-Binding Assay, CSF | NMO/AQP4-IgG CBA, CSF | 1 | 86255 | No | No
PCA1C | [NAME] | Purkinje Cell Cytoplasmic Antibody, Type 1 (PCA-1), [NAME] | Purkinje Cell Cytoplasmic Ab Type 1 | 1 | 86256 | No | No
PCA2C | [NAME] | Purkinje Cell Cytoplasmic Antibody, Type 2 (PCA-2), [NAME] | Purkinje Cell Cytoplasmic Ab Type 2 | 1 | 86256 | No | No
PCTRC | [NAME] | Purkinje Cell Cytoplasmic Antibody, Type Tr (PCA-Tr), [NAME] | Purkinje Cell Cytoplasmc Ab Type Tr | 1 | 86256 | No | No
VGKCC | [NAME] | Neuronal Voltage-Gated Potassium Channel-Complex Autoantibody, Spinal Fluid | VGKC-complex Ab IPA, CSF | 1 | 83519 | No | No
PNEFS | Test | Neuroimmunology Antibody Follow-up, Serum | Neuroimmunology Ab Follow-up, S
AGN1S | [NAME] | Anti-Glial/Neuronal Nuclear Antibody-Type 1 (AGNA-1), Serum | Anti-Glial Nuclear Ab, Type 1 | 1 | 86256 | No | No
AMPCS | [NAME] | AMPA-Receptor Antibody by CBA, Serum | AMPA-R Ab CBA, S | 1 | 86255 | No | No
AMPHS | [NAME] | Amphiphysin Antibody Assay, Serum | [NAME], S | 1 | 86256 | No | No
AMPIS | [NAME] | AMPA-Receptor Antibody Titer Assay by Immunofluorescence, Serum | AMPA-R Ab IF Titer Assay, S | 1 | 86256 | No | No
ANN1S | [NAME] | Antineuronal Nuclear Antibody-Type 1 (ANNA-1), Serum | Anti-Neuronal Nuclear Ab, Type 1 | 1 | 86256 | No | No
ANN2S | [NAME] | Antineuronal Nuclear Antibody-Type 2 (ANNA-2), Serum | Anti-Neuronal Nuclear Ab, Type 2 | 1 | 86256 | No | No
ANN3S | [NAME] | Antineuronal Nuclear Antibody-Type 3 (ANNA-3), Serum | Anti-Neuronal Nuclear Ab, Type 3 | 1 | 86256 | No | No
ARMO | [NAME] | Acetylcholine Receptor ([NAME]) [NAME], Serum | ACh Receptor ([NAME]) [NAME] | 1 | 83519 | No | No
CCN | [NAME] | N-Type Calcium Channel Antibody, Serum | N-Type Calcium Channel Ab | 1 | 83519 | No | No
CCPQ | [NAME] | P/Q-Type Calcium Channel Antibody, Serum | P/Q-Type Calcium Channel Ab | 1 | 83519 | No | No
CRMS | [NAME] | [NAME] Protein-5 Neuronal (CRMP-5-IgG), Serum | CRMP-5-IgG, S | 1 | 86256 | No | No
GABCS | [NAME] | GABA-B-Receptor Antibody by CBA, Serum | GABA-B-R Ab CBA, S | 1 | 86255 | No | No
GABIS | [NAME] | GABA-B-Receptor Antibody Titer Assay by Immunofluorescence, Serum | GABA-B-R Ab IF Titer Assay, S | 1 | 86256 | No | No
GANG | [NAME] | Ganglionic Acetylcholine Receptor (Alpha3) Autoantibody, Serum | [NAME], S | 1 | 83519 | No | No
NMDCS | [NAME] | NMDA-Receptor Antibody by CBA, Serum | NMDA-R Ab CBA, S | 1 | 86255 | No | No
NMDIS | [NAME] | NMDA-Receptor Antibody Titer Assay by Immunofluorescence, Serum | NMDA-R Ab IF Titer Assay, S | 1 | 86256 | No | No
NMOCS | [NAME] | Neuromyelitis Optica (NMO)/Aquaporin-4-IgG Cell-Binding Assay, Serum | NMO/AQP4-IgG CBA, S | 1 | 86255 | No | No
PCAB2 | [NAME] | Purkinje Cell Cytoplasmic Antibody, Type 2 (PCA-2), Serum | Purkinje Cell Cytoplasmic Ab Type 2 | 1 | 86256 | No | No
PCABP | [NAME] | Purkinje Cell Cytoplasmic Antibody, Type 1 (PCA-1), Serum | Purkinje Cell Cytoplasmic Ab Type 1 | 1 | 86256 | No | No
PCATR | [NAME] | Purkinje Cell Cytoplasmic Antibody, Type Tr (PCA-Tr), Serum | Purkinje Cell Cytoplasmic Ab Type Tr | 1 | 86256 | No | No
VGKC | [NAME] | Neuronal Voltage-Gated Potassium Channel (VGKC) Autoantibody, Serum | Neuronal (V-G) K+ Channel Ab, S | 1 | 83519 | No | No
PNEOE | Test | Paraneoplastic Autoantibody Evaluation, Spinal Fluid | [NAME],CSF |  | PROFILE |  |  | If indirect immunofluorescence assay (IFA) (ANN1C, ANN2C, ANN3C, PCA1C, PCA2C, PCTRC, AMPHC, CRMC, [NAME]) is indeterminate, then paraneoplastic autoantibody Western blot is performed at an additional charge.   If IFA pattern suggest NMO/AQP4-IgG, then NMO/AQP4-IgG CBA is performed at an additional charge.   If client requests, or if IFA patterns suggest CRMP-5-IgG, then CRMP-5-IgG Western blot is performed at an additional charge.   If IFA patterns suggest GAD65 antibody, then GAD65 antibody radioimmunoassay is performed at an additional charge.   If IFA patterns suggest neuronal voltage-gated potassium channel-complex autoantibody, then VGKC-complex antibody IPA is performed at an additional charge.   If IFA patterns suggest amphiphysin antibody, then amphiphysin Western blot is performed at an additional charge.   If IFA pattern suggest NMDA-R, then NMDA-R antibody CBA and/or NMDA-R titer is performed at an additional charge.   If IFA pattern suggest AMPA-R, then AMPA-R antibody CBA and/or AMPA-R titer is performed at an additional charge.   If IFA pattern suggest GABA-B-R, then GABA-B-R antibody CBA and/or GABA-B-R titer is performed at an additional charge.
PCA1C | Component | Purkinje Cell Cytoplasmic Antibody, Type 1 (PCA-1), [NAME] | Purkinje Cell Cytoplasmic Ab Type 1 | 1 | 86256 | Yes | No
AMPHC | Component | Amphiphysin Antibody Assay, Spinal Fluid | [NAME], CSF | 1 | 86256 | Yes | No
PCTRC | Component | Purkinje Cell Cytoplasmic Antibody, Type Tr (PCA-Tr), [NAME] | Purkinje Cell Cytoplasmc Ab Type Tr | 1 | 86256 | Yes | No
AGN1C | Component | Anti-Glial/Neuronal Nuclear Antibody-Type 1 (AGNA-1), [NAME] | Anti-Glial Nuclear Ab, Type 1 | 1 | 86256 | Yes | No
ANN3C | Component | Antineuronal Nuclear Antibody-Type 3 (ANNA-3), [NAME] | Anti-Neuronal Nuclear Ab, Type 3 | 1 | 86256 | Yes | No
ANN1C | Component | Antineuronal Nuclear Antibody-Type 1 (ANNA-1), [NAME] | Anti-Neuronal Nuclear Ab, Type 1 | 1 | 86256 | Yes | No
CRMC | Component | [NAME] Protein-5 Neuronal (CRMP-5-IgG), [NAME] | CRMP-5-IgG, CSF | 1 | 86256 | Yes | No
PCA2C | Component | Purkinje Cell Cytoplasmic Antibody, Type 2 (PCA-2), [NAME] | Purkinje Cell Cytoplasmic Ab Type 2 | 1 | 86256 | Yes | No
ANN2C | Component | Antineuronal Nuclear Antibody-Type 2 (ANNA-2), [NAME] | Anti-Neuronal Nuclear Ab, Type 2 | 1 | 86256 | Yes | No
GABIC | [NAME] | GABA-B-Receptor Antibody Titer Assay by Immunofluorescence, Spinal Fluid | GABA-B-R Ab IF Titer Assay, CSF | 1 | 86256 | No | No
CRMWC | [NAME] | [NAME] Protein-5-IgG (CRMP-5-IgG) Western Blot, [NAME] | CRMP-5-IgG Western Blot, CSF | 1 | 84182 | No | No
GD65C | [NAME] | Glutamic Acid Decarboxylase (GAD65) Antibody Assay, Spinal Fluid | GAD65 Ab Assay, CSF | 1 | 86341 | No | Yes
ABLTC | [NAME] | Amphiphysin Antibody Western Blot, [NAME] | Amphiphysin Western Blot, CSF | 1 | 84182 | No | No
NMDIC | [NAME] | NMDA-Receptor Antibody Titer Assay by Immunofluorescence, Spinal Fluid | NMDA-R Ab IF Titer Assay, CSF | 1 | 86256 | No | No
AMPCC | [NAME] | AMPA-Receptor Antibody by CBA, Spinal Fluid | AMPA-R Ab CBA, CSF | 1 | 86255 | No | No
NMOCC | [NAME] | Neuromyelitis Optica (NMO)/Aquaporin-4-IgG Cell-Binding Assay, CSF | NMO/AQP4-IgG CBA, CSF | 1 | 86255 | No | Yes
VGKCC | [NAME] | Neuronal Voltage-Gated Potassium Channel-Complex Autoantibody, Spinal Fluid | VGKC-complex Ab IPA, CSF | 1 | 83519 | No | No
WBNC | [NAME] | [NAME], Western Blot Confirmation, Spinal Fluid | [NAME],CSF | 1 | 84182 | No | No
GABCC | [NAME] | GABA-B-Receptor Antibody by CBA, Spinal Fluid | GABA-B-R Ab CBA, CSF | 1 | 86255 | No | No
AMPIC | [NAME] | AMPA-Receptor Antibody Titer Assay by Immunofluorescence, Spinal Fluid | AMPA-R Ab IF Titer Assay, CSF | 1 | 86256 | No | No
NMDCC | [NAME] | NMDA-Receptor Antibody by CBA, Spinal Fluid | NMDA-R Ab CBA, CSF | 1 | 86255 | No | No
POC | Test | Chromosome Analysis, Autopsy, Products of Conception, or Stillbirth | Chromosome, Autopsy/Concep/Stillbirth |  | PROFILE |  |  | If the chromosome study fails to produce dividing cells, this test will be resulted at no charge, and FPOCR / Aneuploidy Detection, Products of Conception (POC) Reflex, FISH will be performed.
POC | Component |  | Chromosome Culture,Tissue | 1 | 88233 | No | No
POC | Component |  | Cytogenetic Interp/Report | 1 | 88291 | No | No
POC | Component |  | CYTOGENETIC STUDY | 1 | 88299 | No | No
FPOCR | [NAME] | [NAME], Products of Conception (POC) Reflex, FISH | [NAME], POC, FISH |  | PROFILE | No | No
PPOXK | Test | [NAME], Known Mutation | [NAME], Known Mutation | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
PPOXS | Test | [NAME], Full Gene Analysis | [NAME], Full Gene Analysis | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
PROCT | Test | Prolonged Clot Time Profile | Prolonged Clot Time Prof |  | PROFILE |  |  | Initial testing includes: prothrombin time (PT), activated partial thromboplastin time (APTT), dilute Russells viper venom time (DRVVT), thrombin time (bovine), fibrinogen, D-dimer, soluble fibrin monomer, and special coagulation interpretation. If PT is > or =14 seconds, PT mix will be performed. If APTT is >36 seconds, APTT mix will be performed. If APTT mix is >36 seconds with no evidence of heparin in samples, platelet neutralization procedure will be performed. If DRVVT ratio is > or =1.2, DRVVT mix will be performed. If DRVVT mix ratio is > or =1.2, DRVVT confirmation will be performed. If thrombin time is >23 seconds, reptilase time will be performed.     If PT, APTT, or DRVVT is prolonged, coagulation factor assays may be performed.
DIRM | Component | D-Dimer, Plasma | D-Dimer, P | 1 | 85379 | Yes | Yes
SFM | Component | Soluble [NAME] | Soluble [NAME] | 1 | 85366 | Yes | No
FIBC | Component | Fibrinogen, Plasma | Fibrinogen, P | 1 | 85384 | Yes | Yes
PTC | Component | Prothrombin Time (PT), Plasma | Prothrombin Time (PT), P | 1 | 85610 | Yes | Yes
DRVT | Component | [NAME] Viper Venom Time (DRVVT), Plasma | Dilute Russells Viper Venom Time, P | 1 | 85613 | Yes | No
APTTB | Component | Activated Partial Thromboplastin Time (APTT), Plasma | Activated Partial Thrombopl Time, P | 1 | 85730 | Yes | Yes
TT | Component | Thrombin Time (Bovine), Plasma | Thrombin Time (Bovine), P | 1 | 85670 | Yes | Yes
CCC | Component | Special Coagulation Interpretation | Special Coagulation Interpretation | 1 | 85390 | Yes | No
F_9 | [NAME] | Coagulation Factor IX Activity Assay, Plasma | Coag Factor IX Assay, P | 1 | 85250 | No | Yes
F_7 | [NAME] | Coagulation Factor VII Activity Assay, Plasma | Coag Factor VII Assay, P | 1 | 85230 | No | Yes
F_2 | [NAME] | Coagulation Factor II Activity Assay, Plasma | Coag Factor II Assay, P | 1 | 85210 | No | Yes
F8A | [NAME] | Coagulation Factor VIII Activity Assay, Plasma | Coag Factor VIII Activity Assay, P | 1 | 85240 | No | Yes
PTMX | [NAME] | PT Mix 1:1 | PT Mix 1:1 | 1 | 85611 | No | No
FACTV | [NAME] | Coagulation Factor V Activity Assay, Plasma | Coag Factor V Assay, P | 1 | 85220 | No | Yes
F_11 | [NAME] | Coagulation Factor XI Activity Assay, Plasma | Coag Factor XI Assay, P | 1 | 85270 | No | Yes
DRVTM | [NAME] | DRVVT Mix | DRVVT Mix | 1 | 85613 | No | No
F_12 | [NAME] | Coagulation Factor XII Activity Assay, Plasma | Coag Factor XII Assay, P | 1 | 85280 | No | Yes
STLA | [NAME] | Staclot Lupus Anticoagulant, Plasma | Staclot LA, P | 1 | 85598 | No | No
F8IS | [NAME] | Coagulation Factor VIII Inhibitor Screen, Plasma | Coag Factor VIII Assay [NAME],P | 1 | 85335 | No | No
RPTL | [NAME] | Reptilase Time, Plasma | Reptilase Time, P | 1 | 85635 | No | Yes
DRVTC | [NAME] | DRVVT Confirmation | DRVVT Confirmation | 1 | 85613 | No | No
APTTM | [NAME] | APTT Mix 1:1 | APTT Mix 1:1 | 1 | 85732 | No | No
PNP | [NAME] | Platelet Neutralization Procedure | Platelet Neutralization Procedure | 1 | 85597 | No | No
IBETH | [NAME] | Bethesda Units | Bethesda Units | 1 | 85335 | No | No
F_10 | [NAME] | Coagulation Factor X Activity Assay, Plasma | Coag Factor X Assay, P | 1 | 85260 | No | Yes
PSTF | Test | Protein S Antigen, Plasma | Protein S Ag, P | 1 | 85306 |  |  | If this test is abnormal, then total plasma protein S antigen will be performed at an additional charge.
PSF | Component | Protein S Antigen, Free, Plasma | Protein S Ag, Free, P | 1 | 85306 | Yes | No
PST | [NAME] | Protein S Antigen, Total, Plasma | Protein S Ag, Total, P | 1 | 85305 | No | No
PTENS | Test | PTEN Gene, Full Gene Analysis | PTEN Gene, Full Gene Analysis | 1 | 81321 |  |  | When this test is ordered, CGH array will always be performed at an additional charge.
COLDB | [NAME] | Hereditary Colon Cancer CGH Array | Hereditary Colon Cancer CGH Array | 1 | 81228 | Yes | Yes
PTP | Test | Porphyrins, Total, Plasma | Porphyrins, Total, P | 1 | 84311 |  |  | If total porphyrins are >1.0 mcg/[NAME], then PFP / Porphyrins, Fractionation, [NAME] will be performed at an additional charge.
PFP | [NAME] | Porphyrins, Fractionation, Plasma | Porphyrins, Fractionation, P | 1 | 82492 | No | No
PWDNA | Test | Prader-Willi/Angelman Syndrome, Molecular Analysis | [NAME] | 1 | 81331 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
REPU | Test | Electrophoresis, Protein, Random, [NAME] | Electrophoresis, Protein, Random, U |  | PROFILE |  |  | If a discrete electrophoresis band is identified, the laboratory will evaluate the urine protein electrophoresis and, if necessary, perform immunofixation at an additional charge.
RPEU | Component | Electrophoresis, Protein, Random, [NAME] | Protein Electrophoresis, Random, U | 1 | 84166 | Yes | No
PTCON | Component | Protein, Total, Random, [NAME] | Protein, Total, Random, U | 1 | 84156 | Yes | No
RIFXU | [NAME] | Immunofixation, Random, U | Immunofixation, Random, U | 1 | 86335 | No | No
REVP | Test | Erythrocytosis Evaluation | Erythrocytosis Evaluation |  | PROFILE |  |  | This is a consultative evaluation in which the case will be evaluated at Mayo Medical Laboratories, the appropriate tests performed at an additional charge, and the results interpreted.
P50X | Component | Oxygen Dissociation P50 | Oxygen Dissociation P50 |  |  | Yes | No
A2F | Component | [NAME] and F, Blood | [NAME] and F | 1 | 83021 | Yes | Yes
IEF | Component | IEF Confirms | IEF Confirms | 1 | 82664 | Yes | No
HBEL | Component | [NAME], Blood | [NAME], B | 1 | 83020 | Yes | No
REV | Component | Erythrocytosis Interpretation | Erythrocytosis Interpretation |  |  | Yes | No
P50C | Component | P50 Interpretation | P50 Interpretation |  |  | Yes | No
REVP | Component |  | [NAME]. P50, Blood | 1 | 82820 | No | No
MASS | [NAME] | [NAME] by Mass Spectrometry | [NAME] by [NAME], B | 1 | 83789 | No | No
HPFH | [NAME] | [NAME], Red Cell Distribution, Blood | [NAME], Red Cell Distrib, B | 1 | 88184 | No | Yes
HGBMO | [NAME] | [NAME], Molecular | HGB Electrophoresis, Molecular |  | PROFILE | No | No
UNHB | [NAME] | Unstable Hemoglobin, Blood | Unstable Hemoglobin, B | 1 | 83068 | No | Yes
SDEX | [NAME] | [NAME], Screen, Blood | [NAME], Scrn, B | 1 | 85660 | No | Yes
HEMP | [NAME] | Hereditary Erythrocytosis Mutations | Hereditary Erythrocytosis Mut, B | 1 | 81479 | No | Yes
RUA | Test | Urinalysis, [NAME], Includes Microscopic | Urinalysis Complete w/ Microscopic | 1 | 81000 |  |  | When this test is ordered, either automated or manual microscopic examination will always be performed at no additional charge.
PHU_ | Component | pH, [NAME] | pH, U | 1 | 83986 | Yes | Yes
[NAME] | Component | Appearance | Appearance |  |  | Yes | No
P24HP | Component | Predicted 24 Hr Protein | Predicted 24 Hr Protein |  |  | Yes | No
GLUC | Component | Glucose | Glucose |  |  | Yes | Yes
UOSMU | Component | Osmolality, [NAME] | Osmolality, U | 1 | 83935 | Yes | Yes
UBIL | Component | [NAME] | [NAME] |  |  | No | Yes
HGBQL | Component | Hemoglobin, QL | Hemoglobin, QL |  |  | Yes | Yes
P_RGE | Component | Predicted Range | Predicted Range |  |  | Yes | No
PR_OS | Component | Protein/Osmolality | Protein/Osmolality |  |  | Yes | No
CMT51 | Component | Comment | Comment |  |  | Yes | No
PRO5 | Component | Protein | Protein |  |  | Yes | Yes
SRC3 | Component | Source | Source |  |  | Yes | No
UREDU | Component | [NAME], U | [NAME], U |  |  | No | Yes
MICM | [NAME] | Microscopic Manual | Microscopic Manual |  |  | No | No
MICA | [NAME] | [NAME] | [NAME] |  |  | No | No
SAFB | Test | Acid-Fast Smear for Mycobacterium | Acid Fast Smear For Mycobacterium | 1 | 87206 |  |  | When this test is ordered, the reflex tests may be performed and charged.
TBT | [NAME] | Mycobacteria Culture, Concentration ([NAME] Only) | Mycobacteria Culture, Conc | 1 | 87015 | No | No
TISSR | [NAME] | Tissue Processing ([NAME] Only) | Tissue Processing | 1 | 87176 | No | No
SDHSP | Test | Succinate Dehydrogenase (SDH) Gene Analysis | SDH Gene Analysis |  | PROFILE |  |  | If SDH gene sequencing does not identify a mutation, then SDH deletion detection will be performed at an additional charge.
SDHSP | Component |  | MOPATH PROCEDURE LEVEL 6 | 1 | 81405 | No | No
SDHMS | Component | Succinate Dehydrogenase (SDH) Gene, Complete Gene Analysis | SDH Gene Analysis |  | PROFILE | Yes | No
SDHSQ | Component | Succinate Dehydrogenase (SDH) [NAME] | SDH Gene Sequencing | 36 |  | Yes | No
SDHSP | Component |  | MOPATH PROCEDURE LEVEL 5 | 1 | 81404 | No | No
SHDD | [NAME] | Succinate Dehydrogenase (SDH) Deletion Detection | SDH Deletion Detection | 1 | 81403 | No | Yes
SFMON | Test | [NAME] and [NAME] for Therapeutic Monitoring, Blood | Hb S/F Therapeutic Monitoring, B | 1 | 83021 |  |  | If hemoglobin S is detected, hemoglobin S screen will be performed, when appropriate, at an additional charge.
SDEX | [NAME] | [NAME], Screen, Blood | [NAME], Scrn, B | 1 | 85660 | No | Yes
SLFA | Test | Cryptococcus Antigen Screen with [NAME], Serum | Cryptococcus Ag Screen w/Titer, S | 1 | 87899 |  |  | If result is positive, Cryptococcus titer will be performed at an additional charge.
SLFAT | [NAME] | [NAME], [NAME], Serum | Cryptococcus Ag Titer, LFA, S | 1 | 87899 | No | Yes
SLFA | Test | Cryptococcus Antigen Screen with [NAME], Serum | Cryptococcus Ag Screen w/Titer, S | 1 | 87899 |  |  | If result is positive, Cryptococcus titer will be performed at an additional charge.
SLFAT | [NAME] | [NAME], [NAME], Serum | Cryptococcus Ag Titer, LFA, S | 1 | 87899 | No | Yes
SMADS | Test | [NAME], Full Gene Analysis | [NAME], Full Gene Analysis | 1 | 81406 |  |  | When this test is ordered, CGH array will always be performed at an additional charge.
COLDB | [NAME] | Hereditary Colon Cancer CGH Array | Hereditary Colon Cancer CGH Array | 1 | 81228 | Yes | Yes
SMART | Test | Mayo Stratification for Myeloma and Risk-Adapted Therapy Report | mSMART Evaluation, Marrow |  | PROFILE |  |  | When this test is ordered, Plasma Cell Proliferation, Marrow will always be performed at additional charge.
SMART | Component |  | CYTOGENETIC STUDY | 1 | 88299 | No | No
SMART | Component |  | Interpretation and Report | 1 | 88291 | No | No
SMART | Component |  | Tissue Culture for Bone Marrow | 1 | 88237 | No | No
SMART | Component |  | Cytogenetic Interp/Report | 1 | 88291 | No | No
MBM | Component | Chromosomes, mSMART Evaluation, Bone Marrow | Chromosomes, mSMART Eval, Marrow |  | PROFILE | Yes | No
FPCPD | Component | [NAME] Proliferative Disorder (PCPD), FISH | [NAME], FISH |  | PROFILE | Yes | Yes
SMART | Component |  | DNA Probe, each | 12 | 88271 | No | No
SMART | Component |  | CYTOGENETIC STUDY | 1 | 88299 | No | No
88465 | [NAME] | Flow Cytometry Interpretation, 2 to 8 Markers ([NAME] Only) | Flow Cytometry Interp, 2-8 Markers | 1 | 88187 | Yes | No
PCPRO | [NAME] | [NAME], Bone Marrow | [NAME], Marrow |  | PROFILE | Yes | Yes
[NAME] | Test | Sphingomyelinase, Fibroblasts | Sphingomyelinase, Fibroblasts | 1 | 82657 |  |  | When this test is ordered, a fibroblast culture and cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple lysosomal enzyme assays on a patient utilizing fibroblast culture, only 1 culture is required regardless of the number of enzyme assays ordered. If viable cells are not obtained within 10 days, client will be notified.
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
FIBR | [NAME] | Fibroblast Culture | Fibroblast Culture | 1 | 88233 | Yes | Yes
SPN | Test | Pneumocystis Smear | Pneumocystis smear | 1 | 87206 |  |  | When this test is ordered, the reflex test may be performed and charged.
TISSR | [NAME] | Tissue Processing ([NAME] Only) | Tissue Processing | 1 | 87176 | No | No
SPSM | Test | Morphology Evaluation (Special Smear) | Morphology Eval (special smear) | 1 | 85007 |  |  | For MML patients, a physician review is included if clinically abnormal results are identified by microscopic examination.   For Mayo patients, a consultant evaluation is performed if clinically abnormal results are identified by microscopic examination (at an additional charge).
SPSM_ | Component | Morphology Review Member | Special Smear |  |  | Yes | No
DIFFS | Component | Morphology Evaluation (Special Smear) | Morphology Eval (Special Smear) | 1 | 85007 | Yes | No
CE | [NAME] | Consultant Evaluation | Consultant Eval. |  |  | No | No
SPUT | Test | Bacterial Culture, Aerobic, Respiratory | Bacterial Culture, Aerobic, [NAME] | 1 | 87070 |  |  | When this test is ordered, the reflex tests may be performed and charged separately.
SALS | [NAME] | Serologic Agglut Method 1 Ident (Bill Only) | Serologic Agglut Method 1 Ident | 1 | 87147 | No | No
STRP | [NAME] | Identification Streptococcus (Bill Only) | Identification Streptococcus | 1 | 87077 | No | No
KPNRP | [NAME] | KPC (blaKPC) and NDM (blaNDM) in Gram-Negative Bacilli, Molecular Detection, PCR | KPC and NDM PCR | 2 | 87798 | No | Yes
STAP | [NAME] | Identification Staphylococcus ([NAME] Only) | Identification Staphylococcus | 1 | 87077 | No | No
REFID | [NAME] | Additional Identification Procedure (Bill Only) | Additional Identification Procedure | 1 | 87077 | No | No
SHIG | [NAME] | Serologic Agglut Method 3 Ident (Bill Only) | Serologic Agglut Method 3 Ident | 1 | 87147 | No | No
EC | [NAME] | Serologic Agglut Method 2 Ident (Bill Only) | Serologic Agglut Method 2 Ident | 1 | 87147 | No | No
RMALD | [NAME] | Ident by MALDI-TOF Mass Spec ([NAME] Only) | Ident by MALDI-TOF mass spec | 1 | 87077 | No | No
ISAE | [NAME] | Aerobe Ident by Sequencing ([NAME] Only) | Aerobe Ident by Sequencing | 1 | 87153 | No | No
BLA | [NAME] | Beta Lactamase ([NAME] Only) | Beta Lactamase | 1 | 87185 | No | No
GID | [NAME] | [NAME] ([NAME] Only) | [NAME] | 1 | 87077 | No | No
HODGE | [NAME] | Carbapenemase Detection, Modified Hodge Test | Carbapenamase-Modified Hodge Test | 1 | 87185 | No | Yes
COMM | [NAME] | Identification, [NAME] | Identification [NAME] | 1 | 87077 | No | No
SSF1 | Test | Nocardia Stain | Nocardia Stain | 1 | 87206 |  |  | When this test is ordered, the reflex test may be performed and charged.
TISSR | [NAME] | Tissue Processing ([NAME] Only) | Tissue Processing | 1 | 87176 | No | No
STKMS | Test | STK11 Gene, Full Gene Analysis | STK11 Gene, Full Gene Analysis | 1 | 81405 |  |  | When this test is ordered, COLDB / Hereditary Colon Cancer CGH Array will always be performed at an additional charge.
COLDB | [NAME] | Hereditary Colon Cancer CGH Array | Hereditary Colon Cancer CGH Array | 1 | 81228 | Yes | Yes
STL | Test | [NAME], Stool | [NAME], Stool |  | PROFILE |  |  | When this test is ordered, the reflex tests may be performed and charged separately.
STL | Component |  | Stool Additional Pathogens | 3 | 87046 | No | No
STL | Component |  | Stool with Isolation | 1 | 87045 | No | No
REFID | [NAME] | Additional Identification Procedure (Bill Only) | Additional Identification Procedure | 1 | 87077 | No | No
SHIG | [NAME] | Serologic Agglut Method 3 Ident (Bill Only) | Serologic Agglut Method 3 Ident | 1 | 87147 | No | No
HODGB | [NAME] | Carbapenemase-Modified Hodge Test ([NAME] Only) | Carbapenamase-Modified Hodge Test | 1 | 87185 | No | No
[NAME] | [NAME] | KPC and NDM PCR ([NAME] Only) | KPC and NDM PCR |  |  | No | No
ISAE | [NAME] | Aerobe Ident by Sequencing ([NAME] Only) | Aerobe Ident by Sequencing | 1 | 87153 | No | No
RMALD | [NAME] | Ident by MALDI-TOF Mass Spec ([NAME] Only) | Ident by MALDI-TOF mass spec | 1 | 87077 | No | No
GID | [NAME] | [NAME] ([NAME] Only) | [NAME] | 1 | 87077 | No | No
SALS | [NAME] | Serologic Agglut Method 1 Ident (Bill Only) | Serologic Agglut Method 1 Ident | 1 | 87147 | No | No
SUMFK | Test | Multiple Sulfatase Deficiency, Known Mutation | SUMF1 Gene, Known Mutation | 1 | 81479 |  |  | This test is for known mutations in the SUMF1 gene. If a familial mutation has not been identified, this known mutation test cannot be performed. To identify a familial mutation, order SUMFS / Multiple Sulfatase Deficiency, Full Gene Analysis.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
SUMFS | Test | Multiple Sulfatase Deficiency, Full Gene Analysis | SUMF1 Gene, Full Gene Analysis | 1 | 81479 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
SYPGR | Test | [NAME] with [NAME], Serum | [NAME] w/Reflex, S | 1 | 86780 |  |  | If syphilis IgG is positive, RRPR / Rapid Plasma Reagin w/ [NAME], Serum will be performed at an additional charge.
RRPR | [NAME] | Rapid [NAME] with Reflex, Serum | Rapid [NAME] w/ Reflex, S | 1 | 86592 | No | No
RTPPA | [NAME] | [NAME], TP-PA, Serum | [NAME], TP-PA, S | 1 | 86780 | No | No
TAE | Test | Therapeutic Antibody by Flow Cytometry | Therapeutic Antibody Evaluation |  | PROFILE |  |  | When a blood or bone marrow is ordered, a panel specific to the desired antibody and a professional interpretation will always be charged. The panel will be charged based on number of markers tested (80997 for first marker, 81047 for each additional marker). The interpretation will be based on markers tested in increments of 2 to 8, 9 to 15, or 16 and greater.
TAE | Component |  | Each additional marker | 3 | 88185 | No | No
TAE | Component |  | Additional Marker | 1 | 88184 | No | No
80997 | [NAME] | Flow Cytometry, Cell Surface, First (Bill Only) | Flow Cytometry, Cell Surface, First | 1 | 88184 | No | No
81047 | [NAME] | Flow Cytometry, Cell Surface, Additional (Bill Only) | Flow Cytometry, Cell Surface, [NAME] | 1 | 88185 | No | No
88465 | [NAME] | Flow Cytometry Interpretation, 2 to 8 Markers ([NAME] Only) | Flow Cytometry Interp, 2-8 Markers | 1 | 88187 | No | No
88466 | [NAME] | Flow Cytometry Interpretation, 9 to 15 Markers ([NAME] Only) | Flow Cytometry Interp, 9-15 Markers | 1 | 88188 | No | No
88467 | [NAME] | Flow Cytometry Interpretation, 16 or More Markers ([NAME] Only) | Flow Cytometry Interp,16 or greater | 1 | 88189 | No | No
TB1LN | Test | Antimicrobial Susceptibility, Mycobacterium tuberculosis Complex, First Line | Susceptibility, [NAME], 1 Line | 3 | 0 |  |  | When this test is ordered, the additional test will always be performed and charged separately. If resistance to a first line antimicrobial agent is detected reflex testing for confirmation of resistance and second line agents will be performed and charged.
STV2 | [NAME] | Susceptibility, [NAME], 2nd Line (Bill Only) | Susceptibility, [NAME], 2nd Line | 1 | 87186 | No | No
STV1 | [NAME] | Susceptibility, [NAME], [NAME] ([NAME] Only) | Susceptibility, [NAME], Broth | 3 | 87188 | Yes | No
TB2LN | Test | Susceptibility, Mycobacterium tuberculosis Complex, Second Line | Susceptibility, [NAME], 2 Line | 1 | 0 |  |  | When this test is ordered, the additional test will always be performed and charged separately.
STV2 | [NAME] | Susceptibility, [NAME], 2nd Line (Bill Only) | Susceptibility, [NAME], 2nd Line | 1 | 87186 | Yes | No
TBPZA | Test | Susceptibility, Mycobacterium tuberculosis Complex, Pyrazinamide | Susceptibility, [NAME], PZA | 1 | 0 |  |  | When this test is ordered the additional test will always be performed and charged separately.   If resistance to Pyrazinamide is detected, the reflex test for confirmation of resistance will be performed and charged separately.
STVP | [NAME] | Susceptibility, [NAME], PZA ([NAME] Only) | Susceptibility, [NAME], PZA | 1 | 87188 | Yes | No
MTBVP | [NAME] | Mtb PZA Confirmation, [NAME] ([NAME] Only) | Mtb PZA Confirmation, pnc A Sequence | 1 | 87153 | No | No
THCMX | Test | 11-nor-Delta-9-Tetrahydrocannabinol-9-Carboxylic Acid (Carboxy-THC) Confirmation, Chain of Custody, Meconium | Carboxy-THC Confirmation, CoC, M | 1 | 80299
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
THCX | Test | Carboxy-Tetrahydrocannabinol (THC) Confirmation, Chain of Custody, [NAME] | Carboxy-THC Confirmation, CoC, U | 1 | 80299 |  |  | Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
ADLTX | [NAME] | Adulterants Survey, Chain of Custody, [NAME] | Adulterants Survey, CoC, U | 1 | 81005 | Yes | Yes
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
THEVP | Test | Thalassemia and Hemoglobinopathy Evaluation | Thalassemia and [NAME] |  | PROFILE |  |  | This is a consultative evaluation in which the case will be evaluated at Mayo Medical Laboratories, the appropriate tests performed at an additional charge, and the results interpreted. For information on thalassemias and appropriate test ordering, see Thalassemia Tests in Special Instructions.
[NAME] | Component | Hemoglobinopathy Interpretation | Hemoglobinopathy Interpretation |  |  | Yes | No
A2F | Component | [NAME] and F, Blood | [NAME] and F | 1 | 83021 | Yes | Yes
FERR | Component | Ferritin, Serum | Ferritin, S | 1 | 82728 | Yes | Yes
HBEL | Component | [NAME], Blood | [NAME], B | 1 | 83020 | Yes | No
MASS | [NAME] | [NAME] by Mass Spectrometry | [NAME] by [NAME], B | 1 | 83789 | No | No
HPFH | [NAME] | [NAME], Red Cell Distribution, Blood | [NAME], Red Cell Distrib, B | 1 | 88184 | No | Yes
IEF | [NAME] | IEF Confirms | IEF Confirms | 1 | 82664 | No | No
AGPBT | [NAME] | Alpha-Globin Gene Analysis | Alpha-Globin Gene Analysis | 1 | 81404 | No | Yes
UNHB | [NAME] | Unstable Hemoglobin, Blood | Unstable Hemoglobin, B | 1 | 83068 | No | Yes
SDEX | [NAME] | [NAME], Screen, Blood | [NAME], Scrn, B | 1 | 85660 | No | Yes
HGBMO | [NAME] | [NAME], Molecular | HGB Electrophoresis, Molecular |  | PROFILE | No | No
THRMP | Test | Thrombophilia Profile | Thrombophilia Prof |  | PROFILE |  |  | Initial testing includes: prothrombin time (PT); activated partial thromboplastin time (APTT); dilute Russells viper venom time (DRVVT); thrombin time (bovine); fibrinogen; D-dimer; soluble fibrin monomer; antithrombin activity; protein C activity; protein S antigen, free; prothrombin G20210A mutation; activated protein resistance V; and, if appropriate, special coagulation interpretation.   If PT is > or =14 seconds, PT mix will be performed.     If APTT is >36 seconds, APTT mix will be performed.     If APTT mix is >36 seconds with no evidence of heparin in samples, platelet neutralization procedure will be performed.     If DRVVT ratio is > or =1.2, DRVVT mix will be performed.     If DRVVT mix ratio is > or =1.2, DRVVT confirmation will be performed.     If thrombin time is >23 seconds, reptilase time will be performed.     If protein S antigen, free is <65% for males and females > or =50 years of age and <50% for females <50 years of age, protein S antigen, total will be performed.     If protein C activity is <70% with no evidence for an acquired decrease in protein C activity, protein C antigen may be performed.     If antithrombin activity is <80% with no evidence of an acquired decrease in antithrombin activity, antithrombin antigen will be performed.     If activated protein C resistance (APC) ratio is <2.3 or baseline APC APTT is prolonged, factor V leiden (R506Q) mutation analysis will be performed.   If appropriate, protein S activity, plasminogen, coagulation factor assays, or Staclot LA will be performed at an additional charge to clarify significant abnormalities in the screening clotting times.   If factor VIII result is <55%, the factor VIII inhibitor screen may be performed along with the Bethesda titering assay, if inhibitor screen is positive.
TT | Component | Thrombin Time (Bovine), Plasma | Thrombin Time (Bovine), P | 1 | 85670 | Yes | Yes
FIBC | Component | Fibrinogen, Plasma | Fibrinogen, P | 1 | 85384 | Yes | Yes
THRMP | Component |  | F2 GENE | 1 | 81240 | No | No
PTC | Component | Prothrombin Time (PT), Plasma | Prothrombin Time (PT), P | 1 | 85610 | Yes | Yes
CFX | Component | Protein C Activity, Plasma | Protein C Activity, P | 1 | 85303 | Yes | Yes
APTTB | Component | Activated Partial Thromboplastin Time (APTT), Plasma | Activated Partial Thrombopl Time, P | 1 | 85730 | Yes | Yes
PSF | Component | Protein S Antigen, Free, Plasma | Protein S Ag, Free, P | 1 | 85306 | Yes | Yes
CCC | Component | Special Coagulation Interpretation | Special Coagulation Interpretation | 1 | 85390 | Yes | No
PTNT | Component | Prothrombin G20210A Mutation, Blood | Prothrombin G20210A Mutation, B | 1 | 81240 | Yes | Yes
ATTF | Component | [NAME], Plasma | [NAME], P | 1 | 85300 | Yes | Yes
APCRV | Component | Activated Protein C Resistance V (APCRV), Plasma | Activated Protein Resistance V, P | 1 | 85307 | Yes | Yes
SFM | Component | Soluble [NAME] | Soluble [NAME] | 1 | 85366 | Yes | No
DRVT | Component | [NAME] Viper Venom Time (DRVVT), Plasma | Dilute Russells Viper Venom Time, P | 1 | 85613 | Yes | No
DIRM | Component | D-Dimer, Plasma | D-Dimer, P | 1 | 85379 | Yes | Yes
S_FX | [NAME] | Protein S Activity, Plasma | Protein S Activity, P | 1 | 85306 | No | Yes
RPTL | [NAME] | Reptilase Time, Plasma | Reptilase Time, P | 1 | 85635 | No | Yes
F_2 | [NAME] | Coagulation Factor II Activity Assay, Plasma | Coag Factor II Assay, P | 1 | 85210 | No | Yes
PST | [NAME] | Protein S Antigen, Total, Plasma | Protein S Ag, Total, P | 1 | 85305 | No | No
PNP | [NAME] | Platelet Neutralization Procedure | Platelet Neutralization Procedure | 1 | 85597 | No | No
F_10 | [NAME] | Coagulation Factor X Activity Assay, Plasma | Coag Factor X Assay, P | 1 | 85260 | No | Yes
APTTM | [NAME] | APTT Mix 1:1 | APTT Mix 1:1 | 1 | 85732 | No | No
FACTV | [NAME] | Coagulation Factor V Activity Assay, Plasma | Coag Factor V Assay, P | 1 | 85220 | No | Yes
F_7 | [NAME] | Coagulation Factor VII Activity Assay, Plasma | Coag Factor VII Assay, P | 1 | 85230 | No | Yes
F8A | [NAME] | Coagulation Factor VIII Activity Assay, Plasma | Coag Factor VIII Activity Assay, P | 1 | 85240 | No | Yes
F_11 | [NAME] | Coagulation Factor XI Activity Assay, Plasma | Coag Factor XI Assay, P | 1 | 85270 | No | Yes
F5DNA | [NAME] | Factor [NAME] (R506Q) Mutation, Blood | Factor [NAME] (R506Q) Mutation, B | 1 | 81241 | No | Yes
PCAG | [NAME] | Protein C Antigen, Plasma | Protein C Ag, P | 1 | 85302 | No | Yes
ATTI | [NAME] | [NAME], Plasma | [NAME], P | 1 | 85301 | No | Yes
DRVTC | [NAME] | DRVVT Confirmation | DRVVT Confirmation | 1 | 85613 | No | No
F_9 | [NAME] | Coagulation Factor IX Activity Assay, Plasma | Coag Factor IX Assay, P | 1 | 85250 | No | Yes
STLA | [NAME] | Staclot Lupus Anticoagulant, Plasma | Staclot LA, P | 1 | 85598 | No | No
IBETH | [NAME] | Bethesda Units | Bethesda Units | 1 | 85335 | No | No
PSGN | [NAME] | Plasminogen Activity, Plasma | Plasminogen Activity, P | 1 | 85420 | No | Yes
F8IS | [NAME] | Coagulation Factor VIII Inhibitor Screen, Plasma | Coag Factor VIII Assay [NAME],P | 1 | 85335 | No | No
DRVTM | [NAME] | DRVVT Mix | DRVVT Mix | 1 | 85613 | No | No
F_12 | [NAME] | Coagulation Factor XII Activity Assay, Plasma | Coag Factor XII Assay, P | 1 | 85280 | No | Yes
PTMX | [NAME] | PT Mix 1:1 | PT Mix 1:1 | 1 | 85611 | No | No
THSCM | Test | Thyroid Function Cascade, Serum | Thyroid Function Cascade, S | 1 | 84443 |  |  | If thyroid-stimulating hormone (TSH) is <0.3 mIU/L, then free T4 (FT4) is performed at an additional charge.    If [NAME] is normal and the TSH is <0.1 mIU/L, then T3 is performed at an additional charge.    If TSH is >5.0 mIU/L, then [NAME] and thyroperoxidase antibodies are performed at an additional charge.
STSHC | Component | Thyroid-Stimulating Hormone-Sensitive (S-TSH), Serum | TSH, Sensitive, S | 1 | 84443 | Yes | Yes
FRT4C | [NAME] | T4 (Thyroxine), Free, Serum | T4 (Thyroxine), Free, S | 1 | 84439 | No | Yes
T3C | [NAME] | T3 (Triiodothyronine), Total, Serum | T3 (Triiodothyronine), Total, S | 1 | 84480 | No | Yes
TPOC | [NAME] | Thyroperoxidase (TPO) Antibodies, Serum | [NAME], S | 1 | 86376 | No | Yes
TICKS | Test | [NAME], Serum | [NAME], S |  | PROFILE |  |  | If Lyme disease screen is positive or equivocal, then the Lyme disease antibody confirmation (by Western blot) will be performed at an additional charge.
ANAP | Component | Anaplasma phagocytophilum (Human Granulocytic Ehrlichiosis) Antibody, Serum | Anaplasma phagocytophilum Ab, IgG,S | 1 | 86666 | Yes | Yes
BABG | Component | Babesia microti IgG Antibodies, Serum | Babesia microti IgG Ab, S | 1 | 86753 | Yes | Yes
EHRC | Component | Ehrlichia chaffeensis (HME) Antibody, IgG, Serum | Ehrlichia Chaffeensis (HME) Ab, IgG | 1 | 86666 | Yes | Yes
LYME | Component | Lyme Disease Serology, Serum | Lyme Disease Serology, S | 1 | 86618 | Yes | Yes
LYWB | [NAME] | Lyme Disease Antibody, Immunoblot, Serum | Lyme Disease Ab, Immunoblot, S | 2 | 86617 | No | Yes
TPPTF | Test | [NAME] (TPP1) and Palmitoyl-Protein Thioesterase 1 (PPT1), Fibroblasts | TPP1 and PPT1, Fibroblasts | 1 | 82657 |  |  | When this test is ordered, a fibroblast culture and cryopreservation for biochemical studies will always be performed at an additional charge. However, for multiple lysosomal enzyme assays on a patient utilizing fibroblast culture, only 1 culture is required regardless of the number of enzyme assays ordered. If viable cells are not obtained within 10 days, client will be notified.
CRYOB | [NAME] | Cryopreservation for Biochemical Studies | Cryopreserve for Biochem Studies | 1 | 88240 | Yes | No
FIBR | [NAME] | Fibroblast Culture | Fibroblast Culture | 1 | 88233 | Yes | Yes
TSD | Test | Tay-Sachs Disease, Mutation Analysis, HEXA | Tay-Sachs, Mutation Analysis | 1 | 81255 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately. For any prenatal specimen that is received, maternal cell contamination studies will be added.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
TTRX | Test | Amyloidosis, Transthyretin-Associated Familial, [NAME], Blood | Familial Amyloidosis Reflex | 1 | 83788 |  |  | If familial amyloidosis by liquid chromatography-mass spectrometry is abnormal, DNA sequence will be performed and charged separately.
AMYL | [NAME] | Amyloidosis, Transthyretin-Associated Familial, DNA Sequence, Blood | Familial Amyloidosis, DNA Sequence | 1 | 81404 | No | Yes
TXBU | Test | 11-Dehydro-Thromboxane B2, [NAME] | 11-Dehydro-Thromboxane B2, U | 1 | 84431 |  |  | When 11-dehydro-thromboxane B2 testing is performed, urine creatinine will always be performed at no additional charge.
AACT | [NAME] | Creatinine, [NAME] | Creatinine, U |  |  | Yes | No
UBEKM | Test | [NAME], Known Mutation | [NAME], Known Mutation | 1 | 81403 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
UBEMS | Test | [NAME], Full Gene Analysis | [NAME], Full Gene Analysis | 1 | 81406 |  |  | If skin biopsy is received, fibroblast culture will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
UHIST | Test | [NAME], [NAME] | Histoplasma Ag, U | 1 | 87385 |  |  | If antigen test is indeterminate, the specimen will be sent to Mira Vista Laboratories and MVista Histoplasma Antigen, [NAME] will be performed at an additional charge.
FMVHU | [NAME] | MVista Histoplasma Antigen, [NAME] | MVista Histoplasma Ag, U | 1 | 87385 | No | No
UMIC | Test | Urinalysis, Microscopic, Osmolality, and pH | Urinalysis, Microscop,Osmolality,pH | 1 | 81001 |  |  | When this test is ordered, either automated or manual microscopic examination will always be performed at no additional charge.
CMT51 | Component | Comment | Comment |  |  | Yes | No
UBIL | Component | [NAME] | [NAME] |  |  | No | Yes
UREDU | Component | [NAME], U | [NAME], U |  |  | No | Yes
UOSMU | Component | Osmolality, [NAME] | Osmolality, U | 1 | 83935 | Yes | Yes
PHU_ | Component | pH, [NAME] | pH, U | 1 | 83986 | Yes | Yes
SRC3 | Component | Source | Source |  |  | Yes | No
[NAME] | Component | Appearance | Appearance |  |  | Yes | No
HGBQL | Component | Hemoglobin, QL | Hemoglobin, QL |  |  | Yes | Yes
MICA | [NAME] | [NAME] | [NAME] |  |  | No | No
MICM | [NAME] | Microscopic Manual | Microscopic Manual |  |  | No | No
UPD | Test | Uniparental Disomy | Uniparental Disomy | 1 | 81402 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
UR | Test | Bacterial Culture, Aerobic, [NAME] | Bacterial Culture, Aerobic, [NAME] | 1 | 87086 |  |  | When this test is ordered, the reflex tests may be performed and charged separately.
KPNRP | [NAME] | KPC (blaKPC) and NDM (blaNDM) in Gram-Negative Bacilli, Molecular Detection, PCR | KPC and NDM PCR | 2 | 87798 | No | Yes
STRP | [NAME] | Identification Streptococcus (Bill Only) | Identification Streptococcus | 1 | 87077 | No | No
ISAE | [NAME] | Aerobe Ident by Sequencing ([NAME] Only) | Aerobe Ident by Sequencing | 1 | 87153 | No | No
HODGE | [NAME] | Carbapenemase Detection, Modified Hodge Test | Carbapenamase-Modified Hodge Test | 1 | 87185 | No | Yes
RMALD | [NAME] | Ident by MALDI-TOF Mass Spec ([NAME] Only) | Ident by MALDI-TOF mass spec | 1 | 87077 | No | No
REFID | [NAME] | Additional Identification Procedure (Bill Only) | Additional Identification Procedure | 1 | 87077 | No | No
STAP | [NAME] | Identification Staphylococcus ([NAME] Only) | Identification Staphylococcus | 1 | 87077 | No | No
SALS | [NAME] | Serologic Agglut Method 1 Ident (Bill Only) | Serologic Agglut Method 1 Ident | 1 | 87147 | No | No
SHIG | [NAME] | Serologic Agglut Method 3 Ident (Bill Only) | Serologic Agglut Method 3 Ident | 1 | 87147 | No | No
GID | [NAME] | [NAME] ([NAME] Only) | [NAME] | 1 | 87077 | No | No
BLA | [NAME] | Beta Lactamase ([NAME] Only) | Beta Lactamase | 1 | 87185 | No | No
EC | [NAME] | Serologic Agglut Method 2 Ident (Bill Only) | Serologic Agglut Method 2 Ident | 1 | 87147 | No | No
COMM | [NAME] | Identification, [NAME] | Identification [NAME] | 1 | 87077 | No | No
VASC | Test | Antineutrophil Cytoplasmic Antibodies Vasculitis Panel, Serum | ANCA Panel for Vasculitis, S |  | PROFILE |  |  | If myeloperoxidase antibody or proteinase 3 antibody is >=0.4 U, then cytoplasmic neutrophilic antibodies will be performed at an additional charge.
MPO | Component | Myeloperoxidase Antibodies, IgG, Serum | [NAME], S | 1 | 83516 | Yes | Yes
PR3 | Component | Proteinase 3 Antibodies, IgG, Serum | Proteinase 3 Ab (PR3), S | 1 | 83516 | Yes | Yes
ANCA | [NAME] | Cytoplasmic Neutrophil Antibodies, Serum | [NAME], S | 1 | 86255 | No | Yes
VHLSP | Test | [NAME] (VHL) Gene, Full Gene Analysis | VHL Full Gene Analysis | 1 | 81404 |  |  | If reason for referral is diagnosis of [NAME] (VHL) syndrome or it is not known both VHL full gene analysis (amplification) and VHL gene sequencing will be performed.
VHLMS | Component | [NAME] (VHL) Gene, Full Gene Analysis | VHL Full Gene Analysis | 1 | 81404 | Yes | No
VHLGQ | Component | [NAME] | [NAME] | 6 |  | Yes | No
VHDD | [NAME] | VHL Deletion Detection | VHL Deletion Detection | 1 | 81403 | No | Yes
VLTBX | Test | Volatile Screen, Chain of Custody, Blood | Volatile Screen, CoC, B | 1 | 84600 |  |  | Volatile screen includes methanol, ethanol, isopropanol, and acetone.
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
VLTUX | Test | Volatile Screen, Chain of Custody, [NAME] | Volatile Screen, CoC, U | 1 | 84600 |  |  | Volatile screen includes methanol, ethanol, isopropanol, and acetone.
COCH | [NAME] | Chain-of-Custody Processing (Bill Only) | Chain of Custody Processing | 1 | 99001 | Yes | No
VWFX | Test | von Willebrand Factor Activity, Plasma | von Willebrand Factor Activity, P | 1 | 85397 |  |  | If [NAME] factor activity is <55%, then the [NAME] factor ristocetin cofactor activity assay will be performed at an additional charge.
RIST | [NAME] | [NAME], Plasma | [NAME], P | 1 | 85245 | No | No
VWPR | Test | von Willebrand Profile | von Willebrand Prof |  | PROFILE |  |  | Initial testing includes: coag factor VIII activity assay, [NAME] factor (VWF) antigen, and VWF activity.
F8A | Component | Coagulation Factor VIII Activity Assay, Plasma | Coag Factor VIII Activity Assay, P | 1 | 85240 | Yes | Yes
VWFX | Component | von Willebrand Factor Activity, Plasma | von Willebrand Factor Activity, P | 1 | 85397 | Yes | Yes
CCC1 | Component | Interpretation | Interpretation |  |  | Yes | No
VWAG | Component | von Willebrand Factor [NAME], Plasma | von Willebrand Factor Ag, P | 1 | 85246 | Yes | Yes
VWFM | [NAME] | von Willebrand Factor Multimer Analysis, Plasma | von Willebrand Factor Multimer, P | 1 | 85247 | No | Yes
CCC2 | [NAME] | Special Coagulation Interpretation | Special Coagulation Interpretation | 1 | 85390 | No | No
RIST | [NAME] | [NAME], Plasma | [NAME], P | 1 | 85245 | No | No
F8IS | [NAME] | Coagulation Factor VIII Inhibitor Screen, Plasma | Coag Factor VIII Assay [NAME],P | 1 | 85335 | No | No
IBETH | [NAME] | Bethesda Units | Bethesda Units | 1 | 85335 | No | No
[NAME] | Test | X-Linked Adrenoleukodystrophy, Known Mutation | X-ALD, Known Mutation | 1 | 81403 |  |  | This test is for known mutations in the ABCD1 gene. If a familial mutation has not been identified, this known mutation test cannot be performed. To identify a familial mutation, order XALDS / X-Linked Adrenoleukodystrophy, Full Gene Analysis.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
MCC | [NAME] | Maternal Cell Contamination, Molecular Analysis | Maternal Cell Contamination, B | 1 | 81265 | No | Yes
[NAME] | Test | X-Linked Adrenoleukodystrophy, Full Gene Analysis | X-ALD, Full Gene Analysis | 1 | 81405 |  |  | If skin biopsy is received, fibroblast culture for genetic test will be added and charged separately.
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes
ZAP70 | Test | ZAP-70, Chronic Lymphocytic Leukemia (CLL) Prognosis | ZAP-70 |  | PROFILE |  |  | When this test is ordered, flow cytometry interpretation, 2 to 8 markers will always be performed at an additional charge.
ZAP70 | Component |  | Flow cytometry, nuc mark | 1 | 88184 | No | No
ZAP70 | Component |  | Each add'l marker | 2 | 88185 | No | No
88465 | [NAME] | Flow Cytometry Interpretation, 2 to 8 Markers ([NAME] Only) | Flow Cytometry Interp, 2-8 Markers | 1 | 88187 | Yes | No
ZMMLS | Test | Antimicrobial Susceptibility, [NAME], MIC | Susceptibility, Aerobic, MIC | 1 |  |  |  | When this test is ordered, the reflex tests may be performed and charged separately.   Antimicrobial agent appropriate to the organism and specimen source will be chosen from the panels listed below.   Note: Mayo Medical Laboratories will not perform susceptibility testing on select agents (eg, [NAME], [NAME] species, Burkholderia mallei, Burkholderia pseudomallei, Francisella tularensis, and Yersinia pestis). Please consult with your state health department or the CDC regarding antimicrobial susceptibility testing of such isolates.
KPNRP | [NAME] | KPC (blaKPC) and NDM (blaNDM) in Gram-Negative Bacilli, Molecular Detection, PCR | KPC and NDM PCR | 2 | 87798 | No | Yes
BLA | [NAME] | Beta Lactamase ([NAME] Only) | Beta Lactamase | 1 | 87185 | No | No
HODGE | [NAME] | Carbapenemase Detection, Modified Hodge Test | Carbapenamase-Modified Hodge Test | 1 | 87185 | No | Yes
SUS | [NAME] | Susceptibility ([NAME] Only) | Susceptibility | 1 | 87181 | No | No
CARNP | [NAME] | Carbapenemase Detection-Carba NP Test | Carbapenemase-Carba NP Test | 1 | 87185 | No | Yes
ZYG | Test | [NAME] (Multiple Births) | [NAME] (Multiple Births) | 1 | 81265 |  |  | For prenatal specimens only: If amniotic fluid (non-confluent cultured cells) is received, amniotic fluid culture/genetic test will be added and charged separately. If chorionic villus specimen (non-confluent cultured cells) is received, fibroblast culture for genetic test will be added and charged separately.
AFC | [NAME] | Amniotic Fluid Culture for Genetic Testing | Amniotic Fluid Culture/Genetic Test |  | PROFILE | No | Yes
FBC | [NAME] | Fibroblast Culture for Genetic Testing | Fibroblast Culture for Genetic Test |  | PROFILE | No | Yes