Parasite, Blood (Malaria and Non-Malaria)

Orderable EAP code:

LAB00204

Billable EAP Codes:

80001891 x 1
80001945 x 1

CPT Codes:

87207 x 1
87015 x 1

Lab Section:

Core Lab

Includes:

Thin smear, thick smear, parasitemia %

Turnaround Time:

Routine: 4 Hours
Urgent: 2 Hours

Test Schedule:

24 hours, 7 days a week.

Critical Values:

Blood parasites seen

Specimen Requirements:

3 mL fresh blood in a LAVENDER top tube.

Pediatric Specimen Requirements:

0.5 mL fresh blood in a pediatric LAVENDER top microtainer.

Reference Range:

No parasites seen.

Comments:

Preliminary identification will be made 24 hours per day. Final identification will be performed by a pathologist during business hours. Final parasite identification may require 1 to 5 business days.

Travel history is helpful for identification.

Specimen should arrive in the lab within one hour of the collection. If transport to the lab will be delayed, prepare three (3) thin blood smears (unstained, unfixed), and three (3) thick smears (unstained, unfixed) in addition to sending the whole blood tube. Thin smears are prepared in the same manner as for hematology differentials. Thick smears are made by spreading a 10 to 20 microliter drop of blood on a glass slide in a dime-sized area using a glass, plastic, or wooden applicator.

Instructions for thick and thin smears can be found here (Opens in a new window).

Synonyms:

BPA, Malaria, Thick Smear, Thin Smear

Methadone Screen, Urine

Orderable EAP code:

LAB100518

Billable EAP Codes:

80002915 x 1

CPT Codes:

80307 x 1

Lab Section:

Core Lab

Includes:

Methadone

Turnaround Time:

Routine: 2 Hours
Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Specimen Requirements:

6 mL urine cup.

Pediatric Specimen Requirements:

6 mL urine in sample cup or in 10 mL RED top tube.

Reference Range:

Negative

Comments:

Methadone detected in urine at levels greater than or equal to 300 ng/mL are considered "positive". "Positive" results are not confirmed by alternate method. See: Summary of Compounds that may be detected by OHSU Drugs of Abuse Screening Methods. (Opens in a new window)

Synonyms:

Drug Screen, Urine Drug Screen

Oxycodone Screen, Urine

Orderable EAP code:

LAB100519

Billable EAP Codes:

80002914 x 1

CPT Codes:

80307 x 1

Lab Section:

Core Lab

Includes:

Oxycodone

Turnaround Time:

Routine: 2 Hours
Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Specimen Requirements:

6 mL urine cup.

Pediatric Specimen Requirements:

6 mL urine in sample cup or in 10 mL RED top tube.

Reference Range:

Negative

Comments:

Detects Oxycodone in urine at levels greater than or equal to 100 ng/mL. "Positive" results are not confirmed by alternate method. See: Summary of Compounds that may be detected by OHSU Drugs of Abuse Screening Methods. (Opens in a new window)

Synonyms:

Drugs of Abuse, Drug Screen, Urine Drug Screen

Staph Screen, MRSA by PCR

Orderable EAP code:

LAB101656

Billable EAP Codes:

80004142 x 1
80004143 x 1

CPT Codes:

87641 x 1
87640 x 1

Lab Section:

Core Lab

Turnaround Time:

Routine: 4 Hours
Urgent: 2 Hours

Test Schedule:

24 hours, 7 days a week.

Specimen Requirements:

Nasal source only. E-Swab preferred. Stuart swab ok. Swab both nares with each swab. If using E-swab x 2, reprint a label for the second specimen.

Pediatric Specimen Requirements:

Nasal source only. E-Swab preferred. Stuart swab ok. Swab both nares with each swab. If using E-swab x 2, reprint a label for the second specimen.

Comments:

Not Detected

Synonyms:

MRSA, Nasal Screen

Apixaban, Anti-Xa, Level

Orderable EAP code:

LAB103127

Billable EAP Codes:

80005372 x 1

CPT Codes:

80299 x 1

Lab Section:

Core Lab

Turnaround Time:

Routine: 2 Hours
Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Units:

ng/mL

Specimen Requirements:

3.2% sodium citrate tubes are acceptable provided they are filed to the line on the manufacturers label. Tubes must be full (see comments below). Whole blood specimens are stable for up to 4 hours.

For referral testing to Mayo (Opens in a new window), submit at least 1.0 mL frozen platelet-poor citrated plasma. Remove plasma from cells as soon as possible and no later than 4 hours post-draw.

OHSU clinics must cab specimen to the Core Lab, Hatfield Research Center (HRC), if processing is delayed or not possible on site. Detailed instructions are included in this manual under Specialized Lab Services, Hemostasis & Thrombosis section (Opens in a new window).

Pediatric Specimen Requirements:

Add blood to the 1.3 mL mark of Pediatric BLUE top tube, 3.2% sodium citrate.

Reference Range:

Table taken from Mayo Clinic Laboratories Apixaban, Anti-Xa Test Catalog.  Feb 2022.

Routine monitoring of apixaban is not indicated. Therapeutic reference ranges have not been established, however, peak and trough levels observed in clinical trials at different dosing are available. Apixaban concentration may be affected by drug interactions and liver or renal disease.

Comments:

Anticoagulants other than Apixaban will interfere with this test, including but not limited to:  Unfractionated Heparin, Low Molecular Weight Heparin, Rivaroxaban (Xarelto), Edoxaban (Savaysa), and Fondaparinux (Arixtra).

Other sample conditions that may interfere with this test include moderate/marked hemolysis hemolysis (hemoglobin greater than 300 mg/dL), gross icterus (bilirubin greater than 20 mg/dL) and gross lipemia (triglycerides greater than 800 mg/dL).

Draw volume is critical due to the liquid anticoagulant. Allow tubes to fill by vacuum to the fill line indicated by the tube label.

If drawing with syringe, do not remove vacutainer stopper, insert needle through stopper and allow tube to fill, by vacuum. Do not overfill vacutainer.

Synonyms:

Anti Xa
Anti-Xa
Eliquis
FAPIX

Glucose Tol Test, 1 Hour

Orderable EAP code:

LAB00161

Billable EAP Codes:

80001742 x 1

CPT Codes:

82950 x 1

Lab Section:

Core Lab

Turnaround Time:

Routine: 2 Hours
Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Units:

mg/dL

Related Links:

Specimen Requirements:

2 mL blood in a GRAY top tube

Pediatric Specimen Requirements:

0.5 mL blood in a GRAY top tube

Reference Range:

Less than 130 mg/dL

Comments:

This test is to be used for diagnosis of gestational diabetes only. 50 gram oral glucose load. The patient does not need to be fasting.

Synonyms:

Glucose Tolerance; GTT; 1GT

Heparin Anti-Xa, Either Std/LMW

Orderable EAP code:

LAB00967

Billable EAP Codes:

80001819 x 1

CPT Codes:

85520 x 1

Lab Section:

Core Lab

Turnaround Time:

Routine: 2 Hours
Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Units:

U/mL

Specimen Requirements:

3.2% sodium citrate tubes are acceptable provided they are filed to the line on the manufacturers label. Tubes must be full (see comments below). Whole blood specimens are stable up to 4 hours at room temperature. Citrate plasma separated from cells is stable up to 14 days at -20 degrees C.

For referral testing, submit 2 x 1.0 mL frozen platelet-poor citrated plasma. Remove plasma from cells promptly, within 1 hour of draw, to avoid falsely low results due to heparin cofactor II.

Core Lab sodium citrate specimens must be processed and frozen within 2 hours of specimen collection. OHSU clinics must cab specimen to the Core Lab, Hatfield Research Center (HRC), if processing is delayed or not possible on site. Detailed instructions are included in this manual under Specialized Lab Services, Hemostasis & Thrombosis section.

Pediatric Specimen Requirements:

Add blood to the 1.3 mL mark of Pediatric BLUE top tube, 3.2% sodium citrate.

Reference Range:

Heparin, Either STD/LMW - Therapeutic Ranges:
Heparin, Unfractionated: 0.30 to 0.70 U/mL
Enoxaparin, LMWH: 0.70 to 1.20 U/mL
Dalteparin, LMWH: 0.70 to 1.20 U/mL
Tinzaparin, LMWH: Therapeutic range not established. Preliminary studies suggest range similar to dalteparin. Clinical correlation required.

Comments:

Draw volume is critical due to the liquid anticoagulant. Allow tubes to fill by vacuum.

  • Tubes with rubber stopper: fill to line on label.
  • Tubes with plastic (Hemogard) cap: the fill level is above the top of the label.
  • Syringe: do not remove the vacutainer stopper. Insert the needle through the stopper and allow the tube to fill by vacuum. Do not overfill the vacutainer.
  • Pediatric tubes have no vacuum. Remove the cap and add blood to the 1.3 mL mark. Do not overfill.

Monitor 4 to 6 hours post-injection.
Methodology: Anti-Xa chromogenic.

Synonyms:

Anti-Xa Level
LMW Heparin
Unfractionated Heparin
Standard Heparin
Enoxaparin
Dalteparin
Tinzaparin
Heparin Level

Cortisol (ACTH Stimulation) Test

Orderable EAP code:

LAB01025

Billable EAP Codes:

80002089 x 3

CPT Codes:

82533 x 3

Lab Section:

Core Lab

Turnaround Time:

Routine: 2 Hours
Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Units:

mcg/dL

Specimen Requirements:

4 mL blood in a RED top tube for each timepoint: 0, 30 and 60 min.

Pediatric Specimen Requirements:

1.0 mL blood in a RED top tube for each timepoint: 0, 30 and 60 min.

Reference Range:

Baseline:
A.M. Draw (7 to 9 am) = 5.3 to 22.5 micrograms/dL
P.M. Draw (3 to 5 pm) = 3.4 to 16.8 micrograms/dL

30 and 60 minutes = normal response at 30 or 60 minutes is peak. 20 micrograms/dL

Comments:

Ordering LAB01025 "ACTH STIMULATION TEST (0, 30, 60), SERUM" will create three collection labels, one for each timepoint.

Influenza A/B PCR, RAPID

Orderable EAP code:

LAB100504

Billable EAP Codes:

80003516 x 1

CPT Codes:

87502 x 1

Lab Section:

Core Lab

Includes:

Influenza A
Influenza B

Turnaround Time:

Routine: 2 Hours
Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Critical Values:

Positive results will be phoned.

Specimen Requirements:

Nasopharyngeal swab in red-capped universal viral transport media. Nasal aspirate/wash or BAL (bronchoalveolar lavage) in sterile container.

Comments:

This test has not been evaluated for patients without signs and symptoms of respiratory tract infection. Zicam at 15% (w/v) may interfere with the detection of low levels of influenza B and RSV A.

The Xpert Xpress SARS-CoV-2/Flu/RSV PLUS test is a rapid, multiplexed real-time RT-PCR test intended for the detection and differentiation of SARS-CoV-2, influenza A, influenza B, and respiratory syncytial virus (RSV) viral RNA in specimens collected from individuals suspected of respiratory viral infection consistent with COVID-19.

Negative results do not preclude infection and should not be used as the sole basis for treatment or other patient management decisions. Combine results with clinical observations, patient history, and epidemiological information.

Synonyms:

Influenza, Flu virus, Swine Flu, Flu

Platelet Clumping Protocol

Orderable EAP code:

LAB101509

Billable EAP Codes:

80001814 x 1

CPT Codes:

85049 x 1

Lab Section:

Core Lab

Turnaround Time:

Routine: 2 Hours
Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Units:

k/cu mm

Critical Values:

Less than or equal to 10
or
greater than or equal to 1000 k/cu mm.

Specimen Requirements:

BLUE top tube, 3.2% sodium citrate. Tube must be full.

Pediatric Specimen Requirements:

Pediatric BLUE top tube, 3.2% sodium citrate. Tube must be full.

Reference Range:

 Age (years)  PLT Count (k/cu mm)
 0 up to 2  125 to 600
 2 up to 12  150 to 420
 12 up to 150  150 to 400

Comments:

The Platelet Clumping Protocol is used to resolve falsely decreased platelet counts (pseudothrombocytopenia) in patients whose platelets clump in the presence of EDTA. The lab will test the citrate tube and the EDTA tube submitted for the CBC or platelet count ordered concurrently. The lab will examine both tubes for the presence of platelet clumps, and report the platelet count accordingly.

Synonyms:

Platelet Clumper, EDTA Clumper, Pseudothrombocytopenia

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