Valproic Acid, Serum

CERNER / EPIC MNEMONIC: VALPRO
POE DESCRIPTION: VALPROIC ACID, VALPORATE
CPT CODE: 80164
TEST INFORMATION: Optimal sampling time is at trough, just before the next dose.
DAYS PERFORMED: Daily, 24 hours
TURNAROUND TIME: Routine 4 hours; Stat 1 hour
CONTAINER TYPE: Red top tube - 4 mL
SPECIMEN REQUIREMENTS:

2.0 mL blood (1.0 mL serum)

MINIMUM VOLUME: 1.0 mL blood (0.2 mL serum)
REFERENCE RANGE: Therapeutic: 50-100 µg/mL
METHODOLOGY:

Microparticle-enhanced Turbidimetric Immunoassay

CRITICAL VALUES: >175 µg/mL
TEST SYNONYM(S):Depakene., Depakote.

Vancomycin

CERNER / EPIC MNEMONIC: VANCO PRE; VANCO POST; VANCO RND
POE DESCRIPTION: VANCOMYCIN PRE DOSE; VANCO PRE

VANCOMYCIN POST DOSE; VANCO POST

VANCOMYCIN RANDOM LEVEL; VANCO RND

CPT CODE: 80202
TEST INFORMATION: Draw peak: 2 hours after 1-hour infusion; trough: <30 minutes before next dose.
DAYS PERFORMED: Daily, 24 hours
TURNAROUND TIME: Routine 4 hours; Stat 1 hour
SPECIAL INSTRUCTIONS: Requisition must be marked random, pre-, or post dose; indicate date and time specimen drawn.
CONTAINER TYPE: Red top tube - 4 mL
SPECIMEN REQUIREMENTS:

2.0 mL blood (1.0 mL serum)

MINIMUM VOLUME: 1.0 mL blood (0.2 mL serum)
REFERENCE RANGE: Therapeutic: peak (post): 20-40 µg/mL; trough (pre): 10-20 µg/mL
METHODOLOGY:

Particle-enhanced Turbidimetric Immunoassay (PETIA)

CRITICAL VALUES: >50 µg/mL
TEST SYNONYM(S):Vancomycin, Pre; Vancocin.; Vancomycin, Post; Vancomycin, Random

Varicella-Zoster Virus, IgG Antibody Titer

CERNER / EPIC MNEMONIC: VZ IGG
POE DESCRIPTION: VARICELLA ZOSTER IGG AB TITER; VZ IGG
CPT CODE: 86787
DAYS PERFORMED:

Monday and Friday

TURNAROUND TIME: 1-4 days
CONTAINER TYPE:

Red top Vacutainer® tube or SST tube

SPECIMEN REQUIREMENTS:

4 mL blood (2 mL serum)

REJECTION CRITERIA: Hemolysis, gross contamination, icteric, lipemic
MINIMUM VOLUME: 2 mL blood (1 mL serum)
REFERENCE RANGE: <0.90 Index Value
METHODOLOGY: Enzyme immunoassay (EIA)
LAST UPDATED:

4-10-2013

TEST SYNONYM(S):Varicella-Zoster Titer; VZ Titer

Virus Culture

CERNER / EPIC MNEMONIC: C VIR
POE DESCRIPTION: CU VIRUS; C VIR
CPT CODE: 87252
TEST INFORMATION: The test includes inoculation of specific cell cultures for isolation of viral agents.
DAYS PERFORMED: Monday-Saturday, 24 hours
TURNAROUND TIME: Negative viral culture reports will be issued after 2 weeks. Negative viral culture reports for Cytomegalovirus will be issued after 3 weeks.
SPECIAL INSTRUCTIONS: Use a lavender top Vacutainer® (EDTA) tube to collect blood specimens. Obtain a viral transport medium from the Clinical Microbiology Laboratory. Place the non-blood specimen directly into the viral transport medium. Avoid using WOODEN swabs for specimen collection.
CONTAINER TYPE: Lavender top Vacutainer (EDTA) tube for blood, sterile sealed container, viral transport medium (available from Clinical Microbiology Laboratory)
COLLECTION: AVOID using wooden swabs.
SPECIMEN REQUIREMENTS: Blood, sputum, bronchial, nose or throat swabs, ocular swabs, cerebrospinal fluid, urine, biopsy, autopsy specimens, and stool. See table.
REJECTION CRITERIA: Improper storage or transport of specimen, gross specimen contamination, improper specimen collection, failure to use the viral transport medium, inappropriate Vacutainer® tube, wooden swab used for specimen collection.
MINIMUM VOLUME: 1 mL fluid, 0.5 gram solid material
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, refrigerate.
REFERENCE RANGE: No virus isolated
LIMITATIONS OF TEST: Tissue culture may be negative in the presence of a viral infection.
METHODOLOGY: Tissue culture
TEST SYNONYM(S):Virus Identification; Virus Isolation

Von Willebrand Antigen (Factor VIII Antigen )

CERNER / EPIC MNEMONIC: VWF:AG
POE DESCRIPTION:

VON WILLEBRAND FACTOR ANTIGEN; VWF:AG; FVIII ANTG

CPT CODE: 85246-90
CDM NUMBER:

3181083

TURNAROUND TIME: 5-7 working days
SPECIAL INSTRUCTIONS:

This test cannot be added onto an existing sample.

CONTAINER TYPE:

Blue citrate tube

COLLECTION: See Section - Specimen Collection Guidelines - Coagulation Specimens.
SPECIMEN REQUIREMENTS:

4.5 mL blood (1.0 mL citrated plasma)

REJECTION CRITERIA:

Specimen hemolyzed; Hct >55%; underfilled tube (QNS)

MINIMUM VOLUME:

Use pediatric tube: 1.6 mL blood (0.5 mL citrated plasma); pediatric tubes must be fully drawn.

REFERENCE RANGE:

See Specialty Labs   - Search Test Code 1907

TEST SYNONYM(S):Antigenic Factor VIII; Factor VIII Related Antigen; VWF Antigen

Valproic acid, free

CERNER / EPIC MNEMONIC: VALP-FREE
POE DESCRIPTION:

VALPROIC ACID FREE

CPT CODE:

80164

TEST INFORMATION:

Valproic Acid, free

TURNAROUND TIME:

1 to 5 days

CONTAINER TYPE:

 

Red top tube - 10 mLRed top tube - 4 mLMicrotainer (Red), (Red top only)

SPECIMEN REQUIREMENTS:

2.0 mL blood (1.0 mL serum)

REJECTION CRITERIA:

Serum separator tube (SST)

MINIMUM VOLUME:

1.0 mL blood (0.5 mL serum)

REFERENCE RANGE:

See Specialty Lab - Search Test Code 3361

LAST UPDATED:

10-10-2011

TEST SYNONYM(S):Free Valproic Acid

Vanillylmandelic Acid, Quantitative, Urine

CERNER / EPIC MNEMONIC: U/VMA
POE DESCRIPTION: URT VANILLYMANDEIC ACID; URT VMA; U/VMA
CPT CODE:

84585-90

TURNAROUND TIME: 5-7 working days
SPECIAL INSTRUCTIONS:

If possible, patients should discontinue all drugs at least one week prior to collection.  Medications that can interfere with the assay include: L-DOPA, Phenothiazines, Catecholamine-containing drugs, diuretics and vasodilators.  The effect of drugs on Vanillylmandelic Acid result may not be predictable.

CONTAINER TYPE:

24-hour urine bottle - Chemistry bottle #1.  Keep refrigerated.

SPECIMEN REQUIREMENTS: 24-hour urine
MINIMUM VOLUME: Submit entire urine collection to the laboratory.
HANDLING INSTRUCTIONS:

Refrigerate during and after collection.

REFERENCE RANGE: See Specialty Labs  - Search Test Code 3318U

TEST SYNONYM(S):VMA, 24 hr. Urine; Urine VMA

Vasoactive Intestinal Polypeptide (VIP)

CERNER / EPIC MNEMONIC: VIP
POE DESCRIPTION: VASOACTIVE INTESTIN POLYPEPTIDE; VIP
CPT CODE: 84586-90
TURNAROUND TIME: 7-9 working days
SPECIAL INSTRUCTIONS:

This test cannot be added onto an existing sample.

CONTAINER TYPE:

Lavender top (EDTA) tube 

SPECIMEN REQUIREMENTS: 3.0 mL EDTA plasma
MINIMUM VOLUME:

1.1 mL EDTA plasma

REFERENCE RANGE:

See Specialty Labs - Search Test Code S51831

 

 

TEST SYNONYM(S):VIP

Vitamin A

CERNER / EPIC MNEMONIC: VIT A
POE DESCRIPTION: VITAMIN A; VIT A
CPT CODE: 84590-90
TURNAROUND TIME: 5-7 working days
SPECIAL INSTRUCTIONS:

This test cannot be added onto an existing sample.

CONTAINER TYPE:

Red top tube or SST tube

SPECIMEN REQUIREMENTS: 2.0 mL blood (1.0 mL serum). Protect from light.
MINIMUM VOLUME: 1.0 mL blood (0.4 mL serum). Protect from light.
REFERENCE RANGE: See Specialty Labs - Search Test Code 3502
TEST SYNONYM(S):Retinol

Vitamin B1

CERNER / EPIC MNEMONIC: VIT B1
POE DESCRIPTION: VITAMIN B1; VIT B1
CPT CODE: 84425-90
TURNAROUND TIME: 5-7 working days
SPECIAL INSTRUCTIONS:

This test cannot be added onto an existing sample.

CONTAINER TYPE:

red top tube only

SPECIMEN REQUIREMENTS:

4.0 mL blood (2.0 mL serum).  Protect from light.

MINIMUM VOLUME:

2.0 mL blood (1.0 mL serum).  Protect from light.

REFERENCE RANGE:

See Specialty Labs - Search Test Code 90353

LAST UPDATED:

11-11-2013

TEST SYNONYM(S):Thiamine

Vitamin B6

CERNER / EPIC MNEMONIC: VIT B6
POE DESCRIPTION: VITAMIN B6; VIT B6
CPT CODE: 84207-90
TURNAROUND TIME: 5-7 working days
SPECIAL INSTRUCTIONS:

This test cannot be added onto an existing sample.

CONTAINER TYPE:

Lavender tube

SPECIMEN REQUIREMENTS:

1.0 mL whole blood (0.5 mL EDTA plasma). Foil wrapped. Protect from light.

MINIMUM VOLUME:

1.0 mL whole blood (0.5 mL EDTA plasma). Foil wrapped. Protect from light.

REFERENCE RANGE:

See Specialty Labs - Search Test Code S51625

LAST UPDATED:

1-30-2014

TEST SYNONYM(S):Pyridoxal Phosphate; Pyridoxine

Vitamin C

CERNER / EPIC MNEMONIC: VIT C
POE DESCRIPTION: VITAMIN C
CPT CODE: 82180-90
TURNAROUND TIME: 5-7 working days
SPECIAL INSTRUCTIONS:

This test cannot be added onto an existing sample.

CONTAINER TYPE:

Red top tube only

COLLECTION:

Protect from light

SPECIMEN REQUIREMENTS:

4.0 mL blood (2.0 mL serum). Protect from light.

MINIMUM VOLUME:

2.0 mL blood (1.0 mL serum). Protect from light.

REFERENCE RANGE:

See Specialty Labs - Search Test Code S51650

LAST UPDATED:

11-11-2013

TEST SYNONYM(S):Ascorbic Acid

Vitamin E

CERNER / EPIC MNEMONIC: VIT E
POE DESCRIPTION: VITAMIN E; VIT E
CPT CODE:

84446-90, 84591-90

TEST INFORMATION: includes alpha and beta-gamma tocopherol
TURNAROUND TIME: 5-7 working days
CONTAINER TYPE:

Red top tube or SST tube

SPECIMEN REQUIREMENTS: 2.0 mL blood (1.0 mL serum). Protect from light.
MINIMUM VOLUME: 1.0 mL blood (0.4 mL serum). Protect from light.
REFERENCE RANGE: See Specialty Labs - Search Test Code 3530

TEST SYNONYM(S):Tocopherol, Alpha and Gamma

Volatiles Screen, Blood

CERNER / EPIC MNEMONIC: VOL
CPT CODE: 84600-90; 82055-90; 82010-90
TEST INFORMATION: includes acetone; alcohol, ethyl; alcohol, isopropyl; alcohol, methyl
TURNAROUND TIME: 4-6 hours
SPECIAL INSTRUCTIONS:

This test cannot be added onto an existing sample.

CONTAINER TYPE: Gray top (sodium fluoride) tube
SPECIMEN REQUIREMENTS: 1 mL oxalated whole blood
MINIMUM VOLUME: 0.5 mL oxalated whole blood
REFERENCE RANGE:

See Quest Diagnostics - Search Test Code 7240

LAST UPDATED:

1-19-2012

TEST SYNONYM(S):Volatiles Group Toxicology

Von Willebrand Factor Assay

CERNER / EPIC MNEMONIC: VW ASSAY
POE DESCRIPTION: VON WILLEBRAND FACTOR ASSAY; VW ASSAY
CPT CODE: 85245-90
CDM NUMBER:

3181214

TURNAROUND TIME: 5-7 working days
SPECIAL INSTRUCTIONS:

This test cannot be added onto an existing sample.

CONTAINER TYPE:

Blue citrate tube

COLLECTION: See Section - '''' Specimen Collection Guidelines '''' - Coagulation Specimens.
SPECIMEN REQUIREMENTS:

4.5 mL blood (1.0 mL citrated plasma)

REJECTION CRITERIA:

Specimen hemolyzed; Hct > 55%; underfilled tubes (QNS)

MINIMUM VOLUME:

Use pediatric tube: 1.6 mL blood (0.5 mL citrated plasma). Pediatric tubes must be fully drawn.

REFERENCE RANGE:

See Specialty Labs - Search Test Code 4459

LAST UPDATED:

4-3-2013

TEST SYNONYM(S):FVIIIR:RCoF; Ristocetin Cofactor; vWF Activity; vW Factor Assay; vWF Ristocetin Cofactor (R:Co) Activity

Von Willebrand Factor, Multimer Analysis

CERNER / EPIC MNEMONIC: VW MULT
POE DESCRIPTION: VON WILLEBRAND MULTIMER ANALYSIS; VW MULT
CPT CODE: 85247-90
CDM NUMBER:

3181215

TURNAROUND TIME: 5-7 working days
SPECIAL INSTRUCTIONS:

This test cannot be added onto an existing sample.

CONTAINER TYPE:

Blue citrate tube

COLLECTION:

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

SPECIMEN REQUIREMENTS:

Two light blue top - 2.7 mL draw sodium citrate

REJECTION CRITERIA:

Specimen hemolyzed; Hct >55%; underfilled tube (QNS)

MINIMUM VOLUME:

1 mL citrated plasma, one 2.7 mL draw light blue top

REFERENCE RANGE:

See Specialty Labs - Search Test Code 1906

LAST UPDATED:

2-27-2014

TEST SYNONYM(S):Factor VIII, Antigen Multimer Analysis; FVIIIR:Ag Multimers; vWF:Ag Subunit Analysis

Voriconazole

CERNER / EPIC MNEMONIC:

VORICON

POE DESCRIPTION:

VORICON

CPT CODE:

80299-90

TURNAROUND TIME:

5-7 working days

CONTAINER TYPE: Red top tube - 10 mL or Red top tube - 4 mL
SPECIMEN REQUIREMENTS:

4.0 mL blood (2.0 mL serum)

MINIMUM VOLUME:

2.0 mL blood (1.0 mL serum)

REFERENCE RANGE:

See Specialty Labs - Search Test Code S50081

TEST SYNONYM(S):Vfend

Von Willebrand Profile

CERNER / EPIC MNEMONIC:

VW PROF

POE DESCRIPTION:

VW Profile

CPT CODE:

85240-90, 85246-90, 85245-90, 85730 (85247-90 if needed)

TEST INFORMATION:

Includes APTT, Von Willebrand Antigen (FVIII Related Antigen), FVIII Activity and Von Willebrand Assay (Ristocetin Cofactor).  If the Von Willebrand Antigen or Von Willebrand Assay is below the normal range, Von Willebrand multimers will be added.

TURNAROUND TIME:

5-7 working days

SPECIAL INSTRUCTIONS:

This test cannot be added onto an existing sample.

CONTAINER TYPE:

blue top (sodium citrate)  tubes. 2.7 mL draw

COLLECTION:

See Section - Specimen Collection Guidelines - Coagulation Specimens

SPECIMEN REQUIREMENTS:

8 mL blood (3.0 mL citrated platelet poor plasma)

REJECTION CRITERIA:

Hct >55%; hemolyzed specimen; underfilled tube (QNS)

MINIMUM VOLUME:

4 mL blood (2.0 mL citrated platelet poor plasma)

REFERENCE RANGE:

See Specialty Labs - Search Test Code - 9761

LAST UPDATED:

02-27-2014

TEST SYNONYM(S):Von Willebrand Screen

Varicella-Zoster Virus DNA Detection by Real-Time PCR

CERNER / EPIC MNEMONIC:

VZVPCRRT

CPT CODE:

87798

TEST INFORMATION:

This test includes detection of Varicella-zoster virus.  Varicella-zoster virus in CSF.

DAYS PERFORMED:

Monday, Wednesday, and Friday

TURNAROUND TIME:

Maximum of 72 hours

SPECIAL INSTRUCTIONS:

Specimen should be received by the laboratory as soon as possible.

CONTAINER TYPE:

CSF collection tube ; M4 transport medium for swabs

COLLECTION:

Vesicular lesions:  Wash the surface of the vesicles with sterile saline.  Carefully open several vesicles and soak up the vesicular fluid with a clean sterile swab.   The specimen should be collected in the first three days of eruption.  Place the swab into M4 transport medium immediately after collection.
CSF:  Cerebrospinal fluid should be collected by a physician via lumbar puncture using standard sterile technique.

SPECIMEN REQUIREMENTS:

1 ml of CSF in a sterile tube from the lumbar puncture kit
Vesicular fluid on a swab in M4 viral transport media

REJECTION CRITERIA:

Dry swab; swab specimen not in M4 transport media; specimen not refrigerated prior to transport; specimen not received in a sterile sealed container; specimen not closed properly and leaked into transport bag; excessive delay in transport; inappropriate specimen container; specimen unlabeled or mislabeled.

MINIMUM VOLUME:

1 mL of CSF or one swab in M4 transport media

HANDLING INSTRUCTIONS:

The specimen should be transported to the lab as soon as possible.  When transportation is delayed, refrigerate.

REFERENCE RANGE:

No VZV detected.

LIMITATIONS OF TEST:

Reliable results are dependent on appropriate specimen collection, transport storage, and processing procedures.  No detection limits have been established for other specimen types or transport media.

METHODOLOGY:

Isolation of target and control DNA, real time PCR with detection by target specific probes for VZV and internal control.

ADDITIONAL INFORMATION:

The detection of Varicella-Zoster virus DNA is based upon the real-time amplification and detection of specific VZV genomic DNA sequences by PCR from total DNA extracted from the specimen.  Probes specific for VZV are used to identify and differentiate the products of the PCR amplification.
In house studies have shown the analytical sensitivity of this assay is 10 copies/PCR reaction and 250 copies/patient specimen.
The diagnosis of VZV infection should not rely solely upon the result of a PCR assay.  A positive PCR result should be considered in conjunction with clinical presentation and additional established diagnostic tests prior to establishing a diagnosis.  A negative PCR result indicates the absence of VZV DNA in a sample tested and does not exclude the diagnosis of disease.  
This test or one or more of its components was developed and its performance characteristics determined by RML Laboratories, Division of Clinical Microbiology.  It has not been cleared or approved by the U.S. Food and Drug Administration (FDA).  The FDA has determined that such clearance or approval is not necessary.  This test is performed pursuant to a license agreement with Roche Molecular Systems. Inc.

LAST UPDATED:

6-3-2014

TEST SYNONYM(S):VZV detection by real time PCR; VZV PCR; Varicella zoster virus by real time PCR; Herpes zoster

Vitamin K

CERNER / EPIC MNEMONIC:

MISC CHEM

CPT CODE:

84597-90

TURNAROUND TIME:

5-7 working days

SPECIAL INSTRUCTIONS:

This test cannot be added onto an existing sample.

CONTAINER TYPE:

Green top (lithium heparin  - 10 ml, Green top (sodium heparin) - 10 ml; Foil Wrap

SPECIMEN REQUIREMENTS:

8 mL whole blood (4.0 mL plasma).  Protect from light.

MINIMUM VOLUME:

5 mL whole blood (2.0 mL plasma).  Protect from light

REFERENCE RANGE:

See Specialty Labs - Search Test Code S51649