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Ordering information regarding a Tryptase test for Clinical Diagnostic Laboratories. Tryptase Ordering Recommendation Measure total tryptase to confirm mast cell activation in diseases such as mastocytosis, anaphylaxis, urticaria, and asthma. Not generally used acutely except where the diagnosis is unclear. Useful in the prognosis of systemic mastocytosis. Mnemonic EGGWHOLE Methodology Quantitative ImmunoCAP Fluorescent Enzyme Immunoassay Performed Mon-Sat Reported 1-2 days New York DOH Approval Status This test is New York DOH approved. Specimen Required Patient Preparation: Collect: Serum separator tube (SST). Specimen Preparation: Allow serum to clot completely at room temperature. Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to a Standard Transport Tube. (Min: 0.5 mL) Storage/Transport Temperature: Frozen. Unacceptable Conditions: Hemolyzed, icteric, or lipemic specimens. Remarks: Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 72 hours; Frozen: 1 month Reference Interval Less than 11.0 µg/L Interpretive Data Compliance Category: FDA Note This test measures total tryptase and does not distinguish between the alpha and beta protein types. Samples should preferably be collected between 15 minutes and three hours after the event suspected to have caused mast cell activation. CPT Code 83520 Components Component Chart Name Tryptase Component Test Code 0099173 LOINC 21582-2 Aliases Total Tryptase Tryptase, Autopsy (Tryptase)

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Ordering information regarding a Myeloperoxidase (MPO) Antibody test for Clinical Diagnostic Laboratories. Myeloperoxidase (MPO) Antibody Ordering Recommendation When used in conjunction with other autoantibody tests (ANCA, PR3), may aid in evaluating suspected immune-mediated vasculitis, especially microscopic polyangiitis (MPA). May be useful to monitor MPA disease and/or treatment response. Panel tests are available. For the workup of suspected vasculitis, refer to ANCA-Associated Vasculitis Profile (ANCA/MPO/PR3) (3003745 ). For patients with a history of vasculitis, refer to Myeloperoxidase (MPO) Antibody and Serine Proteinase 3 (PR3) Antibody with Reflex to Anti-Neutrophil Cytoplasmic Antibody, IgG by IFA (3003746 ). Mnemonic MPO-AB Performed Mon-Sat Methodology Semi-Quantitative Multiplex Bead Assay Reported 1-3 Days New York DOH Approval Status This test is New York DOH approved. Specimen Required Patient Preparation: Collect: Serum separator tube. Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to a Standard Transport Tube. (Min: 0.2 mL) Storage/Transport Temperature: Refrigerated. Unacceptable Conditions: Plasma, urine, or other body fluids. Contaminated, hemolyzed, or severely lipemic specimens., icteric, or lipemic specimens. Remarks: Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles) Reference Interval 19 AU/mL or less Negative 20-25 AU/mL 26 AU/mL or greater Equivocal Positive Interpretive Data Approximately 90% of patients with a P-ANCA pattern by IFA have antibodies specific for MPO. Compliance Category: FDA Note CPT Code 83516 Components Component Chart Name Myeloperoxidase (MPO) Ab, IgG Component Test Code 0050526 LOINC 6969-0 Aliases MPO MPO Ab PR3

Ordering information regarding a Allergen, Food, Egg Whole test for Clinical Diagnostic Laboratories. Allergen, Food, Egg Whole Ordering Recommendation Not recommended for initial thyroid disorders testing. Distinguish thyroid autoimmune disorders from nonautoimmune disease or hypothyroidism. Mnemonic EGGWHOLE Methodology Quantitative ImmunoCAP Fluorescent Enzyme Immunoassay Performed Mon-Sat Reported 1-3 days New York DOH Approval Status This test is New York DOH approved. Specimen Required Patient Preparation: Multiple patient encounters should be avoided. Collect: Serum separator tube. Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Storage/Transport Temperature: Refrigerated. Unacceptable Conditions: Grossly hemolyzed or lipemic specimens. Remarks: Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year Reference Interval Probability of IgE Mediated Clinical Reaction Reporting Range (reported in kU/L) Class Scoring No significant level detected Less than 0.10 0 0.10 - 0.34 0.35 - 0.70 Clinical relevance undetermined Low 0/1 1 0.71 - 3.50 3.51 - 17.50 Moderate High 2 3 17.51 - 50.00 50.01 - 100.00 Very high Very high 4 5 Greater than 100.00 Very high 6 Interpretive Data Allergen results of 0.10-0.34 kU/L are intended for specialist use as the clinical relevance is undetermined. Even though increasing ranges are reflective of increasing concentrations of allergen-specific IgE, these concentrations may not correlate with the degree of clinical response or skin testing results when challenged with a specific allergen. The correlation of allergy laboratory results with clinical history and in vivo reactivity to specific allergens is essential. A negative test may not rule out clinical allergy or even anaphylaxis. Compliance Category: FDA Note Components CPT Code 86003 Component Chart Name Allergen, Food, Egg Whole IgE Component Test Code 0055381 LOINC 7291-8 Aliases ImmunoCAP f245

Ordering information regarding Beta-2 Glycoprotein 1 Antibodies, IgG and IgM test for Clinical Diagnostic Laboratories. Beta-2 Glycoprotein 1 Antibodies, IgG and IgM Ordering Recommendation Acceptable initial test when antiphospholipid syndrome (APS) is strongly suspected. Order with Lupus Anticoagulant Reflexive Panel (0030181 ) and Cardiolipin Antibodies, IgG and IgM (0099344 ). May also be useful in estimating risk of thrombosis and/or pregnancy-related morbidity in patients with systemic lupus erythematosus (SLE). Mnemonic B2GPI PAN Performed Mon-Sat Methodology Semi-Quantitative Enzyme-Linked Immunosorbent Assay Reported 1-2 days New York DOH Approval Status This test is New York DOH approved. Specimen Required Patient Preparation: Collect: Serum separator tube. Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. (Min: 0.3 mL) Storage/Transport Temperature: Refrigerated. Unacceptable Conditions: Plasma or other body fluids. Contaminated, hemolyzed, grossly icteric, or severely lipemic specimens. Remarks: Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles) Reference Interval Reference Interval Components <=20 SGU B2Glycoprotein 1, IgG Antibody <=20 SMU B2Glycoprotein 1, IgM Antibody Interpretive Data The persistent presence of IgG and/or IgM beta 2 glycoprotein I (B2GPI) antibodies is a laboratory criterion for the diagnosis of antiphospholipid syndrome (APS). Persistence is defined as moderate or high levels of IgG and/or IgM B2GPI antibodies detected in two or more specimens drawn at least 12 weeks apart (J Throm Haemost. 2006;4:295-306). B2GPI results greater than 20 SGU (IgG) and/or SMU (IgM) are considered positive based on the cutoff values established for this test. International reference materials and consensus units for anti-B2GPI antibodies have not been established (Clin Chim Acta. 2012;413(1-2):358-60; Arthritis Rheum. 2012;64(1):1-10.); results can be variable between different commercial immunoassays and cannot be compared. Strong clinical correlation is recommended for a diagnosis of APS. Low positive IgG and IgM B2GPI antibody levels should be interpreted in light of APS-specific clinical manifestations and/or other criteria phospholipid antibody tests. Compliance Category: FDA Note MPL = IgM phospholipid units CPT Code 86146 x2 Components Component Chart Name B2Glycoprotein 1, IgG Antibody Component Test Code 0050322 LOINC 44448-9 0050323 B2Glycoprotein 1, IgM Antibody 44449-7 Aliases Anti-B2-Glycoprotein 1 Anti-B2-Glycoprotein I Anti-B2-GP 1 Anti-B2-GP1 Anti-B2-GPI Anti-beta-2 glycoprotein 1 Anti-beta-2 glycoprotein I Apolipoprotein H Apolipoprotein H, APOH B2 Glycoprotein 1 antibodies B2GP Antibodies B2GP1 B2GPI IgG, IgM BECKY Beta 2 GP1 Ab IgG Beta 2 GP1 Ab IgM Beta 2GP1 Ab Beta 2Glycoprotein 1

Ordering information regarding a Comprehensive Metabolic Panel test for Clinical Diagnostic Laboratories. Comprehensive Metabolic Panel Ordering Recommendation Mnemonic Methodology Quantitative Ion-Selective Electrode/Quantitative Enzymatic Assay/Quantitative Spectrophotometry Performed Mon-Sat Reported Within 24 hours New York DOH Approval Status This test is New York DOH approved. Specimen Required Patient Preparation: Collect: Serum separator tube (SST). Specimen Preparation: Protect from light. Allow serum tube to clot completely at room temperature. Separate serum or plasma from cells ASAP or within 30 minutes of collection. Transfer 1 mL serum or plasma to an Amber Transport Tube. (Min: 0.5 mL) Storage/Transport Temperature: Refrigerated Unacceptable Conditions: EDTA, citrate, oxalate, or sodium fluoride/potassium oxalate. Remarks: Stability: After separation from cells: Ambient: Calcium and CO2: 4 hours, All others: 24 hours; Refrigerated: 1 week; Frozen: 2 weeksated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles) Reference Interval 19 Units or less 20-39 Units Negative Weak Positive 40-59 Units Moderate Positive 60 Units or Greater Strong Positive Interpretive Data Note Tests included in this panel: Albumin, Serum or Plasma (0020030), Alkaline Phosphatase, Serum or Plasma (0020005), Aspartate Aminotransferase, Serum or Plasma (0020007), Alanine Aminotransferase, Serum or Plasma (0020008), Bilirubin, Total, Serum or Plasma (0020032), Calcium, Serum or Plasma (0020027), Carbon Dioxide, Serum or Plasma (0020004), Creatinine, Serum or Plasma (0020025), Chloride, Serum or Plasma (0020003), Glucose, Serum or Plasma (0020024), Potassium, Plasma or Serum (0020002), Protein, Total, Plasma or Serum (0020029), Sodium, Plasma or Serum (0020001), and Urea Nitrogen, Plasma or Serum (0020023). CPT Code 80053 Components Component Chart Name Component Test Code LOINC Sodium, Serum or Plasma 0020001 2951-2 0020002 Potassium, Serum or Plasma 2823-3 0020003 0020004 Chloride, Serum or Plasma 2075-0 Carbon Dioxide, Serum or Plasma 2028-9 0020005 0020007 Alkaline Phosphatase 6768-6 Aspartate Aminotransferase 1920-8 0020008 0020023 Alanine Aminotransferase 1742-6 Urea Nitrogen, Serum or Plasma 0020024 0020025 3094-0 Glucose, Serum or Plasma Creatinine, Serum or Plasma 2345-7 2160-0 0020027 0020029 Calcium, Serum or Plasma Protein Total, Serum/Plasma 17861-6 2885-2 0020030 0020032 Albumin, Serum or Plasma Bilirubin, Total, Serum or Plasma 1751-7 1975-2 0020396 3004293 Anion Gap UH EGFR 33037-3 Aliases ACPA Antibody Anti Citrulline Anti-CCP C12 Chem 12 Chemistry Panel Chemistry Screen CMP SMA 12 SMA 20 SMAC

Ordering information regarding a food allergy panel for Clinical Diagnostic Laboratories. Allergens, Food, Common Adult Food IgE Ordering Recommendation Mnemonic FOOD ADULT Performed Sat-Sun Methodology Quantitative ImmunoCAP Fluorescent Enzyme Immunoassay Reported 1-3 Days New York DOH Approval Status This test is New York DOH approved. Specimen Required Patient Preparation: Multiple patient encounters should be avoided. Collect: Serum separator tube. Multiple specimen tubes should be avoided. Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 2.25 mL serum to a Standard Transport Tube. (Min: 1.04 mL) Storage/Transport Temperature: Refrigerated. Unacceptable Conditions: Hemolyzed, icteric, or lipemic specimens. Remarks: Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year Reference Interval Test Number Components Reference Interval Immunoglobulin E Age Reference Interval (kU/L) 0-5 months 13 or less 6-12 months 34 or less 1-2 years 97 or less 3 years 199 or less 4-6 years 307 or less 7-8 years 403 or less 9-12 years 696 or less 13-15 years 629 or less 16-17 years 537 or less 18 years and older 214 or less Less than or equal to 0.34 kU/L Less than or equal to 0.34 kU/L Allergen, Food, Egg White IgE Allergen, Food, Milk (Cow) IgE Less than or equal to 0.34 kU/L Less than or equal to 0.34 kU/L Less than or equal to 0.34 kU/L Less than or equal to 0.34 kU/L Allergen, Food, Peanut IgE Allergen, Food, Shrimp IgE Allergen, Food, Soybean IgE Allergen, Food, Wheat IgE Less than or equal to 0.34 kU/L Less than or equal to 0.34 kU/L Allergen, Food, Codfish IgE Allergen, Food, Corn IgE Less than or equal to 0.34 kU/L Less than or equal to 0.34 kU/L Allergen, Food, Walnut (Juglans spp) IgE Allergen, Food, Clam IgE Less than or equal to 0.34 kU/L Allergen, Food, Scallop IgE Reference Interval Allergen results of 0.10-0.34 kU/L are intended for specialist use as the clinical relevance is undetermined. Even though increasing ranges are reflective of increasing concentrations of allergen-specific IgE, these concentrations may not correlate with the degree of clinical response or skin testing results when challenged with a specific allergen. The correlation of allergy laboratory results with clinical history and in vivo reactivity to specific allergens is essential. A negative test may not rule out clinical allergy or even anaphylaxis. Reporting Range (reported in kU) Class Scoring Probability of IgE Mediated Clinical Reactionported in kU) Less than 0.10 No significant level detected 0 0.10-0.34 Clinical relevance undetermined 0/1 0.35-0.70 Low 1 0.71-3.50 3.51-17.50 Moderate High 2 3 17.51-50.00 Very High 4 50.01-100.00 Very High 5 Greater than 100.00 Very High 6 Compliance Category: FDA Note Allergens included in this panel: Clam, Egg White, Codfish/Whitefish, Corn, Milk (Cow's), Peanut, Shrimp, Scallop, Soybean, Walnut, Wheat, and IgE Serum Total CPT Code 86003 x11; 82785 Components Component Test Code Component Chart Name LOINC 19113-0 Allergen, Food, Egg White IgE Allergen, Food, Peanut IgE Allergen, Food, Shrimp IgE Allergen, Food, Milk (Cow) IgE 6106-9 7258-7 6206-7 6246-3 Immunoglobulin E 0050345 0055013 0055020 0055024 0055030 Allergen, Food, Soybean IgE Allergen, Food, Wheat IgE 6248-9 6276-0 0055031 0055034 Allergen, Food, Codfish IgE Allergen, Interp, Immunocap Score IgE 6082-2 33536-4 0055036 0055041 Allergen, Food, Corn IgE Allergen, Food, Walnut (Juglans spp) IgE 6087-1 33536-4 0055078 0055209 Allergen, Food, Clam IgE Allergen, Food, Scallop IgE 6076-4 7691-9 0099488 0099495

Ordering information regarding a Basic Metabolic Panel test for Clinical Diagnostic Laboratories. Basic Metabolic Panel Ordering Recommendation Methodology Quantitative Ion-Selective Electrode/Quantitative Enzymatic Assay/Quantitative Spectrophotometry Performed Mon-Sat Reported Within 24 hours New York DOH Approval Status This test is New York DOH approved. Specimen Required Patient Preparation: Collect: Plasma separator tube, or serum separator tube SST Specimen Preparation: Allow serum tube to clot completely at room temperature. Separate serum or plasma from cells ASAP within 30 minutes of collection. Transfer 1 mL serum or plasma to a Standard Transport Tube. (Min: 0.3 mL) Storage/Transport Temperature: Specimens collected in EDTA, citrate, or oxalate. Unacceptable Conditions: EDTA, citrate, oxalate, or sodium fluoride/potassium oxalate. Remarks: Stability: After separation from cells: Ambient: Calcium and CO2: 4 hours, All others: 24 hours; Refrigerated: 1 week; Frozen: 2 weeks Reference Interval Components Available Separately Reference Interval By report (reports may vary based on instrumentation) Interpretive Data Note his panel includes: Calcium, Serum or Plasma (0020027), Carbon Dioxide, Serum or Plasma (0020004), Chloride, Serum or Plasma (0020003), Creatinine, Serum or Plasma (0020025), Glucose, Serum or Plasma (0020024), Potassium, Plasma or Serum (0020002), Sodium, Plasma or Serum (0020001), and Urea Nitrogen, Serum or Plasma (0020023). CPT Code 80048 Components Component Test Code Component Chart Name LOINC 0020001 Sodium, Serum or Plasma 2951-2 0020002 Potassium, Serum or Plasma 2823-3 0020003 Chloride, Serum or Plasma 2075-0 0020004 Potassium, Serum or Plasma 2028-9 0020023 Urea Nitrogen, Serum or Plasma 3094-0 0020024 Glucose, Serum or Plasma 2345-7 0020025 Creatinine, Serum or Plasma 2160-0 0020027 0020396 Calcium, Serum or Plasma Anion Gap 17861-6 33037-3 3004293 UH EGFR Aliases C12 Chem 12 Chemistry Panel Chemistry Screen CMP SMA 12 SMA 20 SMAC

Ordering information regarding Clozapine for Clinical Diagnostic Laboratories. Creatinine, Serum or Plasma Ordering Recommendation Screening test to evaluate kidney function. Methodology Quantitative Enzymatic Assay Performed Mon-Sat Reported Within 24 Hours New York DOH Approval Status This test is New York DOH approved. Specimen Required Patient Preparation: Collect: Plasma separator tube or serum separator tube. Specimen Preparation: Allow serum tube to clot completely at room temperature. Separate serum or plasma from cells within 2 hours of collection. Transfer 1 mL serum or plasma to a standard transport tube. (Min: 0.2 mL) Storage/Transport Temperature: Refrigerated. Unacceptable Conditions: Specimens obtained through catheters used to infuse hyperalimentation fluid. Specimens with potassium oxalate/sodium fluoride, citrate, or EDTA as anticoagulants. Remarks: Stability: After separation from cells: Ambient: 1 week; Refrigerated: 1 week; Frozen: 3 months Reference Interval By Report Interpretive Data Note Assay interference (negative) may be observed when high concentrations of N-acetylcysteine (NAC) are present. Negative interference has also been reported with NAPQI (an acetaminophen metabolite) but only with concentrations at or above those expected during acetaminophen overdose. CPT Code 82565 Components Component Test Code Component Chart Name LOINC 0020025 Creatinine, Serum or Plasma 2160-0 3004293 UH EGFR Aliases Blood Creatinine Serum Creatinine

Ordering information regarding a Deamidated Gliadin Peptide (DGP) Antibody, IgG test for Clinical Diagnostic Laboratories. Deamidated Gliadin Peptide (DGP) Antibody, IgG Ordering Recommendation Acceptable single screening test for celiac disease. IgA testing recommended to identify IgA deficiency. Use IgG test in individuals who are IgA deficient. May be useful in diagnosing children <2 years who test negative for tTG and EMA antibodies. May aid in monitoring adherence to gluten-free diet. Celiac Disease Reflexive Cascade (2008114 ) or Tissue Transglutaminase (tTG) Antibody, IgG (0056009 ) is the preferred test for screening patients with suspected celiac disease. Mnemonic Methodology Semi-Quantitative Enzyme-Linked Immunosorbent Assay Performed Mon-Sat Reported 1-2 Days New York DOH Approval Status This test is New York DOH approved. Specimen Required Patient Preparation: Collect: Serum separator tube (SST). Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transport 0.5 mL serum. (Min: 0.3 mL) Storage/Transport Temperature: Refrigerated Unacceptable Conditions: Plasma or other body fluids. Contaminated, hemolyzed, grossly icteric, or grossly lipemic specimens. Remarks: Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year Reference Interval 19 Units or less 20-30 Units Negative Weak Positive 31 Units or greater Positive Interpretive Data Note CPT Code 86258 Components Component Chart Name Deamidated Gliadin Peptide (DGP) Ab, IgG Component Test Code 0051359 LOINC 63459-2 Aliases Celiac Disease Antibodies Deamidated Gliadin Antibodies (DGP) Deaminated Gliadin Peptide Antibodies DGP DGP Ab DGP IgA