Exchange Transfusion

CERNER / EPIC MNEMONIC: WBN
POE DESCRIPTION:

Customized Whole Blood Exchange

DAYS PERFORMED: Daily, 24 hours
TURNAROUND TIME: 1 hour or more, depending on availability of fresh (ideally less than 10 days old) or frozen red cells
SPECIAL INSTRUCTIONS: Indicate on requisition "Exchange Transfusion" and component.
CONTAINER TYPE: Pink top  tube (mother), MicrotainerTM (newborn)
COLLECTION: Special Labeling Requirements: The content of each sample label must include the patient's full name and medical record number, the phlebotomist's initials, the date and time the sample was collected and, for non-LLT draws, the initials of a second medical professional who has confirmed that the sample came from the patient whose name is on the label; the computer label must have this same information plus an accession number and the tests ordered. NOTE:  LLT phlebotomists should write 'LLT' for the second set of initials.
SPECIMEN REQUIREMENTS: Blood from infant and from mother
MINIMUM VOLUME: Mother: 10 mL; newborn; four MicrotainersTM
REFERENCE RANGE: Compatible

Elution

CERNER / EPIC MNEMONIC: EL SCREEN
CPT CODE: 86860
DAYS PERFORMED: Daily, 24 hours
TURNAROUND TIME: 1- 2+ hours
CONTAINER TYPE: Pink top tube
SPECIMEN REQUIREMENTS: Blood
MINIMUM VOLUME: 7 mL
TEST SYNONYM(S):Dichloromethane Eluate; Elu-Kit II; Lui Freeze-Thaw Eluate; Heat Eluate

Electrolyte Panel, Serum

CERNER / EPIC MNEMONIC: EP
POE DESCRIPTION: ELECTROLYTE PANEL; EP
CPT CODE: 80051
TEST INFORMATION: Test includes sodium, potassium, chloride and carbon dioxide.
DAYS PERFORMED: Daily, 24 hours
TURNAROUND TIME: Routine: 8 hours; stat: 1 hour
CONTAINER TYPE:

SSTTM tube or green top (Heparin) microtainer for neonates

SPECIMEN REQUIREMENTS: Blood (serum)
MINIMUM VOLUME: 0.6 mL blood (0.3 mL serum)
REFERENCE RANGE: See Table
CRITICAL VALUES: Sodium:  ≤ 120 mmol/L, ≥ 160 mmol/L; potassium: < 2.5 mmol/L, > 6.5 mmol/L
TEST SYNONYM(S):EP

Electrolyte Panel, Whole Blood

CERNER / EPIC MNEMONIC: BL
CPT CODE: 84295, 84132, 82435
TEST INFORMATION: Test includes sodium, potassium and chloride.
DAYS PERFORMED: Daily, 24 hours
TURNAROUND TIME: 15 minutes
CONTAINER TYPE: Heparinized syringe
SPECIMEN REQUIREMENTS: Heparinized, whole blood
MINIMUM VOLUME: 1 mL whole blood
HANDLING INSTRUCTIONS: Specimen should be kept on ice if also for blood gases.
REFERENCE RANGE: See Table
CRITICAL VALUES: Sodium: <120 mmol/L, >160 mmol/L; potassium: <2.5 mmol/L, >6.5 mmol/L

Electrolytes, Quantitative, Urine

CERNER / EPIC MNEMONIC: RU/NA; RU/K; RU/CL; U/NA; U/K; U/CL
CPT CODE: 82436; 84133; 84300
TEST INFORMATION: Test includes sodium, potassium and chloride on timed or random collections.
DAYS PERFORMED: Specimen accepted daily, 24 hours
TURNAROUND TIME: Routine: 24-48 hours; stat: 1 hour (random urine only)
SPECIAL INSTRUCTIONS: For timed urine collection, instruct the patient to void at the beginning of the collection period and discard the specimen. Then collect all urine including the final specimen voided at the end of the collection period. Containers must be labeled with patient`s full name, room number, date and time collection started, and date and time collection finished.
CONTAINER TYPE: Plastic 24-hour urine container, no preservative (Chemistry bottle #1)
SPECIMEN REQUIREMENTS: 24-hour or random urine
MINIMUM VOLUME: Submit entire urine collection to the laboratory.
HANDLING INSTRUCTIONS: Refrigerate during collection.
REFERENCE RANGE: See table. For random collection, none established, must be established with clinical finding.
REFERENCE CHART: See Table
TEST SYNONYM(S):Urine Electrolytes

Erythrocyte Sedimentation Rate, Westergren

CERNER / EPIC MNEMONIC: ESR
POE DESCRIPTION: SEDIMENTATION RATE WEST; ESR
CPT CODE: 85651
DAYS PERFORMED: Daily, 24 hours
TURNAROUND TIME: 2-4 hours
SPECIAL INSTRUCTIONS:

This test cannot be added onto an exising sample more than 24 hours old.

CONTAINER TYPE: Lavender top (EDTA) tube; microtainers not acceptable
SPECIMEN REQUIREMENTS:

2.0 mL EDTA whole blood

REJECTION CRITERIA: Specimen clotted, >24 hours old; samples collected in microtainers
MINIMUM VOLUME: 1.0 mL EDTA whole blood
HANDLING INSTRUCTIONS: Specimen should be sent to the laboratory as soon as possible.
REFERENCE RANGE: 0-50 years of age: male: 0-17 mm/hour, female: 0-27 mm/hour; older than 50 years: slightly higher
TEST SYNONYM(S):ESR; Sed Rate; Westergren Sedimentation Rate

Estradiol, Serum

CERNER / EPIC MNEMONIC: E2
POE DESCRIPTION: ESTRADIOL; E2
CPT CODE: 82670
DAYS PERFORMED: Daily on first shift
TURNAROUND TIME: 1 day
CONTAINER TYPE:

SSTTM tube or Red top tube

SPECIMEN REQUIREMENTS: Blood (serum)
MINIMUM VOLUME: 1 mL blood (0.5 mL serum)
REFERENCE RANGE: Male: adult:┐8-50 pg/mL, prepubertal: <8 pg/mL; female: follicular:┐30-140 pg/mL, luteal:┐30-175 pg/dL; preovulatory: 200-500 pg/mL
TEST SYNONYM(S):E2; Estradiol-17 Beta (E2)

Estriol, Unconjugated (E3)

CERNER / EPIC MNEMONIC: ESTRIOL
POE DESCRIPTION: ESTRIOL
CPT CODE: 82677-90
TURNAROUND TIME: 5-7 working days
CONTAINER TYPE:

Red top tube or SSTTM tube

SPECIMEN REQUIREMENTS: 2.0 mL blood (1.0 mL serum)
MINIMUM VOLUME: 0.5 mL blood (0.2 mL serum)
REFERENCE RANGE: See Specialty Labs - Search Test Code 3156
TEST SYNONYM(S):E3; Unconjugated Estriol

Ethanol, Blood

CERNER / EPIC MNEMONIC: ETH
POE DESCRIPTION: ALCOHOL; ETHANOL; ETOH
CPT CODE: 82055
DAYS PERFORMED: Specimen accepted daily, 24 hours
TURNAROUND TIME: Routine: 8 hours; stat: 1 hour
SPECIAL INSTRUCTIONS:

If test added onto an existing sample, results may be lower than with a fresh specimen.

CONTAINER TYPE:

Red top tube or SSTTM tube.  Gray top (sodium fluoride) tube acceptable for storing blood prior to analysis.

SPECIMEN REQUIREMENTS: Blood (serum, plasma)
MINIMUM VOLUME: 0.4 mL blood (0.2 mL serum)
REFERENCE RANGE: None detected. Clinically intoxicated: 150 mg/dL. 80 mg/dL (0.08%) is the legal intoxication limit in the State of Illinois.
CRITICAL VALUES: >80 mg/dL
LAST UPDATED:

9-10-2012

TEST SYNONYM(S):Alcohol, Serum; Blood Alcohol Level; Blood Ethanol Level; Ethyl Alcohol, Blood, EtOH

Endometrium Culture, Anaerobic

CERNER / EPIC MNEMONIC: C ANAEROBE
POE DESCRIPTION: CU ANAEROBIC; C ANAEROBE
CPT CODE: 87075
TEST INFORMATION: Test includes culture for anaerobic organisms. Other isolated organisms (i.e. aerobes, yeast, etc.) may be referred for identification and/or susceptibility testing if medically indicated AND a separate culture procedure has NOT yielded the same organism(s).
DAYS PERFORMED: Daily, 24 hours
TURNAROUND TIME: Cultures are examined every 48 hours. Preliminary culture reports available after 48 hours. Culture reports of no growth will be issued after 5 days. Completion of culture reports may take 7-10 days after receipt of the specimen, depending upon the nature of the microorganisms isolated.
SPECIAL INSTRUCTIONS: Avoid exposure to atmospheric oxygen. Specimens should be transported as soon as possible. When transportation is delayed, leave at room temperature. Do NOT refrigerate. The specific anatomic site of the specimen MUST be specified on the order or requisition.
CONTAINER TYPE: BBLTM Port-A-Cul Transport System
COLLECTION: The specimen of choice is an aspirate or tissue, NOT a swab. Specimens are to be collected from a site prepared utilizing aseptic technique. Overlying and adjacent areas must be carefully prepared to eliminate surface (normal flora) anaerobes. Ideally, material is obtained by needle aspiration through an intact surface, which has been cleaned with antiseptic, then placed directly into the BBLTM Port-A-Cul Transport System. Sampling of open lesions is enhanced by deep aspiration using a sterile plastic catheter. Curetting of the base of an open lesion is optimal. If irrigation is necessary, nonbacteriostatic sterile saline may be used. When a syringe is used to obtain the specimen, ALL air should be expelled after which the specimen should be injected into a BBLTM Port-A-Cul Transport System. Swabs should be used as a last resort due to the small volume of specimen obtainable by this method. If a swab must be used, sample the advancing margin of the lesion and abscess walls firmly. Do NOT sample pus or exudate ONLY. Insert the swab containing the sample about 1 cm from the bottom of the transport tube. Break off the swab shaft and secure the lid tightly. Contamination with normal flora from skin, rectum, vaginal tract, or other body sources MUST be avoided since colonizing bacteria not involved in the infectious process may be introduced into the sample.
SPECIMEN REQUIREMENTS: Aspirate, tissue, or other material appropriately obtained for anaerobic culture from appropriate genital sites without contamination with vaginal or exocervical flora. Genital sites appropriate for anaerobic cultures include: placenta, uterus (endometrium), culdocentesis, fallopian tube, cervical aspirate, ovary, Bartholin`s gland.
REJECTION CRITERIA: Inappropriate specimen container, insufficient specimen volume, refrigerated specimen. Specimens from sites which have anaerobic bacteria as normal flora which will routinely be rejected include cervical-vaginal mucosal swabs and urethral. If an unacceptable specimen is received, the specimen will not be processed.
MINIMUM VOLUME: 0.5-5mL or one swab.
HANDLING INSTRUCTIONS: Avoid exposure to atmospheric oxygen. Specimen should be transported as soon as possible. When transportation is delayed, leave at room temperature. Do NOT refrigerate.
REFERENCE RANGE: No growth of anaerobic bacteria
LIMITATIONS OF TEST: A specimen received in anaerobic transport devices is not suitable for routine fungal or mycobacterial cultures. If more than three anaerobic isolates are present, the Bacteroides fragilis group, pigmented gram-negative rods (Prevotella and/or Porphyromonas species), Actinomyces species, and Clostridium perfringens will be the only isolates identified. Anaerobic susceptibility testing is NOT performed routinely. Should susceptibility testing be required, call the Clinical Microbiology laboratory at (312)942-5452.
METHODOLOGY: Conventional culture utilizing media specifically formulated for anaerobic isolation.
TEST SYNONYM(S):Anaerobic Culture, Endometrium

Environmental Culture, Surveillance Culture

CERNER / EPIC MNEMONIC: C STERILE; C OSTERILE (RML laboratories ONLY)
POE DESCRIPTION: CU ENVIRONMENTAL
CPT CODE: 87071
TEST INFORMATION: Test includes isolation and identification of potential pathogens or assessment of sterility from inanimate objects. Quantitation may be provided based upon the type of specimen submitted.
DAYS PERFORMED: Daily, 24 hours
TURNAROUND TIME: Preliminary culture reports available after 24 hours. Culture reports of no growth will be issued after 72 hours. Completion of culture reports may take 3-4 days after receipt of the specimen when multiple isolates are found.
CONTAINER TYPE: Sealed sterile container or Copan® II swab
SPECIMEN REQUIREMENTS: Inanimate objects, equipment, fluids, air samples, or swabs from surfaces or objects
REJECTION CRITERIA: Insufficient specimen volume, inappropriate specimen container.
MINIMUM VOLUME: Submit entire specimen or appropriate sample.
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, leave at room temperature.
REFERENCE RANGE: No growth or no pathogens present
LIMITATIONS OF TEST: Susceptibility testing is NOT performed. Identification may consist of an isolate Gram stain description or an isolate genus name only based upon the type of specimen submitted. Quantitation may NOT be provided based upon the type of specimen submitted.
METHODOLOGY: Conventional culture; quantitation may be provided for fluid specimens.
ADDITIONAL INFORMATION: This procedure should be used to assess the sterility or determine the pathogen-free status of materials or equipment utilized in patient care and/or non-patient care areas.
TEST SYNONYM(S):Sterility culture

Epstein-Barr Viral Capsid Antigen IgG Antibody

CERNER / EPIC MNEMONIC: EBVCA IGG
POE DESCRIPTION: EBV CAPSID ANTIGEN IGG AB; EBVCA IGG
CPT CODE: 86665
DAYS PERFORMED:

Thursday

TURNAROUND TIME: 1-7 days
CONTAINER TYPE:

Red top Vacutainer® tube or SST TM tube

SPECIMEN REQUIREMENTS:

4 mL blood (2 mL serum)

REJECTION CRITERIA: Hemolysis, gross contamination, icteric, lipemic
MINIMUM VOLUME:

2 mL Blood (0.5 mL serum)

REFERENCE RANGE: <0.90 Index Value
METHODOLOGY: Enzyme immunoassay (EIA)
LAST UPDATED:

4-10-2013

TEST SYNONYM(S):EBV Titer; Epstein-Barr VCA Titer

Epstein-Barr Viral Capsid Antigen IgM Antibody

CERNER / EPIC MNEMONIC: EBVCA IGM
POE DESCRIPTION: EBV CAPSID ANTIGEN IGM AB; EBVCA IGM
CPT CODE: 86665
TEST INFORMATION:

 

DAYS PERFORMED:

Thursday

TURNAROUND TIME: 1-7 days
CONTAINER TYPE:

Red top Vacutainer® tube or SST TM tube

SPECIMEN REQUIREMENTS:

4 mL blood (2 mL serum)

REJECTION CRITERIA: Hemolysis, gross contamination, iteric, lipemic, improper storage of specimen
MINIMUM VOLUME: 2 mL blood (0.5 mL serum)
REFERENCE RANGE: <0.90 Index Value
METHODOLOGY: Enzyme immunoassay (EIA)
LAST UPDATED:

4-10-2013

TEST SYNONYM(S):EBV Acute Antibody; EBVCA IgM

Electron Microscopy

CPT CODE: 88348
TEST INFORMATION: Test includes routine microscopic evaluation and electron microscopic evaluation of ultrathin sections.
DAYS PERFORMED: 7-10 days
TURNAROUND TIME:

1 week

SPECIAL INSTRUCTIONS: Tissue submitted for electron microscopy will be processed at the discretion of the pathologist reporting the case.
CONTAINER TYPE: Glutaraldehyde fixative or fresh tissue submitted in a sterile specimen container
COLLECTION: Specimen obtained by surgical excision should include sufficient tissue for routine evaluation; transport immediately after collection to the laboratory.
SPECIMEN REQUIREMENTS: Fresh unfixed tissue or tissue fixed in glutaraldehyde
REJECTION CRITERIA: Formalin fixed tissue or fresh tissue not immediately transported.
LIMITATIONS OF TEST: Sampling error
ADDITIONAL INFORMATION: Electron microscopy is not a substitute for routine light microscopy. Contact pathologist of record to discuss reported electron microscopy study for a case.
TEST SYNONYM(S):Transmission Electron Microscopy; Ultrastructural Study

Eosinophils in Stool

CERNER / EPIC MNEMONIC: Q/EOS
TEST INFORMATION: R/O allergies versus infection in newborns
DAYS PERFORMED: Daily
TURNAROUND TIME: 8 hours
SPECIAL INSTRUCTIONS: Send to laboratory immediately.
CONTAINER TYPE: Stool container
SPECIMEN REQUIREMENTS: 1.0 mL
REJECTION CRITERIA: Specimen on diaper
MINIMUM VOLUME: 0.5 mL
HANDLING INSTRUCTIONS: Processing must begin within one hour of collection.
REFERENCE RANGE: Negative
METHODOLOGY: Hansel's Stain
TEST SYNONYM(S):Fecal Eosinophils

Erythropoietin, Serum

CERNER / EPIC MNEMONIC: ERYTHROP
POE DESCRIPTION: ERYTHROPOIETIN
CPT CODE:

82668

TURNAROUND TIME:

1 to 5 days

CONTAINER TYPE:

Red top tube - 4 mL or SST tube

SPECIMEN REQUIREMENTS:

4.0 mL blood (1.0 mL serum)

MINIMUM VOLUME:

2.0 mL blood (0.5 mL serum)

REFERENCE RANGE:

See Quest Diagnostics - Search Test Code 427

LAST UPDATED:

4/30/12

TEST SYNONYM(S):EPO

Endomysial IgA Antibodies

CERNER / EPIC MNEMONIC: ENDOMYS-AB
POE DESCRIPTION: ANTI ENDOMYSIAL ANTIBODY; ENDOMYS-AB
CPT CODE: 86255-90
TURNAROUND TIME: 5-7 working days
CONTAINER TYPE:

SSTTM or red top tube

SPECIMEN REQUIREMENTS: 2 mL blood (1.0 mL serum)
MINIMUM VOLUME: 1 mL blood (0.4 mL serum)
REFERENCE RANGE:

See Specialty Labs - Search Test Code - 1191

Ethosuximide, Serum

CERNER / EPIC MNEMONIC: ETHOSUX
POE DESCRIPTION: ETHOSUXIMIDE; ETHOSUX
CPT CODE: 80168-90
TURNAROUND TIME:

5-7 working days

CONTAINER TYPE: Red top tube only
SPECIMEN REQUIREMENTS: 2 mL blood (1.0 mL serum)
MINIMUM VOLUME: 1.0┐mL blood (0.5 mL serum)
REFERENCE RANGE: See Specialty Labs - Search Test Code S51651

TEST SYNONYM(S):Zarontin.

Ethylene Glycol

CERNER / EPIC MNEMONIC: ETH GLY
POE DESCRIPTION: ETHYLENE GLYCOL
CPT CODE:

82693-90

TURNAROUND TIME:

5-7 Business Days

CONTAINER TYPE: Red top tube only
SPECIMEN REQUIREMENTS: 4.0 mL blood (2.0 mL serum)
MINIMUM VOLUME: 1.0 mL blood (0.5 mL serum)
REFERENCE RANGE:

See Quest Diagnostics Labs - Search Test Code 801

Euglobulin Lysis Time

CERNER / EPIC MNEMONIC:

MISC CHEM

CPT CODE: 85360-90
TURNAROUND TIME: 5-7 working days
CONTAINER TYPE: Blue top (sodium citrate) tube
COLLECTION: See Section - Specimen Collection Guidelines - Coagulation Specimens
SPECIMEN REQUIREMENTS:

4.5 mL blood (2 mL citrated platelet poor plasma)

REJECTION CRITERIA: Specimen hemolyzed

>65% Hct

MINIMUM VOLUME:

1.8 mL blood (0.7 mL citrated platelet poor plasma); pediatric tube must be fully drawn.

REFERENCE RANGE:

See Specialty Labs - Search Test Code S41505

TEST SYNONYM(S):Clot Lysis Time; ELT; Fibrinolysis Time

Estrogen, Total

CERNER / EPIC MNEMONIC: ESTROGEN
POE DESCRIPTION: ESTROGEN
CPT CODE: 82672-90
TURNAROUND TIME: 5-7 working days
CONTAINER TYPE:

Red top tube or SSTTM  tube

SPECIMEN REQUIREMENTS: 6.0 mL blood (3.0 mL serum)
MINIMUM VOLUME: 3.0 mL blood (1.5 mL serum)
REFERENCE RANGE: See Specialty Labs - Search Test Code 3164

Egg white (IgE) Rast Allergen

CERNER / EPIC MNEMONIC:

EGG WHITE

POE DESCRIPTION:

Egg white allergen

CPT CODE:

86003-90

TEST INFORMATION:

Included in the Rast Food Panel.

TURNAROUND TIME:

5-7 working days

CONTAINER TYPE:

SSTTM tube or red top

SPECIMEN REQUIREMENTS:

2.0 mL blood (1.0 mL serum)

MINIMUM VOLUME:

1.0 mL blood (0.3 mL serum)

REFERENCE RANGE:

See Specialty Labs - Search Test Code F1

English plantain (IgE) Rast Allergen

CERNER / EPIC MNEMONIC:

ENGPLANT

POE DESCRIPTION:

English plantain allergen

CPT CODE:

86003-90

TEST INFORMATION:

Weed allergen.  Included in the Rast Inhalant Panel.

TURNAROUND TIME:

5-7 working days

CONTAINER TYPE:

SSTTM tube or red top

SPECIMEN REQUIREMENTS:

2.0 mL blood (1.0 mL serum)

MINIMUM VOLUME:

1.0 mL blood (0.3 mL serum)

REFERENCE RANGE:

See Specialty Labs - Search Test Code W9

Everolimus

CERNER / EPIC MNEMONIC:

EVEROLIMUS

CPT CODE:

80169-90

TURNAROUND TIME:

5-7 working days

CONTAINER TYPE:

Lavendar tube (EDTA)

SPECIMEN REQUIREMENTS:

2 mL whole blood in EDTA tube

REJECTION CRITERIA:

SST tubes, clotted specimens

MINIMUM VOLUME:

1 mL whole blood (EDTA)

REFERENCE RANGE:

See Quest Labs - Search Test Code 18883

LAST UPDATED:

11-11-2013

TEST SYNONYM(S):Zortress, Certican

Estrone

CERNER / EPIC MNEMONIC:

ESTRONE

CPT CODE:

82679

TURNAROUND TIME:

5-7 working days

CONTAINER TYPE:

Red top tube only

SPECIMEN REQUIREMENTS:

1.0 mL blood (0.5 mL serum)

REJECTION CRITERIA:

Serum separator tube, gross hemolysis, lipemia

MINIMUM VOLUME:

0.5 mL blood (0.25 mL serum)

REFERENCE RANGE:

See Quest Lab - Search Test Code 23244

LAST UPDATED:

3-22-13

Estradiol PEDS

CERNER / EPIC MNEMONIC:

E2-PED

CPT CODE:

82670-90

TURNAROUND TIME:

5-7 working days

CONTAINER TYPE:

SST tube, Red top tube, microtainer

SPECIMEN REQUIREMENTS:

6.0 mL blood (3.0 mL serum)

MINIMUM VOLUME:

3.0 mL blood (1.2 mL serum)

REFERENCE RANGE:

See Esoterix Labs - Search Test Code 500152

LAST UPDATED:

1-24-2014