MRS Clinical Chemistry Tests

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Biochemistry and Genetics Blood: Lead
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Method

Graphite Furnace Atomic Absorption Spectrophotometer

Reporting

Results Available 4-5 working days after receipt of specimen
Contact: (512) 776-7578 or (888) 963-7111 ext. 7578

Reference

Reference Range <5.0 μg/dL

Diagnostic Information: Small amounts of blood lead can be damaging to the development of a child.

Note: Any screening capillary Blood Lead Level (BLL) 5.0 μg/dL or greater must be confirmed with a venous specimen.

Interpretation: For information on how to interpret and follow up on blood lead levels, view form Pb-109: Reference for Followup Blood Lead Testing and Medical Case Management (PDF 109kb).

Specimen/Supply Requirements

Specimen Collection: EDTA whole blood by venous or fingerstick collection. Consult with the laboratory about specimen collection, handling, and submission requirements before selecting supplies/equipment for use in venous and fingerstick blood collection.

• The preferred specimen is a 2mL K2 EDTA lavender top vacuum tube collected by venipuncture. Fill blood collection tubes to manufacturer’s stated fill volume.

• An acceptable screening specimen is a capillary K2 EDTA lavender top collected by fingerstick.

  • To avoid contamination during collection by lead present on the skin, soap and water should be used to clean the collector’s and the patient’s hands prior to specimen collection.

• The diagnostic or follow up specimen must be collected by venipuncture.

Required Request Form

G-THSTEPS for THSteps Medicaid; G-1B for traditional Medicaid, and other payor sources.

Causes for Rejection

Include but are not limited to:

• Submission form not included with specimen.
• No specimen included with submission form.
• Demographic information is missing or incorrect.
• Specimen identification is missing or incorrect.
• Incorrect blood collection tube used.
• Specimen volume is insufficient or excessive.
• Specimen is clotted.
• Specimen is broken or leaking.
• Specimen is not mailed or shipped in a timely or proper manner.
• Specimen is decomposed.
• Specimen is collected in an expired blood collection tube.

Find help on how to avoid these causes for rejection.

Specimen Submission

Shipping Requirements:

• Mail or ship specimens at ambient temperature the day of collection or the next day.
• Specimens may be refrigerated until shipped.
• Maintain specimen integrity by NOT freezing whole blood specimens and by protecting from high temperature environments (such as mail vans and drop boxes) by delivering specimens inside the post office, especially in the summer.
• For detailed mailing and shipping instructions, refer to Packaging and Shipping Blood Tubes.

Billing

CPT Code: 83655
Fees

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Biochemistry and Genetics Blood: Cholesterol/Lipid Profile

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Method

Quantitative enzymatic                                                                                                                                

Reporting 

Results Available: 4-5 working days after receipt of specimen
Contact #:  (512) 776-6236 or (888) 963-7111 ext. 6236 

Reference

Reference Range

• Male:  0.3 – 1.3 mg/dL
• Female: 0.3 – 1.1 mg/dL

Diagnostic Information

The measurement of creatinine is used to evaluate kidney function.

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Biochemistry and Genetics Blood: Diabetes/Glucose

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Method/Procedure

Enzymatic measure using UV/Visual Spectrophotometry

Reporting

Results Available: 4-5 working days after receipt of specimen
Contact: (512) 776-7578 or (888) 963-7111 ext. 7578

Reference

Reference Range:

• Random................ <140 mg/dL
• 1 Hr Glucose….... <140 mg/dL
• 2-Hr PP............... <140 mg/dL
• Fasting.………....70-105 mg/dL
• 1-Hr Glucose Tolerance……… <180 mg/dL
• 2-Hr Glucose Tolerance……… <155 mg/dL
• 3-Hr Glucose Tolerance……… <140 mg/dL

Diagnostic Information

Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders including diabetes mellitus, hypoglycemia, gestational diabetes and pancreatic islet cell carcinoma. Glucose concentrations are measured using a timed endpoint method and hexokinase reagent.

Specimen/Supply Requirements

Specimen Collection:

• Preferred Specimen:  7 - 10mL red top without gel separator.
  • Collect specimen in red top tube.
  • Allow specimen to clot.
  • Centrifuge and remove serum from clot within 2 hours of collection. Transfer at least 1mL of serum to a plastic transport tube and freeze. Plastic transport tube can be a plain blood collection tube.
     
• Acceptable specimen: 7 – 10mL serum separator tube.
  • Collect specimen in a serum separator tube.
  • Allow specimen to clot.
  • Centrifuge specimen within 2 hours of collection so that gel separates serum from red cells. Transfer at least 1mL of serum to a plastic transport tube and freeze. DO NOT FREEZE gel separator tubes.
     
• Acceptable specimen:  gray top tube, spun down and plasma removed within 24 hours of collection.
  • Transfer at least 1mL of plasma to a plastic transport tube and freeze.

Required Request Form

G-THSTEPS for THSteps Medicaid, G-1B for traditional Medicaid and other payor sources.

Causes for Rejection

 Included but not limited to:

• Submission form not included with specimen.
• No specimen included with submission form.
• Demographic information is missing or incorrect.
• Specimen identification is missing or incorrect.
• Specimen quantity is insufficient for testing.
• Specimen is hemolyzed.
• Specimen is not shipped in a timely or proper manner.

Find help on how to avoid these causes for rejection.

Specimen Submission

Shipping Requirements:

• Ship specimens overnight with enough cold packs or dry ice to maintain specimens at proper temperature until arrival at DSHS Laboratory.
• On each submission form, record the date and time that the specimen was removed from the freezer for shipment.
• Batching of specimens for shipment is recommended. For more information on how to correctly package and ship specimens, refer to Cholesterol, Lipid, and Glucose Packing Diagram.

Billing

CPT Code: 82947
Fees

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Biochemistry and Genetics Blood: Hemoglobin Electrophoresis

(Also known as Hemoglobinopathy, Hemoglobin Type, or Sickle Cell Screening)

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Method

Isoelectric focusing

Reporting

Results Available: approximately 1 week after receipt of specimen
Contact:  (512) 776-7578 or (888) 963-7111 ext. 7578

Reference

Diagnostic Information: Heel stick, finger stick, or venous blood dropped on filter paper is screened by the use of isoelectric focusing for clinically significant hemoglobinopathies and thalassemias, including sickle cell anemia.

Reference/Expected Range: 

• Birth to ~6 months = F,A,A
• ~6 months to 1 year = A,A,F
• Over 1 year = A,A

Interpretation: Results for Hemoglobin Electrophoresis that are outside of the Expected Range should be confirmed with a second specimen at a different laboratory.

Specimen/Supply Requirements

Specimen Collection:  Heel stick, finger stick, or venous blood.
Required Specimen:  Dried filter paper blood spots
Volume/Amount Required:  1-2 dried blood spots

Specimen Collection Card:  The Snap-Apart filter paper card may be ordered from the Container Preparation Group at 512-776-7661 or (888) 963-7111 ext. 7661 and is only valid for Hemoglobin Electrophoresis testing.

Specimen Collection Card Shelf Life:  The expiration date is printed on the flap near the filter paper collection area. Do Not Use Expired Cards.

Specimen Collection Card Storage (prior to use):  Store in original wrapping and stack in a manner (vertically) to avoid compression of the filter paper.

Specimen Collection Instructions:

• Wear powder-free disposable gloves when handling collection card and collecting sample.
• Never touch the specimen collection area.
• Write in name of patient and date of collection where indicated.
• To open the card, grasp thumb notches printed on the card between thumb and forefinger of each hand and snap card apart. The instruction sheet will detach from the card. If the card does not “snap apart,” it may be separated by tearing at the perforated lines.
• Holding cover away from specimen collection paper, fill at least 1-2 circles with blood following standard procedures.
• Holding card at thumb notch near collection area, slightly bend collection card away from cover to allow air to flow beneath the collection paper and place card on flat surface to dry.
• When sample has dried, fold cover at score line, over sample, and tuck into flap.
• Complete submission form and submit with specimen.

Do not batch specimens; mail specimens the day of collection or the day after collection.

Storage Instructions: Allow specimen to air-dry completely at ambient temperature before mailing; mail specimen as soon as possible.

Causes for Rejection:  The Hemoglobin Electrophoresis specimen has to be received by the laboratory by the 13th day after collection on a non-expired form and should have at least 1-2 adequately filled circles, patient name/date of collection, and a complete and accurate specimen submission form.

Additional Causes for Rejection include:

• Insufficient blood has been submitted.
• Specimen is contaminated or discolored.
• Missing or invalid patient demographic information.
• Specimen is too old upon receipt (received 14 or more days following collection).
• No blood samples received with request form.
• Improper specimen submitted (i.e., EDTA whole blood).
• Serum separation due to improper drying or collection.
• Laboratory accident.

Find help on how to avoid these causes for rejection.

Specimen Submission

Required Request Form

G-THSTEPS for THSteps Medicaid, G-1B for traditional Medicaid and other payor sources.

Shipping Requirements:  

Mail specimens the day of collection or the next day. U.S. Postal regulations require double containment of dried blood filter paper specimens. Ensure specimens are thoroughly dried prior to placing in mailing container.

• 1st containment:  Use the attached wrap-around cover with printed universal biohazard symbol.
• 2nd containment:  Use mailing container for shipping Hemoglobin Electrophoresis specimens.

Notes:  Ship specimens at ambient temperature within 24 hours of specimen collection. Avoid temperatures greater than 100 degrees F.

Billing

CPT Code:  83020
Fees