2/16/2016 NEW TESTS - Please update your EMR catalog with those appropriate to your practice New Test Effective : 04/02/2016 Test Code Test Name Mnemonic Category/Type LOINC Reference Range UOM Result Type 5565707 Varicella-Zoster Virus Qualitative by PCR VAR Z QUAL Detail 11483-5 Not Detected Alpha Prompt Code Mnemonic Result Name CPT: 87798 Collection: EDTA plasma, Serum, CSF, Occular Fluid, Vesicle Fluid or Tissue 4195423 VZV Source VZV Source Prompt $225.00 Specimen: 1mL (0.5mL) EDTA Plasma, Serum, CSF, Occular Fluid. Submit Frozen Vesicle Fluid must be placed in Viral Transport Media and submitted frozen. Tissue must be placed in a sterile container and frozen IMMEDIATELY. Stability: RT=Unacceptable, RF=5 days, FZ=3 months. Tissue: Frozen ONLY! Setup: Sun-Sat TAT: 2-4 days after set-up New Test Effective : 04/02/2016 Test Code Test Name Mnemonic Category/Type 5558886 Q-Fever Antibody IgG, Phase I & II with Reflex to Titer Q Fever Ab Group LOINC Result Code Mnemonic Result Name Reference Range UOM Result Type 48720-7 5558881 XQ FV 1 SC Q-Fever Abs, IgG Phase I Screen Negative Alpha CPT: 86638x2 Coxiella burnetii (aka Q-Fever) 48719-9 5558882 XQ FV 2 SC Q-Fever Abs, IgG Phase II Screen Negative Alpha Price $150.80 If either C. Burnetii Abs IgG Phase I and/or Phase II result is indeterminate or positive, then titer(s) will be added. Additional charges apply. If reflexed to Q Fever I Titer 1mL (0.1mL) Serum refrigerated. Spin & separate Possible individual Reflex tests Cpt 86638 serum from cells within 2 hours of collections. Submit refrigerated. 34716-1 5558883 XQ FV1 TTR Q Fever Phase 1 Titer - Reflex [< 1:16] Alpha Price $74.00 Unacceptable: Hemolyzed, or severly lipemic 34717-9 5558884 XQ FV2 TTR Q Fever Phase 2 Titer - Reflex [< 1:16] Alpha Stability After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year If reflexed to (avoid repeated freeze/thaw cycles) Q Fever II Titer Setup: Mon, Wed, Fri TAT: 2-7 days after set-up Cpt 86638 Price $64.00 New Test Effective : 04/02/2016 Test Code Test Name Mnemonic Category/Type 5572451 Cytochrome P450 2C19, CYP2C19 - 9 Variants CYP2C19 9V Group LOINC Result Code Mnemonic Result Name Reference Range UOM Result Type 31208-2 5572454 XCYP2C19 S CYP2C19 SPECIMEN By report Alpha CPT: 81225 Collection: Purple EDTA or Yellow ACD (Solution A or B) 57132-3 5572456 XCYP2C19 G CYP2C19 GENOTYPE By report Alpha with footnote Price $756.00 3mL (1mL) Whole blood refrigerated. Do not spin or separate! 72879-0 5572458 XCYP2C19 P CYP2C19 PHENOTYPE By report Alpha with footnote Unacceptable: Plasma or serum, heparinized specimens. Stability: Ambient: 72 hours; Refrigerated: 2 weeks; Frozen: 1 month. Setup: Mon, Thur TAT: 6-11 days after set-up New Test Effective : 04/02/2016 Test Code Test Name Mnemonic Category/Type 5564053 Scleroderma Antibody (SCL-70 Ab) SCL-70 Antibody Group LOINC Result Code Mnemonic Result Name Reference Range UOM Result Type Detail No Longer Orderable Alone 27416-7 5564050 SCL 70 AB Scl 70 Ab EU/mL Numeric XXXX CPT: 86235 n/a 5564051 SCL 70 Interp Scl 70 Interp Negative Alpha Price $138.90 1 mL Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated New Test Effective : 04/02/2016 Test Code Test Name Mnemonic Category/Type 3805378 JO-1 Antibody JO-1 Ab Group LOINC Result Code Mnemonic Result Name Reference Range UOM Result Type Detail No Longer Orderable Alone n/a 3805375 JO-1 AB JO-1 Ab EU/mL Numeric XXXX CPT: 86235 n/a 3805376 SCL 70 Interp JO-1 Interp Negative Alpha Price $138.90 1 mL Serum Clot Activator SST (Red/Gray or Tiger Top) Refrigerated New Test Effective : 04/02/2016 Test Code Test Name Mnemonic Category/Type 1104403 Platelet Count with Mean Platelet Volume Plt Cnt w MPV Group LOINC Result Code Mnemonic Result Name Reference Range UOM Result Type 777-3 0104400 PLT Platelet Count No Change 10e9/L Numeric XXXX CPT: 85049 5 mL (1 mL) Whole Blood EDTA (Lavender Top) Refrigerated 2623-1 0104575 MPV Mean Platelet Volume No Change fL Numeric XXX.X Price $22.95 Mix tube well after collection to avoid clots For best results: Room temperature specimens should be tested within 12hrs, No Change in the standard RML reference ranges for Platelet and MPV from within the CBC otherwise send Refrigerated. Refrigerated specimens can be tested up to 48hrs. Please contact the RML help desk to arrange for interface testing on any new tests. 918-744-2795 This form and others are available from our website at www.rmlonline.com/downloads 2/16/2016 New Test Effective : 04/02/2016 Test Code Test Name Mnemonic Category/Type 5002403 Hemoglobin A1c and Mean Glucose Hgb A1c w Mn Gluc Group LOINC Result Code Mnemonic Result Name Reference Range UOM Result Type 4548-4 5002400 A1C HPLC Hemoglobin A1c (Glycosylated) 4.0 - 5.6 % Numeric XX.X CPT: 83036 1 mL (0.5) Whole Blood EDTA (Lavender Top) Refrigerated 27353-2 2009250 MEAN GLUC Mean Plasma Glucose N/A mg/dL Numeric XXXX Price $55.70 Patient does not need to be fasting. Specimen stability: Ambient 8 hours. Refrigerated 7 days MODIFICATION TESTS - Please update your EMR catalog with those appropriate to your practice Modify Test Effective : 2/16/2016 Test Code Test Name Mnemonic Category/Type 9107025 PCA3-Prostate Cancer Biomarker by TMA PCA3 URINE Detail Test set up changing to Thur ONLY TAT: 4-9 days Modify Test Effective : 03/07/16 Test Code Test Name Mnemonic Category/Type 3654275 Oxalate Plasma OXALATE PL Detail Collection tube no longer needs to be pre-chilled Specimen volume: Change from 3mL (1.2mL) to 2mL (0.7mL) Serum from red no-gel or EDTA plasma Stability: Room Temp, Refrigerated, Frozen all 30 days Set-up: Wed only TAT: 2-8 days Modify Test Effective : 4/2/2016 Test Code Test Name Mnemonic Category/Type 5606600 Food Allergy Basic Panel A FOOD B P Group LOINC Result Code Detail Name Result Name Reference Range UOM Result Type 15643-0 5606900 Clam CL Clam Allergen Class 0 Alpha CPT: 86003x12 This test will change from a Supergroup to a Group test with 6076-4 5605900 Clam CT Clam Count <0.35 KU/L Numeric XXX.XX Price $360.60 result components as listed to the right. 15650-5 5606075 Codfish CL Codfish Allergen Class 0 Alpha 6082-2 5606050 Codfish CT Codfish Count <0.35 KU/L Numeric XXX.XX Collect 1.2mL of Serum - Room Temperature 15653-9 5605685 Corn,Maize CL Corn,Maize Allergen Class 0 Alpha 6087-1 5605675 Corn,Maize CT Corn,Maize Count <0.35 KU/L Numeric XXX.XX 15689-3 5606850 Egg White CL Egg White Allergen Class 0 Alpha 6106-9 5605825 Egg White CT Egg White Count <0.35 KU/L Numeric XXX.XX 25383-1 5605725 Cow Milk CL Cow Milk Allergen Class 0 Alpha 7258-7 5605700 Cow Milk CT Cow Milk Count <0.35 KU/L Numeric XXX.XX 15917-8 5604825 Peanut CL Peanut Allergen Class 0 Alpha 6206-7 5604800 Peanut CT Peanut Count <0.35 KU/L Numeric XXX.XX 16018-4 5604675 Shrimp CL Shrimp Allergen Class 0 Alpha 6246-3 5604650 Shrimp CT Shrimp Count <0.35 KU/L Numeric XXX.XX 15568-9 5604750 Soybean CL Soybean Allergen Class 0 Alpha 6248-9 5604725 Soybean CT Soybean Count <0.35 KU/L Numeric XXX.XX 16074-7 5604375 Walnut Meat CL Walnut Meat Allergen Class 0 Alpha 6273-7 5604350 Walnut Meat CT Walnut Meat Count <0.35 KU/L Numeric XXX.XX 16085-3 4198111 Wheat CL Wheat Allergen Class 0 Alpha 6276-0 5523750 Wheat CT Wheat Count <0.35 KU/L Numeric XXX.XX 16011-9 5583790 Scallop CL Scallop Allergen Class 0 Alpha 7691-9 5583785 Scallop CT Scallop Count <0.35 KU/L Numeric XXX.XX 16014-3 5555700 Sesame Seed CL Sesame Seed Allergen Class 0 Alpha 6242-2 5531450 Sesame Seed CT Sesame Seed Count <0.35 KU/L Numeric XXX.XX 8251-1 5606925 Allergen Interp Allergen Interpretation By Report Please contact the RML help desk to arrange for interface testing on any new tests. 918-744-2795 This form and others are available from our website at www.rmlonline.com/downloads 2/16/2016 Modify Test Effective : 4/2/2016 Test Code Test Name Mnemonic Category/Type 3812200 Porphyrins and Porphobilinogen Urine 24Hr/Random PORPH URQT Group New New Old Result Code Old Mnemonic LOINC Result Code Detail Name Result Name Reference Range UOM Result Type Note Change in Result Codes on this assay 3000650 NBR HRS 3000650 Ur Collection Hrs Number of Hours of Collection Urine Prompt The Collection Requirements or Reference Ranges 3809175 VOL UR REF 19153-6 3809175 Total Volume Total Volume Prompt are not changing for this assay. 3812350 XPRPH/CR R 2161-8 3873099 U Creatinine Creatinine Urine mg/dL No Change No Change 3812325 XPRPH/CREA 2162-6 3810375 U24 Creat Creatinine Urine mg/day No Change No Change 3812275 XUROPO UR 38508-8 3805800 U Uroporph Uroporphyrin Urine No Change No Change 3812300 XHEPAT UR 38175-6 3812300 U Heptacarb Por Heptacarboxylate Porphyrin Urine No Change No Change 3812250 XCOPRO UR 45313-4 3812250 Copro I Coproporphyrin I No Change No Change 3812425 XCOPRO3 UR 45315-9 3812425 Copro III Coproporphyrin III No Change No Change 3812225 XPBG URINE 2811-8 3812225 U PBG(umol/L) Porphobilinogen, Urine umol/L No Change No Change 3812375 XPBG P24HR 14882-5 3812375 U PBG(Umol/day) Porphobilinogen (PBG) umol/day Urine No Change No Change Gray Codes are being Replaced by the Red Codes 3812400 XPORPH U I 49292-6 3812400 U Porph Intrp Porphyrin Urine Interpretation By Report Modify Test Effective : 4/2/2016 Test Code Test Name Mnemonic Category/Type 3812500 Porphobilinogen Quantitative Urine 24Hr/Random PBG UR QT Group New New Old Result Code Old Mnemonic LOINC Result Code Detail Name Result Name Reference Range UOM Result Type Note Change in Result Codes on this assay 3000650 NBR HRS 3000650 Ur Collection Hrs Number of Hours of Collection Urine Prompt The Collection Requirements or Reference Ranges 3809175 VOL UR REF 19153-6 3809175 Total Volume Total Volume Prompt are not changing for this assay.