Tests Catalogs

LAMIN A/C DNA TESTING

LAB3201

Collect

Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B).

Specimen Preparation

Transport 3 mL whole blood. (Min: 1 mL)

Storage/Transport Temperature

Refrigerated.

Stability (from collection to initiation)

Ambient: 72 hours; Refrigerated: 1 week; Frozen: Unacceptable

Performed

Varies

Methodology

Polymerase Chain Reaction/Sequencing

Reported

Within 21 days

Synonyms

  • LAB3201
  • LMNASEQ
  • LAMIN A/C
  • LAMIN

Ordering Recommendations

Confirm suspected laminopathy caused by LMNA mutations including Hutchinson-Gilford progreria, Emery-Dreifuss muscular dystrophy type 2, Limb-girdle muscular dystrophy 1B, Charcot-Marie-Tooth 2B1, Dunnigan type familial partial lipodystrophy, mandibulo-acral dysplasia, atypical Werner syndrome, restrictive dermopathy or dilated cardiomyopathy.

Interpretive Data

Background Information for LMNA-Related Disorders (LMNA) Sequencing:
Characteristics of Laminopathies: Mutations in the lamin A/C (LMNA) gene cause a broad range of clinical diseases collectively termed laminopathies. Clinical findings are highly variable.
Hutchinson-Gilford progeria syndrome (HGPS): Accelerated aging, profound failure to thrive, characteristic facies, alopecia, joint degeneration, growth retardation.  Average life span is 13 years.
Emery-Dreifuss muscular dystrophy, type 2 (EDMD2): Joint contractures, progressive muscle weakness and wasting, and cardiac disease with conduction defects and arrhythmias.
Familial partial lipodystrophy, Dunnigan type (FLPD): Post-pubescent progressive loss of subcutaneous fat from the extremities and excess fat accumulation on the face and neck.
Mandibuloacral dysplasia (MAD): Post-natal growth retardation, craniofacial and skeletal anomalies, mottled cutaneous pigmentation.
Atypical Werner syndrome (WS): Progeria-like syndrome with features of partial alopecia, premature aging, short stature, hypogonadism, osteoporosis, premature atherosclerosis, weak voice, cataracts.
Restrictive Dermopathy (RD): Skin tightness causes fetal akinesia or hypokinesia deformation sequence; disease is lethal.
Incidence: At least 1 in 8 million for HGPS; DCM occurs in approximately 1 in 2,500 and is familial in 30-60 percent of cases of which approximately 8 percent are caused by LMNA gene mutations; unknown for other LMNA-related conditions. 
Inheritance: Laminopathies are inherited as autosomal dominant, recessive, or de novo.
Penetrance: Complete for HGPS; variable for other LMNA-related disorders.  
Cause: Pathogenic LMNA gene mutations.
Clinical Sensitivity: Clinical sensitivity is dependant upon the specific LMNA-related disorder.
Methodology: Bidirectional sequencing of the LMNA coding region and intron-exon boundaries.
Analytical Sensitivity and Specificity: 99 percent.
Limitations: Diagnostic errors can occur due to rare sequence variations. Some regulatory region mutations, deep intronic mutations, and large deletion/duplications will not be detected.

CPT Codes

81406
Collection

LAB3201

Collect

Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B).

Specimen Preparation

Transport 3 mL whole blood. (Min: 1 mL)

Storage/Transport Temperature

Refrigerated.

Stability (from collection to initiation)

Ambient: 72 hours; Refrigerated: 1 week; Frozen: Unacceptable
Ordering

Performed

Varies

Methodology

Polymerase Chain Reaction/Sequencing

Reported

Within 21 days

Synonyms

  • LAB3201
  • LMNASEQ
  • LAMIN A/C
  • LAMIN

Ordering Recommendations

Confirm suspected laminopathy caused by LMNA mutations including Hutchinson-Gilford progreria, Emery-Dreifuss muscular dystrophy type 2, Limb-girdle muscular dystrophy 1B, Charcot-Marie-Tooth 2B1, Dunnigan type familial partial lipodystrophy, mandibulo-acral dysplasia, atypical Werner syndrome, restrictive dermopathy or dilated cardiomyopathy.
Result Interpretation

Interpretive Data

Background Information for LMNA-Related Disorders (LMNA) Sequencing:
Characteristics of Laminopathies: Mutations in the lamin A/C (LMNA) gene cause a broad range of clinical diseases collectively termed laminopathies. Clinical findings are highly variable.
Hutchinson-Gilford progeria syndrome (HGPS): Accelerated aging, profound failure to thrive, characteristic facies, alopecia, joint degeneration, growth retardation.  Average life span is 13 years.
Emery-Dreifuss muscular dystrophy, type 2 (EDMD2): Joint contractures, progressive muscle weakness and wasting, and cardiac disease with conduction defects and arrhythmias.
Familial partial lipodystrophy, Dunnigan type (FLPD): Post-pubescent progressive loss of subcutaneous fat from the extremities and excess fat accumulation on the face and neck.
Mandibuloacral dysplasia (MAD): Post-natal growth retardation, craniofacial and skeletal anomalies, mottled cutaneous pigmentation.
Atypical Werner syndrome (WS): Progeria-like syndrome with features of partial alopecia, premature aging, short stature, hypogonadism, osteoporosis, premature atherosclerosis, weak voice, cataracts.
Restrictive Dermopathy (RD): Skin tightness causes fetal akinesia or hypokinesia deformation sequence; disease is lethal.
Incidence: At least 1 in 8 million for HGPS; DCM occurs in approximately 1 in 2,500 and is familial in 30-60 percent of cases of which approximately 8 percent are caused by LMNA gene mutations; unknown for other LMNA-related conditions. 
Inheritance: Laminopathies are inherited as autosomal dominant, recessive, or de novo.
Penetrance: Complete for HGPS; variable for other LMNA-related disorders.  
Cause: Pathogenic LMNA gene mutations.
Clinical Sensitivity: Clinical sensitivity is dependant upon the specific LMNA-related disorder.
Methodology: Bidirectional sequencing of the LMNA coding region and intron-exon boundaries.
Analytical Sensitivity and Specificity: 99 percent.
Limitations: Diagnostic errors can occur due to rare sequence variations. Some regulatory region mutations, deep intronic mutations, and large deletion/duplications will not be detected.

Administrative

CPT Codes

81406

LAMOTRIGINE

LAB475

LAMOTR

Collect

One 6 mL red top, no gel, serum (clot activator).

Pediatric Collection

Minimum volume: 0.5 mL serum.

Unacceptable Conditions

Specimen submitted in gel separator tube; sample not properly identified; incorrect container; insufficient sample volume.

Storage/Transport Temperature

Internal: Deliver to laboratory immediately refrigerated/on ice ( 2-8 degrees C).

Offsite:  Allow to clot for 30 minutes before centrifuging. Centrifuge within 2 hours of collection, place at least 0.5 mL serum in plastic aliquot container, and send to lab refrigerted/on ice (2-8 degrees C).

Stability (from collection to initiation)

Prior to centrifugation: Ambient, 2 hours.

Serum aliquot: Ambient, 6 weeks; Refrigerated (2-8 degrees C),  6 weeks; Frozen (-20 degrees C): 6 weeks

Performed by

PCL Clinical Laboratory - Toxicology

Performed

Tuesday and Friday

Methodology

High Performance Liquid Chromatography

Reported

Same day

Synonyms

  • Lamictal
  • LAB475
  • LAMOT

Reference Interval

Therapeutic Range: Not well established.

Interpretive Data

The proposed therapeutic range for seizure control is 3-14 µg/mL.  The pharmacokinetics of Lamotrigine are affected by renal function. The relationship between serum concentration and toxicity is not known.

Performed by

PCL Clinical Laboratory - Toxicology

CPT Codes

80175

Collection

LAB475

LAMOTR

Collect

One 6 mL red top, no gel, serum (clot activator).

Pediatric Collection

Minimum volume: 0.5 mL serum.

Unacceptable Conditions

Specimen submitted in gel separator tube; sample not properly identified; incorrect container; insufficient sample volume.

Storage/Transport Temperature

Internal: Deliver to laboratory immediately refrigerated/on ice ( 2-8 degrees C).

Offsite:  Allow to clot for 30 minutes before centrifuging. Centrifuge within 2 hours of collection, place at least 0.5 mL serum in plastic aliquot container, and send to lab refrigerted/on ice (2-8 degrees C).

Stability (from collection to initiation)

Prior to centrifugation: Ambient, 2 hours.

Serum aliquot: Ambient, 6 weeks; Refrigerated (2-8 degrees C),  6 weeks; Frozen (-20 degrees C): 6 weeks

Performed by

PCL Clinical Laboratory - Toxicology

Ordering

Performed

Tuesday and Friday

Methodology

High Performance Liquid Chromatography

Reported

Same day

Synonyms

  • Lamictal
  • LAB475
  • LAMOT
Result Interpretation

Reference Interval

Therapeutic Range: Not well established.

Interpretive Data

The proposed therapeutic range for seizure control is 3-14 µg/mL.  The pharmacokinetics of Lamotrigine are affected by renal function. The relationship between serum concentration and toxicity is not known.

Performed by

PCL Clinical Laboratory - Toxicology

Administrative

CPT Codes

80175

LD ISOENZYMES

LAB97

Collect

Serum separator tube (SST) or plain red.

Specimen Preparation

Do not refrigerate or freeze. Allow specimen to clot completely at room temperature. Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.6 mL)

Unacceptable Conditions

Specimens collected with EDTA, potassium oxalate, or sodium fluoride anticoagulants. Frozen, refrigerated, or hemolyzed specimens.

Storage/Transport Temperature

Room temperature.

Stability (from collection to initiation)

After separation of cells: Ambient: 1 week; Refrigerated: Unacceptable; Frozen: Unacceptable

Notes

LD-1 and LD-2 are elevated in hemolyzed specimens and serum which has not been separated from cells.  LD-3, LD-4, and LD-5 are labile at low temperatures, and are erroneously low in specimens that have been refrigerated or frozen.

Performed

Sun-Sat

Methodology

Quantitative Enzymatic/Electrophoresis

Reported

1-2 days

Synonyms

  • Lactate Dehydrogenase Isoenzymes
  • Isoenzymes, LD
  • LD Isoenzymes
  • LAB97
  • LDHISO
  • LDH

Ordering Recommendations

Do not use to detect myocardial injury. Troponin I (0090613) and Troponin T (0098803) are the recommended tests for diagnosis and management of acute coronary syndrome. In rare cases, this test may be used to evaluate elevated lactate dehydrogenase associated with non-cardiac muscle injury.

Reference Interval

LD-1: 14-27%
LD-2: 29-42%
LD-3: 18-30%
LD-4: 8-15%
LD-5: 6-23%

Lactate Dehydrogenase, Total:
0-1 month: 200-465 U/L
2-17 months: 200-450 U/L
18 months-10 years: 165-430 U/L
11-16 years: 127-287 U/L
17 years and older: 105-230 U/L

CPT Codes

83625; 83615
Collection

LAB97

Collect

Serum separator tube (SST) or plain red.

Specimen Preparation

Do not refrigerate or freeze. Allow specimen to clot completely at room temperature. Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.6 mL)

Unacceptable Conditions

Specimens collected with EDTA, potassium oxalate, or sodium fluoride anticoagulants. Frozen, refrigerated, or hemolyzed specimens.

Storage/Transport Temperature

Room temperature.

Stability (from collection to initiation)

After separation of cells: Ambient: 1 week; Refrigerated: Unacceptable; Frozen: Unacceptable

Notes

LD-1 and LD-2 are elevated in hemolyzed specimens and serum which has not been separated from cells.  LD-3, LD-4, and LD-5 are labile at low temperatures, and are erroneously low in specimens that have been refrigerated or frozen.
Ordering

Performed

Sun-Sat

Methodology

Quantitative Enzymatic/Electrophoresis

Reported

1-2 days

Synonyms

  • Lactate Dehydrogenase Isoenzymes
  • Isoenzymes, LD
  • LD Isoenzymes
  • LAB97
  • LDHISO
  • LDH

Ordering Recommendations

Do not use to detect myocardial injury. Troponin I (0090613) and Troponin T (0098803) are the recommended tests for diagnosis and management of acute coronary syndrome. In rare cases, this test may be used to evaluate elevated lactate dehydrogenase associated with non-cardiac muscle injury.
Result Interpretation

Reference Interval

LD-1: 14-27%
LD-2: 29-42%
LD-3: 18-30%
LD-4: 8-15%
LD-5: 6-23%

Lactate Dehydrogenase, Total:
0-1 month: 200-465 U/L
2-17 months: 200-450 U/L
18 months-10 years: 165-430 U/L
11-16 years: 127-287 U/L
17 years and older: 105-230 U/L
Administrative

CPT Codes

83625; 83615

LEAD URINE

LAB404

 

Collect

24-hour or random urine collection. Specimen must be collected in a plastic container. ARUP studies indicate that refrigeration of urine alone, during and after collection, preserves specimens adequately, if tested within 14 days of collection.

Patient Preparation

Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, and non-essential over-the-counter medications (upon the advice of their physician). High concentrations of iodine may interfere with elemental testing. Abstinence from iodine-containing medications or contrast agents for at least 1 month prior to collecting specimens for elemental testing is recommended.

Specimen Preparation

Transfer an 8 mL aliquot from a well-mixed collection to ARUP Trace Element-Free Transport Tubes (ARUP supply #43116). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 1 mL)

Unacceptable Conditions

Urine collected within 48 hours after administration of a gadolinium (Gd) containing contrast media (may occur with MRI studies). Acid preserved urine. Specimens contaminated with blood or fecal material. Specimens transported in non-trace element free transport tube (with the exception of the original device).

Storage/Transport Temperature

Refrigerated. Also acceptable: Room temperature or frozen.

Stability (from collection to initiation)

Ambient: 1 week; Refrigerated: 2 weeks; Frozen: 1 year

Remarks

Trace Elements requisition form may be required (ARUP form #32990-Barcode; #32991-No Barcode). Record total volume and collection time interval on transport tube and on test request form.

Performed

Sun-Sat

Methodology

Quantitative Inductively Coupled Plasma-Mass Spectrometry

Reported

1-3 days

Synonyms

  • Pb, Urine
  • LAB404
  • LEAD U
  • LEAD

Ordering Recommendations

May be useful in the assessment of chronic lead exposure or in monitoring chelation therapy. For routine testing of lead exposure, Lead, Blood (Venous) (0020098) is preferred. For occupational exposure, consider Lead, Industrial Exposure Panel, Adults (0025016).

Reference Interval

Effective May, 18 2015
Components
Reference Interval
Lead, Urine - per 24h0-31 µg/d
Lead, Urine - per volume0-23 µg/L
Lead, Urine - ratio to CRTLess than 5 ug/gCRT
Creatinine, 24-Hour Urine
Age
Male
Female
3-8 years140-700 mg/d140-700 mg/d
9-12 years300-1300 mg/d300-1300 mg/d
13-17 years500-2300 mg/d400-1600 mg/d
18-50 years1000-2500 mg/d700-1600 mg/d
51-80 years800-2100 mg/d500-1400 mg/d
81 years and older600-2000 mg/d400-1300 mg/d


CPT Codes

83655
Collection

LAB404

 

Collect

24-hour or random urine collection. Specimen must be collected in a plastic container. ARUP studies indicate that refrigeration of urine alone, during and after collection, preserves specimens adequately, if tested within 14 days of collection.

Patient Preparation

Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, and non-essential over-the-counter medications (upon the advice of their physician). High concentrations of iodine may interfere with elemental testing. Abstinence from iodine-containing medications or contrast agents for at least 1 month prior to collecting specimens for elemental testing is recommended.

Specimen Preparation

Transfer an 8 mL aliquot from a well-mixed collection to ARUP Trace Element-Free Transport Tubes (ARUP supply #43116). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 1 mL)

Unacceptable Conditions

Urine collected within 48 hours after administration of a gadolinium (Gd) containing contrast media (may occur with MRI studies). Acid preserved urine. Specimens contaminated with blood or fecal material. Specimens transported in non-trace element free transport tube (with the exception of the original device).

Storage/Transport Temperature

Refrigerated. Also acceptable: Room temperature or frozen.

Stability (from collection to initiation)

Ambient: 1 week; Refrigerated: 2 weeks; Frozen: 1 year

Remarks

Trace Elements requisition form may be required (ARUP form #32990-Barcode; #32991-No Barcode). Record total volume and collection time interval on transport tube and on test request form.
Ordering

Performed

Sun-Sat

Methodology

Quantitative Inductively Coupled Plasma-Mass Spectrometry

Reported

1-3 days

Synonyms

  • Pb, Urine
  • LAB404
  • LEAD U
  • LEAD

Ordering Recommendations

May be useful in the assessment of chronic lead exposure or in monitoring chelation therapy. For routine testing of lead exposure, Lead, Blood (Venous) (0020098) is preferred. For occupational exposure, consider Lead, Industrial Exposure Panel, Adults (0025016).
Result Interpretation

Reference Interval

Effective May, 18 2015
Components
Reference Interval
Lead, Urine - per 24h0-31 µg/d
Lead, Urine - per volume0-23 µg/L
Lead, Urine - ratio to CRTLess than 5 ug/gCRT
Creatinine, 24-Hour Urine
Age
Male
Female
3-8 years140-700 mg/d140-700 mg/d
9-12 years300-1300 mg/d300-1300 mg/d
13-17 years500-2300 mg/d400-1600 mg/d
18-50 years1000-2500 mg/d700-1600 mg/d
51-80 years800-2100 mg/d500-1400 mg/d
81 years and older600-2000 mg/d400-1300 mg/d


Administrative

CPT Codes

83655

LEAD WHOLE BLD - BLOTTER TEST

LAB830

Collect

Filter paper blotter supplied by Tamarac Medical Center. NBS blotter paper with patient name and medical record number.

Unacceptable Conditions

.

Storage/Transport Temperature

Internal: Deliver to lab immediatley
Offsite: 2 circles filled on the blotter. Place filter paper in plastic bag and mail to the Clinical Lab.

Stability (from collection to initiation)

.

Remarks

Contact PCL Clinical Lab-SENDOUTS @ 720-848-7029 to obtain blotter for testing. Patient's left ring finger is the finger of choice to use for collection. Finger should be washed thoroughly and swabbed with D-Lead wipe (in kit).

Performed by

Tamarac Medical Center

Performed

Varies

Methodology

Graphite-Furnace Atomic Absorption

Reported

7 - 10 days

Synonyms

  • LAB830
  • LEADBLOT

Performed by

Tamarac Medical Center

CPT Codes

83655

Collection

LAB830

Collect

Filter paper blotter supplied by Tamarac Medical Center. NBS blotter paper with patient name and medical record number.

Unacceptable Conditions

.

Storage/Transport Temperature

Internal: Deliver to lab immediatley
Offsite: 2 circles filled on the blotter. Place filter paper in plastic bag and mail to the Clinical Lab.

Stability (from collection to initiation)

.

Remarks

Contact PCL Clinical Lab-SENDOUTS @ 720-848-7029 to obtain blotter for testing. Patient's left ring finger is the finger of choice to use for collection. Finger should be washed thoroughly and swabbed with D-Lead wipe (in kit).

Performed by

Tamarac Medical Center

Ordering

Performed

Varies

Methodology

Graphite-Furnace Atomic Absorption

Reported

7 - 10 days

Synonyms

  • LAB830
  • LEADBLOT
Result Interpretation

Performed by

Tamarac Medical Center

Administrative

CPT Codes

83655

LEAD WHOLE BLOOD

LAB98

 

Collect

Royal blue (K2EDTA or Na2EDTA) or tan (K2EDTA).

Specimen Preparation

Transport 7 mL whole blood (royal blue) OR 3 mL whole blood (tan). (Min: 0.5 mL)

Unacceptable Conditions

Serum. Heparinized or clotted specimens.

Storage/Transport Temperature

Room temperature. Also acceptable: Refrigerated.

Stability (from collection to initiation)

If the specimen is drawn and stored in the appropriate container, the trace element values do not change with time. Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable

Remarks

Trace Elements requisition form may be required (ARUP form #32990).

Performed

Sun-Sat

Methodology

Quantitative Inductively Coupled Plasma-Mass Spectrometry

Reported

1-2 days

Synonyms

  • Pb, Blood
  • LAB98
  • LEAD

Ordering Recommendations

Recommended for routine testing for lead exposure. For occupational exposure, consider Lead, Industrial Exposure Panel, Adults (0025016).

Reference Interval

0.0-4.9 µg/dL

Interpretive Data

Elevated results may be due to skin or collection-related contamination, including use of a noncertified lead-free tube. Elevated levels of blood lead should be confirmed with a second specimen collected in a lead-free tube.

Information sources for reference intervals and interpretive comments include the "CDC Response to the 2012 Advisory Committee on Childhood Lead Poisoning Prevention Report" and the "Recommendations for Medical Management of Adult Lead Exposure, Environmental Health Perspectives, 2007." Thresholds and time intervals for retesting, medical evaluation, and response vary by state and regulatory body. Contact your State Department of Health and/or applicable regulatory agency for specific guidance on medical management recommendations.

Age
Concentration
Comment
All ages5-9.9 µg/dLAdverse health effects are possible, particularly in children under 6 years of age and pregnant women. Discuss health risks associated with continued lead exposure.  For children and women who are or may become pregnant, reduce lead exposure.
All ages10-19.9 µg/dLReduced lead exposure and increased biological monitoring are recommended.
All ages20-69.9 µg/dLRemoval from lead exposure and prompt medical evaluation are recommended. Consider chelation therapy when concentrations exceed 50 µg/dL and symptoms of lead toxicity are present.
Less than 19 years of ageGreater than 44.9 µg/dLCritical.  Immediate medical evaluation is recommended.  Consider chelation therapy when symptoms of lead toxicity are present.
Greater than 19 years of ageGreater than 69.9 µg/dLCritical.  Immediate medical evaluation is recommended.  Consider chelation therapy when symptoms of lead toxicity are present.

CPT Codes

83655
Collection

LAB98

 

Collect

Royal blue (K2EDTA or Na2EDTA) or tan (K2EDTA).

Specimen Preparation

Transport 7 mL whole blood (royal blue) OR 3 mL whole blood (tan). (Min: 0.5 mL)

Unacceptable Conditions

Serum. Heparinized or clotted specimens.

Storage/Transport Temperature

Room temperature. Also acceptable: Refrigerated.

Stability (from collection to initiation)

If the specimen is drawn and stored in the appropriate container, the trace element values do not change with time. Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable

Remarks

Trace Elements requisition form may be required (ARUP form #32990).
Ordering

Performed

Sun-Sat

Methodology

Quantitative Inductively Coupled Plasma-Mass Spectrometry

Reported

1-2 days

Synonyms

  • Pb, Blood
  • LAB98
  • LEAD

Ordering Recommendations

Recommended for routine testing for lead exposure. For occupational exposure, consider Lead, Industrial Exposure Panel, Adults (0025016).
Result Interpretation

Reference Interval

0.0-4.9 µg/dL

Interpretive Data

Elevated results may be due to skin or collection-related contamination, including use of a noncertified lead-free tube. Elevated levels of blood lead should be confirmed with a second specimen collected in a lead-free tube.

Information sources for reference intervals and interpretive comments include the "CDC Response to the 2012 Advisory Committee on Childhood Lead Poisoning Prevention Report" and the "Recommendations for Medical Management of Adult Lead Exposure, Environmental Health Perspectives, 2007." Thresholds and time intervals for retesting, medical evaluation, and response vary by state and regulatory body. Contact your State Department of Health and/or applicable regulatory agency for specific guidance on medical management recommendations.

Age
Concentration
Comment
All ages5-9.9 µg/dLAdverse health effects are possible, particularly in children under 6 years of age and pregnant women. Discuss health risks associated with continued lead exposure.  For children and women who are or may become pregnant, reduce lead exposure.
All ages10-19.9 µg/dLReduced lead exposure and increased biological monitoring are recommended.
All ages20-69.9 µg/dLRemoval from lead exposure and prompt medical evaluation are recommended. Consider chelation therapy when concentrations exceed 50 µg/dL and symptoms of lead toxicity are present.
Less than 19 years of ageGreater than 44.9 µg/dLCritical.  Immediate medical evaluation is recommended.  Consider chelation therapy when symptoms of lead toxicity are present.
Greater than 19 years of ageGreater than 69.9 µg/dLCritical.  Immediate medical evaluation is recommended.  Consider chelation therapy when symptoms of lead toxicity are present.

Administrative

CPT Codes

83655

LEBER'S HEREDITARY OPTIC NEURO

LAB3123

Collect

Two 5 mL purple top (EDTA) - whole blood refrigerated samples.

Unacceptable Conditions

Frozen samples.

Storage/Transport Temperature

Internal: Deliver to lab immediatley
Offsite: 8.5 mL EDTA whole blood - do not centrifuge

Stability (from collection to initiation)

Refrigerated: 48-72 hours

Remarks

Ship to reference lab within 24 hours of collection. Samples are shipped M-Th.

Performed by

Baylor College of Medicine - Medical Genetics Laboratories

Performed

Upon receipt

Methodology

Polymerase Chain Reaction [PCR]

Reported

14 - 21 days

Synonyms

  • LAB3123

Reference Interval

No mutation detected.

Performed by

Baylor College of Medicine - Medical Genetics Laboratories

CPT Codes

83891(1), 83892(2), 83894(1), 83898(2), 83912(1)

Collection

LAB3123

Collect

Two 5 mL purple top (EDTA) - whole blood refrigerated samples.

Unacceptable Conditions

Frozen samples.

Storage/Transport Temperature

Internal: Deliver to lab immediatley
Offsite: 8.5 mL EDTA whole blood - do not centrifuge

Stability (from collection to initiation)

Refrigerated: 48-72 hours

Remarks

Ship to reference lab within 24 hours of collection. Samples are shipped M-Th.

Performed by

Baylor College of Medicine - Medical Genetics Laboratories

Ordering

Performed

Upon receipt

Methodology

Polymerase Chain Reaction [PCR]

Reported

14 - 21 days

Synonyms

  • LAB3123
Result Interpretation

Reference Interval

No mutation detected.

Performed by

Baylor College of Medicine - Medical Genetics Laboratories

Administrative

CPT Codes

83891(1), 83892(2), 83894(1), 83898(2), 83912(1)

LEFLUNOMIDE LEVEL

LAB3113

Collect

Plain red. Also acceptable: Lavender (EDTA), pink (K2EDTA), green (sodium heparin), or gray (sodium fluoride).

Patient Preparation

Timing of specimen collection: Predose (trough). Obtain specimen 12 - 24 hours after last dose.

Specimen Preparation

Separate from cells within 2 hours of draw. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.2 mL)

Unacceptable Conditions

Whole blood. Potassium oxalate or separator tubes.

Storage/Transport Temperature

Refrigerated. Also acceptable: Room temperature or frozen.

Stability (from collection to initiation)

Ambient: 7 days; Refrigerated: 17 days; Frozen: 90 days

Performed by

Alternate CPT =  83789

Performed

Wed, Sun

Methodology

High Performance Liquid Chromatography/Mass Spectrometry

Reported

1-6 days

Synonyms

  • LAB3113
  • LEFLUN

Additional Technical Information

Ordering Recommendations

Therapeutic monitoring and evaluating full elimination of the drug (eg, toxicity, pregnancy).

Reference Interval

Therapeutic RangeGreater than 40.000 µg/mL
Toxic LevelNot well established.

Interpretive Data

Therapeutic and toxic ranges are not well established. Concentrations greater than 40.000 µg/mL tend to correlate with improved patient outcome. A proposed therapeutic range is 50.000 - 100.000 µg/mL. Adverse reactions to Leflunomide, such as diarrhea, hypertension, and liver toxicity, do not correlate well with serum drug concentrations. Leflunomide has a potential risk for teratogenesis. For women being treated with Leflunomide who desire to become pregnant, enhanced drug elimination should be performed until plasma teriflunomide concentrations are lower than 0.020 µg/mL on two separate tests taken at least 14 days apart.

Performed by

Alternate CPT =  83789

CPT Codes

80299
Collection

LAB3113

Collect

Plain red. Also acceptable: Lavender (EDTA), pink (K2EDTA), green (sodium heparin), or gray (sodium fluoride).

Patient Preparation

Timing of specimen collection: Predose (trough). Obtain specimen 12 - 24 hours after last dose.

Specimen Preparation

Separate from cells within 2 hours of draw. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.2 mL)

Unacceptable Conditions

Whole blood. Potassium oxalate or separator tubes.

Storage/Transport Temperature

Refrigerated. Also acceptable: Room temperature or frozen.

Stability (from collection to initiation)

Ambient: 7 days; Refrigerated: 17 days; Frozen: 90 days

Performed by

Alternate CPT =  83789

Ordering

Performed

Wed, Sun

Methodology

High Performance Liquid Chromatography/Mass Spectrometry

Reported

1-6 days

Synonyms

  • LAB3113
  • LEFLUN

Additional Technical Information

Ordering Recommendations

Therapeutic monitoring and evaluating full elimination of the drug (eg, toxicity, pregnancy).
Result Interpretation

Reference Interval

Therapeutic RangeGreater than 40.000 µg/mL
Toxic LevelNot well established.

Interpretive Data

Therapeutic and toxic ranges are not well established. Concentrations greater than 40.000 µg/mL tend to correlate with improved patient outcome. A proposed therapeutic range is 50.000 - 100.000 µg/mL. Adverse reactions to Leflunomide, such as diarrhea, hypertension, and liver toxicity, do not correlate well with serum drug concentrations. Leflunomide has a potential risk for teratogenesis. For women being treated with Leflunomide who desire to become pregnant, enhanced drug elimination should be performed until plasma teriflunomide concentrations are lower than 0.020 µg/mL on two separate tests taken at least 14 days apart.

Performed by

Alternate CPT =  83789

Administrative

CPT Codes

80299

LEGIONELLA ANTIGEN URINE

LAB886

 

Collect

Random urine.

Specimen Preparation

Mix specimen well. Transfer 4 mL urine to an ARUP Standard Transport Tube. (Min: 1 mL)

Unacceptable Conditions

Specimens in preservatives.

Storage/Transport Temperature

Refrigerated.

Stability (from collection to initiation)

Ambient: 24 hours; Refrigerated: 2 weeks; Frozen: 2 weeks

Performed

Sun-Sat

Methodology

Qualitative Enzyme-Linked Immunosorbent Assay

Reported

Within 24 hours

Synonyms

  • Legionella Urinary Antigen
  • LAB886
  • LEGAGU

Ordering Recommendations

Provide retrospective evidence of suspected Legionella pneumophila infection.

Reference Interval

Negative

Interpretive Data

This assay detects Legionella pneumophila serogroup one (1) antigen.  A negative test result does not rule out the possibility of Legionella infection due to other serogroups or species of Legionella.  A positive result may indicate a recent or remote infection with serogroup 1.

CPT Codes

87449
Collection

LAB886

 

Collect

Random urine.

Specimen Preparation

Mix specimen well. Transfer 4 mL urine to an ARUP Standard Transport Tube. (Min: 1 mL)

Unacceptable Conditions

Specimens in preservatives.

Storage/Transport Temperature

Refrigerated.

Stability (from collection to initiation)

Ambient: 24 hours; Refrigerated: 2 weeks; Frozen: 2 weeks
Ordering

Performed

Sun-Sat

Methodology

Qualitative Enzyme-Linked Immunosorbent Assay

Reported

Within 24 hours

Synonyms

  • Legionella Urinary Antigen
  • LAB886
  • LEGAGU

Ordering Recommendations

Provide retrospective evidence of suspected Legionella pneumophila infection.
Result Interpretation

Reference Interval

Negative

Interpretive Data

This assay detects Legionella pneumophila serogroup one (1) antigen.  A negative test result does not rule out the possibility of Legionella infection due to other serogroups or species of Legionella.  A positive result may indicate a recent or remote infection with serogroup 1.

Administrative

CPT Codes

87449

LEGIONELLA CULTURE

LAB902

 

Collect

Respiratory specimens: Abscess material, aspirates, BAL, fluids, secretions, sputum, or tissue; OR pericardial fluid or blood in SPS Vacutainer® tube for microbiology (ARUP supply #24964). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.

Specimen Preparation

Fluid: Transfer to a sterile container.  Place each specimen in an individually sealed bag. (Min. 0.5 mL) Tissue: Place on gauze moistened with sterile non-bacteriostatic saline to prevent drying and transport in sterile container.
Blood: Transport blood in SPS tube.

Unacceptable Conditions

Stool, urine, wounds, or other non-respiratory sites. Dry specimens. Specimens in preservatives or viral transport medium (M4, UTM).

Storage/Transport Temperature

Refrigerated. For non-blood specimens: If delay in transport (greater than 48 hours), transport frozen.

Stability (from collection to initiation)

Ambient: 2 hours; Refrigerated: 48 hours; Frozen: 1 week

Remarks

Specimen source preferred.

Notes

Amplified DNA testing (PCR) is also available for respiratory specimens. Refer to Legionella Species by Qualitative PCR (2010125).  Legionella pneumophila DFA (ARUP test code 2004598) is also available.

Performed

Sun-Sat

Methodology

Culture/Identification

Reported

Within 7 days
Positives are reported as soon as detected
Final: Negative at 7 days

Synonyms

  • LAB902
  • C LEGION
  • LEGION CULT

Ordering Recommendations

Gold standard test; detects L. pneumophila and other Legionella species in clinical specimens.

Reference Interval

Culture negative for Legionella species.

CPT Codes

87081; Identification CPT codes may vary based on method
Collection

LAB902

 

Collect

Respiratory specimens: Abscess material, aspirates, BAL, fluids, secretions, sputum, or tissue; OR pericardial fluid or blood in SPS Vacutainer® tube for microbiology (ARUP supply #24964). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.

Specimen Preparation

Fluid: Transfer to a sterile container.  Place each specimen in an individually sealed bag. (Min. 0.5 mL) Tissue: Place on gauze moistened with sterile non-bacteriostatic saline to prevent drying and transport in sterile container.
Blood: Transport blood in SPS tube.

Unacceptable Conditions

Stool, urine, wounds, or other non-respiratory sites. Dry specimens. Specimens in preservatives or viral transport medium (M4, UTM).

Storage/Transport Temperature

Refrigerated. For non-blood specimens: If delay in transport (greater than 48 hours), transport frozen.

Stability (from collection to initiation)

Ambient: 2 hours; Refrigerated: 48 hours; Frozen: 1 week

Remarks

Specimen source preferred.

Notes

Amplified DNA testing (PCR) is also available for respiratory specimens. Refer to Legionella Species by Qualitative PCR (2010125).  Legionella pneumophila DFA (ARUP test code 2004598) is also available.
Ordering

Performed

Sun-Sat

Methodology

Culture/Identification

Reported

Within 7 days
Positives are reported as soon as detected
Final: Negative at 7 days

Synonyms

  • LAB902
  • C LEGION
  • LEGION CULT

Ordering Recommendations

Gold standard test; detects L. pneumophila and other Legionella species in clinical specimens.
Result Interpretation

Reference Interval

Culture negative for Legionella species.
Administrative

CPT Codes

87081; Identification CPT codes may vary based on method

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