Leukocyte Depletion of Blood Products by Filtration

CERNER / EPIC MNEMONIC: FILTERLP; LR FILTER
DAYS PERFORMED: Daily, 24 hours
TURNAROUND TIME: 1-2 hours
SPECIAL INSTRUCTIONS: Hold for 1 day after crossmatch unless written request is received from the physician; maximum on hold time is 2 days
CONTAINER TYPE: Pink top tube
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
MINIMUM VOLUME: 7 mL
REFERENCE RANGE: Compatible
TEST SYNONYM(S):Leukocyte-Poor Blood Products; Leukocyte Removal by Filtration

Lactate Dehydrogenase, Cerebrospinal Fluid

CERNER / EPIC MNEMONIC: C/LDH
POE DESCRIPTION:

CSF LDH

CPT CODE: 83615
DAYS PERFORMED: Specimen accepted daily, 24 hours
TURNAROUND TIME: 1 hour
SPECIAL INSTRUCTIONS: Fluid type must be specified on the requisition.
CONTAINER TYPE:

CSF collection tubesRed top tube - 10 mLRed top tube - 4 mL

SPECIMEN REQUIREMENTS: Cerebrospinal fluid
MINIMUM VOLUME: 0.4 mL
REFERENCE RANGE: Normal CSF value is approximately 10% of serum LDH value.
TEST SYNONYM(S):CSF LDH

Lactate Dehydrogenase, Serum

CERNER / EPIC MNEMONIC: LDH
POE DESCRIPTION: LACTATE DEHYDROGENASE; LDH
CPT CODE: 83615
DAYS PERFORMED: Specimen accepted daily, 24 hours
TURNAROUND TIME: Routine: 8 hours; stat: 1 hour
CONTAINER TYPE:

SST tube

SPECIMEN REQUIREMENTS: Blood (serum)
MINIMUM VOLUME: 0.4 mL blood (0.2 mL serum)
REFERENCE RANGE:

110-240 u/L

LAST UPDATED:

3-14-12

TEST SYNONYM(S):LDH; LD

Lactate, Cerebrospinal Fluid

CERNER / EPIC MNEMONIC: C/LACT
POE DESCRIPTION:

CSF LACTIC ACID

CPT CODE: 83605
DAYS PERFORMED: Specimen accepted daily, 24 hours
TURNAROUND TIME: 1 hour
SPECIAL INSTRUCTIONS: Place on ice and deliver to lab immediately.
CONTAINER TYPE:

CSF collection tubesRed top tube - 10 mLRed top tube - 4 mL

SPECIMEN REQUIREMENTS: Cerebrospinal fluid
MINIMUM VOLUME: 0.4 mL
TEST SYNONYM(S):CSF LACTIC ACID

Lactate, Venous Blood or Arterial Blood

CERNER / EPIC MNEMONIC: LACT/V; LACT/A
POE DESCRIPTION: LACTATE, VENOUS BLOOD; LACTATE, ARTERIAL BLOOD; LACTIC ACID, VENOUS BLOOD; LACTIC ACID, ARTERIAL BLOOD
CPT CODE: 83605
DAYS PERFORMED: Specimen accepted daily, 24 hours
TURNAROUND TIME:

15 minutes

SPECIAL INSTRUCTIONS: Deliver specimen immediately to the laboratory on ice.  Requisition must indicate source (i.e. venous or arterial) and time specimen is drawn. This test cannot be added onto an existing sample.
CONTAINER TYPE:

Heparinized syringeheparinized capillary tube, or green-top tube (venous only).

SPECIMEN REQUIREMENTS:

Heparinized whole blood

REJECTION CRITERIA:

Needle attached to syringe, clotted sample, or air bubbles in sample.

MINIMUM VOLUME:

0.3 mL

REFERENCE RANGE:

Venous: 0.5-1.7 mmol/L; Arterial: 0.4-1.3 mmol/L

TEST SYNONYM(S):Blood Lactate; Lactate; Lactic Acid

Lead, Blood

CERNER / EPIC MNEMONIC: LEAD <16 years
POE DESCRIPTION: LEAD; PB
CPT CODE: 83655-90
TURNAROUND TIME: 1-3 working days
CONTAINER TYPE:

Tan top (K2EDTA) tube (Vacutainer #367855) - preferred or Lavender top (EDTA) tube

COLLECTION:

Collection material such as alcohol swabs should be lead-free.  Use powder-free gloves or rinse the powder off with tap water.  For capillary collection, wash hands thoroughly with soap and dry with clean, low-lint towel.  Once washed, fingers must not come into contact with any surface, including the other fingers.  Clean skin prior to venipuncture with the lead-free alcohol swab.  Avoid hemolysis.  Avoid worksite collection.

SPECIMEN REQUIREMENTS:

3 mL whole blood

MINIMUM VOLUME:

0.5 mL whole blood

REFERENCE RANGE:

See Quest Diagnostics - Search Test Code - 599

Laboratory is required by state law to report Lead levels of  >10 µg/dL on pediatric patients > 25 ug/dL to the Illinois Department of Public Health.

TEST SYNONYM(S):Pb, Blood

Lidocaine

CERNER / EPIC MNEMONIC: LIDO
POE DESCRIPTION: LIDOCAINE
CPT CODE:

80176-90

TURNAROUND TIME: 4-6 hours
CONTAINER TYPE: Red top tube
SPECIMEN REQUIREMENTS:

2.0 mL blood (1.0 mL serum)

REJECTION CRITERIA:

SST tubes not acceptable

MINIMUM VOLUME: 0.5 mL blood (0.2 mL serum)
REFERENCE RANGE:

See Quest Diagnostics - Search Test Code 605

TEST SYNONYM(S):Xylocaine.

Lipase, Serum

CERNER / EPIC MNEMONIC: LIP
POE DESCRIPTION: LIPASE; LIP
CPT CODE: 83690; 83690
DAYS PERFORMED: Specimen accepted daily
TURNAROUND TIME: Routine: 8 hours; stat: 1 hour
CONTAINER TYPE:

SST tube

SPECIMEN REQUIREMENTS: Blood (serum)
MINIMUM VOLUME: 0.4 mL blood (0.2 mL serum)
REFERENCE RANGE: 10-52 units/L
ADDITIONAL INFORMATION: Lipase is presently thought to be elevated in parallel with amylase in pancreatitis, not later.

Lipid Panel

CERNER / EPIC MNEMONIC: LIPID P
POE DESCRIPTION: LIPID PANEL; LIPID PROFILE; COR SCREEN
CPT CODE: 80061
TEST INFORMATION: Test includes total cholesterol, triglyceride, HDL cholesterol, and LDL cholesterol (calculated). This panel is commonly ordered to assist in assessing risk of coronary artery disease. Do not confuse with Lipoprotein Electrophoresis, Serum which provides different information (see listing) and is ordered much less frequently. In the Lipid Panel, LDL cholesterol is calculated when the triglyceride is 400 mg/dL. When triglyceride is >400 mg/dL, LDL cholesterol is not reported.
DAYS PERFORMED: Daily
TURNAROUND TIME: 1 day
SPECIAL INSTRUCTIONS: Patient should fast for 12-14 hours prior to collection of specimen.
CONTAINER TYPE:

Red top tube - 10 mL or SST tube

SPECIMEN REQUIREMENTS:

Serum

MINIMUM VOLUME:

2 mL blood (1 mL serum)

REFERENCE RANGE: See Table

Lipoprotein (a)

CERNER / EPIC MNEMONIC: LPA
POE DESCRIPTION: LIPOPROTEIN (A)
CPT CODE:

83695-90

TURNAROUND TIME:

5-7 working days

CONTAINER TYPE:

SST tube

SPECIMEN REQUIREMENTS:

2.0 mL blood (1.0 mL serum)

MINIMUM VOLUME: 1 mL blood (0.5 mL serum)
REFERENCE RANGE: See Specialty Labs - Search Test Code 3446
TEST SYNONYM(S):Lp(a)

Lithium, Serum

CERNER / EPIC MNEMONIC: LI
POE DESCRIPTION: LITHIUM; LI
CPT CODE: 80178
DAYS PERFORMED: Specimen accepted daily, 24 hours
TURNAROUND TIME: Routine: 8 hours; stat: 1 hour
CONTAINER TYPE:

SST tube; DO NOT USE GREEN TOP TUBE

SPECIMEN REQUIREMENTS: Blood (serum)
MINIMUM VOLUME: 0.4 mL blood (0.2 mL serum)
REFERENCE RANGE: 0.4-1.3 mEq/L
CRITICAL VALUES: >1.50
TEST SYNONYM(S):Li, Serum

Low Density Lipoprotein Cholesterol, Calculated

CERNER / EPIC MNEMONIC: LDL CALCUL
CPT CODE: None
DAYS PERFORMED: Daily
TURNAROUND TIME: 1 day
SPECIAL INSTRUCTIONS:

In order to calculate the LDL, a total cholesterol, HDL cholesterol, and triglyceride must be ordered. LDL calculation is not reported when triglycerides are >250 mg/dL.

CONTAINER TYPE:

SST tube

SPECIMEN REQUIREMENTS: Blood (plasma)
MINIMUM VOLUME: 2 mL blood (1 mL serum)
REFERENCE RANGE:

See Table

LAST UPDATED:

6-6-2013

TEST SYNONYM(S):LDLC; LDL (Calculated)

Luteinizing Hormone, Serum

CERNER / EPIC MNEMONIC: LH
POE DESCRIPTION: LUTEINZING HORMONE; LH
CPT CODE: 83002
DAYS PERFORMED:

Specimen accepted daily, 24 hours

TURNAROUND TIME: 1 day
CONTAINER TYPE:

SST tube or Red top tube

SPECIMEN REQUIREMENTS: Blood
MINIMUM VOLUME: 1 mL blood (0.5 mL serum)
REFERENCE RANGE: Male: 1-10 mIU/mL; female: follicular: 1-12 mIU/mL, peak of midcycle: 20-70 mIU/mL, luteal 1-12, post-menopausal: 15-70 mIU/mL
TEST SYNONYM(S):ICSH; Interstitial Cell Stimulating Hormone; LH

Legionella pneumophila Antibody Level

CERNER / EPIC MNEMONIC: LEGION AB
POE DESCRIPTION: LEGIONELLA PNEUMOPHILA AB; LEGION AB
CPT CODE: 86713-90
TURNAROUND TIME: 2-7 working days
SPECIAL INSTRUCTIONS: It is the responsibility of the ordering physician to see that both acute and convalescent specimens are obtained. The physician should arrange for the collection of the convalescent serum 14 days after the acute is collected.
CONTAINER TYPE:

Red top Vacutainer® tube or SST tube

SPECIMEN REQUIREMENTS:

2.0 mL blood (1.0 mL serum)

REJECTION CRITERIA: Excessive hemolysis, gross contamination of specimen, chylous serum, improper storage of specimen, inappropriate specimen container, insufficient specimen volume.
MINIMUM VOLUME: 1.0 mL blood (0.5 mL serum)
REFERENCE RANGE:

See Specialty Labs - Search Test Code 8246

LIMITATIONS OF TEST: A negative antibody response does NOT rule out infection with Legionella pneumophila serogroups 1-6. False negative results may occur when samples are drawn too early after onset. It may take up to 9 weeks postinfection for seroconversion. False negative results may also occur due to the lack of antibody acquisition. Only 80% of L. pneumophila culture proven infections develop diagnostic changes in antibody titer. A positive antibody response may be due to cross reacting antibody found in patients with non-Legionella infections. Pneumonia and bacteremia caused by Pseudomonas species, Haemophilus species, Enterobacteriaceae, Bordetella species, Chlamydia, Rickettsia, Bacteroides species, M. tuberculosis and other mycobacteria, Citrobacter species, and Leptospirosis have been shown to cause false positive results in Legionella serology. Due to the background prevalence rate in some populations, a single positive serum titer cannot be construed to constitute a L. pneumophila infection. Therefore, paired sera analysis and Legionella culture or urinary antigen testing should be performed to aid with diagnosis. Cross reactivity may occur with sera with infections due to other Legionella species.
METHODOLOGY: Enzyme immunoassay (EIA)
TEST SYNONYM(S):Legionella Antibody; Legionnaires` Disease Serology

Limulus Test, Solutions

CERNER / EPIC MNEMONIC: LIMULUS
CPT CODE: 87999
TEST INFORMATION: The test includes a qualitative determination of the outer membrane lipopolysaccharide (i.e. gram-negative endotoxin) in solutions..
DAYS PERFORMED: Monday-Friday, 0800-1430
TURNAROUND TIME: 1-3 days. Specimens received before 1430 Monday through Friday will have the results reported the same day.
SPECIAL INSTRUCTIONS: Specimen CANNOT be shared with any other laboratory UNLESS the Clinical Microbiology Laboratory receives the specimen FIRST.
CONTAINER TYPE: Sterile pyrogen-free tubes. Tubes that are sterile only are not acceptable.
COLLECTION: Collect specimen using aseptic technique. Place the specimen in a sterile, pyrogen-free tube.
SPECIMEN REQUIREMENTS: Solutions, including drug samples.
REJECTION CRITERIA: Inappropriate specimen container (i.e. nonpyrogen-free, nonsterile), collection tube opened and sample used for other test procedures prior to performance of Limulus test, insufficient specimen volume, specimen left at room temperature longer than 1 hour.
MINIMUM VOLUME: 0.5 mL supernatant fluid
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible (within 1 hour of collection/preparation). When transportation is delayed, refrigerate. Do NOT freeze.
REFERENCE RANGE: No endotoxin detected
LIMITATIONS OF TEST: Contamination with Pseudomonas species, Bacteroides species, and/or Proteus species require high concentrations of endotoxin to yield a positive reaction. The test is inhibited by albumin binding to endotoxin; results may therefore be inconclusive with high protein fluids. False positives may result from contamination due to improper preparation and/or handling. The test does NOT identify the pathogen. The test does NOT replace Gram stain and culture.
METHODOLOGY: Enzymatic
TEST SYNONYM(S):Limulus Amebocyte Lysate Test; Limulus Assay for Endotoxin

Lyme Disease Antibodies

CERNER / EPIC MNEMONIC: LYME AB
POE DESCRIPTION: LYME DISEASE ANTIBODIES; LYME AB
CPT CODE:

86618 x2

TEST INFORMATION: The test includes testing for IgG and IgM antibodies to Borrelia burgdorferi.
TURNAROUND TIME: 5-7 working days
CONTAINER TYPE:

Red top Vacutainer® tube or SST tube

SPECIMEN REQUIREMENTS:

4 mL blood (2 mL serum)

MINIMUM VOLUME:

2 mL blood (1 mL serum)

REFERENCE RANGE: See Specialty Labs - Search Test Code 8942
ADDITIONAL INFORMATION: Borrelia burgdorferi is the etiologic agent of Lyme disease. Lyme disease is a multisystem disorder, with rash and arthritis conspicuous symptoms. It is widespread in the U.S. and is caused by Borrelia burgdorferi, a spirochete transmitted by the bite of the tick Ixodes dammini. The disease has protean manifestation, can become chronic, and responds to antibiotics, so prompt proper diagnosis is important. False negative results can be seen in patients with early disease (less than 8 weeks) or in patients treated with antibiotics early after onset of erythema migrans (EM). False positive results can be seen with syphilis, lupus, rheumatoid arthritis, and mononucleosis. These diseases should be considered and appropriate serological evaluation pursued, if clinically indicated.The assay is available for total antibody in both serum and cerebrospinal fluid. Most patients with chronic disease will have positive assays.A fourfold or greater rise in titer between acute and convalescent IgG antibodies provides evidence sometimes not attained until 2 months or more after onset of illness. Therefore, a single sera should be collected at least 4 weeks post onset. All serum specimens determined to be positive will undergo Lyme Western Blot confirmatory testing.  See Specialty Labs - Search Test Code 7711B
TEST SYNONYM(S):Lyme Arthritis Serology

Lyme Disease Antibody Index

CERNER / EPIC MNEMONIC: MICRO REF
POE DESCRIPTION: MICROBIOLOGY REFERRAL
CPT CODE: 82040 (per source); 82784 (per globulin); 86618
DAYS PERFORMED: Monday-Thursday, 0800-1430
TURNAROUND TIME: 1 week
SPECIAL INSTRUCTIONS: It is the responsibility of the ordering physician to see that both acute and convalescent specimens are obtained, if desired.
CONTAINER TYPE:

Sealed sterile container for CSF; red top Vacutainer® tube or SST tube

SPECIMEN REQUIREMENTS: Cerebrospinal fluid AND blood (serum)
REJECTION CRITERIA: Excessive hemolysis, gross contamination of specimen, chylous serum, improper storage of specimen, inappropriate specimen container, insufficient specimen volume, cerebrospinal fluid AND serum not available.
MINIMUM VOLUME: 1 ml CSF, 5 mL blood (1 mL serum)
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, refrigerate.
REFERENCE RANGE: No Lyme antibody detected
LIMITATIONS OF TEST: Cerebrospinal fluid specimens MUST be accompanied by a serum collected the SAME day for testing to be performed. The interpretation for cerebrospinal fluid (CSF) specimens has not been firmly established. Recent studies have shown that in cases of Lyme disease with CNS involvement, antibody may be produced intrathecally. These studies suggest that any detectable level of intrathecally produced CSF antibody may be significant. The importance of distinguishing between intrathecally produced antibody and serum antibody present in the CSF due to blood-cerebrospinal fluid barrier leakage must be emphasized. As is true with serum antibody titers, the most significant cross reaction is with specimens from patients with treponemal disease. These can be distinguished with a VDRL test.
METHODOLOGY: Enzyme-linked immunosorbent assay (ELISA)
REFERRAL LABORATORY:

Commercial laboratory

ADDITIONAL INFORMATION: The Lyme Disease Antibody Index on CSF is used as an aid for the diagnosis of neuroborreliosis. An increased Antibody Index (>1.2), accompanied by a Control Antibody Index of less than 1.0 and an Albumin Ratio of less than 0.0078 is strong evidence for intrathecal synthesis or organism-specific antibody, and thus CNS involvement by B. burgdorferi. Elevation of either the Control Antibody Index, the Albumin Ratio, or both may indicate leakage of antibody across the blood-brain barrier which may falsely elevate the B. burgdorferi Antibody Index.

Leukemia Profile, Blood or Bone Marrow

CERNER / EPIC MNEMONIC: LEUKEMIA
POE DESCRIPTION: LEUKEMIA PROFILE
CPT CODE: 88180 (x16)
TEST INFORMATION: METHOD - Immunophenotyping

REFLEX TESTING - Depending upon results, further cell surface markers may be analyzed. This could include up to six additional markers. Cases of B-cell leukemia may be followed up by JH PCR and/or light chain PCR. Cases of T- cell leukemia may be followed up by T-cell PCR.

DAYS PERFORMED: Mon-Fri, 0800-1600; weekends and holidays 0800-1630 by on-call basis. 85-5329.
TURNAROUND TIME: 1-3 days
CONTAINER TYPE: Yellow top (ACD) tube
SPECIMEN REQUIREMENTS: Blood, bone marrow
MINIMUM VOLUME: 10 mL ACD blood, at least 1 mL ACD bone marrow, hypocellular patients may require extra sample
HANDLING INSTRUCTIONS: Do not refrigerate specimen. Tests require viable lymphocytes. Specimen must be in laboratory within 24 hours of collection. Specimen should be submitted with a completed Patient Information Form. Contact the Flow Cytometry Laboratory at 312-942-8393 to obtain a form.
REFERENCE RANGE: Written interpretation is included with report.
TEST SYNONYM(S):Immunophenotyping

Lymphoma Profile, Bone Marrow, or Tissue

CERNER / EPIC MNEMONIC: LYMPHOMA
POE DESCRIPTION: LYMPHOMA BONE MARROW/TISSUE
CPT CODE: 88180 (x16)
DAYS PERFORMED: Mon-Fri, 0800-1600; weekends and holidays 0800-1630 by on-call basis. 85-5329.
TURNAROUND TIME: 5 days
SPECIAL INSTRUCTIONS: Specimen must be received in laboratory within 24 hours of collection. All tissue specimens from Surgery must first be processed by Surgical Pathology. Specimen should be submitted with a completed Patient Information Form. Contact the Flow Cytometry Laboratory at 312-942-8393 to obtain a form.
CONTAINER TYPE: Yellow top (ACD) tube for blood or bone marrow; place tissue in sample container and cover with salt solution (ie, RPMI, PBS, or saline).
SPECIMEN REQUIREMENTS: Blood, bone marrow, or tissue
MINIMUM VOLUME: 10 mL ACD whole blood or 1 mL ACD bone marrow
HANDLING INSTRUCTIONS: Do not refrigerate specimens and/or do not store tissue in formalin or any other fixative.
REFERENCE RANGE: Written interpretation is included with report.
CRITICAL VALUES: test

Lymphoma and Leukemia Gene Rearrangment, Immunoglobulin Heavy Chain (IgH) Gene Rearrangement by PCR

CERNER / EPIC MNEMONIC: JHPCR
POE DESCRIPTION: JH GENE REARRANGEMENT BY PCR; JHPCR
CPT CODE: 83894 x2; 83898 x2; 83912; 83891
DAYS PERFORMED: Mon-Thur, 0900-1600; Fri, 0900-1200
TURNAROUND TIME: 7-10 days
CONTAINER TYPE: Yellow top (ACD) tube for blood and bone marrow
SPECIMEN REQUIREMENTS: Biopsy, bone marrow, blood, body fluid. Note: Leftover tissue submitted to Pathology for morphology will be used whenever possible.
MINIMUM VOLUME: The IgH gene rearrangement test by PCR may be ordered alone, in this case the sample quantity required is 2-3 mL of blood and 1-2 mL of bone marrow.
HANDLING INSTRUCTIONS: Store yellow top (ACD) tubes at room temperature; deliver to the Cellular Laboratory within 48 hours.
REFERENCE RANGE: No rearrangement observed
LIMITATIONS OF TEST:

Will not detect all gene rearrangements.

Lymphoma Gene Translocation, bc1-2 by Polymerase Chain Reaction (PCR)

CERNER / EPIC MNEMONIC: BCL2PCR
POE DESCRIPTION: BCL 2 GENE; BCL2
CPT CODE: 83898; 83898; 83912; 83894; 83891
DAYS PERFORMED: Mon-Thur, 0900-1600; Fri, 0900-1200
TURNAROUND TIME: 7-10 days
CONTAINER TYPE: Yellow top (ACD) tube for blood and bone marrow
SPECIMEN REQUIREMENTS: Biopsy, bone marrow, blood, body fluid. Note: Leftover specimen submitted to Pathology or Cellular Laboratory will be used whenever possible. Specimens submitted for the Lymphoma and Leukemia Gene Rearrangement test will be used to determine the presence of an amplifiable bc1-2 translocation.
MINIMUM VOLUME: The bcl-2 translocation test by PCR may be ordered alone; in this case the sample quantity required is 2-3 mL of blood and 1-2 mL of bone marrow.
HANDLING INSTRUCTIONS: Store yellow top (ACD) tubes at room temperature; deliver to the Cellular Laboratory within 48 hours; 24 hours for quantitative PCR
REFERENCE RANGE: No translocation observed; 0.01-100% of cells in specimen.
LIMITATIONS OF TEST:

Will detect 80% of translocation breakpoints

TEST SYNONYM(S):bc1-2 Translocation; Major Breakpopint Region (MBR) Translocation; Minor Cluster Region (MCR)

Leukemia Gene Translocation, bcr-abl by Reverse Transcriptase PCR and Quantitative PCR (qPCR)

CERNER / EPIC MNEMONIC: BCRABL
POE DESCRIPTION: BCR-ABL TRANSLOCATION
CPT CODE: 83894; 83912; 83898 (x2); 83902; 83891
DAYS PERFORMED: Mon-Thur, 0900-1600; Fri, 0900-1200
TURNAROUND TIME: 7-10 days
CONTAINER TYPE: Yellow top (ACD) tube
SPECIMEN REQUIREMENTS: Blood or bone marrow.
MINIMUM VOLUME: 1-2 mL bone marrow; refer to lymphoma and Leukemia Gene Rearrangement test for minimum blood volume required.
HANDLING INSTRUCTIONS: Store ACD tubes at room temperature; deliver to the Cellular Laboratory within 24 hours.
REFERENCE RANGE: No translocation observed; (BCRABL/ABL + BCRABL) x 100 = 0.01-100
LIMITATIONS OF TEST:

May not detect rare translocation breakpoints

TEST SYNONYM(S):bcr Gene Translocation; Breakpoint Cluster Region Translocation; Chronic Myelogenous Leukemia; Philadelphia Chromosome Translocation

Lymphoma Protocol

CPT CODE: 88307
TEST INFORMATION: Test includes tissue for histologic diagnosis; touch preparations; tissue snap-frozen for immunophenotyping; gene rearrangement, and other molecular diagnosis studies; flow cytometric phenotyping.
DAYS PERFORMED: Mon-Fri, 0800-1700
SPECIAL INSTRUCTIONS: Indicate if previous lymphoma diagnosis is documented. Indicate relevant clinical history for requesting that these special studies be performed. Indicate HIV status. Indicate if microbial cultures were separately submitted. If available, indicate referring hematologist and/or oncologist. If microbial cultures are desired, they should be taken in O.R. suite and submitted separately.
CONTAINER TYPE: Sterile specimen container without fixative
SPECIMEN REQUIREMENTS: Fresh tissue
REJECTION CRITERIA: Formalin fixed tissue improper or discrepant labeling
MINIMUM VOLUME: 2 g with flow phenotyping, 1 g without flow phenotyping
HANDLING INSTRUCTIONS: Deliver specimen to the laboratory immediately after removal. Do not refrigerate specimen.
ADDITIONAL INFORMATION: Contact pathologist on service for additional information or to consult on special studies for a given patient.

Lymphoma and Leukemia Gene Rearrangement, T cell Receptor Gamma Gene Rearrangement by PCR

Lymphoma and Leukemia Gene Rearrangement, T cell Receptor Gamma Gene Rearrangement by PCR

Lymphoma and Leukemia Gene Rearrangement, T cell Receptor Gamma Gene Rearrangement by PCR

Lymphoma and Leukemia Gene Rearrangement, Ig Light Chain Gene Rearrangement by PCR

CERNER / EPIC MNEMONIC: LCPCR
POE DESCRIPTION: LCPCR
CPT CODE: 83891, 83894, 83898, 83912, 83902, 83903 , 83898
CDM NUMBER: 3391014, 3391018, 3391013, 3391006, 3391021, 3391019
TEST INFORMATION: Detects monoclonal B cell population by IgL kappa and IgL lambda gene rearrangement
DAYS PERFORMED: Mon. - Thurs. 9:00-4:00; Fri. 9:00-12:00
TURNAROUND TIME: 14 days
SPECIAL INSTRUCTIONS: Fresh blood or bone marrow
CONTAINER TYPE: ACD tube (yellow top) or EDTA tube (purple top)
COLLECTION: Venipuncture
SPECIMEN REQUIREMENTS: 3-5 ml bone marrow; 5-10 ml blood
MINIMUM VOLUME: 2 ml bone marrow; 3 ml blood
HANDLING INSTRUCTIONS: Deliver to Cellular Laboratory (1188 Jelke) within 48 hours, hold at room temperature
REFERENCE RANGE: No rearrangement observed; rearrangement observed
LIMITATIONS OF TEST: Detects 50% of possible IgL kappa and lambda gene rearrangements
METHODOLOGY: Reverse transcriptase polymerase chain reaction (RT-PCR) and detection by heteroduplex analysis

Levetiracetam (Keppra)

CERNER / EPIC MNEMONIC:

LEVETIRA

POE DESCRIPTION:

Levetiracetam, Keppra

CPT CODE:

80177-90

TURNAROUND TIME: 5-7 working days
CONTAINER TYPE: Red top
SPECIMEN REQUIREMENTS:

2.0 mL blood (1.0 mL serum)

MINIMUM VOLUME:

1.0 mL blood (0.5 mL serum)

REFERENCE RANGE:

See Specialty Labs - Search Test Code 4963

METHODOLOGY: HPLC
LAST UPDATED:

11-11-2013

TEST SYNONYM(S):Keppra

Lamotrigine

CERNER / EPIC MNEMONIC: LAMOTRIG
POE DESCRIPTION: LAMOTRIGINE; LAMOTRIG
CPT CODE:

80175-90

TURNAROUND TIME: 5-7 working days
SPECIAL INSTRUCTIONS:

Draw 1/2 hour to 1 hour before next dose at steady state.

CONTAINER TYPE:

Red top tube only

SPECIMEN REQUIREMENTS:

1.0 mL blood (0.5 mL serum)

MINIMUM VOLUME:

1.0 mL blood (0.5 mL serum)

REFERENCE RANGE:

See Specialty Labs - Search Test Code 22060

LAST UPDATED:

1-28-2014

Latex (IgE) Rast Allergen

CERNER / EPIC MNEMONIC: LATEX RAST
CPT CODE: 86003-90
TEST INFORMATION: Latex (Brazilian Rubber tree)
TURNAROUND TIME: 5-7 working days
CONTAINER TYPE:

10 mL SST tube

SPECIMEN REQUIREMENTS: 2 mL blood (1.0 mL serum)
MINIMUM VOLUME: 1 mL blood (0.3 mL serum)
REFERENCE RANGE:

See Specialty Labs - Search Test Code K82

Lecithin/Sphingomyelin Ratio, Amniotic Fluid

CERNER / EPIC MNEMONIC: L/S
POE DESCRIPTION: L/S RATIO W PG; L/S
CPT CODE:

83661-90, 83516-90

TURNAROUND TIME: 4-6 hours
SPECIAL INSTRUCTIONS: State gestational age on requisition.
CONTAINER TYPE: Brown plastic tubes for amnios
SPECIMEN REQUIREMENTS: Amniotic fluid, 10 mL
MINIMUM VOLUME: Amniotic fluid, 5 mL
HANDLING INSTRUCTIONS: Protect from light. Send sample on ice to the laboratory immediately after collection. Do not process specimen in any manner.
REFERENCE RANGE:

See Quest Diagnostics - Search Test Code 35057

 

Interpretation of the Lecithin/Sphingomyelin (L/S) Ratio is made as follows:

 

Immature <1.0

PG = Not Detected

Weeks Gestation 26 - 30

 

Premature 1.0 - 1.5

PG = Not Detected

Weeks Gestation 30 - 34

 

Transitional 1.5 - 1.9

PG = Not Detected

Weeks Gestation 35 - 36

 

Mature (Caution) 2.0 - 2.5

PG = Not Detected

Weeks Gestation 36 - 37

 

Mature >2.5

PG = Detected

Weeks Gestation 37 - 40

 

A Lecithin/Sphingomyelin Ratio of greater than 2.0 together with the presence of phosphatidylglycerol may suggest mature fetal lung development.

 

The designation 'Mature (Caution)' refers to patients other than those with diabetes.  Phospholipid data in diabetic pregnancies do not necessarily follow the above classification.

TEST SYNONYM(S):Amniotic Fluid Phospholipids; L/S Ratio, Lung Maturity Profiles

Leucine Aminopeptidase

CERNER / EPIC MNEMONIC: LAP
POE DESCRIPTION: LEUCINE AMINOPEPTIDASE; LAP
CPT CODE: 83670-90
TURNAROUND TIME: 5-7 working days
CONTAINER TYPE: Red top 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 S41520
TEST SYNONYM(S):Arylamidase; LAP; SLAP

Lipids, Total, Feces - timed samples only

CERNER / EPIC MNEMONIC: Q/TLIP
POE DESCRIPTION: TOTAL LIPIDS FECES; FECES TOTAL LIPIDS; Q/TLIP
CPT CODE: 82710-90
TURNAROUND TIME: 5-7 working days
SPECIAL INSTRUCTIONS: Only timed samples accepted
CONTAINER TYPE:

One or more stool collection (stool and stool-sidevw) containers. Containers available from Core Laboratory.

SPECIMEN REQUIREMENTS:

24- or 48-hour stool collection

MINIMUM VOLUME:

Submit entire collection to the laboratory.

HANDLING INSTRUCTIONS:

Keep refrigerated during collection.  Please have patient label as a 24 or 48 hour collection.

REFERENCE RANGE:

See Quest Diagnostics Lab - Search Test Code 455

LAST UPDATED:

4-4-2014

TEST SYNONYM(S):Fecal Fat, Quantitative; Total Lipids, Feces; Feces, Unesterfied Fatty Acids

Liver/Kidney Microsomal Antibodies

CERNER / EPIC MNEMONIC: LIV/KID AB
POE DESCRIPTION: LIVER KIDNEY ANTIBODY; LIV/KID AB
CPT CODE: 86376-90
TURNAROUND TIME: 7-10 days
CONTAINER TYPE:

Red top tube or SST tube

SPECIMEN REQUIREMENTS: 2.0 mL blood (1.0 mL serum)
MINIMUM VOLUME:

1.0 mL blood (0.5 mL serum)

REFERENCE RANGE: See Specialty Labs - Search Test Code - 1112

Low Molecular Weight Heparin

CERNER / EPIC MNEMONIC: LMW HEPARN
POE DESCRIPTION: LOW MOLE. WT. HEPARIN
CPT CODE: 85130
DAYS PERFORMED: Everyday on second shift
TURNAROUND TIME:

1 day

SPECIAL INSTRUCTIONS: Deliver blue top (sodium citrate) tube immediately to the Core Laboratory
CONTAINER TYPE:

Blue top (sodium citrate) tube 3.2% (0.109M) citrate preferred; 3.8% (0.129m) citrate is acceptable

COLLECTION:

See Section - "Specimen Collection Guidelines" - Coagulation Specimens.

SPECIMEN REQUIREMENTS:

4.0 mL whole blood (0.5 mL citrated plasma) or pediatric 1.8 mL or 2.7 mL tubes

MINIMUM VOLUME:

3.5 mL blood (0.5 mL citrated plasma) or completely fill pediatric tubes.

REFERENCE RANGE: 0.6-1.0 IU/mL. Heparin Anti-Xa LMWH reference ranges are accepted therapeutic values.
TEST SYNONYM(S):Anti-Xa activity; Lovenox; Anti-FXA

Lysozyme, Serum

CERNER / EPIC MNEMONIC:

LYSOZYME

POE DESCRIPTION: LYSOZYME
CPT CODE: 85549-90
TURNAROUND TIME: 5-7 working days
CONTAINER TYPE:

Red top tube or SST tube

SPECIMEN REQUIREMENTS: 2.0 mL blood (1.0 ml serum)
MINIMUM VOLUME:

1.0 mL blood (0.2 mL serum)

REFERENCE RANGE:

See Specialty Labs - Search Test Code S51290

TEST SYNONYM(S):Muramidase

Leukocyte Adhesion Deficiency (CD 11a/18)

CERNER / EPIC MNEMONIC:

MISC CHEM

POE DESCRIPTION:

CD 11/18 Leukocyte Adhesion Def

CPT CODE:

88184-88185 x2

CDM NUMBER:

3181382, 3181383

TURNAROUND TIME:

7-10 days

SPECIAL INSTRUCTIONS:

Draw Monday through Thursday only. Specimen must arrive at commercial laboratory within 24 hours of draw.

CONTAINER TYPE: Lavender top
SPECIMEN REQUIREMENTS:

5.0 mL EDTA whole blood

MINIMUM VOLUME:

2 mL EDTA whole blood

HANDLING INSTRUCTIONS:

Specimen must remain at room temperature.

REFERENCE RANGE:

See Mayo Clinic - Search Test Code 81155

METHODOLOGY:

Flow Cytometry Immunophenotyping

TEST SYNONYM(S):CD11/18, LAD

Lobster (IgE) Rast Allergen

CERNER / EPIC MNEMONIC:

LOBSTER

POE DESCRIPTION:

Lobster Allergen

CPT CODE:

86003-90

TURNAROUND TIME:

5-7 working days

CONTAINER TYPE:

SST 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 F80

Leflunomide

CERNER / EPIC MNEMONIC:

LEFLUNOMID

POE DESCRIPTION:

Leflunamide

CPT CODE:

80299-90

TURNAROUND TIME:

5-7 working days

CONTAINER TYPE:

Red top tube

SPECIMEN REQUIREMENTS:

2.0 mL blood (1.0 mL serum)

MINIMUM VOLUME:

1.0 mL blood (0.5 mL serum)

REFERENCE RANGE:

See Specialty Labs - Search Test Code 4191

METHODOLOGY:

LC/MS/MS

TEST SYNONYM(S):Arava

Lactate Dehydrogenase, Fluid

CERNER / EPIC MNEMONIC:

F/LDH

POE DESCRIPTION:

FLUID LDH

SPECIAL INSTRUCTIONS:

Must specify fluid type on the requisition.

CONTAINER TYPE:

Red top tube - 10 mLRed top tube - 4 mLSterile 80 mL specimen container

SPECIMEN REQUIREMENTS:

Body fluid

MINIMUM VOLUME:

0.2 mL

REFERENCE RANGE:

None established

TEST SYNONYM(S):Fluid, LDH

Lipase, Fluid

CERNER / EPIC MNEMONIC:

F/LIP

POE DESCRIPTION:

FLUID LIPASE

CPT CODE:

83690

DAYS PERFORMED:

Specimen accepted daily, 24 hours

TURNAROUND TIME:

1 hour

SPECIAL INSTRUCTIONS:

Must specify fluid type on the requisition.

CONTAINER TYPE:

Red top tube - 10 mLRed top tube - 4 mLSterile 80 mL specimen container

SPECIMEN REQUIREMENTS:

Body fluid

MINIMUM VOLUME:

0.2 mL

REFERENCE RANGE:

None established

TEST SYNONYM(S):Fluid Lipase

Lymphoma and Leukemia Gene Rearrangement, T cell Receptor Gamma Gene Rearrangement by PCR

CERNER / EPIC MNEMONIC:

TCPCR

POE DESCRIPTION:

TCR GENE REARRANGEMENT BY PCR, TCPCR

CPT CODE:

83894 x2, 83898, 83912, 83903, 83891

DAYS PERFORMED:

Mon-Thurs, 0900-1600; Fri, 0900-1200

TURNAROUND TIME:

7-10 days

CONTAINER TYPE:

Yellow top (ACD) tube for blood and bone marrow

SPECIMEN REQUIREMENTS:

Bone marrow/ 2-3 mL, blood/ 3-5 mL, fixed tissue.

Leftover material submitted to Pathology for morphology or flow cytometry will be used whenever possible.

REFERENCE RANGE:

No rearrangement observed

LIMITATIONS OF TEST:

Detects 75-80% of T cell receptor gamma gene rearrangements.

Legionella Urinary Antigen

CERNER / EPIC MNEMONIC:

LEGION AG

POE DESCRIPTION:

LEGION AG

CPT CODE:

87449

TEST INFORMATION:

The Legionella Urinary Antigen  test is an in vitro rapid immunochromatographic assay for the qualitative detection of Legionella pneumophila serogroup 1 antigen

DAYS PERFORMED:

Daily, 24 hours

TURNAROUND TIME:

2 hours

CONTAINER TYPE:

Sterile screw cap  or boric acid tube

COLLECTION:

collect using aseptic technique

SPECIMEN REQUIREMENTS:

 urine,  first void preferred

REJECTION CRITERIA:

specimen received in a preservative other than boric acid, insufficient specimen volume

MINIMUM VOLUME:

2 mL

HANDLING INSTRUCTIONS:

Specimen should be transported as soon as possible.  Specimen may be stored at room temperature for 24 hours. If a longer delay is expected specimen  may be refrigerated for up to 14 days.

REFERENCE RANGE:

Negative

LIMITATIONS OF TEST:

This test will not detect infections caused by other Legionella pneumophila serogroups and by other Legionella species.  A negative antigen result does not exclude infection with Legionella pneumophila serogroup 1.  Culture is recommended for suspected pneumonia to detect causative agents other than Legionella pneumophila serogroup 1 and to recover Legionella pneumophila serogroup 1 when antigen is not detected in urine.

METHODOLOGY:

EIA

ADDITIONAL INFORMATION:

The detection of Legionella pneumophila serogroup 1 antigenuria by EIA is highly sensitive and specific.  Excretion of Legionella antigen in urine may vary depending on the individual patient.  Antigen excretion may begin as early as 3 days after onset of symptons and persist for up to 1 year afterwards.  A positive result can occur due to current or past infection and therefore is not  definitive for infection without other supporting evidence.

TEST SYNONYM(S):Legionnaires Disease

Leukocyte Acid Phosphatase (TRAP Stain for Hairy Cell Leukemia)

CERNER / EPIC MNEMONIC:

DISCONTINUED

Lacosamide

CERNER / EPIC MNEMONIC:

Lacosamide

CPT CODE:

82542-90

TURNAROUND TIME:

5-7 working days

CONTAINER TYPE:

Red Top only

SPECIMEN REQUIREMENTS:

2.0 mL blood (1.0 mL serum)

REJECTION CRITERIA:

Serum separator tubes are not acceptable.

MINIMUM VOLUME:

2.0 mL blood (1.0 mL serum)

REFERENCE RANGE:

See Specialty Labs - Search Test Code - 16262

LAST UPDATED:

4-16-2013

Luteinizing Hormone PEDS

CERNER / EPIC MNEMONIC:

LH-PED

CPT CODE:

83002-90

TURNAROUND TIME:

5-7 working days

CONTAINER TYPE:

SST tube, Red top tube, microtainer

SPECIMEN REQUIREMENTS:

2.0 mL blood (1.0 mL serum)

MINIMUM VOLUME:

0.5 mL blood (0.2 mL serum)

REFERENCE RANGE:

See Esoterix Labs - Search Test Code 500234

LAST UPDATED:

1-24-2014