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Section-E

POWERCHART NAME

EAR CULTURE

MERCY TEST NAME

EAR CLT

MERCY LAB CODE

EARC

Specimen:

Collect sample on a routine culturette. Cleanse the external canal. Collect exudate or scrapings of ear canal.

Comments:

  1. Susceptibility testing will be performed on significant isolates.
  2. Haemophilus, Neisseria, & Streptococcus pneumoniae will be screened for penicillin resistance only.
  3. This order is for INTERNAL ear samples only. If the EXTERNAL portion of the ear is to be cultured, order as a wound culture.

RL Client Comments:

  1. Write EAR CULTURE on the order form.
  2. Send specimen at room temperature to Mercy lab.

Processing:

Send at room temperature.

Performed:

Preliminary report: 1,2,3,4 days
Final report:5 days

Reference value:

No growth (commensal skin flora may be present).

Method:

Standard culture techniques

CPT Code:

87070

 

TEST NAME

eGFR

See: eGFR estimated Glomerular Filtration Rate

 

TEST NAME

ELAVIL

See:  Amitriptyline/Nortriptyline*

 

POWERCHART NAME

ELECTROLYTE PANEL

MERCY TEST NAME

ELECTROLYTES      

MERCY LAB CODE

LYTE

Includes:

Anion Gap, Chloride, CO2, Potassium and Sodium

Specimen: 
  • 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: Amm heparin, serum from a plain red top tube. 
  • Keep tube closed.
Stability: 8 hours room temperature, 48 hours refrigerated, freeze if >48 hours.
Cause for rejection:  Hemolyzed specimens not acceptable.
Performed:  Within 8 hours of receipt.  Available stat.
Reference value: 

Please see individual test entries

Method: Refer to individual test.
CPT Code: 80051

 

TEST NAME

ELECTROLYTES MISC FLUID

See:     Sodium/Potassium Body Fluid

 

TEST NAME

ELECTROLYTES URINE

See: Sodium/Potassium 24-Hour Urine  
       Sodium/Potassium Random Urine

 

TEST NAME

ELECTROPHORESIS CSF (SPINAL FLUID)

See:   IGG Index CSF*

 

TEST NAME

EMPLOYEE DRUG SCREENING

See:   Drug Abuse Testing for Employment

 

POWERCHART NAME

ENDOMYSIAL IgA AUTOANTIBODY

MERCY TEST NAME

ENDOMYSIAL ATBY*

MERCY LAB CODE

ENDA

Specimen:

2 ml serum from a SST or plain red top tube. Minimum: Adults 1 ml. Pediatric volume 0.5 ml.

Comment:

Useful for the diagnosis of dermatitis herpetiformis and celiac disease and for monitoring adherence to gluten-free diet in patients with dermatis herpetiforms and celiac disease.

Processing:  Send refrigerated to Mayo. Ambient or frozen acceptalbe.  Mayo order code EMA.
Performed: 2-7 days.  Test set up at Mayo Monday through Friday; 7 a.m.-5 p.m.
Reference value:

Report includes presence and titer of circulating anti-endomysial antibodies. Negative in normal individuals, also negative in dermatitis herpetiformis or celiac disease patients adhering to gluten-free diet.

Method:  Indirect Immunoflourescence (EMA)
CPT Code:  86256

 

POWERCHART NAME

ENTEROVIRUS RNA DETECTOR

MERCY TEST NAME

ENTEROVIRUS BY PCR*

MERCY LAB CODE

ENTRPC

Specimen:

Spinal Fluid: 0.5 mL collected in a sterile screw-capped container.  DO NOT CENTRIFUGE. Specimens grossly contaminated with blood may inhibit the PCR and produce false negative results

Processing:

Send specimens refrigerated to Mayo lab, frozen acceptable. Mayo order code  LENT

RL Client Comments:

  • Write ENTEROVIRUS by PCR (Mayo - LENT) on the order form. Indicate the specimen source.
  • Send specimens refrigerated to Mercy lab.

Performed:

Monday through Friday; varies, Mayo Medical laboratories.

Reference Value:

Included in report

Method:

Real-Time PCR/RNA Probe Hybridization

CPT Code:

87498

 

TEST NAME

EOSINOPHIL COUNT TOTAL

Included in CBC.  Cannot order individually

 

 

 

EOSINOPHIL NASAL SMEAR

No longer available 9-24-2013.

 

POWERCHART NAME

SMEAR FOR EOSINOPHIL URINE

MERCY TEST NAME

EOSINOPHIL URINE  

MERCY LAB CODE

EOUA

Specimen:

10 ml random urine.  Deliver to Lab within 1 hour of collection.  Refrigerate.
Reference Lab Clients:
Refrigerate for transport

Stability: 8 hours refrigerated.
Performed:  Within 8 hours of receipt.
Reference value: None seen
< 1 % may indicate urinary tract infection
1 - 5% is not a good predictor of Acute Interstitial Nephritis
> 5 % may be a valuable predictor of Acute Interstitial Nephritis and may indicate Chronic Urinary Tract infection.
Method:  Microscopy, Wright stained smear.
CPT Code: 87205

 

TEST NAME

EPIDERMAL FLUORESCENT ANTIBODY

See:  Cutaneous Immunofluorescence Biopsy
        Cutaneous Immunofluorescence Serum*   

 

TEST NAME

EPINEPHRINE

See:  Catecholamine Fractionation 24-Hour Urine*

 

POWERCHART NAME

EPSTEIN BARR VIRUS PANEL

MERCY TEST NAME

EPSTEIN BARR AB*

MERCY LAB CODE

EBVA

Comment: Includes VCA IgG, VCA IgM, EBNA IgG, and interpretation.
Specimen:

1 ml serum from a SST tube.

Processing: Send specimen to Mercy Lab FROZEN.
Cause for rejection: Grossly hemolyzed or lipemic samples
Performed: Fridays,Noon
Method:  Enzyme Immunoassay
CPT Code:

86665 x2-VCA, IgG and IgM 
86664 EBNA

 

POWERCHART NAME

ERYTHROPOIETIN LEVEL

MERCY TEST NAME

ERYTHROPOIETIN

MERCY LAB CODE

EPO

Specimen: 

0.5 ml serum from a SST or plain red top tube.  Minimum 0.5 ML.

Comment: There are reports of diurnal variation.  Recommend that samples be collected at a consistent time of day.  Morning samples collected between 7:30 AM and 12:00 noon have been recommended.
Processing:  Stable 24 hours refrigerated.  Freeze if test will not be run within 24 hours.  Do not store in glass tubes.
Turnaround:  Performed within 8 hours of receipt.
Reference value:

2.6-18.5 mIU/mL.

Method: Chemiluminescent immunoassay
CPT Code: 82668

 

TEST NAME

ESR

See:   Sed Rate

 

POWERCHART NAME

ESTRADIOL LEVEL

MERCY TEST NAME

ESTRADIOL

MERCY LAB CODE

ESTD

Specimen: 
  • Preferred in house: 0.5 ml serum from a SST tube.
  • Preferred reference lab: 0.5 ml serum from a SST tube.
  • Also acceptable: serum from a plain red top tube or heparin plasma from a green top tube.
Stability: 8 hours room temperature, 48 hours refrigerated, freeze if >48 hours.
 
Processing:

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

Performed:  Within 8 hours of receipt.
Reference value:

Male:      20 - 47 pg/mL

Female:   Estradiol Expected Values
              for Ovulating non-pregnant females
              based on the hLH peak as Day 0.             
              Day –6 to –8  Mid-Follicular      27-122 pg/mL
              Day –1          Peri-Ovulatory    95-433 pg/mL
              Day +6 to +8  Mid-Luteal        49-291 pg/mL

Post-Menopausal Female                        20- 40 pg/mL     
Method: Competitive Binding Immunoassay Chemiluminescence
CPT Code:  82670
 

Estradiol Female Tanner Ranges

Tanner Stage

Mean Age

Reference Range

     I

7.1

0-20 pg/ml

     II

10.5

0-24 pg/ml

     III

11.6

0-60 pg/ml

     IV

12.3

15-85 pg/ml

     V

14.5

15-350 pg/ml

Puberty onset (transition from Tanner stage I to Tanner stage II) occurs for girls at a median age of 10.2 (+/- 2.0) years.  There is evidence that it may occur up to 1 year earlier in obese girls and in African-American girls.  Progression through Tanner stages is variable.  Tanner stage V (adult) should be reached by age 18.

 

1-14 days of age:  Estradiol levels are very elevated at birth, but will fall to prepubertal levels within a few days.

 

Estradiol Male Tanner Ranges

Tanner Stage

Mean Age

Reference Range

     I

7.1

0-13 pg/ml

     II

12.1

0-16 pg/ml

     III

13.6

0-26 pg/ml

     IV

15.1

0-38 pg/ml

     V

18

10-40 pg/ml

Puberty onset (transition from Tanner stage I to Tanner stage II) occurs for boys at a median age of 11.5 (+/- 2.0) years.  For boys, there is no proven relationship between puberty onset and body weight or ethnic origin.  Progression through Tanner stages is variable.  Tanner stage V (adult) should be reached by age 18.

 

1-14 days of age:  Estradiol levels are very elevated at birth, but will fall to prepubertal levels within a few days.

 

 

TEST NAME

ESTROGEN/PROGESTERONE RECEPTOR ASSAY QUANTITATIVE  (PARAFFIN BLOCK)

MERCY TEST NAME

ERA/PRA BLOCK

MERCY LAB CODE

EPRB

Comment: 

Ordered on paraffin block. Routinely ordered on breast carcinoma.

Processing: Paraffin Block
Performed:    Test set up Tuesday and Friday.
Reference value: Included with pathology report.
Method:  Labeled-Streptavidin Biotin Immunoperoxidase stain.
CPT Code:  88342 X2 Immunocytochem+ X2

 

TEST NAME

ESTROGEN RECEPTOR ASSAY

See:  Estrogen/Progesterone Receptor Assay Quantitative (Paraffin Block)

 

TEST NAME

ESTROGEN TOTAL SERUM

See:   Estradiol

 

TEST NAME

ETHOSUXIMIDE

MERCY TEST NAME

MISC GENERAL LAB

MERCY LAB CODE

CMIS

Specimen: 1 ml of serum from plain, red-top tube. Minimum 0.4 ml.
Comment:    Indicate TEST NAME and time last dose in comment field.      
Processing:         Remove serum from cells within 2 hours of collection.  Send refrigerated. Ambient or frozen acceptable. Mayo order code ETX-Ethosuximide.
Performed:  1 day.  Test set up Monday through Sunday.
Reference value:

Included with report.

Method:  Enzyme-Multiplied Immunoassay Technique (EMIT)
CPT Code: 80168

 

TEST NAME

ETHYLENE GLYCOL

See:   Toxic Volatile Screen  

 

POWERCHART NAME

EYE CULTURE OTHER

MERCY TEST NAME

EYE CLT

MERCY LAB CODE

EYEC

Order:

Indicate which eye when ordering. See beginning of section for ordering help and codes.

Specimen: 

  • Conjunctivitis: 
    Touch the involved area with a sterile swab moistened with sterile saline. Ideally, inoculate directly to the appropriate media (Contact Microbiology).  However, the specimen may be transported on a routine culturette to the lab.
  • Corneal scrapings: 
    The cornea may be anesthetized with 0.5% proparacaine hydrochloride, but better results are obtained if the scrapings are collected without the use of a topical anesthetic.  A topical anesthetic may have an antimicrobial effect.  Scrape the base and margin of the ulcer.  Inoculate these scrapings directly to the appropriate media.

Comment:

  1. Deliver to Lab immediately. The organisms involved in eye infections are often fastidious in nature. 
  2. Susceptibility testing will be performed on significant isolates.
  3. This order is for INTERNAL eye specimens only. If an external eye culture is needed, order as a wound culture.

RL Client Comments:

  1. Write EYE CULTURE on the order form. Indicate which eye was cultured.
  2. Send the specimen room temperature to Mercy lab.

Performed:

Preliminary reports:  Days 1 & 2
Final report:  3 days

Reference value:  

No growth (commensal skin flora may be present)

Method:

Standard culture techniques.

CPT Code: 

87070

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