Urogenital swab collected in V-C-M tube or equivalent (UTM) container
MYHUC – “Mycoplasma hominis/Ureaplasma Culture” replaced by MHURC – “Mycoplasma hominis/Ureaplasma Culture”
Inactivated Test Details
Mnemonic
MYHUC
Ordering Code
3400719
CPT-4 Codes(s)
87109
Replacement Test Details
Mnemonic
MHURC
Ordering Code
3400973
CPT-4 Codes(s)
87109
Turnaround Time
9 - 10 days
Performed
Sunday - Saturday
Legacy Code
MHURC
Example Report
Specimen Information
Collect
Specimen Preparation
Specimen source required. Send urogenital specimen (vaginal, cervical, urethral swabs or secretions) in V-C-M medium (green cap) tube or equivalent Universal Transport Media (UTM).
Alternate Specimen
Submit 1:1 volume of sterile body fluids, tissue, wound swabs, respiratory samples (sputum,
bronchial washings, tracheobronchial secretions, bronchial alveolar lavage) in VCM or equivalent.
Respiratory specimens only acceptable on children <1 yr old.
Urine - Centrifuge urine at 3000 rpm for 15 minutes. Suspend sediment in VCM or equivalent
transport media. If the specimen is not centrifuged, submit a 1:1 volume of urine in VCM or
equivalent transport media.
bronchial washings, tracheobronchial secretions, bronchial alveolar lavage) in VCM or equivalent.
Respiratory specimens only acceptable on children <1 yr old.
Urine - Centrifuge urine at 3000 rpm for 15 minutes. Suspend sediment in VCM or equivalent
transport media. If the specimen is not centrifuged, submit a 1:1 volume of urine in VCM or
equivalent transport media.
Minimum Volume
1.0 mL or 1 swab
Transport Temperature
Frozen (-70° C) on dry ice
Rejection Criteria
Specimens collected on wooden shaft swabs, or cotton swabs, specimen received in expired
transport medium, tissue specimen in formalin, urine containing any preservatives, specimens
received in M4RT transport medium, raw specimens, specimen collected in molecular transport
medium
transport medium, tissue specimen in formalin, urine containing any preservatives, specimens
received in M4RT transport medium, raw specimens, specimen collected in molecular transport
medium
Stability
Room temperature: Unacceptable
Refrigerated: 48 hours
Frozen (-20° C): Unacceptable
Frozen (-70° C): 30 days
Refrigerated: 48 hours
Frozen (-20° C): Unacceptable
Frozen (-70° C): 30 days
Methodology
Culture
Reference Range
Not isolated
Performing Laboratory
Quest
New York DOH Approval Status
Yes
Interface Map for MHURC
| Test Name | Ordering Code | Result Code | Component Name | LOINC Code | AOE Prompt | Units |
|---|---|---|---|---|---|---|
| Mycoplasma hominis/Ureaplasma Culture | 3400973 | |||||
| 3400720 | Source | 31208-2 | Yes | |||
| 3400722 | Mycoplasma hominis | 15388-2 | No | |||
| 3400723 | Ureaplasma Species | 32368-3 | No |
FTGMR – “Francisella tularensis Ab, IgG/M w/ Reflex to Agglutination” replaced by FTGM – “Francisella tularensis Ab IgG/IgM”
Inactivated Test Details
Mnemonic
FTGMR
Ordering Code
3600178
CPT-4 Codes(s)
86668 x 2, plus 86000 if reflexed to agglutination, at additional fee
Replacement Test Details
Mnemonic
FTGM
Ordering Code
3600494
CPT-4 Codes(s)
86668 x 2
Turnaround Time
2 - 8 days
Performed
Monday, Wednesday, Friday
Legacy Code
FTGM
Example Report
Specimen Information
Collect
Serum separator tube (SST)
Specimen Preparation
Centrifuge, separate from cells within 2 hours of collection and send 1.0 mL serum in a screw capped plastic vial.
Alternate Specimen
Red top
Minimum Volume
0.6 mL
Transport Temperature
Refrigerated
Rejection Criteria
Contaminated, heat inactivated or turbid specimen
Stability
Room temperature: 2 days
Refrigerated: 14 days
Frozen: 30 days
Refrigerated: 14 days
Frozen: 30 days
Methodology
Quantitative Enzyme-Linked Immunosorbent Assay
Reference Range
See report
Performing Laboratory
ARUP
New York DOH Approval Status
Yes
Interface Map for FTGM
| Test Name | Ordering Code | Result Code | Component Name | LOINC Code | AOE Prompt | Units |
|---|---|---|---|---|---|---|
| Francisella tularensis Ab IgG/IgM | 3600494 | |||||
| 3600496 | F tularensis Antibody, IgG | 93717-7 | No | |||
| 3600497 | F tularensis Antibody, IgM | 93716-9 | No | |||
| 3600498 | F. tularensis Antibody Interpretation | 93718-5 | No |
HHV6P – “HHV-6 PCR, P”
Inactivated Test Details
Mnemonic
HHV6P
Ordering Code
3800379
CPT-4 Codes(s)
87532
UGHBC – “Gamma-Hydroxybutyric Acid Confirmation, Urine”
Notes
Test discontinued. See Warde test, GHBUR
Inactivated Test Details
Mnemonic
UGHBC
Ordering Code
3300860
CPT-4 Codes(s)
80375 (G0480)
CALC – “Kidney Stone Analysis”
Notes
Update to turnaround time.
Turnaround Time: 2 – 5 days
Test Details
Mnemonic
CALC
Ordering Code
1012600
CPT-4 Codes(s)
82365
CALCI – “Kidney Stone Analysis with Image”
Notes
Update to turnaround time.
Turnaround Time: 2 – 5 days
Test Details
Mnemonic
CALCI
Ordering Code
1012630
CPT-4 Codes(s)
82365
COPS – “Copper”
Notes
Update to turnaround time.
Turnaround Time: 2 – 5 days
Test Details
Mnemonic
COPS
Ordering Code
1004750
CPT-4 Codes(s)
82525
EONE – “Estrone, LC/MS/MS”
Notes
Update to New York Approval.
New York DOH Approval Status: Yes
Test Details
Mnemonic
EONE
Ordering Code
3000892
CPT-4 Codes(s)
82679
ESTM – “Estrogens, Total and Fractionated, LC/MS/MS”
Notes
Update to New York Approval.
New York DOH Approval Status: Yes
Test Details
Mnemonic
ESTM
Ordering Code
3000887
CPT-4 Codes(s)
82671
FNBAL – “Fungitell with Reflex to Titer (BAL)”
Notes
Update to reference range.
Reference Range: There are no established criteria for the interpretation of Fungitell results from BAL fluid.
Test Details
Mnemonic
FNBAL
Ordering Code
3300141
CPT-4 Codes(s)
87449, plus 87449 if reflexed to titer, at additional cost
FNBRW – “Fungitell with Reflex to Titer (Bronch Wash)”
Notes
Update to reference range
Reference Range: There are no established criteria for the interpretation of Fungitell results from BAL fluid.
Test Details
Mnemonic
FNBRW
Ordering Code
3300144
CPT-4 Codes(s)
87449, plus 87449 if reflexed to titer, at additional cost
FNCSF – “Fungitell with Reflex to Titer (CSF)”
Notes
Update to reference range.
Reference Range: There are no established criteria for the interpretation of Fungitell results from CSF.
Test Details
Mnemonic
FNCSF
Ordering Code
3300147
CPT-4 Codes(s)
87449, plus 87449 if reflexed to titer, at additional cost
VB1WB – “Vitamin B1 – Whole Blood”
Notes
Update to turnaround time.
Turnaround Time: 2 – 5 days
Test Details
Mnemonic
VB1WB
Ordering Code
1060100
CPT-4 Codes(s)
84425
VITA – “Vitamin A”
Notes
Update to turnaround time.
Turnaround Time: 2 – 5 days
Test Details
Mnemonic
VITA
Ordering Code
1060200
CPT-4 Codes(s)
84590
VITAE – “Vitamin A and E”
Notes
Update to turnaround time.
Turnaround Time: 2 – 5 days
Test Details
Mnemonic
VITAE
Ordering Code
1060180
CPT-4 Codes(s)
84590, 84446
VITB6 – “Vitamin B6”
Notes
Update to turnaround time.
Turnaround Time: 2 – 5 days
Test Details
Mnemonic
VITB6
Ordering Code
1060140
CPT-4 Codes(s)
84207
VITE – “Vitamin E”
Notes
Update to turnaround time.
Turnaround Time: 2 – 5 days
Test Details
Mnemonic
VITE
Ordering Code
1060300
CPT-4 Codes(s)
84446
ZINC – “Zinc, Plasma”
Notes
Update to turnaround time.
Turnaround Time: 2 – 5 days
Test Details
Mnemonic
ZINC
Ordering Code
1004900
CPT-4 Codes(s)
84630
HPCDP – “Histoplasma capsulatum DNA, Real-Time PCR”
Notes
Update to specimen requirements, alternate specimen, rejection criteria, and stability.
Specimen Preparation: Send 5.0 mL whole blood.
Transport Temperature: Refrigerated (cold packs)
Alternate Specimen: 1.0 mL bronchial lavage wash (BAL), CSF, random urine collected in a sterile plastic screw cap container, 3 cubic mm tissue collected in a sterile screw capped plastic container.
Rejection Criteria: Yellow ACD, heparinized whole blood or fixed tissue.
Stability: Room temperature: 48 hours
Refrigerated: 7 days
Frozen: 30 days
Test Details
Mnemonic
HPCDP
Ordering Code
3400277
CPT-4 Codes(s)
87798
VIPP – “Vasoactive Intestinal Polypeptide (VIP)”
Notes
Update to rejection criteria, stability, reference range, performed days, and performing laboratory.
Rejection Criteria: Gross hemolysis, Grossly lipemic, Grossly icteric
Stability:
EDTA Plasma:
Room temperature: Unacceptable
Refrigerated: 7 days
Frozen: 6 months
G.I. Plasma:
Room temperature: Unacceptable
Refrigerated: 7 days
Frozen: 6 months
Reference Range: < 36 pg/mL
Performed Days: Varies
Performing Laboratory: Inter Science Institute
Test Details
Mnemonic
VIPP
Ordering Code
3400961
CPT-4 Codes(s)
84586
VITC – “Vitamin C”
Notes
Update to alternate specimen.
Alternate Specimen: Green lithium heparin (PST)
Test Details
Mnemonic
VITC
Ordering Code
1060400
CPT-4 Codes(s)
82180
BP – “Bullous Pemphigoid Antigens (180 kDa and 230 kDa), IgG”
Notes
Update to specimen requirements, methodology, and turnaround time.
Specimen Preparation: Centrifuge, separate serum from cells and send 2.0 mL serum in a screw capped plastic vial.
Methodology: Semi-quantitative Enzyme-Linked Immunosorbent Assay (ELISA)
Turnaround Time: 5 – 11 days
Test Details
Mnemonic
BP
Ordering Code
3600016
CPT-4 Codes(s)
83516 x 2
GLUCN – “Glucagon”
Notes
Update to specimen requirements and methodology.
Patient Preparation: Fast 12 hours prior to collection.
Specimen Preparation: Mix well. Centrifuge, separate plasma within 1 hour of collection and send 1.0 mL plasma frozen in sterile screw capped plastic vial.
Methodology: Quantitative Radioimmunoassay
Test Details
Mnemonic
GLUCN
Ordering Code
3680690
CPT-4 Codes(s)
82943
GM1PA – “GM1 Ab Panel”
Notes
Update to specimen requirements, rejection criteria, stability, methodology, performed days, and turnaround time.
Specimen Preparation: Centrifuge and separate serum from cells within 2 hours of collection and send 0.3 mL serum in a screw capped plastic vial.
Rejection Criteria: Plasma, CSF, or other body fluids. Contaminated, heat-inactivated, hemolyzed, icteric, or severely lipemic specimens.
Stability: Room temperature: 48 hours
Refrigerated: 14 days
Frozen: 1 year
Methodology: Semi-quantitative Enzyme-Linked Immunosorbent Assay
Performed Days: Tuesday, Thursday, Saturday
Turnaround Time: 3 – 9 days
Test Details
Mnemonic
GM1PA
Ordering Code
3684540
CPT-4 Codes(s)
83516 x 2
HSS14 – “Horizon 14 (PAN-ETHNIC STANDARD)”
Notes
Update to turnaround time.
Turnaround Time: 16-18 days
Test Details
Mnemonic
HSS14
Ordering Code
3302872
CPT-4 Codes(s)
81479 (or 81200, 81220, 81243, 81251, 81255, 81257, 81260, 81329, 81361, 81400, 81401, 81405, 81408, 81161)
HSS4 – “Horizon 4 (SMA, CF, FRAGILE X, DMD)”
Notes
Update to turnaround time.
Turnaround Time: 16-18 days
Test Details
Mnemonic
HSS4
Ordering Code
3302871
CPT-4 Codes(s)
81479 (or 81220, 81243, 81329, 81408, 81161)
ISLCG – “Islet Cell IgG Cyto Autoabs”
Notes
Update to specimen requirements, rejection criteria, stability, methodology, and turnaround time.
Minimum Volume: 0.50 mL
Rejection Criteria: Plasma, CSF, Contaminated, hemolyzed, or severely lipemic specimens.
Stability: Room temperature: 48 hours
Refrigerated: 14 days
Frozen: 1 month
Methodology: Semi-quantitative Cell-Base Indirect Fluorescent Antibody (IFA)
Turnaround Time: 3 – 5 days
Test Details
Mnemonic
ISLCG
Ordering Code
3700760
CPT-4 Codes(s)
86341
PAN – “Panorama Prenatal Test w/No Microdeletion Panel”
Notes
Update to turnaround time.
Turnaround Time: 7 – 9 days
Test Details
Mnemonic
PAN
Ordering Code
3302531
CPT-4 Codes(s)
81420
PAN22 – “Panorama Prenatal Test with 22Q11 Microdeletion Panel”
Notes
Update to turnaround time.
Turnaround Time: 7 – 9 days
Test Details
Mnemonic
PAN22
Ordering Code
3302540
CPT-4 Codes(s)
81420, 81422 (for 22q11.2)
PANFP – “Panorama Prenatal Test with Extended Microdeletion Panel”
Notes
Update to turnaround time.
Turnaround Time: 7 – 9 days
Test Details
Mnemonic
PANFP
Ordering Code
3302551
CPT-4 Codes(s)
81507