MERCY TEST NAME

CORTISOL ACTH RES

MERCY LAB CODE

CORT
3 orders

• Preferred in house; 0.5 ml plasma from lithium heparin PST tube. 
• Preferred reference lab: 0.5 ml  serum from a SST tube. 
• Also acceptable: serum  from a plain red top tube.  
• A Cortisol Random (CORT) order will be required for each specimen to be collected.

Note:

Mercy lab clients:  For all outpatient orders, First Call/Bed Management must be contacted at 641-428-7162 to schedule the appointment for this test.  This appointment will include date/time and order for injection.  Instruct patient to present at Registration and they will be admitted to a hospital patient room to receive blood draws and injection.

Outpatient draw staff,:  This test is never drawn in the outpatient draw station.  If outpatient presents with orders for this testing, have patient registration staff  contact First Call/Bed Management at 87162 to verify clinic orders.

Stability:

8 hours room temp, 48 hours refrigerated, freeze if >48 hours.

3 separate specimens, requiring 3 separate CORT orders, one prior to and two following injection of 0.25 mg Cortrosyn, given IV bolus, at times specified by Nursing Service.

1. Baseline:  Collect prior to injection
2. 30 minutes following injection
3. 60 miniutes following injection

Nursing service will obtain Cortrosyn from Pharmacy.

POWERCHART NAME

CORTISOL WITH CORTISONE FREE 24 HOUR URINE

MERCY TEST NAME

CORTSL/CORTSNE 24U*

MERCY LAB CODE

CRTF

• Collect a 24-hour urine specimen. 
• At start of collection, add 25 ml of 50% acetic acid preservative. (15 ml 50% acetic acid for children <5 years old.)

• Aliquot 5 ml and indicate total volume. Minimum 3 ml.
• Adjust pH to 2.0-4.0 with 50% acetic acid.
• Send refrigerated in 13 ml urine tube to Mayo. Frozen acceptable.  Ambient with preservative acceptable.  Mayo # 82948. 
• Click on 24-hour urine preservative chart for other acceptable temperatures and additives.

Included with results.
CAUTIONS:  Acute stress (including hospitalization and surgery), alcoholism, depression, and many drugs (ex: exogenous cortisone, anticonvulsants), can obliterate normal diurnal variation, affect response to suppression/stimulation tests, and cause elevated baseline levels.

83789
82530

TEST NAME

CORTROSYN ACTH STIMULATION

See:   Cortisol ACTH Response

TEST NAME

COXSACKIE VIRUS*

See: Virus Serology

POWERCHART NAME

C-PEPTIDE

MERCY TEST NAME

C-PEPTIDE*

MERCY LAB CODE

CPEPT

Included with test results

TEST NAME

CPK   

See:   CK

POWERCHART NAME

CREATININE

MERCY TEST NAME

CREATININE             

MERCY LAB CODE

CREAT

• 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, EDTA plasma, or serum from a plain red top tube. 

Male:     0.7-1.3 mg/dl
Female: 0.6-1.2 mg/dl

POWERCHART NAME

Creatinine 24 HOUR URINE.  Not available Powerchart orders

MERCY TEST NAME

CREAT 24UR

MERCY LAB CODE

VCRT

Volume (ml/24 hours)
Calc. Creatinine (g/24 hours)

• 10 ml urine from a 24-hour urine specimen. 
• Refrigerate urine during collection, no preservative required. 

POWERCHART NAME

CREATININE CLEARANCE 24 HOUR URINE

MERCY TEST NAME

CREAT CL 24UR

MERCY LAB CODE

VCCL

Volume (ml/24 hours)                     Raw Creatinine (mg/dl)
Calc. Creatinine (g/24 hours)            Creatinine Clearance (ml/min)

• 0.5 ml serum from PST or SST plus 10 ml urine from a 24-hour urine specimen. 
• Refrigerate urine during collection, no preservative required. 
• Refrigerate serum.

1. A single 24-hour urine collection may be used for CREATININE CLEARANCE and TOTAL PROTEIN [PROT24U].
2. Outpatients and Inpatient, Mercy Laboratory will order the appropriate serum creatinine (CRTM) if a serum creatinine has not been completed within 48 hours.  This will be done at no additional charge. The patient needs to have blood drawn when the container is picked up or delivered. In order to avoid possible duplication, the serum creatinine is not to be ordered by the physician office, the hospital floor or admitting.
3. Regional Lab Clients, send 0.5 ml serum for the creatinine at the same time that the urine specimen is sent.  This enables analysis of both specimens by the same method for accuracy. 
   Mercy Laboratory will order the serum creatinine at no charge.  Do not order a single creatinine on the requisition.

POWERCHART NAME

CREATININE RANDOM URINE

MERCY TEST NAME

CREAT R UR

MERCY LAB CODE

UCRT

TEST NAME

Cross Linked Degradation Products

See:  D-DIMER TEST 

POWERCHART NAME

TRANSFUSION ORDER SET FOR CROSSMATCH

MERCY TEST NAME

DIRECTED UNITS FOR CROSSMATCH

MERCY LAB CODE

XMI

Under units ordered: Enter the number of units needed. One crossmatch order may be used for both directed and non-directed (homologous) units.  The number of directed units must be specified.

Under Comment: Type # of directed units, followed by, directed units.
        EXAMPLE: 2 directed units.
        EXAMPLE: 1 directed unit and 1 homologous unit needed.

NOTE: Directed unit crossmatch expires in 3 days.  Irradiation is required, proir to transfusion, for all directed units donated by blood relatives.

• Preferred specimen: One 6 ml pink top tube. 
• Also aceptable:  Purple top tube. 
• Refrigerate. 
• SST is unacceptable.

All patients drawn for possible blood product transfusion MUST be correctly identified and MUST BE WEARING an armband with their FULL NAME and MEDICAL RECORD NUMBER before the patient is drawn.

A check mark MUST be put by the Medical Record number on the tubes drawn for a Crossmatch by the person drawing the specimen indicating the phlebotomist has matched the medical record number on the Specimen with the medical record number on the Patient Armband and it is identical along with the name and other pertinent information.

Date, time, and initials of the individual collecting the specimen must be on the tube.

FOR OUTPATIENT AND PRE-SURGICAL PATIENTS:
All the above guidelines must be followed.  The PATIENT is also to be informed to leave the armband on and if the armband is removed they will need to be redrawn and testing repeated. **Qualified staff may remove the armband and replace it with another armband after careful matching.

86900 ABO+
86901 RH+
86850 Antibody Sc
86920 Unit Compatibility (1 for each unit ordered)

For each unit issued:
P9021 Directed unit (proc)
86890 Directed unit (admin)

POWERCHART NAME

TRANSFUSION ORDER SET CROSSMATCH

MERCY TEST NAME

CROSSMATCH

MERCY LAB CODE

XMI

• A Type & Screen is included in a crossmatch order.  Do NOT order separately.
• Irradiation or CMV neg blood, see step 2.
• Directed units, see step 3.
• Autologous units, see Crossmatch Autologous
• For PAT patients:  If surgery is scheduled for more than two days from the date the specimen is drawn, order a Type & Screen instead of a crossmatch.  A crossmatch will need to be ordered and done when the patient is admitted.
• A hemoglobin must be ordered if one has not been performed at Mercy Medical Center-North Iowa Laboratory within one week prior to transfusion for outpatients.

1. Indicate number of units to be crossmatched in units ordered field.  Packed cells will be processed for all crossmatches.
2. If irradiation or CMV negative blood is needed, indicate so in the  comment field for each order.  It is not sufficient to send a message to cover all orders. Prestorage leuko-reduced red cells (CMV safe) will be provided if CMV negative is ordered. Call the Lab when irradiated blood is ordered as
   special arrangements may be necessary.
3. Directed units for crossmatch: 
        Order XMI:
        Under units ordered:  Enter the number of units needed. 
   One crossmatch order may be used  for both directed and non directed (homologous) units. 
   Under comment: Type # of directed units, followed by, directed units. (Specify the number of directed units and also that directed is requested.)
   EXAMPLE:  2 directed units.
   EXAMPLE:  1 directed unit and 1 homologous unit needed.

A directed unit crossmatch expires in 3 days.
Irradiation is required, prior to transfusion, for all directed units donated by blood relatives.             

• Preferred specimen: One 6 ml pink top tube.
• Also acceptable: Purple top tube.  
• Refrigerate. 
• SST is unacceptable.

All patients drawn for possible blood product transfusion MUST be correctly identified and MUST BE WEARING an armband with their FULL NAME and MEDICAL RECORD NUMBER before the patient is drawn.

A check mark MUST be put by the Medical Record number on the tubes drawn for a Crossmatch by the person drawing the specimen indicating the phlebotomist has matched the medical record number on the Specimen with the medical record number on the Patient Armband and it is identical along with the name and other pertinent information. Date, time, and initials of the individual collecting the specimen must be on the tube.

FOR OUTPATIENT AND PRE-SURGICAL PATIENTS:
All the above guidelines must be followed  The PATIENT is also to be informed to leave the armband on and if the armband is removed they will need to be redrawn and testing repeated. **Qualified staff may remove the armband and replace it with another armband after careful matching.

86900 ABO+
86901 RH+
86850 Antibody Sc
86920 Unit Compatibility (1 for each unit ordered)

For each unit issued: P9021 Packed Red Cells (Proc)*

POWERCHART NAME

CROSSMATCH AUTOLOGOUS

MERCY TEST NAME

CROSSMATCH AUTO

MERCY LAB CODE

XMO

• Preferred specimen: One 6 ml pink top tube. 
• Also acceptable: Purple top tube.  
• Refrigerate.
• SST is unacceptable.

All patients drawn for possible blood product transfusion MUST be correctly identified and MUST BE WEARING an armband with their FULL NAME and MEDICAL RECORD NUMBER before the patient is drawn.

A check mark MUST be put by the Medical Records number on the tubes drawn for a Crossmatch by the person drawing the specimen indicating the phlebotomist has matched the medical record number on the Specimen with the medical record number on the Patient Armband and it is identical along with the name and other pertinent information.  Date, time, and initials of the individual collecting the specimen must be on the tube.

FOR OUTPATIENT AND PRE-SURGICAL PATIENTS:
All the above guidelines must be followed.  The PATIENT is also to be informed to leave the armband on and if the armband is removed they will need to be redrawn and testing repeated. **Qualified staff may remove the armband and replace it with another armband after careful matching.

Unit to be crossmatched is patient's own blood that has been previously collected by the Blood Center of Iowa (TBCI) personnel through special arrangement with the patient's physician. Unit is processed by TBCI and returned for crossmatch and possible transfusion.

86900 ABO+
86901 RH+
86920 Unit Compatibility (1 for each unit ordered)

For each unit issued:
86890 Autologour unit (Admin)
P9021 Autologous unit (Proc)*

POWERCHART NAME

CRP  (C-Reactive Protein)

MERCY TEST NAME

CRP

MERCY LAB CODE

CRP

• 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 removed from a plain red top tube.

POWERCHART NAME

CRP HIGH SENSITIVITY (CARDIAC)

MERCY TEST NAME

CRP SENS (CARDIAC)

MERCY LAB CODE

HSCRP

• Fasting is preferred. 
• Sample should be collected 2 or more weeks after resolution of any acute inflammatory disease, recent infection, or trauma.

• 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: EDTA plasma tubes, or serum from a plain red top tube.

• Serum: 8 hours room temp, 72 hours refrigerated, freeze if >48 hours.
• Plasma: 8 hours room temp,  72 hours refrigerated. Do not freeze.

<1 mg/L – low risk
1-3 mg/L – moderate risk
> 3 mg/L – high risk

POWERCHART NAME

CRYOGLOBULIN

MERCY TEST NAME

CRYOGLOBULIN*

MERCY LAB CODE

CRYG

• 5 ml serum from plain red top tube plus 1 ml EDTA plasma. Minimum 3 ml serum and 0.5 ml plasma. 
• Deliver to Lab immediately!
• Keep specimen at 37°C 98.6°F until delivered, by holding tubes in hands, may wrap tubes in a heel warmer. 
• Testing requires both specimens. Specimens MUST remain at 37°C 98.6°F until the plasma and serum are removed from the cells. 
• Regional Lab Clients:  Please call for special instructions before collecting specimen.

• Special instructions are kept in processing book. 
•  Label serum and plasma tubes appropriately.
• Send refrigerated to Mayo. Frozen acceptable.  Mayo # 83659/CRGSP.

82595 Cryoglobulin +*
82585 Cryofibrinogen +*

86334/Immunofixation (if appropriate)

POWERCHART NAME

TRANSFUSION ORDER SET CRYOPRECIPITATE FOR INFUSION

MERCY TEST NAME

CRYO FOR INFUS

MERCY LAB CODE

CRYO

• Indicate number of units desired. 
• An order of 1 will be filled with a pre-pooled product equivalent to 5 individual cryo units. 
• Cryoprecipitate contains factor VIII and fibrinogen.

86927 Cryoprecipitate (1 for each unit)
86595 Cryoprecipitate Pool (Admin) (1 for each pool)
P9012 Cryoprecipitate (Proc)* (1 for each unit)

POWERCHART NAME

FIBRIN GLUE ORDER SET CRYOPRECIPITATE NOT FOR INFUSION

MERCY TEST NAME

CRYO NOT FOR INFUS

MERCY LAB CODE

CRYX

• To be ordered by Nursing Service at the same time an order is placed to Pharmacy for Fibrin Glue.
• One order of Cryoprecipitate is necessary for each unit of Fibrin Glue requested. 
• Used in the preparation of Fibrin Glue, a topical hemostatic agent used in surgery.

POWERCHART NAME

CRYPTOCOCCAL ANTIGEN SCREEN CSF (Mayo)

MERCY TEST NAME

CRYPO SCN CSF*

MERCY LAB CODE

CRYPTS

Specimen:  

• 1.0 ml. CSF.  Submitted in a sterile plastic screw-cap tube. Minimum 0.5 ml.
• Refrigerate the specimen, unless culture is also ordered. 
• Culture should be transported ambient.

Comments:

• Detects the presence of Cryptococcus neoformans in CSF.
• A concurrent Cryptococcus culture is strongly recommended.  

RL Client Comments:

• Write CRYPTOCOCCAL AG (Mayo# 86166/CCRYP) on order form.
• Send specimen refrigerated to Mercy lab. Frozen acceptable.  
• If a culture is also needed, the culture specimen should be sent at room temperature.

Performed: 

• Send to Mayo #86166/CCRYP. 
• If reactive Mayo will reflex #28072/CCRYR Cryoptococcus Antigen CSF.

Reference value: 

Included with test results.

CPT Code: 

87327-Crytococcus EIA
86403-Cryptococcus latex agglutination (if appropriate)

Processing:

Send refrigerated to May #86166/CCRYP

POWERCHART NAME

CRYPTOCOCCAL CULTURE + DIRECT SMEAR CSF

MERCY TEST NAME

CRYPTO CLT/GS

MERCY LAB CODE

CRYP

Specimen:

• 1 ml CSF minimum.  Submit in sterile plastic screw cap tube.
• DO NOT refrigerate specimen.       

RL Client Comments:

• Write CRYPTOCOCCAL CULTURE on order form. Indicate source (CSF).
• Send specimen at room temperature to Mercy lab.

Performed:  

Direct gram Stain: Daily  1600 cutoff
Preliminary report:1 and 2 weeks 
Final report: 3 weeks

Reference value: 

Direct Gram stain: No yeast seen.
Culture: No Cryptococcus neoformans isolated. 

Method:

Culture: Standard culture techniques

CPT Code:  

87205 Gram Stain
87102 Yeast Clt

TEST NAME

CRYPTOSPORIDIUM

  See:  Giardia/Cryp Rapid

TEST NAME

CRYSTALS, BODY FLUID

See: Body Fluid Crystals

TEST NAME

CSF BACTERIAL ANTIGENS

See: Bacterial Antigens

TEST NAME

CSF CULTURE

See: Body Fluid Culture/Gram Stain

POWERCHART NAME

CSF CYTOLOGY

MERCY TEST NAME

CSF CYTOLOGY SPEC

MERCY LAB CODE

• After Chemistry testing is completed, take specimen to Cytology, preserve properly, and place in the Cytology refrigerator. 
• Use worksheet MISU for the test CSFC to enter DLV-;date xx ml. 
  DLV translates to "Delivered to Cytology on".