TEST NAME

CH’50 COMPLEMENT

See: Complement Total

TEST NAME

CHARCOT-MARIE TOOTH TYPE 1A (CHARCO)

MERCY TEST NAME

MISC GENERAL LAB

MERCY LAB CODE

CMIS

TEST NAME

CHEST FLUID CYTLOGY

See: Cytology Section Pleural Fluid  

TEST NAME

CHEMICAL SCREEN ONLY URINALYSIS

See:     Urine Dipstick

TEST NAME

CHICKEN POX

See:Herpes Zoster Culture
Varicella Zoster Antibody IgG IgM (Diagnostic testing)
Varicella Zoster Antibody IgG (Immune status)

POWERCHART NAME

CHLAMYDIA PNEUMONIAE BY PCR*

MERCY TEST NAME

CHLAMYDIA PNEUMONIAE BY PCR*

MERCY LAB CODE

MISM

Specimen:

• Bronchial Wash/Lavage
  • Collect 1 mL in a sterile leak-proof container.
• Sputum
  • Collect 1 mL in a sterile plastic container.
• Respiratory specimen (throat or Nasopharyngeal)
  • Collect specimen on a plastic shafted swab and place in M4 transport media.

RL Client Comments:

• Write CHLAMYDIA PNEUMONIAE PCR on order form. Indicate the specimen source on order form.
• Send specimen refrigerated to Mercy lab.

Days Performed:

Specimen referred M-F to UHL, Iowa City for testing

Method:

Real-Time PCR

Reference Value:

Not Detected

CPT Code:

87486

POWERCHART NAME

CHLAMYDIA PROBE

MERCY TEST NAME

MERCY LAB CODE

CTGP

Specimen: 

Urethral or cervical
A ProbeTec ET collection kit (gender specific) is available from the Microbiology Dept.  This kit contains a cleaning swab, collection swab and transport tube for females and a collection swab and transport tube for males. The transporter must be delivered to Mercy Lab within 6 days of collection and should be transported between 2-27 degrees celcius. The same tranporter can be used for GC DNA Probe testing.

Urine
15 – 20 mL of freshly voided urine. The patient should not have urinated for at least 1h prior to specimen collection. Store urine refrigerated @ 2-6°C and deliver the urine to Mercy Lab within 7 days of collection. If the urine was stored @ room temperature before delivery, please call the Mercy Microbiology Department for further instructions (Ext. 7494).

RL: SPECIMENS RECEIVED IN PRESERVATIVE VIALS ARE NOT ACCEPTABLE FOR TESTING AND WILL BE REJECTED. See urine collection instructions below.

Cervical Specimen Collection:

Use the ProbeTec ET collection kit for females. Using the large cleaning swab provided in the kit, remove the excess mucous from the endocervix.  Discard the swab. Insert the smaller Female Endocervical Swab into the cervical canal and rotate vigorously for approximately 30 seconds.  Avoid touching the vaginal walls when withdrawing the specimen.  Place the swab into the transport tube and snap the swab off at the score mark. Tightly cap the tube and label with the patient’s name, date and time of collection. (Swab must be left in the transport tube.)  Transport at 2-27 degrees celsius, within 6 days of collection.

Urethral Specimen Collection (male):

Use the ProbeTec ET collection kit for males.  Patient should NOT have urinated one hour prior to specimen collection.  Insert a small Dacron swab 2-4 cm into the urethra.  Rotate the swab for 5 seconds and withdraw.  Place the swab in the transport tube and snap the swab off at the score mark. Tightly cap the tube and label with the patient’s name, date and time of collection. (Swab must be left in the transport tube.) Transport at 2-27 degrees celsius, within 6 days of collection.

Urine Collection:

Collect specimen in a sterile, plastic, preservative-free specimen collection cup. The patient should not urinate for at least one hour prior to collection of specimen. Patient should collect the first 15-20 mL (maximum 60 mL) of a voided urine (the first part of stream, not mid-stream). Tightly cap the urine and label with the patient’s name, date and time of collection. Store the urine in the refrigerator (2-6°C) until transport to Mercy Lab. Transport refrigerated, within 7 days of collection.

Cause for rejection:

• Transport tubes that are received without collection swabs inside.
• Transport tubes that have expired.
• Transport tubes received with a swab different from the one provided in the collection kit.
• Transporters received frozen.

Specimen collected from a site other than cervical, male urethral or urine

Comment:

• In the case of suspected child abuse, culture is the only recommended procedure. See: Chlamydia Trachomatis Culture
  Results are directly dependent on specimen quality.  Inadequate or improperly collected specimens may give false negative results.

RL Client Comments:

• Mark CTGP Chlamydia DNA Probe on order form.
• Send swabbed specimens at room temperature or refrigerated to Mercy lab.
• Send urine specimens refrigerated to Mercy lab.

Processing:

BD ProbeTec ET Transport tubes: Store at 2-27 degrees celsius
Urine: Store at 2-6 degrees celsius

Performed:

Monday, Wednesday, and Friday with 0800 cutoff.

Reference value:

Negative for Clamydia trachomatis

Method:

Strand Displacement Amplification (SDA)

CPT Code: 

87491

TEST NAME

Chlamydia trachomatis, Miscellaneous Sites, by Nucleic Acid Amplification 
(OTHER SITES not genital or urine)*

MERCY TEST NAME

 MISCELLANEOUS GENERAL LAB

MERCY LAB CODE

CMIS

Specimen:

Swab specimen collected using the APTIMA Collection Vaginal Swab (the APTIMA Unisex Swab can also be used).  Collection kits are available from Mercy Lab.

Mayo approved:

The following sites are approved for Chlamydia testing at Mayo Med Labs, ONLY (Mercy Lab is not approved to do testing on these sites):

Sites:

• Rectal/anal
• Ocular (corneal/conjunctiva)
• Oral/throat
• Pelvic wash, cul-de-sac fluid (this source requires the APTIMA specimen transfer tube T652, available from Mercy lab). 

        NOTE:  If provider wants both Chlamydia and GC testing done on rectal, ocular, oral or pelvic, a separate order will have to
        be placed for each test.

Cause for rejection:

• Transport tubes that are received without collection swabs inside.
• Transport tubes that have expired.
• Transport tubes received with a swab different from the one provided in the collection kit.
• Sources other than those listed above. 

In the case of suspected child abuse, culture is the only recommended procedure.  See: Chlamydia Trachomatis Culture

RL Client Comments:

• If ordering the test at your facility, order a CMIS and put in comment the test is for MCRNA and include the source (rectal, ocular, oral, pelvic).  If you will order using a requisition, write CMIS on the order form and indicate the testing is for MCRNA and include the source (rectal, ocular, oral, pelvic).
• Send the APTIMA transporter refrigerated to Mercy lab.

Processing:

Refrigerate sample after collection and sendt to Mayo Med Labs refrigerated.  Mayo order MCRNA (C.trach, Misc, Amplified RNA)

Performed:

Monday thru Saturday

Reference valuse

Included in report.

Method:

Transcription Mediated Amplification (Gen-Probe)

 CPT Code:

 87491

POWERCHART NAME

MERCY TEST NAME

MERCY LAB CODE

• The intended use of this order is for suspected child abuse cases.
• Other acceptable sites that can be collected for culture are: Fresh tissue (unfixed), pelvic washing, seminal fluid, peritoneal fluid, and nasopharynx / nasal specimens.

• Collect the specimen on a swab (when appropriate) and place immediately in a viral (M4,M5) transporter. 
• Fluids and tissues can be placed directly into the viral transporter (no swab used).
• FREEZE all specimens immediately, after being placed in the Viral transporter. Send to Mercy Lab Frozen

• Specimens should be sent to Mercy Lab frozen. Mercy Lab send FROZen to Mayo Medical Labs.

Order should be placed as a CMIS. include the mayo order code FCTRC. Freeze the specimen immediately after placing in the transport media. Send to Mercy Lab FROZEN

Monday through Sunday

87110  Culture, Chlamydia, any source                                                                                                                                                                                                                                     87140  Culture, typing; immunofluorescent method, each antiserum

TEST NAME

CHLORAMPHENICOL

See:   Antimicrobial Assay*

POWERCHART NAME

CHLORIDE LEVEL

MERCY TEST NAME

CHLORIDE            

MERCY LAB CODE

CL

• Preferred in house: 0.5 ml lithium heparin plasma from a PST tube.
• Preferred reference lab: 0.5 ml serum from a SST tube. 
• Also acceptable: Sodium Heparin, Amm heparin, NaFl or serum from a plain red top tube.

TEST NAME

CHLORIDE SWEAT

See: Sweat

POWERCHART NAME

CHOLESTEROL

MERCY TEST NAME

CHOLESTEROL       

MERCY LAB CODE

CHOL

• Preferred in house: 0.5 ml lithium heparin plasma from a PST tube.
• Preferred reference lab: 0.5 ml serum from a SST tube. 
• Also acceptable: Sodium Heparin,  Amm heparin, or serum from a plain red top tube. 
• Fasting not necessary.

Stability:

Desirable level:  < 200 mg/dl
Marginal level:   200 - 239 mg/dl
High level:        > 240 mg/dl

TEST NAME

CHOLINESTERASE

See:Pseudocholinesterase, Total

TEST NAME

CHORIONIC GONADOTROPINS

See:  HCG Quant Serum
HCG Tumor Marker*
Pregnancy Test Serum
Pregnancy Test Urine

POWERCHART NAME

CHROMOGRANIN A 

MERCY TEST NAME

CHROMOGRANIN A*  

MERCY LAB CODE

CGA

0.5 ml serum from plain red top tube, serum gel acceptable

Send specimen frozen to Mayo. Mayo CGAK

Homogeneous Time-Resolved Fluorescence

86316

POWERCHART NAME

CHROMOSOME-8537-HEMATOL B   

MERCY TEST NAME

CHRM ANLYS BLD*   

MERCY LAB CODE

CHRB

Bone marrow is the recommended specimen for most neoplastic hematologic disorders, because only about 60% of blood specimens produce adequate metaphases for interpretation. Studies on blood are informative mainly in advanced myeloproliferative disorders.

• 5-10 ml whole blood collected in SODIUM HEPARIN tubes. Minimum 3 ml.
• Also draw a purple top tube if no CBC is ordered.  (needed for WBC)

• Send WHOLE BLOOD.  DO NOT CENTRIFUGE.
• Indicate WBC count under internal notes in Mayo system.  Put information from Genetics Request Form in the internal notes also. 
• Send ambient to Mayo.  DO NOT FREEZE.  Refrigerated acceptable.  Mayo #8537
• ORDER CHROMOSOME ANALYSIS for Hematological disorders, blood. 

Includes 2-banded karyotypes, analysis of 20 or more metaphases whenever possible, nd other banding techniques when required.

88237- Tissue culture
88261-Chromosome analysis; count 5 cells, 1 karyotype, with banding (if appropriate)
88262-Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding (if appropriate)
88264-analyze 20-25 cells (if appropriate)
88285-additional cells counted, each study (if appropriate)
88291-Interpretation and report
88299-Unlisted cytogenetic study

POWERCHART NAME

CHROMOSOME-8696-CONGENITAL B

MERCY TEST NAME

CHRM CONGENITAL BLOOD*

MERCY LAB CODE

CHRC

• Blood: 5 ml whole blood collected in SODIUM HEPARIN tubes.  Minimum 2 ml.  
• Cord Blood: whole blood collected in sodium heparin tube.  Send as much as possible.
• Other anticoagulants may be harmful to the viability of the cells.

• Send WHOLE BLOOD.  DO NOT CENTRIFUGE.
• Put Genetics Request information under internal notes on the Mayo system. 
•  Send ambient to Mayo.  Refrigerated acceptable. DO NOT FREEZE. Mayo #8696.

Includes 2-banded karyotypes, analysis of 20 or more metaphases, and other techniques when required. 
Mitomycin C stress tests and sister chromatid exchange tests are available upon special request.

88230-Tissue culture for chromosome analysis
88261-Chromosome analysis; count 5 cells, 1 karyotype, with banding (if appropriate)
88262-Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding (if appropriate)
88264-analyze 20-25 cells (if appropriate)
88285-additional cells counted, each study (if appropriate)
88291-Interpretation and report
88299-Unlisted cytogenetic study

POWERCHART NAME

CHROMOSOME STUDY BONE MARROW

MERCY TEST NAME

CHRM ANLYS BM*

MERCY LAB CODE

BMC

• 2-3 ml of bone marrow placed in special tube from Mayo labs. Minimum 2 ml.
• See special instructions with the kit.  (stored in Hematology and the Cancer Center Lab)

• Complete the Hematopathology portion of Mayo Connect Additional Test Information form. 
• Send a copy of CBC and/or bone marrow report.

• See Mayo book for complete instructions. 
• Send ambient to Mayo.  Refrigerated acceptable. Mayo # 8506.

Includes 2 or more banded karyotypes, analysis of 20 or more metaphases whenever possible, and other techniques when required. 

88237-Tissue culture for bone marrow
88261-Chromosome analysis; count 5 cells, 1 karyotype, with banding (if appropriate)
88262-count 15-20 cells, 2 karyotypes, with banding (if appropriate)
88264-Chromosome analysis, hematologic disorders (if appropriate)
88285-additional cells counted, each study (if appropriate)
88291-Interpretation and report
88299-Unlisted cytogenetic study

TEST NAME

CHROMOSOME ANALYSIS FRAGILE X

See:   Fragile X Syndrome: Molecular Analysis*
Fragile X Syndrome: Molecular & Chromosome Analysis*

POWERCHART NAME

CHROMOSOME STUDY AUTOPSY

MERCY TEST NAME

CHROMOSOME, AUTOPSY*

MERCY LAB CODE

CHRACS

1. Monday through Friday, notify Histology department.
   After hours and on weekends, notify the pathologist on call.
2. Complete a manual Pathology Specimen requisition form and a Ctyogenetics/AFP
   Congenital Disorders Request form (available from the Lab).
3. Pathologist will interpret specimen that will be sent to Mayo.

• Preferred specimen: Products of conception or stillbirth. 
• Alternate specimen:  Autopsy.
• Transport fresh specimen immediately to Mercy Histology Lab.
• If a fetus cannot be specifically identified, collect villus material or tissue that appears to be of fetal origin. Do not handle with hands. 
• Sterile conditions must be maintained for best results. Label each container with the specimen type (placenta, etc) and patient name.
• Mayo Note:  Due to bacterial contamination or nonviable cells, these specimens fail about 25% of the time. 
• Because there is a problem with maternal cell contamination, please attempt to identify and send fetal tissue for chromosome analysis.

• Put Cytogenetics Request Form information under internal notes in the Mayo computer. (To include fetal age, and notation of any previous miscarriages.) 
• Send refrigerated to Mayo. Ambient acceptable.  Mayo # 8887.

An interpretation will be provided by Mercy pathologist and Mayo Medical Laboratories.
46,XX or 46,XY.  No apparent chromosome abnormality.  Photograph of the representative karyotype sent.

88233-Tissue culture for chromosome analysis
88261-Chromosome analysis; count 5 cells, 1 karyotype, with banding (if appropriate)
88262-Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding (if appropriate)
88264-analyze 20-25 cells (if appropriate)
88269-Chromosome analysis, amniotic fluid
88280-Chromosome analysis, additional karyotypes, each study
88285-additional cells counted, each study (if appropriate)
88291-Interpretation and report
88299-Unlisted cytogenetic study

POWERCHART NAME

CITRATE EXCRETION 24 HR URINE

MERCY TEST NAME

CITRATE EXCRT 24UR*

MERCY LAB CODE

CITRAT

• 24-hour urine collection. 
• Add 25ml 50% acetic acid prior to start of collection. 
• Keep refrigerated during collection.

• Mix 24-hour specimen well before aliquoting. 
• Aliquot 5 ml into Mayo 13 ml tubes.  Minimum 1 ml. 
• Send  to Mayo refrigerated.  Frozen <7 days acceptable. Mayo # 9329.

POWERCHART NAME

CK (CREATINE KINASE)

MERCY TEST NAME

CK                  

MERCY LAB CODE

CK

• Preferred in house: 0.5 ml lithium heparin plasma from a PST tube.
• Preferred reference lab: 0.5 ml serum from a SST tube.
•  Also acceptable: Sodium Heparin, Amm heparin, or serum from a plain red top tube.

A CK MB will be run and charged on all male patients with a CK >273 UI/L and female patients with CK >200 IU/L.

Male:     25-273 IU/L
Female: 30-200 IU/L

POWERCHART NAME

CK-MB TOTAL

MERCY TEST NAME

CKMB                  

MERCY LAB CODE

CKMB

• Preferred in house: 0.5 ml lithium heparin plasma from a PST tube. 
• Preferred reference lab: 0.5 ml serum from a SST tube. 
• Also acceptable: serum from a plain red top tube.
• For serial collections, the same specimen type should be collected.

Regional Lab Clients:  Freeze if not received at Mercy Medical Center - North Iowa Laboratory within 48 hours of collection.

TEST NAME

CKMB/ISOENZYMES

See:   CKMB

TEST NAME

CL

See: Chloride
       Electrolytes Serum
       Sodium/Potassium/Chloride Body Fluid

POWERCHART NAME

CLOMIPRAMINE LEVEL

MERCY TEST NAME

CLOMIPRAMINE*     

MERCY LAB CODE

CMIS 

Included with results.

POWERCHART NAME

CLONAZEPAM (CLONOPIN) LEVEL

MERCY TEST NAME

CLONAZEPAM*

MERCY LAB CODE

CLZP

Included on the report

TEST NAME

CLONOPIN

See:   Clonazepam*

POWERCHART NAME

MERCY TEST NAME

CLOSTRIDIUM DIFFICILE TOXIN GENE

MERCY LAB CODE

CDIFFM

 Test stool for C. difficile on all patients with clinically significant diarrhea AND history of antibiotic exposure.

Specimen:

FRESH SPECIMEN: Minimum of 2 gms. of a random stool.  Submit in a clean container with a tight fitting lid.  Deliver to laboratory as soon as possible, or refrigerate for up to 5 days.  Specimens may be frozen for longer storage. 

PRESERVED SPECIMEN: Specimen may be submitted in Cary-Blair transporter. (Orange lid).  Add stool specimen until liquid level reaches the line on the preservative vial.  Tighten lid securely and mix well by shaking.  Specimen is stable for 5 days.

If the patient has had an enema or contrast medium used, the specimen must be collected at least 24 hours post enema or contrast usage.

Consider C. Difficile testing as an alternative to routine microbiologic studies for INPATIENTS that have been hospitalized for more than 3 days.

 Cause for Rejection:

• Specimens collected within 24 hous of barium or bismuth enema
• Specimens contaminated with toilet water or urine

Comment: 

• Patient should be passing 5 or more liquid or soft stool per 24 hours to be tested for Clostridium difficile. 
• Formed stools are not indicative of Clostridium difficile associated disease, and will not be tested. 
•  Not to be used for children <2 yrs, as up to 50% of healthy infants are carriers.
• Only submit 1 specimen per diarrheal episode is necessary for diagnosis.
• Not to be used as a "test of cure," as this test will also detect non-viable organisms that persist after treatment.
• Useful as an aid in diagnosis of antibiotic associated pseudomembraneous colitis.

RL Comments:

• Mark CLOSTRIDIUM DIFFICILE on the order form.
• Fresh or preserved specimen is stable for 5 days refrigerated,   Fresh stool specimens can be frozen, if testing will be delayed.  Forward promptly to Mercy Lab.

Performed: 

Daily, approximately 9 AM and 1300 PM

Reference value:

Negative for Toxigenic Clostridium Difficile
Result indicates that the patient does not have toxin producing C. difficile

Method:

Amplified DNA

CPT Code:  

87493

TEST NAME

CLOT PANEL

See: FDP, D-Dimer Test, Fibrinogen.

POWERCHART NAME

CLOTTING TIME ACTIVATED

MERCY TEST NAME

CLOT TIME ACT

MERCY LAB CODE

ACT

• 0.5 ml whole blood in non-siliconized syringe.
• Test must be performed at bedside immediately after blood specimen is collected.

TEST NAME

CMV SEROLOGY

See:   Cytomegalovirus Ab* IgG & IgM

POWERCHART NAME

CARBON DIOXIDE LEVEL

MERCY TEST NAME

CO2

MERCY LAB CODE

CO2

• Preferred in house: 0.5 ml lithium heparin plasma from a PST tube.
• Preferred reference lab: 0.5 ml serum from a SST tube.
• Also acceptable: Sodium Heparin, Amm heparin, NaFl, or serum from a plain red top tube.