Mercy Medical Center North Iowa

Section-V

POWERCHART NAME

VALPROIC ACID (DEPAKENE) LEVEL

MERCY TEST NAME

VALPRO ACID

MERCY LAB CODE

VAL

Specimen:

0.5 ml serum from a SST tube.

Comment: Peak reached 1-4 hours after oral dose. Indicate time last dose in comment.
stability: 8 hours room temp, 48 hours refrigerated, or >48 hours frozen
Performed: Within 8 hours of receipt.  Available stat. 
Reference value:

Therapeutic range: 50-100 mcg/ml
Biopolar disorder therapeutic range:  50-125 mcg/ml

Method:   Turbidimetric Inhibition Immunoassay
CPT Code:  80164

 

POWERCHART NAME

VANCOMYCIN LEVEL INTERMEDIATE

MERCY TEST NAME

VANCOMYCIN INT

MERCY LAB CODE

VNI 

Specimen:
  • 0.5 ml serum from a SST tube.
  • Lithium heparin, Sodium Heparin and EDTA plasma tubes are also acceptable. 
  • Stable 48 hours refrigerated
  • If receipt of specimen is delayed by >48 hours specimen can be frozen
Comment:  Consult Pharmacy to establish collection time.  Indicate time last dose in comment.
Performed: Within 8 hours of receipt.
Reference value: Therapeutic range: 18-25 mcg/ml
Method: Emit Enzyme Immunoassay
CPT Code: 80202

 

POWERCHART NAME

VANCOMYCIN TROUGH  LEVEL

MERCY TEST NAME

VANCOMYCIN TRGH

MERCY LAB CODE

VNTR

Specimen: 
  • 0.5 ml serum from a SST tube.
  • Lithium heparin, Sodium Heparin and EDTA plasma tubes are also acceptable. 
  • Stable 48 hours refrigerated
  • If receipt of specimen is delayed by >48 hours specimen can be frozen
Comment: Consult Pharmacy to establish collection time.  Indicate time last dose in comment.
Performed: Within 8 hours of receipt.
Reference value:

Recommendation of Pharmacy and Therapeutic Committee

  • 10-15  mcg/ml  Trough target range for mild infections (UTI, skin and soft tissue).
  • 15-20  mcg/ml  Trough target range for severe and life threatening infections (bacteremia, pneumonia, meningitis, endocarditis, osteomyelitis, diskitis, abscess, and joint infection.
Method:  Emit Enzyme Immunoassay
CPT Code:  80202

 

TEST NAME

VANILLYMANDELIC ACID

See:  VMA (Vanillymandelic Acid) 24-Hour Urine

 

TEST NAME

DERMAL, Herpes Simplex Virus & Varicella Zoster Virus, DNA Detection by PCR*

 

See: HSV AND VZOSTER VIRUS PCR

 

POWERCHART NAME

VARICELLA ZOSTER ANTIBODY IgG

MERCY TEST NAME

VARIC ZOST IgG

MERCY LAB CODE

VZVG

Specimen: 1.0 ml serum from a SST or plain red top tube. (0.3 ml minimum) 
Comment:  This test is for immune status only.
For diagnosis of recent infection, testing of IgM and IgG antibodies are recommended (VZGM)
Processing: 

Samples can be sent Refrigerated, up to 48 hours after collection.  If 48 hours will be exceeded, the sample should be sent Frozen, to Mercy lab.

Inhouse Use Only: Test can be added on to a refrigerated sample within 48 hours of drawing.

Performed: Mondays & Thursdays, 0800 cutoff
Reference value: Immune
Method:  EIA
CPT Code:  86787

 

POWERCHART NAME

VARICELLA ZOSTER ANTIBODY IgG IgM

MERCY TEST NAME

VARIC ZOST IgG IgM*

MERCY LAB CODE

VZGM

Specimen:  1 ml serum from a SST or plain red top tube.  Minimum 0.6 mL.
Comment: Includes IgG and IgM results
Processing:  Send in screw-capped, round bottom, plastic vial, refrigerated to Mayo.  Mayo order code VZGM.
Performed: Test set up Monday through Saturday
Reference value: Included with Results
Method:  

IgG: Multiplex Flow Immunoassay (MFI)
IgM: Immunofluorescence Assay (IFA)

CPT Code:  86787 x2

 

TEST NAME

VARICELLA-ZOSTER VIRUS, MOLECULAR DETECTION, PCR

MERCY TEST NAME

MISC. GENERAL LAB     Designate: Mayo Order Code - LVZV

MERCY LAB CODE

CMIS

Specimen:

Must indicate specimen source and specify for Varicella-Zoster Virus PCR Mayo test (LVZV) on requisition and specimen label

A completed Mayo Additional Test Information form must be sent with the specimen.

Fluid - 0.5 mL of body, amniotic, or ocular in a sterile container. **CSF is NOT ACCPETABLE, if CSF for Varicella Zoster order VZCSF
Misc - Dermal, eye, nasal, or throat on a BBL culture swab
Genital - Cervix, vagina, urethra, anal/rectal, or other genital sources on a BBL culture swab
Respiratory - 1.5 mL of a bronchial washing, bronchoalveolar lavagesputum, tracheal aspirate, or nasopharyngeal in a sterile container
Tissue - Entire collection of brain, colon, kidney, liver, lung, etc in a sterile container with 1 to 2 mL sterile saline

Processing: Refrigerated (preferred) or frozen specimens up to 7 days.
Performed: Monday through Saturday
Method: Real-time Polymerase Chain Reaction (PCR)/Dna Probe Hybridization
CPT Code  87798

 

TEST NAME

VARICELLA ZOSTER VIRUS CSF

MERCY TEST NAME

VARICELLA ZOSTER CSF*

MERCY LAB CODE

VZCSF

Specimen:

Collect 0.5 mL CSF in a sterile screw capped container.

Processing: Send refrigerated to Mayo. Mayo code LVZV
Performed: Monday through Saturday
Reference Value: Included in report
Method: Real-time Polymerase Chain Reaction (PCR)/Dna Probe Hybridization
CPT Code  87798

POWERCHART NAME

NEUTROPHIL CYTOPLASM ANTIBODY VASCULITIS PANEL

MERCY TEST NAME

VASCULITIS ANCA PANEL*

MERCY LAB CODE

VAPNL

Specimen:  1.0 mL serum from a SST tube.  Plain red is also acceptable.  Minimum 0.5 mL.
Processing: 
Send refrigerated to Mayo.  Mayo order code  VASC.
Performed: Monday through Saturday
Reference value:
Reference ranges included with results.
Method:  

Multiplex flow immunoassay.

CPT Code:  83516  Myeloperoxidase antibodies
83516  Proteinase 3 Antibodies
86255  Cytoplasmic Neutrophil Antibodies (ANCA) Screen - if appropriate
86256  Cytoplasmic Neutrophil Antibodies (ANCA) Titer - if appropriate.

 

TEST NAME

VDRL, serum

See:   SYPHL

 

POWERCHART NAME

VDRL CSF QUALITATIVE

MERCY TEST NAME

VDRL CSF*

MERCY LAB CODE

VDRC

Specimen: 0.5 ml spinal fluid in a CSF tube.  Minimum 0.2 mL.
Processing:  Send frozen to Mayo.  Mayo order code VDSF.
Performed:  1-3 days.  Test set up Monday through Friday 12 p.m..
Reference value:  Included in report.
Method:    Flocculation/Agglutination
CPT Code: 86592

 

TEST NAME

Venous Blood Gas

See:   Blood Gas Analysis

 

POWERCHART NAME

CULTURE VIRUS NON-RESPIRATORY

MERCY TEST NAME

NON RESP VIRUS*

MERCY LAB CODE

VRSNR

Order:

Specify site when ordering.

Specimen:

Body Fluid or Cerebrospinal Fluid (CSF): Send 1.0 mL in a sterile screw-capped vial. Send to Mercy lab immediately.

Ocular or Rectal swabs: Collect sample on a Dacron-tipped swab with a plastic handle. Place swab in M5 transport media. Send to Mercy lab immediately.

Stool: 5 – 10 g of stool. Collect in a sterile screw-capped container. Send to Mercy lab immediately.

Tissue (Brain, Colon, Kidney, Liver): Place tissue in 1-2 mL of sterile saline in a sterile screw-capped container or use a M5 transporter. Send to Mercy lab immediately.

Urine (Acceptable for Mumps testing ONLY): Collect 0.5 mL of urine in a sterile screw-capped container. Send to Mercy lab immediately AND clearly indicate on order form and container label "mumps."
 
Dermal (any sort of skin lesion) and Oral (Acceptable for Enterovirus ONLY): Collect specimen on a Dacron-tipped swab with plastic handle.  Place swab in M5 viral transport media AND clearly indicated on order form and container label "Enterovirus" or "Hand, Foot and Mouth Disease."

Comments:

Blood, Bone marrow, Genital, and Respiratory specimens are not acceptable for viral culture.
Dermal or oral specimens for hand-foot-and-mouth disease or enterovirus must clearly indicate this on the order.

  1. Urine and Bone Marrow: specimens for CMV are not acceptable for viral culture. See Mayo test (LCMV) by Rapid PCR.
  2. Dermal (any sort of skin lesion): viral testing other than Enterovirus, must specify and order the following:
    For BOTH HSV-Herpes Simples Virus by PCR and VZV-Varicella-Zoster by PCR,  Mayo test (LHSVZ).
    For only VZV- Varicella-Zoster Virus by PCR, Mayo test (LVZV).
    For only  HSV-Herpes Simpex Virus by PCR, Mayo test (LHSV).
  3. Genital specimens: must order Mayo test (LHSV).
  4. Respiratory specimens: must order Mayo test (VRESP).
  5. Oral Specimens: viral tseting other than Enterovirus, must order Mayo test (LHSV).

RL Client Comments:

  • Write VIRUS CULTURE, NON-RESPIRATORY (Mayo order code-VIRNR) on order form. Indicate specimen source.
  • Send ALL specimens refrigerated to Mercy lab.

Processing:

Deliver to the lab immediately or refrigerate specimen. Send refrigerated to Mayo.  Mayo order code-VIRNR.

Performed:

Test setup daily, Final report 2 weeks.

Reference Value:

Included in report.
(If positive, virus is identified)

Method:

Cell culture

CPT Code:

87252 Tissue Culture Inoculation
87254 Shell vial (if appropriate)
87176 Homogenization, tissue (if appropriate)

 

POWERCHART NAME

CULTURE VIRUS RESPIRATORY

MERCY TEST NAME

RESP VIRUS*

MERCY LAB CODE

VRSRSP

Order:

Specify collection site when ordering.

Specimen:

Throat Swabs: Collect specimen on a routine culturette. Dacron-tipped swab with plastic handle is acceptable. Send culturette to Mercy lab immediately.

Sputum, Bronchoalveolar lavage, Bronchial washings, Tracheal aspirate or Secretions, Nasal washings: Collect 1.0 mL of specimen. Place specimen in a sterile screw-capped container. Send to Mercy lab immediately.

Tissue (Lung and others): Place the tissue specimen in 1-2 mL sterile saline in a sterile screw-capped container or use a M5 transporter (green cap). Send to Mercy lab immediately.

Mumps testing , swab specimens for Mumps must clearly indicate "MUMPS" on request form to insure proper handling and test setup.

Comments:

Oral specimen is not acceptable for respiratory viral culture (unless parotid gland, secretion or client requests enterovirus). Clients with oral specimens for suspected hand-foot-and-mouth disease or enterovirus must order Mayo test ( VIRNR)  Viral Culture, Non-Respiratory and clearly indicate enterovirus on order and specimen label.

RL Client Comments:

  1. Write VIRAL CULTURE, RESPIRATORY (Mayo order code-VRESP) on order form. Indicate specimen source.
  2. Send ALL specimens refrigerated to Mercy lab.

Processing:

Deliver to the lab immediately or refrigerate specimen. Send refrigerated to Mayo.  Mayo order code-VRESP.

Performed:

Test setup daily, Final report 2 weeks.

Reference Value:

Included in report.
If positive, virus is identified

Method:

Cell culture

CPT Code:

87252 Tissue Culture Inoculation
87254 Shell vial (if appropriate)
87176 Homogenization, tissue ( if appropriate)

 

POWERCHART NAME

VISCOSITY

MERCY TEST NAME

VISCOSITY SERUM*

MERCY LAB CODE

VSCT

Specimen:  1.5 ml serum from a red top tube.  Minimum 0.65 mL. 
Keep specimen at 37°C until after centrifugation and separation of cells.
Processing:  Send to Mayo.  Mayo  order code VISCS.
Performed:  1-3 days.  Test set up Monday through Friday; continuously until 2 p.m.
Reference value:  Included in report.
Method:  Sonoclot Coagulation Analyzer.
CPT Code: 85810

 

TEST NAME

VitagelTM  or   VitaPrepTM

Same Day Surgery, Holding, or Surgery will call the Lab to assist with the collection of a specimen in a special syringe provided by surgery, VitaPrepTM syringe.  The special syringe contains sodium citrate and is used to collect 10 cc of the patient's blood.   There is a special cap for the syringe and the syringe should be recapped following the specimen collection.   After collection, verify that the syringe is labeled with the patient's name and medical record number.  Then hand the syringe to nursing personnel and they are responsible for processing the specimen.  There is no Lab order for this blood draw.

If other lab work is needed, draw the VitaPrepTM syringe last.

 

POWERCHART NAME

VITAMIN A (Retinol) LEVEL

MERCY TEST NAME

VITAMIN A*

MERCY LAB CODE

VITA

Specimen:  0.5 mL serum from a SST or plain red top tube.  Minimum 0.25 mL.
Collection:
  • Specimen must be collected following an overnight (12-14 hr) fast.
  • Infants - draw prior to next feeding.
Processing: 

Send serum refrigerated to Mayo Medical Laboratories. Mayo order code  VITA.

Performed: Monday through Friday; first shift
Method: Liquid Chromatography-Tandem mass Spectrometry (LC-MS/MS)
CPT Code: 84590

 

POWERCHART NAME

VITAMIN B1 (THIAMIN) WHOLE BLOOD

MERCY TEST NAME

THIAMIN VIT B1*

MERCY LAB CODE

VB1

Specimen:  4 mL Whole Blood from a EDTA tube. ** Protect from Light ** within 1 hour of collection.
Processing: 

Process by transfering whole blood into amber plastic vial to protect from light. Specimen must be Frozen within 4 hours of collection. Send to Mayo Medical Laboratories Mayo Code - FVBWB

Cause for Rejection: Specimens other than whole blood. 
Performed: Monday through Friday.
Reference value:

Reference ranges included with result

Method: High Performance Liquid Chromatography
CPT Code: 84425 Vitamin B1

 

POWERCHART NAME

VITAMIN B12 LEVEL

MERCY TEST NAME

VITAMIN B12

MERCY LAB CODE

B12

Specimen:  0.5 ml serum from a SST or plain red top tube.
Comment: 

Collect before blood transfusion.

Intrinsic Factor (Mayo test IFBA) will be reflex ordered and charged on all specimens with a B12 less than 180 pg/mL.  NOTE:  Mayo will only accept serum for IFBA testing.   

Cause for rejection: Hemolyzed specimen not acceptable.
Stability:

8 hours room temp, 24 hours refrigerated, or >24 hours frozen.

Regional Lab Clients:  Send in separate aliquot tube.  Freeze if not received at MMC-North Iowa Laboratory within 24 hours of collection.

Performed: Within 8 hours of receipt.
Reference value:

Male & Female: 180-914 pg/mL
Indeterminate Range: 146 - 179 pg/mL
Deficient Rance: 0 - 145 pg/mL

Method: Competitive Binding Immunoassay Chemiluminescent
CPT Code: 82607 Vit B12

 

POWERCHART NAME

VITAMIN B12 AND FOLATE LEVEL

MERCY TEST NAME

VIT B12 FOLATE

MERCY LAB CODE

B12F

Specimen:  0.5 ml serum from a SST tube.
Comment:

Collect before blood transfusion.   Folate should not be ordered for patients who have recently received a radioisotope, methotrexate, or other folic acid antagonist. If adequate amount of specimen and the result is below the reference range.

Folate reference range based on populations with folic acid fortification of foods.  Deficient folate concentrations are considered to be less than 4ng/mL.

Intrinsic Factor (Mayo test IFBA) will be reflex ordered and charged on all specimens with a B12 less than 180 pg/mL.  NOTE:  Mayo will only accept serum specimens for IFBA testing.

Stability: 8 hours room temp, 24 hours refrigerated, or >24 hours frozen.
Cause for rejection: Hemolyzed specimen not acceptable.
Processing:

Regional Lab Clients:   Freeze if not received at Mercy Medical Center - North Iowa Laboratory within 24 hours of collection.

Performed:  Within 8 hours of receipt.
Reference value:

Vitamin B12  Male & Female: 180 - 914 pg/mL
Folate  Male & Female:  5.9->24.8 ng/mL
Indeterminate Range B12: 146 - 179 pg/mL
Deficient Range B12: 0 - 145 pg/mL

Method:     Competitive Binding Immunoassay Chemiluminescent
CPT Code:

82607 Vit B12+
82746 Folate+

 

POWERCHART NAME

VITAMIN D 25 HYDROXY LEVEL

MERCY TEST NAME

VIT D, 25-HYDROXY*

MERCY LAB CODE

VD25H

Comment: Total 25-Hydroxyvitamin D (Sum of  D2 + D3)
Specimen: 

1 ml serum from SST gel or serum aliquoted from plain red tube.   Plasma from Na or Li heparin tubes also acceptable.
Minimum volume is 0.50 ml.  Serum/plasma stable 12 days refrigerated.

Processing:   Specimen is to be sent refrigerated. 
Performed: Daily
Reference Value:

10-24 ng/mL (mild to moderate deficiency)
25-80 ng/mL (optimum levels)
>80 ng/mL (toxicity possible)

Method: CMIA.
CPT Code:

82306 

 

POWERCHART NAME

VITAMIN D 1,25 DIHYDROXY LEVEL

MERCY TEST NAME

1,25 DIHYDR VTMN D*

MERCY LAB CODE

DHVD

Specimen: 1.5 mL serum from SST tube, plain red top tube acceptable. 
Collection
Instructions:
Fasting (4-hour preferred but not required).
Processing: Send serum refrigerated to Mayo.  Mayo order code (DHVD).
Performed: 2-4 days, Monday through Friday; 3 p.m.
Reference
 Value:         
Included with test results.
Method: Extraction/Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS).
CPT Code: 82652

POWERCHART NAME

VMA URINE

MERCY TEST NAME

VMA 24 UR*

MERCY LAB CODE

VVMA

Comment:

This assay is of most value when the specimen is collected during a hypertensive episode.  For children 14 years old and younger, Mayo order code VH (VMA and Homovanillic Acid, Pediatric uring) is the recommended test.

A single 24-hour urine collection may be used for CATECHOLAMINE FRACTIONATION, METANEPHRINES [METN24U] and VMA [VMA24UR].    The specimen must be kept refrigerated during collection.

Patient preparation:

Administration of L-dopa may falsely-increase vanillylmandelic acid results; it should be discontinued 24 hours prior to collection of specimen.

Specimen:

 Add 25 mL 50% acetic acid preservative at the start of the colleciton.  If specimen is refrigerated during collection, preservative may be added up to 4 hours after collection.  This preservative is intended to achieve a pH of between approximately 1 and 5.  If necessary, adjust urine pH to 1 to 5 with 50% acetic or HCl acid.  Patient's age and 24-hour volume required.

Reference Lab Adjust pH to 1.0-5.0 with 50% acetic acid.  Aliquot 20 ml and indicate the 24-hour volume.
Processing:

Separate aliquots must be submitted for Metanephrines and Catecholamines if collected with this specimen.  Identify which specimen is for VMA. Mayo order code (VMA).

Performed: 2-4 days.  Test set up Monday through Friday; 8 a.m..
Mercy lab Processing: Send 5.2 ml in a 10 ml urine tube to Mayo refrigerated.
Reference value:    Included on report.
Method: Liquid Chromatography-tandam mass spectrometry (LC-MS/MS)
CPT Code: 

84585 VMA UR+

 

POWERCHART NAME

FACTOR VIII VON WILLEBRAND ANTIGEN

MERCY TEST NAME

VON WILL FACT AG*

MERCY LAB CODE

VONW

Specimen: 1 ml plasma from blue top tube filled appropriately with amount of blood listed on the label.
Processing:

Centrifuge, remove plasma, spin plasma again, aliquot to a new plastic tube.  Freeze plasma in plastic vial.  Send frozen to Mayo. Order VonWillebrand Antigen  Mayo test code VWAG..

Double spin coagulation specimens to ensure that all platelets are removed:     1.  Centrifuge specimen.  Aliquot plasma (leaving some above the cells) to a plastic centrifuge tube.   2.  Centrifuge the aliquot tube.  Pipette plasma (leaving some above the bottom of the tube) to another plastic aliquot tube.   3.  Store plasma as required for the test ordered.

Performed: 3 days.  Test set up Monday through Saturday.
Reference value:  Included on report.
Method: Automated Latex Immunoassay (LIA)
CPT Code:  85246