LTD 2013

LABORATORY
TEST DIRECTORY
2013
The printed version of ARUP’s Laboratory Test Directory contains information that is
current as of December 19, 2012. All information contained herein is subject to change.
For current, up-to-date test information, including test-collection specifications, please
view the electronic Laboratory Test Directory on www.aruplab.com.
DECEMBER 2012
The printed version of ARUP’s Laboratory Test Directory contains information that is current as of
December 19, 2012. All information contained herein is subject to change. For current, up-to-date
test information, including test-collection specifications, please view the electronic Laboratory Test
Directory on www.aruplab.com.
0049360 1p/19q Deletion by FISH 1P19Q
Methodology: Fluorescence in situ Hybridization
Specimen Required: Collect: Tumor tissue.
Specimen Preparation: Formalin fix (10 percent neutral buffered formalin) and paraffin embed tissue. Transport tissue block or 6 unstained 5
micron slides. (Min: 3 slides) Protect paraffin block from excessive heat. Transport block(s) and/or slide(s) in a tissue transport kit (ARUP supply
#47808) available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.
Storage/Transport Temperature: Room temperature or refrigerated. Ship in cooled container during summer months.
Remarks: Include surgical pathology report.
Unacceptable Conditions: Frozen specimens. Specimens fixed or processed in alternative fixatives (alcohol, Prefer®) or heavy metal fixatives (B-
4 or B-5). No tumor in tissue. Decalcified specimens.
Stability: Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable
CPT Code(s): 88368 x4
0099746 18-Hydroxycorticosterone 18 HYDCORT

Methodology: High Performance Liquid Chromatography/Tandem Mass Spectrometry
Specimen Required: Collect: Plain red.
Specimen Preparation: Separate serum from cells within 1 hour of draw. Transfer 3 mL serum to an ARUP Standard Transport Tube and freeze
immediately. (Min: 1 mL)
Storage/Transport Temperature: Frozen.
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 3 months
CPT Code(s): 82542
0010003 ABO Group & Rh Type IRL-ABORH

Methodology: Hemagglutination
Specimen Required: Collect: Plain red, lavender (EDTA), or pink (K2EDTA).
Specimen Preparation: Do not freeze red cells.
Transport 7 mL whole blood (plain red). OR 3 mL whole blood (EDTA).
Pediatric: Transport 0.5 mL (10 drops) whole blood.
Storage/Transport Temperature: Refrigerated.
Remarks:
Unacceptable Conditions: Separator tubes.
Stability: Ambient: 72 hours; Refrigerated: 1 week; Frozen: Unacceptable
CPT Code(s): 86900 ABO; 86901 Rh Typing
0010014 ABO-Rh Prenatal ABORH-PR

Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA).
Specimen Preparation: Transport 7 mL whole blood. (Min: 3 mL)
Unacceptable Conditions: Frozen specimens.
CPT Code(s): 86900 ABO; 86901 Rh
0010025 ABO-Rh Type ABORH-A

Specimen Required: Collect: Testing is limited to the University of Utah Health Sciences Center, Primary Children's Medical Center, and Intermountain Shriners
Hospital (1017) only.
Lavender (EDTA) or pink (K2EDTA).

Specimen Preparation: Do not freeze. Transport 7 mL whole blood. (Min: 3 mL)
Storage/Transport Temperature: Room temperature.
Remarks:
Unacceptable Conditions: Frozen specimens. Separator tubes.
CPT Code(s): 86900 ABO; 86901 Rh Typing
0060245 Acanthamoeba and Naegleria Culture ACANT

Methodology: Qualitative Culture/Microscopy
Specimen Required: Collect: Corneal scrapings, vitreous fluid or tissue.
Specimen Preparation: Place corneal scrapings, vitreous fluid, or tissue in 2 mL of Page's amoeba saline (ARUP supply #31917). Available online
through eSupply using ARUP Connect™ or contact Client Services at (800) 522-2787.
Remarks: Specimen source preferred.
Unacceptable Conditions: Specimens in media or preservatives.
Stability: Ambient: 72 hours; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 87081
2002584 Acanthamoeba and Naegleria Culture and Stains, CSF ACANTCSF

Methodology: Qualitative Culture/Microscopy/Calcofluor Stain/Giemsa Stain
Specimen Required: Collect: CSF.
Specimen Preparation: Transfer 1 mL CSF to a sterile ARUP Standard Transport Tube (ARUP supply # 43115). Available online through eSupply
using ARUP Connect™ or contact Client Services at (800) 522-2787. (Min: 0.5 mL)
CPT Code(s): 87081 Culture; 87206 Calcofluor Stain; 87207 Giemsa Stain
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0090001 Acetaminophen ACET
Methodology: Spectrophotometry
Specimen Preparation: Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Unacceptable Conditions: Plasma. Specimens collected in separator tubes, sodium fluoride/potassium oxalate, or sodium citrate anticoagulants.
Stability: After separation from cells: Ambient: 2 weeks; Refrigerated: 2 weeks; Frozen: 45 days
CPT Code(s): 82003
0091533 Acetaminophen and Oxycodone Quantitation, Serum or Plasma PERCOC SP

Methodology: Quantitative Gas Chromatography-Mass Spectrometry/Immunoassay
Specimen Required: Collect: Plain red or lavender (EDTA).
Specimen Preparation: Transfer 4 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 1.9 mL)
Stability: Ambient: 23 days; Refrigerated: 1 month; Frozen: 1 month
CPT Code(s): 83925 Opiates; 82003 Acetaminophen
0091404 Acetaminophen and Oxycodone Quantitation, Whole Blood PERCOCET B

Methodology: Quantitative Gas Chromatography-Mass Spectrometry/High Performance Liquid Chromatography
Specimen Required: Collect: Lavender (EDTA).
Specimen Preparation: Transfer 4 mL whole blood to an ARUP Standard Transport Tube. (Min: 1.6 mL)
CPT Code(s): 83925 Opiates; 82003 Acetaminophen
0091366 Acetazolamide, Serum or Plasma ACETAZOLAM

Methodology: High Performance Liquid Chromatography
Stability: Ambient: 2 weeks; Refrigerated: 2 weeks; Frozen: 1 year
CPT Code(s): 80299
0091374 Acetazolamide, Urine ACETAZO U

Specimen Required: Collect: Random urine.
Specimen Preparation: Transfer 1 mL urine to an ARUP Standard Transport Tube. (Min: 0.2 mL)
Unacceptable Conditions: Room temperature specimens.
Stability: Ambient: Unacceptable; Refrigerated: 2 weeks; Frozen: 1 month
CPT Code(s): 80299
0090005 Acetone, Quantitative AC

Methodology: Quantitative Gas Chromatography
Specimen Required: Collect: Plain red. Also acceptable: Lavender (EDTA), pink (K2EDTA), green (sodium heparin), or gray (sodium fluoride/potassium oxalate).
Avoid use of separator tubes.
Specimen Preparation: Transfer 0.5 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.2 mL)
Stability: After separation from cells: Ambient: 5 days (if tightly capped); Refrigerated: 1 week (if tightly capped); Frozen: 1 month
CPT Code(s): 82010
0091322 Acetophenazine, Serum or Plasma ACETOPHEN

Specimen Required: Collect: Plain red. Also acceptable: Gray (sodium fluoride/potassium oxalate), green (sodium heparin), or lavender (EDTA).
Specimen Preparation: Protect from light. Transfer 3 mL serum or plasma to an ARUP Amber Transport Tube. (Min: 1.2 mL)
Stability: Ambient: Undetermined; Refrigerated: Undetermined; Frozen: Undetermined
CPT Code(s): 80299
2005639 Acetylcholine Receptor Antibodies and Striated Muscle Antibody Reflexive Panels, and Titin Antibody MGT R PAN
Methodology: Quantitative Radioimmunoassay/Semi-Quantitative Radioreceptor Assay/Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-
Quantitative Indirect Fluorescent Antibody/Semi-Quantitative Flow Cytometry
Specimen Required: Collect: Plain red top or Serum Separator Tube (SST).
Specimen Preparation: Transport 1.5 mL serum. (Min. 0.7 mL) Separate serum from cells ASAP or within one hour of collection. Transfer to an
ARUP Standard Transport Tube.
Storage/Transport Temperature: Refrigerated. Frozen is also acceptable.
Remarks: Repeated freeze-thaw cycles should be avoided.
Unacceptable Conditions: Plasma. Hemolyzed, lipemic, moderately icteric serum or contaminated specimens.
Stability: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year
CPT Code(s): 83519 ACHR Binding Ab; 83519 ACHR Blocking Ab; if reflexed, add 88182TC ACHR Modulating Ab; 83516 TITIN AB; 86255 STM screen; if
reflexed, add 86256 STM titer
2001571 Acetylcholine Receptor Antibody Reflexive Panel ACHR R PAN

Methodology: Quantitative Radioimmunoassay/Semi-Quantitative Radioimmunoassay/Semi-Quantitative Flow Cytometry
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Specimen Required: Collect: Serum separator tube.
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport
Tube. (Min: 0.5 mL)
Unacceptable Conditions: Contaminated, hemolyzed, or severely lipemic specimens.
Stability: After separation from cells: Ambient: 2 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)
CPT Code(s): 83519 ACHR Binding Ab; 83519 ACHR Blocking Ab; if reflexed, add 88182TC ACHR Modulating Ab
0080009 Acetylcholine Receptor Binding Antibody ACHRBIN

Methodology: Quantitative Radioimmunoassay
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 0.5 mL serum to an ARUP Standard Transport
Tube. (Min: 0.3 mL)
Unacceptable Conditions: Plasma. Contaminated, hemolyzed, or severely lipemic specimens.
CPT Code(s): 83519
0099580 Acetylcholine Receptor Blocking Antibody ACHRBLO

Methodology: Semi-Quantitative Radioimmunoassay
Tube. (Min: 0.5 mL)
CPT Code(s): 83519
0099521 Acetylcholine Receptor Modulating Antibody ACHRMOD

Methodology: Semi-Quantitative Flow Cytometry
Tube. (Min: 0.3 mL)
CPT Code(s): 88182TC
2006848 Acetylcholinesterase and Fetal Hemoglobin, Amniotic Fluid ACETYL AF

Methodology: Qualitative Gel Electrophoresis/Radial Immunodiffusion
Specimen Required: Collect: Amniotic Fluid
Specimen Preparation: Transfer 2 mL amniotic fluid to an ARUP Standard Transport Tube. (Min: 1 mL)
Storage/Transport Temperature: Ambient.
Remarks: Include the Amniotic Fluid AFP and MoM results, if available.
Stability: Ambient; 2 weeks; Refrigerated: 4 months; Frozen: 3 years
CPT Code(s): 82013 Acetylcholinesterase; 83033 Fetal Hemoglobin
0051266 Achondroplasia (FGFR3) 2 Mutations AD PCR

Methodology: Polymerase Chain Reaction/Fluorescence Resonance Energy Transfer
Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B).
Remarks:
Unacceptable Conditions: Serum. Frozen specimens. Hemolyzed specimens.
CPT Code(s): 83891 Isolation; 83898 Amplification; 83896 x2 Nucleic acid probes; 83912 Interpretation and report. Additional CPT code modifiers may be
required for procedures performed to test for oncologic or inherited disorders.
0051265 Achondroplasia (FGFR3) 2 Mutations, Fetal AD PCR FE

Methodology: Polymerase Chain Reaction/Fluorescence Monitoring
Specimen Required: Collect: Fetal Specimen: Two T-25 flasks at 80% confluency of cultured amniocytes. If the client is unable to culture amniocytes, this can be
arranged by contacting ARUP Client Services at (800) 522-2787. Or amniotic fluid.
AND Maternal Cell Contamination Specimen: Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B).
Specimen Preparation: Cultured Amniocytes: Fill flasks with culture media. Transport two T-25 flasks at 80% confluency of cultured
amniocytes. Backup cultures must be retained at the client's institution until testing is complete.
OR Amniotic Fluid: Transport 10 mL unspun fluid. (Min: 5 mL)
AND Maternal Cell Contamination Specimen: Transport 3 mL whole blood. (Min: 1 mL)
Storage/Transport Temperature: Cultured Amniocytes: CRITICAL ROOM TEMPERATURE. Must be received within 48 hours of shipment
due to liability of cells.
Amniotic fluid: Room temperature.
Maternal Cell Contamination Specimen: Room temperature.
Remarks: Maternal specimen is recommended for proper test interpretation. Order Maternal Cell Contamination. Patient History Form
is available on the ARUP Web site or by contacting ARUP Client Services.
Stability: Fetal Specimen: Ambient: 48 hours; Refrigerated: Unacceptable; Frozen: Unacceptable
Maternal Cell Contamination Specimen: Ambient: 72 hours; Refrigerated: 1 week; Frozen: Unacceptable
CPT Code(s): 83891 Isolation; 83898 Amplification; 83896 x2 Nucleic acid probes; 83912 Interpretation and report. FCC: 83900 Multiplex amplification;
83901 x14 Additional amplification; 83909 Capillary electrophoresis. MCC MAT (0050608): 83891 Isolation; 83900 Multiplex amplification;
83901 x14 Additional amplification; 83909 Capillary electrophoresis, 83912 Interpretation and report.
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0060325 Acid Fast Stain, Partial or Modified (for Nocardia spp.) MS PAFS
Methodology: Stain/Microscopy
Specimen Required: Collect: Aspirate, fluid, respiratory specimen, or tissue.
Specimen Preparation: Transport fluid or aspirate in sterile container. OR Tissue: Place on gauze moistened with sterile non-bacteriostatic saline
to prevent drying and transport in sterile container.
Stability: Ambient: 72 hours; Refrigerated: 72 hours; Frozen: Unacceptable
CPT Code(s): 87206
0049010 Acid Hemolysin (Ham Test) HAM

Methodology: Visual Identification
Specimen Required: Collect: Plain red AND lavender (EDTA) or pink (K2EDTA).
Specimen Preparation: Separate serum from cells within 2 hours of collection. Transport 3 mL serum AND 5 mL whole blood. (Min: 1.5 mL
serum AND 1 mL whole blood).
Storage/Transport Temperature: Room temperature. Specimens should be received within 24 hours of collection and testing must be performed
within 48 hours of collection.
Remarks: Indicate patient's blood type on test request form.
Unacceptable Conditions: Serum specimens that have not been separated from the cells within 2 hours of collection.
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 85475
0020544 Acid Phosphatase, Total, Serum ACS

Methodology: Quantitative Enzymatic
Specimen Preparation: Allow specimen to clot completely at room temperature. Transfer 1.5 mL serum to an ARUP Standard Transport Tube.
(Min: 0.5 mL)
Storage/Transport Temperature: CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered.
Unacceptable Conditions: Plasma. Non-frozen specimens. Hemolyzed specimens.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 1 month
CPT Code(s): 84060
0060152 Acid-Fast Bacillus (AFB) Culture and AFB Stain MC AFB

Methodology: Stain/Culture
Specimen Required: Patient Preparation: Recommended collection: Three sputum specimens at 8-24 hour intervals (24 hours when possible) and at least one first-
morning specimen. An individual order must be submitted for each specimen.
Collect: Sputum. OR body fluid, CSF, gastric aspirate, tissue, or urine.
Specimen Preparation: Sputum: Transfer (for each collection) 5-10 mL to a sterile container. (Min: 1 mL)
Body Fluids or CSF: Transfer 5 mL to a sterile container. (Min: 1 mL)
Gastric Aspirates: Must be neutralized (pH7) with sodium carbonate if transport is delayed for more than four hours. Transfer 5-10 mL to a
sterile container. (Min: 1 mL)
Tissue: Transfer to a sterile container. (Min: Visible)
Urine: Transfer at least 40 mL to a sterile container. (Min: 10 mL)
Place each specimen in an individual, sealed bag.
Remarks: Specimen source required. Acid fast stain will not be performed on stool specimens, CSF if less than 5 mL, or urine specimens if less
than 40 mL.
Unacceptable Conditions: Dry material or material collected and transported on a swab.
Stability: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 1 week
CPT Code(s): 87116 Culture. CPT codes for identification and susceptibility vary based on method.
0060738 Acid-Fast Bacillus (AFB) Culture and AFB Stain with Reflex to Mycobacterium tuberculosis Amplified Direct MC AFBR
Detection
Methodology: Stain/Culture
Patient Preparation: Three sputum specimens should be collected at 8-24 hour intervals (24 hours when possible) and should include at least
one first-morning specimen. An individual order must be submitted for each specimen.
Specimen Required: Collect: Respiratory specimen.
Specimen Preparation: Transfer (for each collection) 5-10 mL respiratory specimen to a sterile container. (Min: 1 mL) Place each specimen in an
individually sealed bag.
Remarks: Specimen source required.
Unacceptable Conditions: Multiple same-site specimens (more than one in 24 hours), dry material, or material collected and transported on a
swab. Specimens other than respiratory.
Stability: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 2 weeks
CPT Code(s): 87116 Culture. CPT codes for identification and susceptibility vary based on method. If reflexed, add 87556 Amplified probe.
0060999 Acid-Fast Bacillus (AFB) Identification MC AFBID

Methodology: Identification
Identification methods may include biochemical, sequencing, nucleic acid probe, or polymerase chain reaction.
Specimen Required: Collect: Actively growing organism, in pure culture.
Specimen Preparation: Transport sealed container with pure culture on solid or in liquid media. Place each specimen in an individually sealed bag.
Storage/Transport Temperature: Room temperature. Submit specimen according to Infectious Substance, Category A, shipping guidelines.
Submit specimen according to Infectious Substance, Category A, shipping guidelines.
Remarks: Indicate source of organism and any other pertinent information, such as the growth rate of the organism or DNA probe results. Probes
can be performed directly from Middlebrook 7H9 broth. MGIT is not
suitable for direct probe testing.
Unacceptable Conditions: Mixed cultures or non-viable organisms. Organisms submitted on an agar plate.
Stability: Ambient: 2 weeks; Refrigerated: 2 weeks; Frozen: 2 weeks
Page | 4
CPT Code(s): CPT codes for identification vary based on method.
0060997 Acid-Fast Bacillus (AFB) Identification with Reflex to Susceptibility MC AFBIS

Methodology: Identification/Susceptibility
Specimen Preparation: Transport sealed container with pure culture on solid or in liquid media. Place each specimen in an individually sealed bag.
Remarks: Indicate source of organism and any other pertinent information such as growth rate of the organism or DNA probe results.
Unacceptable Conditions: Mixed cultures or non-viable organisms. Organisms submitted on agar plate.
CPT Code(s): CPT codes for identification and susceptibility vary based on method.
0060151 Acid-Fast Bacillus (AFB) Stain Only MS AFB

Methodology: Auramine O Stain
Specimen Required: Collect: Sputum or other respiratory specimen.
Specimen Preparation: Transfer 5-10 mL specimen to a sterile container (Min: 1 mL). Place each specimen in an individually sealed bag.
Unacceptable Conditions: Non-respiratory specimens. Swabs from any sites.
Stability: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 2 weeks
CPT Code(s): 87206 Acid-fast stain; 87015 Concentration
2003427 ACTH by Immunohistochemistry ACTH IHC

Methodology: Immunohistochemistry
Specimen Required: Collect: Tissue or cells.
Specimen Preparation: Formalin fix (10 percent neutral buffered formalin) and paraffin embed specimen (cells must be prepared into a cellblock).
Protect paraffin block and/or slides from excessive heat. Transport tissue block or 5 unstained (3- to 5-micron thick sections), positively charged
slides in a tissue transport kit (ARUP supply #47808). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services
at (800) 522-2787. (Min: 2 slides). If sending precut slides, do not oven bake.
Remarks: IMMUNOHISTOCHEMISTRY ORDERING AND SUBMISSION DETAILS: Submit electronic request. If you do not have
electronic ordering capability, use an ARUP Immunohistochemistry Stain Form (#32978) with an ARUP client number. For additional technical
details, contact ARUP Client Services at (800) 522-2787.
Unacceptable Conditions: Specimens submitted with non-representative tissue type. Depleted specimens.
Stability: Ambient: Indefinitely, Refrigerated: Indefinitely, Frozen: Unacceptable
CPT Code(s): 88342
0091246 Actifed, Serum or Plasma ACTIFED SP

Methodology: Quantitative High Performance Liquid Chromatography/Mass Spectrometry/Gas Chromatography
Specimen Preparation: Separate serum or plasma from cells within 2 hours. Transfer 6 mL serum or plasma to ARUP Standard Transport Tubes.
(Min: 2.6 mL)
CPT Code(s): 82491 Triprolidine; 82542 Pseudoephedrine
2002647 Acute Lymphocytic Leukemia (ALL) Panel by FISH, Adult FISH A ALL
Specimen Required: Collect: Non-diluted bone marrow aspirate collected in a heparinized syringe. Also acceptable: Whole blood in green (sodium heparin).
Other specimen types may be acceptable, contact the Cytogenetics Laboratory for specific specimen collection and transportation instructions.
Specimen Preparation: Transfer bone marrow to a green (sodium heparin). Transport 3 mL bone marrow OR 5 mL whole blood. (Min: 1 mL bone
marrow OR 2 mL whole blood)
Remarks: If cell pellets or dropped cytogenetics slides are not submitted, a processing fee will apply.
This test must be ordered using Cytogenetic test request form #43099 or through ARUP interface. Submit the Patient History for Cytogenetic
(Chromosome) Studies form with the electronic packing list (available at http://www.aruplab.com/genetics/forms.php).
Unacceptable Conditions: Frozen specimens. Clotted or paraffin-embedded specimens.
CPT Code(s): 88271 x5 DNA probe; 88275 x5 Interphase in situ hybridization 100-300; 88291 Interpretation and report - Additional CPT codes modifiers may
be required for procedures performed to test for oncologic or inherited disorders.
2002719 Acute Lymphocytic Leukemia (ALL) Panel by FISH, Pediatric FISH P ALL
Specimen Preparation: Transfer bone marrow to a green (sodium heparin). Transport 3 mL bone marrow (Min: 1 mL) OR 5 mL whole blood
(Min: 2 mL).
Remarks: If cell pellets or dropped cytogenetics slides are submitted, a processing fee will not apply.
This test must be ordered using Cytogenetic test request form #43099 or through your ARUP interface.
Page | 5
2002653 Acute Myelogenous Leukemia (AML) with Myelodysplastic Syndrome (MDS) or Therapy-Related AML, by F TAML MDS
FISH
Specimen Preparation: Transfer bone marrow to a green (sodium heparin). Transport 3 mL bone marrow OR 5 mL whole blood. (Min: 1 mL bone
marrow OR 2 mL whole blood)
Remarks: If cell pellets or dropped cytogenetics slides are submitted, a processing fee will not apply. This test must be ordered using Cytogenetic
test request form (#43099) or through your ARUP interface.
2002384 Acute Myelogenous Leukemia Panel by FISH FISH AML P

Specimen Preparation: Transfer bone marrow to a green (sodium heparin). Transport 3 mL bone marrow (Min: 1 mL) OR 5 mL whole blood
(Min: 2 mL).
This test must be ordered using Cytogenetic test request form #43099 or through your ARUP interface. Submit the Patient History for Cytogenetic
0091328 Acyclovir, Serum or Plasma ACYCLOV

Methodology: Quantitative High Performance Liquid Chromatography-Tandem Mass Spectrometry
Specimen Required: Collect: Plain red, lavender (EDTA) or Gray (sodium fluoride/potassium oxalate)..
Specimen Preparation: Separate serum or plasma from cells within 2 hours. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube.
(Min: 0.21 mL)
Storage/Transport Temperature: Refrigerated. Also acceptable: Room temperature and frozen.
Stability: Ambient: 1 month; Refrigerated: 1 month; Frozen: 1 month
CPT Code(s): 80299
0091376 Acyclovir, (Zovirax®), Urine ACYCLOVI U

Methodology: High Performance Liquid Chromatography-Tandem Mass Spectrometry
CPT Code(s): 80299-90
0040033 Acylcarnitine Quantitative Profile, Plasma ACYLCARN

Methodology: Tandem Mass Spectrometry
Specimen Required: Collect: Green (sodium or lithium heparin). Also acceptable: Plain red.
Specimen Preparation: Separate serum or plasma from cells ASAP or within 2 hours of collection. Transfer 0.5 mL serum or plasma to an ARUP
Standard Transport Tube and freeze immediately. (Min: 0.2 mL) Avoid hemolysis.
Remarks: Clinical information is needed for appropriate interpretation. Additional required information includes age, gender, diet (eg, TPN
therapy), drug therapy, and family history. Biochemical Genetics Patient History Form is available on the ARUP Web site at
aruplab.com/patienthistory or by contacting ARUP Client Services.
Unacceptable Conditions: Room temperature specimens. Specimens that have been refrigerated for longer than 12 hours.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 12 hours; Frozen: 1 month (avoid repeated freeze/thaw cycles)
CPT Code(s): 82017
0081170 Acylglycines, Quantitative, Urine ACYLGLY

Methodology: Liquid Chromatography-Tandem Mass Spectrometry
Specimen Preparation: Transfer 6 mL urine to ARUP Standard Transport Tubes and freeze immediately. (Min: 3 mL) Avoid dilute urine when
possible.
Remarks: Clinical information is needed for appropriate interpretation. Additional required information includes age, gender, diet (e.g., TPN
http://www.aruplab.com/patienthistory or by contacting ARUP Client Services.
Stability: Ambient: Unacceptable; Refrigerated: 24 hours; Frozen: 2 weeks
CPT Code(s): 82544
0030056 ADAMTS13 Activity ADAMTS-13

Methodology: Fluorescence Resonance Energy Transfer
Specimen Required: Collect: Lt. blue (sodium citrate). Refer to Specimen Handling at aruplab.com for hemostasis/thrombosis specimen handling guidelines.
Specimen Preparation: Transfer 1 mL platelet-poor plasma to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Page | 6
Unacceptable Conditions: Hemolyzed specimens. Serum or EDTA plasma.
Stability: Ambient: 3 hours; Refrigerated: Unacceptable; Frozen: 2 weeks
CPT Code(s): 85397
2006098 Adenosine Deaminase, CSF ADA CSF

Methodology: Quantitative Spectrophotometry
Patient Preparation: Collect specimens in leak-proof container.
Specimen Required: Collect: Cerebrospinal Fluid.
Specimen Preparation: Centrifuge specimen at room temperature. Transfer 0.3 mL fluid to an ARUP Standard Transport Tube and freeze. (Min:
0.1 mL)
Storage/Transport Temperature: Frozen. Specimen must remain frozen until received in lab.
Remarks: Indicate source on requisition.
Unacceptable Conditions: Whole blood. Bronchoalveolar lavage (BAL) specimens. Turbid specimens.
Stability: Ambient: 2 hours; Refrigerated: 1 week; Frozen: 1 month
CPT Code(s): 84311
2006101 Adenosine Deaminase, Peritoneal Fluid ADA PERIT

Patient Preparation: Collect specimens in leak proof container.
Specimen Required: Collect: Peritoneal Fluid.
0.1 mL)
Unacceptable Conditions: Whole blood. Bronchoalveolar Lavage (BAL) specimens. Turbid specimens.
CPT Code(s): 84311
2006096 Adenosine Deaminase, Pleural Fluid ADA PLEURA

Patient Preparation: Collect specimens in leak-proof container.
Specimen Required: Collect: Pleural Fluid.
0.1 mL)
Unacceptable Conditions: Whole blood. Bronchoalveolar lavage (BAL) specimens. Turbid specimens.
CPT Code(s): 84311
0083001 Adenosine Deaminase, RBC ADA

Methodology: Kinetic Spectrophotometry
Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or green (sodium or lithium heparin).
Specimen Preparation: Do not freeze. Transport 1 mL whole blood.
Unacceptable Conditions: Hemolyzed specimens.
Stability: Ambient: 15 days; Refrigerated: 15 days; Frozen: Unacceptable
CPT Code(s): 84311
0065066 Adenovirus 40-41 Antigens by EIA ADENO AG

Methodology: Qualitative Enzyme Immunoassay
Specimen Required: Collect: Stool.
Specimen Preparation: Transfer 5 g stool to an unpreserved stool transport vial (ARUP Supply #40910). Available online through eSupply using
ARUP Connect™ or contact Client Services at (800) 522-2787. (Min: 1 g)
Unacceptable Conditions: Diapers. Specimens in media or preservatives.
Stability: Ambient: 2 hours; Refrigerated: 72 hours; Frozen: 1 week
CPT Code(s): 87301
0051077 Adenovirus Antibodies, IgG & IgM ADENO PAN

Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay
Tube. (Min: 0.05 mL) Parallel testing is preferred and convalescent samples must be received within 30 days of the acute samples. Mark
specimens plainly as "acute" or "convalescent."
Storage/Transport Temperature: Refrigerated. Also acceptable: Room temperature or frozen.
Unacceptable Conditions: Plasma. Bacterially contaminated, heat-inactivated, hemolyzed, icteric, lipemic, or turbid specimens.
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year
0051073 Adenovirus Antibody, IgG ADENO G

Tube. (Min: 0.05 mL) Parallel testing is preferred and convalescent specimens must be received within 30 days of the acute specimens. Mark
Page | 7
CPT Code(s): 86603
0051078 Adenovirus Antibody, IgM ADENO M

CPT Code(s): 86603
2003430 Adenovirus by Immunohistochemistry ADENOV IHC

CPT Code(s): 88342
2002088 Adenovirus DNA, Qualitative, RT-PCR ADENO QUAL

Methodology: Real-Time Polymerase Chain Reaction
Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), yellow (ACD Solution A), plasma preparation tube, or serum separator tube. OR throat,
nasopharyngeal, or eye swabs.
Specimen Preparation: Separate serum or plasma from cells within two hours of collection. Transfer 0.85 mL serum or plasma to an ARUP
Standard Transport Tube. (Min: 0.35 mL) OR transfer swabs to 3 mL viral transport media (Microtest M4 or UTM) (ARUP supply #12884).
Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.
Storage/Transport Temperature: Refrigerated. Also acceptable: Frozen.
Unacceptable Conditions: Calcium alginate swabs.
Stability: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 1 month (avoid repeated freeze/thaw cycles)
CPT Code(s): 87798
2007192 Adenovirus, Quantitative PCR ADENO QNT

Methodology: Quantitative Real-Time Polymerase Chain Reaction
Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or serum separator tube
Specimen Preparation: Do not freeze whole blood specimens. Transport 1 mL whole blood, serum or plasma in a sterile container. (Min: 0.5 mL).
Storage/Transport Temperature: Refrigerated
Unacceptable Conditions: Frozen whole blood. Heparinized specimens.
Stability: Ambient: 24 hours; Refrigerated: 5 days; Frozen: 1 year
CPT Code(s): 87799
0070262 Adiponectin ADIP

Methodology: Quantitative Enzyme-Linked Immunosorbent Assay
Patient Preparation: Patient should fast overnight prior to collection.
Specimen Required: Collect: Plain red or serum separator tube.
Specimen Preparation: Transfer 0.5 mL serum to an ARUP Standard Transport Tube. (Min: 0.1 mL)
Unacceptable Conditions: Specimens from non-fasting patients. Specimens not separated from the red cells. Lipemic specimens.
Stability: After separation from cells: Ambient: 8 hours; Refrigerated: 1 week; Frozen: 1 month
CPT Code(s): 83520
0092330 Adrenal Steroid Quantitative Panel by LC-MS/MS, Serum or Plasma ADSTEROID

Specimen Required: Collect: Serum separator tube. Also acceptable: Plain red, lavender (EDTA), pink (K2EDTA), or green (sodium or lithium heparin).
Standard Transport Tube and freeze immediately. (Min: 0.25 mL)
Unacceptable Conditions: Refrigerated or room temperature specimens.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 6 months
CPT Code(s): 82634 11-Deoxycortisol; 83498 17-Hydroxyprogesterone; 84143 17-Hydroxypregnenolone; 84140 Pregnenolone
0070010 Adrenocorticotropic Hormone ACTH

Methodology: Quantitative Chemiluminescent Immunoassay
Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA). Collection tube must be siliconized glass or plastic.
Specimen Preparation: Separate plasma from cells ASAP or within 2 hours of collection. Transfer 1 mL plasma to an ARUP Standard Transport
Tube and freeze immediately. (Min: 0.5 mL)
Page | 8
Unacceptable Conditions: Serum, tissue or urine. Heparinized plasma. Grossly hemolyzed or lipemic specimens.
Stability: After separation from cells: Ambient: 24 hours; Refrigerated: 72 hours; Frozen 3 months.
CPT Code(s): 82024
0070031 Adrenocorticotropic Hormone Stimulation, 0 Minutes CORTISOL 0

Patient Preparation: Collect 1 timed specimen at 0 minutes.
Specimen Required: Collect: Plasma separator tube or serum separator tube.
Specimen Preparation: Allow specimen to clot completely at room temperature. Separate serum or plasma from cells ASAP or within 2 hours of
collection. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.4 mL) Specimen must be labeled with time drawn.
Stability: After separation from cells: Ambient: 1 week; Refrigerated: 1 week; Frozen: 3 months
CPT Code(s): 82533
0070032 Adrenocorticotropic Hormone Stimulation, 30 Minutes CORTISOL30

CPT Code(s): 82533
0070033 Adrenocorticotropic Hormone Stimulation, 60 Minutes CORTISOL60

CPT Code(s): 82533
0060115 Aerobic Organism Identification MC ORG

Identification methods may include biochemical, mass spectrometry, or sequencing.
Specimen Preparation: Transport sealed container with pure culture on agar slant or on a swab in bacterial transport media. Place each specimen in
an individually sealed bag.
Storage/Transport Temperature: Room temperature. If culture is suspected of being a microorganism listed as infectious substance affecting
humans on IATA list, submit specimen according to Biological Substance, Category A, shipping guidelines.
Remarks: Specimen source required. Indicate suspected pathogen.
Unacceptable Conditions: Mixed cultures or non-viable organisms.
Stability: Ambient: 1 week; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 87077 and/or 87153; CPT codes for identification vary based upon method.
0065070 Aerobic Organism Identification with Reflex to Susceptibility MC ORGIS

Specimen Preparation: Transport sealed container with pure culture on agar slant or on a swab in bacterial transport media. Place each specimen in
an individually sealed bag.
Remarks: Specimen source required. Indicate suspected pathogen.
CPT Code(s): 87077 and/or 87153; CPT codes for identification and susceptibility vary based on method.
2006230 Alagille Syndrome (JAG1) by Targeted Sequencing and Deletion/Duplication JAG1 FGA
Methodology: Sequencing
Specimen Required: Collect: Whole Blood (EDTA)
Remarks: Do not expose specimen to extreme temperatures. Clinical Indication or Reason for testing is required.
Stability: Ambient: 1 week; Refrigerated: 1 week; Frozen: Unacceptable
CPT Code(s): 83891 Isolation; 83898 x22 Amplification; 83894 x11 Gel separation; 83904 x22 Sequencing; 88386 Array-based evaluation of multiple
molecular probes, 251-500; 83892 x2 Digestion; 83912 Interpretation and report.
0020008 Alanine Aminotransferase, Serum or Plasma ALT

Specimen Preparation: Allow serum tube to clot completely at room temperature. Separate serum or plasma from cells within 2 hours of
collection. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.2 mL)
Unacceptable Conditions: Sodium fluoride/potassium oxalate used as an anticoagulant. Hemolyzed specimens. Specimens containing cellular
material.
Page | 9
Stability: After separation from cells: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 1 week
CPT Code(s): 84460
0050024 Albumin, Body Fluid ALB-BF

Methodology: Quantitative Nephelometry/Quantitative Spectrophotometry
Specimen Required: Collect: Body fluid.
Specimen Preparation: Centrifuge and separate to remove cellular material. Transfer 1 mL body fluid to an ARUP Standard Transport Tube. (Min:
0.35 mL)
Remarks: Indicate source on the test request form.
Unacceptable Conditions: Contaminated or grossly hemolyzed specimens. Needle sent with specimen.
Stability: After separation from cellular material: Ambient: 8 hours; Refrigerated: 8 days; Frozen: 1 month (avoid repeated freeze/thaw cycles)
CPT Code(s): 82042
0050671 Albumin by Nephelometry ALB N

Methodology: Quantitative Nephelometry
Specimen Required: Collect: Serum separator tube. Also acceptable: Green (sodium or lithium heparin).
Specimen Preparation: Separate serum or plasma from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard
Transport Tube. (Min: 0.4 mL)
Unacceptable Conditions: Contaminated or hemolyzed specimens.
Stability: After separation from cells: Ambient: 8 hours; Refrigerated: 8 days; Frozen: 1 year (if frozen within 24 hours)
CPT Code(s): 82040
0050200 Albumin, CSF ALB CSF

Specimen Preparation: Centrifuge and separate to remove cellular material. Transfer 1 mL CSF to an ARUP Standard Transport Tube. (Min: 0.4
mL)
Unacceptable Conditions: Grossly bloody, contaminated, or hemolyzed specimens.
Stability: Ambient: 8 hours; Refrigerated: 8 days; Frozen: 1 year (if frozen within 24 hours) (avoid repeated freeze/thaw cycles)
CPT Code(s): 82042
0080700 Albumin, Glycated GLY ALB

Methodology: Quantitative Boronate Affinity Chromatography/Immunoturbidimetry
Specimen Required: Collect: Serum separator tube, lavender (EDTA), or pink (K2EDTA).
Specimen Preparation: Allow serum specimen to clot completely at room temperature. Transfer 1 mL serum or plasma to an ARUP Standard
Stability: After separation from cells: Ambient: 2 hours; Refrigerated: 8 days; Frozen: 3 months
CPT Code(s): 82985
0020030 Albumin, Serum or Plasma by Spectrophotometry ALB

Specimen Required: Collect: Serum separator tube or plasma separator tube.
Stability: After separation from cells: Ambient: 1 week; Refrigerated: 5 months; Frozen: 6 months
CPT Code(s): 82040
0091312 Albuterol, Serum or Plasma ALBUTEROL

Methodology: Quantitative High Performance Liquid Chromatography/Tandem Mass Spectrometry
Specimen Required: Collect: Plain red. Also acceptable: gray (sodium fluoride/potassium oxalate), green (sodium heparin), or lavender (EDTA) or pink (K2EDTA).
(Min: 1.2 mL)
CPT Code(s): 80299
0090131 Alcohols ALCT

Patient Preparation: For medical purposes only.
Specimen Required: Collect: Plain red. Also acceptable: Lavender (EDTA), pink (K2EDTA), or gray (sodium fluoride/potassium oxalate).
Specimen Preparation: Do not freeze whole blood. Separate serum from cells within two hours of collection. Transfer 2 mL serum or plasma to a
tightly-capped tube to minimize alcohol loss. (Min: 0.3 mL) Specimens collected in gray (sodium fluoride/potassium oxalate) may be transported
in the original container.
Stability: After separation from cells: Ambient: 1 week (if tightly capped); Refrigerated: 2 weeks (if tightly capped); Frozen: 1 month (except
whole blood)
CPT Code(s): 84600
0020012 Aldolase, Serum ALDOLASE

Page | 10
Specimen Preparation: Allow specimen to clot completely at room temperature. Transfer 1 mL serum to an ARUP Standard Transport Tube.
(Min: 0.5 mL)
Unacceptable Conditions: Specimen types other than serum. Hemolyzed specimens.
CPT Code(s): 82085
0070016 Aldosterone 30 Minute ALDO 30

Patient Preparation: If upright specimen is collected, patient should be seated or standing for at least 2 hours.
Specimen Required: Collect: Serum separator tube or plain red.
Specimen Preparation: Transport 1 mL serum. (Min: 0.45 mL) Also acceptable: Heparinized plasma.
Unacceptable Conditions: EDTA plasma.
CPT Code(s): 82088
0070017 Aldosterone 60 Minute ALDO 60

CPT Code(s): 82088
2002582 Aldosterone & Renin, Direct with Ratio A/DR

Methodology: Quantitative Radioimmunoassay/Quantitative Immunoradiometry
Patient Preparation: Supine: 1. Both specimens should be obtained between 8 a.m. and 10 a.m. (after at least two hours in supine position); 2.
Normal sodium diet (100-200 mEq/day) for at least three days; 3. Receiving no medications known to affect renin-aldosterone system.
Upright: 1. Both specimens should be obtained before noon (after at least two hours in upright position; seated or standing). 2. Normal sodium
diet (100-200 mEq/day) for at least three days. 3. Receiving no medications known to affect renin-aldosterone system.
Contact Medical Director if more information is needed.
Specimen Required: Collect: Serum separator tube or green (sodium or lithium heparin) AND lavender (EDTA) or pink (K2EDTA). Do not collect in refrigerated
tubes.
Specimen Preparation: Separate from cells ASAP. Transfer 1 mL serum or heparinized plasma AND 2 mL EDTA plasma to individual ARUP
Standard Transport Tubes and freeze immediately. (Min: 0.5 mL serum or heparinized plasma AND 1 mL EDTA plasma)
Storage/Transport Temperature: CRITICAL FROZEN. Separate specimens must be submitted when additional tests are ordered.
Unacceptable Conditions: Refrigerated plasma. Hemolyzed specimens.
Stability: After separation from cells: Ambient: 4 hours; Refrigerated: Unacceptable; Frozen: 1 month
CPT Code(s): 82088 Aldosterone; 84244 Renin, Direct
0070073 Aldosterone/Renin Activity Ratio A/RA

Patient Preparation: Supine: 1. Both specimens should be obtained between 8 a.m. and 10 a.m. (after at least two hours in supine position); 2.
Normal sodium diet (100-200 mEq/day) for at least three days; 3. Receiving no medications known to affect renin-aldosterone system.
Upright: 1. Both specimens should be obtained before noon (after at least two hours in upright position, seated or standing); 2. Normal sodium
diet (100-200 mEq/day) for at least three days; 3. Receiving no medications known to affect renin-aldosterone system.
Specimen Required: Collect: From either a supine or upright patient, serum separator tube or green (sodium or lithium heparin) AND lavender (EDTA) or pink
(K2EDTA). Do not collect in refrigerated tubes.
Specimen Preparation: Separate from cells ASAP. Transfer 1 mL serum or heparinized plasma AND 2 mL EDTA plasma to individual ARUP
Standard Transport Tubes and freeze immediately. (Min: 0.5 mL serum or heparinized plasma AND 1.2 mL EDTA plasma)
Storage/Transport Temperature: CRITICAL FROZEN. Separate specimens must be submitted when additional tests are ordered.
Unacceptable Conditions: Refrigerated plasma. Hemolyzed specimens.
CPT Code(s): 82088 Aldosterone, 84244 Renin activity
0070015 Aldosterone, Serum ALDOST

Specimen Preparation: Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL) Also acceptable: Heparinized plasma.
CPT Code(s): 82088
Page | 11
0070480 Aldosterone, Urine ALDO U
Specimen Required: Collect: 24-hour urine. Urine must be refrigerated during collection.
Specimen Preparation: Add 1 g boric acid per 100 mL urine. Transfer 4 mL aliquot of urine from a 24-hour collection to an ARUP Standard
Transport Tube. (Min: 0.5 mL) Record total volume and collection time interval on transport tube and test request form. Also acceptable:
Preserved urine if the pH of the specimen is adjusted to 2-4 with 6M HCl or 50 percent acetic acid or unpreserved urine if frozen immediately
after collection.
Storage/Transport Temperature: Frozen. Also acceptable: Refrigerated, if preserved with HCl or acetic acid.
Stability: Ambient: 2 hours; Refrigerated (with preservative): 1 week; Frozen: 1 month
CPT Code(s): 82088
2006102 ALK Gene Rearrangements in NSCLC for Crizotinib Eligibility by FISH ALK GENE
Specimen Preparation: Formalin fix (10 percent neutral buffered formalin) and paraffin embed tumor tissue. Transport tissue block or 4 unstained,
consecutively cut, 5-micron thick sections, mounted on positively charged glass slides. (Min: 4 slides) Protect paraffin block and/or slides from
excessive heat.
Storage/Transport Temperature: Room temperature. Also acceptable: Refrigerated.
Remarks: Include surgical pathology report with reason for referral. The laboratory will not reject specimens that arrive without a pathology report
but will hold the specimen until this information is received.
CPT Code(s): 88271 x2 DNA probe each, 88274 Interphase in situ hybridization 25-99 each; 88291 Interpretation and report
2005736 Alkaline Phosphatase Isoenzymes, CSF CSF ALKP I

Methodology: Quantitative Heat Inactivation/Enzymatic
Specimen Preparation: Transfer 2 mL CSF to an ARUP Standard Transport Tube and refrigerate or freeze ASAP or within 2 hours. (Min: 1 mL)
Storage/Transport Temperature: Refrigerated or frozen.
Unacceptable Conditions: Specimens collected in EDTA, potassium oxalate, or sodium fluoride. Grossly hemolyzed or lipemic specimens
CPT Code(s): 84075 ALKP total; 84080 ALKP isoenzymes
0021020 Alkaline Phosphatase Isoenzymes, Serum or Plasma ALKP-ISO

Methodology: Quantitative Heat Inactivation/Enzymatic
Specimen Required: Collect: Serum separator tube or green (sodium or lithium heparin).
Specimen Preparation: Allow serum specimen to clot completely at room temperature. Separate serum or plasma from cells ASAP or within 2
hours of collection. Transfer 2 mL serum or plasma to an ARUP Standard Transport Tube and refrigerate or freeze immediately. (Min: 1 mL)
Unacceptable Conditions: Specimens collected in EDTA, sodium fluoride, or potassium oxalate. Grossly hemolyzed or lipemic specimens.
Stability: After separation from cells: Ambient: 1 hour; Refrigerated: 1 week (total activity will increase 2 percent per day); Frozen: 1 year
CPT Code(s): 84075 ALKP total; 84080 ALKP isoenzymes
0020005 Alkaline Phosphatase, Serum or Plasma ALKP

Unacceptable Conditions: Specimens collected in EDTA or sodium fluoride/potassium oxalate. Grossly hemolyzed specimens.
CPT Code(s): 84075
0055421 Allergen, Drugs, Amoxicillin AMOXICIL

Methodology: Quantitative ImmunoCAP® Fluorescent Enzyme Immunoassay
Patient Preparation: Multiple patient encounters should be avoided.
Specimen Required: Collect: Serum separator tube. Multiple specimen tubes should be avoided.
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 0.25 mL serum plus 0.1 mL for each additional
allergen ordered to an ARUP Standard Transport Tube. (Min: 0.25 mL plus 0.04 mL for each allergen ordered)
Unacceptable Conditions: Hemolyzed, icteric, or lipemic specimens.
CPT Code(s): 86003
0055422 Allergen, Drugs, Ampicillin AMPICIL

CPT Code(s): 86003
0099628 Allergen, Drugs, Penicillin G (major) PENICIL G

Page | 12
CPT Code(s): 86003
0099629 Allergen, Drugs, Penicillin V (minor) PENICIL V

CPT Code(s): 86003
0099635 Allergen, Epidermals and Animal Proteins, Australian Parrot Droppings IgE PARROT DRP
Specimen Preparation: Transfer 0.5 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL/allergen)
Storage/Transport Temperature: Room temperature. Also acceptable: Refrigerated or frozen.
Stability: Ambient: 1 month; Refrigerated: 1 month; Frozen: 1 year
CPT Code(s): 86003
0099714 Allergen, Epidermals & Animal Proteins, Budgerigar Droppings (Parakeet) PARA DROP
CPT Code(s): 86003
0055006 Allergen, Epidermals & Animal Proteins, Cat Dander CATEPI

CPT Code(s): 86003
0055378 Allergen, Epidermals & Animal Proteins, Chicken Feathers CHICKFEATH

CPT Code(s): 86003
0055044 Allergen, Epidermals & Animal Proteins, Cow Hair & Dander COW H/D
CPT Code(s): 86003
0099568 Allergen, Epidermals & Animal Proteins, Dog Dander DOG DANDER
Page | 13
CPT Code(s): 86003
2003300 Allergen, Epidermals and Animal Proteins, Duck Feathers IgE DUCKFEATH
Specimen Required: Collect: Serum separator tube.Multiple specimen tubes should be avoided.
CPT Code(s): 86003
0055037 Allergen, Epidermals and Animal Proteins, Feather Mix FEATHER

Methodology: Qualitative ImmunoCAP® Fluorescent Enzyme Immunoassay
CPT Code(s): 86003
0055188 Allergen, Epidermals and Animal Proteins, Goat Epithelium IgE GOAT EPI
CPT Code(s): 86003
0055177 Allergen, Epidermals & Animal Proteins, Goose Feathers GOOSE FEAT
CPT Code(s): 86003
0055190 Allergen, Epidermals and Animal Proteins, Guinea Pig Epithelium IgE G PIG EPI
CPT Code(s): 86003
0055189 Allergen, Epidermals & Animal Proteins, Hamster Epithelium HAMPST EPI
CPT Code(s): 86003
0055059 Allergen, Epidermals & Animal Proteins, Horse Hair & Dander HORSE
Page | 14
CPT Code(s): 86003
0055191 Allergen, Epidermals & Animal Proteins, Mouse Epithelium MOUSE EPI
CPT Code(s): 86003
0055192 Allergen, Epidermals and Animal Proteins, Mouse Urine IgE MOUSE U
CPT Code(s): 86003
0055193 Allergen, Epidermals & Animal Proteins, Parakeet Feathers (Budgerigar) PARAK FTHR
CPT Code(s): 86003
0055195 Allergen, Epidermals and Animal Proteins, Pig (Swine) Epithelium IgE PIG EPI
CPT Code(s): 86003
0055196 Allergen, Epidermals and Animal Proteins, Pigeon Stools IgE PIGEON STL
CPT Code(s): 86003
0099544 Allergen, Epidermals & Animal Proteins, Rabbit Epithelium RABBIT EPI
CPT Code(s): 86003
Page | 15
0055197 Allergen, Epidermals and Animal Proteins, Rat Epithelium IgE RAT EPI
CPT Code(s): 86003
0055198 Allergen, Epidermals and Animal Proteins, Rat Urine IgE RAT URINE
CPT Code(s): 86003
0055199 Allergen, Epidermals & Animal Proteins, Sheep Epithelium/Wool SHEEP EPI
CPT Code(s): 86003
0099577 Allergen, Food, Almond ALMOND

CPT Code(s): 86003
0090284 Allergen, Food, Almond IgG ALMOND IGG

Specimen Required: Collect: Serum separator tube (SST).
Tube. (Min: 0.2 mL/allergen)
CPT Code(s): 86001
0099543 Allergen, Food, Alpha-Lactalbumin ALPHA-LACT

CPT Code(s): 86003
0093498 Allergen, Food, Anchovy IgE ANCHOVY

CPT Code(s): 86003
0099632 Allergen, Food, Apple APPLE

Page | 16
CPT Code(s): 86003
0055423 Allergen, Food, Apricot APRICOT

CPT Code(s): 86003
2007179 Allergen, Food, Artichoke IgE ARTI IGE

Methodology: Quantitative Conventional RAST
CPT Code(s): 86003
0098873 Allergen, Food, Asparagus IgE ASPARAGUS

CPT Code(s): 86003
0099695 Allergen, Food, Avocado AVOCADO

CPT Code(s): 86003
0055079 Allergen, Food, Baker's Yeast/Brewer's Yeast BAKE YEAST

CPT Code(s): 86003
0097706 Allergen, Food, Baker's Yeast IgG YEAST IGG

CPT Code(s): 86001
0099634 Allergen, Food, Banana BANANA

Page | 17
CPT Code(s): 86003
0090286 Allergen, Food, Banana IgG BANANA IGG

CPT Code(s): 86001
0055056 Allergen, Food, Barley BARLEY

CPT Code(s): 86003
0097707 Allergen, Food, Barley IgG BARLEY IGG

CPT Code(s): 86001
0093496 Allergen, Food, Basil IgE BASIL

CPT Code(s): 86003
0099692 Allergen, Food, Bass Black IgE BASS

CPT Code(s): 86003
0093494 Allergen, Food, Bay Leaf IgE BAY LEAF

CPT Code(s): 86003
0055096 Allergen, Food, Beef BEEF

CPT Code(s): 86003
Page | 18
0097708 Allergen, Food, Beef IgG BEEF IGG
CPT Code(s): 86001
2006689 Allergen, Food, Beet Root IgE BEET ROOT

CPT Code(s): 86003
0055074 Allergen, Food, Beta-Lactoglobulin BETA-LACT

CPT Code(s): 86003
0055214 Allergen, Food, Black Olive IgG OLIVE

Stability: Ambient: 1 week; Refrigerated: 1 month; Frozen: 1 year
CPT Code(s): 86001
0055424 Allergen, Food, Black Pepper BK PEPPER

CPT Code(s): 86003
0055425 Allergen, Food, Blue Mussel MUSSEL

CPT Code(s): 86003
0055426 Allergen, Food, Blueberry BLUEBERRY

CPT Code(s): 86003
0099574 Allergen, Food, Brazil Nut BRAZIL NUT

Page | 19
CPT Code(s): 86003
0098531 Allergen, Food, Broccoli BROCCOLI

CPT Code(s): 86003
0092597 Allergen, Food, Buckwheat IgE (Fagopyrum esculentum) BUCKWH IGE

Tube.
Unacceptable Conditions: Hemolyzed, icteric or lipemic specimens.
CPT Code(s): 86003
0055094 Allergen, Food, Cabbage CABBAGE

CPT Code(s): 86003
2001903 Allergen, Food, Caraway Seed IgE CARAWAY

CPT Code(s): 86003
2001905 Allergen, Food, Cardamom Seed IgE CARD SEED

CPT Code(s): 86003
2001907 Allergen, Food, Carob Gum/Locust Bean IgE CAROB GUM

CPT Code(s): 86003
0055005 Allergen, Food, Carrot CARROT

CPT Code(s): 86003
Page | 20
0055081 Allergen, Food, Casein CASEIN
CPT Code(s): 86003
0097653 Allergen, Food, Casein (Cow's Milk) IgG CASEIN IGG

CPT Code(s): 86001
0099573 Allergen, Food, Cashew CASHEW

CPT Code(s): 86003
0097629 Allergen, Food, Catfish IgE CATFISH

CPT Code(s): 86003
0099054 Allergen, Food, Celery CELERY

CPT Code(s): 86003
0099583 Allergen, Food, Cheese, Cheddar CHEDDAR

CPT Code(s): 86003
0099593 Allergen, Food, Cheese Mold CHEESEMOLD

CPT Code(s): 86003
Page | 21
0099466 Allergen, Food, Cherry IgE CHERRY
CPT Code(s): 86003
0055254 Allergen, Food, Chestnut CHESTNU

CPT Code(s): 86003
0055008 Allergen, Food, Chicken CHICK

CPT Code(s): 86003
0097656 Allergen, Food, Chicken IgG CHICK IGG

CPT Code(s): 86001
0055200 Allergen, Food, Chickpea (Garbanzo Bean) CHICKPEA

CPT Code(s): 86003
0099642 Allergen, Food, Chocolate CHOCOLATE

CPT Code(s): 86003
0097657 Allergen, Food, Chocolate IgG CHOCO IGG

CPT Code(s): 86001
0098876 Allergen, Food, Cinnamon CINNAMON

Page | 22
CPT Code(s): 86003
0099488 Allergen, Food, Clam CLAM

CPT Code(s): 86003
0098875 Allergen, Food, Clove IgE CLOVE

CPT Code(s): 86003
0099473 Allergen, Food, Coconut COCONUT

CPT Code(s): 86003
0055036 Allergen, Food, Codfish IgE COD

CPT Code(s): 86003
0099757 Allergen, Food, Coffee COFFEE

CPT Code(s): 86003
0097302 Allergen, Food, Coffee IgG COFFEE IGG

CPT Code(s): 86001
0055078 Allergen, Food, Corn CORN

Page | 23
CPT Code(s): 86003
0097658 Allergen, Food, Corn IgG CORN IGG

CPT Code(s): 86001
0055011 Allergen, Food, Crab CRAB

CPT Code(s): 86003
0098874 Allergen, Food, Cranberry IgE CRANBERRY

CPT Code(s): 86003
0097637 Allergen, Food, Crayfish IgE CRAY IGE

CPT Code(s): 86003
0098868 Allergen, Food, Cucumber IgE CUCUMBER

CPT Code(s): 86003
2001909 Allergen, Food, Currant Red, IgE CURRANT

Specimen Preparation: Separate serum from cells within 10 minutes. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5
mL/allergen)
CPT Code(s): 86003
0093492 Allergen, Food, Dill IgE DILL

CPT Code(s): 86003
Page | 24
0097639 Allergen, Food, Eel IgE EEL IGE
CPT Code(s): 86003
0055013 Allergen, Food, Egg White EGG

CPT Code(s): 86003
0097659 Allergen, Food, Egg White IgG EGG IGG

CPT Code(s): 86001
0055381 Allergen, Food, Egg Whole EGGWHOLE

CPT Code(s): 86003
0055212 Allergen, Food, Egg Yolk EGG YOLK

CPT Code(s): 86003
0097315 Allergen, Food, Egg Yolk IgG EGGYOLKIGG

CPT Code(s): 86001
0055432 Allergen, Food, Eggplant EGGPLANT

CPT Code(s): 86003
0093490 Allergen, Food, Fennel, Fresh IgE FENNEL FR

Page | 25
CPT Code(s): 86003
2003298 Allergen, Food, Flaxseed/Linseed IgE FLAX

CPT Code(s): 86003
0099739 Allergen, Food, Flounder (Plaice) FLOUNDER

CPT Code(s): 86003
0099479 Allergen, Food, Garlic GARLIC

CPT Code(s): 86003
0090287 Allergen, Food, Garlic IgG GARLIC IGG

CPT Code(s): 86001
2001911 Allergen, Food, Gelatin Bovine IgE GEL BOVINE

CPT Code(s): 86003
2001913 Allergen, Food, Gelatin Porcine IgE GEL PORC

CPT Code(s): 86003
0098865 Allergen, Food, Ginger IgE GINGER

CPT Code(s): 86003
0099569 Allergen, Food, Gluten GLUTEN

Page | 26
CPT Code(s): 86003
0090289 Allergen, Food, Gluten IgG GLUTEN IGG

CPT Code(s): 86001
0055015 Allergen, Food, Grape GRAPE

CPT Code(s): 86003
0099641 Allergen, Food, Grapefruit GRAPEFRUIT

CPT Code(s): 86003
0099649 Allergen, Food, Green Bean (String) STRINGBEAN

CPT Code(s): 86003
2001917 Allergen, Food, Gum Guar IgE GUM GUAR

CPT Code(s): 86003
0098864 Allergen, Food, Haddock IgE HADDOCK

CPT Code(s): 86003
0098516 Allergen, Food, Halibut HALIBUT

Page | 27
CPT Code(s): 86003
0098617 Allergen, Food, Hazelnut (Filbert) HAZELNUT

CPT Code(s): 86003
0097631 Allergen, Food, Herring IgE HERRIN IGE

CPT Code(s): 86003
0055435 Allergen, Food, Honeydew Melon/Cantaloupe HONEY DEW

CPT Code(s): 86003
0055436 Allergen, Food, Hops HOPS

CPT Code(s): 86003
0055440 Allergen, Food, Kidney Bean KIDNEYBEAN

CPT Code(s): 86003
0055203 Allergen, Food, Kiwi KIWI

CPT Code(s): 86003
0099631 Allergen, Food, Lamb LAMB

Page | 28
CPT Code(s): 86003
0098270 Allergen, Food, Lemon LEMON

CPT Code(s): 86003
0099659 Allergen, Food, Lentil LENTIL

CPT Code(s): 86003
0055019 Allergen, Food, Lettuce LETTUCE

CPT Code(s): 86003
0097651 Allergen, Food, Lettuce IgG LETT IGG

CPT Code(s): 86001
0099766 Allergen, Food, Lima Bean/White Bean LIMA BEAN

CPT Code(s): 86003
0098271 Allergen, Food, Lime LIME

CPT Code(s): 86003
Page | 29
0099062 Allergen, Food, Lobster LOBSTER
CPT Code(s): 86003
0093246 Allergen, Food, Macadamia Nut IgE MACADA NUT

CPT Code(s): 86003
0098474 Allergen, Food, Mackerel MACKEREL

CPT Code(s): 86003
0099744 Allergen, Food, Malt MALT

CPT Code(s): 86003
0097652 Allergen, Food, Malt IgG MALT IGG

Specimen Required: Collect: Collect: Serum separator tube (SST).
CPT Code(s): 86001
0055204 Allergen, Food, Mango MANGO

CPT Code(s): 86003
0055020 Allergen, Food, Milk (Cow's) MILK

CPT Code(s): 86003
Page | 30
0099770 Allergen, Food, Mushroom MUSHROOM
CPT Code(s): 86003
0097299 Allergen, Food, Mushroom IgG MUSH IGG

CPT Code(s): 86001
0055443 Allergen, Food, Mustard MUSTARD

CPT Code(s): 86003
0055022 Allergen, Food, Navy Bean NAVY

CPT Code(s): 86003
0093502 Allergen, Food, Nutmeg IgE NUTMEG

CPT Code(s): 86003
0055040 Allergen, Food, Oat OAT

CPT Code(s): 86003
0097654 Allergen, Food, Oat IgG OAT IGG

CPT Code(s): 86001
2001919 Allergen, Food, Octopus IgE OCTOPUS

Page | 31
CPT Code(s): 86003
0099474 Allergen, Food, Onion ONION

CPT Code(s): 86003
0097306 Allergen, Food, Onion IgG ONION IGG

CPT Code(s): 86001
0055023 Allergen, Food, Orange ORANGE

CPT Code(s): 86003
0097647 Allergen, Food, Orange IgG ORANGE IGG

Specimen Required: Collect: Collect: Serum separator tube (SST).
CPT Code(s): 86001
0093500 Allergen, Food, Oregano IgE OREGANO

CPT Code(s): 86003
0098862 Allergen, Food, Orris Root IgE ORRIS

CPT Code(s): 86003
Page | 32
2006436 Allergen, Food, Ovalbumin IgE OVALBUMIN
CPT Code(s): 86003
2006434 Allergen, Food, Ovomucoid IgE OVOMUCOID

Remarks: N/A
CPT Code(s): 86003
0099638 Allergen, Food, Oyster OYSTER

CPT Code(s): 86003
0055250 Allergen, Food, Papaya PAPAYA

CPT Code(s): 86003
0099492 Allergen, Food, Parsley PARSLEY

CPT Code(s): 86003
0099895 Allergen, Food, Pea PEA

CPT Code(s): 86003
0099582 Allergen, Food, Peach PEACH

CPT Code(s): 86003
Page | 33
0055024 Allergen, Food, Peanut PEANUT
CPT Code(s): 86003
2007211 Allergen, Food, Peanut Components (uKnow®) IgE PEANUT COM

Patient Preparation: Multiple patient encounters should be avoided
Specimen Required: Collect: Serum separator tube (SST). Multiple specimen tubes should be avoided
Tube. (Min: 0.25 mL)
Unacceptable Conditions: Hemolyzed, icteric, or lipemic specimens
0097648 Allergen, Food, Peanut IgG PEANUT IGG

CPT Code(s): 86001
0055207 Allergen, Food, Pear PEAR

CPT Code(s): 86003
0099572 Allergen, Food, Pecan PECAN

CPT Code(s): 86003
0055002 Allergen, Food, Pepper C. annuum IgE BELL

CPT Code(s): 86003
0055428 Allergen, Food, Pepper C. frutescens IgE CHILI PEP

CPT Code(s): 86003
Page | 34
0099687 Allergen, Food, Perch IgE PERCH
CPT Code(s): 86003
0055445 Allergen, Food, Pine (Pinon) Nut PINON NUT

CPT Code(s): 86003
0099477 Allergen, Food, Pineapple PINEAPPLE

CPT Code(s): 86003
0055447 Allergen, Food, Pistachio PISTACHIO

CPT Code(s): 86003
0055448 Allergen, Food, Plum PLUM

CPT Code(s): 86003
0098858 Allergen, Food, Poppy Seed IgE POPPY

CPT Code(s): 86003
0099780 Allergen, Food, Pork PORK

CPT Code(s): 86003
0097649 Allergen, Food, Pork IgG PORK IGG

Page | 35
CPT Code(s): 86001
0055051 Allergen, Food, Potato POTATO

CPT Code(s): 86003
0097641 Allergen, Food, Potato (White) IgG POTATO IGG

CPT Code(s): 86001
2001921 Allergen, Food, Pumpkin Seed IgE PUMPKIN

CPT Code(s): 86003
0099493 Allergen, Food, Raspberry IgE RASPBERRY

CPT Code(s): 86003
2001923 Allergen, Food, Red Dye/Carmine (Red 4) IgE RED DYE

CPT Code(s): 86003
0097628 Allergen, Food, Red Snapper IgE RED SNAP

CPT Code(s): 86003
0055054 Allergen, Food, Rice RICE

CPT Code(s): 86003
Page | 36
0097323 Allergen, Food, Rice IgG RICE IGG
CPT Code(s): 86001
2001925 Allergen, Food, Rosemary IgE ROSEMARY

CPT Code(s): 86003
0055026 Allergen, Food, Rye RYE

CPT Code(s): 86003
0097642 Allergen, Food, Rye IgG RYE IGG

CPT Code(s): 86001
0093514 Allergen, Food, Sage IgE SAGE IGE

CPT Code(s): 86003
0099680 Allergen, Food, Salmon SALMON

CPT Code(s): 86003
0097638 Allergen, Food, Sardine IgE SARDIN IGE

CPT Code(s): 86003
0099495 Allergen, Food, Scallop SCALLOP

Page | 37
CPT Code(s): 86003
0099698 Allergen, Food, Sesame Seed SESAME

CPT Code(s): 86003
0055030 Allergen, Food, Shrimp SHRIMP

CPT Code(s): 86003
0093512 Allergen, Food, Sole IgE SOLE

CPT Code(s): 86003
0055031 Allergen, Food, Soybean SOY

CPT Code(s): 86003
0097643 Allergen, Food, Soybean IgG SOY IGG

Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 0.5 mL serum at to an ARUP Standard Transport
CPT Code(s): 86001
0055208 Allergen, Food, Spinach SPINACH

CPT Code(s): 86003
0097632 Allergen, Food, Squid IgE SQUID IGE

CPT Code(s): 86003
Page | 38
0099639 Allergen, Food, Strawberry STRAWBERRY
CPT Code(s): 86003
0098645 Allergen, Food, Sugar Beet IgE SUGARBEET

CPT Code(s): 86003
0099736 Allergen, Food, Sugar Cane IgE SUGARCANE

CPT Code(s): 86003
0097911 Allergen, Food, Sugar Cane IgG4 SUGAR IGG4

Methodology: Quantitative Enzyme Immunoassay
Specimen Preparation: Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL/allergen)
Stability: Ambient: 1 month; Refrigerated: 1 month; Frozen: 2 months
CPT Code(s): 86001
0099122 Allergen, Food, Summer Squash IgE SQUASH SUM

CPT Code(s): 86003
0099496 Allergen, Food, Sunflower Seed IgE SUNFL SEED

CPT Code(s): 86003
0097326 Allergen, Food, Sweet Potato IgE SWTPOTATO

CPT Code(s): 86003
0097633 Allergen, Food, Swordfish IgE SWORD IGE

CPT Code(s): 86003
Page | 39
0055451 Allergen, Food, Tea TEA
CPT Code(s): 86003
0093510 Allergen, Food, Thyme IgE THYME

CPT Code(s): 86003
2003296 Allergen, Food, Tilapia IgE TILAPIA

CPT Code(s): 86003
0055033 Allergen, Food, Tomato TOMATO

CPT Code(s): 86003
0099727 Allergen, Food, Trout TROUT

CPT Code(s): 86003
0055062 Allergen, Food, Tuna TUNA

CPT Code(s): 86003
0099627 Allergen, Food, Turkey TURKEY

CPT Code(s): 86003
0055452 Allergen, Food, Vanilla VANILLA

Page | 40
CPT Code(s): 86003
0055209 Allergen, Food, Walnut (Juglans spp.) IgE WALNUT ENG

CPT Code(s): 86003
0055157 Allergen, Food, Watermelon WATERME

CPT Code(s): 86003
0055034 Allergen, Food, Wheat WHEAT

CPT Code(s): 86003
0097636 Allergen, Food, Wheat IgG WHEAT IGG

CPT Code(s): 86001
0055453 Allergen, Food, Whey WHEY

CPT Code(s): 86003
0090291 Allergen, Food, Whey IgG WHEY IGG

Specimen Required: Collect: Serum separator tube
Unacceptable Conditions: Hemolyzed, icteric, or lipemic specimens
CPT Code(s): 86001
Page | 41
0097634 Allergen, Food, Whitefish IgE WFISH
CPT Code(s): 86003
0097325 Allergen, Food, Yam IgE YAM

CPT Code(s): 86003
0099134 Allergen, Food, Zucchini IgE ZUCCHINI

CPT Code(s): 86003
0050147 Allergen, Fungi & Molds, Trichophyton mentagrophytes, Interdigitale Variant TRICOPHYT
CPT Code(s): 86003
0055001 Allergen, Fungi & Molds, Alternaria alternata (tenuis) ALTER

CPT Code(s): 86003
0097773 Allergen, Fungi and Molds, Alternaria tenuis IgG ALTER IGG
CPT Code(s): 86001
0055061 Allergen, Fungi & Molds, Aspergillus fumigatus ASP RAST

CPT Code(s): 86003
0092598 Allergen, Fungi and Molds, Aspergillus niger IgE ASPNIG IGE
Page | 42
CPT Code(s): 86003
0055383 Allergen, Fungi & Molds, Aureobasidium pullulans AUREOBASID

CPT Code(s): 86003
0097305 Allergen, Fungi and Molds, Aureobasidium pullulans IgG AUREO IGG
CPT Code(s): 86001
2004670 Allergen, Fungi and Molds, Botrytis cinerea IgE BOTRYTIS

Specimen Required: Collect: Serum separator tube. Multiple specimen draws should be avoided.
CPT Code(s): 86003
0055004 Allergen, Fungi & Molds, Candida albicans CAN RAST

CPT Code(s): 86003
0097304 Allergen, Fungi and Molds, Candida albicans IgG CANDIDAIGG

CPT Code(s): 86001
0098522 Allergen, Fungi & Molds, Cephalosporium CEPHALOSPO

CPT Code(s): 86003
0097314 Allergen, Fungi and Molds, Cladosporium IgG CLADO IGG

CPT Code(s): 86001
0055377 Allergen, Fungi & Molds, Curvularia lunata CURVULARIA

Page | 43
CPT Code(s): 86003
0099599 Allergen, Fungi & Molds, Epicoccum EPICOCCUM

CPT Code(s): 86003
0055376 Allergen, Fungi & Molds, Fusarium moniliforme FUSARIUMMO

CPT Code(s): 86003
0093454 Allergen, Fungi and Molds, Fusarium proliferatum/moniliforme IgG FUS M IGG
CPT Code(s): 86001-90
0099541 Allergen, Fungi & Molds, Helminthosporium HELMIN

CPT Code(s): 86003
0097313 Allergen, Fungi and Molds, Helminthosporium halodes/Setomelanomma rostrata IgG HELMINIGG
CPT Code(s): 86001
0055038 Allergen, Fungi & Molds, Hormodendrum (Cladosporium) HORMO

CPT Code(s): 86003
0055442 Allergen, Fungi & Molds, Mucor racemosus MUCOR RAC

Page | 44
CPT Code(s): 86003
0097316 Allergen, Fungi and Molds, Mucor racemosus IgG MUCOR IGG
CPT Code(s): 86001
0097310 Allergen, Fungi and Molds, Penicillium chrysogenum/notatum IgG PENI N IGG
CPT Code(s): 86001
0055080 Allergen, Fungi & Molds, Penicillium notatum PENICIL

CPT Code(s): 86003
0055390 Allergen, Fungi & Molds, Phoma betae PHOMA

CPT Code(s): 86003
0097309 Allergen, Fungi and Molds, Phoma betae IgG PHOMAB IGG
CPT Code(s): 86001
2006438 Allergen, Fungi and Molds, Pityrosporum orbiculare/Malassezia IgE MALASSEZIA

CPT Code(s): 86003
0099555 Allergen, Fungi & Molds, Rhizopus nigricans RHIZOPUS

Page | 45
CPT Code(s): 86003
0097307 Allergen, Fungi and Molds, Rhizopus nigricans IgG RHIZO IGG
CPT Code(s): 86001
0092590 Allergen, Fungi and Molds, Staphylococcal Enterotoxin A IgE STAPHA IGE
CPT Code(s): 86003
0092588 Allergen, Fungi and Molds, Staphylococcal Enterotoxin B IgE STAPHB IGE
CPT Code(s): 86003
0050357 Allergen, Fungi & Molds, Stemphylium botryosum STEMPHYLIU

CPT Code(s): 86003 per allergen tested
0099551 Allergen, Fungi and Molds, Stemphylium solani IgE STEMPH

CPT Code(s): 86003
0090393 Allergen, Fungi and Molds, Trichophyton rubrum IgG TRICHO IGG
CPT Code(s): 86671
0099901 Allergen, Grass, Alfalfa IgE ALFALFA

CPT Code(s): 86003
0055151 Allergen, Grass, Bahia BAHIA

Page | 46
CPT Code(s): 86003
0098644 Allergen, Grass, Barley Pollen, Cultivated IgE BARLEY POL

CPT Code(s): 86003
0055057 Allergen, Grass, Bent Grass/Redtop Grass BENT GRASS

CPT Code(s): 86003
0055070 Allergen, Grass, Bermuda BERMUDA

CPT Code(s): 86003
0099774 Allergen, Grass, Brome Grass BROMEGRASS

CPT Code(s): 86003
0050536 Allergen, Grass, Canary Grass CANARY

CPT Code(s): 86003
0098641 Allergen, Grass, Cultivated Corn Pollen CORN POL

CPT Code(s): 86003
0050533 Allergen, Grass, Cultivated Oat Pollen CUL OAT

Page | 47
CPT Code(s): 86003
0098642 Allergen, Grass, Cultivated Wheat Pollen WHEAT POL

CPT Code(s): 86003
0055047 Allergen, Grass, Johnson Grass JOHN

CPT Code(s): 86003
0055017 Allergen, Grass, June Grass/Kentucky Bluegrass JUNE

CPT Code(s): 86003
0055053 Allergen, Grass, Meadow Fescue MEADOW

CPT Code(s): 86003
0055052 Allergen, Grass, Orchard Grass/Cocksfoot ORCHARD

CPT Code(s): 86003
0055028 Allergen, Grass, Perennial Rye Grass RYEGRASS

CPT Code(s): 86003
Page | 48
0055184 Allergen, Grass, Reed Pollen, Common IgE REED POL
CPT Code(s): 86003
0098470 Allergen, Grass, Salt Grass IgE SALT GRASS

CPT Code(s): 86003
0099667 Allergen, Grass, Sweet Vernal Grass VERNAL

CPT Code(s): 86003
0055032 Allergen, Grass, Timothy Grass TIM

CPT Code(s): 86003
0055091 Allergen, House Dust Greer HOUSEGREER

CPT Code(s): 86003
0055092 Allergen, House Dust Stier HOUSESTIER

CPT Code(s): 86003
0055210 Allergen, Insect, Mosquito, IgE MOSQUITO

CPT Code(s): 86003
0050151 Allergen, Insects & Venom, Cockroach, American COCKROAAM

Page | 49
CPT Code(s): 86003
0055088 Allergen, Insects & Venom, Cockroach, German COCKROACH

CPT Code(s): 86003
0098272 Allergen, Insects & Venom, Fire Ant, Imported FIRE ANT
CPT Code(s): 86003
0055039 Allergen, Insects and Venom, Honey Bee IgE HONEY

CPT Code(s): 86003
0055400 Allergen, Insects and Venom, Honey Bee IgG HON B IGG
CPT Code(s): 86001
0055048 Allergen, Insects & Venom, Paper Wasp WASP PAPER

CPT Code(s): 86003
0055415 Allergen, Insects and Venom, Paper Wasp IgG PAP-W IGG
CPT Code(s): 86001
0055405 Allergen, Insects and Venom, White-Faced Hornet IgG WH F IGG

Page | 50
CPT Code(s): 86001
0055046 Allergen, Insects & Venom, White-Faced Hornet HORNET WF

CPT Code(s): 86003
0055420 Allergen, Insects and Venom, Yellow Hornet IgG YE F IGG

CPT Code(s): 86001
0055410 Allergen, Insects and Venom, Yellow Jacket IgG YEL J IGG
CPT Code(s): 86001
0055139 Allergen, Insects & Venom, Yellow Jacket Venom YELLOW J

CPT Code(s): 86003
0055065 Allergen, Insects & Venom, Yellow-Faced Hornet HORNET YF

CPT Code(s): 86003
0092580 Allergen, Latex Specific IgE Panel by RIA LATEX RIA

Specimen Preparation: Transfer 2 mL serum to an ARUP Standard Transport Tube. (Min 1 mL)
Stability: After separation from cells: Ambient: 1 month; Refrigerated: 1 month; Frozen: 1 year
0055009 Allergen, Mites, Acarus siro IgE A SIRO

CPT Code(s): 86003
Page | 51
2006019 Allergen, Mites, B. tropicalis BTROPIC
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 0.25 mL serum plus 0.1 mL for each
additional allergen ordered to an ARUP Standard Transport Tube. (Min: 0.25 mL plus 0.04 mL/additional allergen)
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; frozen: 1 year
CPT Code(s): 86003
0055064 Allergen, Mites, D. farinae DFARI

CPT Code(s): 86003
0055060 Allergen, Mites, D. microceras IgE D MICROCER

CPT Code(s): 86003
0055063 Allergen, Mites, D. pteronyssinus DPTER

CPT Code(s): 86003
0055087 Allergen, Mites, Euroglyphus maynei IgE E MAYNEI

CPT Code(s): 86003
0055095 Allergen, Mites, Glycyphagus domesticus IgE G DOMESTIC

CPT Code(s): 86003
0050143 Allergen, Mites, Lepidoglyphus destructor LEPIDOGLY

CPT Code(s): 86003
0055183 Allergen, Mites, Tyrophagus putrescentiae IgE T PUTRE

Page | 52
CPT Code(s): 86003
2006687 Allergen, Occupational, Cotton Seed IgE COTTONSEED

CPT Code(s): 86003
0098421 Allergen, Occupational, Ethylene Oxide IgE ETHYLENE

CPT Code(s): 86003
0098423 Allergen, Occupational, Formaldehyde IgE FORMALD

CPT Code(s): 86003
2001915 Allergen, Occupational, Gum Carageenan IgE GUM CARAGE

CPT Code(s): 86003
0098418 Allergen, Occupational, Isocyanate HDI ISO HDI

CPT Code(s): 86003
0098419 Allergen, Occupational, Isocyanate MDI ISO MDI

CPT Code(s): 86003
0098420 Allergen, Occupational, Isocyanate TDI ISO TDI

CPT Code(s): 86003
Page | 53
0099614 Allergen, Occupational, Latex LATEX
CPT Code(s): 86003
0098422 Allergen, Occupational, Phthalic Anhydride IgE ANHYD

CPT Code(s): 86003
0099548 Allergen, Occupational, Tobacco TOB

CPT Code(s): 86003
2005894 Allergen Panel, IgE by ImmunoCap ISAC ISAC MICRO

Methodology: Semi-Quantitative ImmunoCAP® Solid-phase Allergen Chip
Specimen Required: Collect: Serum separator tube. Also acceptable: Lavender (EDTA) or green (sodium or lithium) heparin.
Unacceptable Conditions: Ambient specimens.
Stability: Ambient: Unacceptable; Refrigerated: 1 week; Frozen at -20 °C: 1 month;
Frozen at -70 °C: Indefinite
CPT Code(s): 86003 x112
0055213 Allergen, Parasite, Ascaris ASCARIS

CPT Code(s): 86003
0055141 Allergen, Tree, Acacia Tree ACACIA

CPT Code(s): 86003
0099486 Allergen, Tree, Alder Tree ALDER

CPT Code(s): 86003
0055153 Allergen, Tree, American Beech Tree AMBEE

Patient Preparation: Fasting specimen preferred. Multiple patient encounters should be avoided.
Page | 54
CPT Code(s): 86003
0055150 Allergen, Tree, Arizona Cypress IgE ARIZ CYP

CPT Code(s): 86003
0098870 Allergen, Tree, Bayberry IgE BAYBERRY

allergen ordered to an ARUP Standard Transport Tube. (Min: 0.25 mL plus 0.04 mL/additional allergen)
CPT Code(s): 86003
0055058 Allergen, Tree, Birch Tree BIRCH

CPT Code(s): 86003
0092053 Allergen, Tree, Black Locust IgE BLK LOCUST

CPT Code(s): 86003
0055003 Allergen, Tree, Box Elder/Maple Tree BOX

CPT Code(s): 86003
0097794 Allergen, Tree, California Pepper IgE PEPPERTREE

CPT Code(s): 86003
0055156 Allergen, Tree, Cedar/Red Tree CEDARRED

CPT Code(s): 86003
Page | 55
0055010 Allergen, Tree, Cottonwood Tree COTTON
CPT Code(s): 86003
2003216 Allergen, Tree, Douglas Fir IgE DOUGLAS

CPT Code(s): 86003
0055042 Allergen, Tree, Elm Tree ELM

CPT Code(s): 86003
0055098 Allergen, Tree, Eucalyptus Tree EUCAL

CPT Code(s): 86003
0098871 Allergen, Tree, Groundsel IgE BUCCHARIS

CPT Code(s): 86003
0093506 Allergen, Tree, Hazelnut IgE HAZEL NUT

CPT Code(s): 86003
0097934 Allergen, Tree, Hickory Shagbark IgE SHAGBARK

CPT Code(s): 86003
0098867 Allergen, Tree, Italian Cypress IgE CYPRESS IT

Page | 56
CPT Code(s): 86003
0055187 Allergen, Tree, Japanese Cedar Tree J CEDAR

CPT Code(s): 86003
0098863 Allergen, Tree, Melaleuca Tree IgE MELALEUCA

CPT Code(s): 86003
0055140 Allergen, Tree, Mesquite Tree MESQUITE

CPT Code(s): 86003
0055007 Allergen, Tree, Mountain Cedar (Juniper) Tree CEDAR

CPT Code(s): 86003
0093504 Allergen, Tree, Mulberry Red IgE MULBERRY

CPT Code(s): 86003
0097933 Allergen, Tree, Oak Red IgE OAK RED

CPT Code(s): 86003
0055045 Allergen, Tree, Oak Tree OAK

CPT Code(s): 86003
Page | 57
0055155 Allergen, Tree, Olive Tree OLIVE TREE
CPT Code(s): 86003
0098861 Allergen, Tree, Palm/Queen Tree IgE PALM Q

CPT Code(s): 86003
0055145 Allergen, Tree, Pecan (White Hickory) Tree PECAN TREE

CPT Code(s): 86003
0055089 Allergen, Tree, Pine/Australian Tree PINEAUS

CPT Code(s): 86003
0098859 Allergen, Tree, Poplar White IgE POPLAR W

CPT Code(s): 86003
0055152 Allergen, Tree, Privet Tree PRIVET

CPT Code(s): 86003
0055380 Allergen, Tree, Sweet Gum Tree SWEETGUMTR

CPT Code(s): 86003
0055090 Allergen, Tree, Sycamore Tree SYCAMORE

Page | 58
CPT Code(s): 86003
0055449 Allergen, Tree, Virginia Live Oak Tree VOAK

CPT Code(s): 86003
0055093 Allergen, Tree, Walnut Tree WALNUT TR

CPT Code(s): 86003
0055073 Allergen, Tree, White Ash Tree ASH

CPT Code(s): 86003
0099554 Allergen, Tree, White Mulberry Tree MULB

CPT Code(s): 86003
0055082 Allergen, Tree, White Pine Tree PINE

CPT Code(s): 86003
0055083 Allergen, Tree, Willow Tree WILLOW

CPT Code(s): 86003
0099472 Allergen, Weed, Cocklebur COCKLEBUR

Page | 59
CPT Code(s): 86003
0055085 Allergen, Weed, Common/Short Ragweed CRAG

CPT Code(s): 86003
0055086 Allergen, Weed, Dandelion DANDY

CPT Code(s): 86003
0055049 Allergen, Weed, English Plantain ENGLISH

CPT Code(s): 86003
0055014 Allergen, Weed, False Ragweed FRAG

CPT Code(s): 86003
0055084 Allergen, Weed, Giant Ragweed GRAG

CPT Code(s): 86003
0098471 Allergen, Weed, Goldenrod GOLDENROD

CPT Code(s): 86003
0055018 Allergen, Weed, Kochia/Firebush KOCHIA

Page | 60
CPT Code(s): 86003
0055160 Allergen, Weed, Lamb's Quarters LAMBS QTR

CPT Code(s): 86003
0050910 Allergen, Weed, Marsh Elder MARSHELDER

CPT Code(s): 86003
0055021 Allergen, Weed, Mugwort MUGWORT

CPT Code(s): 86003
0099775 Allergen, Weed, Nettle NETTLE

CPT Code(s): 86003
0055025 Allergen, Weed, Pigweed PIG

CPT Code(s): 86003
0055027 Allergen, Weed, Russian Thistle RUSSIAN

CPT Code(s): 86003
0055029 Allergen, Weed, Sagebrush/Wormwood SAGE

Page | 61
CPT Code(s): 86003
0099553 Allergen, Weed, Scale SCALE

CPT Code(s): 86003
0099785 Allergen, Weed, Sheep Sorrel SHEEP SORR

CPT Code(s): 86003
0055185 Allergen, Weed, Sunflower Pollen IgE SUNFL POL

CPT Code(s): 86003
2006021 Allergen, Weed, Wall pellitory (P. officinalis) WALL PELL

allergen ordered to an ARUP Standard Transport Tube. (Min: 0.25 mL plus 0.04 mL/additional allergen)
CPT Code(s): 86003
0055035 Allergen, Weed, Western Ragweed WRAG

CPT Code(s): 86003
0098433 Allergen, Weed, Yellow Dock (Rumex crispus) DOCK YEL

CPT Code(s): 86003
0051833 Allergens, Additional Molds Profile IgE MOLD PRO

Methodology: ImmunoCAP® Fluorescent Enzyme Immunoassay
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 0.65 mL to an ARUP Standard Transport Tube.
(Min: 0.45 mL)
Page | 62
CPT Code(s): 86003 x5 IgE specific allergens
0055122 Allergens, Animal, Dog/Cat Epithelium Profile EPI PAN 2

CPT Code(s): 86003 per allergen
0055120 Allergens, Animal Epithelium/Dander/Feather Mix Profile EPI PAN

Tube. (Min: 0.4 mL)
0055170 Allergens, Dust/Mite Profile DUSTPRO 4

0055350 Allergens, Food, Cereal Profile CEREAL

Tube. (Min: 0.4 mL)
0050486 Allergens, Food, Common Adult Food FOOD ADULT

CPT Code(s): 86003 per allergen; 82785 IgE
2007215 Allergens, Food, Common Panel IgG G FOOD COM

Page | 63
0055100 Allergens, Food, Comprehensive Profile 1 FOOD PAN
2007213 Allergens, Food, Extended Panel IgG G FOOD PAN

2007036 Allergens, Food, Fish Profile IgE FISH GROUP

Specimen Required: Collect: Serum separator tube (SST). Multiple specimen tubes should be avoided.
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transport 0.8 mL serum to an ARUP Standard Transport
Tube. (Min: 0.5 mL)
Stability: After separation from cells: Ambient 2 days; Refrigerated: 2 weeks; Frozen: 1 year
CPT Code(s): 86003 x6 IgE-specific allergens
2007216 Allergens, Food, IgG Panel IGG FOOD

2007214 Allergens, Food, Meat Panel IgG IGG MEATS

0055345 Allergens, Food, Nut Mix Profile NUT MIX

Tube. (Min: 0.4 mL)
0051831 Allergens, Food, Nuts MIXEDNUTS

0055142 Allergens, Food, Profile 4 ALL PRO B

Page | 64
0055133 Allergens, Food, Profile 8 FOOD 8

0055104 Allergens, Food, Profile 9 FOOD PAN 9

0055174 Allergens, Food, Profile 10 FOODPRO 10

Tube. (Min: 0.6 mL)
0055301 Allergens, Food, Profile 13 FOOD 13

0055172 Allergens, Food, Profile 19 FOODPRO 19

0055340 Allergens, Food, Salad Profile SALAD

Tube. (Min: 0.4 mL)
0055335 Allergens, Food, Seafood Profile SEAFOOD

Page | 65
Tube. (Min: 0.4 mL)
0051835 Allergens, Food, Shell Fish Profile SHELLFISH

0055384 Allergens, Food, Southeast Profile GAFOODPROF

0055370 Allergens, Food, Southwest Basic Profile SWFOOD

0055330 Allergens, Food, Vegetable Profile VEG PRO

Tube. (Min: 0.4 mL)
0055218 Allergens, Food, West Kentucky Group WKTFOOD

Tube. (Min: 1 mL)
CPT Code(s): 86003 x10 IgE-specific allergens; 82785 IgE, Total Quantitative
2002124 Allergens, Foods, Common 10 COMMONFOOD

(Min: 0.8 mL)
0055130 Allergens, Grass Profile GRASS PAN

Page | 66
0055105 Allergens, Hymenoptera, Bee Venom Profile BEE PAN

Tube. (Min: 0.4 mL)
0055368 Allergens, Inhalant Multiallergen IgE, Qualitative INHALALL

Methodology: Qualitative ImmunoCAP® Fluorescent Enzyme Immunoassay
Unacceptable Conditions: Contaminated, heat-inactivated, or hemolyzed specimens.
Stability: After separation from cells: Ambient: 8 hours; Refrigerated: 48 hours; Frozen: 6 months
CPT Code(s): 83516
0055309 Allergens, Inhalants, California Environmental CA ENV PAN

Tube. (Min: 0.4 mL)
0055306 Allergens, Inhalants, California Pollen CA POL PAN

Tube. (Min: 0.6 mL)
0055312 Allergens, Inhalants, Comprehensive Profile AZ TOT PAN

CPT Code(s): 86003 per allergen; 82785 IgE, Total Quantitative
0055231 Allergens, Inhalants, Comprehensive Profile 2 REGRAST

0055305 Allergens, Inhalants, Environmental Profile 10 ENVIRO 10

Tube. (Min: 0.6 mL)
Page | 67
0055114 Allergens, Inhalants/Foods, Comprehensive Profile 1 COMP PAN

0055099 Allergens, Inhalants/Foods, Comprehensive Profile 2 COMP 29

0055307 Allergens, Inhalants/Foods, Environmental Profile FOOD ENV

0055131 Allergens, Inhalants/Foods, Pacific Northwest Profile PACIFIC NW

0055126 Allergens, Inhalants/Foods, Profile A ALL PRO A

0055240 Allergens, Inhalants/Foods, Southeast Profile SE PRO

0055129 Allergens, Inhalants/Foods, Western Allergy Profile WEST PAN

Page | 68
0050493 Allergens, Inhalants, Hawaii Perennial Panel PER PAN

CPT Code(s): 86003 per allergen tested
0051830 Allergens, Inhalants, Indoor INDOOR

(Min: 0.48 mL)
Stability: After separation from cells: Ambient 48 hours; Refrigerated: 2 weeks; Frozen: 1 year
0055138 Allergens, Inhalants, Midwest Comprehensive 1 MIDWEST

0055171 Allergens, Inhalants, Midwest Comprehensive 2 MWPRO 19

0055116 Allergens, Inhalants, Northeast Comprehensive NORTHEAST

Tube. (Min: 0.8 mL)
0055113 Allergens, Inhalants Panel 11 IgE INHALE 11

(Min: 1.00 mL)
Unacceptable Conditions: Hemolyzed, icteric or lipemic samples.
CPT Code(s): 86003 x10 IgE specific allergens; 82785 Total IgE
Page | 69
0055175 Allergens, Inhalants, Profile 13 IgE COMPPRO 13
0055178 Allergens, Inhalants, Profile 18 IgE COMPPRO 18

2002123 Allergens, Inhalants, Profile 28 IgE INHALE 28

(Min: 1.6 mL)
0055149 Allergens, Inhalants, Southeast Coastal Comprehensive SECOASTPAN

0055111 Allergens, Inhalants, Southern California Profile SO CAL PAN

Tube. (Min: 0.6 mL)
0055043 Allergens, Inhalants, Southwest Basic SW PRO

0055360 Allergens, Inhalants, Southwest Comprehensive 1 SWADULT

Tube. (Min: 1 mL)
Page | 70
0055367 Allergens, Inhalants, Southwest Comprehensive 2 SWINHALE
0055375 Allergens, Inhalants, Southwest Extended Profile SWEXT

0055230 Allergens, Inhalants, Southwest Valley Profile SW VALLEY

Tube. (Min: 0.6 mL)
0055395 Allergens, Isocyanate Panel ISOCYANPAN

0055245 Allergens, Latex/Cross-Reactive Food Panel LATEX FOOD

Tube. (Min: 1 mL)
CPT Code(s): 86003 per allergen tested; 82785 IgE
0055125 Allergens, Mold Profile MOLD PAN

Tube. (Min: 0.4 mL)
0055387 Allergens, Mold Profile, Southeast Comprehensive SEMOLDPRO

Tube. (Min: 0.6 mL)
Page | 71
0050529 Allergens, Pediatric Allergy, March (Progression) Profile PED MARCH
CPT Code(s): 86003 per allergen; 82785 IgE
0055300 Allergens, Pediatric Foods/Inhalants Profile PED PAN 2

0055121 Allergens, Pediatric Foods Profile 1 PED PAN

Tube. (Min: 0.4 mL)
0055365 Allergens, Pediatric Inhalants, Southwest SWPED

0050152 Allergens, Pediatric Profile IgE M PED PRO

(Min: 0.80 mL)
Unacceptable Conditions: Hemolyzed, icteric or lipemic samples.
2005717 Allergens, Respiratory Panel, Region 1, North Atlantic (CT, MA, NJ, PA, VT, ME, NH, NY, RI) REG1 PAN
Tube. (Min: 1.4 mL)
2006038 Allergens, Respiratory Panel, Region 10, Southwestern Grasslands (OK, TX) REG10 PAN
Tube. (Min: 1.5 mL)
CPT Code(s): 86003 x 29 IgE specific allergens; 82785 Total IgE
Page | 72
2006039 Allergens, Respiratory Panel, Region 11, Rocky Mountain (AZ, ID, NM, WY CO, MT, UT) REG11 PAN
Tube. (Min: 1.4 mL)
Remarks: Refrigerated.
2006040 Allergens, Respiratory Panel, Region 12, Arid Southwest (S. AZ, S.E. CA) REG12 PAN
Tube. (Min: 1.4 mL)
2006041 Allergens, Respiratory Panel, Region 13, Southern Coastal (CA) REG13 PAN
Tube. (Min: 1.4 mL)
2006042 Allergens, Respiratory Panel, Region 14, Central California (CA) REG14 PAN
Tube. (Min: 1.4 mL)
2006043 Allergens, Respiratory Panel, Region 15, Intermountain West (NV, S. ID) REG15 PAN
Tube. (Min: 1.4 mL)
2006044 Allergens, Respiratory Panel, Region 16, Inland Northwest (OR, Central and East WA) REG16 PAN
Tube. (Min: 1.3 mL)
2006045 Allergens, Respiratory Panel, Region 17, Pacific Northwest (NW CA, W. OR, WA) REG17 PAN
Tube. (Min: 1.4 mL)
CPT Code(s): 86003 x 27 IgE specific allergens; 82785 Total IgE
Page | 73
2006046 Allergens, Respiratory Panel, Region 18, Alaska REG18 PAN
Tube. (Min: 1.1 mL)
2006047 Allergens, Respiratory Panel, Region 19, Puerto Rico REG19 PAN
Tube. (Min: 1.5 mL)
2005718 Allergens, Respiratory Panel, Region 2, Mid-Atlantic (DE, MD, VA, DC, NC) REG2 PAN
Tube. (Min: 1.4 mL)
2006048 Allergens, Respiratory Panel, Region 20, Hawaii REG20 PAN

Tube. (Min: 1.4 mL)
2006025 Allergens, Respiratory Panel, Region 3, South Atlantic (GA, SC, N. FL) REG3 PAN
Tube. (Min: 1.4 mL)
2006026 Allergens, Respiratory Panel, Region 4, Subtropic Florida (S. of Orlando) REG4 PAN
Tube. (Min: 1.4 mL)
86003 x26 IgE specific allergens; 82785 Total IgE
2006031 Allergens, Respiratory Panel, Region 5, Ohio Valley (IN, OH, TN, WV, KY) REG5 PAN
Tube. (Min: 1.5 mL)
Page | 74
2006032 Allergens, Respiratory Panel, Region 6, South Central (AL, AR, LA, MS) REG6 PAN
Tube. (Min: 1.4 mL)
2006033 Allergens, Respiratory Panel, Region 7, Northern Midwest (MI, WI, MN) REG7 PAN
Tube. (Min: 1.4 mL)
2006034 Allergens, Respiratory Panel, Region 8, Central Midwest (IL, MO, IA) REG8 PAN
Patient Preparation: Multiple patient encounters should be avoided
Specimen Required: Collect: Serum separator tube (SST). Multiple specimen tubes should be avoided.
Tube. (Min: 1.4 mL)
2006037 Allergens, Respiratory Panel, Region 9, Great Plains (KS, NE, ND, SD) REG9 PAN
Tube. (Min: 1.4 mL)
0092584 Allergens, Staphylococcal aureus Panel STAPHPANII

Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 0.5 mL serum in an ARUP Standard Transport
Tube. (Min: 0.3 mL)
CPT Code(s): 86003 x2 Staph A, B; 82785 IgE
0055115 Allergens, Tree Profile TREE PAN

Page | 75
0055148 Allergens, Tree Profile 4 TREE PRO 4
Tube. (Min: 0.4 mL)
0055385 Allergens, Tree, Southeast Profile GATREEPRO

0051355 Allergens, Upper Respiratory Disease Profile, Region 9A R9A URD

Unacceptable Conditions: Hemolyzed, icteric or lipemic specimens
CPT Code(s): 86003 x15 IgE-specific allergens
0055110 Allergens, Weed Profile WEED PAN

0055112 Allergens, Weed Profile 5 WEED PAN 5

Tube. (Min: 0.4 mL)
0055379 Allergens, Weeds, Southeast Basic Profile GAWEEDPRO

Tube. (Min: 0.4 mL)
2004243 Allergic Bronchopulmonary Aspergillosis (ABPA) Panel ABPA

Methodology: Quantitative ImmunoCAP® Fluorescent Enzyme Immunoassay/Qualitative Immunodiffusion
Specimen Preparation: Separate serum from cells within 2 hours of collection. Transfer 2.3 mL serum to an ARUP Standard Transport Tube.
(Min: 0.5 mL)
Remarks: Multiple specimen tubes and multiple patient encounters should be avoided.
Unacceptable Conditions: Plasma. Hemolyzed, icteric or lipemic specimens.
CPT Code(s): 82785 Immunoglobulin E; 86003 Allergen specific IgE; 86606 x2 Aspergillus
Page | 76
0091204 Allopurinol, Serum or Plasma ALLOPUR SP
CPT Code(s): 80299
2003418 Alpha-1-Antichymotrypsin (A1ACT) by Immunohistochemistry A1 ACT IHC

CPT Code(s): 88342
0050001 Alpha-1-Antitrypsin A1A

Methodology: Quantitative Immunoturbidimetry
Specimen Required: Collect: Plasma separation tube or serum separator tube. Also acceptable: Lavender (EDTA) or pink (K2EDTA).
collection. Transfer 0.5 mL serum to an ARUP Standard Transport Tube. (Min: 0.2 mL)
Stability: After separation from cells: Ambient: 8 hours; Refrigerated: 5 days; Frozen: 3 months (avoid repeated freeze/thaw cycles)
CPT Code(s): 82103
2003424 Alpha-1-Antitrypsin (AAT) by Immunohistochemistry A1 AT IHC

CPT Code(s): 88342
0099991 Alpha-1-Antitrypsin, Feces A1A FECES

Methodology: Quantitative Radial Immunodiffusion
ARUP Connect™ or contact Client Services at (800) 522-2787. (Min: 1 g)
Remarks:
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 1 week
CPT Code(s): 82103
0080500 Alpha-1-Antitrypsin Phenotype (Includes Alpha-1-Antitrypsin) A1A PHENO

Methodology: Qualitative Isoelectric Focusing/Immunoturbidimetry
Stability: After separation from cells: Ambient: 8 hours; Refrigerated: 5 days; Frozen: 2 weeks (avoid repeated freeze/thaw cycles)
CPT Code(s): 82104 Alpha-1-antitrypsin, phenotype; 82103 Alpha-1-antitrypsin, total
0051256 Alpha-1-Antitrypsin (SERPINA1) Enzyme Concentration and 2 Mutations with Reflex to Alpha-1-Antitrypsin A1A GENO
Phenotype
Methodology: Immunoturbidimetry/Polymerase Chain Reaction/Fluorescence Monitoring/Isoelectric Focusing
Specimen Required: Collect: Serum separator tube AND lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B).
Specimen Preparation: Allow serum to clot completely at room temperature. Separate serum from cells ASAP or within 2 hours of collection.
Transport 0.5 mL serum AND 3 mL whole blood. (Min: 0.5 mL serum AND 0.5 mL whole blood)
Stability: Serum: Ambient: 8 hours; Refrigerated: 5 days; Frozen: 2 weeks
Whole Blood: Ambient: 72 hours; Refrigerated: 1 week; Frozen: Unacceptable
Page | 77
CPT Code(s): 82103 A1A; 83891 Isolation; 83898 x2 Amplification; 83896 x4 Nucleic acid probes; 83912 Interpretation and report. If reflexed, add 82104
Phenotype. Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders.
2003436 Alpha-1-Fetoprotein (AFP) by Immunohistochemistry AFP IHC

CPT Code(s): 88342
0050043 Alpha-1-Microglobulin, Urine A1M

Specimen Required: Collect: 24-hour urine. Specimen must be refrigerated during collection.
Specimen Preparation: Transfer a 4 mL aliquot from a well-mixed 24-hour collection to an ARUP Standard Transport Tube. (Min: 0.4 mL) Do not
add acid or other preservatives. Record total volume and collection time interval on transport tube and test request form.
Unacceptable Conditions: Frozen or preserved specimens.
Stability: Ambient: 8 hours; Refrigerated: 8 days; Frozen: Unacceptable
CPT Code(s): 83883
0098727 Alpha-2-Antiplasmin, Activity ALPHA 2A

Methodology: Chromogenic Assay
Specimen Required: Collect: Lt. blue (sodium citrate). Refer to Specimen Handling at aruplab.com for hemostasis/thrombosis specimen handling guidelines
Specimen Preparation: Transfer 1 mL platelet-poor plasma to an ARUP Standard Transport Tube. (Min: 1 mL)
Unacceptable Conditions: Serum. Non-frozen or hemolyzed specimens.
Stability: Ambient: 8 hours; Refrigerated: Unacceptable; Frozen: 1 month
CPT Code(s): 85410
0050005 Alpha-2-Macroglobulin A2M

Tube. (Min: 0.4 mL) Also acceptable: CSF or pleural fluid (centrifuge and separate to remove cellular material).
Stability: After separation from cells: Ambient: 8 hours; Refrigerated: 8 days; Frozen: 1 year (if frozen within 24 hours). Avoid repeated
freeze/thaw cycles. Ambient: 8 hour sample prep time.
CPT Code(s): 83883
0080427 Alpha Fetoprotein (Amniotic Fluid) with Reflex to Acetylcholinesterase and Fetal Hemoglobin AFP AF
Methodology: Chemiluminescent Immunoassay/Electrophoresis
Patient Preparation: Amniocentesis.
Specimen Required: Collect: Amniotic fluid.
Specimen Preparation: Transport 2.5 mL amniotic fluid. (Min: 1.5mL)
Remarks: Include gestational age at time of collection or estimated due date, physician name and phone number on the test request form.
Unacceptable Conditions: Specimens contaminated with fetal blood.
Stability: Ambient: 2 weeks; Refrigerated: 4 months; Frozen: 3 years
CPT Code(s): 82106 AFP; if reflexed, add 82013 Acetylcholinesterase and 83033 Fetal Hemoglobin
0020729 Alpha Fetoprotein, CSF (Tumor Marker) AFP CSF

Specimen Preparation: Transfer 0.5 mL CSF to an ARUP Standard Transport Tube. (Min: 0.2 mL)
Unacceptable Conditions: Any specimens other than CSF.
Stability: Ambient: 48 hours; Refrigerated: 1 week; Frozen: 1 year
CPT Code(s): 86316
0080428 Alpha Fetoprotein, Serum (Tumor Marker) AFP TM

Specimen Preparation: Allow specimen to clot completely at room temperature. Separate serum from cells within 4 hours of collection. Transfer 1
mL serum to an ARUP Standard Transport Tube. (Min: 0.2 mL)
Unacceptable Conditions: CSF (refer to Alpha Fetoprotein, CSF (Tumor Marker), ARUP test code 0020729) or plasma. Grossly hemolyzed
specimens.
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 1 week; Frozen: 1 year
CPT Code(s): 82105
Page | 78
0081208 Alpha Fetoprotein, Total and L3 Percent AFP L3
Methodology: Quantitative Liquid Chromatography/Immunoassay
Specimen Preparation: 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: 0.5 mL)
Unacceptable Conditions: Plasma.
CPT Code(s): 82107
2003204 Alpha Galactosidase, Serum A GALACTO

Methodology: Fluorometry
Specimen Preparation: Separate from cells. Transfer 2 mL serum to an ARUP Standard Transport Tube. (Min: 0.2 mL)
Unacceptable Conditions: Room temperature or refrigerated specimens.
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 2 weeks
CPT Code(s): 82657
2001582 Alpha Globin (HBA1 and HBA2) Sequencing AG FGS

Methodology: Polymerase Chain Reaction/Sequencing
Specimen Required: Collect: Contact ARUP's genetic counselor at (800) 242-2787 extension 2141 prior to test submission.
CPT Code(s): 83891 Isolation; 83898 x2 Amplification; 83904 x6 Sequencing; 83909 capillary electrophoresis; 83912 Interpretation and report - Additional
CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders.
2006289 Alpha Subunit of Pituitary Glycoprotein Hormones (Alpha-PGH) A SUBUNIT

Storage/Transport Temperature: Frozen. Also acceptable: Refrigerated.
Unacceptable Conditions: Grossly hemolyzed specimens.
Stability: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 3 months
CPT Code(s): 83520
2003419 Alpha-Synuclein by Immunohistochemistry ASYN IHC

CPT Code(s): 88342
0051495 Alpha Thalassemia (HBA1 & HBA2) 7 Deletions ALPHA THAL

Methodology: Polymerase Chain Reaction/Gel Electrophoresis
CPT Code(s): 83891 Isolation; 83900 Amplification multiplex; 83901 x8 Additional amplification; 83894 Gel separation; 83912 Interpretation and report -
Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders.
0050002 Alpha-1-Acid Glycoprotein A1A GLYCO

Specimen Preparation: Separate serum or plasma from cells ASAP or within 2 hours of collection. Transfer 1 mL serum or plasma to an ARUP
Standard Transport Tube. (Min: 0.5 mL)
Stability: After separation from cells: Ambient: 8 hours; Refrigerated: 8 days; Frozen: 1 year
CPT Code(s): 82985
Page | 79
0051710 Alport Syndrome, X-Linked (COL4A5) 3 Mutations ALPORT DNA
CPT Code(s): 83891 Isolation; 83898 Amplification; 83900 Multiplex amplification; 83896 x 6 Nucleic acid probe; 83912 Interpretation and report - Additional
2002394 Alport Syndrome, X-linked (COL4A5) Deletion/Duplication ALPORT DD

Methodology: Polymerase Chain Reaction/Multiplex Ligation-dependent Probe Amplification
CPT Code(s): 83891 Isolation; 83896 x2 Nucleic acid probes; 83898 x2 Amplification; 83914 x2 Extension; 83909 x2
Capillary electrophoresis; 83912 Interpretation and report - Additional CPT code modifiers may be required for procedures performed to test for
oncologic or inherited disorders.
0051786 Alport Syndrome, X-linked (COL4A5) Sequencing ALPORT FGS

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA) or yellow (ACD Solution A or B).
CPT Code(s): 83891 Isolation; 83898 x46 Amplification; 83904 x46 Sequencing; 83909 x2 capillary electrophoresis; 83912 Interpretation and report. -
2002398 Alport Syndrome, X-linked (COL4A5) Sequencing and Deletion/Duplication ALPORT FGA
Methodology: Polymerase Chain Reaction/ Sequencing/Multiplex Ligation-dependent Probe Amplification
Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or yellow (ACD solution A or B).
CPT Code(s): Sequencing: 83891 Isolation; 83898 x46 Amplification; 83904 x46 Sequencing; 83909 x2 capillary electrophoresis.
Del/Dup: 83896 x2 Nucleic Acid Probes; 83898 x2 Amplification; 83914 x2 Extension; 83909 x2 Capillary Electrophoresis; 83912 Interpretation
and report - Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders.
0090010 Alprazolam ALPR

Methodology: Quantitative Liquid Chromatography-Tandem Mass Spectrometry
Specimen Required: Collect: Plain red. Also acceptable: Lavender (K2 or K3EDTA) or pink (K2EDTA).
Specimen Preparation: Separate serum or plasma from cells within 2 hours of collection. Transfer 1 mL serum or plasma to an ARUP Standard
Unacceptable Conditions: Whole blood. Gel separator tubes, light blue (citrate), or yellow (SPS or ACD solution).
CPT Code(s): 80154
0099266 Aluminum, Serum AL S

Methodology: Quantitative Inductively Coupled Plasma-Mass Spectrometry
Patient Preparation: Diet, medication, and nutritional supplements may introduce interfering substances. Patient should be encouraged to
discontinue nutritional supplements, vitamins, minerals, and non-essential over-the-counter medications (upon the advice of their physician).
Specimen Required: Collect: Royal blue (no additives) or Royal blue (EDTA)
Specimen Preparation: Centrifuge; do not allow serum or plasma to remain on cells. Transfer 2 mL serum or plasma to an ARUP Trace Element-
Free Transport Tube (ARUP supply #43116). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800)
522-2787. (Min: 0.5 mL)
Unacceptable Conditions: Separator tubes. Specimens that are not separated from the red cells or clot within 6 hours.
Stability: If the specimen is drawn and stored in the appropriate container, the trace element values do not change with time.
CPT Code(s): 82108
0099408 Aluminum, Urine AL U

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 Required: 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.
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) Record
total volume and collection time interval on transport tube and on test request form.
Unacceptable Conditions: Urine collected within 48 hours after administration of a gadolinium (Gd) containing contrast media (may occur with
MRI studies). Acid preserved urine.
Stability: Ambient: 1 week; Refrigerated: 2 weeks; Frozen: 1 year
CPT Code(s): 82108
Page | 80
0091195 Amantadine (Symmetrel®), Serum or Plasma AMANTADIN
Methodology: Gas Chromatography
Specimen Required: Collect: Plain red, gray (sodium fluoride/potassium oxalate), green (sodium heparin), lavender (EDTA), or pink (K2EDTA).
Stability: Ambient: 1 week; Refrigerated: 2 weeks; Frozen: 5 months
CPT Code(s): 80299
0091162 Amantadine (Symmetrel®), Urine AMANTAD U

CPT Code(s): 80299
0090295 Amikacin, Peak Level AMIKP

Methodology: Immunoassay
Patient Preparation: Draw 30 minutes following completion of drug infusion.
Specimen Required: Collect: Plain red. Also acceptable: Green (sodium heparin).
Specimen Preparation: Separate serum or plasma from cells within one hour of collection. Transfer 1 mL serum or plasma to an ARUP Standard
Storage/Transport Temperature: Refrigerated. If transport is prolonged: Frozen.
Unacceptable Conditions: Specimens collected in citrate or oxalate/fluoride. Specimens exposed to repeated freeze/thaw cycles.
Stability: After separation from cells: Ambient: 4 hours; Refrigerated: 1 week; Frozen: 2 weeks
CPT Code(s): 80150
0090015 Amikacin, Random Level AMIK

Stability: After separation from cells: Ambient: 4 hours; Refrigerated: 1 week; Frozen: 14 days
CPT Code(s): 80150
0090300 Amikacin, Trough Level AMIKT

Patient Preparation: Draw 5-90 minutes before next infusion.
CPT Code(s): 80150
0080137 Amino Acids Quantitative, CSF CSFAA QNT

Methodology: Ion Exchange Chromatography
Specimen Preparation: Centrifuge CSF to separate and remove cellular material. Freeze supernatant. Transport 0.5 mL CSF. (Min: 0.3 mL)
Stability: Ambient: Unacceptable; Refrigerated: 24 hours; Frozen: 1 month
CPT Code(s): 82139
0080710 Amino Acids Quantitative, Plasma AA QNT

Patient Preparation: Adults: Fasting specimen preferred.
Infants and children: Draw specimen prior to feeding or 2-3 hours after a meal.
Specimen Required: Collect: Green (sodium or lithium heparin).
Specimen Preparation: Separate plasma from cells ASAP or within 2 hours of collection. Avoid transferring buffy coat material. Transfer 0.5 mL
plasma to an ARUP Standard Transport Tube and freeze immediately. (Min: 0.25 mL)
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 24 hours; Frozen: 1 month
CPT Code(s): 82139
0080044 Amino Acids Quantitative, Urine UAA QNT

Page | 81
Patient Preparation: First morning urine preferred.
Specimen Required: Collect: Random urine. Avoid dilute urine when possible.
Specimen Preparation: Mix urine well. Transfer 8 mL aliquot of urine to ARUP Standard Transport Tubes and freeze immediately. (Min: 3 mL)
therapy), drug therapy, and family history. Biochemical Genetics Patient History Form is available on the ARUP Website or by contacting
ARUP Client Services.
CPT Code(s): 82139
0091284 Aminocaproic Acid, Serum or Plasma AMINOCAPR

Stability: Ambient: 1 week; Refrigerated: 2 weeks; Frozen: 1 month
CPT Code(s): 80299
0091375 Aminocaproic Acid, Urine AMINOC UR

CPT Code(s): 82491
0080103 Aminolevulinic Acid (ALA), Urine ALA U

Methodology: Quantitative Ion Exchange Chromatography/Spectrophotometry
Patient Preparation: Refrain from alcohol consumption 24 hours prior to collection.
Specimen Required: Collect: 24 hour or random urine. Refrigerate 24-hour specimens during collection.
Specimen Preparation: Protect from light. Transfer a 4 mL aliquot from a well-mixed 24 hour or random collection to an ARUP Amber Transport
Tube. (Min: 1.2 mL) Record total volume and collection time interval on transport tube and test request form.
Unacceptable Conditions: Body fluids other than urine.
Stability: Ambient: Unacceptable; Refrigerated: 4 days; Frozen: 1 month
CPT Code(s): 82135
0090161 Amiodarone and Metabolite AMIOD

Specimen Preparation: Separate serum or plasma from cells within 2 hours of collection. Transfer 1 mL serum or plasma to an ARUP Amber
Stability: After separation from cells: Ambient: 1 month; Refrigerated: 6 weeks; Frozen: 6 weeks
0090158 Amitriptyline and Nortriptyline AMIT/NORT

Stability: After separation from cells: Ambient: 5 days; Refrigerated: 2 weeks; Frozen: 6 months
CPT Code(s): 80152 Amitriptyline; 80182 Nortriptyline
0020043 Ammonia, Plasma AMMON

Methodology: Colorimetry
Specimen Required: Collect: Green (sodium or lithium heparin). Collect on ice.
Specimen Preparation: Separate plasma from cells and freeze within 15 minutes of draw time. Specimens need to be spun in a refrigerated
centrifuge. Transfer 2 mL plasma to an ARUP Standard Transport Tube. (Min: 0.25 mL)
Unacceptable Conditions: Serum or blood. Non-frozen specimens. Specimens containing oxalate or citrate
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 2 hours; Frozen: 3 weeks (do not thaw)
CPT Code(s): 82140
0080276 Amniotic Bilirubin Scan AMBIL

Patient Preparation: Amniocentesis.
Specimen Preparation: Protect from light during collection, storage, and shipment. Transfer 3 mL amniotic fluid to an ARUP Amber Transport
Tube. (Min: 2 mL)
Unacceptable Conditions: Specimens not protected from light.
Stability: If specimen is protected from light: Ambient: 48 hours; Refrigerated: 1 week; Frozen: 1 year
CPT Code(s): 82143
Page | 82
0090978 Amobarbital, Serum or Plasma AMOBARB SP
Methodology: Gas Chromatography/Mass Spectrometry
Specimen Preparation: Transfer 2 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 1 mL)
CPT Code(s): 82205
0091500 Amobarbital, Urine AMOBARB U

CPT Code(s): 82205
0060250 Amoeba Calcofluor Stain ACANTSTAIN

Methodology: Qualitative Calcofluor Stain/Microscopy
Specimen Required: Collect: Corneal scrapings or vitreous fluid.
Specimen Preparation: Place corneal scrapings or vitreous fluid in 2 ml of Page's amoeba saline (ARUP supply #31917). Available online through
eSupply using ARUP Connect™ or contact Client Services at (800) 522-2787.
Unacceptable Conditions: Specimens in media or preservatives. Dry specimens.
CPT Code(s): 87206
0091236 Amoxapine and Metabolite Quantitation, Serum or Plasma AMOXAPINE

Methodology: Quantitative High Performance Liquid Chromatography
Specimen Preparation: Separate from cells within 2 hours. Transfer 2 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.7 mL)
CPT Code(s): 80299
0091237 Amoxapine and Metabolite Quantitation, Urine AMOXAPIN U

Specimen Preparation: Transfer 2 mL urine to an ARUP Standard Transport Tube. (Min: 1 mL)
CPT Code(s): 80299
0020506 Amylase, Body Fluid AMY-FL

Specimen Required: Collect: Body fluid. Also acceptable: Fluid collected in plain red or green (sodium or lithium heparin).
Specimen Preparation: Centrifuge to remove cellular material. Transfer 1 mL body fluid to an ARUP Standard Transport Tube. (Min: 0.2 mL)
Remarks: Indicate source on test request form.
Unacceptable Conditions: Breast milk and salivary fluid. Specimens too viscous to be aspirated by instrument.
Stability: After separation from cellular material: Ambient: 1 week; Refrigerated: 1 month; Frozen: 1 month
CPT Code(s): 82150
0020804 Amylase, Isoenzymes AMYISO

Specimen Required: Collect: Serum separator tube or plasma separator tube. Also acceptable: Lavender (EDTA) or green (sodium or lithium heparin).
Unacceptable Conditions: Body Fluids (refer to Amylase, Body Fluid, ARUP test code 0020506). Hemolyzed specimens.
Stability: After separation from cells: Ambient: 1 week; Refrigerated: 1 month; Frozen: 1 month
CPT Code(s): 82150 Amylase, total; 82150 Amylase, pancreatic
0020013 Amylase, Serum or Plasma AMY

Unacceptable Conditions: Body Fluid (refer to Amylase, Body Fluid, ARUP test code 0020506). Urine (refer to Amylase, Urine, ARUP test code
0020471). Specimens containing calcium chelating anticoagulants such as oxalates, citrates, or EDTA.
CPT Code(s): 82150
Page | 83
0020471 Amylase, Urine UAMY
Methodology: Enzymatic
Specimen Required: Collect: 24-hour or timed urine collection with no preservatives. Refrigerate during collection.
Specimen Preparation: Mix timed urine collection well. Transfer 4 mL urine to an ARUP Standard Transport Tube. (Min: 0.5 mL) Record total
volume and collection time interval on transport tube and test request form.
Unacceptable Conditions: Specimens containing acetic acid, concentrated HCl, nitric acid or sodium carbonate.
Stability: Ambient: 2 days; Refrigerated: 10 days; Frozen: 3 weeks
CPT Code(s): 82150
0089110 Anabolic Steroids Panel ANAB

Methodology: Qualitative Gas Chromatography/Mass Spectrometry
Specimen Preparation: Transport 40 mL urine. (Min: 12 mL)
Stability: Ambient: 1 week; Refrigerated: 1 month; Frozen: Indefinitely
CPT Code(s): 80100
0060143 Anaerobe Culture and Gram Stain MC ANA

Methodology: Stain/Culture/Identification
Specimen Required: Collect: Contact the laboratory prior to collection of the specimen if consultation on collection containers or transport is needed. Aspirate, body
fluids, tissues, or material collected from areas without normal anaerobic flora.
Specimen Preparation: Place specimen immediately into anaerobe transport media (ARUP supply #16426). Available online through eSupply
using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.
Remarks: Specimen source required. Indicate if Actinomyces is suspected.
Unacceptable Conditions: Specimen from site with normal anaerobic flora. Aerobic conditions.
Stability: Ambient: 48 hour; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 87075 Culture; identification and susceptibility CPT codes may vary based on method.
0060164 Anaerobic Organism Identification MC ANAID

Identification methods may include macrobroth dilution or microbroth dilution.
Specimen Required: Collect: Actively growing organism in pure culture.
Specimen Preparation: Transport sealed container with pure culture on agar slant in anaerobic transport pouch or on a swab in anaerobic transport
media. Place each specimen in an individually sealed bag.
CPT Code(s): 87076 and/or 87153; CPT codes for identification vary based upon method.
0060198 Anaerobic Organism Identification with Reflex to Susceptibility MC ANAIS

Identification methods may include macrobroth dilution or microbroth dilution.
Specimen Required: Collect: Actively growing organism, in pure culture
CPT Code(s): 87076 and/or 87153; CPT codes for identification and susceptibility tests vary based upon method.
0097303 Anaplasma phagocytophilum (HGA) Antibodies, IgG & IgM HGE G/M
Methodology: Semi-Quantitative Indirect Fluorescent Antibody
Unacceptable Conditions: Bacterially contaminated, heat-inactivated, hemolyzed, icteric, lipemic, or turbid specimens.
0097317 Anaplasma phagocytophilum (HGA) Antibody, IgG HGE IGG

Unacceptable Conditions: Bacterially contaminated, heat inactivated, hemolyzed, icteric, lipemic, or turbid specimens.
CPT Code(s): 86666
0097318 Anaplasma phagocytophilum (HGA) Antibody, IgM HGE IGM

Page | 84
Unacceptable Conditions: Bacterially contaminated, heat inactivated, hemolyzed, icteric, lipemic, or turbid specimens.
CPT Code(s): 86666
2003439 Anaplastic Lymphoma Kinase 1 (ALK-1) by Immunohistochemistry ALK1 IHC

CPT Code(s): 88342
2006480 ANCA-Associated Vasculitis Profile (ANCA/MPO/PR-3) with Reflex to ANCA Titer ANCA PRO
Methodology: Semi-Quantitative Indirect Fluorescent Antibody/Semi-Quantitative Multiplex Bead Assay
Tube. (Min: 0.5 mL)
Unacceptable Conditions: CSF, plasma, urine, or other body fluids. Contaminated, hemolyzed, or severely lipemic specimens.
CPT Code(s): 83516 MPO; 83516 PR-3; 86255 ANCA; if reflexed, add 86256 ANCA titer
2005419 Androstanediol Glucuronide Quantitative ANDRO GLUC

Methodology: Quantitative Radioimmunoassay/Chromatography
Specimen Preparation: Separate serum from cells within 1 hour. Transfer 2 mL serum to an ARUP Standard Transport Tube and freeze
immediately. (Min: 0.7 mL)
CPT Code(s): 82154
2001638 Androstenedione ANDRO TMS

Patient Preparation: Specimen should be collected between 6-10 a.m.
Specimen Preparation: Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.3 mL) Also acceptable: EDTA plasma.
Stability: After separation from cells: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 6 months
CPT Code(s): 82157
0040208 Aneuploidy Panel by FISH FISHANEU

Specimen Required: Collect: Green (sodium heparin).
Specimen Preparation: Do not freeze or expose to extreme temperatures. Transport 5 mL whole blood. (Min: 1 mL) Specimen and completed
test request form, including clinical indication, must be received within 48 hours of collection.
Remarks: This test must be ordered using Cytogenetic test request form #43097 or through your ARUP interface. Submit the Patient History for
Cytogenetic (Chromosome) Studies with the electronic packing list (available at http://www.aruplab.com/genetics/forms.php).
Unacceptable Conditions: Frozen specimens. Clotted specimens.
CPT Code(s): 88271 x5 DNA probe; 88275 x5 Interphase in situ hybridization 100-300 each; 88291 Interpretation and report - Additional CPT code modifiers
may be required for procedures performed to test for oncologic or inherited disorders.
2005077 Angelman Syndrome and Prader-Willi Syndrome by Methylation AS PWS

Methodology: Methylation Sensitive Polymerase Chain Reaction/Fluorescence Monitoring
CPT Code(s): 83891 Isolation; 83898 Amplification; 83912 Interpretation and report - Additional CPT code modifiers may be required for procedures
performed to test for oncologic or inherited disorders.
2005564 Angelman Syndrome (UBE3A) Sequencing UBE3A FGS

CPT Code(s): Sequencing: 83891 Isolation; 83898 x16 Amplification; 83904 x16 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report -
Page | 85
0098771 Angiotensin II ANGIO II
Specimen Preparation: Separate plasma from cells ASAP or within 2 hours of collection. Keep cold during centrifugation. Transfer 1 mL plasma
to an ARUP Standard Transport Tube. (Min: 0.3 mL)
Unacceptable Conditions: Received room temperature or refrigerated. Hemolyzed specimens.
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 1 month
CPT Code(s): 82163
0098974 Angiotensin Converting Enzyme, CSF ACE CSF

Specimen Preparation: Transfer 1 mL CSF to an ARUP Standard Transport Tube. (Min: 0.3 mL)
Unacceptable Conditions: Hemolyzed or xanthochromic specimens.
Stability: Ambient: 4 hours; Refrigerated: 1 week; Frozen: 6 months
CPT Code(s): 82164
0080001 Angiotensin Converting Enzyme, Serum ACE

Unacceptable Conditions: EDTA or heparin plasma. CSF (refer to Angiotensin Converting Enzyme, CSF test code 0098974)
CPT Code(s): 82164
0081335 1,5 Anhydroglucitol (GlycoMark®) GLYCO MARK

Specimen Required: Collect: Serum separator tube or lavender (EDTA).
Stability: After separation from cells: Ambient: 1 week; Refrigerated: 1 week; Frozen: 1 month
CPT Code(s): 84378
0050392 Ankylosing Spondylitis (HLA-B27) Genotyping HLAB27 PCR

CPT Code(s): 83891 Isolation; 83898 Amplification; 83912 Interpretation and report. Additional CPT code modifiers may be required for procedures performed
to test for oncologic or inherited disorders.
2003463 Anti-Human Epithelial Antigen, Ber-EP4 by Immunohistochemistry BEREP4 IHC

CPT Code(s): 88342
2003126 Anti-IgA Antibody ANTI IGA

Specimen Preparation: Transfer 1 mL serum to an ARUP standard Transport Tube. (Min: 0.5 mL)
Unacceptable Conditions:
CPT Code(s): 83520
Page | 86
2002656 Anti-Mullerian Hormone AMH
Specimen Preparation: Transport 0.5 mL serum. (Min: 0.2 mL)
Storage/Transport Temperature: Critical Frozen.
Unacceptable Conditions: Room temperature specimens. Hemolyzed or lipemic specimens.
Stability: Ambient: Unacceptable; Refrigerated: 48 hours; Frozen: 30 days (avoid repeated freeze/thaw cycles)
CPT Code(s): 83520
0050811 Anti-Neutrophil Cytoplasmic Antibody, IgG ANCA IFA

Unacceptable Conditions: Plasma, urine, or other body fluids. Contaminated, hemolyzed, or severely lipemic specimens.
CPT Code(s): 86255 ANCA; if positive, add 86256 ANCA titer
0050080 Anti-Nuclear Antibodies (ANA), IgG by ELISA with Reflex to ANA, IgG by IFA ANA
Methodology: Qualitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody
Tube. (Min: 0.3 mL)
Unacceptable Conditions: Plasma or urine. Contaminated, grossly hemolyzed, heat-inactivated, severely lipemic specimens or inclusion of fibrin
clots.
CPT Code(s): 86038 ANA; if reflexed, add 86039 ANA titer
0060845 Antibiotic Level, Aztreonam ML AZTREO

Methodology: Quantitative Bioassay
Specimen Preparation: Aseptically remove 2 mL serum to a sterile tube (ARUP supply #43115) and freeze. Available online through eSupply
using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 1 mL).
Remarks: Required information includes: time and date of collection, time of last dose, and list of all antibiotics that the patient is receiving or has
received in the past 48 hours.
CPT Code(s): 80299
2004886 Antibiotic Level, Ceftazidime ML CEFTAZ

Methodology: Bioassay
using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 1 mL)
Stability: Ambient: 2 hours; Refrigerated: 24 hours (local clients only); Frozen: 1 week
CPT Code(s): 80299
0060844 Antibiotic Level, Meropenem ML MERO

Storage/Transport Temperature: Frozen
CPT Code(s): 80299
0060843 Antibiotic Level, Nafcillin ML NAF

CPT Code(s): 80299
Page | 87
0060842 Antibiotic Level, Piperacillin ML PIP
CPT Code(s): 80299
0060841 Antibiotic Level, Ticarcillin ML TICAR

CPT Code(s): 80299
0010004 Antibody Detection, RBC IRL-ABSC

Specimen Preparation: Do not freeze.
Transport 10 mL whole blood (plain red) (Min: 7 mL). AND 5 mL whole blood (EDTA) (Min: 3 mL).
Pediatric: Transport 1 mL whole blood (plain red). AND 0.5 mL whole blood (EDTA).
Remarks:
CPT Code(s): 86850
0013003 Antibody ID Package (IRL) IRL-AB PKG

Specimen Preparation: Do not freeze. Transport 10 mL whole blood (plain red) AND 10 mL whole blood (EDTA). (Min: 7 mL plain red AND 5
mL EDTA).
Storage/Transport Temperature: Refrigerated. Deliver to lab immediately.
Remarks:
CPT Code(s): 86900 ABO; 86901 Rh; 86906 Rh Phen; 86880 DC; 86870 x3 ABID
0013005 Antibody Identification, RBC (Prenatal Only) IRL-ABID

Specimen Required: Collect: Plain red AND lavender (EDTA), pink (K2EDTA) or yellow (ACD solution).
Specimen Preparation: Do not freeze. Transport 10 mL whole blood (plain red) (Min: 7 mL). AND 5 mL whole blood (EDTA) (Min: 3 mL) Also
acceptable: Plasma, serum, or clot.
Remarks:
CPT Code(s): 86900 ABO; 86901 Rh; 86880 DC; 86870 ABID; 86906 Rh Phenotyping
0010020 Antibody Screen RBC with Reflex to Identification ABSC-R

Methodology: Solid Phase
Remarks:
Unacceptable Conditions: Plasma Separator Tubes.
CPT Code(s): 86850 Ab Screen; if reflexed as part of Prenatal Reflexive Panel (0095044): add 86870 Ab Identification; 86880 Direct Coombs; and 86906 Rh
Phenotype
Page | 88
0013006 Antibody Titer IRL-ABTR1
Remarks:
CPT Code(s): 86886
0090601 Antidepressant Panel Quantitation, Serum or Plasma ANTIDEP

Methodology: Quantitative Gas Chromatography/Gas Chromatography-Mass Spectrometry
Stability: Ambient: 1 week; Refrigerated: 2 weeks; Frozen: 2 weeks
CPT Code(s): 82542
0096048 Antidepressant Panel Quantitation, Urine ANTIDEP U

Methodology: Quantitative Gas Chromatography/Gas Chromatography-Mass Spectrometry
Storage/Transport Temperature: 2 mL urine at 2-8°C. (Min: 0.7 mL) Submit specimen in an ARUP Standard Transport Tube.
Stability: Ambient: 1 week; Refrigerated: 11 days; Frozen: 2 weeks
CPT Code(s): 82542
0060846 Antifungal Level, 5-Fluorocytosine (5-FC) ML 5-FLUOR

CPT Code(s): 80299
0013298 Antigen Testing, AHG - Specify Individual RBC Antigen IRL-AG/AHG

Specimen Required: Collect: Plain red. Also acceptable: Lavender (EDTA) or pink (K2EDTA).
Pediatric: Transport 0.5 mL whole blood.
Remarks:
CPT Code(s): 86905 each antigen
0013297 Antigen Testing, Direct - Specify Individual RBC Antigen IRL-AG/DIR

Transport 7 mL whole blood.
Remarks:
CPT Code(s): 86905 each antigen
0013020 Antigen Testing, RBC Phenotype Extended IRL-EXPHEN

Transport 7 mL whole blood (plain red) OR 5 mL whole blood (EDTA).
Remarks:
CPT Code(s): 86905 x7. Other antigen: add 86905 for each additional antigen not listed above
0013019 Antigen Testing, Rh Phenotype IRL-RHPHEN

Specimen Preparation: Do not freeze. Transport 7 mL whole blood (plain red) OR 5 mL whole blood (EDTA).
Page | 89
Remarks:
Unacceptable Conditions: Serum or plasma separator tubes.
CPT Code(s): 86906
0092103 Antimicrobial Level - Amphotericin B by HPLC AMPHO B

Specimen Preparation: Protect from light. Transfer 2 mL serum to an ARUP Amber Transport Tube. (Min: 0.5 mL)
Unacceptable Conditions: Thawed specimens. Specimens not protected from light. Serum separator tubes.
CPT Code(s): 80299
0099972 Antimicrobial Level - Capreomycin (Serum) by HPLC CAPREOMY

Patient Preparation: Draw two hours post does and just prior to next dose.
Specimen Preparation: Freeze at -70°C ASAP. Transport 2 mL serum on dry ice. (Min: 1 mL)
Remarks: Drugs which may interfere with this assay include: Sulindac. List all other antimicrobials being used to treat the patient.
CPT Code(s): 80299
0093142 Antimicrobial Level - Doxycycline (Serum), BA DOXY

Remarks: List all other antimicrobials being used to treat the patient.
Unacceptable Conditions: Thawed specimens. Separator tubes.
CPT Code(s): 80299
0099428 Antimicrobial Level - Isoniazid (Serum) by HPLC ISONIAZID

Specimen Preparation: Transport 2 mL serum. (Min: 1 mL)
Remarks: Include draw time on request form. Drugs which may interfere with this assay include: Iproniazid. List all other antimicrobials being
used to treat the patient.
Unacceptable Conditions: Separator tubes. Refrigerated or room temperature specimens.
CPT Code(s): 80299
0099438 Antimicrobial Level - Rifampin (Serum), HPLC RIFAMPIN

Methodology: Semi-Quantitative High Performance Liquid Chromatography
Specimen Preparation: Protect from light. Transport 2 mL serum. (Min: 1 mL)
Unacceptable Conditions: Serum separator tubes. Room temperature or refrigerated specimens.
CPT Code(s): 80299
0092065 Antimicrobial Level - Streptomycin, HPLC STP MYCIN

Specimen Preparation: Transfer 1 mL serum to an ARUP Standard Transport Tube (Min: 0.5 mL)
Remarks: List all other antimicrobials being used to treat the patient.
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: Indefinitely
CPT Code(s): 80299
0060217 Antimicrobial Susceptibility - AFB/Mycobacteria MA AFB

Methodology: Macrobroth Dilution/Microbroth Dilution
Specimen Required: Collect: Actively growing isolate in pure culture.
Specimen Preparation: Transfer viable organism to sealed container.
Unacceptable Conditions: Mixed cultures or non-viable organisms. Organisms submitted on an agar plate.
0060347 Antimicrobial Susceptibility - AFB/Mycobacterium tuberculosis Primary Panel MA MTBPRIM

Methodology: Broth Macrodilution
Page | 90
Specimen Required: Collect: Actively growing isolate of Mycobacterium tuberculosis in pure culture.
Specimen Preparation: Transport sealed container with pure culture on solid or liquid media. Place each specimen in an individually sealed bag.
Unacceptable Conditions: Mixed cultures or non-viable organisms. Organisms submitted on agar plate.
Stability: Ambient: 2 weeks; Refrigerated: 2 weeks; Frozen: Unacceptable
0060202 Antimicrobial Susceptibility - Anaerobe MA ANA

Methodology: Broth Microdilution
Specimen Required: Collect: Actively growing organism in pure culture.
Unacceptable Conditions: Aerobic conditions. Mixed cultures or non-viable organisms.
CPT Code(s): 87186
0060204 Antimicrobial Susceptibility - Bactericidal Assay MA BCT

Specimen Required: Collect: Actively growing isolate in pure culture AND serum or body fluid. Collect using aseptic technique.
Specimen Preparation: Organism: Transport sealed container with pure culture on agar slant or in bacterial transport media. Place each specimen
in an individually sealed bag.
AND Serum or Body Fluid: Transfer 2 mL serum or body fluid to a sterile container and freeze. (Min: 1 mL)
Storage/Transport Temperature: Organism: Room temperature.
Serum or Body Fluid: Frozen.
Remarks: A list of all antibiotics that the patient is receiving or has received in the past 48 hours must be provided (this information is essential for
performing this assay; missing information may cause delays in turnaround time).
Stability: Organism: Ambient: 1 week; Refrigerated: Unacceptable; Frozen: Unacceptable
Serum or Body Fluid: Ambient: 2 hours; Refrigerated: 24 hours; Frozen: 1 week
CPT Code(s): 87197
2001503 Antimicrobial Susceptibility - Carbapenem Resistance MA KPC

Methodology: Disk Diffusion
Specimen Required: Collect: Actively growing Enterobacteriaceae species in pure culture.
Specimen Preparation: Transport sealed container with pure culture on agar slant or in bacterial transport media. Place each specimen in an
Remarks: Isolate identification required.
Stability: Ambient: 1 week; Refrigerated: 48 hours; Frozen: Unacceptable
CPT Code(s): 87184
0060059 Antimicrobial Susceptibility - D-Test (Macrolide, Lincosamide, Streptogramin Resistance) MA DTEST

Specimen Required: Collect: Actively growing Staphylococcus species or beta-hemolytic Streptococcus species in pure culture.
CPT Code(s): 87184
0060706 Antimicrobial Susceptibility - Enterobacteriaceae MA ENTER

Methodology: Automated Broth Microdilution
Remarks: Isolate identification and specimen source required.
CPT Code(s): 87186
0060708 Antimicrobial Susceptibility - Enterococcus MA ENTERO

CPT Code(s): 87186
Page | 91
0063999 Antimicrobial Susceptibility - Extended Spectrum Beta Lactamase MA ESBL
Specimen Required: Collect: Actively growing E. coli, Klebsiella species, or Proteus mirabilis in pure culture.
Remarks: Isolate identification and specimen source required. Proteus mirabilis is tested only when isolated from a significant source (e.g.,
blood).
CPT Code(s): 87184
0060345 Antimicrobial Susceptibility - Fastidious Organism MA FAST

CPT Code(s): 87186
0060346 Antimicrobial Susceptibility - Gram Positive Rod MA GPR

CPT Code(s): 87186
0060211 Antimicrobial Susceptibility - mecA Gene by PCR MA MEC

Methodology: Qualitative Polymerase Chain Reaction
Specimen Required: Collect: Actively growing Staphylococcus aureus or coagulase-negative Staphylococcus, in pure culture.
CPT Code(s): 87641
0060201 Antimicrobial Susceptibility - MIC, Individual MA MIC

Methodology: Gradient Diffusion/Broth Microdilution
Specimen Preparation: Transport sealed container with pure culture on agar slant or in bacterial transport media. Place each specimen in
Remarks: Isolate identification and specimen source required. Individual antibiotics must be specified.
CPT Code(s): 87181 Gradient dilution or 87186 Broth dilution
0060203 Antimicrobial Susceptibility - MIC/MBC MA MBC

Specimen Preparation: Transport sealed container with pure culture on agar slant or in bacterial transport media. Place each specimen in
Remarks: Isolate identification and specimen source required. Individual antibiotics must be specified.
CPT Code(s): 87186 MIC; 87187 MBC
Page | 92
0060227 Antimicrobial Susceptibility - Mould Susceptibility MA MOULD
Specimen Required: Collect: Actively growing mould in pure culture.
Specimen Preparation: Transport sealed container with pure culture on fungal medium slant. Place each specimen in an individually sealed bag.
Unacceptable Conditions: Mixed cultures or non-viable moulds. Agar plates.
CPT Code(s): 87186
0060193 Antimicrobial Susceptibility - Nocardia MA NOC

Specimen Required: Collect: Actively growing Nocardia isolate in pure culture.
Specimen Preparation: Transport sealed container with isolate in pure culture on agar slant. Place each specimen in individually sealed bag.
Stability: Ambient: 1 month; Refrigerated: 2 weeks; Frozen: Unacceptable
CPT Code(s): 87186
0060216 Antimicrobial Susceptibility - Nonfermenter MA NF

Specimen Preparation: Transport sealed container with pure culture on agar slant. Place each specimen in individually sealed bag.
CPT Code(s): 87186
0060707 Antimicrobial Susceptibility - Staphylococcus MA STAPH

Specimen Preparation: Transport sealed container with pure culture on agar slant. Place each specimen in an individually sealed bag.
CPT Code(s): 87186
0060221 Antimicrobial Susceptibility - Streptococcus pneumoniae MA SPN

CPT Code(s): 87186
0060222 Antimicrobial Susceptibility - Viridans Streptococcus MA VIRS

CPT Code(s): 87186
0060235 Antimicrobial Susceptibility - Yeast Susceptibility MA YST

Stability: Ambient: 1 week; Refrigerated: 2 weeks; Frozen: Unacceptable
CPT Code(s): 87186
0060200 Antimicrobial Susceptibility - Not Otherwise Specified MA SENS

Methodology: Broth Microdilution/Disk Diffusion/Gradient Diffusion
Page | 93
CPT Code(s): CPT codes may vary based on method.
0099007 Antimony, Blood ANT B

Specimen Required: Collect: Royal blue (K2EDTA or Na2EDTA).
Specimen Preparation: Transport 7 mL whole blood in the original collection tube. (Min: 0.5 mL)
Unacceptable Conditions: Heparin anticoagulant. Frozen specimens.
CPT Code(s): 83018
0099409 Antimony, Urine ANT U

Storage/Transport Temperature: Refrigerated. Also acceptable: Room Temperature or frozen.
CPT Code(s): 83018
2002068 Anti-Neutrophil Cytoplasmic Antibody with Reflex to Titer and MPO/PR-3 Antibodies ANCA PN
Methodology: Semi-Quantitative Indirect Fluorescent Antibody/Semi-Quantitative Multiplex Bead Assay
Tube. (Min: 0.5 mL)
Unacceptable Conditions: CSF, plasma, urine, or other body fluids. Contaminated, hemolyzed, or severely lipemic specimens.
CPT Code(s): 86255 ANCA; if reflexed, add 86256 ANCA titer, 83516 MPO and 83516 PR-3
0050317 Anti-Nuclear Antibodies (ANA), IgG by ELISA with Reflexes to ANA, IgG by IFA and to dsDNA, RNP, Smith, ANA REF
SSA, and SSB Antibodies, IgG
Methodology: Qualitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody/Semi-Quantitative Multiplex Bead Assay
Tube. (Min: 0.6 mL)
Unacceptable Conditions: Non-serum specimens. Contaminated, grossly hemolyzed, heat-inactivated, severely lipemic, specimens or inclusion of
fibrin clots.
CPT Code(s): 86038 ANA; if reflexed, add 86039 ANA titer; if reflexed add 86235 RNP and 86235 Smith and 86235 SSA and 86235 SSB and 86225 dsDNA;
if dsDNA reflexed, add 86256 dsDNA titer.
2003222 Antiphospholipid Syndrome Reflexive Panel PHOS SYN

Methodology: Clotting/Semi-Quantitative Enzyme-Linked Immunosorbent Assay
Specimen Required: Collect: Lt. blue (sodium citrate) for Lupus Anticoagulant Reflexive Panel (refer to the Specimen Handling at aruplab.com for
hemostasis/thrombosis specimens handling guidelines) AND serum separator tube for cardiolipin and beta-2 glycoprotein antibodies.
Specimen Preparation: Separate platelet-poor plasma and serum from cells within 10 minutes of draw. Transport 2 mL plasma (Min: 1 mL) AND
1 mL serum (Min: 0.6 mL).
Storage/Transport Temperature: Plasma: CRITICAL FROZEN. Separate specimens must be submitted when mulitiple tests are ordered.
Serum: Refrigerated.
Unacceptable Conditions: For Lupus Anticoagulant Reflexive Panel (Plasma): Serum and non-sodium citrate plasma.
For cardiolipin and beta-2 glycoprotein antibodies (Serum): Plasma and other body fluids, heat-inactivated, hemolyzed, lipemic, or contaminated
specimens.
Stability: For Lupus Anticoagulant Reflexive Panel (Plasma): Ambient: 4 hours; Refrigerated: 24 hours; Frozen: 1 week;
For cardiolipin and beta-2 glycoprotein antibodies (Serum): Ambient: 48 hours; Refrigerated: 2 weeks; Frozen 1 year (avoid repeated freeze/thaw
cycles).
CPT Code(s): Anti-Cardiolipin Antibody G/M: 86147 x2; Beta-2 Glycoprotein I, G/M: 86146 x2; 85610 Prothrombin time (PT); 85730 Partial Thromboplastin
Time (PTT); 85613 dRVVT. If PTT is abnormal, add 85670 Thrombin Time. If Thrombin time is abnormal, add 85635 Reptilase Time. If
Reptilase Time is normal, add PTT Heparin Neutralization 85730 and 85525. If PTT Heparin Neutralization is abnormal, add 85732 PTT 1:1 mix.
If PTT 1:1 mix is abnormal, add 85597 Platelet neutralization procedure (PNP). If dRVVT is abnormal, add 85613 dRVVT 1:1 mix. If dRVVT
1:1 mix is abnormal, perform 85613 dRVVT confirmation. If PNP and dRVVT conf are normal, add 85598 Hexagonal Phospholipid
Neutralization.
0030015 Antithrombin, Antigen AT3AG

Methodology: Microlatex Particle-Mediated Immunoassay
Page | 94
Remarks:
Unacceptable Conditions: Serum. Hemolyzed specimens.
Stability: Ambient: 8 hours; Refrigerated: 8 hours; Frozen: 1 month
CPT Code(s): 85301
0030010 Antithrombin, Enzymatic (Activity) AT3

Specimen Preparation: Transfer 1.5 mL platelet-poor plasma to an ARUP Standard Transport Tube. (Min: 1 mL)
Remarks:
CPT Code(s): 85300
0030370 Antithrombin Panel AT3 PAN

Methodology: Chromogenic Assay/Microlatex Particle-Mediated Immunoassay
Storage/Transport Temperature: CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered
CPT Code(s): 85300 AT III; 85301 AT III Ag
2006546 Aortopathy Deletion/Duplication, 10 Genes AORT DD

Methodology: Exonic Oligonucleotide-based CGH Microarray
Specimen Required: Collect: Lavender (EDTA) or yellow (ACD Solution A or B). Peripheral blood required.
Remarks: Submit the Patient History Form for Aortopathy Disorders with the Electronic Packing List.
CPT Code(s): 83891 Isolation; 88386 Array-based evaluation of multiple molecular probes; 251 through 500
2006540 Aortopathy Panel, Sequencing and Deletion/Duplication, 10 Genes AORT PANEL

Methodology: Massive Parallel Sequencing/Exonic Oligonucleotide-based CGH Microarray
CPT Code(s): 83891 Isolation; 83909 x3 Capillary electrophoresis; 83898 x3 Amplification; 83904 x10 Sequencing; 88386 Array-based evaluation of multiple
molecular probes; 251 through 500; 83912 Interpretation and report.
2006617 Aortopathy Sequencing, 10 Genes AORT SEQ

Methodology: Massive Parallel Sequencing
CPT Code(s): 83891 Isolation; 83909 x3 Capillary electrophoresis; 83898 x3 Amplification; 83904 x10 Sequencing; 83912 Interpretation and report.
0030127 APC Resistance Profile APC RST

Methodology: Clotting
Stability: Ambient: 4 hours; Refrigerated: 4 hours; Frozen: 2 weeks
CPT Code(s): 85307
0030192 APC Resistance Profile with Reflex to Factor V Leiden APC R

Methodology: Clotting/Polymerase Chain Reaction/Fluorescence Monitoring
Specimen Required: Collect: Lt. blue (sodium citrate) AND lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B). Refer to Specimen Handling at
aruplab.com for hemostasis/thrombosis specimen handling guidelines.
Specimen Preparation: Transport 1.5 mL platelet-poor plasma AND 3 mL whole blood. (Min: 1 mL/each)
Storage/Transport Temperature: Plasma: Frozen. Whole Blood: Refrigerated.
Unacceptable Conditions: Plasma: Non-frozen specimens.
Stability: Plasma: Ambient: 4 hours; Refrigerated: Unacceptable; Frozen at -20°C: 3 months; Frozen at -70°C: 6 months
CPT Code(s): 85307 APC; if reflexed, add 83891 Isolation; 83896 Nucleic acid probes; 83898 Amplification; 83912 Interpretation and report; - Additional CPT
code modifiers may be required for procedures performed to test for oncologic or inherited disorders.
0050030 Apolipoprotein A-1 APO A-1

Patient Preparation: Freshly drawn fasting specimen.
Page | 95
Tube. (Min: 0.5 mL)
Remarks: Separate serum from cells ASAP.
CPT Code(s): 82172
0050029 Apolipoprotein B APO B-100

Patient Preparation: Fasting specimen.
Tube. (Min: 0.5 mL)
CPT Code(s): 82172
0050028 Apolipoprotein B/A Ratio APO B/A

Patient Preparation: Fasting specimen recommended.
CPT Code(s): 82172 Apolipoprotein, B; 82172 Apolipoprotein, A-1
0055654 Apolipoprotein B (APOB) Mutation Detection APO B

CPT Code(s): 83891 Isolation; 83898 Amplification; 83896 x2 Nucleic acid probes; 83912 Interpretation and report - Additional CPT code modifiers may be
0055566 Apolipoprotein E (APOE) 2 Mutations, Cardiovascular Risk APO E

0091000 Aprobarbital, Serum or Plasma APROBAR SP

Stability: Ambient: 2 weeks; Refrigerated: 2 weeks; Frozen: 6 months
CPT Code(s): 82205
0091176 Aprobarbital, Urine APROBAR U

CPT Code(s): 82205
2003036 Aquaporin-4 Receptor Antibody AQP4

Tube. (Min: 0.3 mL)
Unacceptable Conditions: CSF, amniotic fluid, ocular fluid peritoneal fluid, synovial fluid, or plasma. Contaminated, hemolyzed, icteric, or
lipemic specimens.
Stability: After separation from cells: Ambient: 72 hours; Refrigerated: 2 weeks; Frozen: 1 month (avoid repeated freeze/thaw cycles)
CPT Code(s): 83516
Page | 96
2001597 Arbovirus Antibodies, IgG & IgM, CSF ARBOCSF GM
Methodology: Semi-Quantitative Indirect Fluorescent Antibody/Semi-Quantitative Enzyme-Linked Immunosorbent Assay
Stability: Ambient: 8 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)
CPT Code(s): 86651 x2 Encephalitis, California (La Crosse); 86652 x2 Encephalitis, Eastern Equine; 86653 x2 Encephalitis, St. Louis; 86654 x2 Encephalitis,
Western Equine; 86789 West Nile Virus IgG; 86788 West Nile Virus IgM
2001594 Arbovirus Antibodies, IgG and IgM, Serum ARBOSER GM

Specimen Required: Collect: Serum separator tube. Also acceptable: Plain red.
Tube. (Min: 0.2 mL) Parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of acute specimens.
Mark specimens plainly as "acute" or "convalescent."
CPT Code(s): 86651 x2 Encephalitis, California (La Crosse); 86652 x2 Encephalitis, Eastern Equine; 86653 x2 Encephalitis, St. Louis; 86654 x2 Encephalitis,
Western Equine; 86789 West Nile Virus IgG; 86788 West Nile Virus IgM
2001596 Arbovirus Antibodies, IgG, CSF ARBO CSF G

Unacceptable Conditions: Plasma. Contaminated, heat-inactivated, hemolyzed, or severely lipemic specimens.
CPT Code(s): 86651 Encephalitis, California (La Crosse); 86652 Encephalitis, Eastern Equine; 86653 Encephalitis, St. Louis; 86654 Encephalitis, Western
Equine; 86789 West Nile Virus
2001593 Arbovirus Antibodies, IgG, Serum ARBO SER G

Unacceptable Conditions: Contaminated, hemolyzed, or severely lipemic, specimens.
Equine; 86789 West Nile Virus IgG
2001595 Arbovirus Antibodies, IgM, CSF ARBO CSF M

Unacceptable Conditions: Contaminated, heat-inactivated , or hemolyzed specimens.
CPT Code(s): 86651 Encephalitis, California (La Crosse); 86652 Encephalitis, Eastern equine; 86653 Encephalitis, Saint Louis; 86654 Encephalitis, Western
equine; 86788 West Nile Virus
2001592 Arbovirus Antibodies, IgM, Serum ARBO SER M

Equine; 86788 West Nile Virus
0070027 Arginine Vasopressin Hormone AVH PLASMA

Specimen Preparation: Separate plasma from cells ASAP or within 2 hours of collection. Transfer 6 mL plasma to ARUP Standard Transport
Tubes and freeze immediately. (Min: 2.5 mL)
Unacceptable Conditions: Non-frozen specimens.
CPT Code(s): 84588
Page | 97
2003178 Aripiprazole, Serum or Plasma ARIPIPRAZ
Specimen Preparation: Separate from cells within 2 hours of draw. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min:
0.5 mL)
CPT Code(s): 83789
0091580 Aromatic Primary Amines, Urine AROMAT AMI

Patient Preparation: Collect at end of shift.
Specimen Required: Collect: Urine.
CPT Code(s): 84311
0091435 Aromatic Solvents Panel, Whole Blood AROMATIC B

Specimen Required: Collect: Lavender (EDTA) or gray (potassium oxalate or sodium fluoride).
Stability: Ambient: Unacceptable; Refrigerated: 5 days; Frozen: 5 days
CPT Code(s): 84600
2006216 Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) Panel, 7 Genes ARVC PANEL
Remarks: Do not expose specimen to extreme temperatures. Clinical indication or reason for testing is required.
CPT Code(s): 83891 Isolation; 83900 Amplification; 83901 x51 Additional amplification; 83904 x51 Sequencing; 83909 x3 Capillary electrophoresis; 83912
Interpretation and report.
2007342 Arsenic Analysis, Hair ARS HAIR

Specimen Required: Collect: Collect a pencil-thick segment of hair. Bundle, cut at roots, wrap with twist tie at root end.
Specimen Preparation: Transfer 500 mg hair to an ARUP Trace Element-Free Transport Tube (ARUP supply #43116) available online through
eSupply using ARUP Connector contact ARUP Client Services at (800) 522-2787. (Min: 500 mg)
Stability: Ambient: Undetermined Refrigerated: Undetermined Frozen: Undetermined
2007344 Arsenic Analysis, Nails ARS NAILS

Methodology: Quantitative Inductively Coupled Plasma/Mass Spectrometry
Specimen Required: Collect: Nails.
Specimen Preparation: Transfer 500 mg nails to an ARUP Trace Element-Free Transport Tube (ARUP supply #43116) available online through
CPT Code(s): 82175 Arsenic; 80103 Tissue preparation
0099045 Arsenic, Blood ARS B

discontinue nutritional supplements, vitamins, minerals, and non-essential over-the-counter medications (upon the advice of their physician) and
avoid shellfish and seafood for 48 to 72 hours.
CPT Code(s): 82175
0090664 Arsenic, Fluid ARSENIC FL

Methodology: Inductively Coupled Plasma/Mass Spectrometry
Patient Preparation: Avoid seafood consumption for 48 hours prior to specimen collection.
Specimen Required: Collect: Fluid.
Specimen Preparation: Transfer 3 mL fluid to an ARUP Trace Element-Free Transport Tube (ARUP supply #43116). Available online through
eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 2 mL)
Remarks: This test can be used for arsenic in water (no drinking water).
CPT Code(s): 82175
Page | 98
0020734 Arsenic, Fractionated, Urine AS UF
Methodology: Quantitative High Performance Liquid Chromatography/Quantitative Inductively Coupled Plasma-Mass Spectrometry
Specimen Required: Collect: 24-hour or random urine collection. Specimen must be collected in a plastic container and should be refrigerated during collection. ARUP
studies indicate that refrigeration of urine alone, during and after collection, preserves specimens adequately if tested within 14 days of
collection.
Specimen Preparation: Transfer an 8 mL aliquot of urine 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: 2 mL)
Record total volume and collection time interval on transport tube and on test request form.
CPT Code(s): 82175
0025000 Arsenic, Urine with Reflex to Fractionated ARS U

Methodology: Quantitative High Performance Liquid Chromatography/Quantitative Inductively Coupled Plasma-Mass Spectrometry
discontinue nutritional supplements, vitamins, minerals, nonessential over-the-counter medications (upon the advice of their physician), and avoid
shellfish and seafood for 48 to 72 hours. 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 Required: Collect: 24-hour or random urine collection. Specimen must be collected in a plastic container and refrigerated during collection. ARUP studies
indicate that refrigeration of urine alone, during and after collection, preserves specimens adequately if tested within 14 days of
collection.
#43116). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 2 mL)
CPT Code(s): 82175; if reflexed, add 82175
ARUP Drug Screen Cup (Point-of-Care test only)

Methodology: Qualitative Competitive Immunoassay, uses CLIA-waived device
Patient Preparation: Do not open test device pouch until ready to collect specimen.
Specimen Required: Collect: Random urine. Requires 30 mL urine to use Testing Cup (NexScreen cup) provided in kit (ARUP supply #49204). Available online
through eSupply using ARUP ConnectTM or contact ARUP Client Services at (800) 522-2787. Collect directly in Testing Cup; may also use
another collection container then pour into Testing Cup.
CONFIRMATION TESTING: If the result of the Testing Cup is not negative (presumptive positive) and is inconsistent with clinical
expectations and pharmacy history, it should be confirmed using a second, more-specific and quantitative technology such as LC-MS/MS or GC-
MS. If the patient is expected to be taking Benzodiazepines and/or Opiates/oxycodone, results should be confirmed by quantitative LC-MS/MS
regardless of the screen result. Transfer 4 mL urine from the Testing Cup into an ARUP Standard Transport Tube. Transport one tube for each test
requested.
Specimen Preparation: If specimen, control, or test devices have been stored at refrigerated temperatures, warm to room temperature (59-83 before
testing.
Unacceptable Conditions: Specimens exposed to repeated freeze/thaw cycles
Stability: Results must be read at exactly 5 minutes after urine is placed in the Testing Cup.
Stability for confirmation testing: Ambient: 1 week; Refrigerated: 1 month; Frozen: 3 years
CPT Code(s): 80104; G0434 (medicare/medicaid only)
0095227 Arylsulfatase A, Urine ARYLSULF A

Methodology: Quantitative Kinetic Colorimetry
Specimen Required: Collect: 24-hour urine. Do not use preservatives.
Specimen Preparation: Transfer 10 mL urine to ARUP Standard Transport Tubes. (Min. 5 mL)
Remarks: Indicate total volume.
Stability: Ambient: Unacceptable; Refrigerated: 2 weeks; Frozen: Unacceptable
CPT Code(s): 84311
0051415 Ashkenazi Jewish Diseases (BLM, ASPA, IKBKAP, FANCC, GBA, MCOLN1, SMPD1, HEXA) AJP
Methodology: Polymerase Chain Reaction/ASPE Bead Array
CPT Code(s): 83891 Isolation; 83892 x2 Enzymatic digestion; 83900 Amplification multiplex (first two amplifications); 83901 x16 Amplification multiplex
(each additional amplification); 83914 x31 Mutation identification; 83909 Separation and identification; 83912 Interpretation and report -
0020007 Aspartate Aminotransferase, Serum or Plasma AST

Page | 99
Unacceptable Conditions: Specimens containing sodium fluoride/potassium oxalate, EDTA, or citrate. Hemolyzed specimens. Specimens
containing cellular material.
CPT Code(s): 84450
0050101 Aspergillus Antibodies by CF and ID ASPER PRO

Methodology: Semi-Quantitative Complement Fixation/Qualitative Immunodiffusion
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer1 mL serum to an ARUP Standard Transport
Tube. (Min: 0.2 mL) Parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of the acute
specimens. Mark specimens plainly as "acute" or "convalescent."
Unacceptable Conditions: Contaminated or severely lipemic specimens.
CPT Code(s): 86606 Aspergillus Ab (CF); 86606 Aspergillus Ab (ID)
0050100 Aspergillus Antibody by CF ASPER

Methodology: Semi-Quantitative Complement Fixation
CPT Code(s): 86606
0050171 Aspergillus Antibody by ID ASPER PPT

Methodology: Qualitative Immunodiffusion
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 0.5 mL serum an ARUP Standard Transport
Unacceptable Conditions: Body fluid.
CPT Code(s): 86606
0097771 Aspergillus fumigatus Antibody, IgG by ELISA ASPFUM IGG

Unacceptable Conditions: Contaminated, lipemic, or turbid specimens.
Stability: After separation form cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)
CPT Code(s): 86606
2003150 Aspergillus Galactomannan Antigen by EIA, Bronchoscopy ASPERAGB

Methodology: Semi-quantitative Enzyme Immunoassay
Specimen Required: Collect: Lower respiratory material by bronchoscopy (BAL ,brushings, and washings).
Specimen Preparation: Transfer 2 mL bronchoscopy specimen to a sterile ARUP Standard Transport Tube (ARUP Supply #43115). Available
online through eSupply using ARUP Connect™ or contact Client Services at (800) 522-2787. (Min: 0.6 mL)
Unacceptable Conditions: Sputum. Specimens in media or preservatives. Grossly bloody specimens.
Stability: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 1 week
CPT Code(s): 87305
0060068 Aspergillus Galactomannan Antigen by EIA, Serum ASPERAG

Specimen Preparation: Separate serum from cells within 2 hours of collection. Transfer 2 mL serum to a sterile ARUP Standard Transport Tube
(ARUP Supply #43115). Available online through eSupply using ARUP Connector contact Client Services at (800) 522-2787. (Min: 1 mL)
Unacceptable Conditions: Plasma. Serum separator tube. Hemolyzed specimens.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 1 week
CPT Code(s): 87305
0091570 Aspirin and Oxycodone Quantitation, Serum or Plasma PERCODAN S

Methodology: Quantitative Gas Chromatography-Mass Spectrometry/Spectrometry
Specimen Preparation: Transfer 3 mL serum or plasma to ARUP Standard Transport Tubes. (Min:1.5 mL)
CPT Code(s): 83925 Opiates; 80196 Salicylate
0091317 Atenolol, Serum or Plasma ATENOLO

Methodology: High Performance Liquid Chromatography/Mass Spectrometry
Page | 100
Stability: Ambient: 72 hours; Refrigerated: 2 weeks; Frozen: 2 weeks
CPT Code(s): 80299
0096047 Atenolol, Urine ATENOLO U

Methodology: Liquid Chromatography/Mass Spectrometry
CPT Code(s): 80299
0091333 Atropine, Serum or Plasma ATROPIN SP

(Min: 1.2)
CPT Code(s): 82542
0091171 Atropine, Urine ATROPIN U

Stability: Ambient: 1 week; Refrigerated: 29 days; Frozen: 29 days
CPT Code(s): 82542
2007210 Autoimmune Liver Disease Evaluation with Reflex to Smooth Muscle Antibody (SMA), IgG by IFA LIVER EVAL
Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody
Tube. (Min: 0.6 mL)
Unacceptable Conditions: Non-serum specimens. Contaminated, heat-inactivated, grossly hemolyzed, grossly icteric, severely lipemic specimens
or inclusion of fibrin clot.
CPT Code(s): 83516 M2 IgG ; 86376 LKM-1 IgG; 83516 F-Actin IgG; if reflexed, add 86256 SMA, IgG titer.
0095505 Autoimmune Lymphoproliferative Profile ALPS

Methodology: Quantitative Flow Cytometry
Specimen Required: Collect: Green (sodium or lithium heparin), lavender (EDTA), or pink (K2EDTA).
Specimen Preparation: Transport 5 mL whole blood. (Min: 0.5 mL)
Storage/Transport Temperature: CRITICAL ROOM TEMPERATURE.
Remarks: Specimens must be analyzed within 48 hours of collection.
Unacceptable Conditions: Frozen or refrigerated specimens. Specimens older than 48 hours. Clotted or hemolyzed specimens.
CPT Code(s): 86356 CD3; 86356 CD4; 86356 CD5; 86356 CD8; 86356 CD20; 86356 ALPHA/BETA; 86356 HLA-DR
0092099 B-Cell CD20 Expression CD20

Methodology: Flow Cytometry
Specimen Required: Collect: Green (sodium heparin). Also acceptable: Lavender (EDTA) or pink (K2EDTA).
Specimen Preparation: Transport 5 mL whole blood.
Storage/Transport Temperature: Room temperature. Also acceptable: Refrigerated. Specimen should be received within 48 hours of collection for
optimal viable testing.
Remarks: Provide CBC, Wright's stained smear, clinical history, differential diagnosis, and any relevant pathology reports.
Unacceptable Conditions: Frozen specimens. Specimens greater than 48 hours old. Clotted or hemolyzed specimens.
CPT Code(s): 88184 First marker and 88185 Each additional marker; AND 88187 interpretation for 2-8 markers
Page | 101
0095940 B-Cell Immunodeficiency Profile B-CELL
New York State Clients: Specimens in heparin must be analyzed within 48 hours of collection; specimens in EDTA must be analyzed within 30
hours of collection.
Unacceptable Conditions: Clotted, frozen, or refrigerated specimens. Specimens older than 48 hours.
New York State Clients: Clotted, frozen, or refrigerated specimens. Specimens in heparin that are more than 48 hours old and specimens in
EDTA that are more than 30 hours old.
New York State Clients: Ambient: 48 hours in heparin, 30 hours in EDTA; Refrigerated: Unacceptable; Frozen: Unacceptable.
CPT Code(s): 86356 CD19; 86356 PSIG; 86356 IGA; 86356 IGD; 86356 IGG; 86356 IGM; 86356 HLA-DR
2003442 B Cell Specific Octamer Binding Protein-1 (BOB-1) by Immunohistochemistry BOB1 IHC
CPT Code(s): 88342
0030191 B-Type Natriuretic Peptide BNP

Specimen Preparation: Separate plasma from cells within 2 hours of collection. Transfer 2 mL plasma to an ARUP Standard Transport Tube and
freeze within 4 hours of collection. (Min: 0.5 mL)
Unacceptable Conditions: Frozen whole blood. Specimens collected in non-EDTA tubes. Specimens frozen in separator tube. Specimen exposed
to repeated freeze/thaw cycles. Refrigerated or room temperature specimens more than 4 hours old. Hemolyzed specimens.
CPT Code(s): 83880
0093048 Babesia microti Antibodies, IgG & IgM by IFA BAB MIC AB
Transport Tube. (Min: 0.1 mL) Parallel testing is preferred, and convalescent specimens must be received within 30 days from receipt of the acute
Unacceptable Conditions: Bacterially contaminated, hemolyzed or lipemic specimens.
CPT Code(s): 86753 IgG; 86753 IgM
0093049 Babesia microti Antibody, IgG by IFA BAB IGG

specimens. Mark specimens plainly as acute or convalescent.
Unacceptable Conditions: Bacterially contaminated, hemolyzed, or lipemic specimens.
CPT Code(s): 86753
0093050 Babesia microti Antibody, IgM by IFA BAB IGM

Unacceptable Conditions: Bacterially contaminated, hemolyzed, or lipemic specimens.
CPT Code(s): 86753
2005275 Baclofen Quantitation, Fluid BACLO FL

Specimen Required: Collect: Fluid.
Page | 102
Specimen Preparation: Transfer 1 mL fluid to an ARUP Standard Transport Tube. (Min: 0.4 mL)
CPT Code(s): 80299
2005273 Baclofen Quantitation, Serum or Plasma BACLO SP

CPT Code(s): 80299
0060182 Bacterial Strain Characterization by Pulsed-Field Gel Electrophoresis MC PFGE

Methodology: Pulsed-Field Gel Electrophoresis
Specimen Required: Collect: Multiple bacterial isolates that are epidemiologically related or are recurrent isolates from the same patient.
Specimen Preparation: Transport individual isolates on agar slants or on swabs in bacterial transport media. Package isolates together in a sealed
container.
Remarks: Contact the Microbiology Laboratory at (800) 242-2787, extension 2248, prior to submission of the isolates. One report will be
generated for each batch tested; billing is per isolate. Order one test, using Infection control, #### (your ARUP client number) as the patient name.
Include a list of isolate identifiers (do not use patient names) on the requisition or as an order note for electronic orders. Identifiers on the
requisition must match identifiers on the isolate samples. Print the following instructions and include in the package:
Stability: Isolate: Ambient: 1 week; Refrigerated: Unacceptable; Frozen: Unacceptable.
CPT Code(s): 87152
0091093 Barbital, Serum or Plasma BARBIT SP

CPT Code(s): 82205
0091377 Barbital, Urine BARBIT URN

Specimen Required: Collect: Random urine
Storage/Transport Temperature: Room temperature
CPT Code(s): 82205
0091282 Barium, Serum or Plasma BARIUM SP

Specimen Required: Collect: Royal blue (no additive or EDTA)
Specimen Preparation: Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL) Also acceptable: Plasma
Unacceptable Conditions: Separator tubes
CPT Code(s): 83018
0091165 Barium, Urine BARIUM URN

Specimen Required: Collect: Random urine in trace metal-free or acid-washed urine bottle.
CPT Code(s): 83018
2002280 Bartonella henselae & B. quintana Antibodies, IgG & IgM BARTONELLA
CPT Code(s): 86611 Bartonella henselae IgG; 86611 Bartonella henselae IgM; 86611 Bartonella quintana IgG; 86611 Bartonella quintana IgM
0050091 Bartonella henselae Antibody, IgG by IFA HENS G

Page | 103
CPT Code(s): 86611
0050092 Bartonella henselae Antibody, IgM by IFA HENS M

CPT Code(s): 86611
0050108 Bartonella henselae (Cat Scratch) Antibodies, IgG & IgM by IFA CATSCRATCH
CPT Code(s): 86611 Bartonella henselae IgG; 86611 Bartonella henselae IgM
0050106 Bartonella quintana Antibodies, IgG & IgM by IFA BART PAN
CPT Code(s): 86611 Bartonella quintana Ab, IgG; 86611 Bartonella quintana Ab, IgM
0050094 Bartonella quintana Antibody, IgG by IFA QUINT G

CPT Code(s): 86611
0050093 Bartonella quintana Antibody, IgM by IFA QUINT M

CPT Code(s): 86611
0093057 Bartonella Species by PCR BART DNA

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA) or serum separator tube. Also acceptable: CSF or tissue.
Specimen Preparation: Separate serum or plasma from cells. Transfer 1 mL serum, plasma or CSF to a sterile container. (Min: 0.5 mL). OR
Tissue: Transfer to a sterile container and freeze immediately.
Unacceptable Conditions: Whole blood (refer to Bartonella Species by PCR, Whole Blood, ARUP test code 0060762). Heparinized specimens.
Stability: Tissue: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 1 month. All Others: Ambient: 24 hours; Refrigerated: 5 days;
Frozen: 1 month.
CPT Code(s): 87471
0060762 Bartonella Species by PCR, Whole Blood BARTPCR WB

Page | 104
Specimen Preparation: : Do not freeze specimen. Transport 1 mL whole blood. (Min: 0.5 mL).
Unacceptable Conditions: Plasma (refer to Bartonella Species by PCR, ARUP test code 0093057). Frozen specimens. Heparinized specimens.
Stability: Ambient: 24 hours; Refrigerated: 5 days; Frozen: Unacceptable.
CPT Code(s): 87471
0020399 Basic Metabolic Panel BMP

Methodology: Immunoturbidimetry/Polymerase Chain Reaction/Fluorescence Monitoring/Isoelectric Focusing
Specimen Required: Collect: Green (sodium or lithium heparin), plasma separator tube, or serum separator tube.
Specimen Preparation: Allow serum tube to clot completely at room temperature. Separate serum or plasma from cells within 30 minutes of
Unacceptable Conditions: Specimens collected in EDTA, citrate, or oxalate.
Stability: After separation from cells: Ambient: Calcium and CO2: 4 hours, All others: 24 hours; Refrigerated: 1 week; Frozen: 6 months
CPT Code(s): 80048
0055592 B-Cell Clonality Assessment by Restriction Fragment Southern Blot Hybridization BCRFSBHF
Methodology: Restriction Fragment Southern Blot Hybridization
Specimen Required: Collect: Lavender (EDTA) OR bone marrow (EDTA) OR fresh tissue..
Specimen Preparation: Whole blood: Transport 10 mL (Min: 3 mL) OR Bone marrow: Transport 3 mL (Min: 3 mL) OR Fresh tissue: Freeze
immediately. Transport 100 mg or 0.5-2.0 cm3 tissue. Transport frozen tissue in a tissue transport kit (ARUP supply #47808) available online
through eSupply using ARUP Connect™or contact ARUP Client Services at (800) 522-2787.
Storage/Transport Temperature: Whole blood OR Bone marrow: Refrigerated. OR Fresh tissue: Frozen on dry ice.
Unacceptable Conditions: Serum. Frozen whole blood or bone marrow. Clotted or grossly hemolyzed specimens. Paraffin-embedded tissue.
Stability: Whole blood OR Bone marrow: Ambient: 24 hours; Refrigerated: 5 days; Frozen: Unacceptable
Fresh tissue: Ambient: Unacceptable; Refrigerated: 2 hours; Frozen: 1 year
CPT Code(s): 83891 Isolation; 83892 x4 Enzymatic digestion; 83894 Gel separation; 83897 Southern transfer; 83896 Nucleic acid probe; 83912 Interpretation
2006193 B-Cell Clonality Screening (IgH and IgK) by PCR BCELL SCRN
Methodology: Polymerase Chain Reaction/Capillary Electrophoresis
Specimen Required: Collect: Lavender (EDTA) OR bone marrow (EDTA) OR tissue.
Storage/Transport Temperature: Whole blood OR Bone marrow: Refrigerated. Fresh tissue: Frozen on dry ice. FFPE tumor tissue: Room
temperature or refrigerated. Ship in cooled container during summer months.
Unacceptable Conditions: Whole blood OR Bone marrow: Frozen specimens. Clotted or grossly hemolyzed specimens. FFPE tumor tissue:
Specimens fixed/processed in alternative fixatives or heavy metal fixatives (B-4 or B-5) or tissue sections on slides. Decalcified specimens.
Fresh Tissue: Ambient: Unacceptable; Refrigerated: 2 hours; Frozen: 1 year
FFPE tumor tissue: Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable
CPT Code(s): 83891 Isolation; 83898 x6 Amplification; 83896 x5 Nucleic acid probes; 83909 x5 Capillary electrophoresis; 83912 Interpretation and report -
2006283 B-Cell Clonality Screening (IgH and IgK) by PCR with Reflex to B-Cell Clonality Assessment by Restriction BCELL RFLX
Fragment Southern Blot Hybridization
Methodology: Polymerase Chain Reaction/Capillary Electrophoresis/Restriction Fragment Southern Blot Hybridization
Specimen Required: Collect: Lavender (EDTA) OR bone marrow (EDTA) OR fresh tissue.
CPT Code(s): 83891 Isolation; 83898 x6 Amplification; 83896 x5 Nucleic acid probes; 83909 x5 Capillary electrophoresis; 83912 Interpretation and report. If
reflexed, add 83892 x4 Enzymatic digestion; 83894 Gel separation; 83897 Southern transfer; 83896 Nucleic acid probe; 83912 Interpretation and
report - Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders.
2004513 BCL-2 by Immunohistochemistry BCL2 IHC

CPT Code(s): 88342
2003457 BCL-6 by Immunohistochemistry BCL6 IHC

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CPT Code(s): 88342
0055553 BCR-ABL, t(9;22) Translocation Qualitative by RT-PCR BCR-ABL

Methodology: Reverse Transcription Polymerase Chain Reaction
Specimen Required: Collect: Lavender (EDTA) or bone marrow (EDTA).
Specimen Preparation: Transport 5 mL whole blood or 3 mL bone marrow. (Min: 1 mL whole blood or 1 mL bone marrow) Specimens must be
received within 48 hours of collection due to lability of RNA.
Unacceptable Conditions: Serum or plasma. Specimens collected in anticoagulants other than EDTA. Severely hemolyzed specimens. Frozen or
clotted specimens.
Stability: Ambient: 1 hour; Refrigerated: 48 hours; Frozen: Unacceptable
CPT Code(s): 83891 Isolation; 83902 Reverse transcription; 83898 x6 Amplification; 83894 x3 Gel separation; 83912 Interpretation and report - Additional
0040138 BCR-ABL1 Kinase Domain Mutation Analysis BCRABL MUT

Specimen Preparation: Transport 5 mL whole blood or 3 mL bone marrow. (Min: 1 mL whole blood or 1 mL bone marrow)
Unacceptable Conditions: Serum or plasma. Frozen or clotted specimens. Specimens collected in anticoagulants other than EDTA. Severely
hemolyzed specimens.
CPT Code(s): 83891 Isolation; 83902 Reverse transcription; 83898 x4 Amplification; 83894 Gel detection; 83912 Interpretation and report. If sequencing is
performed, add: 83892 Enzyme digestion; 83904 Sequencing and 83909 Capillary electrophoresis. Additional CPT code modifiers may be
2005017 BCR-ABL1, Major (p210), Quantitative BCR MAJ

Methodology: Quantitative Reverse Transcription Polymerase Chain Reaction
clotted specimens.
CPT Code(s): 83891 Isolation; 83902 Reverse transcription; 83898 x2 Amplification; 83896 x2 Nucleic acid probes; 83912 Interpretation and report -
2005016 BCR-ABL1, Minor (p190), Quantitative BCR MIN

Methodology: Quantitative Reverse Transcription Polymerase Chain Reaction
clotted specimens.
2005010 BCR-ABL1, Qualitative with Reflex to BCR-ABL1 Quantitative BCR RFLX

clotted specimens.
CPT Code(s): 83891 Isolation; 83902 Reverse transcription; 83898 x6 Amplification; 83894 x3 Gel separation; 83912 Interpretation and report. If reflexed add
83902 Reverse transcription; 83898 x2 Amplification; 83896 x2 Nucleic acid probes; 83912 Interpretation and report - Additional CPT code
modifiers may be required for procedures performed to test for oncologic or inherited disorders.
2004924 BCR-ABL1, T315I Mutation Detection, Quantitative ABL T315I

Methodology: Reverse Transcription Polymerase Chain Reaction/Pyrosequencing
Page | 106
Unacceptable Conditions: Serum or plasma. Specimens collected in anticoagulants other than EDTA. Frozen specimens. Clotted or severely
CPT Code(s): 83891 Isolation; 83902 Reverse transcription; 83898 x2 Amplification; 83904 Sequencing; 83912 Interpretation and report - Additional CPT code
0091315 Belladonna Alkaloids Panel BELLADONNA

CPT Code(s): 82542 x2 Atropine, scopolamine
2002464 Bence Jones Protein Detection, Quantitation and Characterization with Reflex to Quantitative Free Kappa BJP-U REFLEX
and Lambda Light Chains, Urine
Methodology: Semi-Quantitative Electrophoresis/Qualitative Immunofixation Electrophoresis/Quantitative Nephelometry
Specimen Required: Collect: 24-hour urine. Refrigerate during collection. Also acceptable: Urine supernatant.
Specimen Preparation: Transfer two 4 mL aliquots from well-mixed 24 hour collection to individual ARUP Standard Transport Tubes. (Min: 3
mL) Record total volume and collection time interval on transport tube and test request form.
Unacceptable Conditions: Non-refrigerated specimens.
CPT Code(s): 84156 Total protein; 84166 Protein fractionation; 86335 IFE; if reflexed, add 83883 x2 Nephelometry, kappa/lambda
0050161 Bence Jones Protein, Qualitative Free Kappa & Lambda Light Chains, Urine BJQUAL
Methodology: Qualitative Immunofixation Electrophoresis/Quantitative Nephelometry
Specimen Required: Collect: 24-hour urine. Refrigerate during collection. Also acceptable: Random specimens and urine supernate.
Specimen Preparation: Transfer two 4 mL aliquots from a well-mixed 24-hour urine collection to individual ARUP Standard Transport Tubes.
(Min: 4 mL) Record total volume and collection time interval on transport tube and test request form.
CPT Code(s): 84156 Total protein; 86335 IFE
0050618 Bence Jones Protein, Quantitative Free Kappa and Lambda Light Chains, Urine BJ QUANT
Methodology: Qualitative Immunofixation Electrophoresis/Quantitative Nephelometry
Specimen Required: Collect: 24-hour urine. Refrigerate during collection. Also acceptable: Random urine specimens and urine supernate.
Specimen Preparation: Transfer two 4 mL aliquots from a well-mixed 24-hour collection to individual ARUP Standard Transport Tubes. (Min: 3
mL) Record total volume and collection time interval on transport tube and test request form.
CPT Code(s): 84156 Total protein; 86335 IFE; 83883 x2 Nephelometry, kappa/lambda
0050689 Bence Jones Protein, Quantitative Free Kappa Light Chains, Urine BJQNTKAPP
Methodology: Quantitative Nephelometry/Qualitative Immunofixation Electrophoresis
Specimen Required: Collect: 24-hour urine. Refrigerate during collection. Also acceptable: Urine supernate.
Unacceptable Conditions: Random specimens. Non-refrigerated specimens.
CPT Code(s): 84156 Total protein; 86335 IFE; 83883 Nephelometry, kappa
0050682 Bence Jones Protein, Quantitative Free Lambda Light Chains, Urine BJQNTLAMB
Methodology: Quantitative Nephelometry/Qualitative Immunofixation Electrophoresis
Specimen Required: Collect: 24-hour urine. Refrigerate during collection. Also acceptable: Urine supernate.
Unacceptable Conditions: Random specimens. Non-refrigerated specimens.
CPT Code(s): 84156 Total protein; 86335 IFE; 83883 Nephelometry, lambda
0091209 Bendiocarb, Serum or Plasma BENDIOC SP

Methodology: High Performance Thin Layer Chromatography
CPT Code(s): 82491
Page | 107
0091201 Benzene Quantitation, Whole Blood BENZ BLD
Specimen Required: Collect: Gray (potassium oxalate/sodium fluoride) or lavender (EDTA).
Stability: Ambient: Unacceptable; Refrigerated: 2 weeks; Frozen: 3 weeks
CPT Code(s): 84600
0090367 Benzodiazepines Detection S BNZ

Methodology: Fluorescence Polarization Immunoassay
Unacceptable Conditions: Specimens collected in separator tubes or fluoride. Specimens exposed to repeated freeze/thaw cycles.
CPT Code(s): 80101
0091516 Benztropine, Serum or Plasma BENZTROP S

Specimen Preparation: Transfer 5 mL serum or plasma to ARUP Standard Transport Tubes. (Min: 2.2 mL)
CPT Code(s): 80299
0091098 Benztropine, Urine BENZTR U

CPT Code(s): 80299
0091278 Beryllium, Serum or Plasma BERYLLIUM

Specimen Required: Collect: Plain red or Royal blue (trace metal-free).
Specimen Preparation: Transfer 2 mL serum or plasma to an ARUP Trace Element-Free Transport Tube (ARUP supply #43116). (Min: 0.5 mL)
Unacceptable Conditions: Serum separator tubes.
Stability: Ambient: 72 Hours; Refrigerated: 2 weeks; Frozen: Indefinite
CPT Code(s): 83018
0091154 Beryllium, Urine BERYLL URN

Methodology: Quantitative Inductively Coupled Plasma-Mass Spectrometry/Colorimetry
Patient Preparation: High concentrations of gadolinium are known to interfere with most metals tests. If gadolinium-containing contrast media
has been administered, a specimen cannot be collected for 48 hours.
Specimen Required: Collect: Urine in a trace metal-free or acid-washed plastic container.
Specimen Preparation: Transfer 3 mL urine to an ARUP Trace Element-Free Transport Tube (ARUP supply #43116). Available online through
eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 1.8 mL)
Stability: Ambient: 1 week; Refrigerated: 1 week; Frozen: 2 weeks
CPT Code(s): 82570 Creatinine; 83018 Beryllium heavy metal, quantitative
0051288 Beta-2-Adrenergic Receptor (ADBR2) Haplotyping ADRB2 HAP

CPT Code(s): 83891 Isolation; 83898 Amplification; 83896 x2 Nucleic acid probe; 83912 Interpretation and report - Additional CPT code modifiers may be
0050321 Beta-2 Glycoprotein 1 Antibodies, IgG & IgM B2GPI PAN

Tube. (Min: 0.3 mL)
Unacceptable Conditions: Plasma or other body fluids. Contaminated, hemolyzed, grossly icteric, or severely lipemic specimens.
CPT Code(s): 86146 Beta-2 Glycoprotein I, IgG; 86146 Beta-2 Glycoprotein I, IgM
2002569 Beta-2 Glycoprotein 1 Antibodies, IgG, IgM & IgA B2GPI PAN3
Page | 108
CPT Code(s): 86146 Beta-2 Glycoprotein I, IgG; 86146 Beta-2 Glycoprotein I, IgM; 86146 Beta-2 Glycoprotein I, IgA
0050324 Beta-2 Glycoprotein 1 Antibody, IgA B2GPI A

Tube. (Min: 0.3 mL)
CPT Code(s): 86146
0080054 Beta-2 Microglobulin, CSF B2M CSF

Specimen Required: Collect: CSF. Also acceptable: CSF collected in plain red or green (sodium or lithium heparin).
Specimen Preparation: Centrifuge to remove cellular material. Transfer 0.5 mL CSF to an ARUP Standard Transport Tube. (Min: 0.4 mL)
Stability: After separation from cellular material: Ambient: 8 hours; Refrigerated: 1 week; Frozen: 2 weeks
CPT Code(s): 82232
0080053 Beta-2 Microglobulin, Serum or Plasma B2M S

Specimen Required: Collect: Serum separator tube. Also acceptable: Green (sodium or lithium heparin), lavender (EDTA), or pink (K2EDTA).
Unacceptable Conditions: CSF (refer to Beta-2 Microglobulin, CSF, ARUP test code 0080054)
CPT Code(s): 82232
0080432 Beta-2 Microglobulin, Urine B2M U

Patient Preparation: Void the urinary bladder, then drink a large glass of water and collect a urine specimen within 1 hour.
Specimen Preparation: Transfer one 3 mL aliquot from a well-mixed random collection to an ARUP Standard Transport Tube. (Min: 1 mL)
If pH is greater than 8, lower pH to 6-8 by adding 1M HCL. If pH less than 6, increase pH to 6-8 by adding 5% NaOH. Titrate with appropriate
preservative until pH of 6-8 has been reached. Record the pH on the transport tube and test request form.
Stability: Ambient: 8 hours; Refrigerated: 48 hours; Frozen: 2 months
CPT Code(s): 82232
0050047 Beta-2 Transferrin B2TRNSF

Methodology: Qualitative Immunofixation Electrophoresis
Specimen Required: Collect: Serum separator tube (SST) or plain red AND aural or nasal fluid in sterile container.
Specimen Preparation: Do not freeze. Separate serum from cells ASAP or within 2 hours of collection. Transport 2 mL serum AND 2 mL aural or
nasal fluid in a tube without preservative. (Min: 0.5 mL serum and 1 mL aural or nasal fluid)
CPT Code(s): 86334 IFE Serum; 86335 IFE Fluid
2003454 Beta-Catenin-1 by Immunohistochemistry BCAT1 IHC

CPT Code(s): 88342
2002434 (1,3)-Beta-D-Glucan (Fungitell®) BDGLUCAN

Methodology: Semi-Quantitative Colorimetry
Specimen Preparation: Separate serum from cells within 2 hours of collection. Transfer 2 mL serum to a sterile ARUP Standard Transport Tube
(ARUP supply # 43115). Available online through eSupply using ARUP Connector contact ARUP Client Services at (800) 522-2787. (Min: 0.5
mL)
Page | 109
Stability: Ambient: Unacceptable, Refrigerated: 2 weeks; Frozen: 2 weeks
CPT Code(s): 87449
0050578 Beta Globin (HBB) Gene Sequencing BGSEQ

Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA). Also acceptable: Yellow (ACD Solution A or B).
CPT Code(s): 83891 Isolation; 83898 x4 Amplification; 83894 Gel electrophoresis; 83904 x3 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation
0051421 Beta Globin (HBB) HbS, HbC, & HbE Mutations HB SCE
CPT Code(s): 83891 Isolation; 83898 x2 Amplification; 83896 x3 Nucleic acid probe; 83912 Interpretation and report - Additional CPT code modifiers may be
0051422 Beta Globin (HBB) HbS, HbC, and HbE Mutations, Fetal HB SCE FE
CPT Code(s): 83891 Isolation; 83898 x2 Amplification; 83896 x3 Nucleic acid probes; 83912 Interpretation and report. FCC: 83900 Multiplex amplification
(first two sequences); 83901 x14 Additional amplification; 83909 Capillary electrophoresis. If MCC Maternal Cell (0050608) is performed, add:
83891 Isolation; 83900 Multiplex amplification; 83901 x14 Additional amplification; 83909 Capillary electrophoresis; 83912 Interpretation and
0050388 Beta Globin (HBB) Sequencing, Fetal BGSEQ FE

Specimen Required: Collect: Fetal Specimen: Two T-25 flasks at 80% confluent of cultured amniocytes. If the client is unable to culture amniocytes, this can be
OR Whole Blood in lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B).
Specimen Preparation: Cultured Amniocytes: Fill flasks with culture media. Transport two T-25 flasks at 80% confluent of cultured amniocytes
filled with culture media. Backup cultures must be retained at the client's institution until testing is complete.
AND Maternal Cell Contamination Specimen: Transport 3 mL whole blood (Min: 1 mL)
OR Whole Blood: Transport 3 mL whole blood (Min: 1 mL)

Whole Blood or Maternal Cell Contamination Specimen: Room temperature.
Whole Blood or Maternal Cell contamination Specimen: Ambient: 72 hours; Refrigerated: 1 week; Frozen: Unacceptable
CPT Code(s): 83891 Isolation; 83898 x4 Amplification; 83894 Gel separation; 83904 x3 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and
report. FCC: 83900 Multiplex amplification; 83901 x14 Additional Amplification; 83909 Capillary electrophoresis. For MCC Maternal cell
(0050608) add: 83891 Isolation; 83900 Multiplex amplification; 83901 x14 Additional amplification; 83909 Capillary electrophoresis; 83912
0070029 Beta-hCG, Quantitative (Tumor Marker) BHCG TM

Methodology: Quantitative Electrochemiluminescent Immunoassay
Specimen Required: Collect: Serum separator tube. Also acceptable: Lavender (EDTA), pink (K2EDTA), or green (sodium or lithium heparin).
Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.4 mL)
Unacceptable Conditions: CSF (refer to Beta-hCG, Quantitative (Tumor Marker) CSF, ARUP test code 0020730). Specimens left to clot at 2-8°C
or specimens subjected to repeated freeze/thaw cycles.
Page | 110
CPT Code(s): 84702
0020730 Beta-hCG, Quantitative (Tumor Marker), CSF BHCG CSF

Specimen Required: Collect: CSF. Also acceptable: CSF collected in plain red or green (sodium or lithium heparin).
Unacceptable Conditions: Any other body fluids.
CPT Code(s): 84702
0020063 Beta-hCG, Serum Qualitative BHCG-S

Unacceptable Conditions: Plasma. Specimens exposed to repeated freeze/thaw cycles.
CPT Code(s): 84703
0070025 Beta-hCG, Serum Quantitative BHCG QNT

Methodology: Chemiluminescent Immunoassay
Specimen Required: Collect: Plasma separator tube (PST), serum separator tube (SST), or plain red.
Specimen Preparation: Serum specimens must sit for 15-20 minutes for proper clot formation and to assure the absence of fibrin in the serum,
which can interfere with this test. Separate serum from cells within 24 hours of collection. Transfer 2 mL serum to an ARUP Standard Transport
Tube. (Min: 0.5 mL)
Remarks: This test is not appropriate for tumor marker studies and should not be performed on males.
Unacceptable Conditions: Specimens exposed to repeated freeze/thaw cycles. Test ordered for tumor markers or on males.
CPT Code(s): 84702
0020229 Beta-hCG, Urine Qualitative BHCG-U

Specimen Required: Collect: Urine in a plastic container. First-morning urine is the preferred specimen as it usually contains the highest concentration of beta-hCG;
however, any specimen is suitable for testing.
Specimen Preparation: Transfer 1 mL aliquot of urine to an ARUP Standard Transport Tube. If frozen, mix after thawing. Do not refreeze.
Stability: Ambient: 8 hours; Refrigerated: 72 hours; Frozen: 6 months (one freeze/thaw cycle is acceptable)
CPT Code(s): 81025
0080045 Beta-Hydroxybutyric Acid B-OH

Specimen Required: Collect: Serum separator tube, lavender (EDTA), pink (K2EDTA), green (sodium or lithium heparin), or gray (sodium fluoride/potassium oxalate).
CPT Code(s): 82010
2003466 BF-1 by Immunohistochemistry BF1 IHC

CPT Code(s): 88342
0020245 Bicarbonate (HCO3), Urine BICARB

Specimen Required: Collect: Random urine in sealed container.
Specimen Preparation: Immediately upon collection, mix and transfer 4 mL urine to an ARUP Standard Transport Tube. (Min: 0.3 mL) Do not
expose to air.
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 1 month (unstable if thawed and refrozen)
CPT Code(s): 82374
0092610 Bile Acids, Fractionated and Total by LC-MS/MS BILE ACIDS

Page | 111
Patient Preparation: Patient should fast for a minimum of eight hours prior to specimen collection.
Specimen Preparation: After clot formation, centrifuge specimen and pour off serum into a transport tube. Transfer 1 mL serum to an ARUP
Storage/Transport Temperature: Refrigerated. Store specimen refrigerated or frozen.
Stability: Ambient: 8 hours; Refrigerated: 2 weeks; Frozen: 6 months
CPT Code(s): 83789
0070189 Bile Acids, Total BILE AC

Patient Preparation: Patient should fast for 8 hours prior to collection.
Specimen Preparation: Allow specimen to clot completely at room temperature before centrifugation. Transfer 1 mL serum to an ARUP Standard
Unacceptable Conditions: Body fluids. Heparinized specimens. Hemolyzed specimens.
Stability: After separation from cells: Ambient: 8 hours; Refrigerated: 2 weeks; Frozen: 6 months
CPT Code(s): 82239
2005248 Bilirubin, CSF BILCSF

Specimen Required: Collect: CSF. Collect at least 12 hours after suspected hemorrhage. Use the last (ideally the fourth) specimen post lumbar puncture. AND serum
separator tube.
Specimen Preparation: CSF: Transport to local lab quickly and avoid pneumatic tube transport if possible. Protect from light during collection,
storage and shipment. Centrifuge for 5 minutes ASAP or within 1 hour of collection. Transfer 2 mL CSF to an ARUP Amber Transport Tube.
(Min: 1 mL) Do not freeze.
Serum: Protect from light during collection, storage and shipment. Allow specimen to clot completely at room temperature. Separate from cells
ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Amber Transport Tube. (Min: 0.5 mL)
Unacceptable Conditions: Specimens not protected from light. Frozen CSF.
Stability: CSF: Ambient: 4 hours; Refrigerated: 1 week; Frozen: Unacceptable
Serum: Ambient: 4 hours; Refrigerated: 1 week; Frozen: 6 months
CPT Code(s): 84311 Net absorbance, Bilirubin, CSF; 84311 Net absorbance, Oxyhemoglobin, CSF; 82247 Total serum bilirubin
0020426 Bilirubin, Direct & Total, Serum or Plasma BILI

Specimen Preparation: Protect from light during collection, storage, and shipment. Allow serum tube to clot completely at room temperature.
Separate serum or plasma from cells within 2 hours of collection. Transfer 1 mL serum or plasma to an ARUP Amber Transport Tube. (Min: 0.2
mL)
Stability: After separation from cells if protected from light: Ambient: 4 hours; Refrigerated: 1 week; Frozen: 6 months
CPT Code(s): 82247 Total bilirubin; 82248 Direct bilirubin
0020033 Bilirubin, Direct, Serum or Plasma BILID

Specimen Preparation: Protect from light during collection, shipment and storage. Allow serum tube to clot completely at room temperature.
mL)
CPT Code(s): 82248
0020510 Bilirubin, Total, Body Fluid TBILI-FL

Specimen Preparation: Protect from light during collection, storage, and shipment. Transfer 0.5 mL body fluid to an ARUP Amber Transport
Tube. (Min: 0.2 mL)
Unacceptable Conditions: Amniotic fluid, (refer to Amniotic Bilirubin Scan, ARUP test code 0080276) or CSF (refer to Bilirubin, CSF, ARUP
test code 2005248). Breast milk and salivary fluid. Specimens too viscous to be aspirated by instrument.
Stability: If protected from light: Ambient: 4 hours; Refrigerated: 1 week; Frozen: 6 months
CPT Code(s): 82247
0020032 Bilirubin, Total, Serum or Plasma BILIT

Specimen Required: Collect: Plasma separator tube or serum separator tube. Also acceptable: Lavender (EDTA), pink (K2EDTA) or green (sodium or lithium heparin).
Specimen Preparation: Protect from light during collection, storage and shipment. Allow serum tube to clot completely at room temperature.
mL)
CPT Code(s): 82247
Page | 112
0051700 Biotinidase Deficiency (BTD) 5 Mutations BTD MUT
CPT Code(s): 83891 Isolation; 83900 Multiplex amplification; 83901 x2 Additional amplification; 83914 x5 Extension; 83909 Capillary electrophoresis; 83912
Interpretation and report - Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders.
0051730 Biotinidase Deficiency (BTD) Sequencing BTD FGS

CPT Code(s): 83891 Isolation; 83898 x6 Amplification; 83904 x6 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report.
0093362 Biotinidase, Serum (with Paired Normal Control) BTD ENZ

Patient Preparation: A control specimen needs to be sent with the patient specimen. The control specimen needs to be drawn from a normal,
healthy individual who is not biologically related to the patient. Collect control specimen within 30 minutes of patient specimen.
Specimen Required: Collect: Plain red or serum separator tube (patient) AND plain red serum separator tube (control).
Specimen Preparation: Separate serum from cells and freeze ASAP or within 2 hours of collection. Transfer 2 mL serum (patient) AND 2 mL
serum (control) to individual ARUP Standard Transport Tubes. (Min: 0.2 mL (patient) AND 0.2 mL (control)). Label control tube as "Control for
[patient name]".
Storage/Transport Temperature: CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered. Ship patient
and control specimens together.
Unacceptable Conditions: Refrigerated or room temperature specimens. Specimens subjected to more than one freeze/thaw cycle.
Stability: After separation from cells: Ambient: 1 hour; Refrigerated: 1 hour; Frozen: 1 month
CPT Code(s): 82261
0055691 BIRC2-MALT1 (API2-MALT1) Translocation, t(11;18) by RT-PCR API2-MLT1

Specimen Required: Collect: Tissue.
Specimen Preparation: Freeze fresh tissue immediately. Transport 100 mg or 0.5 cm3 tissue.
OR Formalin fix (10% neutral buffered formalin) and paraffin embed tissue. Transport tissue block or 4 tissue scrolls (tissue shavings), 10
microns thick. Protect paraffin block from excessive heat.
Storage/Transport Temperature: Fresh tissue: Frozen at -70°C.
OR formalin-fixed, paraffin-embedded tissue: Room temperature or refrigerated. Ship in cooled container during summer months.
Unacceptable Conditions: Specimens fixed/processed in alternative fixatives (alcohol, Prefer®) or heavy metal fixatives (B-4 or B-5). Slides.
Decalcified tissue.
Stability: Fresh tissue: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen at -70°C: 48 hours
Formalin-fixed, paraffin-embedded tissue: Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable
CPT Code(s): 83891 Isolation; 83902 Reverse transcription; 83898 x3 Amplification; 83894 Gel separation; 83912 Interpretation and report - Additional CPT
0099478 Bismuth, Blood BS B

CPT Code(s): 83018
0099410 Bismuth, Urine BS U

CPT Code(s): 83018
0090067 BK Virus, Quantitative PCR BK QNT

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA) or serum separator tube. OR Urine.
Page | 113
Specimen Preparation: Do not freeze whole blood specimens. Transport 1 mL whole blood, serum, plasma or urine in a sterile container. (Min: 0.5
mL).
Unacceptable Conditions: Frozen whole blood. Heparinized specimens.
CPT Code(s): 87799
2002304 BK Virus, Quantitative PCR, Blood BK QNT BLD

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or serum separator tube
Specimen Preparation: Do not freeze whole blood specimens. Transport 1 mL whole blood, serum or plasma in a sterile container. (Min: 0.5 mL).
Unacceptable Conditions: Urine (refer to BK Virus, Quantitative PCR, Urine, ARUP test code 2002310). Frozen whole blood. Heparinized
specimens.
CPT Code(s): 87799
2002310 BK Virus, Quantitative PCR, Urine BK QNT URN

Specimen Preparation: Transfer 1 mL urine to a sterile container. (Min: 0.5 mL).
Unacceptable Conditions: Plasma, serum or whole blood (refer to BK Virus, Quantitative PCR, Blood, ARUP test code 2002304).
Stability: Ambient: 24 hours; Refrigerated: 5 days; Frozen: 1 month.
CPT Code(s): 87799
8100500 Bladder Tumor Associated Antigen BT REPORT

Methodology: Qualitative Immunoassay
Specimen Preparation: Transport 2 mL urine.
Unacceptable Conditions: Bladder washings, plasma, serum, or whole blood.
CPT Code(s): 86294
0050626 Blastomyces Antibodies by CF & ID BLASTO PAN

CPT Code(s): 86612 Blastomyces Ab (CF); 86612 Blastomyces Ab (ID)
0050130 Blastomyces Antibody by CF BLASTO

CPT Code(s): 86612
0050172 Blastomyces Antibody by ID BLASTO PPT

Tube. (Min: 0.1 mL)
Unacceptable Conditions: Body fluids.
CPT Code(s): 86612
2002926 Blastomyces dermatitidis Antigen EIA BLAST DERM

Specimen Required: Collect: Random urine. OR plain red, serum separator tube, or green (sodium or lithium heparin). Also acceptable: CSF or BAL.
Specimen Preparation: Transfer 2 mL urine, serum, or plasma to an ARUP Standard Transport Tube. (Min: 1 mL)
Stability: Ambient: 2 weeks; Refrigerated: 2 weeks; Frozen: Indefinitely
CPT Code(s): 87449-90
Page | 114
0062224 Blastomyces dermatitidis Identification by DNA Probe MC BP
Methodology: Nucleic Acid Probe
Specimen Required: Collect: Actively growing fungal isolate in pure culture
Specimen Preparation: Transport sealed container with pure culture on non-blood containing fungal medium. Place each specimen in individually
sealed bag.
Remarks: Results may be delayed if growth of the organism is inadequate.
Unacceptable Conditions: Mixed or non-viable organisms. Agar plate.
CPT Code(s): 87149
2003417 Bleeding Disorders (Common) BLEED COM

Methodology: Microlatex Particle-Mediated Immunoassay/Platelet Agglutination/Electromagnetic Mechanical Clot Detection
Remarks:
Stability: Ambient: 4 hours; Refrigerated: Unacceptable; Frozen at -20°C: 3 months; Frozen at -70°C: 6 months
CPT Code(s): 85240 F8; 85246 vWF/AG; 85245 vWF/RCF; 85250 Factor IX ; 85270 Factor XI; 85610 PT; 85730 PTT
2003947 Bleeding Disorders (Uncommon) with Reflex to Factor XIII 1:1 Mix and/or Fibrinogen Antigen BLEED UCOM
Methodology: Electromagnetic Mechanical Clot Detection/Solubility/Radial Immunodiffusion
Specimen Preparation: Transfer 8 mL platelet-poor plasma to ARUP Standard Transport Tubes. (Min: 6 mL)
CPT Code(s): 85610 PT; 85730 PTT; 85210 Factor II; 85220 Factor V; 85230 Factor VII; 85260 Factor X; 85291 Factor XIII: if reflexed add factor 13 1:1 mix
85291; 85384 Fibrinogen; if reflexed add 85385 Fibrinogen Antigen
0060102 Blood Culture MC BLD

Methodology: Continuous Monitoring Blood Culture/Identification
Patient Preparation: Aseptic draw.
Specimen Required: Collect: Bactec® aerobic resin bottle and standard anaerobic bottle. For infants, use pediatric bottle.
Specimen Preparation: Transfer blood to a Bactec® aerobic resin bottle and standard anaerobic bottle using aseptic techniques, as defined for
blood culture collection. Site of specimen draw is required (e.g. left antecubital, A-line, etc).
Adult minimum: 3 mL blood (aerobic: 8-10 mL recommended, anaerobic: 5-7 mL recommended).
Pediatric minimum: 1 mL blood (1-3 mL recommended).
*Low volume will result in decreased recovery of pathogens.
Remarks: Note in the order if the patient is suspected of having Bartonella, Brucella, or any other unusual organism. Refer to Brucella Culture
(ARUP test code 0060159) or Legionella Species Culture (ARUP test code 0060113) for additional information.
Unacceptable Conditions: More than four blood culture sets per 24 hours.
CPT Code(s): 87040
0060060 Blood Culture, Acid-Fast Bacillus (AFB) MC BAFB

Specimen Required: Collect: Whole blood in yellow (SPS) (ARUP supply #24964) or in Bactec® Myco/F Lytic bottle (ARUP supply # 31916).
OR bone marrow in yellow (SPS) (ARUP supply # 24964).
Specimen Preparation: Whole Blood: Transport 7 mL in tube or 5 mL bottle. (Min: 1 mL)
Bone Marrow: Transport 7 mL in tube. (Min: 0.5 mL)
Storage/Transport Temperature: Room Temperature
CPT Code(s): 87116
0060024 Blood Culture, AFB and Fungal MC BLDAF

Methodology: BACTEC® Continuous Monitoring Blood Culture/Identification
Bone Marrow: Transport 7 mL in tube. (Min: 0.5 mL)
CPT Code(s): 87103 Fungal culture, blood; 87116 AFB culture
0060070 Blood Culture, Fungal MC BFUNG

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OR Bone Marrow: Transport 7 mL in tube. (Min: 0.5 mL)
CPT Code(s): 87103
2004741 Blood Group (5 Minor Antigens) Genotyping by Bead Array BLD GROUP5
Methodology: Polymerase Chain Reaction/Bead Array
Specimen Preparation: Transfer 7 mL whole blood to ARUP Standard Transport Tubes. (Min: 2 mL) Specimen must be labeled with patient's
name, date of birth, and the date and time of draw.
Stability: Ambient: 72 hours; Refrigerated: 2 weeks; Frozen: Unacceptable
CPT Code(s): 83891 Isolation; 83892 Digestion; 83900 Multiplex amplification; 83901 x16 Additional amplification; 83914 x25 Mutation identification; 83909
Separation and identification; 83912 Interpretation and report - Additional CPT code modifiers 4H (Kell) or 4Z (blood typing) may be required.
2004743 Blood Group (9 Minor Antigens) Genotyping by Bead Array BLD GROUP9
Methodology: Polymerase Chain Reaction/Bead Array
name, date of birth, and the date and time of draw.
CPT Code(s): 83891 Isolation; 83892 Digestion; 83900 x2 Multiplex amplification; 83901 x21 Additional amplification; 83914 x31 Mutation identification;
83909 Separation and identification; 83912 Interpretation and report - Additional CPT code modifiers 4H (Kell) or 4Z (blood typing) may be
required.
2004739 Blood Group (ABO & 8 Minor Antigens) Genotyping by Microarray BLD GROUP8
Methodology: Polymerase Chain Reaction/ASH Microarray
name, date of birth, and date and time of draw.
CPT Code(s): 83890 Isolation; 83892 Digestion; 83898 Amplification; 83900 x2 Multiplex amplification; 83901 x30 Additional amplification; 88386
Microarray, 250-500 probes; 83912 Interpretation and report
0051433 Bloom (BLM) 2281del6/ins7 Mutation BLM

CPT Code(s): 83891 Isolation; 83892 x2 Enzymatic digestion; 83898 Amplification; 83914 Mutation identification; 83909 Separation and identification; 83912
0051434 Bloom (BLM) 2281del6/ins7 Mutation, Fetal BLM FE

CPT Code(s): 83891 Isolation; 83892 x2 Digestion; 83898 Amplification; 83914 Extension; 83909 Capillary electrophoresis 83912 Interpretation and report.
FCC: 83900 Multiplex amplification (first two sequences); 83901 x14 Additional amplification; 83909 Capillaryelectrophoresis. If MCC MAT
(0050608) is performed: 83891 Isolation; 83900 Multiplex amplification; 83901 x14 Additional amplification; 83909 Capillary electrophoresis;
83912 Interpretation and report - Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited
disorders.
0060108 Body Fluid Culture and Gram Stain MC BF

Specimen Required: Collect: Aspirate of amniotic, culdocentesis, pericardial, peritoneal, synovial, thoracentesis, or fluid.
OR body fluid collected in blood culture bottle(s), accompanied by original fluid (if possible).
Specimen Preparation: Transfer aspirate to a sterile tube, sterile container, or anaerobe gel transport tube. Place each specimen in an individual
sealed bag.
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Remarks: Specimen source required. Anaerobe Culture (ARUP test code 0060143) will be performed on properly collected and transported
specimens.
Unacceptable Conditions: Specimens submitted in anticoagulant other than SPS. Syringes with needle attached.
CPT Code(s): 87070
0060103 Bone Culture MC BONE

Methodology: Culture/Identification
Specimen Required: Collect: Bone.
Specimen Preparation: Transfer bone to a sterile container and place on gauze moistened with sterile non-bacteriostatic saline to prevent drying.
Unacceptable Conditions: Dry specimens.
CPT Code(s): 87070
0060104 Bone Marrow Culture MC BM

Specimen Required: Collect: Bone marrow, aspirate in sterile SPS Vacutainer® tube (ARUP Supply #24964). Available online through eSupply using ARUP
Connect™ or contact ARUP Client Services at (800) 522-2787.
Specimen Preparation: Transport bone marrow in SPS tube. (Min: 0.5 mL)
For AFB and fungal culture order Blood Culture, AFB & Fungal (ARUP test code 0060024).
Unacceptable Conditions: Specimens submitted in anticoagulant other than SPS.
CPT Code(s): 87070
Bone Marrow Services

Methodology: Microscopy
Specimen Required: Collect: Contact your ARUP Business Development Manager or the Hematopathology Department at (800) 242-2787 for more information.
Bone marrow in lavender (EDTA) or pink (K2EDTA).

Specimen Preparation: Transport 5 mL bone marrow (Min: 5 mL).
AND transport 2 unfixed bone marrow aspirate slides for each stain requested (Min: 2 slides/stain).
Remarks: Collection/Submission instructions must be followed. Submit clinical history and a preliminary report. If special studies are anticipated
such as cytogenetics, flow cytometry, etc., submit additional specimens in appropriate anticoagulant/fixative if required.
Unacceptable Conditions: Specimens older than 24 hours. Clotted or hemolyzed specimens.
CPT Code(s): Varies, depending upon actual testing performed.
0070053 Bone Specific Alkaline Phosphatase BSAP

Unacceptable Conditions: Urine. Grossly hemolyzed specimens.
CPT Code(s): 84080
2001774 Bordetella pertussis Antibodies, IgA and IgG by ELISA with Reflex to Immunoblot BORDPAN2
Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Qualitative Immunoblot
Tube. (Min: 0.3 mL) Parallel testing is preferred, and convalescent specimens must be received within 30 days from receipt of the acute
Unacceptable Conditions: Contaminated, heat-inactivated, or severely lipemic specimens.
CPT Code(s): 86615 x2 Bordetella IgA and IgG; if reflexed, add 86615 for each Bordetella Immunoblot
2001775 Bordetella pertussis Antibodies, IgA, IgG, and IgM by ELISA with Reflex to Immunoblot BORDPAN3
Tube. (Min: 0.3 mL) Parallel testing is preferred, and convalescent specimens must be received within 30 days from receipt of the acute
CPT Code(s): 86615 x3 Bordetella (IgA, IgG, & IgM); if reflexed, add 86615 for each Bordetella Immunoblot
2004328 Bordetella pertussis Antibodies, IgA, IgG, & IgM by Immunoblot BORD BLOTS
Methodology: Qualitative Immunoblot
Page | 117
Tube. (Min: 0.2 mL)
Unacceptable Conditions: Heat-inactivated specimens.
2001784 Bordetella pertussis Antibodies, IgG and IgM by ELISA with Reflex to Immunoblot BORDPAN
Tube. (Min: 0.3 mL) Parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of the acute specimens.
CPT Code(s): 86615 x2 Bordetella (IgG & IgM); if reflexed add 86615 for each Bordetella Immunoblot
2004316 Bordetella pertussis Antibody, IgA by Immunoblot BORDA BLOT

Unacceptable Conditions: Contaminated or heat-inactivated specimens.
CPT Code(s): 86615
2005268 Bordetella pertussis Antibody, IgG by ELISA BORDIGG

Unacceptable Conditions: Contaminated, heat-inactivated, hemolyzed, or severely lipemic specimens.
CPT Code(s): 86615
2001768 Bordetella pertussis Antibody, IgG by ELISA with Reflex to Immunoblot BORDG
CPT Code(s): 86615 Bordetella IgG; if reflexed add 86615 Bordetella IgG Immunoblot
2004327 Bordetella pertussis Antibody, IgG by Immunoblot BORDG BLOT

CPT Code(s): 86615
2001769 Bordetella pertussis Antibody, IgM by ELISA with Reflex to Immunoblot BORDM
CPT Code(s): 86615 Bordetella IgM; if reflexed add 86615 for Bordetella IgM Immunoblot
2004326 Bordetella pertussis Antibody, IgM by Immunoblot BORDM BLOT

Page | 118
CPT Code(s): 86615
0065078 Bordetella pertussis by PCR BPERT

Methodology: Polymerase Chain Reaction
Specimen Required: Collect: Respiratory specimens on rayon or Dacron® swab, or direct respiratory specimen such as BAL, respiratory aspirate, or sputum.
Specimen source is required.
Storage/Transport Temperature: 2 mL respiratory specimen on swab or direct respiratory specimen should be sent in sterile container, or in viral
transport media (Microtest M4 or UTM) (ARUP supply #12884), frozen. (Min: 0.5 mL)
Unacceptable Conditions: Calcium-alginate swabs (shown to inhibit PCR). Respiratory aspirates in collection containers with tubing.
Stability: Ambient: 4 hours; Refrigerated: 2 days; Frozen: 2 weeks
CPT Code(s): 87798
0060117 Bordetella pertussis Culture MC PERT

Specimen Required: Collect: Nasal aspirate or washing or nasopharyngeal swab.
Specimen Preparation: Aspirate or Washing: Transfer to a sterile container.(Min: 0.5 mL). Nasopharyngeal Swab: Place swab in Regan-Lowe
transport media and incubate for 24-48 hours at 35°C (ARUP supply# 24962). Available online through eSupply using ARUP Connect™ or
contact ARUP Client Services at (800) 522-2787. Also acceptable: Swab in Jones Kendrick media or Amies with charcoal media, or swabs in
described media sent directly without incubation.
Storage/Transport Temperature: Room temperature or refrigerated.
Unacceptable Conditions: Sputum, Eswabs or medias other than listed above.
Stability: Incubated Regan-Lowe: Ambient: 4 days; Refrigerated: 4 days; Frozen: Unacceptable
Unincubated Regan-Lowe, Amie with charcoal swab, Aspirate or Washing: Ambient: 48 hours; Refrigerated: 48 hours; Frozen: Unacceptable
CPT Code(s): 87081 presumptive identification. If definitive identification required, add 87077.
2004667 Bordetella pertussis DFA PERTFA

Methodology: Direct Fluorescent Antibody Stain
Specimen Required: Collect: Nasal aspirate or washing or nasopharyngeal swab.
Specimen Preparation: Aspirate or Washing: Transfer to a sterile container.(Min: 0.5 mL)
Nasopharyngeal Swab: Place swab in Regan-Lowe transport media and incubate for 24-48 hours at 35°C (ARUP supply# 24962). Available
online
through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. Also acceptable: Swab in Jones Kendrick media or
Aimes
with charcoal media, or swabs in described media sent directly without incubation.
If both culture and DFA are ordered, two swabs or swab plus slides are required.
Remarks: Source of specimen is preferred.
Unacceptable Conditions: Sputum. Swabs or media other than listed above.
Stability: Incubated Regan-Lowe: Ambient: 4 days; Refrigerated: 4 days; Frozen: Unacceptable.
Unincubated Regan-Lowe, Aimes with charcoal swab, Aspirate or Washing: Ambient: 48 hours; Refrigerated: 48 hours; Frozen:
Unacceptable.
Slides: Ambient: 1 week; Refrigerated: 1 week; Frozen: 1 month
CPT Code(s): 87265
0065080 Bordetella pertussis/parapertussis by PCR BORD PCR

Specimen Required: Collect: Respiratory specimen: Aspirate, bronchoalveolar lavage (BAL), swab or sputum.
Specimen Preparation: Fluid: Transfer 2 mL respiratory specimen to a sterile container. (Min: 0.5 mL) Also acceptable: Transfer to viral transport
media (ARUP supply #12884). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787
Swabs: Place in viral transport media.
Unacceptable Conditions: Calcium-alginate swabs.
Stability: Ambient: 24 hours; Refrigerated: 5 days; Frozen: 2 weeks.
CPT Code(s): 87801
0091330 Boron, Serum or Plasma BORON SP

Methodology: Quantitative Inductively Coupled Plasma-Optical Emission Spectrometry
Specimen Required: Collect: Royal blue, plastic (trace metal-free; EDTA) or royal blue, plastic (trace metal-free; no additive).
Specimen Preparation: Separate from cells within 2 hours of draw. Transfer 2 mL serum or plasma to an ARUP Trace Element-Free Transport
Tube (ARUP supply #43116). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.
(Min: 0.7 mL)
Unacceptable Conditions: Glass containers or separator tubes.
CPT Code(s): 83018
0091331 Boron, Urine BORON URN

has been administered, a specimen cannot be collected for 48 hours.
Specimen Required: Collect: Random urine in a plastic trace metal-free or acid-washed container.
Specimen Preparation: Transfer 6 mL urine to ARUP Trace Element-Free Transport Tubes (ARUP supply #43116). Available online through
Unacceptable Conditions: Glass containers.
Page | 119
CPT Code(s): 83018
0050254 Borrelia burgdorferi Antibodies, IgG & IgM by Western Blot LYME WB
Methodology: Qualitative Western Blot
Tube. (Min: 0.1 mL)
Unacceptable Conditions: CSF or plasma. Contaminated, heat-inactivated, hemolyzed, or severely lipemic specimens.
CPT Code(s): 86617 Lyme IgG; 86617 Lyme IgM
0055260 Borrelia burgdorferi Antibodies, IgG & IgM by Western Blot (CSF) LYME WBCSF
Specimen Preparation: Transfer 3 mL CSF to an ARUP Standard Transport Tube. (Min: 2 mL)
CPT Code(s): 86617 B. burgdorferi IgG WB; 86617 B. burgdorferi IgM WB
0050216 Borrelia burgdorferi Antibodies, Total by ELISA LYME EIA

Tube. (Min: 0.1 mL)
Unacceptable Conditions: CSF. Contaminated, heat-inactivated, hemolyzed, or severely lipemic specimens.
CPT Code(s): 86618
0099483 Borrelia burgdorferi Antibodies, Total by ELISA (CSF) LYME CSF

CPT Code(s): 86618
0050267 Borrelia burgdorferi Antibodies, Total by ELISA with Reflex to IgG & IgM by Western Blot (Early Disease) LYME ACUTE
Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Qualitative Western Blot
Tube. (Min: 0.1 mL)
CPT Code(s): 86618 B. burgdorferi total Ab. IgG/IgM; if reflexed, add 86617 B. burgdorferi Western blot IgG and 86617 B. burgdorferi Western blot IgM
0050255 Borrelia burgdorferi Antibody, IgG by Western Blot LYME G WB

Tube. (Min: 0.1 mL)
Unacceptable Conditions: CSF or plasma. Contaminated, heat-inactivated, hemolyzed, severely lipemic specimens.
CPT Code(s): 86617
0055259 Borrelia burgdorferi Antibody, IgG by Western Blot (CSF) LYMEGWBCSF

CPT Code(s): 86617
Page | 120
0050253 Borrelia burgdorferi Antibody, IgM by Western Blot LYME M WB
Tube. (Min: 0.1 mL)
CPT Code(s): 86617
0055258 Borrelia burgdorferi Antibody, IgM by Western Blot (CSF) LYMEMWBCSF

CPT Code(s): 86617
0051044 Borrelia burgdorferi C6 Peptide Antibodies, Total by ELISA C6 PEP

Specimen Preparation: Remove serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport
Tube. (Min: 0.1 mL)
Unacceptable Conditions: CSF. Contaminated, heat-inactivated, hemolyzed or lipemic specimens.
CPT Code(s): 86618
0051046 Borrelia burgdorferi C6 Peptide Antibodies, Total by ELISA (CSF) C6 PEP CSF
Remarks: Indicate source on test requisition.
Unacceptable Conditions: Specimen types other than CSF. Contaminated or heat-inactivated specimens.
Stability: Ambient: 8 hours; Refrigerated: 2 weeks; Frozen 1 year
CPT Code(s): 86618
0051043 Borrelia burgdorferi C6 Peptide Antibodies, Total by ELISA with Reflex to IgG & IgM by Western Blot C6 ACUTE R
Stability: After separation from cells: Ambient 48 hours; Refrigerated: 2 weeks; Frozen: 1 year
CPT Code(s): 86618 C6 Peptide; if positive add, 86617 x2 Lyme IgG/IgM
0051045 Borrelia burgdorferi C6 Peptide Antibodies, Total by ELISA with Reflex to IgG by Western Blot C6 CHRON R
Tube. (Min: 0.2 mL)
CPT Code(s): 86618 C6 Peptide; if positive, add 86617 Lyme IgG
0050268 Borrelia burgdorferi Total Antibodies, IgG and/or IgM by ELISA with Reflex to IgG by Western Blot (Late LYME CHRO
Disease)
Tube. (Min: 0.1 mL)
CPT Code(s): 86618 B. burgdorferi total Ab. IgG/IgM; if reflexed, add 86617 Borrelia burgdorferi Western blot IgG
0093170 Borrelia hermsii Antibody Panel, IFA BORRELIA

Methodology: Semi-Quantitative Immunofluorescence Assay
(Indirect Fluorescent Antibody)
Specimen Preparation: Tranfer 1 mL serum to an ARUP Standard Transport Tube (Min: 0.25 mL)
Page | 121
0055570 Borrelia Species by PCR (Lyme Disease) LYMEPCR
Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA) or serum separator tube. OR CSF, synovial fluid or tissue.
Specimen Preparation: Separate serum or plasma from cells. Transfer 1 mL serum, plasma, CSF or synovial fluid to a sterile container. (Min: 0.5
mL). Tissue: Transfer to a sterile container and freeze immediately.
Unacceptable Conditions: Heparinized specimens.
Stability: Tissue: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 1 year
All Others: Ambient: 8 hours; Refrigerated: 72 hours; Frozen: 1 year
CPT Code(s): 87476
2006297 Borrelia Species by PCR (Lyme Disease), Tick LYME TICK

Methodology: Qualitative Real-Time Polymerase Chain Reaction
Specimen Required: Collect: Deer tick
Specimen Preparation: Transfer one deer tick in 70 percent ethanol or in wet tissue to an ARUP Standard Transport Tube.
CPT Code(s): 87476
2002498 BRAF Codon 600 Mutation Detection by Pyrosequencing BRAF PCR

Methodology: Polymerase Chain Reaction/Pyrosequencing
Specimen Preparation: Formalin fix (10 percent neutral buffered formalin) and paraffin embed tissue. Protect from excessive heat. Transport
tissue block or 5 unstained 5-micron slides. (Min: 3 slides).
Unacceptable Conditions: Less than 25 percent tumor. Specimens fixed/processed in alternative fixatives (alcohol, Prefer®) or heavy metal
fixatives. Decalcified specimens.
CPT Code(s): 88381 Microdissection; 83907 Lysis; 83898 Amplification; 83904 Sequencing; 83912 Interpretation and report. Additional CPT code modifiers
may be required for procedures performed to test oncologic or inherited disorders.
0051750 BRAF Codon 600 Mutation Detection with Reflex to MLH1 Promoter Methylation BRAF RFLX
microns slides. (Min: 3 slides). Protect paraffin block and/or slides from excessive heat.
CPT Code(s): 83907 Lysis; 88381 Microdissection; 83904 Sequencing; 83898 Amplification; 83912 Interpretation and report; if reflexed, add 83896 x2 Nucleic
Acid Probes; 83898 x2 Amplification; 83912 Interpretation and report. Additional CPT code modifiers may be required for procedures performed
to test oncologic or inherited disorders.
2006516 BRAF V600E Mutation Detection by Allele-Specific PCR, Fine Needle Aspirate BRAF FNA
Specimen Required: Collect: Tumor cells by Fine Needle Aspiration (FNA).
Specimen Preparation: Prepare FNA smear and Diff-Quick or equivalent stain by standard methods.
Storage/Transport Temperature: Two FNA slides (min: 1 slide) Transport slide(s) in a tissue transport kit (ARUP supply # 47808) available online
Remarks: Include cytology report. For a general FNA collection and smear preparation refer to ARUP's Laboratory Test Directory: Cytology, Fine
Needle Aspiration Collection at http://www.aruplab.com/guides/ug/tests/arup014.jsp
Unacceptable Conditions: Slides with less than 50 atypical or tumor cells.
CPT Code(s): 88381 Microdissection; 83907 Lysis; 83898 x2 Amplification; 83896 Nucleic acid probe; 83912 Interpretation and report. Additional CPT code
modifiers may be required for procedures performed to test oncologic or inherited disorders.
2007132 BRAF V600E Mutation Detection in Hairy Cell Leukemia by Real-Time PCR, Quantitative BRAF HCL
Specimen Required: Collect: Lavender (EDTA) OR bone marrow (EDTA).
Specimen Preparation: Transport 5 mL whole blood. (Min: 1 mL) OR 3mL bone marrow (Min: 1 mL)
Unacceptable Conditions: Serum, plasma, FFPE tissue blocks/slides, or frozen tissue. Specimens collected in anticoagulants other than EDTA.
Clotted or severely hemolyzed specimens
CPT Code(s): 83891 Isolation; 83898 x2 Amplification; 83896 x2 Nucleic Acid Probe; 83912 Interpretation and report
2003472 Breast 2 (GCDFP-15) by Immunohistochemistry BRST2 IHC

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CPT Code(s): 88342
2003445 Breast Carcinoma b72.3 by Immunohistochemistry B72.3 IHC

CPT Code(s): 88342
0091291 Bretylium, Serum or Plasma BRETYLIUM

Specimen Required: Collect: Plain red, gray (sodium fluoride/potassium oxalate), green (sodium heparin), or lavender (EDTA).
CPT Code(s): 80299
0096065 Bretylium, Urine BRETYLIU

CPT Code(s): 80299
0090035 Bromide BR
Stability: After separation from cells: Ambient: 1 week; Refrigerated: 1 week; Frozen: Indefinitely
CPT Code(s): 80299
0060700 Bronchoscopy Culture MC BAL

Methodology: Quantitative Culture/Identification
Specimen Required: Collect: Lower respiratory material by bronchoscopy (BAL fluid or protected brush specimens).
Specimen Preparation: Transfer fluids to a sterile container.
Place each specimen in an individually sealed bag.
Stability: Ambient: Unacceptable; Refrigerated: 24 hours; Frozen: Unacceptable
CPT Code(s): 87071
0050135 Brucella Antibody (Total) by Agglutination BRUC

Methodology: Semi-Quantitative Agglutination
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 6 months (avoid repeated freeze/thaw cycles)
CPT Code(s): 86622
0060159 Brucella Culture MC BRUC

Specimen Required: Collect: Blood in sterile SPS Vacutainer® tube for microbiology (ARUP Supply #24964) or Bactec® Blood Culture bottles. Available online
through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. OR abscess, aspirate, body fluid, CSF, or tissues.
Specimen Preparation: Adult Blood: Transport 7 mL whole blood. (Min: 3 mL)*
Pediatric Blood: Transport 3 mL whole blood. (Min: 1 mL)*
Abscess, Aspirate, Body fluid, CSF: Transfer to a sterile container. Place each specimen in an individually sealed bag.
Page | 123
Tissue: Transfer tissue to a sterile container and place on gauze moistened with sterile non-bacteriostatic saline to prevent drying.
*Low volume will result in decreased recovery of pathogens.
Unacceptable Conditions: Swabs. Specimens submitted in anticoagulant other than SPS. Clotted blood specimens.
2006218 Brugada Syndrome Panel, 7 Genes BRS PANEL

0092566 Bullous Pemphigoid (180 kDa and 230 kDa) Antigens, IgG BP180 230G
Methodology: Enzyme-Linked Immunosorbent Assay
Unacceptable Conditions: Hemolyzed or lipemic specimens.
Stability: After separation from cells: Ambient: 72 hours; Refrigerated: 3 months; Frozen: Indefinitely
2002742 Buprenorphine and Metabolites - Confirmation/Quantitation - Serum/Plasma BUPREN SP

Specimen Required: Collect: Gray (sodium fluoride/potassium oxalate). Also acceptable: Plain red, green (sodium heparin), lavender (EDTA), or pink (K2EDTA).
Standard Transport Tube. (Min: 1 mL)
Unacceptable Conditions: Separator tubes. Plasma or whole blood collected in lt. blue (sodium citrate). Specimens exposed to repeated
freeze/thaw cycles.
Stability: After separation from cells: Ambient: 1 week; Refrigerated: 2 weeks; Frozen: 3 years
CPT Code(s): 83925
2002749 Buprenorphine and Metabolites - Confirmation/Quantitation - Urine BUPREN UR

Specimen Preparation: Transfer 2 mL urine with no additives or preservatives to an ARUP Standard Transport Tube. (Min: 1 mL)
Unacceptable Conditions: Specimens exposed to repeated freeze/thaw cycles.
Stability: Ambient: 1 week; Refrigerated: 1 month; Frozen: 3 years
CPT Code(s): 83925
0099184 Bupropion BUPROPION

Remarks:
CPT Code(s): 80299
0091299 Buspirone Quantitation, Serum or Plasma BUSPIRON

Patient Preparation: Recommended peak draw 40-90 minutes post dose.
CPT Code(s): 80299
0091164 Buspirone, Urine BUSPIRO U

Specimen Required: Collect: Urine. Recommended peak collection at 40-90 minutes post dose.
Remarks: Recommended peak occurs at 40 to 90 minutes post dose.
Stability: Ambient: 1 week; Refrigerated: 2 weeks: Frozen: 17 months
CPT Code(s): 82491
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0090980 Butabarbital, Serum or Plasma BUTABAR SP
CPT Code(s): 82205
0091170 Butabarbital, Urine BUTABA UR

CPT Code(s): 82205
0090045 Butalbital BUTAL

Methodology: Quantitative Gas Chromatography-Mass Spectrometry
Stability: After separation from cells: Ambient: 3 months; Refrigerated: 3 months; Frozen: 1 year
CPT Code(s): 82205
0091521 Butorphanol, Serum or Plasma - Screen with Reflex to Confirmation/Quantitation STADOL SP

Methodology: Qualitative High Performance Liquid Chromatography-Tandem Mass Spectrometry/Quantitative High Performance Liquid Chromatography-
Tandem Mass Spectrometry
Stability: Ambient: 1 week; Refrigerated: 10 days; Frozen: 1 month
CPT Code(s): 80101 Drug screen, if positive, add 83925
0091520 Butorphanol, Urine - Screen with Reflex to Confirmation/Quantitation STADOL UR

CPT Code(s): 80101 Drug screen; if positive, add 83925
0050139 C-1-Esterase Inhibitor Panel C1 INH PAN

Methodology: Immunoturbidimetry/Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Quantitative Nephelometry
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer three 1 mL aliquots of serum to individual
ARUP Standard Transport Tubes and freeze immediately. (Min: 0.5 mL/tube)
Stability: Refer to individual components.
CPT Code(s): 86160 Complement C4; 86160 C-1-Esterase inhibitor; 86161 C-1 Esterase inhibitor functional
0081121 C-Peptide, 24-Hour Urine CPEP UR

Specimen Required: Collect: 24-hour urine. Refrigerate during collection. Also acceptable: Random urine (no reference intervals).
Specimen Preparation: Transfer 2 mL aliquot from a well-mixed 24-hour urine to an ARUP Standard Transport Tube. (Min: 0.5 mL)
CPT Code(s): 84681
0070103 C-Peptide, Serum or Plasma C PEP

Patient Preparation: Fasting specimen preferred.
Specimen Required: Collect: Serum separator tube or plasma separator tube. Also acceptable: Green (sodium or lithium heparin), lavender (EDTA), or pink
(K2EDTA).
Specimen Preparation: Allow specimen to clot completely at room temperature. Separate serum or plasma from cells ASAP. Submit specimen in
an ARUP Standard Transport Tube.
Storage/Transport Temperature: Transport 1 mL serum or plasma, frozen. (Min: 0.5 mL)
Stability: After separation from cells: Ambient: 8 hours; Refrigerated: 2 days; Frozen: 1 month
CPT Code(s): 84681
Page | 125
0050180 C-Reactive Protein CRP
Specimen Required: Collect: Serum separator tube. Also acceptable: Plasma separator tube, green (lithium heparin), lavender (EDTA), or pink (K2EDTA).
collection. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.3 mL)
Stability: After separation from cells: Ambient: 11 days; Refrigerated: 2 months; Frozen: 3 years (if frozen within 24 hours)
CPT Code(s): 86140
0050182 C-Reactive Protein, High Sensitivity HSCRP

Specimen Required: Collect: Serum separator tube. Also acceptable: Plasma separator tube, lavender (EDTA), pink (K2EDTA), or green (sodium or lithium heparin).
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 months; Frozen: 1 year
CPT Code(s): 86141
0050181 C-Reactive Protein, Neonatal CRPN

Specimen Required: Collect: Plasma separator tube (PST) microtainer. Also acceptable: Serum separator tube (SST), lavender (EDTA) or pink (K2EDTA).
Specimen Preparation: Separate plasma or serum from cells within 2 hours of collection. If serum is used allow specimen to clot completely at
room temperature. Transport 0.2 mL serum. (Min: 0.1 mL)
Stability: After separation from cells: Ambient: 11 days; Refrigerated: 2 months; Frozen: 3 years
CPT Code(s): 86140
0070416 C-Telopeptide, Beta-Cross-Linked, Serum CTX

Patient Preparation: For patients receiving therapy with high biotin doses (e.g. greater than 5 mg/day), specimen should not be drawn until at
least 8 hours after the last biotin administration.
Specimen Required: Collect: Serum separator tube, pink (K2EDTA), or green (sodium heparin).
Specimen Preparation: Allow serum separator tube to sit for 15-20 minutes at room temperature for proper clot formation. Centrifuge and separate
serum or plasma from cells ASAP or within 2 hours of collection. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min:
0.5 mL)
CPT Code(s): 82523
0050140 C1-Esterase Inhibitor C1ESTER

Tube. (Min: 0.4 mL)
Stability: After separation from cells: Ambient: 2 hours; Refrigerated: Unacceptable; Frozen: 2 weeks
CPT Code(s): 86160
0050141 C1-Esterase Inhibitor Functional C1 INH F

Specimen Required: Collect: Serum separator tube lavender (EDTA), or pink (K2EDTA).
CPT Code(s): 86161
0050301 C1q Binding Assay C1Q

Specimen Preparation: Let stand on clot for two hours. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.3 mL) If ordered in
conjunction with a Raji Cell Assay, transfer two 1 mL aliquots of serum to individual ARUP Standard Transport Tubes.
Stability: After separation from cells: Ambient: 2 hours; Refrigerated: Unacceptable; Frozen: 2 weeks (avoid repeated freeze/thaw cycles)
CPT Code(s): 86332
2003475 C4D by Immunohistochemistry C4D IHC

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CPT Code(s): 88342
0099675 Cadmium, Blood CADMIUM B

discontinue nutritional supplements, vitamins, minerals, non-essential over-the-counter medications (upon the advice of their physician).
CPT Code(s): 82300
0025013 Cadmium Exposure Panel - OSHA CD EXP

Methodology: Cadmium, Urine & Blood: Quantitative Inductively Coupled Plasma-Mass Spectrometry
Urine: Spectrophotometry
Urine: Chemiluminescent Immunoassay
Specimen Required: Collect: Royal blue (K2EDTA or Na2EDTA) AND minimum 40 mL urine using spot technique (single void) in an open-top urine collection cup.
To avoid contamination, please collect specimens at the beginning of work shift. Blood and urine should be collected the same day.
Specimen Preparation: Blood: Transport 7 mL whole blood.
Urine for -2-Microglobulin: Transfer aliquot from original urine collection to an ARUP Standard Transport Tube. Adjust the pH of this
specimen immediately after pouring off collection so that the pH is between 6 and 8. Use 1M HCl or 5% NaOH to adjust the urine pH. Label tube
as -2-Microglobulin. Freeze within one hour of collection.
Urine for Cadmium: Transfer aliquot from original urine collection to an ARUP Standard Transport Tube. Add 0.1 mL of the 12M HNO3 to the
aliquot. Label tube as Cadmium.
Urine for Creatinine: Transfer aliquot from original urine collection to an ARUP Standard Transport Tube. Label tube as Creatinine.
Storage/Transport Temperature: Blood: Refrigerated.
Urine for -2-Microglobulin: Frozen.
Urine for Cadmium: Refrigerated.
Urine for Creatinine: Refrigerated.
MRI studies).
CPT Code(s): 82300 Cadmium, blood; 82300 Cadmium, urine; 82232 2 Microglobulin; 82570 Creatinine, Urine
0025040 Cadmium, Urine CADMIUM U

CPT Code(s): 82300
0090050 Caffeine CAF

Methodology: Quantitative Enzyme Multiplied Immunoassay Technique
Specimen Required: Collect: Plain red. Also acceptable: Lavender (EDTA), pink (K2EDTA or K3EDTA), green (sodium or lithium heparin), or gray (sodium
fluoride/potassium oxalate). Also acceptable (avoid if possible): Serum separator tube or plasma separator tube (follow preparation instructions
below).
Specimen Preparation: Separate serum or plasma from cells within 6 hours of collection. Transfer 0.5 mL serum or plasma to an ARUP Standard
SST or PST: Serum or plasma in a gel separator tube stored at room temperature is acceptable if separated from the gel within 6 hours. Serum or
plasma in a gel separator tube stored refrigerated is acceptable if separated from the gel within 2 hours.
Unacceptable Conditions: Citrated plasma. Tubes that contain liquid anticoagulant.
CPT Code(s): 80299
0070006 Calcitonin CALCI

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Unacceptable Conditions: Tissue or urine. EDTA plasma. Grossly hemolyzed or lipemic specimens.
CPT Code(s): 82308
2003481 Calcitonin by Immunohistochemistry CALCIT IHC

CPT Code(s): 88342
0020135 Calcium, Ionized, Serum IONCA-S

Methodology: Ion-Selective Electrode/pH Electrode
Specimen Preparation: Do not open the tube or split the specimen. Do not freeze separator tube. Do not expose specimen to air at any time
during collection or transport process. Centrifuge with stopper in place within one hour of collection. Transport 5 mL serum in original serum
separator tube. (Min: 0.5 mL)
Storage/Transport Temperature: Refrigerated. Ship upright in original serum separator collection tube and transport in the ARUP shipping rack.
Do not ship on dry ice.
CPT Code(s): 82330
0020140 Calcium, Ionized, Whole Blood IONCA-WB

Methodology: Ion-Selective Electrode/pH Electrode
Specimen Required: Collect: Testing available to UUHC clients only.
Green (sodium or lithium heparin). Collect on ice.
Pediatric Collect: 2 full heparinized capillary tubes (call lab for tube).
Specimen Preparation: Do not freeze. Transport minimum 0.5 mL specimen.
Pediatric Specimen Preparation: Transport 2 full heparinized capillary tubes.
Storage/Transport Temperature: Deliver to lab within 10 minutes on wet ice.
Unacceptable Conditions: Frozen or room temperature specimens.
CPT Code(s): 82330
0020027 Calcium, Serum or Plasma CA

Specimen Required: Collect: Serum separator tube or plasma separator tube. Do not use powdered gloves during collection.
Unacceptable Conditions: Specimens from patients receiving EDTA therapy or Hypaque. EDTA, citrate, or oxalate.
CPT Code(s): 82310
0020472 Calcium, Urine UCA

Specimen Required: Collect: 24-hour urine specimens. Urine must be refrigerated during collection. Also acceptable: Random urine.
Specimen Preparation: Adjust pH to 1.5-2.0 by adding 6M HCl in 1 mL increments. Transfer one 3 mL aliquot from a well-mixed 24-hour
collection to an ARUP Standard Transport Tube. (Min: 0.5 mL) Record total volume, collection time interval, and pH on transport tube and test
request form.
Stability: Ambient: 48 hours; Refrigerated: 4 days; Frozen: 3 weeks
CPT Code(s): 82340
0099460 Calculi (Stone) Analysis CALCULI

Methodology: Quantitative Reflectance Fourier Transform Infrared Spectroscopy/Quantitative Polarizing Microscopy
Specimen Required: Collect: Calculi specimen.
Specimen Preparation: Air-dry calculi and transfer to an ARUP Standard Transport Tube. Larger calculi specimens may be transferred to a
clean, empty urine cup (150 mL) or similar container.
Storage/Transport Temperature: Room temperature. Also acceptable: Frozen or refrigerated.
Remarks: Calculi specimens transported in liquid or contaminated with blood require special handling which will delay analysis. Specimens that
are wrapped in tape or embedded in wax will delay or prevent analysis and should not be submitted.
Unacceptable Conditions: Any collection or shipping container with a needle attached.
Stability: Ambient: Indefinitely; Refrigerated: Indefitnitely; Frozen: Indefinitely
CPT Code(s): 82365
Page | 128
2005231 Calculi (Stone) Analysis with Photo CALCPHOTO
Methodology: Quantitative Reflectance Fourier Transform Infrared Spectroscopy/Quantitative Polarizing Microscopy
Specimen Required: Collect: Calculi specimen greater than 2 mg.
Specimen Preparation: Air dry calculi and transfer to an ARUP Standard Transport Tube. Larger calculi specimens may be transported in a
clean, empty urine cup (150 mL) or similar container.
Remarks: Calculi specimens that are transported in liquid and received wet or bloody will be dried for 48-72 hours, which will cause a delay in
processing.
Unacceptable Conditions: Specimens that are wrapped in tape or embedded in wax will delay or prevent analysis and should not be submitted.
Stability: Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Indefinitely
CPT Code(s): 82365
2003484 Caldesmon by Immunohistochemistry CALDES IHC

CPT Code(s): 88342
0098893 California Encephalitis Antibody, IgG by IFA, CSF CAL G CSF

CPT Code(s): 86651
0050508 California Encephalitis Antibody, IgG by IFA, Serum CALIF

specimens. Please mark specimens plainly as acute or convalescent.
Unacceptable Conditions: Contaminated, hemolyzed, severely lipemic specimens.
CPT Code(s): 86651
0098898 California Encephalitis Antibody, IgM by IFA, CSF CAL M CSF

CPT Code(s): 86651
0098731 California Encephalitis Antibody, IgM by IFA, Serum CAL M SER

Specimen Preparation: Remove from serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard
Transport Tube. (Min: 0.15 mL) Parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of the
acute specimens. Mark specimens plainly as acute or convalescent.
Unacceptable Conditions: Plasma. Heparinized specimens. Contaminated, heat-inactivated, or severely lipemic specimens.
CPT Code(s): 86651
2003487 Calponin by Immunohistochemistry CALPON IHC

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CPT Code(s): 88342
0092303 Calprotectin, Fecal CALPRO

ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 1 g)
Stability: Ambient: 5 days; Refrigerated: 5 days; Frozen: 1 year
CPT Code(s): 83993
2003490 Calretinin by Immunohistochemistry CALRET IHC

CPT Code(s): 88342
0058002 Campylobacter Antigen CAMPY

Methodology: Qualitative Immunochromatography
Specimen Preparation: Transfer 5 g stool to an unpreserved stool transport vial (ARUP supply #40910).OR place 5 g stool in enteric transport
media (Cary-Blair) within one hour of collection (ARUP supply #29799). (Min: 1 g)
Unacceptable Conditions: Specimens in any transport media other than indicated above.
Stability: Ambient: Unacceptable; Refrigerated: 4 days; Frozen: 2 weeks
CPT Code(s): 87899
0098841 Campylobacter jejuni Antibody, IgG CAMP JEJ

Specimen Preparation: Separate serum or plasma from cells ASAP or within 2 hours of collection. Transport 1 mL serum. (Min: 0.15 mL)
CPT Code(s): 86625
0051454 Canavan (ASPA) 4 Mutations, Fetal ASPA FE

CPT Code(s): 83891 Isolation; 83892 x2 Digestion; 83900 Multiplex amplification (first two amplifications); 83901 Additional amplification; 83914 x5
Extension; 83909 Capillary electrophoresis; 83912 Interpretation and report. FCC: 83900 Multiplex amplification (first two sequences); 83901
x14 Additional amplification; 83909 Capillary electrophoresis. If MCC MAT (0050608) is performed: 83891 Isolation; 83900 Multiplex
amplification; 83901 x14 Additional amplification; 83909 Capillary electrophoresis; 83912 Interpretation and report - Additional CPT code
0051453 Canavan Disease (ASPA) 4 Mutations ASPA

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CPT Code(s): 83891 Isolation; 83892 x2 Enzymatic digestion; 83900 Amplification multiplex (first two amplifications); 83901 Amplification multiplex (each
additional amplification) 83914 x5 Mutation identification; 83909 Separation and identification; 83912 Interpretation and report - Additional CPT
0080392 Cancer Antigen 27.29 CA27.29

CPT Code(s): 86300
0080462 Cancer Antigen 125 CA125

Specimen Required: Collect: Plasma separator tube or serum separator tube. Also acceptable: Green (sodium or lithium heparin), lavender (EDTA), or pink (K2EDTA).
CPT Code(s): 86304
2003478 Cancer Antigen 125 by Immunohistochemistry CA125 IHC

CPT Code(s): 88342
0080464 Cancer Antigen-Breast (CA 15-3) CA-BREAST

(K2EDTA).
CPT Code(s): 86300
0080461 Cancer Antigen-GI (CA 19-9) CA-GI

(K2EDTA).
Unacceptable Conditions: Body Fluid (refer to Cancer Antigen-GI (CA19-9), Body Fluid, ARUP test code 0020746). Specimens collected in
sodium citrate.
CPT Code(s): 86301
0020746 Cancer Antigen-GI (CA 19-9), Body Fluid CA-GI FL

Specimen Preparation: Transport 1 mL body fluid. (Min: 0.5 mL)
Stability: Ambient: 8 hours; Refrigerated: 5 days; Frozen: 3 months
CPT Code(s): 86301
0095200 Candida albicans Antibodies IgA, IgG, and IgM by ELISA CANDIDA AB
Tube (Min: 0.1 mL)
Page | 131
0055565 Candida Antibody by ID CAN PPT

CPT Code(s): 86628
0091339 Canrenone, Serum or Plasma CANRENON

Methodology: Spectrofluorometry
Specimen Preparation: Protect from light. Transfer 1 mL serum or plasma to an ARUP Amber Transport Tube.
CPT Code(s): 80299
0091502 Canrenone, Urine CANREN UR

Specimen Preparation: Transfer 2 mL urine to an ARUP Standard Transport Tube.
CPT Code(s): 80299
0091166 Carbamazepine - 10,11 Epoxide, Urine CARB EP U

CPT Code(s): 80156
0092211 Carbamazepine Epoxide and Total CARB EPOXT

Methodology: Quantitative Liquid Chromatography-Tandem Mass Spectrometry/Quantitative Enzyme Multiplied Immunoassay Technique
Patient Preparation: Obtain trough specimen after steady-state is achieved (3-5 days). Draw within one hour prior to next dose. The epoxide
half-life is 6-10 hours.
CPT Code(s): 80156; Carbamazepine, total; 80299 Carbamazepine, Epoxide
0090615 Carbamazepine, Free and Total FCARB

Specimen Required: Collect: Plain red. Also acceptable (avoid if possible): Serum separator tube (follow preparation instructions below).
Specimen Preparation: Separate serum from cells within 2 hours of collection. Transfer 2 mL serum to an ARUP Standard Transport Tube. (Min:
1 mL)
Remarks: Separate serum from cells ASAP.
Stability: After separation from cells: Ambient: 5 days; Refrigerated: 5 days; Frozen: 4 months
CPT Code(s): 80156 Carbamazepine, total; 80157 Carbamazepine, free
0090260 Carbamazepine, Total TEG

Methodology: Enzyme Immunoassay
Specimen Preparation: Allow specimen to clot completely at room temperature. Ensure complete clot formation has taken place prior to
centrifugation. Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport Tube.
(Min: 0.5 mL)
Unacceptable Conditions: Separator tubes or potassium oxalate/sodium fluoride tubes. EDTA plasma.
Stability: After separation from cells: Ambient: 2 days; Refrigerated: 7 days; Frozen: 1 month
CPT Code(s): 80156
0091352 Carbidopa and Levodopa Quantitation, Serum or Plasma SINEMET SP

Specimen Preparation: Separate serum or plasma from cells within 2 hours of draw. Transfer 2 mL serum or plasma to an ARUP Standard
Page | 132
CPT Code(s): 80299
0070412 Carbohydrate Deficient Transferrin for Alcohol Use CDT

Methodology: Quantitative Electrophoresis
Unacceptable Conditions: Plasma. Hemolyzed specimens.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 10 days; Frozen: 1 month
CPT Code(s): 82373
2002918 Carbohydrate Deficient Transferrin for Congenital Disorders of Glycosylation CARBOH-CDG

Methodology: Affinity Chromatography/Mass Spectrometry
Remarks: Patient age is required on the test request form. Provide reason (eg, diagnosis) for referral with each specimen.
CPT Code(s): 82373
0020004 Carbon Dioxide, Serum or Plasma CO2

collection. Transport 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.2 mL)
Unacceptable Conditions: Other body fluids. Specimens containing citrate as anticoagulant.
Stability: After separation from cells: Ambient: 4 hours; Refrigerated: 1 week (in a closed container); Frozen: 1 month (in a closed container)
CPT Code(s): 82374
2005757 Carboxyhemoglobin Quantitation, Whole Blood by Co-Oximetry CARBOXY HB

Specimen Required: Collect: Green (sodium or lithium heparin). Do not collect by finger stick or heel stick. Collect Sunday-Thursday only.
Specimen Preparation: Keep specimen anaerobic; do not remove cap from collection tube. Refrigerate within 30 minutes after collection.
Transport 5 mL whole blood. (Min: 0.5 mL) Specimen should be received within 24 hours of collection.
Storage/Transport Temperature: Refrigerated. Separate specimens must be submitted when multiple tests are ordered. Ship Sunday- Thursday
only.
Unacceptable Conditions: Specimens collected in EDTA tubes or not anaerobically. Specimens that have been opened or exposed to room air.
Frozen or room temperature specimens. Specimens containing air bubbles or clots.
Stability: Ambient: Unacceptable; Refrigerate: 72 hours; Frozen: Unacceptable
CPT Code(s): 82375
0080080 Carcinoembryonic Antigen CEA

Unacceptable Conditions: Body Fluid (refer to Carcinoembryonic Antigen, Fluid, ARUP test code 0020742). Plasma.
CPT Code(s): 82378
0020742 Carcinoembryonic Antigen, Fluid CEA FL

Specimen Preparation: Transfer 1 mL body fluid to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Remarks: Indicate a source on test request form.
CPT Code(s): 82378
2003824 Carcinoembryonic Antigen, Monoclonal (CEA M) by Immunohistochemistry CEA M IHC

CPT Code(s): 88342
Page | 133
2003827 Carcinoembryonic Antigen, Polyclonal (CEA P) by Immunohistochemistry CEA P IHC
CPT Code(s): 88342
0051600 Cardiolipin and Non-Criteria Anti-Phospholipid Syndrome (APS) Antibody Panel PHOS PAN
Tube. (Min: 1.2 mL)
Unacceptable Conditions: Urine or plasma. Contaminated, heat-inactivated, grossly hemolyzed, icteric, or lipemic specimens.
CPT Code(s): 86147 x3 aCL IgG, IgM, & IgA; 86148 x3 aPS IgG, IgM, & IgA; 83520 x9 aPE, aPG, aPI IgG, IgM, & IgA
0099344 Cardiolipin Antibodies, IgG and IgM ANTI-CARD

Tube. (Min: 0.3 mL)
Unacceptable Conditions: Plasma or other body fluids. Contaminated, heat-inactivated, hemolyzed, or lipemic specimens.
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen 1 year (avoid repeated freeze/thaw cycles)
0051162 Cardiolipin Antibodies, IgG, IgM, and IgA CARD PAN

Tube. (Min: 0.3 mL)
CPT Code(s): 86147 AC-IgG; 86147 AC-IgM; 86147 AC-IgA
0098358 Cardiolipin Antibody, IgA CARDIO IGA

Tube. (Min: 0.3 mL)
CPT Code(s): 86147
0050901 Cardiolipin Antibody, IgG AC-IGG

Tube. (Min: 0.3 mL)
CPT Code(s): 86147
0050902 Cardiolipin Antibody, IgM AC-IGM

Tube. (Min: 0.3 mL)
CPT Code(s): 86147
0090600 Carisoprodol and Meprobamate CARIS

Methodology: Gas Chromatography-Mass Spectrometry
Page | 134
Stability: After separation from cells: Ambient: 1 week; Refrigerated: 1 month; Frozen: 3 months
CPT Code(s): 83805 Meprobamate; 80299 Carisoprodol
2007234 Carisoprodol and Metabolite, Urine CARIS URN

Specimen Required: Collect: Urine
Specimen Preparation: Transport 2 mL urine in an ARUP Standard Transport Tube. (Min: 0.7 mL)
Storage/Transport Temperature: Refrigerated. Also acceptable: Room temperature or frozen
CPT Code(s): 80299 Carisoprodol; 83805 Meprobamate
0080065 Carnitine, Free CARN

Specimen Preparation: Separate serum or plasma from cells and freeze ASAP or within 2 hours of collection. Transfer 0.5 mL serum or plasma to
an ARUP Standard Transport Tube and freeze immediately. (Min: 0.2 mL) Avoid hemolysis.
Unacceptable Conditions: Room temperature specimens. Specimens that have been refrigerated for greater than 12 hours.
CPT Code(s): 83789
0080068 Carnitine, Free & Total (Includes Carnitine, Esterified) CARN F&T
Unacceptable Conditions: Room temperature specimens. Specimens refrigerated greater than 12 hours.
CPT Code(s): 82379
0081308 Carnitine, Free & Total, Urine CARN URINE

Specimen Preparation: Freeze specimen immediately after collection. Transport 5 mL urine. (Min: 2 mL)
CPT Code(s): 82379
0081309 Carnitine, Free, Urine CARNU FREE

CPT Code(s): 83789
0081110 Carnitine Panel CARNPAN

Specimen Preparation: Separate plasma or serum from cells ASAP or within 2 hours of collection. Transfer 0.5 mL serum or plasma to an ARUP
CPT Code(s): 82017 Acylcarn; 82379 Carnitine
0080067 Carnitine, Total CARN TOTAL

Stability: Ambient: Unacceptable; Refrigerated: 12 hours; Frozen: 1 month (avoid repeated freeze thaw cycles)
CPT Code(s): 83789
0081307 Carnitine, Total, Urine CARNU TOT

Page | 135
CPT Code(s): 83789
0080512 Carnitine Transport, Fibroblasts CARNIFIBRO

Methodology: Radioassay
Specimen Required: Collect: Fibroblasts from skin biopsy.
Specimen Preparation: Cells should be kept in 37°C incubator until shipped. Transport two T-25 flasks of fibroblasts from skin biopsy.
Storage/Transport Temperature: CRITICAL ROOM TEMPERATURE. Call lab before shipping. Ship Monday-Thursday only.
Unacceptable Conditions: Frozen or refrigerated specimens. Specimens in improper media. Dead cells.
Stability: Ambient: 4 days; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 84238
0080055 Carotene, Serum Total CARO

Patient Preparation: Fasting specimens preferred.
Specimen Preparation: CRITICAL: Protect from light immediately after collection and during storage and shipment. Transfer 3 mL serum to
ARUP Amber Transport Tube. (Min: 1.1 mL)
Storage/Transport Temperature: Frozen. Separate specimens must be submitted when multiple tests are ordered.
Unacceptable Conditions: Any specimen other than serum. Refrigerated or room temperature specimens. Hemolyzed or icteric specimens.
CPT Code(s): 82380
0021021 Carotenes, Fractionated, Plasma or Serum CARO FRAC

Patient Preparation: Patient should fast overnight for 12 hours and should not consume alcohol for 24 hours prior to blood draw.
Specimen Preparation: CRITICAL: Protect from light within one hour of collection and during storage and shipment. Transfer 1 mL serum or
plasma to an ARUP Amber Transport Tube ASAP or within 2 hours of collection. (Min: 0.3 mL)
Unacceptable Conditions: EDTA plasma, whole blood, or body fluids. Room temperature specimens. Hemolyzed specimens.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 72 hours; Frozen: 1 year
CPT Code(s): 82380
2003496 Caspase-3 by Immunohistochemistry CASPA3 IHC

Unacceptable Conditions: Depleted specimens. Specimens submitted with non-representative tissue type.
Stability: Ambient: Indefinite; Refrigerated: Indefinite; Frozen: Unacceptable
CPT Code(s): 88342
2006224 Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) Panel, 3 Genes CPVT PANEL
0080407 Catecholamines Fractionated by LC-MS/MS, Urine Free CATE UF

Patient Preparation: Abstain from medications for 72 hours prior to collection.
Specimen Required: Collect: 24-hour or random urine. Refrigerate 24-hour specimen during collection.
Specimen Preparation: Transfer a 4 mL aliquot from a well-mixed 24-hour or random collection to an ARUP Standard Transport Tube. (Min: 2.5
mL) Preservation can be enhanced by adjusting the pH to 2-3 by adding an acid such as 6 mol/L HCl. Catecholamines are not stable above pH 7.
The pH of such specimens must be adjusted by the addition of acid prior to transport. A pH less than 2 can cause assay interference. Record total
Stability: Ambient: Unacceptable; Refrigerated: 1 month; Frozen: 6 months
CPT Code(s): 82384
Page | 136
0080957 Catecholamines Fractionated (Epinephrine, Norepinephrine), Plasma CATE PF,EN
Patient Preparation: Patient should be calm and supine for 30 minutes prior to collection.
Specimen Preparation: Specimen should be centrifuged and frozen within one hour (refrigerated centrifuge is preferred but not required). Transfer
4 mL plasma to an ARUP Standard Transport Tube. (Min: 2.1 mL)
Unacceptable Conditions: EDTA plasma, serum, or urine.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen at -20°C: 1 month; Frozen at -70°C: 1 year
CPT Code(s): 82384
0080216 Catecholamines Fractionated, Plasma CATE PF

Patient Preparation: Patient should be calm and supine for 30 minutes prior to collection.
Specimen Preparation: Specimen should be centrifuged and frozen within one hour (refrigerated centrifuge is preferred but not required). Transfer
4 mL plasma to an ARUP Standard Transport
Tube. (Min: 2.1 mL)
Unacceptable Conditions: EDTA plasma, serum, or urine.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen at -20°C: 1 month; Frozen at -70°C: 1 year
CPT Code(s): 82384
0040002 CBC with Platelet Count CBC

Methodology: Automated Cell Count
Unacceptable Conditions: Frozen specimens. Clotted or hemolyzed specimens.
Stability: Ambient: 8 hours; Refrigerated: MPV: 8 hours, All Others: 24 hours; Frozen: Unacceptable
CPT Code(s): 85027
0040003 CBC with Platelet Count and Automated Differential CBCAD

Methodology: Automated Cell Count/Differential
Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA) AND unstained whole blood smears.
Specimen Preparation: Transport 3 mL whole blood AND 2 unstained whole blood smears. (Min: 0.5 mL. Tube must contain at least 0.25 mL of
specimen AND two unstained blood smears.)
Unacceptable Conditions: Frozen specimens. Clotted or grossly hemolyzed specimens.
Stability: Ambient: 8 hours (without smears); Refrigerated: MPV: 8 hours, All others: 24 hours; Frozen: Unacceptable
CPT Code(s): 85025
0092209 CBFB-MYH1, inv(16) by RT-PCR INV(16)

CPT Code(s): 83891 Isolation; 83902 Reverse transcription; 83898 x5 Amplification; 83894 x3 Gel separation; 83912 Interpretation and report - Additional CPT
2003502 CD1a by Immunohistochemistry CD1A IHC

CPT Code(s): 88342
2003505 CD2 by Immunohistochemistry CD2 IHC

Page | 137
CPT Code(s): 88342

details, please contact ARUP Client Services at (800) 522-2787.
CPT Code(s): 88342

CPT Code(s): 88342

CPT Code(s): 88342

CPT Code(s): 88342

Page | 138
CPT Code(s): 88342
2003523 CD10 (CALLA) by Immunohistochemistry CD10 IHC

CPT Code(s): 88342

CPT Code(s): 88342
2003529 CD15, Leu M1 by Immunohistochemistry CD15 IHC

CPT Code(s): 88342

CPT Code(s): 88342
2003532 CD20, L26 by Immunohistochemistry CD20 IHC

Stability: Ambient: Indefinite, Refrigerated: Indefinite, Frozen: Unacceptable
CPT Code(s): 88342
Page | 139
2003535 CD21 (Dendritic Cell) by Immunohistochemistry CD21 IHC
CPT Code(s): 88342

CPT Code(s): 88342

CPT Code(s): 88342
2003547 CD30 (Ki-1) by Immunohistochemistry CD30 IHC

details, please contact ARUP Client Services.
Stability: Ambient: Indefinite; Refrigerated: Indefinite; Frozen: Indefinite
CPT Code(s): 88342

CPT Code(s): 88342

Page | 140
CPT Code(s): 88342
2003556 CD34, QBEnd/10 by Immunohistochemistry CD34 IHC

CPT Code(s): 88342

CPT Code(s): 88342
2003565 CD42b by Immunohistochemistry CD42b IHC

Stability: Ambient: Indefinite, Refrigerated: Indefinite, Frozen: Indefinite
CPT Code(s): 88342
2003568 CD43, L60 (Leu 22) by Immunohistochemistry CD43 IHC

CPT Code(s): 88342

Page | 141
CPT Code(s): 88342

CPT Code(s): 88342
2003586 CD52 (CAMPATH-1) by Immunohistochemistry CD52 IHC

details, please contact ARUP Client Services
CPT Code(s): 88342
2003589 CD56 (NCAM) by Immunohistochemistry CD56 IHC

CPT Code(s): 88342

CPT Code(s): 88342
2003595 CD61 (Platelet Gycoprotein IIIA) by Immunohistochemistry CD61 IHC

Page | 142
CPT Code(s): 88342
2003598 CD68, KP1 by Immunohistochemistry CD68 IHC

CPT Code(s): 88342
2003800 CD79A by Immunohistochemistry CD79A IHC

CPT Code(s): 88342
2003806 CD117 (c-Kit) by Immunohistochemistry CD117 IHC

CPT Code(s): 88342

CPT Code(s): 88342
2003812 CD138 (Syndecan-1) by Immunohistochemistry CD138 IHC

Page | 143
CPT Code(s): 88342

CPT Code(s): 88342
2005534 CDK4 by Immunohistochemistry CDK4 IHC

CPT Code(s): 88342
2004927 CDKL5-Related Disorders (CDKL5) Deletion/Duplication CDKL5 DD

CPT Code(s): 83891 Isolation; 83896 x21 Nucleic acid probes; 83898 x21 Amplification; 83914 x21 Extension; 83909 Capillary electrophoresis; 83912
2004931 CDKL5-Related Disorders (CDKL5) Sequencing CDKL5 FGS

CPT Code(s): 83891 Isolation; 83898 x26 Amplification; 83904 x26 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report - Additional
2004935 CDKL5-Related Disorders (CDKL5) Sequencing and Deletion/Duplication CDKL5 FGA

Methodology: Polymerase Chain Reaction/Sequencing/Multiplex Ligation-dependent Probe Amplification
CPT Code(s): Sequencing: 83891 Isolation; 83898 x26 Amplification; 83904 x26 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report.
DelDup: 83896 x21 Nucleic Acid Probes; 83898 x21 Amplification; 83914 x21 Extension; 83909 Capillary Electrophoresis - Additional CPT
2003821 CDX2 by Immunohistochemistry CDX2 IHC

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CPT Code(s): 88342
2004247 CEBPA Mutation Detection CEBPA MUT

Specimen Preparation: Transport 5 mL whole blood (Min: 1 mL) OR 3 mL bone marrow (Min: 1 mL).
CPT Code(s): 83891 Isolation; 83898 x2 Amplification; 83894 Gel separation; 83904 x2 Sequencing, 83912 Interpretation and report - Additional CPT code
0051689 Celiac Disease Dual Antigen Screen TTG DGP

Unacceptable Conditions: Plasma or other body fluids. Contaminated, heat-inactivated, hemolyzed, icteric, or lipemic specimens.
CPT Code(s): 83516
2002026 Celiac Disease Dual Antigen Screen with Reflex CELIAC SCRN
Tube. (Min: 1 mL)
Unacceptable Conditions: Plasma. Contaminated, hemolyzed, or grossly lipemic specimens.
CPT Code(s): 83516 Dual antigen screen. If Dual antigen screen is 20 Units or greater, add 83516 tTG IgA and 83516 Gliadin IgA. If tTG IgA and Gliadin IgA
are negative, add 83516 tTG IgG and 83516 Gliadin IgG.
2005018 Celiac Disease (HLA-DQA1*05, HLA-DQB1*02, and HLA-DQB1*03:02) Genotyping HLA CELIAC
CPT Code(s): 83891 Isolation; 83898 Amplification; 83900 Multiplex amplification; 83912 Interpretation and report - Additional CPT code modifiers may be
0051065 Celiac Disease Reflexive Panel CELIAC TTG

Methodology: Quantitative Nephelometry/Semi-Quantitative Enzyme-Linked Immunosorbent Assay
Tube. (Min: 0.5 mL)
Remarks: Specify age of patient on test request form.
Unacceptable Conditions: Plasma. Contaminated, hemolyzed, or grossly lipemic specimens.
CPT Code(s):
82784 IgA; if less than 7 mg/dL, add 83516 tTG IgG and 83516 Gliadin IgG. If IgA is greater than or equal to 7 mg/dL, add 83516 tTG IgA and
83516 Gliadin IgA
0095019 Cell Count, Body Fluid FLD

Methodology: Cell Count/Differential
Specimen Required: Collect: Body fluid in liquid EDTA or sodium heparin.
Specimen Preparation: Do not freeze. Transport 3 mL body fluid. (Min: 0.5 mL)
Unacceptable Conditions: BAL fluid, gastric fluid, or seminal fluid. Synovial fluids collected in powdered EDTA or powdered lithium heparin.
Specimens sent with needle. Frozen specimens. Clotted specimens.
Stability: Ambient: 4 hours; Refrigerated: Crystal Analysis: 12 hours, All Others: 24 hours; Frozen: Unacceptable
CPT Code(s): 89051
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0095018 Cell Count, CSF CSF
Methodology: Cell Count/Differential
Specimen Preparation: Do not freeze. Transport 0.5 mL CSF.
CPT Code(s): 89051
0051273 Cell-Mediated Immune Function Screen LMPS

Methodology: Cell Culture/Quantitative Chemiluminescent Immunoassay
Specimen Required: Collect: Green (sodium heparin). Specimen must be collected within 30 hours of test performance.
Specimen Preparation: Transport 3 mL whole blood in original collection tube. (Min: 0.5 mL) LIVE LYMPHOCYTES REQUIRED.
Storage/Transport Temperature: CRITICAL ROOM TEMPERATURE. Do not refrigerate or freeze.
Unacceptable Conditions: Refrigerated or frozen specimens. Specimens older than 30 hours.
CPT Code(s): 86352
0050714 Centromere Antibody, IgG ANTICENT

Methodology: Semi-Quantitative Multiplex Bead Assay
CPT Code(s): 83516
2003172 Cerebral Cavernous Malformation (CCM1, CCM2 and CCM3) Deletion/Duplication CCM DELDUP
CPT Code(s): 83891 Isolation; 83896 x2 Nucleic Acid Probes; 83898 x2 Amplification; 83914 x2 Extension; 83909 x2 Capillary Electrophoresis; 83912
2003152 Cerebral Cavernous Malformation (CCM1) Sequencing CCM1 FGS

CPT Code(s): 83891 Isolation; 83898 x16 Amplification; 83904 x16 Sequencing; 83909 Capillary electrophoresis, 83912 Interpretation and report - Additional
2003164 Cerebral Cavernous Malformation (CCM1) Sequencing with Reflex to (CCM1, CCM2 and CCM3) CCM COMP
Deletion/Duplication with Reflex to (CCM2) Sequencing with Reflex to (CCM3) Sequencing
CPT Code(s): CCM1 Sequencing: 83891 Isolation; 83898 x16 Amplification; 83904 x16 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation
and report.
If reflexed to Del/Dup: 83896 x2 Nucleic Acid Probes; 83898 x2 Amplification; 83914 x2 Extension; 83909 x2 Capillary electrophoresis. If
reflexed to CCM2 Sequencing, add 83898 x10 Amplification; 83904 x10 Sequencing; 83909 Capillary electrophoresis. If reflexed to CCM3
Sequencing, add 83898 x7 Amplification; 83904 x7 Sequencing; 83909 Capillary electrophoresis. - Additional CPT code modifiers may be


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0060106 Cerebrospinal Fluid (CSF) Culture and Gram Stain MC CSF
Specimen Preparation: Do not refrigerate for bacterial culture. Transfer 1 mL CSF to a sterile container. Place each specimen in an individually
sealed bag.
CPT Code(s): 87070
0050160 Ceruloplasmin CERU

Specimen Required: Collect: Serum separator tube or plasma preparation tube. Also acceptable: Plasma collected in green (lithium heparin).
collection. Transfer 0.5 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.2 mL)
Unacceptable Conditions: EDTA plasma or hemolyzed specimens.
Stability: After separation from cells: Ambient: 8 hours; Refrigerated: 72 hours; Frozen: 1 month
CPT Code(s): 82390
2006222 CHARGE Syndrome (CHD7) Sequencing CHARGE FGS

CPT Code(s): 83891 Isolation; 83900 Amplification; 83901 x43 Additional amplification; 83894 x45 Gel separation; 83904 x90 Sequencing; 83892 x2
Digestion; 83912 Interpretation and report.
2002067 Chimerism, Donor STR-DONOR

Methodology: Polymerase Chain Reaction/Fragment Analysis
Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B). OR bone marrow in lavender (EDTA). OR buccal brushes from
donor.
Specimen Preparation: Transport 3 mL whole blood (Min: 1 mL) OR 1 mL bone marrow OR 2 buccal brushes in a sterile, dry tube.
Remarks: Post-transplantation results will be compared to pre-transplant recipient and donor genotypes, therefore, donor and recipient
samples must be obtained and genotyped before the transplant event occurs.
CPT Code(s): 83891 Isolation; 83900 Multiplex amplification; 83901 x14 Multiplex amplification; 83909 Capillary Electrophoresis; 83912 Interpretation and
2002066 Chimerism, Post-Transplant STR-POST

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B). OR bone marrow in lavender (EDTA).
Specimen Preparation: Transport 3 mL whole blood OR 1 mL bone marrow.
specimens must be obtained and genotyped before the transplant event occurs.
If cell sorting is required, refer to Chimerism, Post-Transplant, Sorted Cells (ARUP test code 2002064).
CPT Code(s): 83891 Isolation; 83900 Multiplex amplification; 83901 x14 Multiplex amplification; 83909 Capillary electrophoresis; 83912 Interpretation and
2002064 Chimerism, Post-Transplant, Sorted Cells STR-POSTSC

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B). OR bone marrow.
Specimen Preparation: Transport 3 mL whole blood. (Min: 3 mL) OR 1 mL bone marrow. Ship overnight. If cell sorting is required, specimens
should be received within 24 hours of collection for optimal isolation of the requested cell line(s). Increase the amount of blood/bone marrow
submitted based on the number of cell lines requested and for patients with low cell counts.
Remarks: Post-transplantation genotypes will be compared to pre-transplant recipient and donor genotypes. Therefore, donor and
recipient specimens must be obtained and genotyped before the transplant event occurs. Please provide the results and date of the patient's
most recent WBC and differential counts. When submitting bone marrow specimens for cell sorting, please provide information regarding the
general cellularity of the patient's bone marrow. See Cell Isolation Request for Chimerism, Post-Transplant, Sorted Cells.
CPT Code(s): 83891 Isolation; 83900 Multiplex amplification; 83901 x14 Additional amplification; 83909 Capillary electrophoresis; 83912 Interpretation and
2002065 Chimerism, Recipient Pre-Transplant STR-PRE

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B). OR bone marrow in lavender (EDTA). OR buccal brushes from
recipient.
Specimen Preparation: Transport 3 mL whole blood (Min: 1 mL) OR 1 mL bone marrow OR 2 buccal brushes in a sterile, dry tube.
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specimens must be obtained and genotyped before the transplant event occurs.
CPT Code(s): 83891 Isolation; 83900 Multiplex amplification; 83901 x14 Additional amplification; 83909 Capillary Electrophoresis; 83912 Interpretation and
0065100 Chlamydia Antibody Panel, IgG & IgM by IFA V CHLM PAN
Unacceptable Conditions: Contaminated, hemolyzed, or hyperlipemic sera.
CPT Code(s): 86631 C. trachomatis IgG; 86631 C. pneumoniae IgG; 86631 C. psittaci IgG; 86632 C. trachomatis IgM; 86632 C. pneumoniae IgM; 86632 C.
psittaci IgM
0065139 Chlamydia Antibody Panel, IgG by IFA CHLAM G

CPT Code(s): 86631 C. trachomatis IgG; 86631 C. pneumoniae IgG; 86631 C. psittaci
0065105 Chlamydia Antibody Panel, IgM by IFA V CHLAM M

CPT Code(s): 86632 C. trachomatis IgM; 86632 C. pneumoniae IgM; 86632 C. psittaci IgM
0060715 Chlamydia pneumoniae by PCR CPNEUMOPCR

Specimen Required: Collect: Respiratory specimen: Bronchoalveolar lavage (BAL), nasal wash, nasopharyngeal swab, or pleural fluid.
media (ARUP supply #12884). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.
Place each specimen in a separate, individually sealed bag. Swabs: Place in viral transport media
CPT Code(s): 87486
0060241 Chlamydia trachomatis and Neisseria gonorrhoeae by Amplified Detection (APTIMA®) CGAMD
Methodology: Qualitative Target Amplification Nucleic Acid Probe
Specimen Required: Collect: Endocervical or vaginal swab, first catch urine, or male urethral swabs. Collect in APTIMA® Combo 2 Assay transport media (ARUP
Supply: Swabs #28907, Urine #28908). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-
2787. Refer to "Sample Collection for the Diagnosis of STD" under Specimen Handling at www.aruplab.com for specific specimen collection and
transport instructions.
Specimen Preparation: Transfer swab or urine to APTIMA® Combo 2 Assay transport media. (Min: 2 mL urine)
Remarks: Specimen source is required.
Unacceptable Conditions: Large white swab is for preparatory cleaning of the endocervix and is unacceptable for testing. Specimens in any
transport media other than indicated above. Specimen in swab transport media without a swab.
Stability: Unpreserved Urine: Ambient: 24 hours; Refrigerated: 24 hours; Frozen: Unacceptable. APTIMA® Transport Media: Swab:
Ambient: 2 months; Refrigerated: 2 months; Frozen: 12 months Urine: Ambient: 1 month; Refrigerated: 1 month; Frozen: 12 months
CPT Code(s): 87491 Chlamydia trachomatis, 87591 Neisseria gonorrhoeae
0060774 Chlamydia trachomatis and Neisseria gonorrhoeae by Amplified Detection (APTIMA®), M4/UTM Specimens CTNG M4
Specimen Required: Collect: Endocervical or urethral swab in viral transport media (M4) or UTM (ARUP supply #12884). Available online through eSupply using
ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. Refer to "Sample Collection for the Diagnosis of STD" under Specimen
Handling at www.aruplab.comwww.aruplab.com for specific specimen collection and transport instructions.
Specimen Preparation: Transport swab in 3 mL viral transport media (M4 or UTM). (Min: 1 mL)
Stability: Ambient: 1 week; Refrigerated: 1 month; Frozen: 3 months
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2001551 Chlamydia trachomatis and Neisseria gonorrhoeae by Amplified Detection (APTIMA®) on SurePath™ CTNG SP
Specimen Required: Collect: Cervical brush in SurePath™ liquid-based Pap test Media. Refer to "Sample Collection for the Diagnosis of STD" under Specimen
Handling at www.aruplab.com for specific specimen collection and transport instructions.
Specimen Preparation: Vortex SurePath™ media and transfer a 1 mL aliquot to APTIMA® Combo 2 transport media (ARUP supply #42711)
within 24 hours of collection. Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. To
reduce the potential for contamination SurePath® specimens should be poured off, using sterile technique, into the APTIMA® Specimen Transfer
Tube prior to Cytology Testing.
Stability: SurePath™ Media: Ambient: 24 hours; Refrigerated: 48 hours; Frozen: 1 week
APTIMA® Media: Ambient: 2 weeks; Refrigerated: 1 month; Frozen: 1 month
0060734 Chlamydia trachomatis and Neisseria gonorrhoeae by Amplified Detection (APTIMA®) on ThinPrep™ CG MATP
Specimen Required: Collect: Cervical brush in ThinPrep® transport Pap Test™ Media. Refer to "Sample Collection for the Diagnosis of STD" under Specimen
Specimen Preparation: Vortex Pap Test™ media and transfer a 1 mL aliquot to APTIMA® Combo 2 transport media (ARUP supply #42711).
Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. To reduce the potential for
contamination, ThinPrep® specimens should be poured off, using sterile technique, into the APTIMA® Specimen Transfer Tube prior to
Cytology Testing.
Stability: Specimen in ThinPrep® media: Ambient: 1 month; Refrigerated: 1 month; Frozen: Unacceptable
Specimen in APTIMA® transport media: Ambient: 2 weeks; Refrigerated: 1 month; Frozen: 12 months
0060224 Chlamydia trachomatis and Neisseria gonorrhoeae DNA Probe GCCHP

Methodology: Qualitative Nucleic Acid Probe
Patient Preparation: For urethral swab specimens, patients should not have urinated for at least 1 hour prior to collection.
Specimen Required: Collect: Endocervical or male urethral swabs. Collect in Gen-ProbePace 2 collection and transport kit (ARUP Supply: Female kit: #12575, Male
kit: #12576). Available online through eSupply using ARUP Connector contact ARUP Client Services at (800) 522-2787.
Specimen Preparation: Transport swab in Gen-Probe® Pace 2 transport media.
Unacceptable Conditions: Specimens in any transport media other than indicated above. Specimen in swab transport media without a swab. Gross
presence of blood in the specimen.
Stability: Ambient: 1 week; Refrigerated: 1 week; Frozen: 1 month
CPT Code(s): 87800
0060243 Chlamydia trachomatis by Amplified Detection (APTIMA®) CTAMD

Specimen Required: Collect: Endocervical or vaginal swab, first catch urine, or male urethral swabs . Collect in APTIMA® Combo 2 Assay transport media (ARUP
supply: Swabs #28907, Urine #28908). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-
2787. Refer to Sample Collection for the Diagnosis of STD under Specimen Handling at www.aruplab.com for specific specimen collection and
Stability: Unpreserved Urine: Ambient: 24 hours; Refrigerated: 24 hours; Frozen: Unacceptable. APTIMA®Transport Media: Swab:
Ambient: 2 months; Refrigerated: 2 months; Frozen: 12 months Urine: Ambient: 1 month; Refrigerated: 1 month; Frozen: 12 months
CPT Code(s): 87491
0060850 Chlamydia trachomatis Culture CHLAM

Methodology: Cell Culture/Immunofluorescence
Specimen Required: Collect: Cervical, eye, rectal, urethral swab, or peritoneal fluid. Also acceptable for newborns: Nasopharyngeal aspirate, swab or washing.
Specimen Preparation: Transfer specimen immediately to Chlamydia transport media (UTM) (ARUP supply #12884). Available online through
eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. Place each specimen in an individually sealed bag. Also
acceptable: Any transport media validated for Chlamydia transport.
Storage/Transport Temperature: Frozen on dry ice.
Unacceptable Conditions: Urine. Specimens not preserved in Chlamydia culture transport media. Calcium alginate, dry, or wood swabs.
Stability: Ambient: 1 hour; Refrigerated: 48 hours; Frozen at -70°C: 1 month
CPT Code(s): 87110 Culture; 87140 Stain
0060287 Chlamydia trachomatis DFA CHLAF

Specimen Required: Collect: Eye, genital, nasopharyngeal, or rectal swab.
For Chlamydia DFA only, collection kits with fixative are available (ARUP supply #16578). Available online through eSupply using ARUP
Specimen Preparation: Fix slide as directed by collection kit. Transport fixed slide.
Unacceptable Conditions: Swabs in gel. Transport systems designed for use with other methodologies of Chlamydia testing. Dry swabs.
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Stability: Fixed Slide: Ambient: 1 week; Refrigerated: 1 week; Frozen: 1 week
CPT Code(s): 87270
0065059 Chlamydia trachomatis DNA Probe CHLDNAP

Specimen Required: Collect: Conjunctival, endocervical or male urethral swabs. Collect in Gen-Probe® Pace 2 collection and transport media (ARUP Supply: Female
kit: #12575, Male kit: #12576). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.
Unacceptable Conditions: Specimen in swab transport media without a swab. Gross presence of blood in the specimen.
Stability: Ambient: 1 week; Refrigerated: 1 week; Frozen: 1 month.
CPT Code(s): 87490
0091267 Chloral Hydrate, Serum or Plasma TRICHLOROE

Specimen Required: Collect: Plain red or gray (sodium fluoride/potassium oxalate).
CPT Code(s): 82491
0090346 Chloramphenicol CHLORAM

Specimen Preparation: Separate serum or plasma from cells within 2 hours of collection. Transport 1 mL serum or plasma to an ARUP Standard
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 3 weeks; Frozen: 3 weeks
CPT Code(s): 82415
0020381 Chloride, Fecal FE-CL

Methodology: Quantitative Ion-Selective Electrode
Specimen Required: Collect: Liquid random stool.
Specimen Preparation: Transfer 5 g aliquot of liquid random stool to an unpreserved stool transport vial (ARUP Supply #40910). (Min: 1 g) Do
not add saline or water to liquefy specimen.
Unacceptable Conditions: Formed or viscous stool.
Stability: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 1 month
CPT Code(s): 82438
0020163 Chloride, Fluid CL FL

Unacceptable Conditions: Breast milk and salivary fluid. Specimens containing sodium fluoride/potassium oxalate as anticoagulants.
Contaminated or hemolyzed specimens. Specimens too viscous to be aspirated by instrument.
CPT Code(s): 82438
0020003 Chloride, Serum or Plasma CL

Unacceptable Conditions: Body Fluid (refer to Chloride, Fluid, ARUP test code 0020163). Urine (refer to Chloride, Urine, ARUP test code
0020850). Specimens containing sodium fluoride/potassium oxalate as anticoagulants. Hemolyzed specimens.
CPT Code(s): 82435
0020850 Chloride, Urine U CL

Methodology: UUHC Clients: Titration
All other clients: Quantitative Ion-Selective Electrode
Specimen Required: Collect: 24-hour urine (without additives). Refrigerate during collection. Also acceptable: Random urine.
Specimen Preparation: Transfer 1 mL aliquot of urine from a well-mixed collection to an ARUP Standard Transport Tube. (Min: 0.5 mL) Record
total volume and collection time interval on transport tube and test request form.
CPT Code(s): 82436
0091310 Chloroquine, Plasma CHLOROQUI

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Specimen Preparation: Separate plasma from cells within 2 hours of draw. Transfer 1 mL plasma to an ARUP Standard Transport Tube. (Min: 0.4
mL)
CPT Code(s): 82101
0090870 Chlorpromazine CHLORP

Transport Tube. (Min: 1 mL)
SST or PST: Separate serum or plasma from gel within 6 hours and hold at room temperature or separate within 2 hours and store refrigerated.
Unacceptable Conditions: Whole blood. Light blue (citrate) or yellow (SPS or ACD solution).
Stability: After separation from cells: Ambient: 12 hours; Refrigerated: 72 hours; Frozen: 5 days
CPT Code(s): 84022
0091216 Chlorpropamide, Serum or Plasma CHLORPRO S

CPT Code(s): 80299
0091494 Chlorpropamide, Urine CHLORPR U

CPT Code(s): 80299
0020714 Cholesterol, Fluid CHOL FL

CPT Code(s): 84311
0020031 Cholesterol, Serum or Plasma CHOL

Unacceptable Conditions: Body Fluid (refer to Cholesterol, Fluid, ARUP test code 0020714).
CPT Code(s): 82465
0020174 Cholinesterase, RBC/Hb Ratio CHE-RBC

Specimen Preparation: DO NOT FREEZE. Transport 3 mL whole blood. (Min: 1 mL))
Storage/Transport Temperature: Refrigerated. Do not place whole blood directly on cool packs when shipping.
Unacceptable Conditions: Green (sodium or lithium heparin). Frozen specimens. Clotted or hemolyzed specimens.
CPT Code(s): 82482
0040203 Chorionic Villus, FISH FISHCVS

Specimen Required: Collect: Thaw media prior to collection. Chorionic villus in a sterile, screw-top container filled with tissue culture transport medium (ARUP
Supply #32788). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.
Specimen Preparation: DO NOT FREEZE. Do not place in formalin. Transport chorionic villus (CVS) specimen in a sterile, screw-top container
filled with tissue culture transport medium.
Cytogenetic (Chromosome) Studies with the electronic packing list (available at http://www.aruplab.com/genetics/forms.php).
Unacceptable Conditions: Frozen specimens. Specimens preserved in formalin.
CPT Code(s): 88271 x5 DNA probe; 88275 Chromosomal in situ hybridization, 100-300 cells; 88291 Interpretation and report
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2005287 Chromatin Antibody, IgG CHROMATIN
Unacceptable Conditions: Urine or plasma. Contaminated, heat-inactivated, severely hemolyzed, icteric, or lipemic specimens.
CPT Code(s): 83516
2005548 Chromium, Joint Fluid CR F

Patient Preparation: High concentrations of iodine may interfere with elemental testing. Patients should abstain from iodine-containing
medications or contrast agents for at least 1 month prior to specimen collection for elemental testing.
Specimen Required: Collect: Joint fluid. The use of betadine-like topical antiseptics should be avoided during specimen collection.
Specimen Preparation: Transfer 1 mL joint fluid to an ARUP Trace Element-Free Transport Tube (ARUP supply #43116). Available online
through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 0.5 mL)
Unacceptable Conditions: Separator tubes or gels. Fluid collected after administration of a gadolinium (Gd) containing contrast media (may occur
with MRI studies).
CPT Code(s): 82495
0098830 Chromium, Serum CR S

Specimen Required: Collect: Royal blue (no additive).
Specimen Preparation: Centrifuge; do not allow serum to remain on cells. Transfer 2 mL serum to an ARUP Trace Element-Free Transport Tube
(ARUP supply #43116). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 0.5
mL)
CPT Code(s): 82495
0025068 Chromium, Urine CR-U

CPT Code(s): 82495
0080469 Chromogranin A CGA SERUM

Specimen Preparation: Allow serum specimen to clot completely at room temperature. Transfer 1 mL serum to an ARUP Standard Transport
Tube. (Min: 0.5 mL)
Unacceptable Conditions: Plasma. Icteric or lipemic specimens.
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 6 weeks
CPT Code(s): 86316
2003830 Chromogranin A by Immunohistochemistry CHROMO IHC

CPT Code(s): 88342
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2005749 Chromosome Analysis - Breakage, Ataxia Telangiectasia, Whole Blood BREAKAGEAT
Methodology: Giemsa Band
Patient Preparation: Specimens must be collected and shipped Monday-Thursday only and not the day before a holiday.
Specimen Preparation: Transport 10 mL whole blood. (Min: 5 mL) Specimens must be received within 48 hours to insure adequate culture of
living cells.
CPT Code(s): 88230 Tissue culture, non-neoplastic; 88248 Baseline breakage
0097688 Chromosome Analysis - Breakage, Fanconi Anemia BREAKAGE

Patient Preparation: Specimens must be collected and shipped Monday-Thursday only and not the day before a holiday.
Specimen Preparation: Transport 10 mL whole blood. (Min: 5 mL) Specimens must be received within 48 hours to insure adequate culture of
living cells.
CPT Code(s): 88230 x2 Tissue culture, nonneoplastic; 88248 Baseline breakage; 88249 Score 100 clastogens stress; 88280 Additional karyotypes; 88291
Interpretation and report
2002293 Chromosome Analysis, Amniotic Fluid CHR AF

Specimen Preparation: Do not freeze or expose to extreme temperatures. Transport 30 mL amniotic fluid in sterile centrifuge tubes. (Min: 15
mL) Specimen and completed test request form, including clinical indication, must be received within 48 hours of collection.
Prenatal Cytogenetics form (available at http://www.aruplab.com/genetics/forms.php).
Unacceptable Conditions: Frozen specimens. Bloody specimens.
CPT Code(s): 88269 Chromosome analysis in situ; 88235 Tissue culture; 88280 Additional karyotypes; 88291 Interpretation and report - Additional CPT code
2002292 Chromosome Analysis, Bone Marrow CHR BM

Specimen Required: Collect: Non-diluted bone marrow aspirate. Collect in a heparinized syringe.
Specimen Preparation: Do not freeze or expose to extreme temperatures. Transfer 3 mL bone marrow to a green (sodium heparin). (Min: 0.5
mL)
Remarks: Although bone marrow is the recommended specimen type for hematological disorder studies, blood can be substituted if bone marrow
cannot be obtained. Refer to Chromosome Analysis, Leukemic Blood (ARUP test code 2002290). This test must be ordered using Cytogenetic test
request form #43099 or through your ARUP interface.
CPT Code(s): 88237 Tissue culture; 88264 Analyze 20-25 cells; 88291 Interpretation and report - Additional CPT code modifiers may be required for
procedures performed to test for oncologic or inherited disorders.
2007130 Chromosome Analysis, Bone Marrow with Reflex to Genomic Microarray BM REFLEX
Methodology: Giemsa Band/Genomic Microarray (Oligo-SNP array)
Specimen Required: Collect: Non-diluted bone marrow aspirate. Collect in a heparinized syringe
Specimen Preparation: Do not freeze or expose to extreme temperatures. Transfer 3 mL bone marrow to a green (sodium heparin). (Min: 0.5
mL)
Submit specimen according to Biological Substance, Category B, shipping guidelines.
Remarks: Although bone marrow is the recommended specimen type for hematological disorder studies, blood can be substituted if bone marrow
cannot be obtained. Refer to Chromosome Analysis, Leukemic Blood with Reflex to Genomic Microarray (ARUP test code 2007131). This test
must be ordered using Cytogenetic test request form (#43099) or through your ARUP interface. Submit the Patient History for Cytogenetic
(Chromosome) Studies with the electronic packing list (available at http://www.aruplab.com/genetics/forms.php).
Unacceptable Conditions: Frozen specimens. Clotted specimens
CPT Code(s): 88237 Tissue culture; 88264 Analyze 20-25 cells; 88291 Interpretation and report, if reflexed, add 83891 Isolation; 88386 x6 Array-based
evaluation of multiple molecular probes, 251-500. Additional CPT code modifiers may be required for procedures performed to test for oncologic
or inherited disorders.
2002291 Chromosome Analysis, Chorionic Villus CHR CVS

Specimen Required: Collect: Thaw media prior to collection. Chorionic villus in a sterile, screw-top container filled with tissue culture transport medium (ARUP
Supply #32788). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. If cytogenetics
tissue media is not available, collect in plain RPMI, Hanks solution, saline, or ringers.
Specimen Preparation: DO NOT FREEZE. Do not place in formalin. Transport chorionic villus (CVS) specimen in a sterile, screw-top container
filled with tissue culture transport medium. If specimen size is too large for a normal collection tube, a larger sterile container can be used such as
a sterile urine cup and can be flooded with several tubes of cytogenetic tissue media.
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Prenatal Cytogenetics form with the electronic packing list (available at http://www.aruplab.com/genetics/forms.php).
CPT Code(s): 88269 Chromosome analysis in situ; 88235 Tissue culture; 88280 Additional karyotype; 88291 Interpretation and report - Additional CPT code
2002290 Chromosome Analysis, Leukemic Blood CHR LKB

Remarks: This test must be ordered using Cytogenetic test request form (#43099) or through your ARUP interface.
2007131 Chromosome Analysis, Leukemic Blood with Reflex to Genomic Microarray LKB REFLEX
Methodology: Giemsa Band/Genomic Microarray (Oligo-SNP array)
Specimen Preparation: Do not freeze or expose to extreme temperatures. Transfer 5mL whole blood to a green (sodium heparin). (Min: 1.0
mL)
Cytogenetic (Chromosome) Studies form with the electronic packing list (available at http://www.aruplab.com/genetics/forms.php).
Unacceptable Conditions: Frozen specimens. Clotted specimens
CPT Code(s): 88237 Tissue culture; 88264 Analyze 20-25 cells; 88291 Interpretation and report, if reflexed, add 83891 Isolation; 88386 x6 Array-based
evaluation of multiple molecular probes, 251-500. Additional CPT code modifiers may be required for procedures performed to test for oncologic
2002300 Chromosome Analysis, Lymph Node CHR ONC

Specimen Required: Collect: Any specimen type for oncology studies other than peripheral blood, bone marrow, and solid tumors.
Thaw media prior to tissue inoculation. Collect tissue in a sterile, screw-top container filled with tissue culture transport medium (ARUP Supply
#32788). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. If no transport media is
available, collect in plain RPMI, Hanks solution, saline, or ringers.
Collect pleural or other body fluids in a green (sodium heparin).
Contact ARUP Genetics Processing for other specimen types or information and specific collection and transportation instructions.
Specimen Preparation: DO NOT FREEZE. Do not place in formalin.
Tissues: Transport 10 mm biopsy in a sterile, screw-top container filled with tissue culture transport media.
Fluid: Transport 5 mL fluid in original collection tube.
Remarks: This test must be ordered using Cytogenetic test request form #43099 or through your ARUP interface.
Unacceptable Conditions: Frozen specimens. Tissue submitted in formalin.
2002289 Chromosome Analysis, Peripheral Blood CHR PB

Remarks: This test must be ordered using Cytogenetic test request form #43097 or through your ARUP interface. Please submit the Patient
History for Cytogenetic (Chromosome) Studies form with the electronic packing list (available at http://www.aruplab.com/genetics/forms.php).
CPT Code(s): 88262 Chromosome analysis count 15-20 cells; 88230 Tissue culture; 88291 Interpretation and report - Additional CPT code modifiers may be
2005763 Chromosome Analysis, Peripheral Blood, with Reflex to Genomic Microarray PB REFLEX
Methodology: Giemsa Band/Genomic Microarray (Oligo-SNP Array)
Remarks: This test must be ordered using Cytogenetic test request form #43097 or through your ARUP interface. Please submit the Patient
CPT Code(s): 88262 Chromosome analysis count 15-20 cells; 88230 Tissue culture; 88291 Interpretation and report; if reflexed, add 83891 Isolation; 88386 x6
Array-based evaluation of multiple molecular probes, 251-500 - Additional CPT code modifiers may be required for procedures performed to test
for oncologic or inherited disorders.
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2002288 Chromosome Analysis, Products of Conception CHR POC
Specimen Required: Collect: Thaw media prior to tissue inoculation. Products of conception in a sterile, screw-top container (Wide mouth containers: ARUP supply
#42710) filled with tissue culture transport medium (ARUP Supply # 32788). Available online through eSupply using ARUP Connect™ or
contact ARUP Client Services at (800) 522-2787. If cytogenetics tissue media is not available, collect in plain RPMI, Hanks solution, saline, or
ringers.
If autopsy is performed: Chest wall cartilage (particularly if macerated), gonad, spleen, kidney, or other internal organs.
If no autopsy is performed: Placenta from fetal side is preferred (e.g. villi).
Also acceptable: Umbilical cord or achilles tendon.
Specimen Preparation: DO NOT FREEZE. Do not place in formalin. Transport products of conception in sterile, screw-top container filled with
tissue transport medium. If specimen size is too large for a normal collection tube, a larger sterile container can be used such as a sterile urine cup
and can be flooded with several tubes of cytogenetic tissue media.
Prenatal Cytogenetics with the electronic packing list (available at http://www.aruplab.com/genetics/forms.php).
Unacceptable Conditions: Intact fetus. Frozen specimens. Specimens preserved in formalin.
CPT Code(s): 88262 Chromosome analysis count 15-20 cells; 88233 Tissue culture; 88291 Interpretation and report - Additional CPT code modifiers may be
2005762 Chromosome Analysis, Products of Conception, with Reflex to Genomic Microarray POC REFLEX
Methodology: Giemsa Band/Genomic Microarray (Oligo-SNP Array)
Specimen Required: Collect: Thaw media prior to tissue inoculation. Products of conception in a sterile, screw-top container (Wide mouth containers: ARUP supply
#42710) filled with tissue culture transport medium (ARUP Supply # 32788). Available online through eSupply using ARUP Connect™ or
contact ARUP Client Services at (800) 522-2787. If cytogenetics tissue media is not available, collect in plain RPMI, Hanks solution, saline, or
ringers.
If autopsy is performed: Chest wall cartilage (particularly if macerated), gonad, spleen, kidney, or other internal organs.
If no autopsy is performed: Placenta from fetal side is preferred (e.g. villi).
Also acceptable: Umbilical cord or achilles tendon.
Specimen Preparation: DO NOT FREEZE. Do not place in formalin. Transport products of conception in sterile, screw-top container filled with
Prenatal Cytogenetics with the electronic packing list (available athttp://www.aruplab.com/genetics/forms.php).
Unacceptable Conditions: Frozen specimens. Intact fetus. Specimens preserved in formalin.
CPT Code(s): 88262 Chromosome analysis count 15-20 cells; 88233 Tissue culture; 88291 Interpretation and report; if reflexed, add 83891 Isolation; 88386 x6
Array-based evaluation of multiple molecular probes, 251-500 - Additional CPT code modifiers may be required for procedures performed to test
for oncologic or inherited disorders.
2002287 Chromosome Analysis, Rule Out Mosaicism CHR R/OM

Cytogenetic (Chromosome) Studies with the electronic packing list (available at http://www.aruplab.com/guides/ug/tests/2002287.jsp).
CPT Code(s): 88230 Tissue culture; 88263 Chromosome analysis count 45 cells; 88280 Additional karyotypes; 88285 Chromosome analysis, additional cells
counted; 88291 Interpretation and report
0097677 Chromosome Analysis, Sister Chromatid Exchange SCE

CPT Code(s): 88230 x2 Tissue culture; 88245 Chromosome analysis breakage syndrome, baseline SCE; 88262 Chromosome analysis count 15-20 cells; 88280
Additional karyotypes; 88291 Interpretation and report
2002286 Chromosome Analysis, Skin Biopsy CHR SKIN

Specimen Required: Collect: Thaw media prior to tissue inoculation. Skin biopsy in a sterile, screw-top container filled with tissue culture transport medium (ARUP
Supply # 32788) Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. If cytogenetics
tissue media is not available, collect in plain RPMI, Hanks solution, saline, or ringers.
Specimen Preparation: DO NOT FREEZE. Do not place in formalin. Transport a 4 mm skin biopsy in a sterile, screw-top container filled with
Cytogenetic (Chromosome) Studies form with the electronic packing list (available at http://www.aruplab.com/genetics/forms.php).
CPT Code(s): 88262 Chromosome analysis count 15-20 cells; 88233 Tissue culture; 88291 Interpretation and report
Page | 155
2002296 Chromosome Analysis, Solid Tumor CHR ST
Specimen Required: Collect: Thaw media prior to tissue inoculation. Solid tumor biopsy in a sterile, screw-top container filled with tissue culture transport medium
(ARUP Supply #32788). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. If
cytogenetics tissue media is not available, collect in plain RPMI, Hanks solution, saline, or ringers.
Specimen Preparation: DO NOT FREEZE. Do not place in formalin. Transport a 10 mm biopsy in a sterile, screw-top container filled with tissue
culture transport medium. (Min: 5 mm) If specimen size is too large for a normal collection tube, a larger sterile container can be used such as a
sterile urine cup and can be flooded with several tubes of cytogenetic tissue media.
2002295 Chromosome FISH, CLL Panel FISH CLLP

Specimen Required: Collect: Green (sodium heparin). Also acceptable: Non-diluted bone marrow aspirate collected in a heparinized syringe.
Specimen Preparation: Transport 5 mL whole blood (Min: 2 mL). OR Transfer 3 mL bone marrow to a green (sodium heparin) (Min: 1 mL)
Remarks: If cell pellets or dropped cytogenetic slides are submitted, processing fee will not apply.
Unacceptable Conditions: Frozen specimens. Paraffin-embedded specimens. Clotted specimens.
Stability: Ambient: 48 hours; Refrigerated: 48 hours; Frozen; Unacceptable.
CPT Code(s): 88271 x4 DNA probe; 88275 x4 Chromosomal in situ hybridization 100-300 cells; 88291 Interpretation and report - Additional CPT code
modifiers may be required for procedures performed to test for oncologic or inherited disorders
2002298 Chromosome FISH, Interphase CHR FISHI

Specimen Required: Collect: Non-diluted bone marrow aspirate collected in a heparinized syringe. Also acceptable: Green (sodium heparin).
Specimen Preparation: Transfer 3 mL bone marrow to a green (sodium heparin) (Min: 1 mL). OR transport 5 mL whole blood (Min: 2 mL)
CPT Code(s): 88271 DNA probe each; 88275 Interphase in situ hybridization 100-300 each; 88291 Interpretation and report - Additional CPT codes modifiers
may be required for procedures performed to test for oncologic or inherited disorders
2002299 Chromosome FISH, Metaphase CHR FISHM

Specimen Required: Collect: Green (sodium heparin). Also acceptable: Non-diluted bone marrow aspirate collected in a heparinized syringe.
Specimen Preparation: Transport 5 mL whole blood (Min: 2 mL). OR transfer 3 mL bone marrow to a green (sodium heparin) (Min: 1 mL).
Remarks: It is recommended that all FISH studies be done in conjunction with routine cytogenetic analysis. (Refer to appropriate Chromosome
Analysis test for order instructions). If FISH only is requested, please submit a copy of previous cytogenetics report.
If cell pellets or dropped cytogenetic slides are submitted, processing fee will not apply.
CPT Code(s): 88271 DNA probe each; 88273 Chromosomal in situ hybridization 10-30 cells each; 88291 Interpretation and report - Additional CPT code
2006270 Chromosome FISH, Multiple Myeloma Panel Process and Hold MMF PR &HLD
Methodology: Cell culture/Fluorescence in situ Hybridization
Specimen Required: Collect: Non-diluted bone marrow collected in a heparinized syringe. Also acceptable: Green (sodium heparin).
Specimen Preparation: Transfer 3 mL bone marrow to a green (sodium heparin). (Min: 1 mL)
CPT Code(s): 88237
2002297 Chromosome FISH, Prenatal CHR FISHP

Specimen Preparation: Do not freeze or expose to extreme temperatures. Transport 30 mL amniotic fluid in sterile centrifuge tubes. (Min: 15
mL)
Remarks: Specimen and completed test request form, including clinical indication, must be received within 48 hours of collection.
It is recommended that FISH be performed in conjunction with routine cytogenetic analysis.
Page | 156
(Chromosome) Studies form with the electronic packing list (available at available at http://www.aruplab.com/genetics/forms.php).
Unacceptable Conditions: Frozen specimens. Bloody specimens.
CPT Code(s): 88271 x5 DNA probe; 88275 Interphase in situ hybridization 100-300; 88291 Interpretation and report - Additional CPT code modifiers may be
2006356 Chronic Granulomatous Disease (CYBB Gene Scanning and NCF1 Exon 2 GT Deletion) with Reflex to CYBB CGD PANEL
Sequencing
Methodology: High Resolution Melt Analysis
Unacceptable Conditions: Frozen
CPT Code(s): 83891 Isolation; 83898 Amplification; 83896 Nucleic acid probe; 83900 Multiplex Amplification; 83901 x14 Additional Amplification; 83903
x16 Mutation Scanning; 83912 Interpretation and report. If reflexed, add 83904 Sequencing, each segment. Additional CPT code modifiers may
2006366 Chronic Granulomatous Disease (NCF1) Exon 2 GT Deletion NCF1

CPT Code(s): 83891 Isolation; 83898 Amplification; 83896 Nucleic acid probe; 83912 Interpretation and report. Additional CPT code modifiers may be
2006361 Chronic Granulomatous Disease, X-Linked (CYBB) Gene Scanning with Reflex to Sequencing CYBB
CPT Code(s): 83891 Isolation; 83900 Multiplex Amplification; 83901 x14 Additional Amplification; 83903 x16 Mutation Scanning; 83912 Interpretation and
report. If reflexed, add 83904 Sequencing, each segment. Additional CPT code modifiers may be required for procedures performed to test for
0093194 Chronic Lymphocytic Leukemia Follow up Phenotyping by Flow Cytometry CLL FLOW
Specimen Required: Collect: Green (sodium heparin), lavender (EDTA), or pink (K2EDTA).
Storage/Transport Temperature: Room temperature. Specimen should be received within 24 hours of collection for optimal viable testing.
Remarks: This assay is for follow up after the diagnosis of CLL has been established by previous flow cytometry immunophenotyping. If prior
studies were not performed at ARUP, the outside flow cytometry report and histograms must accompany the specimen. In addition, please provide
CBC, Wright's stained smear, clinical history, and any relevant pathology reports.
Unacceptable Conditions: Frozen specimens. Specimens greater than 48 hours old. Clotted or hemolyzed specimens.
CPT Code(s): 88184 First marker, 88185 x7 Each additional marker, 88187 Interpretation
0098457 Chylomicron Screen, Body Fluid CHYLO FL

Methodology: Qualitative Electrophoresis
Specimen Preparation: Do not freeze. Transport 1 mL body fluid. (Min: 0.2 mL
Remarks: Specify type of body fluid.
Unacceptable Conditions: Plasma, serum, or whole blood. Frozen specimens.
Stability: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: Unacceptable
CPT Code(s): 82664
2005160 Chymotrypsin, Fecal CHYMOTRYP

Methodology: Quantitative Enzymatic/Spectrophotometry
Patient Preparation: Patients receiving pancreatic enzymes should discontinue taking the enzymes at least 5 days prior to stool collection.
Specimen Required: Collect: Random stool.
Specimen Preparation: Transfer 1 g stool to a clean, unpreserved stool transport vial (ARUP Supply #40910). (Min: 0.5 g)
CPT Code(s): 84311
0091337 Cimetidine, Serum or Plasma CIMETIDINE

CPT Code(s): 80299
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0091422 Cimetidine, Urine CIMETID U
CPT Code(s): 80299
0093399 Circulating Tumor Cell Count (Cell Search™) CTC COUNT

Methodology: Immunomagnetic Separation/Immunofluorescent Stain/Computer Assisted Analysis
Patient Preparation: If the patient is on doxorubicin therapy, allow at least 7 days following administration of a dose of doxorubicin before
blood draw.
Specimen Required: Collect: CellSave®Preservative tube (ARUP supply # 44867). Available online through eSupply using ARUP ConnectTM or contact
ARUP Client Services at (800) 522-2787. Due to stability, collect Monday-Thursday only.
Specimen Preparation: Transport 20 mL whole blood. (Min: 10 mL) The minimum collection amount will not allow for repeat testing.
Storage/Transport Temperature: Room temperature. Do not refrigerate or freeze.
Remarks: HISTORY IS REQUIRED. Specify type of metastatic cancer (breast, colorectal, or prostate). This assay is FDA approved only for these
3 metastatic cancers; other types will not be tested.
Unacceptable Conditions: Frozen or refrigerated specimens. Specimens not collected in the CellSave® tube or collected in expired CellSave®
tubes. Short draws.
CPT Code(s): 0279T
2003302 Citalopram, Serum or Plasma CITALO

Specimen Preparation: Separate from cells within 2 hours of draw. Transfer 1 mL serum or plasma into an ARUP Standard Transport Tube. (Min:
0.4 mL)
CPT Code(s): 82491
0080011 Citric Acid, Serum CITRIC S

Methodology: Spectrophotometry/Enzymatic
Specimen Preparation: Transfer 2 mL serum to an ARUP Standard Transport Tube. (Min: 1 mL)
Stability: Ambient: 8 hours; Refrigerated: 18 days; Frozen: 1 month
CPT Code(s): 82507
0020852 Citric Acid, Urine CITRIC U

Specimen Required: Collect: 24-hour urine. Refrigerate during collection. Also acceptable: Random urine.
Specimen Preparation: Adjust pH to less than or equal to 2 by adding 6M HCl. Transfer a 4 mL aliquot of urine to an ARUP Standard
Transport Tube. (Min: 0.5 mL) Record total volume, collection time interval, and pH on transport tube and test request form. Also acceptable:
Specimens previously preserved with boric acid.
Remarks:
Stability: Ambient: 8 hours; Refrigerated: 1 week; Frozen: Indefinitely
CPT Code(s): 82507
2006261 Citrin Deficiency (SLC25A13) Sequencing CITRIN FGS

CPT Code(s): 83891 Isolation; 83898 x19 Amplification; 83904 x19 Sequencing; 83909 capillary electrophoresis; 83912 Interpretation and report -Additional
2007069 Citrullinemia, Type I (ASS1) Sequencing ASS1 FGS

CPT Code(s): 83891 Isolation; 83898 x14 Amplification; 83904 x14 Sequencing; 83909 Capillary electrophoresis, 83912 Interpretation and report. Additional
0099336 Clomipramine and Metabolite CLOMIP

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0090055 Clonazepam CLON

Stability: After separation from cells: Ambient: 6 weeks; Refrigerated: 6 weeks; Frozen: 2 months
CPT Code(s): 80154
0091362 Clonidine, Serum or Plasma CLONIDI SP

CPT Code(s): 80299
0091223 Clonidine, Urine CLONID UR

CPT Code(s): 80299
0090196 Clorazepate (Assayed as Nordiazepam) CLORAZ

CPT Code(s): 80154
0060140 Clostridium difficile Culture with Reflex to Cytotoxin Cell Assay MC CDIF
Specimen Required: Collect: Stool: Transfer 5 mL to an unpreserved stool transport vial (ARUP supply #40910). OR place 5 mL in enteric transport media (Cary-
Blair) (ARUP supply #29799). (Min: 1 mL) Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800)
522-2787.
Tissue: Transfer specimen immediately into anaerobe transport media (ARUP supply #16426).
Specimen Preparation: Transfer 5 mL stool to an unpreserved stool transport vial (ARUP supply #40910). OR place 5 mL stool in enteric transport
media (Cary-Blair) (ARUP supply #29799). (Min: 1 mL) Available online through eSupply using ARUP Connector contact ARUP Client Services
at (800) 522-2787. Storage/Transport Temperature: Frozen.
Storage/Transport Temperature: Stool: Frozen. Tissue: Room Temperature.
Unacceptable Conditions: Multiple specimens (more than one in 24 hours), formed stools, or stool in PVA or formalin.
Stability: Unpreserved or preserved Stool: Ambient: 2 hours; Refrigerated: 48 hours; Frozen: 1 week. Tissue: Ambient: 48 hours; Refrigerated:
Unacceptable; Frozen: Unacceptable.
CPT Code(s): 87075; if reflexed add 87230
2002552 Clostridium difficile Cytotoxin Antibody by Neutralization CDIFF AB

Methodology: Antibody Neutralization
Specimen Preparation: Separate serum from cells. Transfer 2 mL serum to an ARUP Standard Transport Tube. (Min: 1 mL)
CPT Code(s): 87230
0060851 Clostridium difficile Cytotoxin Cell Assay CDIFTX

Methodology: Cell Culture/Neutralization
Specimen Preparation: Transfer 1 mL stool to an unpreserved stool transport vial (ARUP supply #40910). Available online through eSupply using
ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 0.5 mL)
Unacceptable Conditions: Specimens in preservatives. Specimens submitted on swabs.
Stability: Ambient: 2 hours; Refrigerated: 72 hours; Frozen at -20°C: 72 hours; Frozen at -70°C: 1 week
CPT Code(s): 87230
2002838 Clostridium difficile toxin B gene (tcdB) by PCR CDIFF PCR

Specimen Required: Collect: Soft or liquid stool.
Specimen Preparation: Transfer 1 mL stool to a clean, unpreserved transport vial (ARUP Supply# 40910). Available online through eSupply using
ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 0.5 mL).
Page | 159
CPT Code(s): 87493
0065146 Clostridium difficile Toxins (A & B) by EIA CDIFF

Specimen Preparation: Transfer 5 mL stool to an unpreserved stool transport vial (ARUP Supply #40910). Available online through eSupply using
ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 1 mL)
Unacceptable Conditions: Formed stool. Specimens in media or preservatives.
Stability: Unpreserved: Ambient: 2 hours; Refrigerated: 72 hours; Frozen: 1 week
CPT Code(s): 87324
0098930 Clozapine CLOZAPINE

Stability: After separation from cells: Ambient: 5 weeks; Refrigerated: 2 months; Frozen: 2 months
CPT Code(s): 80299
2006476 Clozapine and Metabolite, Serum or Plasma CLOZMET SP

Specimen Required: Collect: Plain red or lavender (EDTA) or pink (K2EDTA).
Stability: Ambient: 8 Days; Refrigerated: 1 Month; Frozen: 1 Month
CPT Code(s): 80299
0099231 Cobalt, Blood COBALT B

CPT Code(s): 83018
2005549 Cobalt, Joint Fluid CO F

Unacceptable Conditions: Separator tubes and gels. Fluid collected after administration of a gadolinium (Gd) containing contrast media (may
occur with MRI studies).
CPT Code(s): 83018
0025037 Cobalt, Serum or Plasma COBALT S

Specimen Required: Collect: Royal blue (no additive) or Royal blue (EDTA)
Specimen Preparation: Centrifuge; Do not allow serum to remain on cells. Transfer 2 mL serum or plasma to an ARUP Trace Element-Free
Transport Tube (ARUP supply #43116). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800)
522-2787. (Min: 0.5 mL)
Unacceptable Conditions: Separator tubes. Specimens that are not separated from the red cells, or clot, within 6 hours.
CPT Code(s): 83018
0025032 Cobalt, Urine COBALT U

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Storage/Transport Temperature: Refrigerated. Also acceptable: Ambient or frozen.
CPT Code(s): 83018
0050137 Coccidioides Antibodies, IgG & IgM by ELISA COCCI G/M

Specimen Required: Collect: Serum separator tube OR CSF.
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 2 mL serum OR CSF to an ARUP Standard
acute specimens. Please Mark specimens plainly as "acute" or "convalescent."
CPT Code(s): 86635 Cocci IgM; 86635 Cocci IgG
0050710 Coccidioides Antibodies Panel, CSF by CF, ID, ELISA COCCI CSF
Methodology: Semi-Quantitative Complement Fixation/Qualitative Immunodiffusion/Semi-Quantitative Enzyme-Linked Immunosorbent Assay
Specimen Preparation: Transfer two 1 mL aliquots of CSF to individual ARUP Standard Transport Tubes. (Min: 0.3 mL per aliquot)
Unacceptable Conditions: Grossly bloody or hemolyzed specimens.
CPT Code(s): 86635 Cocci Ab (CF); 86635 Cocci Ab (ID); 86635 Cocci IgG (EIA); 86635 Cocci IgM (EIA)
0050588 Coccidioides Antibodies Panel, Serum by CF, ID, ELISA COCCI PAN
Methodology: Semi-Quantitative Complement Fixation/Qualitative Immunodiffusion/Semi-Quantitative Enzyme-Linked Immunosorbent Assay
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer two 1 mL aliquots of serum to individual ARUP
Standard Transport Tube. (Min: 0.3 mL per aliquot) Parallel testing is preferred and convalescent specimens must be received within 30 days
from receipt of the acute specimens. Mark specimens plainly as "acute" or "convalescent."
Unacceptable Conditions: Other body fluids. Contaminated, hemolyzed, or severely lipemic specimens.
CPT Code(s): 86635 Cocci Ab (CF); 86635 Cocci Ab (ID); 86635 Cocci Ab, IgG (EIA); 86635 Cocci Ab, IgM (EIA)
0050170 Coccidioides Antibody by CF COCCI

Transport Tube. (Min: 0.15 mL) Parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of acute
CPT Code(s): 86635
0050183 Coccidioides Antibody by ID COCCI-PPT

Specimen Preparation: Transfer 0.5 mL serum OR CSF to an ARUP Standard Transport Tube (Min: 0.15 mL)
Unacceptable Conditions: Bloody or grossly hemolyzed specimens.
CPT Code(s): 86635
0050179 Coccidioides Antibody, IgG by ELISA COCCI G

Specimen Preparation: Transfer 1 mL serum OR CSF to an ARUP Standard Transport Tube. (Min: 0.15 mL)
CPT Code(s): 86635
0050178 Coccidioides Antibody, IgM by ELISA COCCI M

Transport Tube. (Min: 0.15 mL) Parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of the acute
Page | 161
CPT Code(s): 86635
0062225 Coccidioides immitis Identification by DNA Probe MC CP

Specimen Required: Collect: Actively growing fungal isolate in pure culture.
Specimen Preparation: Transport sealed container pure culture on non-blood containing fungal medium. Place each specimen in an individually
sealed bag.
Storage/Transport Temperature: Room temperature. If culture is suspected to be of a microorganism listed by the IATA as infectious to humans,
submit according to Biological Substance, Category A, shipping guidelines.
Unacceptable Conditions: Mixed or non-viable organisms. Agar plate.
CPT Code(s): 87149
0081119 Coenzyme Q10, Total COENZ Q10

Patient Preparation: Patient should fast overnight prior to specimen collection. Patient may have water. It is not necessary to discontinue
nutritional supplements prior to this test.
Specimen Required: Collect: Plasma separator tube, green (sodium or lithium heparin), serum separator tube, or plain red.
Specimen Preparation: Protect from light within one hour of collection and during storage and shipment. Transfer 1 mL serum or plasma to an
Unacceptable Conditions: Specimens other than heparinized plasma or serum. Hemolyzed specimens. Specimens exposed to repeated freeze/thaw
cycles.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 3 weeks; Frozen: 1 month
CPT Code(s): 82491
0050175 Cold Agglutinins COLD

Methodology: Semi-Quantitative Hemagglutination
Specimen Preparation: Keep in warm water (37°C) until processed for transport by laboratory; refrigeration of specimen before separation of
serum from cells will adversely affect test results. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.25 mL)
Unacceptable Conditions: Plasma or CSF. Refrigerated whole blood. Contaminated, severely hemolyzed, or lipemic, specimens.
CPT Code(s): 86157
2003839 Collagen IV by Immunohistochemistry COLL 4 IHC

CPT Code(s): 88342
0093167 Colorado Tick Fever Antibodies, IgG & IgM, IFA COLOR TICK
Methodology: Immunofluorescence Assay
2005373 Complement Activity, Alternative Pathway (AH50) AH50

Methodology: Semi-Quantitative Radial Immunodiffusion
Specimen Preparation: Allow specimen to clot for one hour at room temperature. Separate serum from cells ASAP or within 2 hours of collection.
Transfer 1 mL serum to an ARUP Standard Transport Tube and freeze. (Min: 0.3 mL)
Unacceptable Conditions: Specimen types other than serum. Refrigerated or room temperature specimens. Specimens left to clot at refrigerated
temperature. Specimens exposed to repeated freeze/thaw cycles.
CPT Code(s): 86162
0050198 Complement Activity Enzyme Immunoassay, Total CH50

Page | 162
Unacceptable Conditions: Separator tubes. Specimens left to clot at 2-8°C. Specimens exposed to repeated freeze/thaw cycles. Non-frozen
specimens.
CPT Code(s): 86162
0099078 Complement Component 1, Functional C1

Methodology: Quantitative Hemolytic Assay
Specimen Preparation: Allow blood to clot at room temperature for 20-60 minutes. Separate serum from cells and freeze on dry ice or at -70°C
within 2 hours. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 1 mL)
CPT Code(s): 86161
0099130 Complement Component 1Q Level COMP 1Q

Methodology: Radial Immunodiffusion
Unacceptable Conditions: Grossly hemolyzed, hyperlipemic, or room temperature specimens. Serum or non-EDTA plasma.
CPT Code(s): 86160
0050148 Complement Component 2 C2

Transfer 1 mL serum to an ARUP Standard Transport Tube and freeze immediately. (Min: 0.3 mL)
Unacceptable Conditions: Non-frozen specimens. Specimens exposed to repeated freeze/thaw cycles. Specimens left to clot at refrigerated
temperature.
CPT Code(s): 86160

Specimen Preparation: Allow specimen to clot at room temperature. Separate serum from cells ASAP or within 2 hours of collection. Transfer 0.5
mL serum to an ARUP Standard Transport Tube and freeze. (Min: 0.3 mL)
Unacceptable Conditions: Specimens left to clot at refrigerated temperature. Specimens exposed to repeated freeze/thaw cycles.
CPT Code(s): 86160
2003304 Complement Component 3A COMP 3A

Methodology: Radioimmunoassay
Specimen Preparation: Separate from cells within 1 hour of draw. Transfer 1 mL plasma to an ARUP Standard Transport Tube. Freeze at -70or on
dry ice immediately. (Min: 1 mL)
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable: Frozen at -70°C: 1 month
CPT Code(s): 86160

Specimen Preparation: Allow specimen to clot at room temperature. Separate serum from cells ASAP or within 2 hours of collection and freeze.
Transport 0.5 mL serum. (Min: 0.3 mL)
Stability: Ambient: 48 hours; Refrigerated: 48 hours; Frozen: 2 weeks (avoid repeated freeze/thaw cycles)
CPT Code(s): 86160
2003180 Complement Component 4A COMP 4A

Specimen Preparation: Separate from cells within 1 hour of draw. Transfer 1 mL plasma to an ARUP Standard Transport Tube. Freeze at -70°C or
on dry ice immediately. (Min: 1 mL)
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: Frozen at -70°C: 1 year
CPT Code(s): 86160
Page | 163
Transfer 1 mL serum to an ARUP Standard Transport Tube and freeze immediately. (Min: 0.3 mL) Plasma is not recommended.
Unacceptable Conditions: Non-frozen specimens. Specimens exposed to repeated freeze/thaw cycles. Specimens left to clot at refrigerated
temperature.
CPT Code(s): 86160
0099072 Complement Component 6 COMP 6

Specimen Preparation: Separate plasma from cells within 1 hour. Transfer 1 mL plasma to an ARUP Standard Transport Tube and freeze on dry
ice or at -70(Min: 1 mL)
CPT Code(s): 86160
0099131 Complement Component 6 Functional COMP 6 F

Specimen Preparation: Allow to clot at room temperature for 20-60 minutes. Transfer 1 mL serum to an ARUP Standard Transport Tube. Separate
from clot and freeze at -70°C or on dry ice within 2 hours of draw. (Min: 1 mL)
CPT Code(s): 86161

Specimen Required: Collect: Plain red. Also acceptable: Lavender (EDTA).
CPT Code(s): 86160

Specimen Preparation: Allow blood to clot at room temperature for 20-60 minutes. Separate from clot. Transfer 1 mL serum to an ARUP Standard
Transport Tube and freeze at -70°C or on dry ice within 2 hours of draw. (Min: 1 mL)
Remarks: CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered. Allow blood to clot at room temperature
for 20 to 60 minutes. Must be separated from clot and frozen at -70° C or on dry ice within 2 hours of draw.
CPT Code(s): 86161

CPT Code(s): 86160

Methodology: Hemolytic Assay
CPT Code(s): 86161

CPT Code(s): 86160
Page | 164
CPT Code(s): 86161
2003499 Complement Component C9 (CCC9) by Immunohistochemistry CCC9 IHC

CPT Code(s): 88342
0050149 Complement Components 3 and 4 C3C4

Specimen Preparation: Allow specimen to clot at room temperature. Separate serum from cells ASAP or within 2 hours of collection. Transfer 1
mL serum to an ARUP Standard Transport Tube and freeze. (Min: 0.6 mL)
Stability: Ambient: 8 hours; Refrigerated: 24 hours; Frozen: 2 weeks (avoid repeated freeze/thaw cycles)
CPT Code(s): 86160 C3; 86160 C4
0051720 Complement Factor B COMP FAC B

Specimen Preparation: Allow specimen to clot for 30 minutes to one hour at refrigerated temperature. Separate serum from cells ASAP or within 2
hours of collection. Transfer 1 mL serum to an ARUP Standard Transport Tube and place on refrigerant pack or freeze immediately. (Min: 0.3
mL)
Unacceptable Conditions: Room temperature specimens. Specimens exposed to repeated freeze/thaw cycles.
Stability: After separation from cells: Ambient: Unacceptable, Refrigerated: 48 hours; Frozen: 1 year
CPT Code(s): 86160
0020408 Comprehensive Metabolic Panel CMP

Methodology: Quantitative Ion-Selective Electrode/Quantitative Enzymatic/Quantitative Spectrophotometry
Specimen Preparation: Protect from light. Allow serum tube to clot completely at room temperature. Separate serum or plasma from cells ASAP
or within 30 minutes of collection. Transfer 1 mL serum or plasma to an ARUP Amber Transport Tube. (Min: 0.5 mL)
Unacceptable Conditions: EDTA, citrate, oxalate, or sodium fluoride/potassium oxalate.
CPT Code(s): 80053
2002282 Congenital Adrenal Hyperplasia Panel, 11-Beta Hydroxylase Deficiency CAH 11-B HYDROX
Patient Preparation: Collect between 6-10 a.m.
Specimen Required: Collect: Serum separator tube or green (sodium or lithium heparin). Also acceptable: Lavender (EDTA) or pink (K2EDTA).
CPT Code(s): 82157 Androstenedione; 83498 17-Hydroxyprogesterone; 84403 Testosterone; 82634 11-Deoxycortisol;
82626 Dehydroepiandrosterone.
2002283 Congenital Adrenal Hyperplasia Panel, 21-Hydroxylase Deficiency CAH 21 HYDROX

Specimen Required: Collect: Serum separator tube or green (sodium or lithium heparin). Also acceptable: Lavender (EDTA) or pink (K2EDTA).
CPT Code(s): 82157 Androstenedione; 83498 17-Hydroxyprogesterone; 84143 17-Hydroxypregnenolone; 82626 Dehydroepiandrosterone
Page | 165
2002029 Congenital Adrenal Hyperplasia Treatment Panel CAH RX PANEL
Specimen Required: Collect: Serum separator tube or green (sodium or lithium heparin). Also acceptable: Lavender (EDTA).
Specimen Preparation: Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min 0.5 mL)
CPT Code(s): 82157 Androstenedione; 83498 17-Hydroxyprogesterone; 84403 Total Testosterone
2006220 Congenital Amegakaryocytic Thrombocytopenia (CAMT) Sequencing CAMT FGS

CPT Code(s): 83891 Isolation; 83898 x32 Amplification; 83894 x32 Gel electrophoresis; 83904 x32 Sequencing; 83892 x3 Digestion; 83912 Interpretation and
report.
0051668 Connective Tissue Diseases Profile CONN

Tube. (Min: 0.3 mL)
Unacceptable Conditions: Plasma or other body fluids. Bacterially contaminated specimens.
CPT Code(s): 86235 x6 ENAs; 83516 Centromere; 83516 RIBPP
0051374 Connexin 26 (GJB2), Sequencing CX26SEQ

Methodology: Nucleic Acid Probe/Fluorescence Signal Amplification/Polymerase Chain Reaction/Sequencing
CPT Code(s): 83891 Isolation: 83898 x2 Amplification; 83904 x3 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report.
Consultation, Cytopathology
Specimen Required: Collect: Submit pap slides, nongynecological slide preparations, any special slides, paraffin-embedded block if applicable, copy of preliminary
cytopathology report, clinical history, and a brief explanatory note. If special studies are anticipated such as cytogenetics, flow cytometry, PCR,
FISH, EM, IHC, IF, etc., submit additional tissue in appropriate fixative if required.
Contact your ARUP Business Development Manager or the Anatomic Pathology Business Development Manager at (800) 522-2787 for more
information.
CPT Code(s): 88321 Basic, consultation and report on referred material; or 88323 Moderate, consultation and report on referred material requiring slide
preparation; or 88325 Complex, consultation, with review of records and specimens, and report on referred material. Additional billing may apply
if special studies are indicated.
Consultation, Dermatopathology
Specimen Required: Collect: Submit hematoxylin and eosin slides, any special stain slides, paraffin-embedded block if applicable, copy of preliminary cytopathology
report, clinical history and a brief explanatory note. If special studies are anticipated such as cytogenetics, flow cytometry, PCR, FISH, EM, IHC,
IF, etc., submit additional tissue in appropriate fixative if required.
Contact your ARUP Business Development Manager or the Anatomic Pathology Business Development Manager (800) 522-2787 for more
information.
Consultation, Head and Neck

Specimen Required: Collect: Submit hematoxylin and eosin slides, any special stain slides, paraffin-embedded block , copy of preliminary pathology report, clinical
history and a brief explanatory note. If special studies are anticipated such as cytogenetics, flow cytometry, PCR, FISH, EM, IHC, IF, etc., submit
additional tissue in appropriate fixative if required.
information.
Consultation, Hematopathology
Page | 166
Specimen Required: Collect: Transport prepared slides (Hematoxylin and eosin, Wright stained, etc.) any special stain slides, paraffin-embedded block, copy of
preliminary pathology report, clinical history and a brief explanatory note. If special studies are anticipated such as cytogenetics, flow cytometry,
PCR, FISH, EM, IHC, IF, etc., submit additional tissue in appropriate fixative if required.
Contact your ARUP Business Development Manager at (800) 522-2787 for more information.
Consultation, Neuropathology
Specimen Required: Collect: Submit hematoxylin and eosin slides, any special stain slides, paraffin-embedded block, copy of preliminary pathology report, clinical
history and brief explanatory note. If special studies are anticipated such as cytogenetics, flow cytometry, PCR, FISH, EM, IHC, IF, etc., submit
additional tissue in appropriate fixative if required.
information.
Consultation, Surgical Pathology

Specimen Required: Collect: Transport hematoxylin and eosin slides, any special stain slides, and paraffin-embedded block. Include copy of preliminary pathology
report, clinical history and brief explanatory note. If special studies are anticipated such as cytogenetics, flow cytometry, PCR, FISH, EM, IHC,
IF, etc., submit additional tissue in appropriate fixative if required.
information.
if special studies are included.
0020694 Copper, Liver CU-LIVER

Specimen Required: Collect: Liver tissue obtained with an 18 gauge needle.
Specimen Preparation: Transport at least a 1 cm long specimen. Tissue can be fresh, paraffin-embedded, or dried. Also acceptable: Formalin-
fixed. Specimens other than paraffin-embedded should be stored and transported in a metal-free container such as a royal blue (no additive).
Unacceptable Conditions: Specimens less than 0.25 mg (dry weight). Paraffin blocks that have been processed with Hollandes or other copper-
containing stain.
Stability: Paraffin block, preserved (formalin), or dried: Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Indefinitely
Fresh tissue: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: Indefinitely
CPT Code(s): 82525
2007252 Copper, RBC COPPER RBC

Specimen Required: Collect: Royal blue (EDTA).
Specimen Preparation: Separate cells within 2 hours of collection. Transfer 2 mL RBCs to an ARUP Trace Element-Free Transport Tube (ARUP
supply #43116). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 0.7 mL)
CPT Code(s): 82525
0020096 Copper, Serum COPPER

Specimen Required: Collect: Royal blue (no additive) or Royal blue (EDTA)
522-2787. (Min: 0.5 mL)
Unacceptable Conditions: Separator tubes and specimens that are not separated from the red cells or clot within 6 hours.
CPT Code(s): 82525
0020596 Copper, Serum Free (Direct) COPPER F

Specimen Preparation: Centrifuge. Transfer 2.5 mL serum to an ARUP Trace Element-Free Transport Tube. (Min: 1.5 mL) Do not allow serum to
remain on cells.
Unacceptable Conditions: Separator tubes. Specimens that are not separated from the red cells or clot.
CPT Code(s): 82525
Page | 167
0020461 Copper, Urine COPPER U
CPT Code(s): 82525
2003292 CordStat 12 Reflexive Panel CORD 12

Methodology: Qualitative Enzyme-Linked Immunosorbent Assay/Quantitative Gas Chromatography-Mass Spectrometry/Liquid Chromatography-Tandem Mass
Spectrometry
Specimen Required: Collect: Umbilical cord. Collection instructions are provided with kit (ARUP Supply #46990). Available online through eSupply using ARUP
Specimen Preparation: Avoid any contact of ethanol liquid or vapor with the umbilical cord. Do not place in formalin. Transport 6-inch to 8-inch
segment of umbilical cord.
Remarks: Submissions require tamper evident seal to be placed on the specimen collection container. Unsealed containers will be rejected.
CPT Code(s): 80101 x12 Drug screen; 80103 Tissue preparation; if positive, add 80102 Drug confirmation and 80103 Tissue preparation for each procedure
0098513 Corticosteroid Binding Globulin (CBG) CORTICO BG

Stability: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 2 years
CPT Code(s): 84449
2003250 Cortisol by LC-MS/MS, Serum or Plasma CORT TMS

Patient Preparation: It is recommended that the specimen be collected between 6-11 a.m.
Specimen Required: Collect: Serum separator tube, lavender (EDTA), pink (K2EDTA), or green (sodium or lithium heparin).
Specimen Preparation: Separate serum or plasma from cells ASAP or within 2 hours of collection. Transport 1 mL serum or plasma. (Min: 0.5
mL)
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 6 months
CPT Code(s): 82533
0092100 Cortisol/Cortisone Urine Free by LC-MS/MS CORTURATIO

Specimen Preparation: Transport one 4 mL aliquot of urine. (Min: 1 mL) Record total volume and collection time interval on transport tube and
test request form.
Unacceptable Conditions: Room temperature specimens. Acidified specimens or specimens with preservatives.
CPT Code(s): 82530 Cortisol; 83789 LC-MS/MS
0098391 Cortisol, Free FCORTS

Methodology: Equilibrium Dialysis/Quantitative Electrochemiluminescent Immunoassay
Specimen Required: Collect: Plain red or serum separator tube. Also acceptable: Lavender (EDTA) or pink (K2EDTA).
Specimen Preparation: Centrifuge specimen. Separate serum or plasma from cells within 2 hours of collection. Transfer 1 mL serum or plasma to
an ARUP Standard Transport Tube. (Min: 0.6 mL) Label plainly as a.m. or p.m. collection.
Unacceptable Conditions: Specimens collected in plasma separator tubes containing heparin. Grossly hemolyzed or heparinized specimens.
CPT Code(s): 82530
0081117 Cortisol, Saliva CORT SAL

Patient Preparation: Do not collect specimen within 60 minutes after eating a meal, within 12 hours after consuming alcohol, immediately after
brushing teeth or after any activity that may cause gums to bleed. Rinse mouth thoroughly with water 10 minutes before specimen collection.
Recommended collection time is between 11:00 p.m. - 1:00 a.m.
Specimen Required: Collect: Saliva. Swab must be completely saturated to ensure sufficient volume for testing.
Specimen Preparation: Transfer saturated swab to plain (non-citric acid) cotton Salivette® collection device (ARUP Supply #41252). Record the
time of collection on the test request form, and on Salivette® transport container.
Page | 168
Unacceptable Conditions: Specimens not collected using the Salivette® collection device. Sodium azide preservative. Specimens with pH values
greater than 9.0 or less than 3.5 must be recollected. Specimens visibly contaminated with blood, cellular debris, food particles, or mucus.
CPT Code(s): 82533
0070030 Cortisol, Serum or Plasma CORTISOL

Specimen Required: Collect: Serum separator tube or plasma separator tube. Also acceptable: Green (sodium or lithium heparin).
Unacceptable Conditions: Saliva (refer to Cortisol, Saliva, ARUP test code 0080117).
CPT Code(s): 82533
0097222 Cortisol Urine Free by LC-MS/MS CORT UF

Specimen Preparation: Transport one 4 mL aliquot of urine. (Min: 1 mL) Record total volume and collection time interval on transport tube and
test request form.
Unacceptable Conditions: Room temperature specimens. Acidified specimens or specimens with preservatives.
Stability: Ambient: Unacceptable; Refrigerated: 2 weeks; Frozen: 6 months
CPT Code(s): 82530
2003252 Cortisone by LC-MS/MS, Serum or Plasma CONE TMS

mL)
CPT Code(s): 83491
0060360 Corynebacterium diphtheriae Culture MC DIPH

Specimen Required: Collect: Nasopharynx, throat, or wound swab.
Swab nasopharynx and throat at the site of membrane or inflammation to significantly increases recovery. Swab base of cleansed wound, if
present.
Specimen Preparation: Place swab in bacterial transport media.
2007081 Cotinine Screen, Urine COTININE

Methodology: Enzyme Multiplied Immunoassay Technique
Specimen Preparation: Transfer 4 mL urine with no additives to an ARUP Standard Transport Tube. (Min: 2 mL)
Unacceptable Conditions: Specimens exposed to repeated freeze/thaw cycles
Stability: Ambient: 10 days; Refrigerated: 10 days; Frozen: 8 months
CPT Code(s): 80101
2003102 Coxiella burnetii (Q-Fever) Antibodies, IgG & IgM by IFA with Reflex to Titer C BURNETII
Stability: Ambient: 4 days; Refrigerated: 1 week; Frozen: 1 month
CPT Code(s): 86638 x4; if reflexed add 86638 per titer performed
0050462 Coxiella burnetii (Q-Fever) Antibody IgG, Phase I & II by IFA Q-F 1,2
specimens. Mark specimens plainly as "acute" and "convalescent."
CPT Code(s): 86638 Q-Fever Phase I; 86638 Q-Fever Phase II
Page | 169
0050463 Coxiella burnetii (Q-Fever) Antibody IgG, Phase I by IFA Q-F I
Unacceptable Conditions: Urine. Contaminated, hemolyzed, or severely lipemic specimens.
CPT Code(s): 86638
0050464 Coxiella burnetii (Q-Fever) Antibody IgG, Phase II by IFA Q-F II

Unacceptable Conditions: Urine. Contaminated, hemolyzed, or severely lipemic specimens.
CPT Code(s): 86638
2003097 Coxiella burnetii (Q-Fever) Antibody, IgM by IFA with Reflex to Titer COXIELLA B
CPT Code(s): 86638 x2; if reflexed add 86638 per titer performed
2002932 Coxsackie A Antibodies (A-2, 4, 7, 9, 10 & 16 Serotypes) COX A AB

Methodology: Complement Fixation
Specimen Preparation: Transfer 2 mL serum to an ARUP standard transport tube. (Min: 1 mL)
CPT Code(s): 86658 x6 A-2, 4, 7, 9, 10 and 16 serotypes
0050503 Coxsackie A9 Virus Antibodies by CF COX A9

CPT Code(s): 86658
0060055 Coxsackie B Virus Antibodies COX B

Methodology: Semi-Quantitative Serum Neutralization
Specimen Required: Collect: Serum separator tube or plain red. OR CSF.
Specimen Preparation: Separate serum from cells within 2 hours of collection. Transfer 1 mL serum or CSF to an ARUP Standard Transport Tube.
(Min: 0.3 mL) Parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of acute specimens. Mark
CPT Code(s): 86658 x6 Coxsackie (B1, B2, B3, B4, B5, and B6)
2002328 Creatine Disorders Panel, Plasma or Serum CRTN DIS P

Methodology: Liquid Chromatography/Tandem Mass Spectrometry
Specimen Required: Collect: Green (sodium or lithium heparin), lavender (EDTA), plain red, or serum separator tube.
Specimen Preparation: Separate from cells ASAP or within 2 hours of collection. Transfer 1 mL serum or plasma to an ARUP Standard Transport
Unacceptable Conditions: Specimens exposed to more than one freeze/thaw cycle.
CPT Code(s): 82540 Creatine; 83789 Guanidinoacetic acid
2002333 Creatine Disorders Panel, Urine CRTN DIS U

Specimen Required: Collect: Random or timed urine.
Page | 170
Specimen Preparation: Transfer 2 mL urine to an ARUP Standard Transport Tube and freeze immediately. (Min: 0.5 mL)
CPT Code(s): 82540 Creatine, 82570 Creatinine, 83789 Guanidinoacetic acid
0020414 Creatine Kinase Isoenzymes CKISO

Methodology: Quantitative Enzymatic/Electrophoresis
Specimen Preparation: Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL) CK-MB and CK-BB are quite labile;
specimens should be frozen if the assay cannot be performed within 24 hours.
Remarks: This test will detect CK macroenzymes.
Unacceptable Conditions: Specimens preserved in citrate, EDTA, fluoride, heparin, or iodoacetate. Room temperature specimens.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 24 hours; Frozen: 2 weeks (avoid repeated freeze/thaw cycles)
CPT Code(s): 82552 Creatine kinase isoenzymes; 82550 Creatine kinase, total
0080480 Creatine Kinase, MB CK MB

Specimen Required: Collect: Green (sodium or lithium heparin), plasma separator tube, serum separator tube.
Specimen Preparation: SST needs to sit for 15-20 minutes for proper clot formation and to assure the absence of fibrin in the serum which can
interfere with this assay. Centrifuge and remove from cells ASAP or within 2 hours of collection. Specimens must be free of all particulate matter
which can interfere with the assay. Transfer 2 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Remarks: CK-MB is quite labile. CK-MB relative percent will be calculated only if Creatine Kinase, Total, Serum or Plasma (ARUP test
code 0020010) is ordered.
CPT Code(s): 82553
0020010 Creatine Kinase, Total, Serum or Plasma CK

Specimen Required: Collect: Plasma preparation tube or serum separator tube.
Specimen Preparation: Allow specimen to clot completely at room temperature. Separate serum or plasma from cells ASAP. Transfer 1 mL serum
or plasma to an ARUP Standard Transport Tube. (Min: 0.2 mL)
Unacceptable Conditions: Specimens collected in potassium oxalate or sodium fluoride. Grossly hemolyzed specimens.
CPT Code(s): 82550
2002340 Creatine, Serum or Plasma CRTN SP

Specimen Required: Collect: Plain red, serum separator tube, green (sodium or lithium heparin), or lavender (EDTA).
CPT Code(s): 82540
2001875 Creatine Transport, Fibroblasts CRTN FIBRO

Specimen Preparation: Transport two T-25 flasks of fibroblasts from skin biopsy. Cells should be kept in 37°C incubator until shipped.
Storage/Transport Temperature: CRITICAL ROOM TEMPERATURE. Must call lab before shipping. Ship Monday-Thursday only.
Remarks: Clinical information is needed for appropriate interpretation. Biochemical Genetics Patient History Form is available on the
ARUP Web site at http://www.aruplab.com/patienthistory or by contacting ARUP Client Services.
Unacceptable Conditions: Frozen or refrigerated specimens. Specimens in improper media. Dead cells.
CPT Code(s): 84238
2002343 Creatine, Urine CRTN URINE

Specimen Preparation: Transfer 2 mL urine to an ARUP Standard Transport Tube and freeze immediately. (Min: 0.5 mL)
CPT Code(s): 82540
0020473 Creatinine, 24-Hour Urine UCRT

Specimen Required: Collect: 24-hour urine. Specimen must be refrigerated during collection. Also acceptable: Random urine (no reference intervals).
Specimen Preparation: Transfer one 3 mL aliquot to an ARUP Standard Transport Tube. (Min: 0.5 mL) Record total volume and collection time
interval on transport tube and test request form. Also acceptable: Specimens previously preserved with 6M HCl, boric acid, or 5% NaOH.
Page | 171
CPT Code(s): 82570
0020509 Creatinine, Body Fluid CRT-FL

Specimen Preparation: Centrifuge and separate to remove cellular material. Transport 1 mL body fluid. (Min: 0.2 mL)
Stability: Ambient: 5 days; Refrigerated: 1 month; Frozen: 6 months
CPT Code(s): 82570
0020474 Creatinine Clearance, Urine CRTCL

Methodology: Quantitative Spectrophotometry/Enzymatic
Specimen Required: Collect: 24-hour urine. Specimen must be refrigerated during collection. AND plasma separator tube or serum separator tube, collected within 48
hours of initiating urine collection.
Specimen Preparation: Transfer one 3 mL aliquot from a well-mixed 24-hour collection (Min: 0.5 mL) AND 1 mL serum or plasma (Min: 0.2 mL)
to individual ARUP Standard Transport Tubes. Record total volume and collection time interval on transport tube and test request form.
Unacceptable Conditions: Random urine collections.
Stability: Serum: (after separation from cells) Ambient: 4 hours; Refrigerated: 1 week; Frozen: 6 months
Urine: Ambient: 24 hours; Refrigerated: 4 days; Frozen: 6 months.
CPT Code(s): 82575
0020025 Creatinine, Serum or Plasma CRT

collection. Transfer 1 mL plasma or serum or plasma to an ARUP Standard Transport Tube. (Min: 0.2 mL)
Unacceptable Conditions: Specimens obtained through catheters used to infuse hyperalimentation fluid. Specimens with potassium oxalate/sodium
fluoride, citrate, or EDTA as anticoagulants.
CPT Code(s): 82565
0091485 Cresols, Urine CRESOL URN

Specimen Required: Collect: Random urine in a preservative-free container.
Unacceptable Conditions: Specimens preserved with Benzoic Acid.
CPT Code(s): 84600
2001613 Crohn Disease Prognostic Panel CROHN PAN

Tube. (Min: 0.3 mL)
Unacceptable Conditions: Plasma, other body fluids, grossly icteric, heat-inactivated, grossly hemolyzed, severely lipemic, or contaminated
specimens.
(avoid repeated freeze/thaw cycles)
CPT Code(s): 86671 gASCA IgG; 83516 Lam Ag IgG; 83516 Man Ag IgG; 83516 Chito Ag IgA
0050190 Cryofibrinogen CRYO FIB

Methodology: Qualitative Cold Precipitation
Specimen Required: Collect: Whole blood drawn in a pre-warmed (37°C) syringe. Specimen may be drawn directly into a pre-warmed lt. blue (sodium citrate) or
black (sodium citrate).
Specimen Preparation: Maintain whole blood at 37°C from collection to transport; do not refrigerate or freeze at any time. Immediately
after blood has been obtained, transfer specimen to a pre-warmed blue (sodium citrate) or black (sodium citrate) (if not used for collection).
Separate plasma from cells using a 37°C centrifuge, if possible. Transfer 3 mL plasma to an ARUP Standard Transport Tube. (Min: 1 mL)
Remarks: Proper collection and transport of specimen is critical to the outcome of the assay. Quantities less than 3 mL may affect the sensitivity of
the assay.
Unacceptable Conditions: Refrigerated or frozen specimens. Heparinized specimens. Grossly hemolyzed or lipemic specimens.
Stability: After separation from cells: Ambient: 1 week; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 82585
0050185 Cryoglobulin, Qualitative CRYGB

Methodology: Qualitative Cold Precipitation
Specimen Required: Collect: Plain red tube.
Page | 172
Specimen Preparation: 1) Draw approximately 7 mL of blood into a pre-warmed (37°C) plain red tube. Alternatively: draw into a pre-warmed
(37°C) syringe and immediately transfer blood to a pre-warmed (37°C) plain red tube. 2) Maintain collected blood at 37°C until clotting is
complete. 3) Separate serum from cells within 1 hour of collection. Transfer 3 mL serum to an ARUP Standard Transport Tube. (Min: 1 mL) See
Remarks.
Remarks: Proper collection and transport of specimen is critical to the outcome of the test. Submitting quantities less than 3 mL may affect the
sensitivity of the test.
Unacceptable Conditions: Plasma. Refrigerated or frozen specimens. Serum separator tubes (SST or clot-activating tubes). Grossly hemolyzed or
lipemic specimens.
CPT Code(s): 82595
2002403 Cryoglobulin, Qualitative with Reflex to IFE Typing and Quantitative IgA, IgG, and IgM CRYO TYPING
Methodology: Qualitative Cold Precipitation/Qualitative Immunofixation Electrophoresis/Quantitative Nephelometry
Specimen Required: Collect: Whole blood drawn in a pre-warmed (37°C) syringe. Specimen may be drawn directly into a pre-warmed plain red.
Specimen Preparation: Maintain whole blood at 37°C until clotting is complete; do not refrigerate or freeze at any time. Immediately after
blood has been obtained, transfer specimen to a pre-warmed plain red (if not used for collection). Separate plasma from cells using a 37°C
centrifuge, if possible. Transfer 3 mL serum to an ARUP Standard Transport Tube. (Min: 3 mL)
Remarks: Proper collection and transport of specimen is critical to the outcome of the assay. Quantities less than 3 mL may affect the sensitivity of
the assay.
Unacceptable Conditions: Plasma. Refrigerated or frozen specimens. Separator tubes. Grossly hemolyzed or lipemic specimens.
CPT Code(s): 82595 Cryoglobulin; if reflexed, add 86334 IFE and 82784 x3 (IgA, IgG, IgM)
2002063 Cryoglobulin, Qualitative, with Reflex to Quantitative IgA, IgG, and IgM CRYGB QNT
Methodology: Qualitative Cold Precipitation/Quantitative Nephelometry
Specimen Required: Collect: Plain red tube.
Specimen Preparation: 1) Draw approximately 7 mL of blood into a pre-warmed (37 degrees C) plain red tube. Alternatively: draw into a pre-
warmed (37 degrees C) syringe and immediately transfer blood to a pre-warmed (37 degrees C) plain red tube. 2) Maintain collected blood at 37
degrees C until clotting is complete (up to 1 hour). 3) Separate serum from cells ASAP. Transfer 3 mL serum to an ARUP Standard Transport
Tube. (Min: 1 mL) See Remarks.
Remarks: Proper collection and transport of specimen is critical to the outcome of the test. Submitting quantities less than 3 mL may affect the
sensitivity of the test.
Unacceptable Conditions: Plasma. Refrigerated or frozen specimens. Serum separator tubes (SST or other clot-activating tubes). Grossly
hemolyzed or lipemic specimens.
CPT Code(s): 82595 Cryoglobulin; if reflexed, add 82784 x3 (IgA, IgG, IgM)
0098947 Cryptococcus Antibody CRYPTO AB

CPT Code(s): 86641
0050195 Cryptococcus Antigen, CSF CRY CSF

Specimen Preparation: Transfer 1 mL CSF to a sterile ARUP Standard Transport Tube (ARUP supply #43115). Available online through eSupply
using ARUP Connector contact ARUP Client Services at (800) 522-2787. (Min: 0.25 mL)
Stability: Ambient: 1 hour; Refrigerated: 72 hours; Frozen: Indefinitely
CPT Code(s): 87327
0050196 Cryptococcus Antigen, Serum CRY BLD

Specimen Preparation: Separate serum from cells. Transfer 1 mL serum to a sterile ARUP Standard Transport Tube (ARUP supply # 43115).
Available online through eSupply using ARUP Connector contact ARUP Client Services at (800) 522-2787. (Min: 0.25 mL)
Stability: Ambient: 1 hour; Refrigerated: 72 hours; Frozen: Indefinitely
CPT Code(s): 87327
Page | 173
0060045 Cryptosporidium Antigen by EIA CRYSPOR
Specimen Preparation: Preserve 5 g stool in 10 percent formalin within one hour of collection (ARUP supply #16355). Available online through
eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 1 g)
Unacceptable Conditions: Specimens in any other preservative than indicated above.
Stability: Ambient: 9 months; Refrigerated: 9 months; Frozen: Unacceptable
CPT Code(s): 87328
0009500 Crystals (Local Clients Only) CRYSTALS

Methodology: Microscopy/Polarizing Microscopy
Specimen Required: Collect: Synovial or bile fluid in liquid EDTA or sodium heparin.
Specimen Preparation: Transport 1 mL synovial or bile fluid. (Min: 0.5 mL)
Unacceptable Conditions: Any fluid other than synovial or bile. Synovial or bile fluids collected in powdered EDTA or powdered lithium heparin.
Specimens sent with needle. Frozen specimens.
CPT Code(s): 89060
0092572 Cutaneous Direct Immunofluorescence, Biopsy CUTDIF

Methodology: Direct Immunofluorescence
(Direct Fluorescent Antibody Stain)
Specimen Required: Collect: Tissue, skin, or mucous membrane.
Specimen Preparation: Transport epidermis/epithelium and dermis tissue (optimal 4-5 mm) in Michel's (or Zeus) medium.
Unacceptable Conditions: Formalin-fixed tissue.
CPT Code(s): 88346 x5 IgG, IgM, IgA, C3, & fibrinogen
0090060 Cyanide CYAN

Methodology: Quantitative Colorimetry
Specimen Required: Collect: Green (sodium or lithium heparin). Also acceptable: Lavender (EDTA) or pink (K2EDTA or K3EDTA).
Specimen Preparation: Do not freeze. Transport 4 mL whole blood in original collection container. (Min: 3 mL) Also acceptable: Transfer
specimen to an ARUP Standard Transport Tube.
Unacceptable Conditions: Serum or plasma. Frozen or refrigerated specimens. Clotted or hemolyzed specimens.
Stability: Ambient: 72 hours (if tightly capped); Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 82600
0070181 Cyclic AMP, Nephrogenous CAMP-NEPH

Patient Preparation: Refer to individual components.
Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA) AND urine, timed or random.
Specimen Preparation: Separate plasma from cells and freeze ASAP or within 2 hours of collection. Transfer 1 mL plasma to an ARUP Standard
Transport Tube and freeze immediately. (Min: 0.1 mL) AND transfer 5 mL urine to ARUP Standard Transport Tubes. (Min: 0.1 mL)
CPT Code(s): 82030 Cyclic AMP, urine; 82030 Cyclic AMP, plasma
0070180 Cyclic AMP, Plasma CAMP

Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 1 hour; Frozen: 3 months
CPT Code(s): 82030
0070485 Cyclic AMP, Urine CAMP-U

Specimen Required: Collect: Random urine (unpreserved). Also acceptable: 24-hour urine. Collect in container with 10 mL 6M HCl.
Specimen Preparation: Transfer 5 mL aliquot of urine to ARUP Standard Transport Tubes. (Min: 1 mL) Record total volume and collection time
interval on transport tube and test request form.
CPT Code(s): 82030
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0055256 Cyclic Citrullinated Peptide (CCP) Antibody, IgG CCP IGG
Tube. (Min: 0.3 mL)
Unacceptable Conditions: Urine or plasma. Contaminated, hemolyzed, grossly icteric, heat-inactivated, or severely lipemic specimens.
CPT Code(s): 86200
2003842 Cyclin D1, SP4 by Immunohistochemistry CYCSP4 IHC

CPT Code(s): 88342
0091303 Cyclobenzaprine (Flexeril), Serum or Plasma CYCLOBENZA

Stability: Ambient: 1 week; Refrigerated: 16 days; Frozen: 1 year
CPT Code(s): 80299
0091155 Cyclobenzaprine (Flexeril), Urine CYCLOBEN U

Stability: Ambient: 1 week; Refrigerated: 16 days; Frozen: 1 year
CPT Code(s): 82491
0070035 Cyclosporine A by Tandem Mass Spectrometry CYA

Patient Preparation: Pre-dose (trough) levels should be drawn.
Specimen Preparation: Transfer 1 mL well-mixed whole blood to a plastic vial. (Min: 0.25 mL)
Unacceptable Conditions: Serum or plasma. Specimens left at room temperature for longer than 24 hours. Clotted specimens.
CPT Code(s): 80158
0058902 Cyclosporine A, C2 by Tandem Mass Spectrometry C2CYA

Patient Preparation: Two hour post-dose level should be drawn.
CPT Code(s): 80158
0081344 CYFRA 21-1 (Cytokeratin 19 Fragment), Serum CYFRA

Specimen Preparation: Allow serum specimen to clot completely at room temperature. Separate serum from cells ASAP or within 2 hours of
Unacceptable Conditions: Plasma. Icteric, lipemic, or hemolyzed specimens.
CPT Code(s): 86316
0095229 Cystatin C, Serum CYSTAT C

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Stability: After separation from cells: Ambient: 48 hourS; Refrigerated: 1 week; Frozen: 2 months
CPT Code(s): 82610
0056003 Cystic Fibrosis (CFTR) 5T Mutation IVS-8

CPT Code(s): 83891 Isolation; 83900 Multiplex amplification; 83901 x31 Additional amplification; 83914 x2 OLA; 83909 Capillary electrophoresis; 83912
0050098 Cystic Fibrosis (CFTR) 3199del6 Mutation CF3199DEL6

CPT Code(s): 83891 Isolation; 83898 x2 Amplification; 83896 x4 Nucleic acid probes; 83912 Interpretation and report - Additional CPT code modifiers may be
2001933 Cystic Fibrosis (CFTR) 32 Mutations CF PAN

Methodology: Polymerase Chain Reaction/Oligonucleotide Ligation/Fragment Analysis
Remarks: Patient History Form is available on the ARUP Web site or by contacting Client Services at (800) 522-2787.
Stability: Ambient: 3 days; Refrigerated: 1 week; Frozen: Unacceptable
CPT Code(s): 83891 Isolation; 83900 Amplification; 83901 x30 Multiplex amplification; 83914 x32 OLA; 83909 Capillary electrophoresis; 83912 Interpretation
2001969 Cystic Fibrosis (CFTR) 32 Mutations, Atypical CF PAN 5T

CPT Code(s): 83891 Isolation; 83900 Amplification; 83901 x30 Multiplex amplification; 83914 x33 OLA; 83909 Capillary electrophoresis; 83912 Interpretation
2001970 Cystic Fibrosis (CFTR) 32 Mutations, Fetal CF PAN FE

arranged by contacting ARUP Client Services at (800) 522-2787.
Maternal Specimen: Lavender (EDTA) or yellow (ACD Solution A or B).
Specimen Preparation: Cultured amniocytes: Fill flasks with culture media. Transport two T-25 flasks at 80% confluent of cultured amniocytes.
Backup cultures must be retained at the client's institution until testing is complete.
Maternal Specimen: Transport 3 mL whole blood.
Storage/Transport Temperature: Cultured amniocytes: CRITICAL ROOM TEMPERATURE. Must be received within 48 hours of shipment
due to lability of cells.
Maternal Specimen: Room temperature. Ship with the fetal specimen.
Remarks: Maternal sample is recommended for proper test interpretation; order Maternal Cell Contamination. Patient History Form is
available on the ARUP Web site or by contacting ARUP Client Services.
Stability: Fetal: Ambient: 48 hours; Refrigerated: Unacceptable; Frozen: Unacceptable
Maternal: Ambient: 72 hours; Refrigerated: 1 week; Frozen: Unacceptable
CPT Code(s): 83891 Isolation; 83900 Multiplex amplification; 83901 x30 Additional amplification; 83914 x32 Mutation identification by OLA; 83909 Capillary
electrophoresis; 83912 Interpretation and report. FCC: 83900 Multiplex amplification; 83901 x14 Additional amplification; 83909 Capillary
electrophoresis. If MCC Maternal Cell (0050608) is performed, add: 83891 Isolation; 83900 Multiplex amplification; 83901 x14 Additional
amplification; 83909 Capillary electrophoresis; 83912 Interpretation and report - Additional CPT code modifiers may be required for procedures
2001968 Cystic Fibrosis (CFTR) 32 Mutations with Reflex to Sequencing CF PAN-SEQ

Methodology: Polymerase Chain Reaction/Oligonucleotide Ligation/Fragment Analysis/Sequencing
Interpretation and report. If reflexed to sequencing, add 83891 Isolation; 83898 x32 Amplification; 83904 x32 Sequencing; 83909 Capillary
electrophoresis - Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders.
2001967 Cystic Fibrosis (CFTR) 32 Mutations with Reflex to Sequencing and Reflex to Deletion/Duplication CF COMPR
Methodology: Polymerase Chain Reaction/Oligonucleotide Ligation/Fragment Analysis/Sequencing/Multiplex Ligation-dependent Probe Amplification
Page | 176
Interpretation and report. If reflexed to sequencing, add 83891 Isolation; 83898 x32 Amplification; 83904 x32 Sequencing; 83909 Capillary
electrophoresis. If reflexed to Deletion/Duplication, add 83896 Nucleic acid probes; 83898 Amplification; 83914 Extension; 83909 Capillary
electrophoresis - Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders.
0051642 Cystic Fibrosis (CFTR) Deletion/Duplication CFTRDELDUP

Methodology: Multiplex Ligation-dependent Probe Amplification
Remarks: Patient History Form is available on the ARUP Web site or by contacting ARUP Client Services at (800) 522-2787.
CPT Code(s): 83891 Isolation; 83896 Nucleic Acid Probes; 83898 Amplification; 83914 Extension; 83909 Capillary Electrophoresis; 83912 Interpretation and
0051110 Cystic Fibrosis (CFTR) Sequencing CF-CFTR

CPT Code(s): 83891 Isolation; 83898 x32 Amplification; 83904 x32 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report. Additional
0051640 Cystic Fibrosis (CFTR) Sequencing with Reflex to Deletion/Duplication CFTR FGA
If reflexed to Deletion/Duplication, add 83896 Nucleic Acid Probes; 83898 Amplification; 83914 Extension; 83909 Capillary electrophoresis.
0056006 Cystic Fibrosis Cis-Trans(CFTR) R117H and 5T Mutations CFCIS-TRAN

Methodology: Polymerase Chain Reaction/Oligonucleotide Ligation
CPT Code(s): 83891 Isolation; 83900 Amplification; 83901 Multiplex amplification; 83914 x4 Mutation identification; 83909 Separation and identification;
disorders.
0060130 Cystic Respiratory Culture MC CYST

Specimen Required: Collect: Sputum from cystic fibrosis patient.
Specimen Preparation: Transfer sputum to a sterile container. Place each specimen in an individually sealed bag.
Unacceptable Conditions: Multiple specimens (more than one in 24 hours).
CPT Code(s): 87070
0055284 Cysticercosis Antibody, IgG by ELISA CYST SER

Specimen Preparation: Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.1 mL) Parallel testing is preferred and convalescent
specimens must be received within 30 days from receipt of the acute specimens. Mark specimens plainly as acute or convalescent.
Unacceptable Conditions: CSF. Contaminated, heat-inactivated, hemolyzed, icteric, or lipemic specimens.
CPT Code(s): 86682
0055285 Cysticercosis Antibody, IgG by ELISA (CSF) CYST CSF

Unacceptable Conditions: Serum. Contaminated, heat-inactivated, hemolyzed, icteric, or lipemic specimens.
CPT Code(s): 86682
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0055283 Cysticercosis Antibody, IgG by Western Blot CYST WB
Tube. (Min: 0.1 mL)
Unacceptable Conditions: CSF. Contaminated, heat-inactivated, hemolyzed, icteric, or severely lipemic specimens.
CPT Code(s): 86682
0055282 Cysticercosis Antibody, IgG by Western Blot (CSF) CYSTCSF WB

CPT Code(s): 86682
0081106 Cystine Quantitative, Urine QNT CYS U

Specimen Required: Collect: 24-hour or other timed urine collection. Avoid dilute urine when possible. Refrigerate 24-hour/timed specimens during collection.
Specimen Preparation: Mix urine well. Transfer 8 mL aliquot urine to ARUP Standard Transport Tubes and freeze immediately. (Min: 3 mL)
Record total volume and collection time interval on transport tube and test request form.
therapy), drug therapy, and family history. Biochemical Genetics Patient History Form is available on the ARUP Web site or by contacting
CPT Code(s): 82131
0081105 Cystinuria Panel CYS PAN

Specimen Preparation: Mix urine well. Transfer 8 mL urine to ARUP Standard Transport Tubes and freeze immediately. (Min: 3 mL)
therapy), drug therapy, and family history. Biochemical Genetics Patient History Form is available on the ARUP web site or by contacting
CPT Code(s): 82136
0051103 Cytochrome P450 2C9 (CYP2C9) 2 Mutations CYP2C9

Methodology: Polymerase Chain Reaction/DNA Hybridization/Electrochemical Detection
CPT Code(s): 83891 Isolation; 83892 Enzymatic Digestion, 83900 Amplification, 83901 Additional Amplification x13, 88384 Array-based evaluation of
multiple molecular probes; 11 through 50 probes, 83912 Interpretation and report - Additional CPT code modifiers may be required for procedures
0051104 Cytochrome P450 2C19 (CYP2C19) 9 Mutations CYP2C19

Methodology: Polymerase Chain Reaction/Primer Extension
CPT Code(s): 83891 Isolation; 83900 Multiplex Amplification; 83901 x4 Additional Amplification; 83914 x18 Extension; 83912 Interpretation and report -
0051232 Cytochrome P450 2D6 (CYP2D6) 14 Mutations and Gene Duplication CYP 2D6
Methodology: Polymerase Chain Reaction/Primer Extension
CPT Code(s): 83891 Isolation; 83900 Amplification multiplex; 83901 x6 Amplification; 83914 x12 Mutation identification; 83912 Interpretation and report -
2003414 Cytogenomic SNP Microarray CMA SNP

Methodology: Genomic Microarray (Oligo-SNP Array)
Specimen Required: Collect: Green (sodium heparin) or lavender (EDTA). Peripheral blood required.
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CPT Code(s): 83891 Isolation; 88386 x 6, Array-based evaluation of multiple molecular probes, 251-500
2006325 Cytogenomic SNP Microarray - Oncology CMA ONC

Specimen Required: Collect: Green (sodium heparin). Bone marrow or peripheral blood required.
Specimen Preparation: Transport 3 mL bone marrow. (Min: 1 mL) or 5 mL peripheral blood (Min: 2 mL)
2006267 Cytogenomic SNP Microarray Buccal Swab CMA BUCCAL

Specimen Required: Collect: One buccal swab using the Oracollect collection kit ensuring the sponge tip does not come into contact with any suface prior to collection.
Donor should not eat, drink, smoke or chew gum for 30 minutes before collecting oral sample.
Specimen Preparation: Transport Buccal swab in ORAcollect Collection kit
Unacceptable Conditions: Specimen exposed to extreme temperatures
Stability: Ambient: 72 hours; Refrigerated: 72 hours;
2003851 Cytokeratin 5,6 (CK 5,6) by Immunohistochemistry CYTO56 IHC

2003854 Cytokeratin 7 (CK 7) by Immunohistochemistry CYTO 7 IHC

CPT Code(s): 88342
2003493 Cytokeratin 8,18 Low Molecular Weight (CAM 5.2) by Immunohistochemistry CAM5.2 IHC
CPT Code(s): 88342
2003845 Cytokeratin 19 (CK 19) by Immunohistochemistry CYTO19 IHC

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CPT Code(s): 88342
2003848 Cytokeratin 20 (CK 20) by Immunohistochemistry CYTO20 IHC

CPT Code(s): 88342
0051394 Cytokine Panel 12 by MAFD CYT 12 SE

Methodology: Quantitative Multiplex Bead Assay
Specimen Required: Collect: Serum separator tube, plain red, or green (lithium heparin).
Storage/Transport Temperature: CRITICAL FROZEN. Additional specimens must be submitted when multiple tests are ordered.
Remarks:
Unacceptable Conditions: Refrigerated specimens. Contaminated or heat inactivated specimens.
Stability: After separation from cells: Ambient: 30 minutes; Refrigerated: Unacceptable; Frozen: 1 year
CPT Code(s): 83520 x 12
0051524 Cytokine Panel, Monokines by MAFD CYT MON SE

Remarks:
Unacceptable Conditions: Refrigerated specimens. Contaminated or heat-inactivated specimens.
CPT Code(s): 83520 x 4
0051408 Cytokine Panel, TH1 by MAFD CYT TH1 SE

Remarks:
0051518 Cytokine Panel, TH2 by MAFD CYT TH2 SE

Remarks:
0051540 Cytokine Production by Mononuclear Cells in Response to Mitogen Stimulation, 12 Cytokines CYT 12 LY
Methodology: Cell Culture/Quantitative Multiplex Bead Assay
healthy individual who is not biologically related to the patient, and drawn at approximately the same time as and under similar conditions to the
patient specimen.
Specimen Required: Collect: Yellow (ACD Solution A) (patient) AND yellow (ACD Solution A) (control). Patient and control samples must be collected within 48
hours of test performance.
Specimen Preparation: Transport 10 mL whole blood (patient) AND 10 mL whole blood (control) in original collection tubes. (Min: 7 mL whole
blood (patient) AND 7 mL whole blood (control)). LIVE CELLS REQUIRED. Do not refrigerate or freeze.
Infant Minimum: 3 mL whole blood (patient) AND 7 mL whole blood (control).
Remarks:
Unacceptable Conditions: Frozen or refrigerated specimens. Specimens in transport longer than 48 hours.
CPT Code(s): 86353 x3 Lymphocyte transformation; 83520 x12 Cytokines
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0051574 Cytokine Production by Mononuclear Cells in Response to Mitogen Stimulation, Interferon gamma IFNG L DO
patient specimen.
Remarks:
CPT Code(s): 86353 x3 Lymphocyte transformation; 83520 Cytokine
0051580 Cytokine Production by Mononuclear Cells in Response to Mitogen Stimulation, Interleukin 1 beta IL1B L DO
patient specimen.
Remarks:
0051571 Cytokine Production by Mononuclear Cells in Response to Mitogen Stimulation, Interleukin 2 IL2 L DO
patient specimen.
Remarks:
0051572 Cytokine Production by Mononuclear Cells in Response to Mitogen Stimulation, Interleukin 2 Receptor (Soluble) IL2R L DO
patient specimen.
patient specimen.
Remarks:
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patient specimen.
Remarks:
patient specimen.
patient specimen.
Remarks:
patient specimen.
Remarks:
patient specimen.
Remarks:
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0051566 Cytokine Production by Mononuclear Cells in Response to Mitogen Stimulation, Monokines CYT MON LY
patient specimen.
Remarks:
0051558 Cytokine Production by Mononuclear Cells in Response to Mitogen Stimulation, TH1 Cytokines CYT TH1 LY
patient specimen.
Remarks:
0051562 Cytokine Production by Mononuclear Cells in Response to Mitogen Stimulation, TH2 Cytokines CYT TH2 LY
patient specimen.
Remarks:
0051583 Cytokine Production by Mononuclear Cells in Response to Mitogen Stimulation, Tumor Necrosis Factor alpha TNFA L DO
patient specimen.
Remarks:
8290122 Cytology, Anal AN

Patient Preparation: Indications: Cytologic screening for anal squamous intraepithelial lesions (ASIL).
Specimen Required: Collect: Anal sampling.
Supplies: Glass microscope slide for smears or, preferably, collected in SurePath™ or PreservCyt® collection fluid. Available online through
eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.
Also required: ARUP Cytology test request form and a black lead lab pencil.
Page | 183
Collection Procedure: To obtain an anal sampling, moisten the Dacron® swab with water, not lubricant. The Dacron® swab should be inserted
approximately 1.5 to 2 inches into the anal canal. It is important to use Dacron® and not a cotton swab, as cells tend to cling to cotton and do not
release easily into cytology collection fluids. Once inserted deep enough into the anus (necessary in order to collect both rectal columnar and anal
squamous cells) the swab should be pulled out, applying some pressure to the wall of the anus, rotating the swab in a spiral motion along the way.
The cells collected can be placed in a cytology collection fluid (preferred) or spread on a glass slide and immediately spray-fixed. The preferred
method of collection is in SurePath™ collection fluid. The collection device should be thoroughly rinsed and swirled in the vial. The vial should
be labeled with the patient's first and last name and collection date, placed in a specimen bag, and shipped to the Cytology Lab. The specimen
must be accompanied by an ARUP Cytology test request form with the requested test marked.
Storage/Transport Temperature: If collected in SurePath™, Cytolyt®, or CytoRich™:
Unacceptable Conditions: Specimens submitted in expired reagents. Refer to the Specimen Rejection section of the Specimen Transport Guide.
Stability: SurePath™: Ambient: 4 weeks
PreservCyt®: Ambient: 3 weeks
CPT Code(s): Depending on collection method: 88112 Selective cellular enhancement with interpretation or 88160 Smear with interpretation - Additional CPT
codes may apply if special studies are required.
8209701 Cytology, Body Cavity Fluid CF

Specimen Required: Collect: Refer to Cytology, Body Cavity Fluid Collection for specific collection and transportation guidelines.
CPT Code(s): 88108 Concentration and interpretation and/or 88106 Cytopathology, filter; 88305 Cell block. Additional CPT codes may apply if special studies
are required.
Cytology, Body Cavity Fluid Collection
Patient Preparation: Body cavity fluids are commonly evaluated for the presence of malignant cells from metastatic disease. Body cavity fluids
in general are relatively easy to obtain and are relatively difficult to compromise. However, in some instances, due to a large number of
inflammatory cells, specimens may degenerate rapidly. In addition, if large amounts of protein are present, the specimen may clot, trapping
diagnostic cells within the clot. These fluids include pleural, peritoneal, pericardial, synovial, and pelvic washing.
Specimen Required: Collect: Body Cavity Fluids
Indications: Detection and characterization of malignant cells in body cavity fluids.
Specimen Required: 10 mL (or more) of fluid obtained from an appropriately performed paracentesis.
Supplies: Standard paracentesis equipment. Clean collection container of appropriate size. Fixative (50% ethyl alcohol).
Collection Procedure: Using standard paracentesis technique, obtain a fluid specimen from the desired body cavity. If necessary, move the
patient into multiple positions to suspend cellular material in the fluid. A minimum of 10 mL of specimen is desirable for optimal cytologic
evaluation. If other studies are required, withdraw a fraction of the specimen and submit it to the appropriate laboratory separately, following their
guidelines for specimen collection. Heparin may be added to the specimen to reduce clotting. Place 3 units of heparin per mL capacity of the
collection container. Agitate the container to coat the sides with heparin. Rinse the paracentesis instrument with a small amount of heparin to
prevent clotting of specimen before it is put into the collection container. Add specimen to the heparinized container. Gently agitate to thoroughly
mix the specimen and heparin. Label the container with the patient's first and last name, date of birth, specimen type, and collection date. Submit
the specimen to the Cytopathology Laboratory along with the completed Cytology test request form. If transport of the specimen will be delayed
more than 24 hours, add an equal volume of 50% ethyl alcohol (if sample size is too large to accommodate this volume, a well mixed aliquot of
the specimen with an equal volume of fixative may be utilized). If transport time will be less than 24 hours, or fixative is not available, the
specimen should be refrigerated or kept on wet ice until transport to the lab.
Pelvic Washing
Indications: Detection and characterization of malignant cells in pelvic washing.
Specimen Required: 10 mL (or more) of fluid obtained from an appropriately performed washing.
Supplies: Standard suction equipment. Clean collection container of appropriate size. Fixative (50% ethyl alcohol).
Collection Procedure: Using appropriate sterile technique during intra-abdominal surgery, instill a physiologic solution into the pelvic cavity.
Lavage the area of interest. Aspirate the solution and place in a clean container. Label the container with the patient's first and last name, date of
birth, specimen type and collection date. Submit the specimen and completed Cytology test request form to the Cytopathology Laboratory. If
transport of the specimen will be delayed more than 24 hours, add an equal volume of 50% ethyl alcohol. If transport time will be less than 24
hours, or fixative is not available, the specimen should be refrigerated or kept on wet ice until transport to the lab.
8209700 Cytology, Breast Nipple Secretion BN

Patient Preparation: Indications: Detection of malignant cells in nipple discharge specimens.
Specimen Required: Collect: Direct smear of nipple discharge.
Supplies: Two clean glass slides (single-end frosted), fixative (spray fixative or 95% ethanol), test request form.
Collection Procedure: Label the two slides with the patient's first and last name, date of birth and specimen site in pencil on the frosted end.
Collect a small amount of nipple secretion directly onto one of the slides. Oppose a second glass slide onto the first, allowing the collected
material to provide surface tension between the two slides, and then gently and quickly pull the two slides apart in a horizontal motion to distribute
the material in a thin film over both slides. The smears should be immediately fixed either by spray fixative or in 95% ethyl alcohol to prevent air-
drying. Submit the specimen and the completed test request form to the Cytopathology Laboratory.
Unacceptable Conditions: Refer to the Specimen Rejection section in the Specimen Transport Guide.
Stability: Fixed slides: Indefinitely
CPT Code(s): 88104
8280005 Cytology, Bronchoalveolar Lavage, Malignancy BAL 2

Patient Preparation: Use this for all nonopportunistic infection indications (e.g., malignancy).
Page | 184
Specimen Required: Collect: Refer to Cytology, Bronchoalveolar Lavage Specimen Collection for specific collection and transportation guidelines.
CPT Code(s): 88108 Concentration and interpretation or 88112 Selective cellular enhancement with interpretation and/or 88106 Cytopathology, filter.
Additional CPT codes may apply if special studies are required.
8209703 Cytology, Cerebrospinal Fluid CS

Patient Preparation: Indications: Detection and characterization of malignant cells in the central nervous system. In cytology, cerebrospinal
fluid is most commonly evaluated to detect and characterize malignancy which may have gained access to the central nervous system. While in
most individuals, CSF specimens are relatively easy to obtain, in some individuals collection may require radiographic guidance. In addition, due
to lack of nutrients in this fluid, cells may rapidly degenerate rendering morphologic evaluation less than optimal if adequate care is not taken.
Specimen Required: Collect: Minimum of 3 mL cerebrospinal fluid (CSF). (10 mL CSF minimum required for immunologic marker studies)
Supplies: Standard cerebrospinal fluid collection equipment. Clean, clear 10 mL collection container for CSF. Fixative (50% ethyl alcohol).
Collection Procedure: Using standard CSF procedure, collect 3 mL of CSF. In general, morphology of cells within the CSF can be adequately
maintained with prompt refrigeration for 24 hours. Although a fresh specimen is preferred, if a longer time period between collection and
processing is anticipated, the specimen may be preserved by adding an equal volume of 50% ethyl alcohol to the specimen. Label the container
with the patient's first and last name, date of birth, specimen type and collection date. Submit the specimen to the Cytopathology Laboratory
along with the completed Cytology test request form.
Note: Specimens submitted for immunocytochemical testing must be submitted fresh.

Stability: Refrigerated: 72 hours
CPT Code(s): 88108 Concentration and interpretation or 88112 Selective cellular enhancement with interpretation and/or 88106 Cytopathology, filter.
8209713 Cytology, Conjunctival Scraping OS

Patient Preparation: Indications: Detection and characterization of inflammatory/infectious processes of the conjunctiva.
Specimen Required: Collect: Direct smear of material collected from the conjunctival surface.
Supplies: Two clean glass slides, fixative (95% ethyl alcohol), conjunctival scraping spatula, test request form.
Collection Procedure: Label the slides with the patient's first and last name, date of birth, and specimen source in pencil on the frosted end and
place in a container filled with 95% ethyl alcohol so that the slides are completely covered. Gently scrape the area of abnormality. Remove one of
the slides from the fixative. Quickly and evenly smear the collected material on one of the glass slides. Immediately re-immerse the slide in
fixative. Repeat the process with the second slide, if necessary, for better diagnostic yield. Submit the specimen and the completed request form to
the Cytopathology Laboratory.
Unacceptable Conditions: Refer to the Specimen Rejection in the Specimen Transport Guide.
CPT Code(s): 88160
8209706 Cytology, Fine Needle Aspirate FA

Specimen Required: Collect: Refer to Cytology, Fine Needle Aspiration Collection for specific collection and transportation guidelines.
CPT Code(s): 88173 This CPT code may also be reported in conjunction with aspiration of the specimen (10021) and/or evaluation of fine needle aspirate,
immediate cytohistologic study to determine adequacy for diagnosis (88172, 88177). Additional CPT codes may be reported depending on the
preparation methods, such as: 88305 or 88342.
2006889 Cytology, Fine Needle Aspirate with Reflex to BRAF V600E Mutation Detection by Allele-Specific PCR, Fine FR REQUEST
Needle Aspirate
Methodology: Microscopy/Polymerase Chain Reaction
Patient Preparation: For superficial aspiration, a clean technique suffices for cleansing of the skin. Local anesthetic may or may not be needed.
If more than two or three passes are anticipated, anesthetic is recommended. However, do not contaminate the lesion with a large volume of
anesthetic. Make passes so as to not affect the ability to palpate and localize the lesion. For deep aspiration, sterile technique is required and local
anesthetic is usually needed.
Use good aspiration technique and appropriate processing of the aspirate to ensure an adequate specimen.
Specimen Required: Collect: FNA specimen, include source and completed Cytology Test Request form.
Specimen Preparation: Specimen Required: Slides with air-dried smear or air-dried and Diff-Quick stained smear. Specimen should be
adequately cellular for cytologic evaluation and obtained from an appropriately performed FNA. Specimen must contain enough material for the
cytopathologist to determine if a mass lesion has been sampled.
Supplies: 10 mL syringe or syringe pistol (optional) and 23 to 27 gauge needle of appropriate length. Multiple single-end-frosted glass for
preparation of direct smears. Fixative for needle rinse (e.g., CytoRich Red, CytoLyt, Saccomanno, etc.).
Preparation of Direct Smears

Before performing the FNA, prepare slides. Use a pencil to label each slide with the patient's first and last name, date of birth, and specimen
source. After collection, carefully transfer the aspirate to the prepared slides using a method appropriate to the nature of the aspirate. If the aspirate
is abundant and fluid, gently express onto the slide. Gentle expression allows for better control of the smear and provides the greatest number of
slides per FNA pass. If the aspirate is scant or is more viscous or solid, appropriate force may be needed to express the aspirate. Excessive force
can result in fewer slides per FNA pass if the aspirate splatters off the slide during expression, and additional FNA passes may be needed if more
studies are required.
Aspirate must be smeared after application to the slide. The simplest procedure is to oppose a second glass slide onto the first, allowing the
material to provide surface tension between the two slides. Then, gently and quickly pull the two slides apart in a horizontal, sliding motion to
distribute the material in a thin film over both slides. Immediately air dry.
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The smears should be: air-dried for Diff-Quik staining (delineate with an "A" on the frosted end of the slide).
If aspirate remains in the needle, use to, prepare additional smears or rinse needle into a tube containing fixative or a physiologic solution such as
normal saline, or RPMI.
Submit the specimen (smears and aspirate rinsed into solution) to the ARUP Cytopathology Laboratory along with a completed Cytology test
request form. If transport of specimen in fluid will be delayed more than 24 hours, submit in fixative. If transport time of fluid specimen will be
less than 24 hours, or fixative is not available, keep refrigerated or on wet ice until transport to the lab.
Unacceptable Conditions: Specimens received without an air dried slide or Diff-Quik smear slide. Frozen specimens.
Stability: Needle rinse unfixed. Ambient: Unacceptable; Refrigerated: 24 hours; Frozen: Unacceptable
Needle rinse in fixative. Ambient: Unacceptable; Refrigerated: 1 week; Frozen: Unacceptable
Air-dried smear or Diff-Quik stained smear. Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable
CPT Code(s): 88173 This CPT code may also be reported in conjunction with aspiration of the specimen (10021) and/or evaluation of fine needle aspirate,
immediate cytohistologic study to determine adequacy for diagnosis (88172, 88177). Additional CPT codes may be reported depending on the
preparation methods, such as: 88305 or 88342 if reflexed, add 88381 Microdissection; 83907 Lysis; 83898 x2 Amplification; 83896 Nucleic acid
probe; 83912 Interpretation and report. Additional CPT code modifiers may be required for procedures performed to test oncologic or inherited
disorders.
8209709 Cytology, Gastrointestinal GI

Specimen Required: Collect: Refer to Cytology, Gastrointestinal Specimen Collection specific collection and transportation guidelines.
CPT Code(s): 88108 Concentration and interpretation, 88112 Selective cellular enhancement with interpretation and/or 88106 Cytopathology, filter.
8209710 Cytology, Oral GO

Specimen Required: Collect: Refer to Cytology, Oral Scraping or Brushing Specimen Collection for specific collection and transportation guidelines.
CPT Code(s): Depending on collection method: 88108 Concentration and interpretation or 88112 Selective cellular enhancement with interpretation or 88104
Smears with interpretation. Additional CPT codes may apply if special studies are required.
2000624 Cytology, Pap Smear GG REQUEST

Patient Preparation: 1. In premenopausal patients, obtain specimens during the second half of the menstrual period to avoid contamination by
obscuring blood.
2. Instruct the patient not to douche or engage in sexual intercourse within 24 hours of the procedure.
Specimen Required: Collect: (See below for specific instructions)
1. Label the slide(s) with the patient's first and last name, date of birth, and specimen source directly on the frosted end of the glass, in pencil,
before beginning the procedure. THE LABORATORY WILL NOT ACCEPT UNLABELED SLIDES. Note that a PAP smear folder labeled with
the patient's name is not adequate for patient identification. The patient information must appear on the slide.
2. Obtain all specimens prior to bimanual examination.
3. Place the patient in the lithotomy position. Using an unlubricated vaginal speculum (saline may be used as a lubricant) visualize the cervix as
fully as possible.
4. After collection and proper fixation of specific specimens as outlined below, place slide(s) in a cardboard slide folder and submit to the
Cytopathology Laboratory, with the clinical information.
Specimen Preparation: Routine Cervical/Endocervical (Pap) Smear (1 slide)*
Specimens Required: Unstained cervical or cervical/endocervical slides.
Supplies: Vaginal speculum, plastic extended-tip spatula, cytobrush***, fixative** (spray fixative or bottle of 95 percent ethyl alcohol), clean
glass slide (single-end frosted) and a black lead lab pencil.
Collection Procedure: Label one slide with the patient's first and last name, date of birth, and specimen source (prior to obtaining the specimen).
Obtain specimen prior to bimanual examination. Use an unlubricated speculum (saline or warm water may be used). After visualization of the
cervix is accomplished insert the cytobrush*** into the endocervical canal and rotate half a turn. Withdraw the cytobrush and spread the collected
material quickly and evenly onto the half of the slide opposite the frosted end. The endocervical mucus will prevent air-drying during collection of
the subsequent cervical component. Using the extended-tip spatula, scrape material with the spatula from the whole circumference of the cervix.
Withdraw the spatula and spread the collected material quickly and evenly onto the half of the slide adjacent to the frosted end. Fix immediately
(drop slide into fixative or spray with fixative, holding the spray bottle approximately 8 to 12 inches from the slide). Complete the Cytology test
request form as indicated, including relevant clinical information. Submit the specimen to the Cytopathology Laboratory.
Routine Vaginal Smear - 1 or More Slides

Indications: Can be used in conjunction with routine cervical/endocervical smears in individuals with a uterus, or alone in hysterectomized
patients.
Specimen Required: Lateral vaginal wall smear or smear of sample from a clinically concerning area.
Supplies:Vaginal speculum, one or more plastic cervical spatulas, fixative** (spray fixative or 95% ethyl alcohol), one or more clean glass slides
(single-end frosted) and a black lab pencil.
Collection Procedure: If only a routine lateral vaginal wall sample will be obtained, label one slide with the patient's first and last name, date of
birth, and specimen source. If vaginal sample will be obtained in conjunction with a cervical and endocervical component, make sure that the
slides are also appropriately labeled according to site. If smears from separate vaginal areas are also to be obtained, label the sites accordingly as
to specific site (e.g., left lateral vaginal wall, posterior vaginal wall, etc.). Obtain specimens prior to bimanual evaluation. Use an unlubricated
speculum (saline or warm water may be used). Scrape the desired region of the vaginal mucosa with the spatula. Withdraw the spatula and spread
the material quickly and evenly onto the glass slide (if cervical/endocervical smears are also obtained, or smears from other areas of the vagina are
obtained, make certain that each smear is performed on the correspondingly labeled slide). Fix immediately (drop slide into fixative or spray with
fixative, holding the spray bottle approximately 8 to 12 inches from the slide). Scrape additional areas of the vagina that appear abnormal and
spread and fix as above. Submit the specimen to the Cytopathology Laboratory with relevant clinical history.
Routine Cervical/Endocervical (PAP) Smear (2 or More Slides)*

Specimens Required: Unstained cervical or endocervical slides.
Supplies: Vaginal speculum, plastic extended-tip spatula, cytobrush***, fixative** (spray fixative or bottle of 95% ethyl alcohol), two clean glass
slides (single end frosted) and a black lead lab pencil.
Page | 186
Collection Specimen: Label two slides with the patient's first and last name, date of birth, and specimen source (prior to obtaining the specimen).
Obtain specimens prior to bimanual examination. Use an unlubricated speculum (saline or warm water may be used). After visualization of the
cervix is accomplished, scrape material with the spatula from the whole circumference of the cervix. Withdraw the spatula and spread the
collected material quickly and evenly onto the glass slide. Fix immediately (drop slide into fixative or spray with fixative, holding the spray bottle
approximately 8 to 12 inches from the slide). Insert the cytobrush*** into the endocervical canal and rotate half a turn. Withdraw the cytobrush
and spread the collected material quickly and evenly onto the second slide. Fix immediately (drop slide into fixative or spray with fixative,
holding the spray bottle approximately 8 to 12 inches from the slide). Submit the specimen to the Cytopathology Laboratory with relevant clinical
history.
Vaginal Smear, DES Exposure - 2 or more slides

Indications: Evaluation of potential changes associated with in utero DES exposure.
Specimens Required: Lateral vaginal wall sample, cervical sample, endocervical sample.
Supplies: Vaginal speculum, one or more cervical spatulas, one extended-tip spatula, cytobrush***, fixative** (spray fixative or 95% ethyl
alcohol), two or more clean glass slides (single end frosted), black lead lab pencil, and test request form as indicated.
Collection Procedure: Label two or more slides with patient's first and last name, date of birth, and specimen source. Label one slide "C" and one
"LVW." Label others as necessary (see below). Obtain specimens prior to bimanual examination. Use an unlubricated speculum (saline or warm
water may be used). After visualization of the upper 1/3 of the vagina is accomplished, with the spatula scrape the upper 1/3 of either lateral
vaginal wall. Withdraw the spatula and spread the material quickly and evenly onto the slide clearly marked "LVW." Fix immediately (drop slide
into fixative or spray with fixative, holding the spray bottle approximately 8 to 12 inches from the slide). Scrape additional areas of the vagina that
appear abnormal. Label slides accordingly (prior to sampling) and spread and fix as above. Obtain routine cervical and endocervical specimens as
outlined in the respective procedures. These smears should be collected on the slide labeled "C." Submit the specimen to the Cytopathology
Laboratory with relevant clinical history.
* Procedures for collection of the cervical and endocervical components on either one or two slides are provided.
**Most hair sprays no longer contain adequate amounts of alcohol for appropriate fixation.
***Endocervical sampling devices other than a cytobrush may be used. Refer to specific specimen collection procedures provided with these
devices for more information.
Storage/Transport Temperature: Ambient
Stability: Indefinite
CPT Code(s): CPT codes vary based on testing performed.
8209702 Cytology, Pulmonary CP

Specimen Required: Collect: Refer to Cytology, Pulmonary Specimen Collection for specific collection and transportation guidelines.
CPT Code(s): Depending on methodology: 88112 Selective cellular enhancement with interpretation or 88108 Concentration and interpretation or 88104 Smears
with interpretation or 88106 Cytopathology, filter. Additional CPT codes may apply if special studies are required.
8209712 Cytology, Skin Scraping SS

Patient Preparation: Indications: Detection and characterization of inflammatory/infectious processes of the skin, especially herpetic
infections (Tzanck smear).
Specimen Required: Collect: Direct smear of material collected from a skin lesion, usually a vesicle.
Supplies: Two (or more) clean glass slides (fully frosted), fixative (95% ethyl alcohol), skin scraping spatula, test request form.
place in a container filled with 95% ethyl alcohol so the slides are completely covered. Gently scrape the area of abnormality. If the abnormality is
a vesicle, remove the covering and scrape both at the base of the vesicle and around the rim. Remove one of the slides from the fixative. Quickly
and evenly smear the collected material on one of the glass slides. Immediately re-immerse the slide in fixative. Repeat the process with the
second slide, if necessary, for better diagnostic yield. Repeat the process for additional areas if necessary. After collection, leave the slides in the
95% alcohol for 10 minutes and then air dry. Submit the specimen and the completed request form to the Cytopathology Laboratory.
CPT Code(s): 88160
8100400 Cytology, SurePath™ Liquid-Based Pap Test (AutoCyte PREP™ System) GA REPORT
Specimen Required: Collect: Refer to Cytology, SurePath™ Liquid-Based Pap Test (AutoCyte PREP™ System) Specimen Collection for collection guidelines.
This test requires a SurePath™ special collection kit that is available by contacting ARUP Client Services at (800) 522-2787.
Unacceptable Conditions: Specimens not collected in a SurePath™ special collection kit provided by ARUP. Expired SurePath™ vials or vials
received without the collection devices will not be processed. Refer to Specimen Rejection in the Specimen Transport Guide.
Stability: Ambient: 1 month; Refrigerated: 1 month; Frozen: Unacceptable
CPT Code(s): Refer to the Cytopathology section in front of this User's Guide.
8100214 Cytology, SurePath™ Liquid-Based Pap Test (AutoCyte PREP™ System) with Reflex to Human Papillomavirus GR REPORT
(HPV) DNA Probe, High Risk
Methodology: Microscopy/Nucleic Acid Probe
Specimen Required: Collect: Refer to Cytology, SurePath™ Liquid-Based Pap Test (AutoCyte PREP™ System) Specimen Collection for collection guidelines.
Remarks: This test includes a Cytology, SurePath™Liquid-Based Pap Test (AutoCyte PREP™ System) (ARUP test code 8100400) and a Human
Papillomavirus (HPV) DNA Probe, SurePath® (Autocyte™) (ARUP test code 0060744), ONLY if the SurePath™ Liquid-Based Pap Test is
interpreted as atypical squamous cells of undetermined significance (ASC-US).
Unacceptable Conditions: Refer to Unacceptable Conditions for Human Papillomavirus (HPV) DNA Probe, High Risk, SurePath® (Autocyte™)
(ARUP test code 0060744) and Cytology, SurePath™ Liquid-Based Pap Test (AutoCyte PREP™ System) (ARUP test code 8100400).
CPT Code(s): CPT Codes vary based on testing performed. If reflexed to HPV add 87621 High Risk HPV
Page | 187
2000134 Cytology, SurePath Liquid-Based Pap Test GA REQUEST
Patient Preparation: 1. For premenopausal patients, obtain specimens during the second half of the menstrual period to avoid contamination by
obscuring blood.
2. Instruct the patient not to douche or engage in sexual intercourse within 24 hours of the procedure
Supplies: This test requires a SurePath collection kit, which includes a preservative fluid collection vial and sampling device(s). Kits may be
ordered separately through ARUP Client Services at (800) 522-2787 or (801) 583-2787. Also required: ARUP Cytology test request form,
permanent marker.
Specimen Required: Collect: 1. Label the vial(s) with the patient's first and last name, date of birth, and specimen source before beginning the procedure.
fully as possible.
4. Follow the instructions for the specific collection kit used.
Collection Procedure: Obtain cervical specimen prior to bimanual examination. Use an unlubricated speculum (saline or warm water may be
used). Vaginal discharge or secretion, when present in large amounts, should be removed before obtaining the cervical sample so as not to disturb
the epithelium (i.e., cellulose swab). Small amounts of blood will not interfere with the cytologic evaluation; however, large amounts of blood as
present during menses may interfere with cytologic evaluation because cells may be obscured by blood. Use of liquid-based specimen collection
minimizes the interference from these factors. If testing for sexually transmitted disease is indicated, the cervical cytology sample should be taken
first. After visualization of the cervix is accomplished, collect the sample. Obtain an adequate sampling from the cervix using the Rovers®
Cervex-Brush® or Cervex-Brush® Combi or the Pap Perfect® plastic spatula with the Cytobrush® Plus GT.
ROVERS® CERVEX-BRUSH® Collection (Kit #22216): Device may be referred to as broom. Position the tip of the longer bristles into the
cervical os/endocervical canal. Begin rotating in a clockwise direction (one-quarter to one-half turn). The bristles will begin to stiffen. Continue
rotating in a clockwise direction and gently push towards the cervix until the shorter bristles begin to bend extending over the ectocervix.
Complete five 360-degree rotations. Direction must be consistent. Do not alter or vary the direction of the broom during sampling. Transfer the
entire sample by placing your thumb against the back of the brush pad, and simply disconnect the entire brush from the stem into the preservative
vial. Contraindication: Do not use on pregnant patients after the first 10 weeks of gestation.
PAP PERFECT® PLASTIC SPATULA AND CYTOBRUSH® PLUS GT Collection (Kit #41126): Insert the contoured end of the Pap
Perfect plastic spatula and rotate 360 degrees around the entire exocervix. Disconnect the spatula head and place it in into the vial. Insert the
Cytobrush Plus GT into the endocervix until only the bottom most fibers are exposed at the cervical os. Slowly rotate or turn one half turn in one
direction. To reduce unnecessary bleeding, DO NOT over rotate. Disconnect the brush head and place in the preservative vial. Contraindication:
Do not use on pregnant patients or for endometrial sampling.
ROVERS® CERVEX-BRUSH® COMBI Collection (Kit #45031): Insert central bristles into the endocervical canal. Use gentle pressure on
the cervix until the lateral bristles bend against the ectocervix. Maintain gentle pressure and rotate two times in a clockwise direction by rolling the
stem between the thumb and forefinger. Disconnect the brush head and place in the preservative vial. Contraindication: This device should not
be used during pregnancy.
For all kits, recap the preservative vial and tighten. Record the patient's information and medical history on the ARUP Cytology test request form.
Place the vial and test request form in a specimen bag for transport to the laboratory.
Storage/Transport Temperature: Ambient
Unacceptable Conditions: Specimens not collected in a SurePath collection kit. Expired preservative vials or vials received without the collection
devices.
CPT Code(s): 88174 (automated) or 88175 (automated with manual review) or 88142 (manual screening) or 88143 (manual screening with rescreening) if
reviewed by pathologist 88141
8100211 Cytology, ThinPrep® Pap Test™ GT REPORT

Methodology: ThinPrep® 2000 System
Specimen Required: Collect: Refer to Cytology, Thin Prep® Pap Test™ Specimen Collection for specific collection guidelines. Discard collection device.
This test requires a ThinPrep® Pap Test™ special collection kit that is by contacting ARUP Client Services at (800) 522-2787.
Remarks: Human Papillomavirus (HPV) DNA Probe testing can be performed on the PreservCyt® Solution vial, refer to Human Papillomavirus
(HPV) DNA Probe, High Risk (ARUP test code 0065999), or Cytology, ThinPrep® Pap with Reflex to Human Papillomavirus (HPV) DNA
Probe, High Risk (ARUP test code 8100212).
Unacceptable Conditions: Specimens not collected in a ThinPrep® Pap Test™ special collection kit or specimens submitted in an expired
collection kit. Refer to Specimen Rejection in the Specimen Transport Guide.
Stability: PreservCyt® Solution preserves cells for up to three weeks refrigerated or room temperature.
CPT Code(s): CPT codes vary based on testing performed. Refer to the Cytopathology section in front of this User's Guide.
8100212 Cytology, ThinPrep® Pap with Reflex to Human Papillomavirus (HPV) DNA Probe, High Risk TR REPORT
Methodology: ThinPrep® 2000 System/Microscopy/Nucleic Acid Probe
Specimen Required: Collect: Refer to Cytology, ThinPrep® Pap Test™ Specimen Collection for collection guidelines.
Remarks: This test includes a Cytology, ThinPrep® Pap Test™(ARUP test code 8100211), and an Human Papillomavirus (HPV) DNA Probe,
High Risk, ThinPrep® (ARUP test code 0060750) ONLY if the ThinPrep® PapTest™ is interpreted as atypical squamous cells of undetermined
significance (ASC-US).
Unacceptable Conditions: Refer to unacceptable conditions for Human Papillomavirus (HPV) DNA Probe, High Risk, ThinPrep® (ARUP test
code 0060750) and Cytology, ThinPrep® PapTest™ (ARUP test code 8100211).
CPT Code(s): CPT codes vary based on testing performed. If reflexed to HPV add: 87621 High-risk HPV
8209714 Cytology, Tzanck Smear SZ

Patient Preparation: Indications: Detection and characterization of inflammatory/infectious processes of the skin, especially herpetic
infections.
Page | 188
Specimen Required: Collect: Direct smear of material collected from a skin lesion, usually a vesicle.
Supplies: Two (or more) clean glass slides fixative (95% ethyl alcohol), skin scraping spatula, and Cytology test request form.
place in a container filled with 95% ethyl alcohol so the slides are completely covered. Gently scrape the area of abnormality. If the abnormality is
a vesicle, remove the covering and scrape both at the base of the vesicle and around the rim. Remove one of the slides from the fixative. Quickly
and evenly smear the collected material on one of the glass slides. Immediately re-immerse the slide in fixative. Repeat the process with the
second slide, if necessary, for better diagnostic yield. Repeat the process for additional areas if necessary. After collection, leave the slides in the
95% alcohol for 10 minutes and then air dry. Submit the specimen and the completed test request form to the Cytopathology Laboratory.
Unacceptable Conditions: Air dried smears. Refer to the Specimen Rejection section Specimen Transport Guide.
CPT Code(s): 88160
8209704 Cytology, Urologic CU

Specimen Required: Collect: Refer to Cytology, Urologic Specimen Collection for collection and transport guidelines.
CPT Code(s): 88108 Concentration and interpretation or 88112 Selective cellular enhancement with interpretation and/or 88106 Cytopathology, filter. -
8209715 Cytology, Vitreous Fluid VF

Patient Preparation: Indications: Detection and characterization of malignant cells in the eye. In cytology, vitreous fluid is most commonly
evaluated to detect and characterize malignancy which may have gained access to the eye. Vitreous fluid specimens require special collection
procedures under the direction of an ophthalmologist. In addition, due to lack of nutrients in this fluid, cells may rapidly degenerate rendering
morphologic evaluation less than optimal if adequate care is not taken.
Specimen Required: Collect: For vitreous fluids, there is no minimum amount, but collect as much as possible.
Supplies: Standard vitreous aspiration equipment. Standard vitreous aspirate collection container for vitreous fluid. Fixative (50% ethyl alcohol).
Collection Procedure: Using standard vitreous collection procedures, collect an appropriate amount of vitreous fluid. In general, morphology of
cells within vitreous fluid can be adequately maintained with prompt refrigeration for 24 hours. Although a fresh specimen is preferred, if a longer
time period between collection and processing is anticipated, the specimen may be preserved by adding an equal volume of 50% ethyl alcohol to
the specimen. Label the specimen with patient's first and last name, date of birth and specimen source. Submit the specimen to the Cytopathology
Laboratory along with the completed Cytology request form.
Note: Specimens submitted for immunocytochemical testing must be submitted fresh. If necessary, on-call personnel can be utilized during the
evenings or on weekends for processing of urgent specimens or those which need to be processed rapidly to avoid degeneration.
Stability: Refrigerated: 72 hours
CPT Code(s): 88108 Concentration and interpretation or 88112 Selective cellular enhancement with interpretation and/or 88106 Cytopathology, filter -
0050622 Cytomegalovirus Antibodies, IgG and IgM CMV PAN

Methodology: Semi-Quantitative Chemiluminescent Immunoassay
Specimen Required: Collect: Serum separator tube.Also acceptable: Serum from umbilical cord blood
Transfer 2 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL) Parallel testing is preferred and convalescent specimens must be
received within 30 days from receipt of the acute specimens. Mark specimens plainly as "acute" or "convalescent."
Unacceptable Conditions: Urine. Contaminated, hemolyzed, or heat-inactivated specimens.
CPT Code(s): 86644 CMV IgG; 86645 CMV IgM
0050165 Cytomegalovirus Antibody, IgG CMV IGG

Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL) Acute and convalescent specimens must be labeled as such; parallel
testing is preferred and convalescent specimens must be received within 30 days from receipt of the acute specimens. Mark specimens plainly as
"acute" or "convalescent." Also acceptable: Serum from umbilical cord blood.
Unacceptable Conditions: Urine. Contaminated, hemolyzed, or heat-inactivated specimens.
CPT Code(s): 86644
0050553 Cytomegalovirus Antibody, IgM CMV IGM

Specimen Required: Collect: Serum separator tube. Also acceptable: Serum from umbilical cord blood.
Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL) Acute and convalescent specimens must be labeled as such; parallel
testing is preferred and convalescent specimens must be received within 30 days from receipt of the acute specimens. Mark specimens plainly as
"acute" or "convalescent."
Unacceptable Conditions: Urine. Contaminated, heat-inactivated or hemolyzed specimens.
CPT Code(s): 86645
Page | 189
2004760 Cytomegalovirus Antiviral Drug Resistance by Sequencing CMV RESIST
Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA) or plasma preparation tube.
Specimen Preparation: Separate plasma from cells within 8 hours. Transfer 4 mL plasma to an ARUP Standard Transport Tube. (Min: 2.5 mL)
Remarks: Viral load required.
Unacceptable Conditions: Serum. Heparinized specimens.
CPT Code(s): 83891 Isolation; 83894 Separation; 83898 x5 Amplification; 83904 x5 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation
0060040 Cytomegalovirus by PCR CMVPCR

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or serum separator tube. Amniotic fluid, bronchoalveolar lavage (BAL), CSF, ocular fluid, tissue, or
urine.
Specimen Preparation: Separate serum or plasma from cells. Transfer 1 mL plasma, serum, amniotic fluid, BAL, CSF, ocular fluid, or urine to a
sterile container. (Min: 0.5 mL) Tissue: Transfer to a
sterile container and freeze immediately.
Storage/Transport Temperature: Frozen. Submit specimen according to Biological Substance, Category B, shipping guidelines.
Unacceptable Conditions: Whole blood or bone marrow; refer to Cytomegalovirus by PCR, Whole Blood or Bone Marrow (ARUP test code
0060031). Heparinized specimens.
Stability: Tissue: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 3 months
All others: Ambient: 8 hours; Refrigerated: 72 hours; Frozen: 3 months
CPT Code(s): 87496
0060031 Cytomegalovirus by PCR, Whole Blood or Bone Marrow CMVPCR B

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA) or bone marrow aspirate in lavender (EDTA) or pink (K2EDTA).
Specimen Preparation: Do not freeze specimens. Transport 1 mL whole blood OR 1 mL bone marrow. (Min: 0.5 mL).
Unacceptable Conditions: Plasma (refer to Cytomegalovirus by PCR, ARUP test code 0060040). Heparinized specimens. Frozen specimens.
CPT Code(s): 87496
2003833 Cytomegalovirus (CMV) by Immunohistochemistry CMV IHC

CPT Code(s): 88342
2006568 Cytomegalovirus (CMV) CD8 T-Cell Immune Competence, HLA-A1 CMV CD8 A1
Methodology: Cell Culture/Quantitative Flow Cytometry
Patient Preparation: Patient must be CMV-seropositive and have one or more of the five major histocompatibility complex (MHC) alleles:
HLA-A1, -A2, -B7, -B8, or -B35.
Specimen Required: Collect: Green (sodium heparin). Collect only one specimen for any combination of five CMV CD8 T-Cell Immune Competence assays ordered.
Patient specimen must be collected within 48 hours of test performance.
Specimen Preparation: Transport 10 mL whole blood (total volume for up to five separate CMV CD8 tests) in original collection tubes. (Min: 7
mL).
Do not refrigerate or freeze. LIVE LYMPHOCYTES REQUIRED.
Unacceptable Conditions: Refrigerated or frozen specimens. Gross hemolysis or gross lipemia. Specimens in transport longer than 48 hours.
CPT Code(s): 88184 - Flow Cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker
86352 - Cellular functional assessment of allele-specific stimulation
For orders of up to 5 separate HLA alleles (CMV CD8 A1, A2, B7, B8 and/or B35) on the same patient specimen, add the following just once:
88185 x2 - Flow Cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker
86352 - Cellular functional assessment of non-allele-specific stimulation
2006576 Cytomegalovirus (CMV) CD8 T-Cell Immune Competence, HLA-A2 CMV CD8 A2
HLA-A1, -A2, -B7, -B8, or -B35.
mL). Do not refrigerate or freeze. LIVE LYMPHOCYTES REQUIRED.
Page | 190
2006588 Cytomegalovirus (CMV) CD8 T-Cell Immune Competence, HLA-B35 CMV CD8B35
HLA-A1, -A2, -B7, -B8, or -B35.
2006580 Cytomegalovirus (CMV) CD8 T-Cell Immune Competence, HLA-B7 CMV CD8 B7
HLA-A1, -A2, -B7, -B8, or -B35.
2006584 Cytomegalovirus (CMV) CD8 T-Cell Immune Competence, HLA-B8 CMV CD8 B8
HLA-A1, -A2, -B7, -B8, or -B35.
mL).
Do not refrigerate or freeze. LIVE LYMPHOCYTES REQUIRED.
For orders of up to 5 separate HLA alleles (CMV CD8 -A1, -A2, -B7, -B8 and/or -B35) on the same patient specimen, add the following just once:
2003044 Cytomegalovirus IgG Avidity (AviDx™), ELISA CMV AVID

Stability: Ambient: 5 days; Refrigerated: 2 weeks; Frozen: 1 month
CPT Code(s): 86644x2
0051813 Cytomegalovirus, Quantitative PCR CMV QNT

Methodology: Quantitative Polymerase Chain Reaction
Specimen Preparation: Separate plasma from cells. Transfer 1 mL plasma to a sterile container. (Min: 0.5 mL).
Page | 191
CPT Code(s): 87497
2006966 Cytomegalovirus, Quantitative PCR with Reflex to Drug Resistance Testing by Sequencing CMV QNT GR
Methodology: Quantitative Polymerase Chain Reaction/Sequencing
Specimen Preparation: Separate plasma from cells. Transfer 4 mL plasma to a sterile container. (Min: 2.5 mL)
Stability: Ambient: 8 hours; Refrigerated: 72 hours; Frozen: 1 year
CPT Code(s): 87497 Cytomegalovirus Quantitative PCR; if reflexed, add 83891 Isolation; 83894 Separation; 83898 x5 Amplification; 83904 x5 Sequencing;
83909 Capillary electrophoresis; 83912 Interpretation
0065004 Cytomegalovirus Rapid Culture V CMVC

Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA). OR bronchoalveolar lavage (BAL), throat swab, tissue, or urine.
Specimen Preparation: Blood: Transport 5 mL whole blood. (Min: 1 mL)
Fluid specimen: Transfer specimen to a sterile container. Transfer 2 mL fluid to a sterile container. (Min: 0.5 mL). Also acceptable: Transfer to
viral transport media (ARUP supply #12884). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at
(800) 522-2787.
Swab or tissue: Place in viral transport media.
Unacceptable Conditions: CSF, rectal swab, or stool. Whole blood in viral transport media. Calcium alginate, dry, or wood swabs.
Stability: Ambient: 2 hours; Refrigerated: 72 hours; Frozen: Unacceptable.
CPT Code(s): 87254 Shell vial
0030057 D-Dimer D-DI

Methodology: Immunoturbidimetry
Specimen Required: Collect: Light blue (sodium citrate). Refer to Specimen Handling at aruplab.com for hemostasis/thrombosis specimen handling guidelines.
Specimen Preparation: Transfer 2 mL platelet poor plasma to an ARUP Standard Transport Tube. (Min: 0.5 mL)
CPT Code(s): 85379
2003857 D2-40 by Immunohistochemistry D240 IHC

CPT Code(s): 88342
0091356 Dantrolene, Serum or Plasma DANTROLENE

Specimen Preparation: Protect from light. Transfer 2 mL serum or plasma to an ARUP Amber Transport Tube. (Min: 0.3 mL)
Unacceptable Conditions: Separator tubes. Specimens not protected from light.
CPT Code(s): 80299
0091576 Darvocet, Serum or Plasma DARVOCET S

Methodology: Quantitative Gas Chromatography/Mass Spectrometry/High Performance Liquid Chromatography
CPT Code(s): 80299; 82003
0091589 Darvocet, Urine DARVO URN

Methodology: Quantitative Gas Chromatography/Mass Spectrometry/High Performance Liquid Chromatography
CPT Code(s): 80299; 82003
Page | 192
2007223 DDIT3 (CHOP) (12q13) Gene Rearrangement by FISH CHOP FISH
#47808) available online through eSupply using ARUP Connect™or contact ARUP Client Services at (800) 522-2787.
Storage/Transport Temperature: Room temperature. Also acceptable: Refrigerated. Ship in cooled container during summer months.
0051358 Deamidated Gliadin Peptide (DGP) Antibodies, IgA and IgG GLIAD PAN
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transport 1 mL serum. (Min: 0.3 mL)
Unacceptable Conditions: Plasma or other body fluids. Contaminated, hemolyzed, or grossly lipemic specimens.
0051357 Deamidated Gliadin Peptide (DGP) Antibody, IgA GLIADPEP A

Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transport 0.5 mL serum. (Min: 0.3 mL)
Unacceptable Conditions: Plasma or other body fluids. Contaminated, hemolyzed, grossly icteric, or grossly lipemic specimens.
CPT Code(s): 83516
0051359 Deamidated Gliadin Peptide (DGP) Antibody, IgG GLIADPEP G

Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transport 0.5 mL serum. (Min: 0.3 mL)
Unacceptable Conditions: Plasma or other body fluids. Contaminated, hemolyzed, grossly icteric, or grossly lipemic specimens.
CPT Code(s): 83516
2003326 deCODE ProstateCancer™ (Genetic Risk Assessment) PROST CAN

Methodology: Polymerase Chain Reaction/Fluorescent Primer/Nucleic Acid Probe
Specimen Required: Collect: All specimens must be collected using the Buccal DNA Collector Kit (ARUP Supply #47080). Available online through eSupply using
ARUP Connector contact ARUP Client Services at (800) 522-2787.
1. Use gloves to protect the specimen from contamination.
2. Remove the Buccal DNA Collector from the pouch, holding the handle at the base.
3. Move slider cover back if necessary to fully expose the collection paper. Press the collection paper flat against cheek and drag across at least 7
times.
Specimen Preparation: Push cover forward towards the tip of the collector, covering the collection paper. Transport 2 buccal swabs.
Unacceptable Conditions: This test was validated for patients of European Caucasian descent only; specimens from patients of other ethnicities
will be rejected. Swabs other than those provided in the Buccal DNA Collector Kit.
CPT Code(s): 83891 Isolation; 83892 Enzymatic digestion; 83898 x25 Amplification; 83896 x25 Nucleic acid probes; 83914 x25 Extension; 83912
2001640 Dehydroepiandrosterone, Serum or Plasma DHEA TMS

CPT Code(s): 82626
0070040 Dehydroepiandrosterone Sulfate, Serum DHEAS

(K2EDTA).
CPT Code(s): 82627
Page | 193
0093096 Dengue Fever Virus Antibodies, IgG & IgM DENGUE AB
specimens. Mark specimens plainly as "acute or convalescent."
Unacceptable Conditions: Contaminated, heat-inactivated, hemolyzed, severely lipemic specimens.
CPT Code(s): 86790 Dengue fever IgG; 86790 Dengue fever IgM
0093097 Dengue Fever Virus Antibody, IgG DEN G

specimens. Mark specimens plainly as "acute or convalescent."
CPT Code(s): 86790
0093098 Dengue Fever Virus Antibody, IgM DEN M

specimens. Mark specimen plainly as "acute or convalescent."
CPT Code(s): 86790
2007206 Deoxycorticosterone (DOC), Serum DOC SER

CPT Code(s): 82633
0092331 11-Deoxycortisol Quantitative by LC-MS/MS, Serum or Plasma DEOXYCORT

CPT Code(s): 82634
0070212 Deoxypyridinoline Crosslinks, Urine DPD

Patient Preparation: First-morning void.
Specimen Preparation: Transfer 3.5 mL aliquot from a well-mixed, first-morning urine to an ARUP Standard Transport Tube. (Min: 0.5 mL)
CPT Code(s): 82523
0081312 Des-gamma-carboxy Prothrombin DCP

Specimen Preparation: Allow specimen to clot completely at room temperature. Separate from cells ASAP or within 2 hours of collection.
Stability: After separation from cells: Ambient: 8 hours; Refrigerated: 1 week; Frozen: 3 months (avoid repeated freeze/thaw cycles)
CPT Code(s): 83951
0090072 Desipramine DESIP HPLC

Patient Preparation: If imipramine has been administered, order Imipramine and Desipramine (ARUP test code 0090157).
Page | 194
CPT Code(s): 80160
2003863 Desmin by Immunohistochemistry DESMIN IHC

CPT Code(s): 88342
2003248 Dexamethasone, Serum or Plasma by LC-MS/MS DEXA TMS

Specimen Required: Collect: Serum separator tube, lavender (EDTA), pink (K2EDTA), or green (sodium heparin).
mL)
CPT Code(s): 80299
2006236 Diamond-Blackfan Anemia (RPL11) Sequencing RPL11 FGS

CPT Code(s): 83891 Isolation; 83898 x12 Amplification; 83894 x6 Gel separation; 83904 x12 Sequencing; 83892 x2 Digestion; 83912 Interpretation and report.
2006234 Diamond-Blackfan Anemia (RPL5) Sequencing RPL5 FGS

CPT Code(s): 83891 Isolation; 83898 x26 Amplification; 83894 x13 Gel separation; 83904 x26 Sequencing; 83892 x2 Digestion; 83912 Interpretation and
report.
2006238 Diamond-Blackfan Anemia (RPS19) Sequencing RPS19 FGS

CPT Code(s): 83891 Isolation, 83898 x8 Amplification; 83894 x8 Gel separation; 83904 x8 Sequencing; 83892 x2 Digestion; 83912 Interpretation and report.
0090076 Diazepam and Nordiazepam DIAZ

0091471 Diazoxide, Urine DIAZOX UR

Stability: Undetermined; Refrigerated: Undetermined; Frozen: Undetermined
CPT Code(s): 80299
Page | 195
0091324 2,4-Dichlorophenoxyacetic Acid, Serum or Plasma 2-4-DICHL
Specimen Preparation: Transfer 4 mL serum or plasma to an ARUP Standard Transport Tube.
CPT Code(s): 83921
0091379 2,4-Dichlorophenoxyacetic Acid, Urine 2-4-D U

Stability: Ambient: Undetermined; Refrigerated: Undetermined; Frozen: Undetermined.
CPT Code(s): 83921
0090085 Digitoxin DIGT

Methodology: Quantitative CEDIA Immunoassay
CPT Code(s): 80299
0090080 Digoxin DIG

Patient Preparation: Collect specimen 8-12 hours (no earlier than 6 hours) after administration of oral dose.
Specimen Required: Collect: Plain red. Also acceptable: Green (sodium or lithium heparin).
Specimen Preparation: Remove serum or plasma from cells within 2 hours of collection. Transfer 4 mL serum or plasma to an ARUP Standard
Remarks: Refrigerated.
Unacceptable Conditions: Specimens collected in sodium fluoride, potassium oxalate or separator tubes. Hemolyzed specimens.
Stability: After separation from cells: Ambient: 8 hours; Refrigerated: 48 hours; Frozen: 1 week
CPT Code(s): 80162
2002349 5-a-Dihydrotestosterone by Tandem Mass Spectrometry, Serum DHT TMS

CPT Code(s): 82651
2006226 Dilated Cardiomyopathy (DCM)/Left Ventricular Noncompaction (LVNC) Panel, 27 Genes DCM PANEL
0091348 Diltiazem, Serum or Plasma DILTIAZE

Specimen Required: Collect: Lavender (EDTA) or plain red.
Stability: Ambient: 8 days; Refrigerated: 8 days; Frozen: 1 year
CPT Code(s): 80299
0030461 Dilute Russell Viper Venom Time (dRVVT) with Reflex to dRVVT 1:1 Mix & Confirmation DRV CONF
CPT Code(s): 85613 dRVVT; if reflexed add 85613 dRVVT 1:1 mix; and 85613 dRVVT confirmation
Page | 196
0091308 Diphenhydramine Quantitation, Serum or Plasma DIPHENHYDR
Stability: Ambient: 2 weeks; Refrigerated: 25 days; Frozen: 18 months
CPT Code(s): 80299
0091219 Diphenhydramine, Urine DIPHEN UR

Stability: Ambient: 2 weeks; Refrigerated: 25 days; Frozen: 18 months
CPT Code(s): 80299
0050595 Diphtheria & Tetanus Antibodies, IgG D/T

Specimen Required: Collect: Serum separator tube. "Pre" and "post" vaccination specimens should be submitted for testing. "Post" specimen should be drawn 30 days
after immunization.
Tube. (Min: 0.15 mL) Mark specimens clearly as "Pre-Vaccine" or "Post-Vaccine". If shipped separately, "Post" specimen must be received
within 60 days of "Pre" specimen.
Unacceptable Conditions: Plasma or other body fluids.
CPT Code(s): 86317 Diphtheria; 86317 Tetanus
0050210 Diphtheria Antibody, IgG DIP

Specimen Required: Collect: Serum separator tube. "Pre" and "post" vaccination specimens should be submitted together for testing. "Post" specimen should be drawn
30 days after immunization.
Tube. (Min: 0.15 mL) Mark specimens clearly as "Pre-Vaccine" or "Post-Vaccine". If shipped separately, "Post" specimen must be received
within 60 days of "Pre" specimen.
Stability: After separation from the cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)
CPT Code(s): 86317
0050779 Diphtheria, Tetanus, and H. Influenzae b Antibodies, IgG DTH

Specimen Preparation: Transfer 1.5 mL serum to an ARUP Standard Transport Tube. (Min: 0.45 mL) Acute and convalescent specimens must be
labeled as such. Clearly mark specimens as "Pre-Vaccine" or "Post-Vaccine". Parallel testing is preferred and convalescent specimens must
be received within 30 days from receipt of the acute specimens.
Unacceptable Conditions: Plasma or other body fluids. Contaminated, hemolyzed, or severely lipemic specimens.
CPT Code(s): 86317 Diphtheria; 86317 Tetanus; 86317 H. influenzae
0091467 Dipyridamole, Serum or Plasma DIPYRIDAMO

CPT Code(s): 80299
0091466 Dipyridamole, Urine DIPYRIDA U

CPT Code(s): 80299
0013008 Direct Coombs (Anti-Human Globulin) IRL-DC

Pediatric: Transport 1 mL whole blood.
Remarks:
Page | 197
Unacceptable Conditions: Separator or gel tubes.
CPT Code(s): 86880
0014008 Direct Coombs (Anti-Human Globulin) with Reflex to Direct Antiglobulin-Mono DAT
Specimen Required: Collect: Testing is limited to the University of Utah Health Sciences Center, Primary Children's Medical Center (10432), and Intermountain
Shriners Hospital (10367) only.
Lavender (EDTA) or pink (K2EDTA).

Remarks:
CPT Code(s): 86880 Direct Coombs; if positive, add 86880 x2 DAT-MONO
2002247 Disaccharidase, Tissue DISAC

Specimen Required: Collect: Biopsies of small bowel by endoscopy.
Specimen Preparation: Place two 5 mg biopsies of tissue on the wall of a small, tightly-capped plastic tube without any supporting media. A 1 mL
flat-bottom microtube is recommended. Freeze within 2 hours of collection.
Storage/Transport Temperature: Frozen. Ship on dry ice.
Unacceptable Conditions: Room temperature or refrigerated specimens. Specimens placed on gauze, filter paper, or any other type of support
media. Tissue preserved in formalin.
CPT Code(s): 82657 X4
0090095 Disopyramide DISO

Methodology: Quantitative Enyzme Multiplied Immunoassay Technique
Specimen Preparation: Separate serum or plasma from cells within 2 hours of collection. Transfer 1 mL serum or plasma at to an ARUP Standard
Stability: After separation from cells: Ambient: 4 days; Refrigerated: 2 months; Frozen: 2 months
CPT Code(s): 80299
0091349 Disulfiram (Antabuse) and Metabolite Quantitation, Serum or Plasma ANTABUS SP

Specimen Required: Collect: Plain red or lavender EDTA.
Specimen Preparation: Separate serum or plasma from cells within 1 hour. Transfer 7 mL serum or plasma to ONE transport container and freeze
within one hour of collection. (Min: 3.2 mL)
Unacceptable Conditions: Thawed specimens. Specimens submitted in glass tubes. Separator tubes.
CPT Code(s): 80299
0091293 Disulfiram (Antabuse) and Metabolite Quantitation, Urine ANTABUS UR

Specimen Preparation: Transfer 15 mL urine to ONE transport container and freeze within one hour of collection. (Min: 6.2 mL)
Unacceptable Conditions: Glass containers. Thawed specimens.
CPT Code(s): 84311
0091258 Diuretic Screen, Urine DIURETIC U

Methodology: Qualitative High Performance Liquid Chromatography/Ultraviolet Detection
Specimen Preparation: Transfer 10 mL urine to ARUP Standard Transport Tubes. (Min: 1.2 mL)
CPT Code(s): 82486
0091320 Diuretic Survey, Serum or Plasma DIURETIC

Stability: Ambient: 1 week; Refrigerated: 1 week; Frozen: 6 months
CPT Code(s): 82492
0095735 DNA Content/Cell Cycle Analysis, Breast (Paraffin) DNA HIST P

Specimen Required: Collect: Breast tumor tissue.
Page | 198
Specimen Preparation: Paraffin embed tissue block enriched with breast tumor. If no normal tissue is included in the block, supply a control tissue
block to be processed in parallel.
Remarks: Include H&E stained slide and surgical pathology report.
Unacceptable Conditions: No tumor tissue remaining on block. Specimens fixed in Bouin's solution (picric acid), mercuric chloride containing
fixatives (e.g., B5, Zenker's solution), or ethanol-based fixatives containing ethylene glycol, acetic acid, or zinc chloride. Decalcified specimens.
Stability: Paraffin block: Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable
CPT Code(s): 88182
0095140 DNA Content/Cell Cycle Analysis, Colon DNA COL

Specimen Required: Collect: Colon tumor tissue.
Specimen Preparation: Paraffin embed tissue block enriched with colon tumor. If no normal tissue is included in the block, supply a control tissue
block to be processed in parallel.
fixatives (e.g., B5, Zenker's solution), or ethanol-based fixatives containing ethylene glycol, acetic acid or zinc chloride. Decalcified specimens.
CPT Code(s): 88182
0095155 DNA Content/Cell Cycle Analysis, Miscellaneous DNA MISC

Specimen Required: Collect: Tumor tissue, body fluid, peripheral blood in green (sodium or lithium), bone marrow in green (sodium or lithium), OR urine/bladder
washings.
Specimen Preparation: Tissue: Paraffin embed tissue block enriched with tumor
OR Body Fluid: Transport: 100 mL body fluid. (Min: 10 mL)
OR Peripheral Blood: Transport 5 mL whole blood.
OR Bone Marrow: Transport 2 mL bone marrow (specimens with low mononuclear cell counts may require more volume).
OR Urine/Bladder Washings: Centrifuge and remove supernatant. The cell pellet should then be re-suspended in a cell culture media such as
Hank's Balanced Salt Solution or RPMI.
Storage/Transport Temperature: Tissue (paraffin embedded), Peripheral Blood, or Bone Marrow: Refrigerated or Room temperature.
Body Fluid or Urine/Bladder Washings: Refrigerated or Refrigerated.
Remarks: Provide a Wright stained slide with all bone marrow and whole blood specimens along with clinical information and specimen source.
fixatives (e.g., B5, Zenker's solution) or ethanol-based fixatives containing ethylene glycol, acetic acid, or zinc chloride. Clotted or hemolyzed
blood or bone marrow. Decalcified specimens.
Stability: Tissue (paraffin embedded): Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable
Body Fluid or Urine/Bladder Washings: Ambient: Unacceptable; Refrigerated: 24 hours; Frozen: Unacceptable
Peripheral Blood or Bone Marrow: Ambient: 48 hours; Refrigerated: 48 hours; Frozen: Unacceptable
CPT Code(s): 88182
0095145 DNA Content/Cell Cycle Analysis, Prostate DNA PROS

Specimen Required: Collect: Prostate tumor tissue.
Specimen Preparation: Paraffin embed tissue block enriched with prostate tumor. If no normal tissue is included in the block, supply a control
tissue block to be processed in parallel.
fixatives (e.g., B5, Zenker's solution), or ethanol-based fixatives containing ethylene glycol, acetic acid, or zinc chloride. Decalcified specimens.
CPT Code(s): 88182
2006178 DNA Content/Cell Cycle Analysis, Hydatidiform Mole DNA HYDAT

Specimen Required: Collect: Hydatidiform mole tissue.
Specimen Preparation: Paraffin embed tissue block with hydatidiform mole. If no normal tissue is included in the block, please supply a control
tissue block to be processed in parallel.
Unacceptable Conditions: No tissue remaining on the block. Specimens fixed in Bouin's Solution (picric acid), fixatives containing mercuric
chloride (e.g. B5, Zenker's solution) or ethanol-based fixatives containing ethylene glycol, acetic acid, or zinc chloride. Decalcified specimens.
CPT Code(s): 88182
0050220 DNase-B Antibody DNSB

Tube. (Min: 0.4 mL)
Unacceptable Conditions: Plasma or severely hemolyzed specimens.
CPT Code(s): 86215
0013039 Donath Landsteiner IRL-DL

Methodology: Hemolysis
Page | 199
Specimen Preparation: Do not freeze red cells. Maintain specimen at 37until serum is separated from cells. Transport 2 mL serum. (Min: 1.5 mL)
Remarks:
CPT Code(s): 86941
0050215 Double-Stranded DNA (dsDNA) Antibody, IgG by ELISA with Reflex to dsDNA Antibody, IgG by IFA DNA
Methodology: Qualitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody
Tube. (Min: 0.5 mL)
CPT Code(s): 86225 dsDNA; if reflexed, add 86256 dsDNA IFA
2002693 Double-Stranded DNA (dsDNA) Antibody, IgG by IFA (using Crithidia luciliae) DNA IFA
Stability: After separation from cells: Ambient 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)
CPT Code(s): 86256
0090102 Doxepin and Metabolite DOXEPIN

CPT Code(s): 80166 Doxepin; 80299 Nordoxepin
0091120 Doxepin, Urine DOXEPIN U

Methodology: Nitrogen Phosphorus Detection-Gas Chromatography
CPT Code(s): 80166
2006621 Drug Detection Panel by High-Resolution Time-of-Flight Mass Spectrometry, Umbilical Cord Tissue TOF SCR CD
Methodology: Qualitative Liquid Chromatography-Time of Flight Mass Spectrometry
Specimen Required: Collect: at least 6 inches of umbilical cord.
Specimen Preparation: Drain and discard any blood. Rinse the exterior of the cord segment with normal saline or an equivalent. Pat the specimen
dry and place in container for transport.
Remarks: Collection kit with optional chain of custody available (ARUP supply #46990)
Unacceptable Conditions: Cords soaking in blood. Tissue that is obviously decomposed.
Stability: Ambient, 1 week; Refrigerated, 3 weeks; Frozen, 1 year
CPT Code(s): 80100 x2 (HCPCS: G0431)
0092182 Drug Panel 5, Urine - Screen with Reflex to Confirmation/Quantitation CDASU 5

Methodology: Qualitative Enzyme Multiplied Immunoassay Technique/ Quantitative Gas Chromatography-Mass Spectrometry/Quantitative Liquid
Chromatography-Tandem Mass Spectrometry
Specimen Preparation: Transfer 8 mL urine with no additives or preservatives to ARUP Standard Transport Tubes. (Min: 4 mL)
CPT Code(s): 80101 x5 Screen; if positive add appropriate CPT Code for drug confirmed: 82542 Marijuana; 82520 Cocaine; 83925 Opiates; 83992
Phencyclidine; 82145 Amphetamines
0092183 Drug Panel 5A, Urine - Screen with Reflex to Confirmation/Quantitation CDASU 5A
Methodology: Enzyme Immunoassay/Gas Chromatography-Flame Ionization Detection/Gas Chromatography-Mass Spectrometry/Liquid Chromatography-
Phencyclidine; 82145 Amphetamines; 82055 Alcohol
Page | 200
Specimen Preparation: Transfer 8 mL urine with no additives or preservative to ARUP Standard Transport Tubes. (Min: 4 mL)
Phencyclidine; 82145 Amphetamines; 82205 Barbiturates; 80154 Benzodiazepines
Phencyclidine; 82145 Amphetamines; 82205 Barbiturates; 80154 Benzodiazepines; 82055 Alcohol

CPT Code(s): 80101 x9 Screen (HCPCS:G0431); if positive add appropriate CPT Code for drug confirmed: 82542 Marijuana; 82520 Cocaine; 83925 Opiates;
83992 Phencyclidine; 82145 Amphetamines; 82205 Barbiturates; 80154 Benzodiazepines; 83840 Methadone; 83925 Propoxyphene
Specimen Preparation: Transfer 8 mL urine with no additives or preservatives in ARUP Standard Transport Tubes. (Min: 4 mL)
CPT Code(s): 80101 x10 Screen (HCPCS:G0431); if positive add appropriate CPT Code for drug confirmed: 82542 Marijuana; 82520 Cocaine; 83925 Opiates;
83992 Phencyclidine; 82145 Amphetamines; 82205 Barbiturates; 80154 Benzodiazepines; 83840 Methadone; 83925 Propoxyphene; 82055
Alcohol
0092420 Drug Screen 9 Panel, Serum or Plasma - Immunoassay Screen with Reflex to Mass Spectrometry DRUG SCRSP
Confirmation/Quantitation
Methodology: Qualitative Enzyme-Linked Immunosorbent Assay/ Quantitative Gas Chromatography-Mass Spectrometry/Quantitative Liquid Chromatography-
Specimen Preparation: Remove plasma from cells ASAP or within 2 hours of collection. Transfer 4 mL plasma to an ARUP Standard Transport
Tube. (Min: 3 mL) Also acceptable: Serum.
Remarks: Cocaine and cocaethylene are more stable in fluoride-preserved plasma than serum.
Unacceptable Conditions: Specimens exposed to repeated freeze/thaw cycles. Separator tubes. Plasma or whole blood collected in lt. blue (sodium
citrate).
CPT Code(s): 80101 x9 Screen (HCPS: G0431) ; if positive, add appropriate code for drug confirmed: 82542 Marijuana; 82520 Cocaine; 83925 Opiates; 83992
Phencyclidine; 82145 Amphetamines; 82205 Barbiturates; 80154 Benzodiazepines; 83840 Methadone; 83925 Propoxyphene
0090560 Drug Screen (Nonforensic), Comprehensive, Serum & Urine TOX SCREEN
Methodology: Immunoassay/Gas Chromatography-Mass Spectrometry
Patient Preparation: First morning catch of urine, if possible.
Specimen Required: Collect: Plain red AND fresh random urine.
Specimen Preparation: Transfer 6 mL serum to ARUP Standard Transport Tubes (Min: 4.5 mL) AND transport 40 mL urine. (Min: 15 mL)
Stability: Serum: After separation from cells: Ambient: 48 hours; Refrigerated: 1 week; Frozen: 2 months
Urine: Ambient: 5 days; Refrigerated: 2 weeks; Frozen 2 months
CPT Code(s): 80101 Serum, immunoassay (HCPCS:G0431); 80100 Serum, GC/FID; 80100 Serum, GC/ECD; 80100 Urine, immunoassay; 80101 Urine ,
GC/MS
0090499 Drug Screen (Nonforensic), Serum BLD SCREEN

Methodology: Semi-Quantitative Immunoassay/Gas Chromatography-Mass Spectrometry
Specimen Preparation: Transfer 6 mL serum to ARUP Standard Transport Tubes. (Min: 4.5 mL)
Remarks: Avoid use of separator tubes and gels.
Page | 201
CPT Code(s): 80101 Immunoassay (HCPCS:G0431); 80100 GC/FID; 80100 GC/ECD; 80100 GC/MS
0090500 Drug Screen (Nonforensic), Urine, Qualitative URN SCREEN

Methodology: Qualitative Immunoassay/Gas Chromatography-Mass Spectrometry
Specimen Required: Collect: Fresh random urine.
Stability: Ambient: 5 days; Refrigerated: 2 weeks; Frozen: 2 months
CPT Code(s): 80101 Immunoassay (HCPCS:G0431); 80100 GC/FID; 80100 GC/MS
2003254 Drug Screen, Targeted, Serum or Plasma TOF SCR SP

Methodology: Qualitative Liquid Chromatography-Time of Flight Mass Spectrometry
Remarks: Cocaine and cocaethylene are more stable in fluoride-preserved plasma than serum.
Unacceptable Conditions: Specimens exposed to repeated freeze/thaw cycles. Separator tubes. Plasma or whole blood collected in lt. blue (sodium
citrate).
2005444 Drug Screen, Targeted with Reflex to Confirmation, Serum or Plasma TOF RFX SP
Methodology: Qualitative Liquid Chromatography-Time of Flight Mass Spectrometry/Quantitative Gas Chromatography-Mass Spectrometry/Quantitative
Liquid Chromatography-Tandem Mass Spectrometry
Unacceptable Conditions: Separator tubes or lt. blue (sodium citrate). Specimens exposed to repeated freeze/thaw cycles.
CPT Code(s): 80100 x2. If reflexed, refer to individual confirmation components.
0090491 Drugs of Abuse 5 Panel, Urine - Screen Only CDTI5

Methodology: Qualitative Enzyme Multiplied Immunoassay Technique
0090492 Drugs of Abuse 5A Panel, Urine - Screen Only CDTI5A

Methodology: Qualitative Enzyme Multiplied Immunoassay Technique/Alcohol Dehydrogenase



CPT Code(s): 80101 x9 (HCPCS:G0431)
Page | 202
CPT Code(s): 80101 x10 (HCPCS:G0431)
0092310 Drugs of Abuse Confirmation/Quantitation - Amphetamines (Amphetamine & Methamphetamine) - Meconium CONFAMP M
Specimen Required: Collect: All meconium (blackish material) excreted until milk/formula based stool (yellow-green) appears.
Specimen Preparation: Transport 1 g (equivalent to 1/2 inch cube) for each separate confirmation required. (Min: 0.5 g or 1/4 inch cube)
Stability: Ambient: 1 week; Refrigerated: 3 months; Frozen: 1 year
CPT Code(s): 82145
0090439 Drugs of Abuse Confirmation/Quantitation - Amphetamines - Urine CDCO AMPS

Specimen Preparation: Transfer 4 mL urine with no additives or preservatives to an ARUP Standard Transport Tube. (Min: 0.5 mL)
CPT Code(s): 82145
0092311 Drugs of Abuse Confirmation/Quantitation - Barbiturates - Meconium CONFBRB M

CPT Code(s): 82205
0093308 Drugs of Abuse Confirmation/Quantitation - Barbiturates - Serum or Plasma BARB SP

freeze/thaw cycles.
CPT Code(s): 82205
0090357 Drugs of Abuse Confirmation/Quantitation - Barbiturates - Urine CDCO BARB

CPT Code(s): 82205
0092520 Drugs of Abuse Confirmation/Quantitation - Benzodiazepines - Meconium CONFBENZ M

CPT Code(s): 80154
0093300 Drugs of Abuse Confirmation/Quantitation - Benzodiazepines - Serum or Plasma BENZ SP

freeze/thaw cycles.
CPT Code(s): 80154
0090358 Drugs of Abuse Confirmation/Quantitation - Benzodiazepines - Urine CDCO BENZ

Page | 203
CPT Code(s): 80154
0090676 Drugs of Abuse Confirmation/Quantitation - Cannabinoids (9-carboxy-THC) - Serum or Plasma CANNAB SP

freeze/thaw cycles.
CPT Code(s): 82542
0090369 Drugs of Abuse Confirmation/Quantitation - Cannabinoids (9-carboxy-THC) - Urine CDCO THC

CPT Code(s): 82542
0092316 Drugs of Abuse Confirmation/Quantitation - Cannabinoids (Marijuana) - Meconium CONFTHC M

CPT Code(s): 82542
0092312 Drugs of Abuse Confirmation/Quantitation - Cocaine & Metabolites - Meconium CONFCOC M

CPT Code(s): 82520
0090684 Drugs of Abuse Confirmation/Quantitation - Cocaine & Metabolites - Serum or Plasma COC MET SP
freeze/thaw cycles.
CPT Code(s): 82520
0090359 Drugs of Abuse Confirmation/Quantitation - Cocaine Metabolite (Benzoylecgonine) - Urine CDCO COCA
CPT Code(s): 82520
0092313 Drugs of Abuse Confirmation/Quantitation - Methadone & Metabolite - Meconium CONFMTD M

CPT Code(s): 83840
0092314 Drugs of Abuse Confirmation/Quantitation - Opiates - Meconium CONFOPI M

CPT Code(s): 83925
Page | 204
0092315 Drugs of Abuse Confirmation/Quantitation - Phencyclidine (PCP) - Meconium CONFPCP M
CPT Code(s): 83992
0090366 Drugs of Abuse Confirmation/Quantitation - Phencyclidine (PCP) - Urine CDCO PCP

CPT Code(s): 83992
0091571 Drugs of Abuse Confirmation/Quantitation - Phencyclidine - Serum or Plasma PHENCYCLID

freeze/thaw cycles.
CPT Code(s): 83992
0092524 Drugs of Abuse Confirmation/Quantitation - Propoxyphene & Metabolite - Meconium CONFPPXY M

CPT Code(s): 83925
0091363 Drugs of Abuse Confirmation/Quantitation - Propoxyphene & Metabolite - Serum or Plasma PROPOXY SP
freeze/thaw cycles.
CPT Code(s): 80299
0090368 Drugs of Abuse Confirmation/Quantitation - Propoxyphene & Metabolite - Urine CDCO PPXY
Specimen Preparation: Transfer 4 mL with no additives or preservatives urine to an ARUP Standard Transport Tube. (Min: 1 mL)
CPT Code(s): 83925
0091372 Drugs of Abuse Confirmation/Quantitation - Amphetamine - Serum or Plasma AMPHETAM

freeze/thaw cycles.
CPT Code(s): 82145
0092516 Drugs of Abuse Panel, Meconium - Screen with Reflex to Confirmation/Quantitation MEC 9
Methodology: Qualitative Enzyme-Linked Immunosorbent Assay/Quantitative Gas Chromatography-Mass Spectrometry/Quantitative Liquid Chromatography-
Specimen Required: Collect: Meconium. All meconium (blackish material) excreted until milk/formula based stool (yellow-green) appears.
Storage/Transport Temperature: All meconium available (4 g is preferred) at 20-25°C. (Min: 2 g or 3/4 inch cube on each side)
CPT Code(s): 80101 x9 Screen (HCPCS: G0431); if positive add appropriate CPT code for drug confirmed: 82542 Marijuana; 82520 Cocaine; 83925 Opiates;
83992 Phencyclidine; 82145 Amphetamines; 82205 Barbiturates; 83840 Methadone; 80154 Benzodiazepine; 83925 Propoxyphene
Page | 205
0090306 Drugs of Abuse Screen - Cocaine & Metabolites - Urine U COC
Specimen Preparation: Mix well. Transfer 4 mL urine to an ARUP Standard Transport Tube. (Min: 1 mL)
CPT Code(s): 80101
0090312 Drugs of Abuse Screen - Opiates - Urine U OPI

CPT Code(s): 80101
0090302 Drugs of Abuse Screen - Stimulant Amines - Urine U AMP

Storage/Transport Temperature: Frozen. Also acceptable: Room temperature or refrigerated.
CPT Code(s): 80101
0092280 Drugs of Abuse Test, Alcohol, Urine - Screen with Reflex to Confirmation/Quantitation CDASUALC
Methodology: Semi-Quantitative Alcohol Dehydrogenase/ Qualitative Gas Chromatography-Flame Ionization Detection
Newborn minimum: 1 mL for the initial test and 1 mL for the confirmation of screen positive.
Remarks: If applicable, indicate NEWBORN prominently on the test request form.
CPT Code(s): 80101 Drug screen; if positive, add 82055 Confirmation
2006473 Duloxetine Quantitation, Serum or Plasma DULOX SP

Specimen Required: Collect: Plain red or lavender (EDTA) or pink (K2EDTA).
Specimen Preparation: Separate from cells within 2 hours. Protect from light. Transfer 1 mL serum or plasma to an ARUP Amber Transport Tube.
(Min: 0.4 mL)
Unacceptable Conditions: Not light protected. Separator tubes.
Stability: Ambient: 1 Month; Refrigerated: 1 Month; Frozen: 12 Months
CPT Code(s): 80299
0091326 Dyazide, Serum or Plasma DYAZID

0091325 Dyazide, Urine DYAZIDE UR

0091368 Dyphylline Quantitative, Serum or Plasma DYPHYLLIN

CPT Code(s): 80299
0091503 Dyphylline Quantitative, Urine DYPHYLLI U

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CPT Code(s): 80299
0051463 Dysautonomia, Familial (IKBKAP) 2 Mutations IKBKAP

CPT Code(s): 83891 Isolation; 83892 x2 Enzymatic digestion; 83898 Amplification; 83914 x2 Mutation identification; 83909 Separation and identification;
disorders.
0051464 Dysautonomia, Familial (IKBKAP) 2 Mutations, Fetal IKBKAP FE

CPT Code(s): 83891 Isolation; 83892 x2 Digestion; 83898 Amplification; 83914 x2 Extension; 83909 Capillary electrophoresis; 83912 Interpretation and report.
FCC: 83900 Multiplex amplification (first two sequences); 83901 x14 Additional amplification; 83909 Capillary electrophoresis. If MCC MAT
(0050608) is performed: 83891 Isolation; 83900 Multiplex amplification; 83901 x14 Additional amplification; 83909 Capillary electrophoresis;
disorders.
2006244 Dyskeratosis Congenita, Autosomal (TERC) Sequencing TERC FGS

Stability: Ambient: 1 week, Refrigerated: 1 week, Frozen: Unaccepta
report.
2006228 Dyskeratosis Congenita, X-linked (DKC1) Sequencing DKC1 FGS

CPT Code(s): 83891 Isolation; 83898 x30 Amplification; 83894 x15 Gel separation; 83904 x15 Sequencing; 83892 x2 Digestion; 83912 Interpretation and
report.
2003869 E-Cadherin by Immunohistochemistry ECADH IHC

CPT Code(s): 88342
0060047 E. coli Shiga-like Toxin by EIA ECSLT AG

Specimen Required: Collect: Stool. OR actively growing isolate of E. coli, in pure culture.
Specimen Preparation: Stool: Place 5 g stool in enteric transport media (Cary-Blair) (ARUP Supply #29799) immediately after collection.
Available online through eSupply using ARUP Connector contact ARUP Client Services at (800) 522-2787. (Min: 1 g)
Page | 207
E. coli Isolate: Transport sealed container with pure culture on agar slant or on a swab in bacterial transport media. Place each specimen in an
Storage/Transport Temperature: Stool: Refrigerated.
E. coli Isolate: Room temperature.
Unacceptable Conditions: Specimens or isolates from sources other than stool. Specimens in preservatives.
Stability: Stool: Ambient: 1 hour; Refrigerated: 72 hours; Frozen: 1 week
E. coli Isolate: Ambient: 1 week; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 87427
0060361 Ear Culture MC EAR

Specimen Required: Collect: Aspirate or drainage on swab.
Specimen Preparation: Aspirate: Transfer to a sterile container. (Min: 0.1 mL)
Swab: Transfer to bacterial transport media.
Unacceptable Conditions: Swabs of external ear canal without drainage. Dry swabs.
CPT Code(s): 87070
0098896 Eastern Equine Encephalitis Antibody, IgG by IFA, CSF EAST G CSF
CPT Code(s): 86652
0050509 Eastern Equine Encephalitis Antibody, IgG by IFA, Serum EASTERN

Unacceptable Conditions: Severely contaminated, hemolyzed, or severely lipemic specimens.
CPT Code(s): 86652
0098729 Eastern Equine Encephalitis Antibody, IgM by IFA, CSF EAST M CSF
CPT Code(s): 86652
0098733 Eastern Equine Encephalitis Antibody, IgM by IFA, Serum EAST M SER
specimens must be received within 30 days from receipt of the acute specimens. Mark specimens plainly as acute or convalescent.
Unacceptable Conditions: Plasma. Contaminated, heat-inactivated, hemolyzed, or severely lipemic or specimens.
CPT Code(s): 86652
2007220 Echinococcus Antibody, IgG ECHINO IGG

Mark specimens plainly as acute or convalescent.
CPT Code(s): 86682
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0060053 Echovirus Antibodies ECHO
Specimen Required: Collect: Serum separator tube or plain red. OR CSF.
Specimen Preparation: Separate serum from cells within 2 hours of collection. Transport 1 mL serum or CSF. (Min: 0.3 mL) Parallel testing is
preferred and convalescent samples must be received within 30 days from receipt of acute samples. Mark samples plainly as "acute" or
"convalescent."
CPT Code(s): 86658 x5 Echovirus (Types 6, 7, 9, 11, and 30)
0049234 EGFR Gene Amplification by FISH EGFRFISH

2002440 EGFR Mutation Detection by PCR and Fragment Analysis EGFR PCR
tissue block or 5 unstained 5 micron slides. (Min: 3 slides) Transport block and/or slide(s) in a tissue transport kit (ARUP supply # 47808)
available online through eSupply using ARUP Connect™or contact ARUP Client Services at (800) 522-2787.
fixatives. Decalcified specimens
CPT Code(s): 88381 Microdissection; 83907 Lysis; 83898 x2 Amplification; 83892 Digestion; 83909 Separation and identification; 83896 x2 Nucleic acid
probes; 83912 Interpretation and report - Additional CPT code modifiers may be required for procedures performed to test oncologic or inherited
disorders.
2004857 EGFR Mutation Detection with Reflex to EML4/ALK Translocation by RT-PCR EGFR RFLX
Methodology: Qualitative Polymerase Chain Reaction/Qualitative Reverse Transcription Polymerase Chain Reaction
tissue block or 5 unstained 5 micron slides (Min: 3 slides). AND 6 tissue scrolls (tissue shavings) 10 microns thick. Transport block and/or
slide(s) in a tissue transport kit (ARUP supply # 47808) available online through eSupply using ARUP Connect™or contact ARUP Client
Services at (800) 522-2787.
Remarks: Include surgical pathology report. Tissue block will be returned after testing.
CPT Code(s): 88381 Microdissection; 83907 Lysis; 83898 x2 Amplification; 83892 Digestion; 83909 Separation and identification; 83896 x2 Nucleic acid
probes; 83912 Interpretation and report. If reflexed add 83907 Lysis; 83891 Isolation; 83902 Reverse Transcription; 83898 x3 Amplification;
83894 x3 Gel Separation; 83912 Interpretation and report - Additional CPT code modifiers may be required for procedures performed to test
2005555 Ehlers-Danlos Syndrome Kyphoscoliotic Form, Type VI (PLOD1) Deletion/Duplication EDS-VI DD

2005559 Ehlers-Danlos Syndrome Kyphoscoliotic Form, Type VI (PLOD1) Sequencing and Deletion/Duplication EDS-VI FGA
Del/Dup: 83896 x18 Nucleic acid probes; 83898 x18 Amplification; 83914 x18 Extension; 83909 Capillary electrophoresis - Additional CPT
0080351 Ehlers-Danlos Syndrome Type VI Screen EDS6

Patient Preparation: First-morning urine is preferred.
Page | 209
Specimen Required: Collect: Urine. First-morning void. Also acceptable: Random specimens.
CPT Code(s): 82492
2003078 Ehrlichia and Anaplasma Species by Real-Time PCR EHRLI ANA

Methodology: Real-Time Polymerase Chain Reaction/DNA Probe Hybridization
Specimen Preparation: Transfer 5 mL whole blood to ARUP Standard Transport Tubes. (Min: 0.2 mL)
Unacceptable Conditions: Specimens collected in green (sodium or lithium heparin) or yellow (ACD).
CPT Code(s): 87798
0051002 Ehrlichia chaffeensis Antibodies, IgG & IgM by IFA E CHAF ABS
CPT Code(s): 86666 Ehrlichia chaffeensis IgG; 86666 Ehrlichia chaffeensis IgM
0051004 Ehrlichia chaffeensis Antibody, IgG by IFA E CH G

CPT Code(s): 86666
0051003 Ehrlichia chaffeensis Antibody, IgM by IFA E CH M

CPT Code(s): 86666
2002994 Ehrlichia chaffeensis DNA, Real-Time PCR EHRLICHIA

Specimen Required: Collect: Lavender (EDTA) or yellow (ACD). .Also acceptable CSF.
Specimen Preparation: Transfer 0.7 mL whole blood, tick (in ethanol or live), or 1 mL CSF to an ARUP Standard Transport Tube. (Min: 0.3 mL
or 1 tick)
Unacceptable Conditions: Frozen whole blood.
Stability: Ambient: 48 hours; Refrigerated: 1 week; Frozen: 1 month (frozen whole blood unacceptable)
CPT Code(s): 87798
0020699 Electrolyte & Osmolality Profile, Fecal FEC PRO

Methodology: Quantitative Ion-Selective Electrode/Freezing Point
Specimen Required: Collect: 24-hour or random liquid stool.
Specimen Preparation: Mix specimen well and transfer 10 g liquid stool to an unpreserved stool transport vial. (ARUP Supply #40910) (Min: 5 g)
Do not add saline or water to liquefy specimen. Indicate time and volume.
Unacceptable Conditions: Formed or viscous stools.
CPT Code(s): 84999 Potassium; 84302 Sodium; 83735 Magnesium; 84999 Osmolality
0020410 Electrolyte Panel LYTES

Methodology: Quantitative Ion-Selective Electrode/Enzymatic
Stability: After separation from cells: Ambient: 4 hours; Refrigerated: 1 week (tightly capped); Frozen: 1 month
CPT Code(s): 80051
Page | 210
0060185 Electrolytes, Fecal FEC LYTES
Specimen Required: Collect: 24-hour or random liquid stool.
Specimen Preparation: Mix well and transfer a 5 g aliquot of stool to an unpreserved stool transport vial (ARUP Supply #40910). Available online
through eSupply using ARUP Connect™ or contact Client Services at (800) 522-2787. (Min: 1 g) Do not add saline or water to liquefy specimen.
CPT Code(s): 84999 Potassium; 84302 Sodium; 82438 Chloride
0020498 Electrolytes, Urine ULYTE

Specimen Required: Collect: 24-hour or random urine. Refrigerate during collection.
Specimen Preparation: Do not adjust specimen pH. Transfer a 1 mL aliquot of urine from a well-mixed collection to an ARUP Standard Transport
Tube. (Min: 0.5 mL) Record total volume and collection time interval on transport tube and test request form.
CPT Code(s): 82436 Chloride, urine; 84133 Potassium, urine; 84300 Sodium, urine
0013010 Elution & Antibody Identification, RBC IRL-ELU

Pediatric: Transport 2 mL whole blood.
Remarks:
CPT Code(s): 86860 Elution; 86870 AB ID
2004547 EML4-ALK Translocation by RT-PCR EML4-ALK

tissue block or 6 tissue scrolls (tissue shavings), 10 microns thick AND an H&E slide (to be retained at ARUP). Transport block and/or slide(s) in
a tissue transport kit (ARUP supply # 47808) available online through eSupply using ARUP Connect™or contact ARUP Client Services at (800)
522-2787.
fixatives. Slides. Decalcified specimens.
CPT Code(s): 83907 Lysis; 83891 Isolation; 83902 Reverse transcription; 83898 x3 Amplification; 83894 x3 Gel Separation; 83912 Interpretation and report -
2001741 Encephalitis Panel, CSF with Reflex to HSV Type 1 and 2 Glycoprotein G-Specific Ab, IgG ENCEPHCSFR
Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody Semi-Quantitative Chemiluminescent
Immunoassay
Unacceptable Conditions: Serum or plasma. Contaminated or heat-inactivated specimens.
CPT Code(s): 86765 Measles G; 86765 Measles M; 86735 Mumps G; 86735 Mumps M; 86787 VZE; 86787 VZM; 86727 x2 LCM G/M; 86694 HSV MC;
86694 HERP I/II; if reflexed, add 86695 HERP I; 86696 HERP II;
2001742 Encephalitis Panel, Serum with Reflex to HSV Type 1 and Type 2 Glycoprotein G-Specific Ab, IgG ENCEPH R
Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody/Semi-Quantitative Chemiluminescent
Immunoassay
Unacceptable Conditions: Refer to individual components.
CPT Code(s): 86765 Measles G; 86765 Measles M; 86735 Mumps G; 86735 Mumps M; 86787 VZE; 86787 VZM; 86727 x2 LCM G/M; 86694 HSV MC;
86694 HERP I/II; if reflexed, add 86695 HERP I; 86696 HERP II
0050736 Endomysial Antibody, IgA by IFA EMAR TITER

Specimen Preparation: Separate serum from cells ASAP. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.15 mL)
Unacceptable Conditions: Plasma. Severely lipemic, contaminated, or hemolyzed specimens.
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid freeze/thaw cycles)
CPT Code(s): 86256
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2005501 Endomysial Antibody, IgG EMA IGG
Unacceptable Conditions: Contaminated specimens.
CPT Code(s): 86256
0050070 Entamoeba histolytica (amebiasis), Antibody, IgG AMB

CPT Code(s): 86753
0058001 Entamoeba histolytica Antigen, EIA AMOEBA

Specimen Preparation: Transfer 5g stool to an unpreserved stool transport vial (ARUP supply #40910). Available online through eSupply using
ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min 1g)
Stability: Ambient: Unacceptable; Refrigerated: 48 hours; Frozen: 1 week
CPT Code(s): 87337
2005730 Enterovirus and Parechovirus Detection by RT-PCR EVPEHV

Methodology: Qualitative Reverse Transcription Polymerase Chain Reaction
Specimen Required: Collect: (EDTA), pink (K2EDTA), serum separator tube, or CSF.
Specimen Preparation: Separate serum or plasma from cells. Transfer 1 mL plasma, serum or CSF to a sterile container. (Min: 0.5 mL)
Storage/Transport Temperature: Frozen. Submit specimen according to Biological Substance, Category B, shipping guidelines.
CPT Code(s): 87498 Enterovirus detection by RT-PCR; 87798 Parechovirus detection by RT-PCR
2003259 Enterovirus Antibody Panel ENT PANEL

Methodology: Serum Neutralization/Complement Fixation
0.75 mL) Parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of the acute specimens. Mark
CPT Code(s): 86658, x15: Cox (A9), Coxsackie (B1, B2, B3, B4, B5, and B6), Echovirus (Types 6, 7, 9, 11, and 30), Poliovirus (1, 2, and 3)
0050249 Enterovirus Detection by RT-PCR EV PCR

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA) or serum separator tube. OR CSF.
Specimen Preparation: Separate serum or plasma from cells. Transfer 1 mL serum, plasma or CSF to a sterile container. (Min: 0.5 mL)
CPT Code(s): 87498
0065058 Enterovirus Typing V ENTTYP

Methodology: Immunofluorescence
Patient Preparation: Typing may not be requested directly on a patient specimen.
Specimen Required: Collect: Transfer positive cell culture fluid to a sterile container..
Specimen Preparation: Transport positive cell culture.
CPT Code(s): 87252 Tissue culture; 87253 Additional studies
0050232 Eosinophil Cationic Protein ECP

Methodology: Quantitative Fluorescent Enzyme Immunoassay
Specimen Preparation: Collect a FULL serum separator tube of blood. Invert 5 times. Let clot 60 to 120 minutes at room temperature. Centrifuge
at 1000 to 1300 g for 10 minutes. Transfer 1 mL serum to an ARUP Standard Transport Tube and freeze immediately. (Min: 0.5 mL)
Page | 212
Unacceptable Conditions: Thawed specimens. Plasma and hemolyzed serum.
CPT Code(s): 86849
0090648 Eosinophil Granule Major Basic Protein in Tissues EMBP TISS

Methodology: Immunofluorescence/Affinity Chromatography
Specimen Preparation: Formalin fix or formalin fix and paraffin embed. Transport 5 micron tissue sections on three slides (no specific size
requirement available).
Unacceptable Conditions: Frozen fixed tissue. Thawed tissue.
Stability: Ambient: In formalin: 3 weeks, Paraffin block: Indefinitely; Frozen (no medium): Indefinitely
CPT Code(s): 88342 Immunocytochemistry; 88323 Consultation & report
2002378 Eosinophilia Panel by FISH FISH EOS P

Specimen Required: Collect: Non-diluted bone marrow aspirate collected in a heparinized syringe.Also acceptable: Green (sodium heparin).
This test must be ordered using Cytogenetic test request form #43097 or through your ARUP interface. Submit the Patient
0040190 Eosinophils, Nasal EOS NASAL

Specimen Required: Collect: Nasopharyngeal swab.
Specimen Preparation: Transport nasopharyngeal swab or prepared slides.
Storage/Transport Temperature: Room temperature. Transport in a protective container.
Stability: Swab: Ambient: 24 hours; Refrigerated: 24 hours; Frozen: Unacceptable
Prepared Unstained Slides: Ambient: 1 week; Refrigerated: 1 week; Frozen: Unacceptable
CPT Code(s): 89190
0040192 Eosinophils, Sputum EOS SPUTUM

Specimen Required: Collect: Sputum.
Specimen Preparation: Transport 0.5 mL sputum or prepared slides.
Storage/Transport Temperature: Room temperature. Transport in a protective container.
Stability: Sputum: Ambient: 8 hours; Refrigerated: 24 hours; Frozen: Unacceptable
Unstained Slides: Ambient: 1 week; Refrigerated: 1 week; Frozen: Unacceptable
CPT Code(s): 89190
0091244 Ephedrine, Serum or Plasma EPHEDRIN

CPT Code(s): 80299
0091205 Ephedrine, Urine EPHEDRI U

CPT Code(s): 80299
0092057 Epithelial Basement Membrane Zone IgA Antibodies EBMZ IGA

Methodology: Indirect Immunofluorescence
Remarks: For specimens less than 0.5 mL, call the Immunodermatology lab at (866) 266-5699.
Stability: Ambient: 4 days; Refrigerated: 3 months; Frozen: Indefinitely
CPT Code(s): 88347 x2 Substrates (monkey esophagus and human split skin)
0092056 Epithelial Basement Membrane Zone IgG Antibodies EBMZ IGG

Page | 213
CPT Code(s): 88347 x2 Substrates (monkey esophagus and human split skin)
2003872 Epithelial Membrane Antigen (EMA) by Immunohistochemistry EMA IHC

CPT Code(s): 88342
2003875 Epithelial-Related Antigen, MOC-31 by Immunohistochemistry ERA IHC

CPT Code(s): 88342
0090299 Epithelial Skin Antibody EPITHELIAL

CPT Code(s): 88347 x4 Substrates (BMZ, cell surface, IgG and IgA)
0050600 Epstein-Barr Virus Antibody Panel I EBV PAN

Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transport 2 mL serum. (Min: 0.5 mL) Parallel testing is
preferred and convalescent specimens must be received within 30 days from receipt of acute specimens. Mark specimens plainly as "acute" or
"convalescent."
Unacceptable Conditions: Tissue or urine. Contaminated or heat-inactivated specimens.
CPT Code(s): 86665 EBV VCA IgG; 86665 EBV VCA IgM; 86664 EBV NA; 86663 EBV Early
0050602 Epstein-Barr Virus Antibody Panel II EBV PAN 2

specimens. Mark specimen plainly as "acute" or "convalescent."
CPT Code(s): 86665 EBV VCA IgG; 86665 EBV VCA IgM
0050225 Epstein-Barr Virus Antibody to Early D Antigen (EA-D), IgG EBV EAD
Page | 214
CPT Code(s): 86663
0050245 Epstein-Barr Virus Antibody to Nuclear Antigen, IgG EBV NA

CPT Code(s): 86664
0051626 Epstein-Barr Virus Antibody to Viral Capsid Antigen, IgA EBV A

Mark specimen plainly as "acute" or "convalescent."
CPT Code(s): 86665
0050235 Epstein-Barr Virus Antibody to Viral Capsid Antigen, IgG EBV G

CPT Code(s): 86665
0051627 Epstein-Barr Virus Antibody to Viral Capsid Antigen, IgG & IgA EBV PAN 3
Methodology: Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Chemiluminescent Immunoassay
Unacceptable Conditions: Urine. Contaminated or heat-inactivated specimens.
0050240 Epstein-Barr Virus Antibody to Viral Capsid Antigen, IgM EBV M

CPT Code(s): 86665
0050246 Epstein-Barr Virus by PCR EBVPCR

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), serum separator tube, OR Bone marrow aspirate in lavender (EDTA) or pink (K2EDTA), OR CSF or
tissue.
Specimen Preparation: Separate serum or plasma from cells. Transfer 1 mL serum, plasma, bone marrow or CSF to a sterile container. (Min: 0.5
mL). OR Tissue: Transfer to sterile container and freeze immediately. Also acceptable: Formalin fixed and paraffin embedded tissue.
Storage/Transport Temperature: Paraffin-Embedded Tissue: Room temperature. Bone marrow: Refrigerated. All others: Frozen.
Unacceptable Conditions: Heparinized specimens. Tissues in formalin (not paraffin embedded) or other preservatives.
Stability: Fresh Tissue: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 1 year.
Paraffin Embedded Tissue: Ambient: Indefinitely; Refrigerated: 2 weeks; Frozen: Unacceptable.
Bone Marrow: Ambient: 24 hours; Refrigerated: 5 days; Frozen: Unacceptable.
All others: Ambient: 24 hours; Refrigerated: 5 days; Frozen: 1 year.
CPT Code(s): 87798
2002902 Epstein-Barr Virus (EBV) By in situ Hybridization, Paraffin EBV ISH

Methodology: In situ Hybridization
Page | 215
Specimen Preparation: Formalin fix (10% neutral buffered formalin) and paraffin-embed tissue. Transport tissue block or 5 unstained 5 micron
slides. (Min: 3 slides) Protect paraffin block and/or slides from excessive heat.
Unacceptable Conditions: Specimens fixed or processed in alternative fixatives (alcohol, Prefer®) or heavy metal fixatives (B-4 or
B-5). Frozen specimens.
CPT Code(s): 88365
0051352 Epstein-Barr Virus, Quantitative PCR EBV QNT

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or serum separator tube. OR CSF.
Unacceptable Conditions: Whole blood (refer to Epstein-Barr Virus, Quantitative PCR, Whole Blood, ARUP test code 0051353). Heparinized
specimens.
Stability: Ambient: 24 hours; Refrigerated: 5 days; Frozen: 1 year.
CPT Code(s): 87799
0051353 Epstein-Barr Virus, Quantitative PCR, Whole Blood EBV QNT WB

Specimen Preparation: Do not freeze whole blood specimens. Transport 1 mL whole blood. (Min: 0.5 mL)
Unacceptable Conditions: Plasma (refer to Epstein-Barr Virus Quantitative PCR, ARUP test code 0051352). Heparinized specimens. Frozen
specimens.
Stability: Ambient: 24 hours; Refrigerated: 5 days; Frozen: Unacceptable.
CPT Code(s): 87799
2002217 ERBB2 (HER2/neu) (4B5) by Immunohistochemistry, Tissue with Reflex to FISH if 2+ 4B5 2 IP
Specimen Required: Collect: Tumor tissue
Specimen Preparation: Formalin fix (10 percent neutral buffered formalin) and paraffin embed tissue within 30 minutes of removal from patient..
Fixative duration: 8-48 hours. Transport tissue block or 10 unstained (3-5 micron thick sections), positively charged slides in a tissue transport kit
(ARUP supply #47808) available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800)522-2787 (min: 6
slides). If sending precut slides, do not oven bake.
Remarks: Pathology report including tissue source and tumor origin must be submitted. Document time from tissue acquisition to fixation and
fixation duration on requisition or enter at time of order. IMMUNOHISTOCHEMISTRY ORDERING AND SUBMISSION DETAILS:
Submit electronic request. If you do not have electronic ordering capability, use an ARUP Immunohistochemistry form (#32978) with an ARUP
client number. For additional technical details, please contact ARUP Client Services at (800) 522-2787.
Unacceptable Conditions: Specimens with fixation delayed for more than 30 minutes. Specimens fixed in any other fixative other than 10 percent
neutral buffered formalin. Tissue fixed for less than 8 hours or greater than 48 hours. Cytology specimens fixed in alcohol.
Stability: Ambient: Indefinite; Refrigerated: Indefinite ; Frozen: Unacceptable
CPT Code(s): 88360; if reflexed, add 88368 x2
2002216 ERBB2 (HER2/neu) (4B5) by Immunohistochemistry, Tissue with Reflex to FISH if 2+ or 3+ 4B5 23 IP
Specimen Preparation: Formalin fix (10 percent neutral buffered formalin) and paraffin embed tissue within 30 minutes of removal from patient.
Fixative duration: 8-48 hours. Transport tissue block or 10 unstained (3- to 5-micron thick sections), positively charged slides in a tissue transport
kit (ARUP supply #47808) available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800)522-2787. (Min: 6
slides) If sending precut slides, do not oven bake.
Unacceptable Conditions: Paraffin block with no tumor tissue remaining. Specimens with fixation delayed for more than 30 minutes. Specimens
fixed in any other fixative other than 10 percent neutral buffered formalin. Tissue fixed for less than 8 hours or greater than 48 hours. Cytology
specimens fixed in alcohol.
CPT Code(s): 88360; if reflexed, add 88368 x2
2002218 ERBB2 (HER2/neu) (4B5) with Interpretation by Immunohistochemistry, Tissue 4B5 IP

kit (ARUP supply #47808) available online through eSupply using ARUP Connect ™ or contact ARUP Client Services at (800)522-2787. (Min: 3
Page | 216
CPT Code(s): 88360
0049218 ERBB2 (HER-2/neu) Gene Amplification by FISH, Tissue HER2FISH

0049390 ERBB2 (HER2/neu) Gene Amplification by PCR HER2 PCR

tissue block or 4 unstained (Min: 2 slides) Transport block and/or slide(s) in a tissue transport kit (ARUP supply #47808) available online through
eSupply using ARUP Connect™or contact ARUP Client Services at (800) 522-2787.
Unacceptable Conditions: Specimens fixed/processed in alternative fixatives (alcohol, Prefer®) or heavy metal fixatives (B-4 or B-5). Decalcified
specimens.
CPT Code(s): 88381 Microdissection; 83907 Lysis; 83898 x2 Amplification; 83912 Interpretation and report - Additional CPT code modifiers may be required
for procedures performed to test for oncologic or inherited disorders.
0049178 ERBB2 (HER2/neu) (HercepTest) by Immunohistochemistry, Tissue with Reflex to FISH if 2+ HERCEP2IP
Fixative duration: 8-48 hours. Transport tissue block or 10 unstained (3-to 5-micron thick sections), positively charged slides in a tissue transport
CPT Code(s): 88360, if reflexed, add 88368 x2
0049172 ERBB2 (HER2/neu) (HercepTest) by Immunohistochemistry, Tissue with Reflex to FISH if 2+ or 3+ HERCE23 IP
CPT Code(s): 88360, if reflexed add 88368 x2
0049174 ERBB2 (HER2/neu) (HercepTest) with Interpretation by Immunohistochemistry, Tissue HERCEPIP

Specimen Required: Collect: Tumor Tissue
Fixative duration: 8-48 hours. Transport tissue block or 5 unstained (3-to 5-micron thick sections), positively charged slides in a tissue transport
Page | 217
CPT Code(s): 88360
0020610 Erythrocyte Porphyrin (EP), Whole Blood FEP

Methodology: Fluorometry
Specimen Required: Collect: Royal blue (EDTA), lavender (EDTA), or pink (K2EDTA). Use royal blue tube when also testing for lead.
Specimen Preparation: Protect from light within one hour of collection and during storage and shipment. Transfer 1 mL whole blood to an
Remarks: Specimen should be tested for lead FIRST to avoid potential contamination problems. Specimens not protected from light acceptable
with a disclaimer.
Unacceptable Conditions: Specimens not collected in EDTA. Clotted specimens.
CPT Code(s): 84202
0050227 Erythropoietin ERYTH

Specimen Preparation: Allow serum to clot completely at room temperature. Separate serum or plasma from cells ASAP or within 2 hours of
Unacceptable Conditions: Bone marrow aspirate. EDTA plasma. Hemolyzed specimens.
CPT Code(s): 82668
0092382 Escitalopram, Serum or Plasma ESCITALO

CPT Code(s): 80299
0049050 Esterase Stain, Nonspecific EST-NS

Methodology: Cytochemical Stain
Specimen Required: Collect: Lavender (EDTA) or green (sodium or lithium heparin). OR heparinized bone marrow aspirate.
Specimen Preparation: Blood: Protect from light. Transport 5 mL whole blood AND 6 unfixed, air-dried, and unstained push smears made from
the blood submitted. (Min: 1 mL AND 6 unfixed smears).
OR Bone Marrow: Protect from light. Transport 1 mL heparinized aspirate AND 6 unfixed, air-dried, and unstained bone marrow aspirate
smears. (Min: 0.5 mL AND 6 unfixed smears).
Storage/Transport Temperature: Room temperature. Specimens should be received within 24 hours of collection; testing must be performed
Unacceptable Conditions: Frozen specimens. Peripheral blood smears older than one year. Anticoagulated blood or bone marrow sent without
well-prepared unfixed smears older than 48 hours.
CPT Code(s): 88319
0049055 Esterase Stain, Specific EST-SP

Specimen Required: Collect: Lavender (EDTA) or green (sodium or lithium heparin). OR heparinized bone marrow aspirate. OR paraffin slides/tissue block.
Specimen Preparation: Blood: Protect from light. Transport 5 mL whole blood AND 6 unfixed, air-dried, and unstained push smears made from
the blood submitted. (Min: 1 mL AND 6 unfixed smears).
OR Bone Marrow: Protect from light. Transport 1 mL heparinized aspirate AND 6 unfixed, air-dried, and unstained bone marrow aspirate
smears. (Min: 0.5 mL AND 6 unfixed smears).
OR Paraffin: Transport tissue block or 4 unstained (4-micron thick sections), in a tissue transport kit (ARUP supply #47808). Available online
through eSupply using ARUP ConnectTM or contact ARUP Client Services at (800) 522-2787. (Min: 4 slides) Protect paraffin block and/or slides
from excessive heat.
Storage/Transport Temperature: Blood and Bone Marrow: Room temperature. Specimens should be received within 24 hours of collection;
testing must be performed within 48 hours of collection.
Paraffin: Room temperature. Blocks and slides must be protected from excessive heat. Ship in cooled containers during summer months.
well-prepared unfixed smears older than 48 hours.
Stability: Blood and Bone marrow: Ambient: 48 hours; Refrigerated: Unacceptable; Frozen: Unacceptable
Paraffin: Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable
CPT Code(s): 88319
0070045 Estradiol, Adult Premenopausal Female, Serum or Plasma ESTRA

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Unacceptable Conditions: EDTA plasma. Grossly hemolyzed or lipemic specimens.
CPT Code(s): 82670
0093247 Estradiol, Males, Children or Postmenopausal Females by Tandem Mass Spectrometry ESDIOL TMS
Specimen Required: Collect: Serum separator tube, lavender (EDTA), pink (K2EDTA) or green (sodium or lithium heparin).
Specimen Preparation: Separate serum or plasma from cells within 2 hours after collection. Transfer 0.5 mL serum or plasma to an ARUP
Standard Transport Tube. (Min 0.3 mL) Indicate age and sex of patient on test request form AND specimen tube.
CPT Code(s): 82670
0070051 Estriol, Serum EST

Remarks: Patient gestational age required.
Stability: After separation from cells: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 1 month (avoid repeated freeze/thaw cycles)
CPT Code(s): 82677
2004516 Estrogen Receptor (ER) by Immunohistochemistry ER IHC

CPT Code(s): 88342
0049210 Estrogen/Progesterone Receptor with Interpretation by Immunohistochemistry ERPR IP

Specimen Preparation: Formalin fix (10 percent neutral buffered formalin) and paraffin embed tissue no later than 1 hour after removal from
patient. Fixative duration: 6-72 hours. If sending precut slides, do not oven bake. Transport tissue block or 5 unstained (3-5 micron thick sections),
positively charged slides in a tissue transport kit (ARUP supply #47808) available online through eSupply using ARUP Connect™ or contact
ARUP Client Services at (800)522-2787.(Min: 4 slides).If sending precut slides, do not oven bake.
Remarks: Document time from tissue acquisition to fixation and fixation duration on submitting requisition or enter at time of order. Include
surgical pathology report.
Unacceptable Conditions: Paraffin block with no tumor tissue remaining. Specimens with fixation delayed for more than one hour. Specimens
fixed in any fixative other than 10 percent neutral buffered formalin. Biopsies fixed for less than 6 hours and greater than 72 hours. Cytology
CPT Code(s): 88360 ER; 88360 PR
0093248 Estrogens, Fractionated by Tandem Mass Spectrometry EST FR TMS

Transport Tube. (Min 0.3 mL)
CPT Code(s): 82671
0093249 Estrone, by Tandem Mass Spectrometry ESTRNE TMS

Specimen Preparation: Separate serum or plasma from cells within 2 hours of collection. Transfer 0.5 mL serum or plasma an ARUP Standard
Transport Tube. (Min 0.3 mL)
CPT Code(s): 82679
0092254 Estronex™ Profile ESTRONEX

Methodology: Ultra Performance Liquid Chromatography-Tandem Mass Spectrophotometry
(High Performance Liquid Chromatography-Tandem Mass Spectrophotometry)
Page | 219
Patient Preparation: Patient should fast for eight hours prior to morning urine collection. Restrict fluid intake to three 8 oz glasses or less for 24
hours. Make sure that no more than 8 oz is consumed after 8:00 PM the evening prior to collection. Empty bladder before going to bed. Collection
is preferred on days 18-25 after the start of the menstrual cycle. Do not collect during menstruation. Timing is not important for post-menopausal
women. Testing is not recommended during pregnancy.
Specimen Required: Collect: Urine, first morning void. Order kit prior to collection (ARUP Supply #40478). Collection kit available online through eSupply using
ARUP Connect or contact ARUP Client Services at (800) 522-2787.
Specimen Preparation: Transport 13 mL urine.
CPT Code(s): 82679 x5 Estrone (2-hydroxyestrone (2-OHE1), 4-hydroxyestrone (4-OHE1),16(16, 2-methoxyestrone (2-MeOE1), 4-methoxyestrone (4-MeOE1
); 82570x1 Creatinine; 82670 Estradiol
0091319 Ethambutol, Serum or Plasma ETHAMBUT

Stability: Ambient: 15 days; Refrigerated: 15 days; Frozen: 15 days
CPT Code(s): 80299
0091472 Ethambutol, Urine ETHAMBU U

CPT Code(s): 80299
0090120 Ethanol, Serum or Plasma - Medical ETOH

Methodology: Quantitative Gas Chromatography/Enzymatic
Specimen Required: Collect: Plain red or gray (sodium fluoride/potassium oxalate). Also acceptable: Lavender (EDTA) or plasma separator tube.
Specimen Preparation: Do not freeze whole blood. Separate serum or plasma from cells immediately after collection. Immediately transfer 2 mL
serum or plasma to a tightly-capped ARUP Standard Transport Tube to minimize alcohol loss. (Min: 0.5 mL) Sodium fluoride/potassium oxalate
whole blood may be transported in the original container.
Stability: After separation from cells: Ambient: 4 hours (if tightly capped); Refrigerated: 1 week (if tightly capped); Frozen: Serum or Plasma: 6
months, Whole Blood: Unacceptable
CPT Code(s): 82055
0090518 Ethanol, Urine, Qualitative - Medical ETOH URN

Specimen Required: Collect: Fresh random urine.
Specimen Preparation: Mix specimen well. Transfer 10 mL aliquot urine to a tightly sealed container for storage and transport. (Min: 0.5 mL)
Stability: Ambient: 4 hours; Refrigerated: 1 week; Frozen: Indefinitely
CPT Code(s): 80101
0091009 Ethchlorvynol, Serum or Plasma ETHCHLO SP

Stability: Ambient: 2 weeks; Refrigerated: 1 year; Frozen: 1 year
CPT Code(s): 82690
0091470 Ethchlorvynol, Urine ETHCHLOR U

Stability: Ambient: 2 weeks; Refrigerated: 1 year; Frozen: 1 year
CPT Code(s): 82690
0090415 Ethosuximide ETHSUX

CPT Code(s): 80168
0090221 Ethotoin ETIN

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Stability: After separation from cells: Ambient: 4 days; Refrigerated: 4 days; Frozen: 3 weeks
CPT Code(s): 80299
2003189 Ethyl Glucuronide, Urine - Screen with Reflex to Confirmation/Quantitation ETHYL GLUC
Methodology: Qualitative Enzyme Immunoassay/Quantitative High Performance Liquid Chromatography-Tandem Mass Spectrometry
CPT Code(s): 80101; if positive add 82055
0090110 Ethylene Glycol ETG

Stability: After separation from cells: Ambient: 1 week; Refrigerated: 2 weeks; Frozen: 1 month
CPT Code(s): 82693
0056008 ETV6-RUNX1 (TEL-AML1) Translocation, t(12;21) by RT-PCR TEL AML1

Specimen Required: Collect: Lavender (EDTA) bone marrow (EDTA).
Specimen Preparation: Transport 5 mL whole blood OR 3 mL bone marrow. (Min: 1 mL whole blood OR 1 mL bone marrow) Specimens must
be received within 48 hours of collection due to lability of RNA...
0092118 Everolimus by Tandem Mass Spectrometry EVEROLIMUS

CPT Code(s): 80299
0051220 Ewing Sarcoma by RT-PCR EWS

Methodology: Reverse Transcription Polymerase Chain Reaction/Fluorescence Monitoring
Specimen Required: Collect: Fresh tissue.
Specimen Preparation: Freeze immediately. Transport 100 mg or 0.5-2.0 cm3 tissue..
Remarks:
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 1 year
CPT Code(s): 83891 Isolation; 83902 Reverse transcription; 83898 x3 Amplification; 83896 x3 Nucleic acid probes; 83912 Interpretation and report. Additional
CPT code modifiers may be required for procedures performed to test for oncologic and inherited disorders.
2004055 Ewing Sarcoma (O13) by Immunohistochemistry O13 IHC

CPT Code(s): 88342
2007225 EWSR1 (22q12) Gene Rearrangement by FISH EWSR1 FISH

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2006332 Exome Sequencing Symptom-Guided Analysis EXOME SEQ

Remarks: A completed Exome Sequencing consent form, signed by the patient (or legal guardian) is required for all specimens. Call Genetics
Processing with additional questions at 800-242-2787 ext 3301.
CPT Code(s): 83891 Isolation; 83909 x3 Capillary electrophoresis; 83898 x3 Amplification; 83904 x100 Sequencing; 83912 Interpretation and report.
2006336 Exome Sequencing Symptom-Guided Analysis, Patient Only EXOSEQ PRO

Specimen Required: Collect: Contact ARUP's genetic counselor at (800) 242-2787 ext. 2141 prior to test submission.
Remarks: A completed Exome Sequencing consent form, signed by the patient (or legal guardian) is required for all specimens. Call Genetics
Processing with additional questions at (800) 242-2787 ext 3301.
CPT Code(s): 83891 Isolation; 83909 x3 Capillary electrophoresis; 83898 x3 Amplification; 83904 x100 Sequencing; 83912 Interpretation and report
0050653 Extractable Nuclear Antigen Antibodies (RNP, Smith, Scleroderma, SSA, & SSB) ENA ABS5
Tube. (Min: 0.3 mL)
Unacceptable Conditions: Plasma or other body fluids. Bacterially contaminated or severely lipemic specimens.
CPT Code(s): 86235 SSA; 86235 SSB; 86235 RNP; 86235 SCLER; 86235 Smith
0050652 Extractable Nuclear Antigen Antibodies (RNP, Smith, SSA, & SSB) ENA ABS4
Tube. (Min: 0.3 mL)
Storage/Transport Temperature: Refrigerated..
CPT Code(s): 86235 SSA; 86235 SSB; 86235 RNP; 86235 Smith
0050791 Extractable Nuclear Antigen Antibodies (SSA & SSB) SSA/SSB

Tube. (Min: 0.3 mL)
CPT Code(s): 86235 SSA; 86235 SSB
0060142 Eye Culture MC EYE

Specimen Required: Collect: Drainage, fluid, or scrapings.
Specimen Preparation: Fluid: Transfer to a sterile container.
Swab: Transfer to bacterial transport media.
Scrapings: Place directly on culture media plates. Media is available from ARUP for direct inoculation, particularly for corneal scrapings.
Unacceptable Conditions: Dry swabs.
CPT Code(s): 87070
0051724 F-Actin (Smooth Muscle) Antibody, IgA ACTIN IGA

Unacceptable Conditions: Plasma. Contaminated, severely hemolyzed, icteric, or lipemic specimens.
CPT Code(s): 83516
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0055248 F-Actin (Smooth Muscle) Antibody, IgG ACTIN IGG
Tube. (Min: 0.3 mL)
Unacceptable Conditions: Urine or plasma. Contaminated, heat-inactivated, hemolyzed, icteric, or severely lipemic specimens.
CPT Code(s): 83516
0051174 F-Actin (Smooth Muscle) Antibody, IgG by ELISA with Reflex to Smooth Muscle Antibody, IgG Titer SMA R
Tube.(Min: 0.25 mL)
Unacceptable Conditions: Plasma. Contaminated, heat-inactivated, hemolyzed, or lipemic specimens.
CPT Code(s): 83516 Actin IgG; if reflexed, add 86256 ASMR Titer
0030007 Factor II, Activity (Prothrombin) F2

Remarks:
CPT Code(s): 85210
0030075 Factor V, Activity F5

Remarks:
CPT Code(s): 85220
0097720 Factor V Leiden (F5) R506Q Mutation FACV

CPT Code(s): 83891 Isolation; 83898 Amplification; 83896 Nucleic acid probes; 83912 Interpretation and report - Additional CPT code modifiers may be
2001549 Factor V, R2 Mutation F5 R2

Methodology: Polymerase Chain Reaction/Restriction Enzyme Digestion/Gel Electrophoresis
Stability: Ambient: 2 weeks; Refrigerated: 2 Weeks; Frozen: Undetermined
CPT Code(s): 83891 Isolation; 83892 Digestion; 83894 Gel separation; 83898 Amplification; 83912 Interpretation and report.
0030080 Factor VII, Activity F7

Remarks:
CPT Code(s): 85230
0030095 Factor VIII, Activity F8

Remarks:
Stability: Ambient: 4 hours; Refrigerated: Unacceptable; Frozen at -20° C: 3 months; Frozen at -70° C: 6 months
CPT Code(s): 85240
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0030026 Factor VIII Activity with Reflex to Bethesda Quantitative, Factor VIII F8 BETHR
Specimen Preparation: Transfer two 3 mL aliquots of platelet-poor plasma to ARUP Standard Transport Tubes. (Min: 2 mL/each)
Remarks:
Unacceptable Conditions: Serum. Non-frozen and hemolyzed specimens.
CPT Code(s): 85240 Factor VIII; if reflexed, add 85335 Bethesda Quantitative
2003881 Factor VIII by Immunohistochemistry FACT 8 IHC

CPT Code(s): 88342
0030100 Factor IX, Activity F9

Remarks: For hemophiliacs: Note dose, date, and time of last factor IX concentrate infusion.
CPT Code(s): 85250
0030032 Factor IX Activity with Reflex to Bethesda Quantitative, Factor IX F9 BETHR

Specimen Preparation: Transfer two 3 mL aliquots of platelet-poor plasma to two ARUP Standard Transport Tubes. (Min: 2 mL/each)
Remarks: For hemophiliacs: Note dose, date, and time of last factor IX concentrate infusion.
CPT Code(s): 85250; if reflexed, add 85335 Bethesda quantitative
0030105 Factor X, Activity F10

Remarks:
CPT Code(s): 85260
0030110 Factor XI, Activity F11

Remarks:
CPT Code(s): 85270
0030115 Factor XII, Activity F12

Remarks:
CPT Code(s): 85280
2003220 Factor XIII (F13A1) V34L Variant FAC 13 MUT

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2002819 Factor XIII, Qualitative, with Reflex to Factor XIII 1:1 Mix FACTOR 13
Methodology: Qualitative Solubility
Remarks:
CPT Code(s): 85291 Factor XIII; if reflexed, add 85291 1:1 Mix
2003878 Factor XIIIa by Immunohistochemistry FAC 13 IHC

CPT Code(s): 88342
2006182 Factor XIII Activity F13 A

Specimen Required: Collect: Lt. blue (sodium citrate). Refer to Specimen Handling at www.aruplab.com for hemostasis/thrombosis specimen handling guidelines.
Unacceptable Conditions: Serum. Non-frozen specimens. Hemolyzed specimens. Wrong anticoagulant (non-sodium citrated plasma).
Stability: Ambient: 4 hours; Refrigerated: Unacceptable; Frozen: at -20°C or below: 1 month; Frozen at -70°C or below: 3 months
CPT Code(s): 85290
2004920 Familial Adenomatous Polyposis (APC) Deletion/Duplication APC DELDUP

2004863 Familial Adenomatous Polyposis (APC) Sequencing APC FGS

2004915 Familial Adenomatous Polyposis Panel: (APC) Sequencing and Deletion/Duplication, (MUTYH) 2 Mutations FAP Panel
CPT Code(s): Sequencing (APC and MUTYH): 83891 Isolation; 83898 x42 Amplification; 83904 x42 Sequencing; 83909 Capillary electrophoresis. Del/Dup:
83896 x17 Nucleic acid probes; 83898 x17 Amplification; 83914 x17 Extension; 83909 Capillary electrophoresis; 83912 Interpretation and report
- Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders.
2002658 Familial Mediterranean Fever (MEFV) Sequencing FMF FGS

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2001961 Familial Mutation, Targeted Sequencing SEQ FSM
Specimen Required: Collect: Contact ARUP's genetic counselor at (800) 242-2787 extension 2141 prior to test submission. Disease-specific patient history forms
are available at www.aruplab.com/Testing-Information/consentforms-patienthistory.jsp
CPT Code(s): 83891 Isolation; 83898 Amplification; 83904 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report. Add the following
for each additional mutation: 83898 Amplification; 83904 Sequencing - Additional CPT code modifiers may be required for procedures
2001980 Familial Mutation, Targeted Sequencing, Fetal SEQ FSM FE

Fetal Specimen: Two T-25 flasks at 80% confluent of cultured amniocytes. If the client is unable to culture amniocytes, this can be arranged
by contacting ARUP Client Services at (800) 522-2787. Or amniotic fluid.
Specimen Preparation: Cultured Amniocytes: Fill flasks with culture media. Transport two T-25 flasks at 80% confluent of cultured amniocytes.
Remarks: Maternal specimen is recommended for proper test interpretation. Order Maternal Cell Contamination.
CPT Code(s): 83891 Isolation; 83898 Amplification; 83904 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report. Add the following
for each additional mutation: 83898 Amplification; 83904 Sequencing. FCC: 83900 Multiplex amplification; 83901 x14 Additional amplification;
83909 Capillary electrophoresis. If MCC Maternal Cell (0050608) is performed, add: 83891 Isolation; 83900 Multiplex amplification; 83901 x14
Additional amplification; 83909 Capillary electrophoresis; 83912 Interpretation and report - Additional CPT code modifiers may be required for
0051468 Fanconi Anemia, Group C (FANCC) 2 Mutations FANCC

CPT Code(s): 83891 Isolation; 83892 x2 Enzymatic digestion; 83900 Amplification multiplex; 83914 x2 Mutation identification; 83909 Separation and
identification; 83912 Interpretation and report - Additional CPT code modifiers may be required for procedures performed to test for oncologic or
inherited disorders.
0051469 Fanconi Anemia, Group C (FANCC) 2 Mutations, Fetal FANCC FE

CPT Code(s): 83891 Isolation; 83892 x2 Digestion; 83900 Amplification multiplex; 83914 x2 Mutation identification; 83909 Separation and identification;
83912 Interpretation and report. FCC: 83900 Amplification multiplex (first two sequences); 83901 x14 Amplification; 83909 Capillary
electrophoresis. If MCC MAT (0050608) is performed: 83891 Isolation; 83900 Amplification multiplex; 83901 x14 Amplification; 83909
Capillary electrophoresis; 83912 Interpretation and report - Additional CPT code modifiers may be required for procedures performed to test for
0060315 Fat, Body Fluid FATBF

Methodology: Qualitative Microscopy
Specimen Preparation: Transport 1 mL body fluid in an ARUP Standard Transport Tube (ARUP Supply #43115). (Min 0.5 mL)
Unacceptable Conditions: Respiratory specimens or breast secretions or milk.
CPT Code(s): 89125
0020385 Fat, Fecal Qualitative FECFAT

Methodology: Qualitative Microscopy/Stain
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Specimen Preparation: Transfer 5 g stool to an unpreserved stool transport vial (ARUP supply #40910). Available online through eSupply using
Stability: Ambient: 1 hour; Refrigerated: 4 days; Frozen: 2 weeks
CPT Code(s): 82705
2002354 Fat, Fecal Quantitative 24-Hour Collection (Includes Homogenization) FECQFAT24

Methodology: Nuclear Magnetic Resonance Spectroscopy
Patient Preparation: The patient should be on a diet consisting of 50 to 150 g of fat per day for 3 days prior to the study.
Specimen Required: Collect: 24-hour stool. Refrigerate during collection. Provide patient a Timed Stool Collection Kit (ARUP supply# 44192). Available online
through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.
Specimen Preparation: Refer to instructions in Stool Collection-Timed Specimens (24, 48, 72 Hours) under Specimen Handling at
www.aruplab.com <http://www.aruplab.com>. Submit entire 24-hour stool collection in an ARUP approved transport container(s) provided in kit
using additional containers as needed for the full collection (available separately, ARUP supply #28077).
Unacceptable Conditions: Random collections. Specimens containing barium or charcoal. Specimens in media or preservatives. Containers larger
than 500 mL (500 g), such as paint cans, will be rejected and discarded.
CPT Code(s): 82710

Specimen Required: Collect: 48-hour stool. Refrigerate during collection. Provide patient a Timed Stool Collection Kit (ARUP Supply# 44192) and an additional fecal
fat container (ARUP Supply #28077). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-
2787.
www.aruplab.com. Submit each 24-hour stool collection in an ARUP approved transport container provided in kit using additional containers as
needed for the full collection (available separately, ARUP Supply #28077).
CPT Code(s): 82710

Specimen Required: Collect: 72-hour stool. Refrigerate during collection. Provide patient a Timed Stool Collection Kit (ARUP Supply# 44192) and 2 additional fecal
fat containers (ARUP Supply #28077). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-
2787.
www.aruplab.com. Submit each 24-hour stool collection in an ARUP approved transport container provided in kit using additional containers as
needed for the full collection (available separately, ARUP Supply #28077).
CPT Code(s): 82710
2002350 Fat, Fecal Quantitative, Homogenized Aliquot FECQ FAT

Specimen Required: Collect: 24, 48, or 72-hour stool collection. Refrigerate during collection.
Specimen Preparation: Weigh entire collection. Homogenize entire collection (using a graduated cylinder, add sufficient water to give "milk
shake" consistency) and aliquot 20 mL (20 g) to a clean, unpreserved vial (ARUP supply #40910). Available online through eSupply using ARUP
Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 5 mL) Refer to instructions in Stool Collection-Timed Specimens (24, 48,
72 Hours) under Specimen Handling at www.aruplab.com.
Remarks: Provide weight of entire collection, volume of water added for homogenization (if applicable), and duration of collection. Complete
information is required in order to perform accurate calculations. If weight and time are not provided it is assumed the collection is random and
alternative testing (Fat, Fecal Qualitative, ARUP test code 0020385) can be performed.
than 500 mL (500 g), such as paint cans, will be rejected and discarded. Submissions without collection time and weight information.
CPT Code(s): 82710 Quantitative
0020240 Fat, Urine Qualitative UFAT

Specimen Preparation: Mix specimen well. Transfer 4 mL urine to an ARUP Standard Transport Tube. (Min: 1 mL).
Unacceptable Conditions: Specimens in preservatives.
CPT Code(s): 89125
0080120 Fatty Acids, Free FFA

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Patient Preparation: Overnight fasting specimen is preferred.
Specimen Required: Collect: Serum separator tube. Collect on ice. Also acceptable: Plasma collected in EDTA, sodium fluoride/potassium oxalate, sodium citrate, or
ammonium oxalate.
Specimen Preparation: Allow serum specimen to clot completely on ice. Serum must be separated from cells and frozen immediately, otherwise
lipase continues to break down triglycerides, giving rise to elevated levels of nonesterified (free) fatty acids. Transfer 1 mL serum to an ARUP
Unacceptable Conditions: Heparinized or non-frozen specimens.
CPT Code(s): 82725
0095302 Fatty Acids Profile, Essential (C12-C22) FA PRO E

Methodology: Gas Chromatography/Mass Spectrometry/Stable Isotope Dilution
Patient Preparation: Patient should fast overnight for 12-14 hours. Patient must not consume any alcohol for 24 hours before the specimen is
drawn.
Specimen Preparation: Separate serum from cells within 45 minutes of draw. Transfer 0.5 mL serum to an ARUP Standard Transport Tube. (Min:
0.15)
Remarks: Patient age is required on the test request form. Include information regarding treatment, family history, and tentative diagnosis.
CPT Code(s): 82544
2001789 Febrile Antibodies Panel FEB ABS

Methodology: Semi-Quantitative Agglutination/Semi-Quantitative Indirect Fluorescent Antibody/Qualitative Immunoblot
Specimen Preparation: Remove serum from cells ASAP or within 2 hours of collection. Transfer 2.5 mL serum to an ARUP Standard Transport
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen 1 year
CPT Code(s): 86622 Brucella; 86757 x4 Rickettsia; 86768 x5 Salmonella
2006069 Febrile Seizures Panel FEBRIL PAN

Methodology: Denaturing High Performance Liquid Chromatography/Sequencing/Multiplex Ligation-dependent Probe Amplification/Polymerase Chain
Reaction
Specimen Required: Collect: Lavender (EDTA)
Stability: Ambient: 3 weeks; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 83891 Isolation, 83892 Digestion, 83896 x26 Nucleic acid probes, 83898 x90 Amplification, 83900 Multiplex amplification, 83901 x24
Amplification, 83904 x90 Sequencing, 83909 x91 Capillary electrophoresis, 83912 Interpretation and report
0094030 Felbamate FELBAMA

Specimen Required: Collect: Plain red. Also acceptable: Lavender (EDTA), pink (K2EDTA), green (sodium heparin), gray (sodium fluoride/potassium oxalate). Avoid
use of separator tubes and gels.
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 1 month; Frozen: 6 months
CPT Code(s): 80299
0092569 Fentanyl and Metabolite - Confirmation/Quantitation - Serum or Plasma CDCO FENSP

freeze/thaw cycles.
CPT Code(s): 83925
0092570 Fentanyl and Metabolite - Confirmation/Quantitation - Urine CDCO FENU

Stability: Ambient: 1 month; Refrigerated: 1 month; Frozen: 9 months
CPT Code(s): 83925
0070065 Ferritin FERITN

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CPT Code(s): 82728
0082024 Fetal Fibronectin FFN

Methodology: Semi-Quantitative Immunoassay/Immunosorbent
Patient Preparation: Specimens for fetal fibronectin testing should be collected prior to collection of culture specimens. Specimens should be
obtained prior to digital cervical examination or vaginal probe, ultrasound examination as manipulation of the cervix may cause the release of fetal
fibronectin.
Testing should not be performed if the patient has had sexual intercourse within 24 hours prior to the sampling time because semen present may
increase the possibility of a false positive result.
Specimen Required: Collect: Swab from the posterior fornix of the vagina or the ectocervical region of the external cervical os. Do not to contaminate the swab or
cervicovaginal secretions with lubricants, soaps disinfectants or creams.
Specimen Preparation: Specimens that are not tested within eight hours of collection must be stored, refrigerated, and tested within 72 hours of
collection. Avoid extreme temperatures. Transport swab in Fetal Fibronectin Specimen Collection Kit (ARUP supply #32748). Available online
through eSupply using ARUP Connect (TM) or contact Client Services at (800) 522-2787. Required Information: Specimen must be labeled
with gestational age and list patient condition as either "symptomatic" or "asymptomatic."
Unacceptable Conditions: Specimens collected in or by any specimen device other than Fetal Fibronectin Specimen Collection Kit.
Stability: Ambient: 8 hours; Refrigerated: 3 days; Frozen: 2 weeks Only one freeze/thaw cycle acceptable.
CPT Code(s): 82731
0020156 Fetal Hemoglobin, APT Test APT

Specimen Required: Collect: Gastric aspirate or stool with fresh red blood.
Specimen Preparation: Transport 1 mL gastric aspirate or stool.
Unacceptable Conditions: Frozen stool. Specimens without visible fresh red blood.
CPT Code(s): 83033
2001743 Fetal Hemoglobin Determination for Fetomaternal Hemorrhage FHGB

Patient Preparation: Maternal, pregnant or post-partum whole blood.
Unacceptable Conditions: Frozen specimens. Clotted or hemolyzed specimens. Specimens older than 72 hours. Specimens from males or non-
pregnant females.
CPT Code(s): 86356 HgB-F
0011510 Fetal Screen FS

Methodology: Red Blood Cell Rosetting
Patient Preparation: Collect specimen after delivery.
Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), green (sodium or lithium heparin), or yellow (ACD Solution A).
Specimen Preparation: Do not freeze. Transport 5 mL whole blood. (Min: 0.5 mL)
Remarks:
Unacceptable Conditions: Separator or gel tubes. Frozen specimens.
CPT Code(s): 85461
0051752 FG Syndrome, FGS1 (MED12) R961W Mutation FGS 1

CPT Code(s): 83891 Isolation; 83898 Amplification; 83896 x 2 Nucleic acid probes; 83912 Interpretation and report - Additional CPT code modifiers may be
required for procedure performed to test oncologic or inherited disorders.
2007099 FGFR2 Gene Amplification by FISH FGFR2 FISH

Page | 229
0030140 Fibrin/Fibrinogen Degradation Split Products FDP
Methodology: Latex Agglutination
Specimen Required: Collect: Whole blood drawn into tube with Thrombin/Soybean trypsin inhibitor. (ARUP supply #16496) Available online through eSupply using
ARUP Connector contact ARUP Client Services at (800) 522-2787.
Unacceptable Conditions: Plasma. Specimens not collected in Thrombin/Soybean trypsin inhibitor or that have not clotted.
CPT Code(s): 85362
2006491 Fibrin/Fibrinogen Degradation Split Products, Plasma FDP PLASMA

Specimen Required: Collect: Lt. blue (sodium citrate).
Stability: Ambient: 8 hours; Refrigerated: Unacceptable; Frozen: 1 month at -20°C, 1 year at -70°C.
CPT Code(s): 85362
0030130 Fibrinogen FIB

Methodology: Electromagnetic Mechanical Clot Detection
Specimen Preparation: Separate plasma from cells ASAP or within 2 hours of collection. Transfer 1 mL platelet-poor plasma to an ARUP
Standard Transport Tube.
Unacceptable Conditions: Serum. Clotted, hemolyzed, or non-frozen specimens.
CPT Code(s): 85384
0030135 Fibrinogen Antigen FIBAG

Methodology: Radial Immunodiffusion
CPT Code(s): 85385
0030137 Fibrinogen Panel FIB PAN

Methodology: Electromagnetic Mechanical Clot Detection/Radial Immunodiffusion
Unacceptable Conditions: Serum. Hemolyzed specimens. Specimens older than 24 hours.
CPT Code(s): 85384 Fibrinogen; 85385 Fibrinogen Ag
0098411 Fibronectin Aggregates IgA, ELISA FIB-IGA

Methodology: Enzyme-Linked Immunoassay
(Enzyme-Linked Immunosorbent Assay)
Specimen Preparation: Transport 1 mL serum. (Min: 0.5 mL)
Stability: Ambient: 1 week; Refrigerated: 2 months; Frozen: 3 years
CPT Code(s): 83516
2004745 FibroSURE HCV FIBRO

Methodology: Semi-Quantitative Immunologic/Colorimetry/Kinetic/Nephelometry
Patient Preparation: Patient must be 14 years of age or older.
Specimen Preparation: Separate from cells within one hour of collection. Transfer 3 mL serum to an ARUP standard Transport Tube. (Min: 3 mL)
Remarks: Patient age and gender must be included on the request form.
Unacceptable Conditions: Grossly hemolyzed or lipemic specimens.
CPT Code(s): 82172 Apolipoprotein A-1; 82247 Total bilirubin; 82977 Gamma Glutamyl Transferase; 83010 Haptoglobin; 83883 A2-Macroglobulin; 84460
Alanine Aminotransferase.
0099598 Filaria IgG4 Antibody FILARIASIS

CPT Code(s): 86682
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0090003 Flecainide FLEC
Specimen Required: Collect: Plain red. Also acceptable: Lavender (EDTA), pink (K2EDTA or K3EDTA), green (sodium or lithium heparin), or gray (sodium
fluoride/potassium oxalate).
Specimen Preparation: Separate serum or plasma from cells within 6 hours of collection. Transfer 2 mL serum to an ARUP Standard Transport
Tube. (Min: 0.5 mL)
Unacceptable Conditions: Gel separator tubes or gels of any kind; drug loss is immediate and no testing will be performed.
Stability: After separation from cells: Ambient: 6 weeks; Refrigerated: 6 weeks; Frozen: 6 weeks
CPT Code(s): 80299
2005400 FLT3 Mutation Detection by PCR FLT3 MUTAT

Methodology: Qualitative Polymerase Chain Reaction/Capillary Electrophoresis
Specimen Required: Collect: Lavender (EDTA), yellow (ACD solution A or B), or green (sodium or lithium heparin).
Specimen Preparation: Transport 5 mL whole blood (Min: 4 mL) OR 3 mL bone marrow. (Min: 1 mL) Separate specimens must be submitted
when multiple tests are ordere
Unacceptable Conditions: Serum or plasma. Frozen specimens. Clotted whole blood. Severely hemolyzed specimens.
CPT Code(s): 83891 Isolation; 83898 x2 Amplification; 83892 Digestion; 83909 x2 Separation and identification; 83912 Interpretation and report
0097621 Fluconazole, Quantitation by LC-MS/MS FLUCON

Specimen Required: Collect: Plain red, lavender (EDTA), or green (sodium or lithium heparin).
Unacceptable Conditions: Lipemic specimens.
CPT Code(s): 80299
0091116 Flunitrazepam and Metabolites, Serum or Plasma - Screen with Reflex to Confirmation/Quantitation FLUNITR SP
Specimen Preparation: Remove serum or plasma from cells within 2 hours. Transfer 3 mL serum or plasma to an ARUP Standard Transport Tube.
(Min: 1.4 mL)
0091163 Flunitrazepam and Metabolites, Urine - Screen with Reflex to Confirmation/Quantitation FLUNITR UR
0091341 Fluoride, Serum or Plasma FLUORIDE

Methodology: Quantitative Ion Chromatography
(Ion Exchange Chromatography)
Specimen Preparation: Separate from cells within 2 hours. Transfer 2 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 1 mL)
Unacceptable Conditions: Gray (potassium oxalate/sodium fluoride) or separator tubes.
CPT Code(s): 82735
0091515 Fluoride, Urine FLUORIDE U

Methodology: Quantitative Ion-Specific Electrode/Colorimetry
(Ion-Selective Electrode/Colorimetry)
Patient Preparation: Avoid exposure to gadolinium-based contrast media for 48 hours prior to specimen collection.
Specimen Required: Collect: Urine collected in a trace metal-free or acid-washed plastic container.
Specimen Preparation: Transport 6 mL urine. (Min: 3 mL) Submit in 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.
CPT Code(s): 82735 Fluoride; 82570 Creatinine
2007228 5-Fluorouracil (5-FU) Toxicity and Chemotherapeutic Response, 7 Mutations 5-FU PANEL
Methodology: Polymerase Chain Reaction/Single Nucleotide Extensions/Fragment Analysis
Page | 231
CPT Code(s): 83891 Isolation; DPYD: 83900 x2 Multiplex amplification; 83901 Additional amplification; 83914 x5 Extension; 83909 Capillary electrophoresis;
TYMS: 83898 x2 Amplification; 83892 Digestion; 83909 Capillary electrophoresis; 83912 Interpretation and report - Additional CPT code
modifiers may be required for procedures performed to test for oncologic or inherited disorders. (2012 CPT codes: 81401 MOPATH Procedure
Level 2 (identification of 2-10 SNPs))
0090450 Fluoxetine and Metabolite FLUOX

0099906 Fluphenazine FLUPHEN

Patient Preparation: Measure at least two weeks after initiating treatment.
Specimen Required: Collect: Plain red. Also acceptable: Lavender (K2 or K3EDTA) or pink (K2 EDTA).
CPT Code(s): 84022
0090180 Flurazepam NDES

CPT Code(s): 82742
0091234 Fluvoxamine, Serum or Plasma FLUVOXAM

CPT Code(s): 80299
0070385 Folate, RBC RBCFOLATE

Specimen Preparation: Protect from light during collection, storage, and shipment. Mix specimen well. Transfer 1 mL whole blood to an
ARUP Amber Transport Tube.
Remarks: Hematocrit must be performed and indicated on the test request form. If the patient has not received a transfusion or
experienced excessive bleeding between the RBC folate draw and the hematocrit draw, any hematocrit drawn within 24 hours of the RBC
folate draw is acceptable.
Unacceptable Conditions: Non-frozen specimens. Clotted specimens.
CPT Code(s): 82747
0070070 Folate, Serum FOL

Specimen Preparation: Protect from light during collection, storage, and shipment. Transfer 1 mL serum to ARUP Amber Transport Tube. (Min:
0.5 mL)
Unacceptable Conditions: Specimens collected in EDTA. Hemolyzed or heparinized specimens. Refrigerated specimens exposed to light for more
than 24 cumulative hours.
CPT Code(s): 82746
0070055 Follicle Stimulating Hormone, Serum FSH

(K2EDTA).
Specimen Preparation: Pooled specimens must be all serum or all plasma. Allow specimen to clot completely at room temperature and separate
serum or plasma from cells ASAP or within 2 hours of collection. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min:
0.3 mL)
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CPT Code(s): 83001
0091517 Formic Acid, Serum or Plasma FORMIC P

Methodology: Ion Chromatography
Specimen Required: Collect: Green (sodium or lithium heparin) or plain red.
Unacceptable Conditions: Gray (sodium fluoride/potassium oxalate) or separator tubes.
CPT Code(s): 83921
0091509 Formic Acid, Urine FORMIC UR

Patient Preparation: Collect urine prior to the last shift of the work week.
CPT Code(s): 82570 Creatinine; 83921 Formic acid
2001497 FOXO1 (FKHR) (13q14) Gene Rearrangement by FISH FKHRFISH

0040011 Fragile X (FMR1) Diagnostic FRAG X

Methodology: Southern Blot/Polymerase Chain Reaction/Fragment Analysis
Storage/Transport Temperature: Room temperature. If transport time will exceed 48 hours: Refrigerated.
CPT Code(s): PCR: 83898 x2 Amplification; 83909 Capillary electrophoresis Southern Blot: 83891 Isolation; 83892 x2 Digestion; 83894 Gel Separation;
83897 Southern transfer; 83896 Nucleic acid probe; 83912 Interpretation & report - Additional CPT code modifiers may be required for
0050543 Fragile X (FMR1) Diagnostic, Fetal FRAG X FE

Methodology: Southern Blot/Polymerase Chain Reaction/Fragment Analysis
Specimen Required: Collect: Fetal Specimen: Four T-25 flasks at 80 percent confluency of cultured amniocytes. If the client is unable to culture amniocytes, this
can be arranged by contacting ARUP Client Services at (800) 522-2787. Or amniotic fluid. Amniotic fluid submissions will require cultured
amniocytes (Order Amniocyte Culture, Four Flask).
Specimen Preparation: Cultured Amniocytes: Fill flasks with culture media. Transport four T-25 flasks at 80 percent confluency of cultured
due to viability of cells.
CPT Code(s): PCR: 83898 x2 Amplification; 83909 Capillary electrophoresis Southern Blot: 83891 Isolation; 83892 x2 Digestion; 83894 Gel separation;
83897 S. trans; 83896 Nucleic acid probe; 83912 Interpretation and report Fetal Cell Contamination (FCC): 83900 Amplification multiplex;
83901 x14 Amplification; 83909 Capillary electrophoresis Maternal Cell Contamination (MCC) (0050608): 83891 Isolation; 83900
Amplification; 83901 x 14 Amplification; 83909 Capillary electrophoresis; 83912 Interpretation and report - Additional CPT code modifiers may
2001946 Fragile X (FMR1) Screen with Reflex to Fragile X (FMR1) Diagnostic FRAG X SCR
Patient Preparation: For buccal collection, the patient should not eat, drink, smoke, or chew gum for 30 minutes before collecting oral samples.
Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B). Or, one buccal sponge using the ORAcollect™collection kit
(ARUP supply #49295)
Specimen Preparation: Transport 3 mL whole blood. (Min: 3 mL); or, one buccal sponge in the ORAcollect™collection kit.
Storage/Transport Temperature: For whole blood, ship refrigerated. For buccal sponge, ship at room temperature.
Remarks: Use only the ORAcollect™kit for buccal sampling. Other buccal collection devices (e.g., swab) are not acceptable for testing.
Page | 233
CPT Code(s): 83891 Isolation; 83898 Amplification; 83909 Capillary electrophoresis; 83912 Interpretation & report; if reflexed, add PCR: 83891 Isolation;
83898 x2 Amplification; 83909 Capillary electrophoresis. Southern Blot: 83891 Isolation; 83892 x2 Digestion; 83894 Gel Separation; 83897
Southern transfer; 83896 Nucleic acid probe; 83912 Interpretation & report - Additional CPT code modifiers may be required for procedures
2005350 Francisella tularensis Antibodies, IgG and IgM FTULARPAN

Specimen Required: Collect: Serum separator tube (SST), lavender (EDTA), Lt. blue (sodium citrate) or green (sodium or lithium heparin).
Unacceptable Conditions: Contaminated, heat-inactivated, or turbid specimens.
2005353 Francisella tularensis Antibody, IgG FTULARG

CPT Code(s): 86668
2005354 Francisella tularensis Antibody, IgM FTULARM

CPT Code(s): 86668
2006160 Free Estradiol by ED/LC-MS/MS ESDIOL FR

Methodology: Quantitative Equilibrium Dialysis/High Performance Liquid Chromatography-Tandem Mass Spectrometry
Specimen Required: Collect: Serum separator tube or green (sodium or lithium heparin), Red Top, Plasma Separator Tube.
Specimen Preparation: Separate from cells ASAP or within 2 hours of collection. Transport 2 mL serum or plasma. (Min: 1.0 mL)
Stability: After separation from cells: Ambient: unacceptable; Refrigerated: 1 week; Frozen: 6 months
CPT Code(s): 82670
2002662 Freeman-Sheldon Syndrome (MYH3) Sequencing Exon 17 FSS SEQ

CPT Code(s): 83891 Isolation; 83898 x2 Amplification; 83904 x2 Sequencing; 83909 Capillary electrophoresis, 83912 Interpretation and report. Additional CPT
2003887 Friend Leukemia Integration-1 (Fli-1) by Immunohistochemistry FLI1 IHC

CPT Code(s): 88342
0099012 Fructosamine FRUCTOSAM

Specimen Preparation: Allow specimen to clot completely at room temperature before centrifuging. Transfer 0.5 mL serum or plasma to an ARUP
Unacceptable Conditions: Hemolyzed specimens (may cause falsely elevated results).
CPT Code(s): 82985
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0080112 Fructose, Semen FRUCTOSE
Specimen Required: Collect: Semen.
Specimen Preparation: Specimen should be frozen within 2 hours of collection. (Min: 0.3 mL)
Storage/Transport Temperature: CRITICAL FROZEN. Separate specimens must be submitted with multiple tests are ordered.
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 2 years
CPT Code(s): 82757
0050750 Fungal Antibodies by CF, CSF FUNG CSF

CPT Code(s): 86606 Aspergillus; 86612 Blastomyces; 86635 Coccidioides; 86698 x2 Histoplasma (M & Y)
0050605 Fungal Antibodies by CF, Serum FUNG PKG

CPT Code(s): 86606 Aspergillus; 86612 Blastomyces; 86635 Coccidioides; 86698 x2 Histoplasma (M & Y)
0050164 Fungal Antibodies by ID FUNG PPT

Unacceptable Conditions: Body fluid.
CPT Code(s): 86606 Aspergillus; 86612 Blastomyces; 86635 Coccidioides; 86698 Histoplasma
0060149 Fungal Culture MC FUNG

Specimen Required: Collect: Material or fluid from any body site, except blood, hair, nails, or skin.
Specimen Preparation: Transport specimen in a sterile container. (Min: 1 mL fluid) Also acceptable: Swabs (but sub-optimal for recovery of
fungi). A single specimen may be cultured for both bacteria and fungi. Place each specimen in an individually sealed bag.
Storage/Transport Temperature: Specimens from a sterile body site (fluids, tissues, etc.): Room temperature.
Specimens from a nonsterile site (respiratory, GI tract, etc.): Refrigerated.
If CSF cannot be transported within eight hours, hold at 35°C until the time of transport.
Remarks: Specimen source required. Notify laboratory if Malassezia furfur is suspected, special media must be used for the cultivation of this
yeast.
Unacceptable Conditions: Catheter tips.
Stability: Ambient: CSF: 48 hours, All others: 72 hours; Refrigerated: 1 week; Frozen: Unacceptable
CPT Code(s): 87102
0060728 Fungal Culture, Skin, Hair or Nails MC FUNGSHN

Specimen Required: Collect: Clippings or scrapings of skin, hair, or nails.
Specimen Preparation: Transfer clippings or scrapings to sterile container.
Remarks: Specimen source required. Indicate suspected organism(s).
Unacceptable Conditions: Specimens other than skin, hair or nails, refer to Fungal Culture (ARUP test code 0060149).
Stability: Ambient: 2 weeks; Refrigerated: 1 week; Frozen: Unacceptable
CPT Code(s): 87101
0060756 Fungal Identification by ITS rDNA Sequencing MC YSTSEQ

Specimen Required: Collect: Actively growing mould or yeast in pure culture.
Unacceptable Conditions: Isolates from environmental sources. Mixed cultures or non-viable organisms. Agar plate.
CPT Code(s): 87153
0060163 Fungal (Mould/Yeast) Identification MC FUNGID

Specimen Required: Collect: Actively growing mould or yeast in pure culture.
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Unacceptable Conditions: Mixed cultures or non-viable organisms. Isolates from environmental sources. Agar plate.
CPT Code(s): Varies based on identification methods
2004589 Fungal Stain, KOH with Calcofluor White CWP-KOH

Specimen Required: Collect: Corneal or skin scrapings, hair, nail clippings, respiratory specimens, or tissue.
Specimen Preparation: Do not put nail clippings or hair in a moist environment (saline).Transport specimen in a sterile container.
Unacceptable Conditions: Swabs, blood, or bone marrow. Specimens submitted in gauze.
CPT Code(s): 87206
0091263 Furosemide, Serum or Plasma FUROSEM

Specimen Preparation: Transfer to 2 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.7 mL)
CPT Code(s): 80299
0091469 Furosemide, Urine FUROSE U

Specimen Preparation: Transfer 1 mL urine to an ARUP Amber Transport Tube. (Min: 0.25 mL)
CPT Code(s): 80299
0090057 Gabapentin GABAP

CPT Code(s): 80299
2006301 Gabapentin Quantitation, Urine GAB UR

CPT Code(s): 80299
0092442 Galactokinase, Blood GALACTOKI

Methodology: Quantitative Radioisotopic
Specimen Preparation: Transfer 5 mL whole blood to ARUP Standard Transport Tubes. (Min: 1 mL) Do not freeze. Specimen must be received
within 48 hours of draw. Submit to vendor lab directly; contact ARUP Referral Testing for direct submission procedure.
Remarks: Date of draw is required.
CPT Code(s): 82759
0081296 Galactose-1-Phosphate in Red Blood Cells GAL1P RBC

Specimen Required: Collect: Lavender (EDTA) or green (sodium or lithium heparin).
Specimen Preparation: DO NOT FREEZE. Place tube on wet ice immediately after collection. Transport 5 mL whole blood. (Min: 2 mL)
CPT Code(s): 84378
0080125 Galactose-1-Phosphate Uridyltransferase G1PUT

Specimen Required: Collect: Green (sodium or lithium heparin), lavender (EDTA), or pink (K2EDTA). Collect on ice.
Specimen Preparation: DO NOT FREEZE. Transport 7 mL whole blood. (Min: 3 mL)
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Stability: Ambient: Unacceptable; Refrigerated: 5 days; Frozen: Unacceptable
CPT Code(s): 82775
0051176 Galactosemia, (GALT) 9 Mutations GALTDNA

Methodology: Polymerase Chain Reaction/Single Nucleotide Extensions
Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or green (sodium heparin).
CPT Code(s): 83891 Isolation; 83898 Amplification; 83914 x9 Mutation identification; 83909 Capillary electrophoresis; 83912 Interpretation and report -
0051270 Galactosemia (GALT) 9 Mutations, Fetal GALTDNA FE

Specimen Required: Collect: Cultured cells: Two T-25 flasks at 80% confluent of cultured amniocytes. If the client is unable to culture amniocytes, this can be
Maternal specimen: Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B).
Specimen Preparation: Fetal Specimen: Fill flasks with culture media. Transport two T-25 flasks at 80% confluent of cultured amniocytes filled
with culture media. Backup cultures must be retained at the client's institution until testing is complete.
Storage/Transport Temperature: Fetal Specimen: CRITICAL ROOM TEMPERATURE. Must be received within 48 hours of shipment due to
lability of cells.
Maternal Specimen: Room temperature.
Remarks: Maternal specimen is recommended for proper test interpretation. Order Maternal Cell Contamination. Patient History Forms
are available on aruplab.com or by contacting ARUP Client Services.
CPT Code(s): 83891 Isolation; 83898 Amplification; 83914 x9 Mutation identification; 83909 Capillary electrophoresis; 83912 Interpretation and report. FCC:
83900 Amplification multiplex (first two sequences); 83901 x14 Amplification; 83909 Capillary electrophoresis. If MCC MAT (0050608) is
performed: 83891 Isolation; 83900 Amplification multiplex (first two sequences); 83901 x14 Amplification; 83909 Capillary electrophoresis;
83912 Interpretation and report - Additional CPT code modifiers may be required for procedures performed to test for oncological or inherited
disorders.
0051175 Galactosemia (GALT) Enzyme Activity and 9 Mutations GALTPAN

Methodology: Enzymatic/Polymerase Chain Reaction/Single Nucleotide Extensions
Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or green (sodium heparin).
Remarks:
CPT Code(s): 82775 Enzymatic; 83891 Isolation; 83898 Amplification; 83914 x9 Mutation identification; 83909 Capillary Electrophoresis; 83912 Interpretation
2007138 Galectin-3, Serum GALECTIN

Specimen Required: Collect: Serum separator tube (SST) or plain red
collection. Transport 1 mL serum. (Min: 0.2 mL)
Unacceptable Conditions: Plasma. Specimens stored or transported at room temperature for more than 48 hours. Severely hemolyzed specimens
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 4 months (Avoid repeated freeze/thaw cycles)
CPT Code(s): 83520
2006697 GALT (Galactosemia) Sequencing GALT FGS

Patient Preparation:
Specimen Required: Collect: Contact ARUP's genetic counselor at (800) 242-2787 extension 2141 prior to test submission. A patient history from speficif for
Galactosemia must be submitted with specimen; available at at http://aruplab.com/genetics/forms.php
CPT Code(s): 83891 Isolation; 83898 x7 Amplification; 83904 x7 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report
0020009 Gamma Glutamyl Transferase, Serum or Plasma GT

Specimen Required: Collect: Serum separator tube or plasma separator tube. Also acceptable: Pink (K2EDTA).
CPT Code(s): 82977
0091193 Gamma-Hydroxybutyric Acid, Serum or Plasma - Screen with Reflex to Confirmation/Quantitation GHB SP
Methodology: Qualitative Gas Chromatography-Mass Spectrometry/Quantitative Gas Chromatography-Mass Spectrometry
Specimen Required: Collect: Plain red, lavender (EDTA), or pink (K2EDTA). Also acceptable: Gray (sodium fluoride/potassium oxalate) or green (sodium heparin).
Page | 237
Specimen Preparation: Separate serum or plasma from cells within 2 hours. Transfer 6 mL serum to ARUP Standard Transport Tubes. (Min: 2.4
mL)
Unacceptable Conditions: Separator tubes or citrate buffered tubes.
Stability: Ambient: 1 week; Refrigerated: 1 week; Frozen: 1 week
0091161 Gamma-Hydroxybutyric Acid, Urine - Screen with Reflex to Confirmation/Quantitation GHB U

Methodology: Qualitative Gas Chromatography-Mass Spectrometry/Quantitative Gas Chromatography-Mass Spectrometry
Specimen Preparation: Transfer 5 mL urine to ONE transport container. (Min: 2.4 mL)
Stability: Ambient: 1 week; Refrigerated: 1 week; Frozen: 1 week
0051033 Ganglioside (Asialo-GM1, GM1, GM2, GD1a, GD1b, and GQ1b) Antibodies GM1 COMBI
Specimen Preparation: Separate serum from cells ASAP. Transfer 0.3 mL serum to an ARUP Standard Transport Tube. (Min: 0.1 mL)
Unacceptable Conditions: Room temperature specimens. Plasma, CSF, or other body fluids. Contaminated, heat-inactivated, hemolyzed , severely
icteric, or lipemic specimens.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 2 weeks; Frozen: 1 year
0050591 Ganglioside (GM1) Antibodies, IgG and IgM GM1 PAN

Tube. (Min: 0.1 mL)
Unacceptable Conditions: Room temperature specimens. Plasma, CSF, or other body fluids. Contaminated, heat-inactivated, hemolyzed, icteric, or
severely lipemic specimens.
2004998 Ganglioside (GM1, GD1b, and GQ1b) Antibodies, IgG and IgM GM1 LIGHT
Unacceptable Conditions: CSF, plasma, or other body fluids. Room temperature specimens. Contaminated, heat-inactivated, hemolyzed, severely
0020149 Gastric Analysis GASTRIC

Methodology: Quantitative Titration
Specimen Required: Collect: Gastric aspirate.
Specimen Preparation: Transport 10 mL gastric aspirate. (Min: 1 mL) Record collection time interval on transport tube and test request form.
CPT Code(s): 82930
0099484 Gastric Inhibitory Polypeptide GIP

Patient Preparation: Patient should be fasting for 10-12 hours prior to collection of specimen. Medications affecting intestinal motility or
insulin levels should be discontinued, if possible, 48 hours prior to collection.
Specimen Required: Collect: GI Preservative tube (ARUP supply #47531). Available online through eSupply using ARUP Connect or by contacting ARUP Client
Services at (800) 522-2787 . Tubes for this test are provided at a cost of $30 each.
Specimen Preparation: Separate from cells within 10 minutes. Transfer 3 mL plasma to an ARUP Standard Transport Tube and freeze
CPT Code(s): 83519
0070075 Gastrin GAST

Patient Preparation: Patient fast for 12 hours prior to collection is recommended.
Unacceptable Conditions: Plasma, Tissue or Urine. Grossly hemolyzed or lipemic specimens.
CPT Code(s): 82941
2003896 Gastrin by Immunohistochemistry GASTRI IHC

Page | 238
CPT Code(s): 88342
2002674 Gastrointestinal Stromal Tumor Mutation GIST MUT

Methodology: Polymerase Chain Reaction/High Resolution Melting
tissue block or 6 unstained 5 microns slides. (Min: 4 slides).
Storage/Transport Temperature: Room temperature. Ship in cooled container during summer months.
Unacceptable Conditions: Specimens fixed/processed in alternative fixatives (alcohol, Prefer ®). Decalcified specimen. Less than 25 percent
tumor.
CPT Code(s): 88381 Microdissection; 83907 Lysis; 83898 x2 Amplification; if additional exons are required, add 83898 Amplification times number of exons
tested; 83912 Interpretation and report - Additional CPT code modifiers may be required for procedures performed to test for oncologic or
0051438 Gaucher (GBA) 8 Mutations GBA

0051439 Gaucher (GBA) 8 Mutations, Fetal GBA FE

CPT Code(s): 83891 Isolation; 83892 x2 Digestion; 83900 Multiplex amplification; 83914 x8 Extension; 83909 Capillary electrophoresis; 83912 Interpretation
and report. FCC: 83900 Multiplex amplification (first two sequences); 83901 x14 Additional amplification; 83909 Capillary electrophoresis. If
MCC MAT (0050608) is performed: 83891 Isolation; 83900 Multiplex amplification; 83901 x14 Additional amplification; 83909 Capillary
electrophoresis; 83912 Interpretation and report - Additional CPT code modifiers may be required for procedures performed to test for oncologic
2005633 Genomic SNP Microarray, Products of Conception ARRAY POC

Specimen Required: Collect: Fetal tissue or villi from products of conception. Also acceptable: Culture flasks. A maternal blood sample may be requested to exclude
maternal cell contamination / overgrowth in long term cultures.
Specimen Preparation: Transport 5 mg specimen in transport medium. (Min: 5 mg)
Storage/Transport Temperature: Room temperature (fresh tissue or culture flask).
Unacceptable Conditions: Specimens consisting of maternal tissue (decidua) only. Autolyzed or contaminated specimens.
Stability: Ambient: 48 hours; Refrigerated: 72 hours; Frozen: Indefinitely.
CPT Code(s): 83891 Isolation; 88386 x6 Array-based evaluation of multiple molecular probes, 251-500
0090305 Gentamicin, Peak Level GENTP

Patient Preparation: Draw 30 minutes following completion of infusion.
Specimen Required: Collect: Plain red. Also acceptable: Heparinized plasma.
Specimen Preparation: Allow specimen to clot completely. Separate serum or plasma from cells. Transfer 1 mL serum to an ARUP Standard
Unacceptable Conditions: Separator tubes. Plasma collected in the presence of citrate or oxalate/fluoride or EDTA. Hemolyzed specimens.
Page | 239
Stability: After separation from cells: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 2 weeks (avoid repeated freeze/thaw cycles)
CPT Code(s): 80170
0090130 Gentamicin, Random Level GENT

Transport Tube. (Min: 0.5 mL) Also acceptable: Heparinized plasma.
Remarks: .
Unacceptable Conditions: Separator tubes. Plasma collected in the presence of citrate or oxalate/fluoride or EDTA. Hemolyzed specimens.
CPT Code(s): 80170
0090310 Gentamicin, Trough Level GENTT

Patient Preparation: Draw specimen 30 minutes before next infusion.
Transport Tube. (Min: 0.5 mL) Also acceptable: Heparinized plasma.
Unacceptable Conditions: Separator tubes. Plasma collected in citrate or oxalate/fluoride tubes. Hemolyzed specimens.
CPT Code(s): 80170
0060048 Giardia Antigen by EIA GLAM

Specimen Preparation: Preserve 5g stool in 10 percent formalin (ARUP supply #16355) within one hour of collection. Available online through
eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 1g)
Unacceptable Conditions: Unpreserved stool. Specimens in any preservative other than indicated above.
CPT Code(s): 87329
0099439 Giardia lamblia Antibody by IFA GIARDIA AB

Stability: Ambient: 1 week; Refrigerated: 2 months; Frozen: 3 years
CPT Code(s): 86674
0051476 Glaucoma (Primary Congenital), CYP1B1 Sequencing CYP1B1

2003899 Glial Fibrillary Acidic Protein (GFAP) by Immunohistochemistry GFAP IHC

CPT Code(s): 88342
0091357 Glipizide, Serum or Plasma GLIPIZID

CPT Code(s): 80299
Page | 240
0049190 Glomerular Basement Membrane Antibodies, IgA & IgG (IFA) GBM IFA
Methodology: Indirect Fluorescent Antibody
CPT Code(s): 86255 GBM IgA; 86255 GBM IgG
0049192 Glomerular Basement Membrane Antibody, IgA (IFA) GBM-A IFA

CPT Code(s): 86255
0051000 Glomerular Basement Membrane Antibody, IgG by Multi-Analyte Fluorescent Detection GBM-G ELIS
CPT Code(s): 83516
0049191 Glomerular Basement Membrane Antibody, IgG (IFA) GBM-G IFA

CPT Code(s): 86255
0051001 Glomerular Basement Membrane Antibody Panel GBM PAN

Methodology: Semi-Quantitative Multiplex Bead Assay/Qualitative Indirect Fluorescent Antibody
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer two 1 mL aliquots of serum to individual ARUP
Standard Transport Tubes. (Min: 1 mL)
CPT Code(s): 83516 GBM ELISA; 86255 GBM IgA; 86255 GBM IgG
0020725 Glomerular Filtration Rate, Estimated GFRE

Specimen Required: Collect: Plasma separator tube or serum separator tube. Also acceptable: Lavender (EDTA).
Unacceptable Conditions: Specimens obtained through catheters used to infuse hyperalimentation fluid. Specimens collected with potassium
oxalate/sodium fluoride or sodium citrate.
CPT Code(s): 82565
0099165 Glucagon GLUCA

Specimen Required: Collect: Protease Inhibitor tube.
Specimen Preparation: Protease Inhibitor tube (ARUP supply #49662), available online through eSupply using ARUP Connect™ or contact
ARUP Client Services at (800) 522-2787. A winged collection set must be used. NOT RECOMMENDED: Filling collection tubes directly
through a needle/tube-holder assembly increases the risk of chemical reflux back into the vein of the patient. WARNING: Collection tubes are
NOT STERILE. Mix Collection tube thoroughly. Separate the plasma from cells within 1 hour of collection by centrifugation. Transfer 1 mL
plasma to an ARUP Standard Transport Tube and freeze. (Min: 0.5 mL) Do not submit the collection tube for testing.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 72 hours; Frozen: 3 months
CPT Code(s): 82943
2003902 Glucagon by Immunohistochemistry GLUCAG IHC

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CPT Code(s): 88342
0080135 Glucose-6-Phosphate Dehydrogenase G6PD

Specimen Required: Collect: Yellow (ACD Solution A), green (sodium or lithium heparin), lavender (EDTA), or pink (K2EDTA). Enzyme most stable in acid citrate
dextrose (ACD).
CPT Code(s): 82955
0051684 Glucose-6-Phosphate Dehydrogenase (G6PD) 2 Mutations G6PD AFRIC

Methodology: Polymerase Chain Reaction/TaqMAN®
0020503 Glucose, Body Fluid GLU-FL

Unacceptable Conditions: CSF (Refer to Glucose, CSF, ARUP test code 0020515). Breast milk and salivary fluid. Specimens too viscous to be
aspirated by instrument.
Stability: After separation from cellular material: Ambient: 8 hours; Refrigerated (if free of cells): 1 week; Frozen: 1 year
CPT Code(s): 82945
0020515 Glucose, CSF GLU-CF

Specimen Preparation: Centrifuge and separate to remove cellular material. Transport 0.5 mL CSF. (Min: 0.3 mL)
Remarks: Process immediately to avoid falsely low results.
Stability: After separation from cellular material: Ambient: 8 hours; Refrigerated: 1 month; Frozen: Not defined
CPT Code(s): 82945
0020024 Glucose, Plasma or Serum GLU

Specimen Required: Collect: Gray (sodium fluoride/potassium oxalate), plasma separator tube, or serum separator tube.
CPT Code(s): 82947
0020047 Glucose Screen, Pregnancy GSCN

Patient Preparation: Collect at 60 minutes post-glucose load.
Specimen Required: Collect: Gray (sodium fluoride/potassium oxalate).
Specimen Preparation: Separate plasma from cells within 24 hours. Transport 1 mL plasma. (Min: 0.2 mL)
CPT Code(s): 82950
0020542 Glucose Tolerance Test GTT

Patient Preparation: Patient should fast for at least eight hours prior to collection of fasting specimen.
Specimen Required: Collect: Collect 2 timed specimens (fasting and 120 minutes). Gray (sodium fluoride/potassium oxalate). Collect separate tube for each timed
specimen.
Specimen Preparation: Separate plasma from cells and refrigerate within 2 hours of collection. Transfer 1 mL plasma per time point to individual
ARUP Standard Transport Tube. (Min: 0.2 mL/time point)
CPT Code(s): 82947 Glucose, fasting; 82950 Glucose, post challenge
0020543 Glucose Tolerance Test, Pregnancy GTT PRG

Patient Preparation: Patient should fast for at least eight hours prior to collection of specimens.
Specimen Required: Collect: Collect 4 timed specimens (fasting, 60, 120, and 180 minutes). Gray (sodium fluoride/potassium oxalate). Collect separate tube for each
timed specimen.
Page | 242
Specimen Preparation: Separate plasma from cells within 2 hours of collection. Transport 1 mL plasma per time point. (Min: 0.2 mL per time
point)
CPT Code(s): 82951 Tolerance test, three specimens (includes fasting glucose); 82952 Tolerance test, each additional beyond three specimens
2003905 Glucose Transporter-1 (GLUT-1) by Immunohistochemistry GLUT1 IHC

CPT Code(s): 88342
0020476 Glucose, Urine UGLU

Specimen Required: Collect: 24-hour urine. Specimen must be refrigerated during collection. Also Acceptable: Random urine (no reference intervals).
Specimen Preparation: Mix 24 hour urine collection well. Transfer 4 mL to an ARUP Standard Transport Tube. (Min 0.5 mL) Record total
Unacceptable Conditions: Urine collected in preservatives.
CPT Code(s): 82945
2007163 Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD) Sequencing G6PD FGS

CPT Code(s): 83891 Isolation; 83898 x9 Amplification; 83904 x9 Sequencing; 83909 Capillary electrophoresis, 83912 Interpretation and report. Additional CPT
2001771 Glutamic Acid Decarboxylase Antibody GAD-AB

Unacceptable Conditions: Plasma. Grossly hemolyzed specimens.
CPT Code(s): 83516
2002862 Glutamic Acid Decarboxylase Antibody (GAD65) and Insulin Antibodies with Reflex to IA-2 Antibody GADINS ABS
Methodology: Quantitative Radioimmunoassay/Quantitative Enzyme-Linked Immunosorbent Assay
Unacceptable Conditions: Plasma. Hemolyzed or lipemic specimens.
CPT Code(s): 86337 ANTI-INS; 83516 GAD-AB; if reflexed, add 86341 IA-2 Antibody
2001510 Glutarylcarnitine Quantitative, Urine C5DC URINE

Specimen Preparation: Transfer 2.5 mL urine to an ARUP Standard Transport Tube and freeze immediately. (Min: 0.5 mL)
Unacceptable Conditions: Specimens that have exposed to more than one freeze/thaw cycle.
CPT Code(s): 82017
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2006328 Glutathione Total GLUT TOT
Methodology: Quantitative Kinetic
Specimen Required: Collect: Yellow top (ACD Solution B) (ARUP supply #49658). Available online through eSupply using ARUP Connect™or contact ARUP Client
Services at (800) 522-2787.
Specimen Preparation: Transport 10 mL blood in original collection container. (Min: 1 mL).
Storage/Transport Temperature: Critical Refrigerated
Unacceptable Conditions: Hemolyzed specimens
CPT Code(s): 82978
0091086 Glutethimide, Serum or Plasma GLUTETH SP

Storage/Transport Temperature: Refrigerated preferred; ambient and frozen also acceptable.
CPT Code(s): 82980
0091353 Glyburide, Serum or Plasma GLYBURID

CPT Code(s): 80299
2003908 Glycophorin A by Immunohistochemistry GLYC A IHC

CPT Code(s): 88342
0091265 Gold, Serum or Plasma GOLD SP

Methodology: Graphite Furnace Atomic Absorption Spectroscopy
Specimen Required: Collect: Royal blue (no additive) or royal blue (EDTA).
Specimen Preparation: Transfer 1 mL plasma or serum to an ARUP Standard Transport Tube. (Min: 0.5 mL)
CPT Code(s): 80172
0090665 Gold, Urine GOLD URN

Specimen Required: Collect: Random urine in a trace metal free or acid washed plastic container.
Specimen Preparation: Transfer 1.0 mL urine to an ARUP Standard Transport Tube. (Min: 2 mL)
CPT Code(s): 80172
0060110 Gonorrhea Culture MC GC

Specimen Required: Collect: Any body site or fluid.
*Detection by amplified nucleic acid methodology can be performed on genital or urine specimens received in test-specific transport media.
*Refer to Infectious Disease under Specimen Handling at www.aruplab.com <http://www.aruplab.com> for special specimen collection
instructions.
Specimen Preparation: Do not refrigerate specimen.
Inoculated Modified Thayer Martin Agar (MTM): Transfer to a sealed in plastic bag with CO2 generating tablet.
Swab: Transport in Amies with charcoal.
Fluids: Transfer to a sterile container.
*Submit slide for Gram stain on male urethra specimens.
Incubate MTM at 35°C if delay occurs.
Unacceptable Conditions: Dry swabs, or delayed transport of inoculated MTM agar in non-CO2 environment.
CPT Code(s): 87081 Presumptive identification; If definitive identification is required add 87077
Page | 244
0060101 Gram Stain MS GRAM
Specimen Required: Collect: Any site or fluid.
Specimen Preparation: Transport specimen and/or labeled slide.
Unacceptable Conditions: Blood, bone marrow, stool, vaginal specimens, or body fluid inoculated in culture bottles.
CPT Code(s): 87205
2007173 Granzyme B by Immunohistochemistry GRANZB IHC

slides in a tissue transport kit (ARUP supply #47808) available online through eSupply using ARUP connect™ or contact ARUP Client Services
at (800)522-2787. (Min. 2 slides) If sending precut slides, do not oven bake.
details, please contact ARUP Client Services at (800)522-2787.
Stability: Ambient: Indefinite; Refrigerated: Indefinitely; Frozen: Unacceptable
CPT Code(s): 88342
0070080 Growth Hormone HGH

Patient Preparation: Patient must be fasting and at complete rest for 30 minutes before blood collection
Unacceptable Conditions: Tissue or urine. Grossly hemolyzed or lipemic specimens.
CPT Code(s): 83003
0070081 Growth Hormone, 0 Minutes GH 0

Specimen Required: Collect: Plasma separator tube or serum separator tube. Collect one tube per timed specimen. Also acceptable: Green (sodium or lithium heparin)
or lavender (EDTA), or pink (K2EDTA).
collection. Transfer 1 mL serum or plasma per timed specimen to individual ARUP Standard Transport Tubes. (Min: 0.4 mL per timed specimen)
CPT Code(s): 83003

Storage/Transport Temperature: Frozen. Also acceptable: Refrigerated
CPT Code(s): 83003

CPT Code(s): 83003

Page | 245
CPT Code(s): 83003

CPT Code(s): 83003

CPT Code(s): 83003

Stability: 24 hours; Refrigerated: 1 week; Frozen: 2 months
CPT Code(s): 83003
0092142 Growth Hormone Antibody G HORM AB

Methodology: Radiobinding Assay
CPT Code(s): 86277
2003929 Growth Hormone by Immunohistochemistry HGH IHC

CPT Code(s): 88342
0070069 Growth Hormone, Timed - Other GH OTHER

Specimen Required: Collect: Plasma separator tube or serum separator tube. Also acceptable: Green (sodium or lithium heparin) or lavender (EDTA).
Specimen Preparation: Transport 1 mL serum or plasma. (Min: 0.4 mL)
CPT Code(s): 83003
Page | 246
0050542 Haemophilus influenzae b Antibody, IgG HIBE IGG
Specimen Required: Collect: Serum separator tube. "Pre" and 30-day "post" Haemophilus influenzae b vaccination specimens should be submitted together for testing.
"Post" specimen should be drawn 30 days after immunization and must be received within 60 days of "pre" specimen.
Tube. (Min: 0.15 mL) Mark specimens clearly as "Pre-Vaccine" or "Post-Vaccine".
Unacceptable Conditions: Plasma or other body fluids. Contaminated, hemolyzed or, severely lipemic specimens.
CPT Code(s): 86317
0092068 Hairstat 5 Reflexive Panel HAIRSTAT 5

Methodology: Qualitative Enzyme-Linked Immunosorbent Assay/Quantitative Gas Chromatography-Mass Spectrometry
Patient Preparation: Ensure that hair has not been bleached, dyed, or permanently waved within the past three months. If so, collect body hair.
Specimen Required: Collect: 100 mg hair. A kit must be ordered prior to collecting specimen (ARUP supply #40477). Available online through eSupply using ARUP
Connect™ or by contacting Client Services at (800) 522-2787.
Specimen Preparation: Transport 100 mg hair (a ponytail 1.5 inches long and the diameter of a #2 pencil). (Min: 100 mg)
Remarks: Submissions require tamper evident seal to be placed on the specimen collection container. Unsealed containers will be rejected.
Stability: Ambient: 1 year; Refrigerated: Undetermined; Frozen: Undetermined
2003860 Hairy Cell Leukemia, DBA.44 by Immunohistochemistry DBA 44 IHC

CPT Code(s): 88342
0099640 Haloperidol HALO

CPT Code(s): 80173
2001540 Hantavirus Antibodies, IgG and IgM with Reflex to Confirmation HANTAVIRUS
Specimen Preparation: Separate serum from cells. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.25 mL)
CPT Code(s): 86790 x2 Hantavirus IgG and IgM; if reflexed add 86790 for each procedure.
0050280 Haptoglobin HAPTO

Stability: After separation from cells: Ambient: 3 months; Refrigerated: 3 months; Frozen: 3 months
CPT Code(s): 83010
0040116 Haptoglobin (HP) Genotyping HAPTO PCR

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2003914 HBME-1 (Mesothelial Cell) by Immunohistochemistry HBME IHC
CPT Code(s): 88342
0020053 HDL Cholesterol CH HDL

Methodology: Detergent Solubilization/Enzymatic
collection. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube.
CPT Code(s): 83718
0098829 HDL Subclasses GGE HDL GGE

Methodology: Segmented Gradient Gel Electrophoresis (Gel Electrophoresis)
Patient Preparation: Patient should fast 12 to 14 hours prior to draw. Patient should not consume alcohol 12 hours prior to draw.
Specimen Preparation: Allow specimen to clot for 30 minutes at room temperature. Transfer 3 mL serum to an ARUP Standard Transport Tube.
Refrigerate within 1 hour. (Min: 1 mL)
CPT Code(s): 83701
0051383 Hearing Loss, Nonsyndromic, Connexin 26 (GJB2) 35delG Mutation CX 35DELG

Methodology: Nucleic Acid Probe/Fluorescence Signal Amplification
CPT Code(s): 83891 Isolation; 83896 x2 Nucleic acid probes; 83912 Interpretation and report
2001956 Hearing Loss, Nonsyndromic, Connexin 30 (GJB6) 2 Deletions GJB6 DEL

CPT Code(s): 83891 Isolation; 83900 Multiplex amplification; 83901 Additional amplification; 83909 Capillary electrophoresis; 83912 Interpretation and report.
2002044 Hearing Loss, Nonsyndromic, Mitochondrial DNA 2 Mutations HL MTDNA

2001992 Hearing Loss, Nonsyndromic Panel (GJB2) Sequencing, (GJB6) 2 Deletions and Mitochondrial DNA 2 Mutations HL PANEL
Methodology: Polymerase Chain Reaction/Capillary Electrophoresis/Sequencing
CPT Code(s): GJB2: 83891 Isolation; 83898 x2 Amplification; 83904 x3 Sequencing; 83909 Capillary electrophoresis. GJB6: 83900 Amplification; 83901
Muliplex Amplification; 83909 Capillary electrophoresis. mt DNA: 83898 x2 Amplification; 83904 x2 Sequencing; 83909 Capillary
0097338 Heat Shock Protein 70 (68 kDa), IgG by Western Blot 68KD HSP
Page | 248
Unacceptable Conditions: Specimens collected with anticoagulants or preservatives. Hemolyzed or lipemic specimens. Specimens with large clots
or bacterial growth present.
CPT Code(s): 84182
0099470 Heavy Metals Panel 3, Blood HY MET B

Methodology: Quantitative Atomic Absorption/Quantitative Inductively Coupled Plasma-Mass Spectrometry
Remarks: Lead requisition form may be required (ARUP form #32990-Barcode; #32991-No Barcode). Notification will be given if required.
Stability: Mercury is volatile; concentration may reduce after seven or more days of storage. If the specimen is drawn and stored in the appropriate
container, the arsenic and lead values do not change with time.
CPT Code(s): 82175 Arsenic; 83655 Lead; 83825 Mercury
0099475 Heavy Metals Panel 3, Urine with Reflex to Arsenic Fractionated HY MET U
discontinue nutritional supplements, vitamins, minerals, non-essential over-the-counter medications (upon the advice of their physician), and
avoid shellfish and seafood for 48 to 72 hours. 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.
collection.
Specimen Preparation: Transfer 8 mL aliquot from a well-mixed collection to ARUP Trace Element-Free Transport Tubes (ARUP supply
CPT Code(s): 82175 Arsenic; 83655 Lead; 83825 Mercury; if reflexed, add 82175 Arsenic fractionated
0020584 Heavy Metals Panel 4, Blood HY MET B4

Remarks: Lead requisition form may be required (ARUP form #32990-Barcode; #32991-No Barcode). Notification will be given if required.
Stability: Mercury is volatile; concentration may reduce after seven or more days of storage. If the specimen is drawn and stored in the
appropriate container, the arsenic, cadmium, and lead values do not change with time.
CPT Code(s): 82175 Arsenic; 82300 Cadmium; 83655 Lead; 83825 Mercury
0020572 Heavy Metals Panel 4, Urine with Reflex to Arsenic Fractionated HY MET U4
collection.
CPT Code(s): 82175 Arsenic; 83655 Lead; 83825 Mercury; 82300 Cadmium; if reflexed, add 82175 Arsenic fractionated
0025055 Heavy Metals Panel 6, Urine with Reflex to Arsenic Fractionated HYMET 6
collection.
Page | 249
CPT Code(s): 82175 Arsenic; 82300 Cadmium; 82525 Copper; 83655 Lead; 83825 Mercury; 84630 Zinc; if reflexed, add 82175 Arsenic fractionated
0049090 Heinz Body Stain HEINZ

Methodology: Supravital Stain
Storage/Transport Temperature: Room temperature. Ship Sunday-Thursday only. Specimen must be received within 24 hours of collection;
testing must be performed within 48 hours of collection.
Unacceptable Conditions: Specimens from infants under 6 months of age; test results are unreliable.
Stability: Ambient: 48 hours
CPT Code(s): 85441 Direct component; 85445 Induced, acetylphenylhydrazine
0050994 Helicobacter pylori Antibodies, IgG & IgA PYLORI PAN

Methodology: Semi-Quantitative Enzyme Immunoassay
CPT Code(s): 86677 H. pylori IgG; 86677 H. pylori IgA
0050995 Helicobacter pylori Antibody, IgA A PYLORI

CPT Code(s): 86677
0099359 Helicobacter pylori Antibody, IgG G PYLORI

CPT Code(s): 86677
0098392 Helicobacter pylori Antibody, IgM M PYLORI

Unacceptable Conditions: Contaminated, heat-activated, hemolyzed, or severely lipemic specimens.
CPT Code(s): 86677
0065147 Helicobacter pylori Antigen, Fecal by EIA PYLORI AG

Patient Preparation: To avoid false negative results, no antibiotics, proton pump inhibitors, or a bismuth preparation should be administered to
patient for 14 days prior to specimen collection.
ARUP Connect™or contact ARUP Client Services at (800) 522-2787. (Min: 1 g)
Unacceptable Conditions: Gastric specimens, swabs or tissue. Specimens in media or preservatives.
Stability: Ambient: 2 hours; Refrigerated: 72 hours; Frozen: 1 month.
CPT Code(s): 87338
0020646 Helicobacter pylori Breath Test UBT

Methodology: Qualitative Spectrophotometry
Patient Preparation: The patient should fast and abstain from smoking for 1 hour prior to test administration. The patient should not have taken
antibiotics, proton pump inhibitors (e.g., Prilosec®, Prevacid®, Aciphex®, Nexium®), or bismuth preparations (e.g., Pepto-Bismol®) within the
previous 14 days. When used to monitor treatment, the test should be performed four weeks after cessation of definitive therapy. The patient
should be informed that the Pranactin®-Citric drink that will be administered contains phenylalanine. Phenylketonurics restrict dietary
phenylalanine.
Specimen Required: Collect: BreathTek UBiT® Kit. (ARUP Supply #33396 ) Available online through eSupply using ARUP Connect™ or contact ARUP Client
Services at (800) 522-2787. Kits are provided at a cost of $50 each.
Page | 250
Specimen Preparation: 1) Label breath collection bags with patient name, MRN, date and time of collection, and designate Pre (blue) or Post
(pink).
2) Collect the baseline breath specimen:
-Remove cap from collection bag (blue).
-Have patient take a deep breath, pause momentarily then exhale into the mouthpiece of the bag filling it completely.
-Replace cap on the bag.
3) Prepare Pranactin®-Citric solution:
-Empty packet from test kit into the cup provided.
-Add drinking water up to the fill line (raised ridge).
-Replace lid; swirl for up to two minutes until completely dissolved. Solution should be clear. The solution is stable up to 60 minutes at room
temperature.
4) Instruct patient to drink the solution without stopping using the straw provided. Advise the patient not to "rinse" the mouth with the solution
before swallowing.
5) Set timer for 15 minutes. Start timer as soon as the patient has completed drinking. Patient should sit quietly without eating, drinking, or
smoking.
6) Prepare the post specimen collection (pink) bag. At exactly 15 minutes, have the patient take a deep breath, pause momentarily and then exhale
to fill the second sample collection bag (pink). Note: for a valid result, the post specimen must be collected within 13 to 18 minutes after
administration of the Pranactin®-Citric Solution.
Do not freeze.
Unacceptable Conditions: Bags not fully inflated or only one of the two bags submitted. Breath collected in tubes. Pediatric specimens from
persons 17 years or younger.
CPT Code(s): 83013
2003941 Helicobacter pylori by Immunohistochemistry HPYLOR IHC

CPT Code(s): 88342
2006686 Helicobacter pylori, Culture MC HPYL

Specimen Required: Collect: Duodenal or gastric biopsy.
Specimen Preparation: Preserve in enteric transport media immediately (ARUP supply #29799). Available online through eSupply using ARUP
Connect™or contact ARUP Client Services at (800) 522-2787.
Unacceptable Conditions: Fecal specimens, swabs
CPT Code(s): 87070 Aerobic culture; 87176 Homogenization
0040080 Hematocrit HCT

Specimen Preparation: Mix specimen thoroughly. Transport 3 mL whole blood. (Min: 0.25 mL)
CPT Code(s): 85014
0055656 Hemochromatosis (HFE) 3 Mutations HFE PCR

0040085 Hemoglobin HGB

CPT Code(s): 85018
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2003926 Hemoglobin A by Immunohistochemistry HGB A IHC
CPT Code(s): 88342
0050613 Hemoglobin (Hb) A2 & F by Column HGBA2F COL

CPT Code(s): 83021
0070426 Hemoglobin A1c HBA1C

Methodology: Quantitative High Performance Liquid Chromatography/Boronate Affinity
Specimen Preparation: Transport 5 mL whole blood in original tube. (Min: 1 mL)
Unacceptable Conditions: Tissue or urine.
Stability: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 1 year (avoid repeated freeze/thaw cycles)
CPT Code(s): 83036
2005792 Hemoglobin Evaluation Reflexive Cascade HB CASCADE

Methodology: High Performance Liquid Chromatography/Electrophoresis/RBC Solubility/Polymerase Chain Reaction/Fluorescence Resonance Energy
Transfer/Sequencing
Remarks: Patient history form, including information from a recent CBC, is required for interpretation.
CPT Code(s): 83021 Chromatography
If reflexed to Sickle Cell Solubility, add 85660; if reflexed to Hemoglobin, Acid Electrophoresis, add 83020; if reflexed to Hemoglobin, Alkaline
Electrophoresis, add 83020
If reflexed to Beta Globin (HBB) HbS, HbC, & HbE Mutations (ARUP test code 0051421), add: 83891 Isolation; 83898 x2 Amplification, 83896
x3 Nucleic acid probe, 83912 Interpretation and report
If reflexed to Alpha Thalassemia (HBA1 & HBA2) 7 Deletions (ARUP test code 0051495), add: 83891 Isolation; 83900 Amplification multiplex;
83901 x8 Additional amplification; 83894 Gel separation; 83912 Interpretation and report
If reflexed to Beta Globin (HBB) Gene Sequencing (ARUP test code 0050578), add: 83891 Isolation; 83898 x4 Amplification; 83894 Gel
electrophoresis; 83904 x3 sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report
If reflexed to Alpha Globin (HBA1 and HBA2) Sequencing (ARUP test code 2001582), add: 83891 Isolation; 83898 x2 Amplification; 83904 x6
Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report
If reflexed to Hemoglobin Lepore (HBD/HBB Fusion) 3 Mutations (ARUP test code 2004686), add: 83891 Isolation; 83900 Multiplex
amplification; 83901 x2 Additional amplification; 83909 Capillary electrophoresis; 83912 Interpretation and report
If reflexed to Hereditary Persistence of Fetal Hemoglobin (HPFH) 8 Mutations (ARUP test code 2005408), add: 83891 Isolation; 83900 Multiplex
amplification; 83901 x7 Additional amplification; 83909 Capillary electrophoresis; 83912 Interpretation and report
0050610 Hemoglobin Evaluation with Reflex to Electrophoresis and/or RBC Solubility HGBEL
Methodology: High Performance Liquid Chromatography/Electrophoresis/RBC Solubility
CPT Code(s): 83021 Chromatography; if reflexed to Sickle Cell Solubility, add 85660; if reflexed to Hemoglobin, Acid Electrophoresis, add 83020; if reflexed
to Hemoglobin, Alkaline Electrophoresis, add 83020
0081348 Hemoglobin F HB F
Page | 252
Stability: Ambient: Unacceptable, Refrigerated: 1 week, Frozen: Unacceptable
CPT Code(s): 83021
2004686 Hemoglobin Lepore (HBD/HBB Fusion) 3 Mutations LEPORE

Methodology: Qualitative Polymerase Chain Reaction/Qualitative Electrophoresis
Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA). Also acceptable: Yellow (ACD Solution A or B), lt. blue (sodium citrate), green (sodium or
lithium heparin).
CPT Code(s): 83891 Isolation; 83900 Multiplex amplification, 83901 x2 Additional amplification; 83909 Capillary electrophoresis; 83912 Interpretation and
0020058 Hemoglobin, Plasma HGBP

Specimen Preparation: Separate plasma from cells ASAP or within 2 hours of collection (delayed separation from cells will elevate plasma
hemoglobin). Transfer 2 mL plasma to an ARUP Standard Transport Tube. (Min: 0.7 mL)
Unacceptable Conditions: EDTA or citrated plasma.
CPT Code(s): 83051
0050520 Hemoglobin S, Evaluation with Reflex to RBC Solubility SCKL

Stability: Ambient: Unacceptable, Refrigerated: 1 week, Frozen: Unacceptable
CPT Code(s): 83021 Chromatography; if reflexed, add 85660 Sickling of RBC, reduction
0020057 Hemoglobin, Serum HGBS

Specimen Preparation: Allow specimen to clot completely at room temperature. Separate serum from cells ASAP or within 2 hours of collection
(delayed separation from cells will elevate serum hemoglobin).Transfer 2 mL serum to an ARUP Standard Transport Tube. (Min: 0.7 mL)
CPT Code(s): 84311
0049020 Hemoglobin, Unstable HGB UNSTAB

Patient Preparation: Test results are unreliable in infants younger than 6 months of age.
Specimen Preparation: DO NOT FREEZE. Transport 5 mL whole blood. (Min: 2 mL)
Unacceptable Conditions: Samples more than 7 days old. Specimens collected on infants less than 6 months old.
Stability: Ambient: Unacceptable; Refrigerated 7 days; Frozen: Unacceptable
CPT Code(s): 83068
0020221 Hemoglobin, Urine HGBU

Specimen Preparation: Centrifuge and separate urine from cells and other sediment. Transfer 4 mL aliquot from a well-mixed random urine to an
ARUP Standard Transport Tube. (Min: 0.7 mL)
CPT Code(s): 83069
2001759 Hemophilia A (F8) 2 Inversions F8 INV

Methodology: Inverse Polymerase Chain Reaction/Electrophoresis
CPT Code(s): Inversion: 83891 Isolation; 83892 x2 digestion; 83914 x2 Extension; 83898 Amplification; 83894 Gel separation; 83912 Interpretation and report
2001755 Hemophilia A (F8) 2 Inversions, Fetal F8 INV FE

Methodology: Inverse Polymerase Chain Reaction/Electrophoresis
Maternal Specimen: Lavender (EDTA) or yellow (ACD Solution A or B).
Page | 253
CPT Code(s): Inversion: 83891 Isolation; 83892 x2 digestion; 83914 x2 Extension; 83898 Amplification; 83894 Gel separation; 83912 Interpretation and report
- Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders. FCC: 83900 Multiplex
amplification; 83901 x14 Additional Amplification; 83909 Capillary electrophoresis. If MCC Maternal cell (0050608) is performed, add: 83891
Isolation; 83900 Multiplex amplification; 83901 x14 Additional amplification; 83909 Capillary electrophoresis; 83912 Interpretation and report.
2001614 Hemophilia A (F8) 2 Inversions with Reflex to Sequencing and Reflex to Deletion/Duplication F8 COMP
Methodology: Inverse Polymerase Chain Reaction/Sequencing/Multiplex Ligation-dependent Probe Amplification
CPT Code(s): Inversion: 83891 Isolation; 83892 x2 Digestion; 83914 x2 Ligation; 83898 Amplification; 83894 Gel separation; 83912 Interpretation and report.
If reflexed to sequencing, add 83891 Isolation; 83898 x34 Amplification; 83904 x34 Sequencing; 83909 Capillary electrophoresis. If reflexed to
Deletion/Duplication, add 83896 Nucleic acid probes; 83898 Amplification; 83914 Extension; 83909 Capillary electrophoresis - Additional CPT
2001751 Hemophilia A (F8) Deletion/Duplication F8 DELDUP

CPT Code(s): 83891 Isolation; 83896 Nucleic acid probes; 83898 Amplification; 83914 Extension; 83909 Capillary electrophoresis; 83912 Interpretation and
2001747 Hemophilia A (F8) Sequencing F8 FGS

2001578 Hemophilia B (F9) Sequencing F9 FGS

0099414 HemoQuant, Fecal HEMO FECES

Methodology: Fluorescence Quantitation
Patient Preparation: Patient should not ingest red meat or aspirin for at least 72 hours prior to collection.
Specimen Required: Collect: Stool from a single defecation in a sterile, plastic, screw-top container with no preservatives.
Specimen Preparation: Transport 1 g stool. (Min: 1 g)
Storage/Transport Temperature: Refrigerated. Also acceptable: Frozen or room temperature.
Stability: Ambient: 1 week; Refrigerated: 1 week; Frozen: 1 month
CPT Code(s): 84126
0020222 Hemosiderin, Urine UHEMSID

Methodology: Semi-Quantitative Microscopy
Patient Preparation: First-morning collection is preferred.
Specimen Preparation: Mix specimen well. Transfer 4 mL to an ARUP Standard Transport Tube. (Min: 1 mL).
Stability: Ambient: 1 hour; Refrigerated: 24 hours; Frozen: 1 week
CPT Code(s): 83070
0030144 Heparin Anti-Xa, Low Molecular Weight Heparin HA LMW

Specimen Preparation: Centrifuge specimen within one hour of collection. Transport 2 mL platelet-poor plasma. (Min: 1.5 mL)
Remarks: Record heparin type on test request form.
Unacceptable Conditions: Serum. EDTA, oxalate, heparin, or plasma separator tubes. Specimens refrigerated more than eight hours. Hemolyzed
specimens.
Page | 254
Stability: After separation from cells: Ambient: 4 hours; Refrigerated: 8 hours; Frozen: 2 weeks
CPT Code(s): 85520
0030143 Heparin Anti-Xa, Unfractionated HA UN

Specimen Preparation: Centrifuge specimen within one hour of collection. Transport 2 mL platelet-poor plasma. (Min: 1 mL)
Remarks: Record heparin type on test request form.
Unacceptable Conditions: Serum. EDTA, oxalate, heparin, or plasma separator tubes. Specimens refrigerated more than eight hours. Hemolyzed
specimens.
CPT Code(s): 85520
0092540 Heparin Cofactor II HEP COF II

Methodology: Chromogenic Substrate Assay
(Chromogenic Assay)
Specimen Preparation: Separate plasma from cells ASAP. Transfer 1 mL plasma to an ARUP Standard Transport Tube and freeze. (Min: 0.5 mL)
Unacceptable Conditions: Specimens that have been through several freeze/thaw cycles.
CPT Code(s): 85130
0051052 Heparin-Induced Thrombocytopenia Antibodies PLT HAT

Specimen Preparation: Separate serum or plasma from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to ARUP Standard
Transport Tube. (Min: 0.2 mL) Also acceptable: EDTA or sodium citrated plasma.
Storage/Transport Temperature: CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered. Specimen
may be stored refrigerated if tested within 48 hours.
Pediatric Transport: Ship on dry ice using overnight service.
Remarks: Microbially contaminated, heat-inactivated, hemolyzed, icteric, or lipemic sera may give inconsistent results.
CPT Code(s): 86022
0051249 Heparin-Induced Thrombocytopenia Antibodies with Reflex to Serotonin Release Assay (Heparin Dependent PLT HAT R
Platelet Antibody), Unfractionated Heparin
Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Serotonin Release Assay
Storage/Transport Temperature: CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered. Ship on dry
ice.
Remarks: Heat-inactivated, hemolyzed, icteric, or lipemic sera may give inconsistent results.
Unacceptable Conditions: Plasma. Contaminated specimens.
2007145 Heparin-Induced Thrombocytopenia (HIT) Antibodies, PF4 IgA and IgM by ELISA HIT ABS AM
Specimen Preparation: Transfer 5 mL serum to ARUP Standard Transport Tubes. (Min: 1 mL)
Stability: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: Indefinite
CPT Code(s): 86022X4
2007140 Heparin-Induced Thrombocytopenia (HIT) Antibody, PF4 IgG by ELISA HIT AB

CPT Code(s): 86022
0020416 Hepatic Function Panel HEPATIC

Methodology: Quantitative Enzymatic/Quantitative Spectrophotometry
CPT Code(s): 80076
0020591 Hepatitis A Virus Antibodies (Total) HAVAB

Methodology: Qualitative Chemiluminescent Immunoassay
Page | 255
Tube. (Min: 0.5 mL) Also acceptable: K2EDTA plasma.
Unacceptable Conditions: Specimens collected in citrate-based anticoagulant. Specimens containing particulate material. Heat-inactivated,
severely hemolyzed, or lipemic specimens.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: Indefinitely (avoid repeated freeze/thaw cycles)
CPT Code(s): 86708
0020093 Hepatitis A Virus Antibody, IgM HAVABM

Unacceptable Conditions: Heparinized plasma. Specimens collected in citrate-based anticoagulant. Specimens containing particulate material.
Heat-inactivated, severely hemolyzed, or lipemic specimens.
CPT Code(s): 86709
0020597 Hepatitis A Virus Panel HEP A PAN

Specimen Required: Collect: Serum separator tube. Also acceptable: Lavender (EDTA) or pink (K2EDTA).
Unacceptable Conditions: Specimens containing particulate material. Severely hemolyzed or lipemic specimens. Heat-inactivated specimens.
Specimens collected in citrate-based anticoagulant.
CPT Code(s): 86708 Hepatitis A antibodies (total); 86709 Hepatitis A antibody, IgM
2003917 Hepatitis B Surface Antigen by Immunohistochemistry HBSAG IHC

CPT Code(s): 88342
0020091 Hepatitis B Virus Core Antibodies (Total) HBCAB

tube. (Min: 0.5 mL) Also acceptable: K2EDTA plasma.
Unacceptable Conditions: Heparinized plasma. Specimens containing particulate material. Heat-inactivated, severely hemolyzed, or lipemic
specimens.
CPT Code(s): 86704
0020092 Hepatitis B Virus Core Antibody, IgM HBCABM

specimens.
CPT Code(s): 86705
0056025 Hepatitis B Virus DNA Quantitative, Real-Time PCR HBVUPCR

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA) or serum separator tube.
Specimen Preparation: Separate serum or plasma from cells within 24 hours. Transfer 2 mL serum or plasma to an ARUP Standard Transport
Stability: On cells: Ambient: 24 hours. After separation from cells: Ambient: 72 hours; Refrigerated: 1 week; Frozen: 6 weeks
CPT Code(s): 87517
Page | 256
2004722 Hepatitis B Virus DNA Quantitative, Real-Time PCR with Reflex to Genotyping HBV QT GR
Methodology: Quantitative Real-Time Polymerase Chain Reaction/Sequencing
Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA) or serum separator tube.
Specimen Preparation: Separate serum or plasma from cells within 24 hours. Transfer 2 mL serum or plasma to an ARUP Standard Transport
Tube. (Min: 1.2 mL)
CPT Code(s): 87517 Hepatitis B Quantitative; if reflexed, add 83890 Isolation, 83898 Amplification, 83904 x2 Sequencing, 83909 Capillary electrophoresis,
83912 Interpretation and report
2001567 Hepatitis B Virus Genotyping HBVGENO

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or plasma preparation tube.
CPT Code(s): 83890 Isolation, 83898 Amplification, 83904 x2 Sequencing, 83909 Capillary electrophoresis, 83912 Interpretation and report.
0020454 Hepatitis B Virus Panel, Chronic with Reflex to HBsAg Confirmation HEPCHRONIC
Methodology: Qualitative Chemiluminescent Immunoassay/Qualitative Enzyme Immunoassay
Tube. (Min: 2 mL) Also acceptable: K2EDTA plasma.
specimens.
CPT Code(s): 86317, 86707, 87350, 87340, if reflexed add 87341.
0020090 Hepatitis B Virus Surface Antibody HBSAB

Unacceptable Conditions: Heparinized plasma. Specimens containing particulate material. Heat-inactivated , severely hemolyzed, or lipemic
specimens.
CPT Code(s): 86317
0020128 Hepatitis B Virus Surface Antigen, Confirmation HBSAG CONF

Specimen Preparation: Separate serum or plasma from cells ASAP or within 2 hours of collection. Transfer 2.5 mL serum to an ARUP Standard
Unacceptable Conditions: Heparinized plasma. Specimens containing particulate material or obvious microbial contamination. Heat-inactivated,
severely hemolyzed, or lipemic specimens.
CPT Code(s): 87341
0020089 Hepatitis B Virus Surface Antigen with Reflex to Confirmation HBSAG

Tube. (Min: 1 mL) Also acceptable: K2EDTA plasma.
Unacceptable Conditions: Heparinized plasma. Specimens containing particulate material. Heat-inactivated, severely hemolyzed or lipemic
specimens.
CPT Code(s): 87340 HBsAg; if reflexed, add 87341 HBsAg confirmation
0020095 Hepatitis Be Virus Antibody HBEAB

Specimen Required: Collect: Serum separator tube (SST). Also acceptable:Lavender (EDTA) or pink ( K2EDTA).
Unacceptable Conditions: Specimens containing particulate material or collected in citrate-based anticoagulant. Heat-inactivated, grossly
hemolyzed or lipemic specimens.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 6 days; Frozen: Indefinitely (avoid repeated freeze/thaw cycles)
CPT Code(s): 86707
Page | 257
0020094 Hepatitis Be Virus Antigen HBEAG
Specimen Required: Collect: Serum separator tube (SST). Also acceptable: Lavender (EDTA) or pink (K2EDTA).
Unacceptable Conditions: Heat-inactivated, grossly hemolyzed, or lipemic specimens. Specimens containing particulate material, or collected in
citrate-based anticoagulant.
CPT Code(s): 87350
2002483 Hepatitis C Virus Antibody by CIA HCV AB

Tube. (Min: 0.5 mL)
Unacceptable Conditions: Specimens containing particulate material. Severely hemolyzed, heat-inactivated, or lipemic specimens. Heparinized
plasma.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: Indefinitely (avoid freeze/thaw cycles)
CPT Code(s): 86803
0055593 Hepatitis C Virus Genotyping HEPCGENO

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), plasma preparation tube or serum separator tube.
(Min: 0.5 mL)
Remarks: Please submit most recent viral load and test date, if available.
Stability: On cells: Ambient: 6 hours. After separation from cells: Refrigerated: 72 hours; Frozen: 4 months.
CPT Code(s): 87902
2006898 Hepatitis C Virus High-Resolution Genotyping HCV CORE

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), plasma preparation tube, or serum separator tube (SST).
(Min: 0.5 mL)
Remarks: Please submit most recent viral load and test date if available.
Stability: On cells: Ambient: 6 hours. After separation from cells: Refrigerated: 72 hours; Frozen: 4 months
CPT Code(s): 87902
0098264 Hepatitis C Virus RNA Qualitative PCR HEP C PCR

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or serum separator tube.
(Min: 0.25 mL)
Stability: On cells: Ambient: 6 hours. After separation from cells: Refrigerated: 72 hours; Frozen: 4 months
CPT Code(s): 87521
0051811 Hepatitis C Virus RNA Quantitative bDNA HCVRNA BC

Methodology: Quantitative Branched Chain DNA
Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), plasma preparation tube, or serum separator tube.
(Min: 0.2 mL).
PPT: Separate plasma from cells within 2 hours. Transport 1 mL plasma in original container. (Min: 0.2 mL)
Stability: PPT: On Cells: Ambient: 2 hours. All others: On cells: Ambient 4 hours. After separation from cells; Refrigerated: 48 hours; Frozen at
-20°C: 72 hours; Frozen at -70°C: 4 months
CPT Code(s): 87522
Page | 258
2002681 Hepatitis C Virus RNA Quantitative bDNA with Reflex to Genotype HCVBD GR
Methodology: Quantitative Branched Chain DNA/Sequencing
Specimen Preparation: Separate serum or EDTA plasma from cells within 4 hours. Transfer 1 mL serum or plasma to an ARUP Standard
Stability: PPT: On Cells: Ambient: 2 hours. After separation from cells: Refrigerated: 48 hours; Frozen at -20°C: 72 hours; Frozen at -70°C: 4
months All others: On cells: Ambient 4 hours. After separation from cells: Refrigerated: 48 hours; Frozen at -20 °C: 72 hours; Frozen at -70°C: 4
months
CPT Code(s): 87522 Hep C; if reflexed, add 87902 Genotype
2002682 Hepatitis C Virus RNA Quantitative bDNA with Reflex to Hepatitis C Virus RNA Quantitative, Real-Time PCR HCVBD QTR
Methodology: Quantitative Branched Chain DNA/Polymerase Chain Reaction
Specimen Preparation: Separate serum or EDTA plasma from cells within 4 hours. Transfer 2 mL serum or plasma to an ARUP Standard
Stability: PPT: On Cells: Ambient: 2 hours. After separation from cells: Refrigerated: 48 hours; Frozen at -20°C: 72 hours; Frozen at -70°C: 4
months All others: On cells: Ambient 4 hours. After separation from cells: Refrigerated: 48 hours; Frozen at -20°C: 72 hours; Frozen at -70°C: 4
months
CPT Code(s): 87522 HCV Quant bDNA; if reflexed add 87522 HCV Quant PCR
0098268 Hepatitis C Virus RNA Quantitative, Real-Time PCR HEPCQNT

Specimen Preparation: Separate serum or plasma from cells within 6 hours. Transfer 3.5 mL serum or plasma to an ARUP Standard Transport
Tube. (Min: 1.5 mL)
Stability: On Cells: Ambient: 6 hours; After separation from cells: Refrigerated: 72 hours; Frozen: 6 weeks
CPT Code(s): 87522
2002685 Hepatitis C Virus RNA Quantitative Real-Time PCR with Reflex to Genotype HCV QT GR
Specimen Preparation: Separate serum or plasma from cells within 6 hours. Transfer 3.5 mL serum or plasma to an ARUP Standard Transport
Tube. (Min: 1.8 mL)
Stability: On Cells: Ambient: 6 hours; After separation from cells: Refrigerated: 72 hours; Frozen: 6 weeks
CPT Code(s): 87522 Hep C quantitative; if reflexed, add 87902 Genotype
2006450 Hepatitis Delta Antigen by ELISA HEPD AG

Methodology: Qualitative Enzyme-Linked Immunosorbent Assay
Specimen Preparation: Separate from cells within 1 hour of draw. Transfer 1 mL serum to an ARUP Standard Transport Tube and freeze
immediately. (Min: 0.5 mL)
Unacceptable Conditions: Grossly hemolyzed or lipemic specimens. Thawed specimens.
CPT Code(s): 87380
0020799 Hepatitis Delta Virus Antibody HEP D AB

Tube. (Min: 0.5 mL) Also acceptable: Citrate, EDTA, or heparin plasma.
Unacceptable Conditions: Room temperature specimens. Specimens containing particulate material or obvious microbial contamination.
Hemolyzed or lipemic specimens.
CPT Code(s): 86692
0098507 Hepatitis Delta Virus (HDV), IgM Antibody, EIA HEP D IGM
Stability: Ambient: 1 week; Refrigerated: 2 months; Frozen: Indefinitely
CPT Code(s): 86692
0098655 Hepatitis E Antibody, IgG HEP E IGG

Page | 259
CPT Code(s): 86790
0098656 Hepatitis E Antibody, IgM HEP E IGM

CPT Code(s): 86790
0020457 Hepatitis Panel, Acute with Reflex to HBsAg Confirmation HEP ACUTE
Unacceptable Conditions: Heparinized plasma. Specimens containing particulate material. Heat inactivated, severely hemolyzed, or lipemic
specimens.
CPT Code(s): 80074 Hepatitis panel acute; if reflexed, add 87341 HBsAg confirmation
0081326 Hepatocellular Carcinoma Tumor Marker Panel HEP CAR

Unacceptable Conditions: Plasma
CPT Code(s): 82107 AFP L3; 83951 DCP
2003923 Hepatocyte Specific Antigen (HSA) by Immunohistochemistry HEP SA IHC

CPT Code(s): 88342
0091289 Heptachlor & Metabolite, Fat HEPTACHLOR

Specimen Required: Collect: Adipose tissue.
Specimen Preparation: Transport 1 g adipose tissue. (Min: 0.7 g)
CPT Code(s): 82441
0091510 Heptachlor and Metabolite, Serum or Plasma HEPTACHL

Specimen Preparation: Transfer 4 mL serum to an ARUP Standard Transport Tube. (Min: 1 mL) Also acceptable: Plasma.
CPT Code(s): 82441
2004672 HER-2/neu Quantitative by ELISA HER2 QUANT

Unacceptable Conditions: Hemolyzed or thawed specimens.
CPT Code(s): 83950
0051348 Hereditary Hemorrhagic Telangiectasia (ACVRL1 and ENG) Deletion/Duplication HHT DELDUP
Page | 260
CPT Code(s): 83891 Isolation; 83896 x2 Nucleic Acid Probes; 83914 x2 Extension; 83898 x2 Amplification; 83909 Capillary electrophoresis; 83912
0051381 Hereditary Hemorrhagic Telangiectasia (ACVRL1 and ENG) Sequencing HHT-FGS

CPT Code(s): 83891 Isolation; 83898 x23 Amplification; 83904 x23 Sequencing; 83909 x2 Capillary electrophoresis; 83912 Interpretation and report -
0051382 Hereditary Hemorrhagic Telangiectasia (ACVRL1 and ENG) Sequencing and Deletion/Duplication HHT FGA
CPT Code(s): Sequencing: 83891 Isolation; 83898 x23 Amplification; 83904 x23 Sequencing; 83909 x2 Capillary electrophoresis; Del/Dup: 83896 x2 Nucleic
Acid Probes; 83898 x2 Amplification; 83914 x2 Extension; 83909 Capillary electrophoresis; 83912 Interpretation and report. Additional CPT
2007113 Hereditary Paraganglioma-Pheochromocytoma (SDHB, SDHC, and SDHD) Deletion/Duplication SDHBCD DD

CPT Code(s): 83891 Isolation; 83896 x18 Nucleic acid probes; 83898 x18 Amplification; 83914 x18 Extension; 83909 Capillary electrophoresis, 83912
2007167 Hereditary Paraganglioma-Pheochromocytoma (SDHB, SDHC, and SDHD) Sequencing and SDHBCD PAN
Deletion/Duplication Panel
CPT Code(s): 83891 Isolation; 83898 x19 Amplification; 83904 x19 Sequencing; 83909 Capillary electrophoresis, 83912 Interpretation and report Del/Dup:
83896 x18 Nucleic acid probes; 83898 x18 Amplification; 83914 x18 Extension; 83909 Capillary electrophoresis - Additional CPT code
2007108 Hereditary Paraganglioma-Pheochromocytoma (SDHB) Sequencing and Deletion/Duplication SDHB FGA

CPT Code(s): Sequencing: 83891 Isolation; 83898 x9 Amplification; 83904 x9 Sequencing; 83909 Capillary electrophoresis, 83912 Interpretation and report
Del/Dup: 83896 x8 Nucleic acid probes; 83898 x8 Amplification; 83914 x8 Extension; 83909 Capillary electrophoresis - Additional CPT code
2007117 Hereditary Paraganglioma-Pheochromocytoma (SDHC) Sequencing and Deletion/Duplication SDHC FGA

CPT Code(s): Sequencing: 83891 Isolation; 83898 x6 Amplification; 83904 x6 Sequencing; 83909 Capillary electrophoresis, 83912 Interpretation and report
2007122 Hereditary Paraganglioma-Pheochromocytoma (SDHD) Sequencing and Deletion/Duplication SDHD FGA

CPT Code(s): Sequencing: 83891 Isolation: 83898 x4 Amplification; 83904 x4 Sequencing; 83909 Capillary electrophoresis, 83912 Interpretation and report
2005408 Hereditary Persistence of Fetal Hemoglobin (HPFH) 8 Mutations HPFH

Methodology: Polymerase Chain Reaction/Electrophoresis
Page | 261
Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA). Also acceptable: Yellow (ACD Solution A or B), lt. blue (sodium citrate), or green (sodium or
lithium heparin).
CPT Code(s): 83891 Isolation; 83900 Multiplex amplification, 83901x7 Additional amplification; 83909 Capillary electrophoresis; 83912 Interpretation and
0091203 Heroin, Serum or Plasma - Screen with Reflex to Confirmation/Quantitation HEROIN SP

Methodology: Qualitative Enzyme-Linked Immunosorbent Assay/Quantitative Gas Chromatography-Mass Spectrometry
Specimen Required: Collect: Plain red, lavender (EDTA) or pink (K2EDTA). Also acceptable: Gray (sodium fluoride/potassium oxalate).
0091586 Heroin, Urine - Screen with Reflex to Confirmation/Quantitation HEROIN URN

Methodology: Qualitative Enzyme Immunoassay/Quantitative Gas Chromatography-Mass Spectrometry
Unacceptable Conditions: Thawed specimens.
0092283 Herpes Gestationis Factor (IgG Complement-Fixing Basement Membrane Zone Antibody) HG FACTOR
Methodology: Quantitative Indirect Immunofluorescence
CPT Code(s): 88347 Complement-fixing IgG; 88347 anti IgG; 88347 no complement anti C3; 83516 IgG BP 180
0051152 Herpes Simplex Type 1 & Type 2 Glycoprotein G-Specific Antibodies, IgG by ELISA (HerpeSelect®) HERP PAN 2
Transport Tube. (Min: 0.2 mL) Parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of the acute
specimen. Mark specimens plainly as "acute" or "convalescent."
Unacceptable Conditions: Contaminated, heat-inactivated, hemolyzed, or lipemic specimens.
CPT Code(s): 86695 HSV 1; 86696 HSV 2
0060041 Herpes Simplex Virus by PCR HSVPCR

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or serum separator tube. OR Amniotic fluid, bronchoalveolar lavage (BAL), CSF, ocular fluid,
tissue, vesicle fluid. OR Endocervical specimen in ThinPrep® Pap Test media.
Specimen Preparation: Separate plasma or serum from cells. Transfer 1 mL serum, plasma, amniotic fluid, BAL, CSF, ocular fluid, or ThinPrep®
specimen to a sterile container. (Min: 0.5 mL)
Vesicle Fluid: Transfer to viral transport media (ARUP supply #12884). Available online through eSupply using ARUP Connect™ or contact
ARUP Client Services at (800) 522-2787.
All Others: Ambient: 8 hours; Refrigerated: 72 hours; Frozen: 3 months
CPT Code(s): 87529
0065005 Herpes Simplex Virus Culture V HSVC

Methodology: Cell Culture/Immunoassay
Specimen Required: Collect: Buccal mucosa, eye, genital, rectal, throat or vesicle swab, bronchoalveolar lavage (BAL), tissue, or vesicle fluid.
Specimen Preparation: Fluid: Transfer to a sterile container. Also acceptable: Transfer to viral transport media (ARUP Supply #12884). Available
online through eSupply using ARUP Connector contact ARUP Client Services at (800) 522-2787.
Swab or Tissue: Place in viral transport media.
Unacceptable Conditions: Blood, CSF, plasma, or serum. Calcium alginate, dry, or wood swabs.
CPT Code(s): 87252 Tissue culture; 87253 IP stain
0065065 Herpes Simplex Virus Culture with Reflex to HSV Typing V HSVCT
Methodology: Cell Culture/Immunoassay
Page | 262
Specimen Required: Collect: Buccal mucosa, eye, genital, rectal, throat or vesicle swab, or bronchoalveolar lavage, tissue or vesicle fluid.
Specimen Preparation: Fluid: Transfer to a sterile container. Also acceptable: Transfer to viral transport media (ARUP Supply #12884). Available
online through eSupply using ARUP Connector contact ARUP Client Services at (800) 522-2787.
Swab or Tissue: Place in viral transport media.
Unacceptable Conditions: Blood, CSF, plasma, or serum. Calcium alginate, dry, or wood swabs.
CPT Code(s): 87252 Tissue culture and 87253 IP stain; if reflexed, add 87140 x2 Typing HSV 1, HSV 2
0060280 Herpes Simplex Virus DFA with Reflex to Herpes Simplex Virus Culture HSVFAC
Specimen Required: Collect: Buccal mucosa lesion, cervical or genital lesion, eye, throat or vesicle swab, bronchoalveolar lavage (BAL), tissue or vesicle fluid.
Specimen Preparation: Fluid: Transfer specimen to a sterile container. Also acceptable: Transfer to viral transport media (ARUP Supply #12884).
Available online through eSupply using ARUP Connector contact ARUP Client Services at (800) 522-2787.
Swab or Tissue: Place in viral transport media. Place each specimen in an individually sealed bag.
Unacceptable Conditions: Bone marrow, CSF, or whole blood. Calcium alginate, dry, or wood swabs.
CPT Code(s): 87274 Antigen detection HSV 1; 87273 Antigen detection HSV 2; if reflexed, add 87252 tissue culture; 87253 IP stain.
0050293 Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgG HERPES

Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transport 1 mL serum. (Min: 0.5 mL) Parallel testing is
preferred and convalescent specimens must be received within 30 days from receipt of the acute specimens. Mark specimens plainly as "acute"
or "convalescent."
Unacceptable Conditions: Urine. CSF (refer to Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgG, CSF, ARUP test code 0050394).
Contaminated, heat-inactivated, or hemolyzed specimens.
CPT Code(s): 86694
0050291 Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgG & IgM HERP PAN
Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Chemiluminescent Immunoassay
specimens must be received within 30 days from receipt of the acute specimens. Mark specimens plainly as "acute" or "convalescent."
CPT Code(s): 86694 HSV IgM; 86694 Herpes type 1 and 2 IgG nonspecific
0050364 Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgG & IgM (CSF) with Reflex to Type 1 & 2 Glycoprotein G- HERPRCSF
Specific Ab, IgG
Methodology: Semi-Quantitative Chemiluminescent Immunoassay/Semi-Quantitative Enzyme-Linked Immunosorbent Assay
CPT Code(s): 86694 HSV IgG and 86694 HSV IgM; if reflexed, add 86695 Herpes type 1, IgG confirmation and 86696 Herpes type 2, IgG confirmation
0050916 Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgG & IgM with Reflex to Type 1 & 2 Glycoprotein G-Specific HERPR PAN
Ab, IgG
CPT Code(s): 86694 HSV IgG and 86694 HSV IgM; if reflexed, add 86695 Herpes type 1, IgG confirmation and 86696 Herpes type 2, IgG confirmation
0050394 Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgG, CSF HER1/2CSF
Unacceptable Conditions: Specimens types other than CSF. Contaminated, heat-inactivated or hemolyzed specimens.
CPT Code(s): 86694
0050641 Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgM by ELISA HSV MC
Page | 263
specimens. Mark specimens plainly as "acute" or convalescent."
Unacceptable Conditions: Contaminated, heat-inactivated, hemolyzed, icteric, or severely lipemic specimens.
CPT Code(s): 86694
0050408 Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgM by ELISA, CSF HSVMCCSF
CPT Code(s): 86694
0050459 Herpes Simplex Virus Type 1 & Type 2 Glycoprotein G-Specific Antibodies, IgG by Immunoblot (HerpeSelect®) HSV BLOT
Unacceptable Conditions: Contaminated, heat-inactivated, hemolyzed, or hyperlipemic specimens.
CPT Code(s): 86695 Herpes simplex type 1; 86696 Herpes simplex type 2
0050292 Herpes Simplex Virus Type 1 Glycoprotein G-Specific Antibody, IgG by ELISA (HerpeSelect®) HERP I
CPT Code(s): 86695
0050379 Herpes Simplex Virus Type 1 Glycoprotein G-Specific Antibody, IgG by ELISA (HerpeSelect®), CSF HERPICSF
CPT Code(s): 86695
2003944 Herpes Simplex Virus Type 1 (HSV 1) by Immunohistochemistry HSV I IHC

CPT Code(s): 88342
0050359 Herpes Simplex Virus Type 2 Glycoprotein G-Specific Antibody, IgG by ELISA (HerpeSelect®), CSF HERPIICSF
CPT Code(s): 86696
0050294 Herpes Simplex Virus Type 2 Glycoprotein G-Specific Antibody, IgG by ELISA (HerpeSelect®) HERP II
Page | 264
CPT Code(s): 86696
2003954 Herpes Simplex Virus Type 2 (HSV 2) by Immunohistochemistry HSV II IHC

CPT Code(s): 88342
0051708 Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgG with Reflex to Type 1 and 2 Glycoprotein G-Specific HERPR PAN2
Ab, IgG
specimens must be received within 30 days from receipt of acute specimens. Mark specimens plainly as "acute" or "convalescent."
CPT Code(s): 86694 HSV 1/2 IgG. If reflexed, add 86695 HSV 1 gG IgG; 86696 HSV 2 gG IgG
0060847 Herpes Simplex Virus Typing HSVT

Patient Preparation: Typing may not be requested directly on a specimen.
Specimen Required: Collect: Herpes simplex isolate from cell culture with infected cells present.
Specimen Preparation: Transport positive cell culture or acetone fix a two-well slide with infected cells. Place each specimen in an individually
sealed bag.
CPT Code(s): 87140 x2 Typing HSV 1, HSV 2
2003932 Herpes Virus 8 by Immunohistochemistry HHV8 IHC

CPT Code(s): 88342
2002996 Herpes Virus 8 DNA, Qualitative Real-Time PCR HERPES 8

Specimen Required: Collect: Lavender (EDTA), yellow (ACD), plain red, or serum separator tube.
Specimen Preparation: Transfer 0.7 mL whole blood, serum, or plasma to an ARUP standard transport tube. (Min: 0.3 mL)
Unacceptable Conditions: Frozen whole blood.
Stability: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 1 month (frozen whole blood unacceptable)
CPT Code(s): 87798
2002829 Herpesvirus 6 Antibody, IgM HHV6 IGM

CPT Code(s): 86790
0065288 Herpesvirus 6 (HHV-6) Antibody, IgG HHV6 IGG

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CPT Code(s): 86790
0060071 Herpesvirus 6 (HHV6) (A and B), Quantitative PCR HHV6PCR

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), serum separator tube, or CSF.
CPT Code(s): 87533
0050621 Heterophile Antibody by Latex Agglutination with Reflex to Titer HETER R

Methodology: Semi-Quantitative Latex Agglutination
Unacceptable Conditions: CSF.
CPT Code(s): 86308 Heterophile antibody; if reflexed, add 86309 Heterophile titer
0091335 Hexachlorobenzene, Serum or Plasma HEXACHLOR

Specimen Preparation: Transfer 4 mL serum to an ARUP Standard Transport Tube. (Min: 1 mL) Also acceptable: Plasma.
CPT Code(s): 82441
0030064 Hexagonal Phospholipid Neutralization HEX PHOS

Methodology: Qualitative Clotting
Unacceptable Conditions: Serum. Hemolyzed or non-frozen specimens.
CPT Code(s): 85598
0092471 Hexosaminidase A & Total, Leukocytes HEXOSAMI

Methodology: Heat Inactivation/Fluorometry, Semiautomated
Specimen Required: Collect: Yellow (ACD Solution A or B). Collect specimen Monday through Thursday only and not the day before a holiday. Specimen should be
collected and packaged as close to shipping time as possible.
Unacceptable Conditions: Specimens that are not in the primary draw container. Frozen specimens. Specimens older than 4 days.
0095269 Hexosaminidase A & Total, Serum HEXOSAMIN

Methodology: Quantitative Heat Inactivation/Fluorometry, Automated
Unacceptable Conditions: Results are not valid on pregnant females therefore, testing will not be performed.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 1 month
CPT Code(s): 83080
2005526 High Avidity Double-Stranded DNA (HA dsDNA) Antibody, IgG HA DSDNA
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze-thaw cycles)
CPT Code(s): 86225
0093002 High Molecular Weight Kininogen HIGH KININ

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Specimen Preparation: Transfer two 1 mL aliquots of plasma to individual ARUP Standard Transport Tubes. (Min: 0.5 mL per aliquot). Up to four
freeze/thaw cycles are acceptable.
CPT Code(s): 85293
2005457 High-Specificity Antiphospholipid Antibodies, IgG and IgM HS APL

Unacceptable Conditions: Contaminated, heat-inactivated, grossly hemolyzed, grossly icteric, or severely lipemic specimens.
0091175 Hippuric Acid, Urine HIPPUR U

Methodology: Quantitative Ion Chromatography/Colorimetry
(Colorimetry/Ion Chromatography)
CPT Code(s): 83918
2001763 Hirsutism Evaluation Panel HIRSUTISM

Methodology: Quantitative Chemiluminescent Immunoassay/Electrochemiluminescent Immunoassay/Liquid Chromatography-Tandem Mass Spectrometry
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer three 1 mL aliquots of serum to individual
ARUP Standard Transport Tubes. (Min: 0.6 mL/aliquot)
CPT Code(s): 82157 Androstenedione; 82627 Dehydroepiandrosterone sulfate; 84403 Total Testosterone; 84270 SHBG
0070036 Histamine, Plasma HIST-P

Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA). Collect in a pre-chilled tube and on ice.
Specimen Preparation: Centrifuge refrigerated and separate upper two-thirds of plasma within 20 minutes. Transfer 1 mL plasma to an ARUP
Unacceptable Conditions: Non-frozen or hemolyzed specimens.
Stability: After separation from cells: Ambient: 1 hour; Refrigerated: 6 hours; Frozen: 6 months
CPT Code(s): 83088
0070038 Histamine, Urine HIST-U

Specimen Required: Collect: Random or 24-hour urine in a plastic container. Refrigerate during collection.
Specimen Preparation: Transfer a 4 mL aliquot from a well-mixed random or 24-hour collection to an ARUP Standard Transport Tube and freeze
immediately. (Min: 1 mL) Record total volume and collection time interval on transport tube and test request form. Also acceptable: Specimens
preserved with HCl, if frozen immediately.
Stability: Ambient: Unacceptable; Refrigerated: 24 hours; Frozen: 6 months
CPT Code(s): 83088
0070037 Histamine, Whole Blood HIST-WB

Specimen Preparation: Transfer 1 mL well-mixed whole blood to an ARUP Standard Transport Tube and freeze. (Min: 0.5 mL)
CPT Code(s): 83088
0050860 Histone Antibody, IgG AHA

Tube. (Min: 0.3 mL)
Unacceptable Conditions: Plasma or urine. Contaminated specimens. Grossly hemolyzed, icteric, or lipemic specimens.
CPT Code(s): 83516
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0050625 Histoplasma Antibodies by CF HISTO
CPT Code(s): 86698 Histoplasma mycelia; 86698 Histoplasma yeast
0050627 Histoplasma Antibodies by CF & ID HISTO PAN

CPT Code(s): 86698 Histoplasma (ID); 86698 Histoplasma mycelia (CF); 86698 Histoplasma yeast (CF)
0050174 Histoplasma Antibody by ID HISTO PPT

Tube. (Min 0.1 mL)
CPT Code(s): 86698
0092522 Histoplasma Antigen by EIA, Serum HISTOAG S

Specimen Preparation: Transfer 2 mL serum to an ARUP Standard Transport Tube (ARUP Supply #43115). (Min: 1 mL)
Unacceptable Conditions: Urine (refer to test Histoplasma Antigen Detection EIA, Urine (ARUP test code 2006110). Specimens other than serum.
Stability: Ambient: Unacceptable; Refrigerated: 5 weeks; Frozen: Indefinitely (avoid repeated freeze/thaw cycles)
CPT Code(s): 87385
2006110 Histoplasma Antigen Detection EIA, Urine HISTO AG U

Stability: Ambient: Unacceptable; Refrigerated: 2 weeks; Frozen: 2 weeks (avoid repeated freeze/thaw cycles)
CPT Code(s): 87385
0062226 Histoplasma capsulatum Identification by DNA Probe MC HP

Specimen Required: Collect: Actively growing fungal isolate in pure culture.
Specimen Preparation: Transport sealed container with pure culture on non-blood containing fungal medium. Place each specimen in an
Unacceptable Conditions: Mixed cultures or non-viable organisms. Agar plate.
CPT Code(s): 87149
2004457 HIV-1 Integrase Inhibitor Resistance by Sequencing HIV1INT

Methodology: Reverse Transcription Polymerase Chain Reaction/Sequencing
Stability: On cells: Ambient: 6 hours; After separation from cells: Ambient: 24 hours; Refrigerated: 5 days; Frozen: 4 months
CPT Code(s): 87906
2004331 HIV GenoSure® MG GENOSURE

Specimen Required: Collect: Lavender (EDTA) or plasma preparation tube.
Specimen Preparation: Separate PPT plasma from cells within 2 hours of collection. Separate EDTA plasma from cells within 6 hours of
collection. Transfer 3 mL plasma to an ARUP Standard Transport Tube and freeze immediately. (Min: 3 mL)
Page | 268
Remarks: Indicate viral load and viral load collection date on the test request form. If viral load is less than 500 copies, testing MAY NOT be
performed.
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen at -20°C: 2 weeks; Frozen at -70°C: Indefinitely
CPT Code(s): 87900 Phenotype; 87901 Genotype
0092399 HIV PhenoSense GT® HIVPHENOGT

Methodology: Phenotyping/Genotyping
Remarks: Indicate patient's most recent viral load and viral load collection date on the test request form. If viral load is less than 500 copies,
testing MAY NOT be performed.
CPT Code(s): 87900 Phenotype; 87901 Genotype; 87903 Phenotype with culture, 1-10 drugs; 87904 x11 Phenotype with culture, each additional drug
2003085 HLA-A Sequencing SBT A

Specimen Required: Collect: Peripheral blood in yellow (ACD Solution A), lavender (EDTA), or pink (K2EDTA).
Unacceptable Conditions: Frozen specimens. Clotted or heparinized specimens.
CPT Code(s): 83891 Isolation; 83898 Amplification; 83904 x3 Sequencing; 83909 Separation and identification; 83912 Interpretation and report - Additional
2002788 HLA-ABC Sequencing SBT ABC

CPT Code(s): 83891 Isolation; 83898 x3 Amplification; 83904 x8 Mutation identification by sequencing; 83909 Separation and identification; 83912
2002805 HLA Antibody Detection HLA ABSCN

Methodology: Multiplex Bead Assay
Specimen Preparation: Transfer 5 mL serum to ARUP Standard Transport Tubes. (Min. 2 mL)
Stability: Ambient: 48 hours; Refrigerated: 1 month; Frozen: 2 years
CPT Code(s): 88184 First marker; 88185 x3 Each additional marker; 88187 Interpretation on 2-8 markers
2002429 HLA-B*5701 Associated Variant Genotyping for Abacavir Sensitivity HLA-B5701

2002784 HLA-B Sequence SBT B

CPT Code(s): 83891 Isolation; 83898 Amplification; 83904 x3 Sequencing; 83909 Separation and identification; 83912 Interpretation and report - Additional
0095840 HLA-B27 HLAB27

Methodology: Qualitative Flow Cytometry
Specimen Required: Collect: Lavender Hemogard (EDTA), pink Hemogard (K2EDTA), or green Hemogard (sodium or lithium heparin). Hemogard tubes are preferred
for laboratory safety.
New York State Clients: EDTA specimens must be analyzed within 30 hours of collection. Heparin specimens must be analyzed within 48 hours
of collection.
New York State Clients: Frozen or refrigerated specimens. Heparin specimens older than 48 hours or EDTA specimens older than 30 hours.
Clotted or hemolyzed specimens.
Page | 269
New York State Clients: Ambient: 30 hours in EDTA, 48 hours in heparin; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 86812
2002806 HLA Bone Marrow Transplantation Evaluation HLA-BMT

Methodology: Polymerase Chain Reaction/Sequence Specific Oligonucleotide Probe Hybridization
Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA). Also acceptable: Yellow (ACD Solution A or B).
Unacceptable Conditions: Specimens collected in green (sodium or lithium heparin). Frozen specimens.
CPT Code(s): 83891 Isolation; 83898 Amplification; 83900 Multiplex Amplification; 83896 x10 Nucleic acid probes; 88384 Probes 11-50; 88385 Probes 51-
250; 83912 Interpretation and report -Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited
disorders.
2002814 HLA-C Sequencing SBT C

CPT Code(s): 83891 Isolation; 83898 Amplification; 83904 x2 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report - Additional CPT
2002810 HLA-DQB Genotyping HLA-DQ DNA

Unacceptable Conditions: Specimens collected in green (sodium or lithium heparin).
CPT Code(s): 83891 Isolation; 83900 Multiplex Amplification; 83896 x10 Nucleic acid probes; 88384 Probes 11-50; 83912 Interpretation and report -Additional
2002798 HLA-DR Genotyping HLA-DR DNA

CPT Code(s): 83891 Isolation; 83898 Amplification; 83896 x10 Nucleic acid probes; 88384 Probes 11-50; 88385 Probes 51-250; 83912 Interpretation and
report -Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders.
2002779 HLA-DRB1 Sequencing SBT DRB1

CPT Code(s): 83891 Isolation; 83898 Amplification; 83904 x2 Sequencing; 83909 Separation and identification; 83912 Interpretation and report -Additional
2006984 HLA-A Genotype HLA A

CPT Code(s): 83891 Isolation; 83900 x2 Multiplex Amplification; 83896 x10 Nucleic acid probes; 88384 Probes 11-50; 88385 Probes 51-250; 83912
Interpretation and report -Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders.
2006986 HLA-B Genotype HLA B

CPT Code(s): 83891 Isolation; 83900 x2 Multiplex Amplification; 83896 x10 Nucleic acid probes; 88384 Probes 11-50; 88385 Probes 51-250; 83912
Interpretation and report -Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders.
2006988 HLA-C Genotype HLA C

Page | 270
CPT Code(s): 83891 Isolation; 83900 Multiplex Amplification; 83896 x10 Nucleic acid probes; 88384 Probes 11-50; 88385 Probes 51-250; 83912 Interpretation
and report -Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders.
2001728 HNPCC/Lynch Syndrome Deletion/Duplication HNPCC DD

CPT Code(s): 83891 Isolation; 83896 x10 Nucleic Acid probes; 83898 x10 Amplification; 83914 x10 Extension; 83909 Capillary electrophoresis; 83912
Interpretation and report. If sequencing is performed for PMS2, add 83898 x10 Amplification; 83904 x8 Sequencing; 83909 Capillary
electrophoresis. - Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders.
0051650 HNPCC/Lynch Syndrome (MLH1) Sequencing and Deletion/Duplication MLH1 FGA

CPT Code(s): Sequencing portion: 83891 Isolation; 83898 x20 Amplification; 83904 x20 Sequencing; 83909 x2 Capillary electrophoresis; Del: 83896 Nucleic
Acid Probes; 83898 Amplification; 83914 Extension; 83909 Capillary Electrophoresis; 83912 Interpretation and report - Additional CPT code
0051654 HNPCC/Lynch Syndrome (MSH2) Sequencing and Deletion/Duplication MSH2 FGA

CPT Code(s): Sequencing portions: 83891 Isolation; 83898 x20 Amplification; 83904 x20 Sequencing; 83909 x2 Capillary electrophoresis; Del: 83896 Nucleic
Acid Probes; 83898 Amplification; 83914 Extension; 83909 Capillary Electrophoresis; 83912 Interpretation and report - Additional CPT code
0051656 HNPCC/Lynch Syndrome (MSH6) Sequencing and Deletion/Duplication MSH6 FGA

CPT Code(s): Sequencing: 83891 Isolation; 83898 x19 Amplification; 83904 x19 Sequencing; 83909 x2 Capillary electrophoresis.
Del: 83896 x10 Nucleic Acid Probes; 83898 x10 Amplification; 83914 x10 Extension; 83909 Capillary Electrophoresis; 83912 Interpretation and
0051737 HNPCC/Lynch Syndrome (PMS2) Sequencing and Deletion/Duplication PMS2 FGA

CPT Code(s): Sequencing: 83891 Isolation; 83898 x18 Amplification; 83904 x15 Sequencing; 83909 Capillary electrophoresis.
Del/Dup: 83896 x15 Nucleic Acid Probes; 83898 x15 Amplification; 83914 x15 Extension; 83909 Capillary electrophoresis; 83912 Interpretation
and report. If pseudogene analysis is performed, add: 83898 x6 Amplification; 83904 x5 Sequencing; 83909 Capillary electrophoresis. -
0099869 Homocysteine, Total HOMOCY-QNT

Specimen Required: Collect: Green (sodium or lithium heparin) or serum separator tube.
Specimen Preparation: Serum or plasma must be separated from cells within one hour of collection. If specimen cannot be separated from
cells within one hour, store specimen on ice. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Unacceptable Conditions: Sodium citrate.
Stability: Ambient: 1 hour; Refrigerated: 1 week; Frozen: 3 months
CPT Code(s): 83090
0080413 Homocystine Quantitative, Urine HOMOCYS-U

Patient Preparation: Patients should abstain from vitamin C ingestion for 48 hours prior to specimen collection.
Specimen Required: Collect: 24-hour urine. Specimen must be refrigerated during collection. Also acceptable: Random urine (reported as homocystine/creatinine
ratios).
Specimen Preparation: Mix well. Transfer 5 mL urine to ARUP Standard Transport Tubes. (Min: 3 mL) Record total volume and collection time
Unacceptable Conditions: pH less than 5 or greater than 8. Specimens with acid or other preservatives. Ascorbic acid interferes with this assay.
Large amounts of blood or hemoglobin can interfere with quantitation.
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CPT Code(s): 82131
0080422 Homovanillic Acid (HVA), Urine HVA U

Specimen Required: Collect: 24-hour or random urine. Refrigerate 24-hour specimens during collection.
Specimen Preparation: Transfer 4 mL aliquot from a well-mixed 24-hour or random collection to an ARUP Standard Transport Tube. (Min: 1 mL)
Unacceptable Conditions: Specimen types other than urine.
CPT Code(s): 83150
0098299 Human Anti-Mouse Antibody (HAMA), ELISA HAMA

CPT Code(s): 83520
2003920 Human Chorionic Gonadotropin (Beta-hCG) by Immunohistochemistry HCG IHC

CPT Code(s): 88342
2003020 Human Epididymis Protein 4 (HE4) HE4

Specimen Preparation: Allow specimen to clot completely at room temperature. Transfer 0.5 mL serum to an ARUP Standard Transport Tube.
(Min: 0.1 mL)
Stability: Ambient: 4 hours; Refrigerated: 72 hours; Frozen: 60 days
CPT Code(s): 86305
0055670 Human Immunodeficiency Virus 1, Genotyping HIV1GENO

Methodology: Reverse Transcription Polymerase Chain Reaction/Sequencing
Stability: On Cells: Ambient: 6 hours; After separation from cells: Ambient: 24 hours; Refrigerated: 5 days; Frozen: 4 months
CPT Code(s): 87901
0020466 Human Immunodeficiency Virus 1 RNA Quantitative bDNA HIV BDNA

Methodology: Quantitative Branched Chain DNA
Specimen Preparation: Separate EDTA plasma from cells within 4 hours. Transfer 3 mL plasma to an ARUP Standard Transport Tube. (Min: 1.5
mL)
Stability: PPT: On Cells: Ambient: 2 hours; After separation from cells: Ambient: 24 hours; Refrigerated: Unacceptable; Frozen at -20°C: 72
hours; Frozen at -70°C: 4 months
All others: On Cells: Ambient: 4 hours; After separation from cells: Refrigerated: 48 hours; Frozen at -20°C: 72 hours; Frozen at -70°C: 4 months
CPT Code(s): 87536
2002688 Human Immunodeficiency Virus 1 RNA Quantitative bDNA with Reflex to Genotype HIVBD GR
Methodology: Quantitative Branched Chain DNA/Sequencing
Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or plasma preparation tube. Multiple tubes may be required.
Specimen Preparation: Separate plasma from cells within 4 hours. Transfer two 3 mL aliquots of plasma to individual ARUP Standard Transport
Tubes. (Min: 3 mL)
PPT: Separate plasma from cells within 2 hours. Transport total of 6 mL plasma in original containers. (Min: 3 mL)
Page | 272
Stability: PPT: On Cells: Ambient: 2 hours; After separation from cells: Ambient: 24 hours; Refrigerated: Unacceptable; Frozen at -20°C: 72
hours; Frozen at -70°C: 4 months
All others: On Cells: Ambient: 4 hours; After separation from cells: Refrigerated: 48 hours; Frozen at -20°C: 72 hours; Frozen at -70°C: 4 months
CPT Code(s): 87536 HIV bDNA; if reflexed, add 87901 Genotype
0055598 Human Immunodeficiency Virus 1 RNA Quantitative Real-Time PCR HIVPCRQ

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), plasma preparation tube, or CSF.
Specimen Preparation: Separate plasma from cells within 24 hours of collection. Transfer 3 mL plasma or CSF to an ARUP Standard Transport
Tube and freeze. (Min: 1.5 mL)
Unacceptable Conditions: Serum. Heparinized specimens. Specimens submitted in plasma preparation tube.
Stability: On Cells: Ambient: 24 hours; After separation from cells: Ambient: 24 hours; Refrigerated: 6 days; Frozen: 6 weeks
CPT Code(s): 87536
2002689 Human Immunodeficiency Virus 1 RNA Quantitative Real-Time PCR with Reflex to Genotype HIVQT GR
Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or plasma preparation tube. Multiple tubes may be required.
Specimen Preparation: Separate plasma from cells within 24 hours. Transfer two 3 mL aliquots of plasma to individual ARUP Standard Transport
Tubes. (Min: 3 mL)
Unacceptable Conditions: Serum. Heparinized specimens. Specimens submitted in a plasma preparation tube.
Stability: Ambient: On cells: 24 hours. After separation from cells: Ambient: 24 hours; Refrigerated: 6 days; Frozen: 6 weeks
CPT Code(s): 87536 Quantitative PCR; if reflexed, add 87901 Genotyping
0051186 Human Immunodeficiency Virus 1, virco®TYPE HIV1VT

Methodology: Reverse Transcription Polymerase Chain Reaction/Sequencing/Phenotype Interpretation
Stability: On cells: Ambient: 6 hours; After separation from cells: Ambient: 24 hours; Refrigerated: 5 days; Frozen: 4 months
CPT Code(s): 87900 Phenotype prediction using genotypic bioinformatics; 87901 Genotype analysis by nucleic acid
0093272 Human Immunodeficiency Virus 2 Antibody Confirmation by Immunoblot HIV 2 IBL

Specimen Preparation: Transport 1 mL serum. (Min: 0.25 mL) Also acceptable: Plasma.
Stability: After separation from cells: Ambient: 1 week; Refrigerated: 2 weeks; Frozen: 1 month
CPT Code(s): 86689
0051250 Human Immunodeficiency Virus 2 Antibody with Reflex to Confirmation HIV-2 PAN
Methodology: Qualitative Enzyme Immunoassay/Qualitative Immunoblot
Specimen Required: Collect: Serum separator tube. Also acceptable: Lavender (EDTA) OR PINK (K2EDTA)
Unacceptable Conditions: Heat-inactivated, Cadaveric, severely hemolyzed, or lipemic specimens.
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 1 week; Frozen: 1 year (avoid repeated freeze/thaw cycles.)
CPT Code(s): 86702 HIV2; if reflexed add 86689 HIV2 Ab confirmation
0093061 Human Immunodeficiency Virus 1, PCR, Qualitative HIV DNA

Specimen Preparation: Do not freeze specimen. Transport 1 mL whole blood. (Min: 0.5 mL)
Storage/Transport Temperature: Refrigerated. Specimen must be received at ARUP within 84 hours.
Unacceptable Conditions: Heparinized specimens. Frozen specimens.
CPT Code(s): 87535
2006526 Human Immunodeficiency Virus (HIV) Combo Antigen/Antibody (HIV-1/O/2) by ELISA, with Reflex to HIV-1 HIV AGAB
Antibody Confirmation by Western Blot
Methodology: Qualitative Enzyme-Linked Immunosorbent Assay/Qualitative Western Blot
Specimen Required: Collect: Serum separator tube. Also acceptable: Lavender (EDTA), pink (K2EDTA), green (sodium or lithium heparin), or red (clot activator)
Transport Tube. Remove particulate material. (Min: 0.5 mL).
Remarks: Submit specimen according to Biological Substance, Category B, shipping guidelines.
Unacceptable Conditions: Specimens containing particulate material. Severely hemolyzed or heat-inactivated specimens.
CPT Code(s): 87389 HIV-1 Ag w/HIV-1 Ab and HIV-2 Ab; if reflexed, add 86689 HIV-1 confirmation
0092050 Human Immunodeficiency Virus (HIV) Phenotype Comprehensive HIV COMPRE

Methodology: Drug Susceptibility using HIV Culture
(Cell Culture)
Page | 273
Remarks: Indicate patient's most recent viral load and viral load collection date on the test request form. If viral load is less than 500 copies,
testing MAY NOT be performed.
CPT Code(s): 87903 Phenotype with culture 1-10 drugs; 87904 x11 Phenotype with culture, each additional drug
0020284 Human Immunodeficiency Virus Type 1 (HIV-1) Antibody Confirmation by Western Blot HIV WBLOT
Specimen Required: Collect: Serum separator tube. Also acceptable: Lavender (EDTA), green (sodium or lithium heparin) or lt. blue (sodium citrate).
Stability: After separation from cells: Ambient: Up to 1 week is acceptable, but not preferred; Refrigerated: 1 week; Frozen: Indefinitely (avoid
repeated freeze/thaw cycles)
CPT Code(s): 86689
2005375 Human Immunodeficiency Virus Type 1 (HIV-1) Antibody with Reflex to Human Immunodeficiency Virus HIV 1 SCRN
Type 1 (HIV-1) Antibody Confirmation by Western Blot
Methodology: Qualitative Chemiluminescent Immunoassay/Qualitative Western Blot
Unacceptable Conditions: Heat-inactivated, severely hemolyzed, or lipemic specimens.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: Indefinitely (avoid repeated freeze/thaw cycles).
CPT Code(s): 86701 HIV-1 Ab; if reflexed, add 86689 HIV-1 Ab confirmation
2005377 Human Immunodeficiency Virus Types 1 and 2 (HIV-1, HIV-2) Antibodies with Reflex to HIV-1 Antibody HIV1,2 SCR
Confirmation by Western Blot
Methodology: Qualitative Chemiluminescent Immunoassay/Qualitative Western Blot
Unacceptable Conditions: Heat-inactivated, severely hemolyzed, or lipemic specimens.
CPT Code(s): 86703 HIV-1, 2; if reflexed, add 86689 HIV-1 confirmation
0060779 Human Metapneumovirus by DFA HMPVFA

Specimen Required: Collect: Respiratory specimen: Bronchoalveolar lavage (BAL), nasopharyngeal (aspirate, swab, or washing), or tracheal aspirate.
Fluid: Transfer specimen to a sterile container. Also acceptable: Transfer to viral transport media (ARUP supply #12884). Available online
Swab: Place in viral transport media.
Unacceptable Conditions: Calcium alginate, dry, or wood swabs. Slides.
CPT Code(s): 87299
0060784 Human Metapneumovirus by RT-PCR HMPVPCR

Specimen Required: Collect: Respiratory specimen: Bronchoalveolar lavage (BAL), sputum, swabs, washes or pleural fluid.
Swabs: Place in viral transport media. Place each specimen in an individually sealed bag.
CPT Code(s): 87798
2005389 Human Papillomavirus (HPV) DNA, High Risk by Invader Method HPVHI INV
Patient Preparation: Females should avoid high concentrations of antifungal cream, contraceptive jelly, or douche at time of collection.
Specimen Required: Collect: Cervical Brush in ThinPrep® transport Pap Test™ Media.
Specimen Preparation: Place each specimen in an individually sealed bag. (Min: 2 mL)
CPT Code(s): 87621
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0060049 Human Papillomavirus (HPV) DNA Probe, High- and Low-Risk Groups, Cervix HPV HL
Specimen Required: Collect: Cervical brush in HPV Digene Collection Kit, ThinPrep® Pap Test transport media or SurePath Pap transport media.
Specimen Preparation: Transport cervical brush in HPV Digene Collection Kit (cervical brush and specimen transport medium) (Min: 1 mL) or
ThinPrep Pap Test transport media (Min: 4 mL) or SurePath Pap specimen transport media. (Min: 2 mL)
Unacceptable Conditions: Swabs or specimens in transport media other than Digene STM, SurePath media, or ThinPrep media. Samples other
than cervical are not accepted for children under age 13.
Stability: Digene transport medium: Ambient: 2 weeks; Refrigerated: 3 weeks; Frozen: 3 months
ThinPrep®Pap Test ™ transport media: Ambient: 3 months; Refrigerated: 3 months; Frozen: Unacceptable
SurePath™ transport media: Ambient: 2 weeks; Refrigerated: 4 weeks; Frozen: Unacceptable
CPT Code(s): 87621 High-risk HPV; 87621 Low-risk HPV
0065999 Human Papillomavirus (HPV) DNA Probe, High Risk, Cervical Brush (Digene) HPV-HI
Specimen Required: Collect: Cervical brush in HPV Digene Collection Kit (ARUP supply #12578). Available online through eSupply using ARUP Connect™ or
contact ARUP Client Services at (800) 522-2787.
For specimens in ThinPrep® Pap Test transport media, refer to test code 0060750; for specimens in SurePath® Pap specimen transport media,
refer to test code 0060744.
CPT Code(s): 87621
0060750 Human Papillomavirus (HPV) DNA Probe, High Risk (ThinPrep®) TP HPV-HI
Specimen Required: Collect: Cervical Brush in ThinPrep® transport Pap Test™ media.
Unacceptable Conditions: Specimens in any transport media other than indicated above. For specimens in ThinPrep® Test transport media, refer
to ARUP test code 0060750. For cervical brush specimens in Digene Transport media, refer to ARUP test code 0065999.
CPT Code(s): 87621
0060744 Human Papillomavirus (HPV) DNA Probe, High-Risk Surepath™ (AutoCyte) SP HPV-HI
Specimen Required: Collect: Cervical Brush in SurePath™ liquid-based Pap test media.
Unacceptable Conditions: Specimens in any transport media other than indicated above
For specimens in ThinPrep® Test transport media refer to ARUP test code 0060750. For cervical brush specimens in Digene specimen transport
media, refer to ARUP test code 0065999.
CPT Code(s): 87621
2005277 Human Papillomavirus (HPV), Genotypes 16 and 18 HPV16,18

Specimen Required: Collect: Cervical Brush in ThinPrep® transport Pap Test Media.
Stability: Ambient: 18 weeks; Refrigerated 18 weeks; Frozen: Unacceptable
2002899 Human Papillomavirus (HPV) High Risk in situ Hybridization, Paraffin HPVHI ISH
slides in a tissue transport kit (ARUP supply #47808). Available online through eSupply using ARUP ConnectTM or contact ARUP Client
Services at (800) 522-2787. (Min: 3 slides) Protect paraffin block and/or slides from excessive heat.
Unacceptable Conditions: Specimens fixed or processed in alternative fixatives (alcohol, Prefer®) or heavy metal fixatives (B-4 or B-5). Frozen
specimens.
CPT Code(s): 88365
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2005283 Human Papillomavirus (HPV), High Risk with Reflex to Genotypes 16 and 18 HPVHI R
Specimen Required: Collect: Cervical Brush in ThinPrep® transport Pap Test Media ™.
CPT Code(s): 87621 HPV High Risk; if reflexed, add 87621 x2 HPV 16 and HPV 18 Genotyping.
2002896 Human Papillomavirus (HPV) Low Risk by in situ Hybridization, Paraffin HPVLOW ISH
Specimen Preparation: Formalin fix (10% neutral buffered formalin) and paraffin embed tissue. Transport tissue block or 5 sections on "plus"
(positively) charged or silanized slides. (Min: 3 slides) Protect from excessive heat.
Unacceptable Conditions: Specimens in fixative other than 10% neutral buffered formalin. Decalcified specimens.
CPT Code(s): 88365
2002893 Human Papillomavirus (HPV) Panel by in situ Hybridization, Paraffin HPVPAN ISH
Remarks: Room temperature or refrigerated. Ship in cooled container during summer months.
specimens.
0099721 Human Placental Lactogen (HPL) HPL

Specimen Preparation: Separate from cells within 2 hours. Transfer 1 mL serum to an ARUP Standard Transport Tube and freeze immediately.
(Min: 0.5 mL).
Unacceptable Conditions: Specimens that have been thawed and refrozen.
CPT Code(s): 83632
2003938 Human Placental Lactogen (HPL) by Immunohistochemistry HPL IHC

CPT Code(s): 88342
0020642 Human T-Lymphotropic Virus Types I/II Antibodies, Western Blot HTLV WBLOT
Tube. (Min: 0.5 mL) Also acceptable: Plasma.
Stability: After separation from cells: Ambient: 1 week is acceptable, but not preferred; Refrigerated: 1 week; Frozen: Indefinitely (avoid repeated
freeze/thaw cycles)
CPT Code(s): 86689
0051164 Human T-Lymphotropic Virus Types I/II Antibodies with Reflex to HTLV I/II Confirmation HTLV PAN
Methodology: Qualitative Enzyme Immunoassay/Qualitative Western Blot
Tube. (Min: 0.5 mL) Also acceptable: Citrate, EDTA or heparin plasma.
Unacceptable Conditions: Specimens containing particulate material. Heat-inactivated, severely hemolyzed, or lipemic specimens.
CPT Code(s): 86790 HTLV I/II; if reflexed, add 86689 HTLV confirmation, confirmatory test
Page | 276
2003075 Human T-Lymphotropic Virus Types I/II DNA, Qualitative Real-Time PCR HTLV RTPCR
New York State Clients: Transport 5 mL whole blood in original collection tube. (Min: 5 mL)
New York State Clients: Specimens in pour-off tubes. Clotted specimens.
Stability: Ambient: 1 week; Refrigerated: 2 Weeks; Frozen: Unacceptable
New York State Clients: Ambient: 4 days; Refrigerated: 4 days; Frozen: Unacceptable
0093179 Humoral Immunity Evaluation Panel HUM PAN

Methodology: Enzyme-Linked Immunosorbent Assay/Multi-Analyte Immunodetection
(Enzyme-Linked Immunosorbent Assay/Multiplex Bead Assay)
Specimen Preparation: Separate from cells. Transfer 4 mL serum to an ARUP Standard Transport Tube. (Min: 2 mL)
CPT Code(s): 86317x6 Pneumo serotypes; 86648 Diphtheria; 86684 Haemophilus; 86774 Tetanus
0050980 Humoral Immunity Panel I HUMPAN I

Methodology: Quantitative Nephelometry/Semi-Quantitative Multiplex Bead Assay
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer four 1 mL aliquots of serum to individual ARUP
Standard Transport Tubes. (Min: 1 mL total)
Stability: After separation from cells: Ambient: 2 hours; Refrigerated: 8 days; Frozen: 1 year (avoid repeated freeze/thaw cycles).
(Refer to individual components for further information.)
CPT Code(s): 86317 Diphtheria; 86317 x14 Pneumo serotypes; 86317 Tetanus; 82787 x4 IgG subclasses; 82784 Immunoglobulin IgA; 82784 Immunoglobulin
IgG; 82784 Immunoglobulin IgM
0050981 Humoral Immunity Panel II HUMPAN II

Specimen Preparation: Transfer two 1 mL aliquots of serum to individual ARUP Standard Transport Tubes. (Min: 0.1 mL/aliquot)
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles).
CPT Code(s): 86317 Diphtheria; 86317 x14 Pneumo serotypes; 86317 Tetanus
0040018 Huntington Disease (HD) Mutation with Reflex to Southern Blot HD

Remarks: A completed HD specific consent form, signed by the patient (or legal guardian) and physician, is required for all specimens. Testing for
patients under the age of 18 years or fetal specimens is not offered. Presymptomatic patients are strongly encouraged to be tested through a
counseling program approved by the Huntington Disease Society of America at (800) 345-4372. Call Genetics Processing with additional
questions at 800-242-2787 ext 3301.
CPT Code(s): 83891 Isolation; 83898 Amplification; 83909 Separation and identification; 83912 Interpretation and report; If reflexed to Southern blot, add
83891 Isolation; 83892 Digestion; 83894 Separation by gel electrophoresis; 83897 Southern transfer; 83896 Nucleic acid probe - Additional CPT
0081138 Hyaluronic Acid, Serum HYA

Specimen Required: Collect: Serum separator tube. Also acceptable: Green (sodium or lithium heparin), lavender (EDTA), or pink (K2EDTA).
hours of collection. Transfer 2 mL serum or plasma to an ARUP
CPT Code(s): 83520
0091573 Hydralazine, Serum or Plasma HYDRALAZIN

CPT Code(s): 80299
0091172 Hydralazine, Urine HYDRAL UR

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Specimen Required: Collect: Random Urine.
CPT Code(s): 80299
0091177 Hydrocarbon and Oxygenated Volatiles Panel, Serum or Plasma HYDROX OXY
Specimen Required: Collect: Gray (potassium oxalate/sodium fluoride), plain red, royal blue (no additive or EDTA).
CPT Code(s): 84600
0091128 Hydrocarbon & Oxygenated Volatiles, Urine HYDR OX UR

CPT Code(s): 84600
0091364 Hydrochlorothiazide HYDROCHL

Specimen Preparation: Transfer 2 mL serum or plasma to an ARUP Standard Transport Tube.(Min: 0.7 mL)
CPT Code(s): 80299
0091504 Hydrochlorothiazide, Urine HYDROCHL U

Storage/Transport Temperature: Room Temperature.
CPT Code(s): 80299
0097321 3-Hydroxy Fatty Acids 3HYDFATTY

Methodology: Gas Chromatography/Mass Spectrometry/Stable Isotope
Specimen Required: Collect: Serum separator tube or plain red. Also acceptable: Lavender (EDTA) or green (sodium heparin).
Specimen Preparation: Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.5 mL). Also acceptable: 2 mL whole blood.
(Min: 1 mL)
Remarks: Clinical History Required: Patient name, date of birth, tests required, requesting physician's name and phone number, brief clinical
history including test results.
Unacceptable Conditions: Citrated plasma. Omission of clinical history information.
Stability: Ambient: 1 month; Refrigerated: Indefinitely; Frozen: Indefinitely
CPT Code(s): 83789
0070490 17-Hydroxycorticosteroids, Urine HYD CORT

Specimen Required: Collect: 24-hour urine. Refrigerated during collection. Also acceptable: Random urine. Reported as mg/L and have no reference interval.
Specimen Preparation: Transfer 12 mL aliquot of urine from a well-mixed 24-hour collection to ARUP Standard Transport Tubes. Also
acceptable: Specimens refrigerated with preservatives are acceptable. Sample pH must be 5.0 - 7.0. Mix well, add 1 g boric acid/100 mL urine,
adjust pH (with boric acid) to 5.0-7.0 and freeze. Record total volume, collection time, and pH on transport tube and test request form.
Unacceptable Conditions: Alkali preservatives (e.g. specimens previously preserved with NaOH).
Stability: Ambient: 4 hours (with preservative); Refrigerated: 1 week (with preservative); Frozen: 1 month
CPT Code(s): 83491
0080420 5-Hydroxyindoleacetic Acid (HIAA), Urine HIAA

Patient Preparation: Patients should abstain, if possible, from medications, over-the-counter drugs, and herbal remedies for at least 72 hours
prior to the test. Foods rich in serotonin (avocados, bananas, eggplant, pineapple, plums, tomatoes, walnuts) and medications that may affect
metabolism of serotonin must be avoided at least 72 hours before and during collection of urine for HIAA.
Unacceptable Conditions: Any sample except urine.
CPT Code(s): 83497
0070265 21-Hydroxylase Antibody 21-OH AB

Page | 278
CPT Code(s): 83519
0092335 17-Hydroxypregnenolone Baseline Specimen OHPRGNBASE

CPT Code(s): 84143
0092336 17-Hydroxypregnenolone 30-Minute Timed Specimen OHPRGN 30

CPT Code(s): 84143

CPT Code(s): 84143

CPT Code(s): 84143
0092333 17-Hydroxypregnenolone Quantitative by LC-MS/MS, Serum or Plasma OHPRGNLON

CPT Code(s): 84143
0070005 17-Hydroxyprogesterone 17OHPROG

CPT Code(s): 83498
0092332 17-Hydroxyprogesterone Quantitative by LC-MS/MS, Serum or Plasma OHPRGSTON

CPT Code(s): 83498
0098378 17-Hydroxyprogesterone, Urine 17OHPROGU

Specimen Required: Collect: 24-hour urine. No special preservatives required.
Page | 279
Specimen Preparation: Mix specimen well. Transfer 5 mL aliquot of urine to ARUP Standard Transport Tubes. (Min: 1 mL) HCL or boric acid
can be used, but is not necessary.
Storage/Transport Temperature: Frozen. On dry ice is preferred. Separate specimens must be submitted when multiple tests are ordered.
CPT Code(s): 83498
2002348 25-Hydroxyvitamin D2 and D3 by Tandem Mass Spectrometry, Serum VITD2D3TMS

Specimen Required: Collect: Plain red or serum separator tube. Also acceptable: Green (sodium heparin), lavender (EDTA), or pink (K2EDTA).
Unacceptable Conditions: Room temperature specimens older than 24 hours.
CPT Code(s): 82306
0091207 Hydroxyzine, Serum or Plasma HYDROXY SP

(Min: 1.2 mL)
CPT Code(s): 80299
0091495 Hydroxyzine, Urine HYDROXY U

CPT Code(s): 80299
0055076 Hypersensitivity Pneumonitis I HYPER PRO

CPT Code(s): 86331 x4 Gel Diffusion Qualitative; 86606 x2 Aspergillus
0055226 Hypersensitivity Pneumonitis II HYPER II

CPT Code(s): 86331 x3 Gel Diffusion Qualitative; 86606 x3 Aspergillus
0050157 Hypersensitivity Pneumonitis Extended Panel (Farmer's Lung Panel) HYPER EXT
Methodology: Quantitative Immunodiffusion/Quantitative ImmunoCAP® Fluorescent Enzyme Immunoassay
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer two 2.5 mL aliquots of serum to individual
ARUP Standard Transport Tubes. (Min: 1 mL)
CPT Code(s): 86003 x4 IgE-specific allergens; 86331 x7 Gel Diffusion Qualitative; 86606 x5 Aspergillus
0093482 Hypertrophic Cardiomyopathy, Familial Mutation HCMFSM

Specimen Required: Collect: Lavender (K3EDTA).
Remarks: Include completed requisition and signed consent form. Patient History Form and Patient Consent Form for Molecular Testing are
Stability: Ambient: 5 Days; Refrigerated: 5 Days; Frozen: Unacceptable
CPT Code(s): 83891 Isolation; 83898 Amplification; 83904 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report
2006265 Hypertrophic Cardiomyopathy (HCM) Panel, 18 Genes HCM PAN

Page | 280
Storage/Transport Temperature: Room temperature. Also acceptable: Refrigerated
Remarks: Include completed patient history and signed consent form. Patient History Form and Patient Consent Form for Molecular Testing are
available on the ARUP web site or by contacting ARUP Client Services at (800) 522-2787.
CPT Code(s): 83891 Isolation; 83892 Digestion; 83898 x18 Amplification; 83896 x18 Nucleic Acid Probes; 83904 x18 Sequencing; 83912 Interpretation and
report
0051367 Hypochondroplasia (FGFR3) 1 Mutation HYPOCH

CPT Code(s): 83891 Isolation; 83898 x2 Amplification; 83896 x4 Nucleic acid probes; 83912 Interpretation and report. Additional CPT code modifiers may be
required for procedures to test for oncologic or inherited disorders.
0050202 IA-2 Antibody IA-2

CPT Code(s): 86341
0090176 Ibuprofen IBUPRO

Patient Preparation: Collect 1 hour after dosing.
CPT Code(s): 80299
2006444 IDH1 and IDH2 Mutation Analysis, exon 4 IDH1-2

Specimen Required: Collect: Lavender (EDTA) OR bone marrow (EDTA) OR tumor tissue.
Specimen Preparation: Whole blood: Transport 5 mL (Min: 1 mL) OR Bone marrow: Transport 3 mL (Min: 1 mL) OR FFPE tumor tissue:
Formalin fix (10 percent neutral buffered formalin) and paraffin embed tissue. Protect from excessive heat. Transport tissue block or 4 unstained
5-micron thick slides (Min: 3 slides). Transport block and/or slid (s) in a tissue transport kit (ARUP supply # 47808) available online through
eSupply using ARUP Connect™or contact ARUP Client Services at (800)522-2787.
Storage/Transport Temperature: Whole blood OR Bone marrow: Refrigerated. FFPE tumor tissue: Room temperature or refrigerated. Ship in
cooled containers during summer months.
Remarks: For FFPE specimens include surgical pathology report. Tissue block will be returned after testing.
Unacceptable Conditions: Whole blood OR Bone marrow: Serum or plasma. Specimens collected in anticoagulants other than EDTA. Frozen
specimens. Clotted or grossly hemolyzed specimens. FFPE tumor tissue: No tumor in tissue. Specimens fixed/processed in alternative fixatives
(alcohol, Prefer®) or heavy metal fixatives (B-4 or B-5). Decalcified specimens.
CPT Code(s): 83891 Isolation; 83898 x2 Amplification; 83894 Gel separation; 83904 x2 Sequencing, 83912 Interpretation and report; for FFPE tumor tissue,
add 88381 Microdissection. Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders.
2005857 IDH1 R132H by <TestName>Immunohistochemistry IDH1 IHC

CPT Code(s): 88342
0098843 IGF Binding Protein-1 IGFBP-1

Patient Preparation: Patient should fast overnight (12 hours) prior to collection.
CPT Code(s): 83519
Page | 281
0098842 IGF Binding Protein 2 IGFBP-2
Stability: Ambient: Unacceptable; Refrigerated: 4 days; Frozen: 28 days
CPT Code(s): 83519
0070060 IGF Binding Protein-3 IGFBP-3

Specimen Required: Collect: Serum separator tube. Also acceptable: Green (sodium heparin).
CPT Code(s): 82397
0070125 IGF-1 (Insulin-Like Growth Factor 1) IGF-1

CPT Code(s): 84305
0090649 IgG Desmoglein 1 & Desmoglein 3 IGG DESMOG

CPT Code(s): 83516 Desmoglein 1; 83516 Desmoglein 3
0090266 IgG Epithelial Cell Surface Antibodies IGG EPI AB

CPT Code(s): 88347 x2 Substrates (monkey esophagus and intact human skin)
2001536 IGH-BCL2 Fusion, t(14;18) by FISH BCL2FISH

Specimen Preparation: Formalin fix (10 percent neutral buffered formalin) and paraffin-embed tissue. Transport tissue block or 5 unstained 5-
2001538 IGH-MYC Fusion t(8;14) by FISH IGHMYCFISH

0055616 IGH-BCL2 (BCL-2/JH) Translocation, t(14;18) by PCR BCL2C-F

Page | 282
Specimen Preparation: Whole blood: Transport 5 mL. (Min: 1 mL) OR Bone marrow: Transport 3 mL. (Min: 1 mL) OR Fresh tissue: Freeze
immediately. Transport 100 mg or 0.5-2.0 cm3 tissue. OR FFPE tumor tissue: Formalin fix (10 percent neutral buffered formalin) and paraffin
embed tissue. Protect from excessive heat. Transport tissue block or four 10-micron shavings. Tissue block will be returned after testing.
Transport block(s) and/or shavings in a tissue transport kit (ARUP supply #47808) available online through eSupply using ARUP Connect™or
CPT Code(s): 83891 Isolation; 83898 x6 Amplification; 83894 x3 Gel separation; 83912 Interpretation and report - Additional CPT code modifiers may be
0055557 IGH-CCND1 (BCL-1/JH) Translocation, t(11;14) by PCR BCL1-F

Specimen Required: Collect: Lavender (EDTA) OR bone marrow (EDTA) OR tissue
Specimen Preparation: Whole blood: Transport 5 mL. (Min: 1 mL) OR Bone marrow: Transport 3 mL. (Min: 1 mL) OR Fresh tissue: Freeze
Transport block(s) and/or shavings in a tissue transport kit (ARUP supply #47808) available online through eSupply using ARUP Connect™or
CPT Code(s): 83891 Isolation; 83898 x3 Amplification; 83894 x2 Gel separation; 83912 Interpretation and report - Additional CPT code modifiers may be
2007226 IGH-CCND1 Fusion, t(11;14) by FISH IGHCC FISH

Stability: Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable.
0040227 IGHV Mutation Analysis by Sequencing IGHV MUT

Specimen Preparation: Transport 5 mL whole blood OR 3 mL bone marrow. (Min: 1 mL whole blood OR 1 mL bone marrow) Specimens must
be received within 48 hours of collection due to lability of RNA..
CPT Code(s): 83891 Isolation; 83902 Reverse transcription; 83898 x5 Amplification; 83894 Gel separation; 83912 Interpretation and report; if sequencing is
performed, add 83892 Enzyme digestion; 83904 Sequencing, 83909 Capillary electrophoresis - Additional CPT code modifiers may be required
for procedures performed to test for oncologic or inherited disorders.
0090157 Imipramine and Desipramine DESIP/IMIP

CPT Code(s): 80174 Imipramine; 80160 Desipramine
Page | 283
0050667 Immune Complex Panel C1Q/RAJI
Methodology: Quantitative Flow Cytometry/Semi-Quantitative Enzyme-Linked Immunosorbent Assay
Specimen Preparation: Let stand for 2 hours, then separate serum from cells within 1 hour. Transfer TWO 1.5 mL aliquots of serum to individual
ARUP Standard Transport Tubes and freeze immediately. (Min: 0.5 mL/aliquot)
Unacceptable Conditions: Non-frozen specimens. Specimens exposed to repeated freeze/thaw cycles.
CPT Code(s): 86332 Raji; 86332 C1Q
0050272 Immunofixation Electrophoresis Gel IFE GEL

Tube. (Min: 0.3 mL)
Remarks: IFE gel includes a qualitative interpretation of an IFE only.
CPT Code(s): 86334
0050049 Immunofixation Electrophoresis, Immunoglobulin D & Immunoglobulin E, Serum IFE D/E

Tube. (Min: 0.3 mL)
Remarks: Assay is designed for qualitative assessment of monoclonal IgD or IgE protein.
CPT Code(s): 86334
0050340 Immunoglobulin A IGA

CPT Code(s): 82784
0050341 Immunoglobulin A, CSF IGA CSF

mL)
Stability: Ambient: 8 hours; Refrigerated: 8 days; Frozen: 1 year (if frozen within 24 hours)
CPT Code(s): 82784
2003957 Immunoglobulin A (IgA) by Immunohistochemistry IGA IHC

CPT Code(s): 88342
0050525 Immunoglobulin A, Saliva SEC

Specimen Required: Collect: Saliva.
Specimen Preparation: Centrifuge and separate to remove cellular material. Transfer 1 mL saliva to an ARUP Standard Transport Tube. (Min: 0.4
mL)
Stability: Ambient: 8 hours; Refrigerated: 8 days; Frozen: 3 months (if frozen within 24 hours)
CPT Code(s): 82784
Page | 284
0093149 Immunoglobulin A Subclasses (1&2) IGA SUB
CPT Code(s): 82784 IgA; 82787 x2 IgA subclasses
2003960 Immunoglobulin D (IgD) by Immunohistochemistry IGD IHC

CPT Code(s): 88342
0099200 Immunoglobulin D, Serum IGD

Tube. (Min: 0.5 mL) Plasma is not recommended.
CPT Code(s): 82784
0050345 Immunoglobulin E IGE

(K2EDTA).
CPT Code(s): 82785
0050350 Immunoglobulin G IGG

Unacceptable Conditions: Hemolyzed specimens
CPT Code(s): 82784
0050680 Immunoglobulin G/Albumin Ratio, CSF IGG/ALB

Methodology: Nephelometry
mL)
CPT Code(s): 82784 IgG; 82042 Albumin, CSF
0050670 Immunoglobulin G, CSF IGG CSF

mL)
CPT Code(s): 82784
0050676 Immunoglobulin G, CSF Index IGG SYN

Specimen Required: Collect: CSF AND serum separator tube.
Page | 285
Specimen Preparation: Centrifuge and separate CSF to remove cellular material. Separate serum from cells ASAP or within 2 hours of collection.
Transfer 1 mL CSF AND 1 mL serum to individual ARUP Standard Transport Tubes. (Min: 0.4 mL CSF AND 0.4 mL serum)
CPT Code(s): 82784 x2 Immunoglobulins; 82040 Albumin, serum; 82042 Albumin, CSF
2003963 Immunoglobulin G (IgG) by Immunohistochemistry IGG IHC

CPT Code(s): 88342
0050571 Immunoglobulin G Subclass 1 IGG1

CPT Code(s): 82787

CPT Code(s): 82787

CPT Code(s): 82787

CPT Code(s): 82787
0050577 Immunoglobulin G Subclasses (1, 2, 3, 4) IGG SUB

CPT Code(s): 82787 x4 IgG Subclasses (1, 2, 3, 4)
2005844 Immunoglobulin G4 by Immunohistochemistry IGG4 IHC

Specimen Preparation: Formalin fix (10 percent neutral buffered formalin is preferred) and paraffin embed specimen (cells must be prepared into a
cellblock). Protect paraffin block and/or slides from excessive heat. Transport tissue block or 5 unstained (3-5 micron thick sections), positively
charged slides in a tissue transport kit (ARUP supply #47808). Available online through eSupply using ARUP Connect ™ or contact ARUP
Client Services at (800) 522-2787. (Min: 2 slides). If sending precut slides, do not oven bake.
electronic ordering capability, use an ARUP Immunohistochemistry Stain Form (#32978) and include an ARUP client number. For additional
technical details, contact ARUP Client Services at (800) 522-2787.
Page | 286
Stability: Ambient: Indefinitely Refrigerated: Indefinitely; Frozen: Unacceptable
CPT Code(s): 88342
0050355 Immunoglobulin M IGM

CPT Code(s): 82784
0050356 Immunoglobulin M, CSF IGM CSF

mL)
CPT Code(s): 82784
2003966 Immunoglobulin M (IgM) by Immunohistochemistry IGM IHC

CPT Code(s): 88342
0050631 Immunoglobulins, CSF Quantitative QNTIG CSF

mL)
CPT Code(s): 82784 Immunoglobulin IgA; 82784 Immunoglobulin IgG; 82784 Immunoglobulin IgM
0050630 Immunoglobulins (IgA, IgG, IgM), Quantitative QNTIG

Stability: After separation from cells: Ambient 8 hours; Refrigerated: 8 days; Frozen: 1 year (if frozen within 24 hours)
CPT Code(s): 82784 Immunoglobulin IgA; 82784 Immunoglobulin IgG; 82784 Immunoglobulin IgM
2004593 India Ink Stain INDIA INK

Specimen Preparation: Transfer 1 mL CSF specimen to a sterile container. (Min: 0.5 mL) Place each specimen in a separate, individually sealed
bag.
CPT Code(s): 87210
0080403 Indicans, Urine Qualitative INDICANS

Methodology: Qualitative Colorimetry
Specimen Preparation: Do not add preservatives. Transfer two 4 mL aliquots from a well-mixed random collection to individual ARUP Standard
Transport Tubes. (Min: 3 mL)
Stability: Ambient: Unacceptable; Refrigerated: 8 hours; Frozen: 1 year
CPT Code(s): 81005
Page | 287
0099114 Indinavir Quantitation INDINAVIR
Unacceptable Conditions: Separator tubes. Thawed specimens.
CPT Code(s): 80299
0050385 Infectious Mononucleosis Slide Test by LA INF MONO

Methodology: Semi-Quantitative Latex Agglutination
CPT Code(s): 86308
0050567 Inflammatory Bowel Disease Differentiation Profile IBD

Tube. (Min: 0.6 mL)
CPT Code(s): 86671 x2 Semiquantitative immunoassay-fungus not elsewhere specified; 86255 Fluorescent noninfectious agent antibody screen
0051069 Influenza A & B Virus Antibodies, IgG & IgM INFLU ABS
2004217 Influenza A H1N1 (2009) Detection by RT-PCR H1N1

Specimen Required: Collect: Respiratory specimen: Broncheoalveolar lavage (BAL), nasal aspirate, nasopharyngeal swab, sputum, throat swab, or tracheal aspirate.
media (ARUP Supply #12884). Available online through eSupply using ARUP Connector contact ARUP Client Services at (800) 522-2787.
CPT Code(s): 87501
2004218 Influenza A H1N1 (2009) Oseltamivir Resistance by Sequencing H1N1 RES

Methodology: Reverse Transcription Polymerase Chain Reaction/Pyrosequencing
Specimen Required: Collect: Respiratory specimen: Broncheoalveolar lavage (BAL), bronchial aspirate, bronchial wash, endotracheal aspirate, endotracheal wash,
nasal swab, nasopharyngeal swab, nasal aspirate, sputum, throat swab or tracheal aspirate.
Specimen Preparation: Transfer 1 mL respiratory specimen to viral transport media (ARUP supply #12884). Available online through eSupply
using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 0.5 mL). Place each specimen in an individually sealed bag.
CPT Code(s): 83891 Isolation; 83898 Amplification; 83894 Separation; 83904 Sequencing; 83912 Interpretation and report
2004421 Influenza A Virus Antibodies, IgG & IgM FLUA PAN

0051074 Influenza A Virus Antibody, IgG FLUA G

Page | 288
CPT Code(s): 86710
0051081 Influenza A Virus Antibody, IgM FLUA M

Unacceptable Conditions: Plasma. Bacterially contaminated, heat-inactivated, hemolyzed, icteric, lipemic, turbid specimens.
CPT Code(s): 86710
2004422 Influenza B Virus Antibodies, IgG & IgM FLUB PAN

0051080 Influenza B Virus Antibody, IgG FLUB G

CPT Code(s): 86710
0051079 Influenza B Virus Antibody, IgM FLUB M

CPT Code(s): 86710
0060284 Influenza Virus A & B DFA with Reflex to Influenza Virus A & B Rapid Culture FLUFAC
Specimen Required: Collect: Respiratory specimen: Bronchoalveolar lavage (BAL),nasopharyngeal aspirate, swab, or washing, or tracheal aspirate.
Fluid: Transfer specimen to a sterile container. Also acceptable: Transfer to viral transport media (ARUP Supply #12884). Available online
Place each specimen in a separate, individually sealed bag.
CPT Code(s): 87276 Influenza A, FA; 87275 Influenza B, FA; if reflexed, add 87254 Rapid culture
Page | 289
2002643 Influenza Virus A and B DFA with Reflex to Respiratory Virus Mini Panel by RT-PCR FLUFAPCR
Specimen Required: Collect: Nasal aspirate or nasopharyngeal swab.
Specimen Preparation: Fluid: Transfer specimen to a sterile container. Also acceptable: Transfer to viral transport media (ARUP supply #12884).
Available online through eSupply using ARUP
Connect ™ or contact ARUP Client Services at (800) 522-2787.
CPT Code(s): 87276 Influenza A, FA; 87275 Influenza B, FA; If reflexed add 87502 Influenza A & B; 87798 RSV
0060286 Influenza Virus A and B Rapid Culture V FLUC

Specimen Required: Collect: Respiratory specimen: Bronchoalveolar lavage (BAL), nasopharyngeal aspirate, swab, or washing, or tracheal aspirate.
Specimen Preparation: Fluid: Transfer specimen to a sterile container. Transfer 2 mL fluid to a sterile container. (Min: 0.5 mL).Also acceptable:
Transfer to viral transport media (ARUP supply #12884). Available online through eSupply using ARUP Connect™ or contact ARUP Client
Services at (800) 522-2787.
Unacceptable Conditions: Calcium alginate, dry, or wood swabs.
CPT Code(s): 87254
0091530 Inhalants Panel, Solvents, Serum or Plasma INHALANT S

CPT Code(s): 84600
2006274 Inherited Insulin Resistance Syndromes (INSR) Sequencing INSR FGS

CPT Code(s): 83891 Isolation; 83898 x22 Amplification; 83904 x22 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report -Additional
0070137 Inhibin A (Dimer) INHIBA

Patient Preparation: Fasting specimens are recommended, but not required.
Unacceptable Conditions: Plasma. Hemolyzed or severely lipemic specimens.
Stability: After separation from cells: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 1 year (avoid repeated freeze/thaw cycles)
CPT Code(s): 86336
0070413 Inhibin B INHIBINB

Specimen Preparation: Transport 0.5 mL serum. (Min: 0.2 mL)
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 48 hours; Frozen 1 month
CPT Code(s): 83520
2003969 Inhibin by Immunohistochemistry INHIBI IHC

Page | 290
CPT Code(s): 88342
2003260 Inhibitor Assay, PT with Reflex to PT 1:1 Mix PT INHIB

Specimen Preparation: Transport 1 mL plasma. (Min: 0.5 mL)
Storage/Transport Temperature: CRITICAL FROZEN. Seperate specimens must be submitted when multiple tests are ordered.
Unacceptable Conditions: Serum. Refrigerated specimens. Hemolyzed specimens.
CPT Code(s): 85610; if reflexed, add 85611 PT 1:1 mix
2003266 Inhibitor Assay, PTT with Reflex to PTT 1:1 Mix, with Reflex to 1-Hour Incubation PTT INHIB
Specimen Preparation: Transfer 2 mL plasma to an ARUP Standard Transport Tube. (Min: 1 mL)
Storage/Transport Temperature: CRITICAL FROZEN. Seperate specimens must be submitted when multiple tests are ordered.
Unacceptable Conditions: Serum. Specimens refrigerated more than four hours. Hemolyzed specimens.
CPT Code(s): 85730 PTT; if reflexed, add 85732 PTT 1:1 mix; if reflexed add 85730 1 hour PTT and 85732 1 hour PTT 1:1 mix
2003448 INI1 (BAF47) by Immunohistochemistry BAF47 IHC

CPT Code(s): 88342
2006344 Inosine Triphosphatase (ITPA) and Interleukin 28 B (IL28B)-Associated Variants, 4 SNPs ITPA-IL28B
CPT Code(s): 83891 Isolation; 83900 Amplification; 83901 x2 Multiplex amplification; 83914 x4 Extension; 83909 Capillary Electrophoresis; 83912
Interpretation and report - Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders
0020175 Insecticide Exposure Panel CHE-SCRN

Specimen Preparation: DO NOT FREEZE. Do not spin down or separate. Transport 3 mL whole blood. (Min: 2 mL)
Storage/Transport Temperature: Refrigerated. Do not place whole blood directly on cool pack when shipping.
Remarks:
Unacceptable Conditions: Green (sodium or lithium heparin). Frozen whole blood. Hemolyzed specimens.
CPT Code(s): 82480 Cholinesterase, plasma; 82482 Cholinesterase, RBC
0070064 Insulin, 30 Minutes INSULIN 30

Unacceptable Conditions: Heparinized plasma. Vitreous or I.V. fluids. Gray (sodium fluoride/potassium oxalate). Hemolyzed specimens.
CPT Code(s): 83525

Unacceptable Conditions: Heparinized plasma. I.V. fluid. Vitreous fluid. Gray (sodium fluoride/potassium oxalate). Hemolyzed specimens.
CPT Code(s): 83525

Page | 291
CPT Code(s): 83525
0070068 Insulin, 120 Minutes INSULIN120

CPT Code(s): 83525
0099228 Insulin Antibody ANTI-INS

CPT Code(s): 86337
0080860 Insulin Binding, Fibroblasts INSULFIBRO

Specimen Preparation: Cells should be kept in 37°C incubator until shipped. Transport two T-25 flasks of fibroblasts from skin biopsy.
Storage/Transport Temperature: CRITICAL ROOM TEMPERATURE. Call lab before shipping. Ship Monday-Thursday only.
Unacceptable Conditions: Frozen or refrigerated specimen. Specimens in improper media. Dead cells.
CPT Code(s): 84238
2003972 Insulin by Immunohistochemistry INSULI IHC

CPT Code(s): 88342
0070063 Insulin, Fasting INSULIN FT

collection. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min 0.5 mL)
Unacceptable Conditions: Heparinized plasma. Vitreous or I.V. fluids. Specimens collected in gray (sodium fluoride/potassium oxalate).
Hemolyzed specimens.
CPT Code(s): 83525
0070155 Insulin, Free and Total INS F&T

Methodology: Quantitative Ultrafiltration/Quantitative Chemiluminescent Immunoassay
Patient Preparation: Fasting specimen preferred; reference intervals established for fasting specimens.
Specimen Required: Collect: Serum separator tube. Also acceptable: Lavender (EDTA), or pink (K2EDTA).
Unacceptable Conditions: Heparinized specimens. Sodium fluoride/potassium oxalate plasma. Hemolyzed specimens.
CPT Code(s): 83525 Insulin, total; 83527 Insulin, free
0070240 Insulin, I.V. Fluid INS IVF

Specimen Required: Collect: I.V. fluid.
Specimen Preparation: Transfer 1 mL I.V. fluid to an ARUP Standard Transport Tube. (Min: 0.4 mL)
Remarks: Specify concentration if known.
Unacceptable Conditions: Specimens types other than I.V. fluid.
Page | 292
Stability: Ambient: 8 hours; Refrigerated: Unacceptable; Frozen: 1 month
CPT Code(s): 83525
0079011 Insulin-Like Growth Factor II IGF-II

Patient Preparation: Overnight fasting preferred.
Specimen Preparation: Separate serum from cells within one hour of collection. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min:
0.5 mL). Up to four freeze/thaw cycles are acceptable.
CPT Code(s): 83519
0070022 Insulin, Other INSULINOTH

Specimen Required: Collect: Serum separator tube. Also acceptable: Lavender (EDTA).
Specimen Preparation: Allow sample to clot completely at room temperature. Separate serum or plasma from cells ASAP or within 2 hours of
Unacceptable Conditions: Vitreous fluid. Gray (sodium fluoride/potassium oxalate) or heparinized plasma. Hemolyzed specimens.
CPT Code(s): 83525
0070107 Insulin, Random INSULIN R

Unacceptable Conditions: Heparinized plasma. I.V. fluid. Vitreous fluid. Gray (potassium oxalate/sodium fluoride). Hemolyzed specimens.
CPT Code(s): 83525
0070690 Insulin, Veterinary VT INSULIN

Patient Preparation: Veterinary specimens only.
Specimen Required: Collect: Serum separator tube. Also acceptable: Lavender (EDTA).
Unacceptable Conditions: Heparinized plasma. Vitreous or I.V. fluids.
CPT Code(s): 83525
0093148 Interferon-Alpha (Serum) by EIA, Serum or Plasma INTERFERON

Specimen Required: Collect: Plain red, serum separator tube, or lavender (EDTA).
CPT Code(s): 83520
2003390 Interferon Beta Neutralizing Antibody with Reflex to Titer IFNB NEU R
Methodology: Cell Culture/Chemiluminescent Immunoassay
Patient Preparation: Collect specimens before Interferon beta treatment, or more than 48 hours following the most recent dose. Patient should
not be on steroid therapy in excess of 10 mg prednisolone (or equivalent) daily. High endogenous levels of Interferon beta, alpha, or gamma may
interfere with this assay.
Tube. (Min: 0.3 mL)
Unacceptable Conditions: Contaminated, hemolyzed, icteric, or lipemic specimens.
CPT Code(s): 86352 Interferon Beta Neutralizing Antibody screen; if reflexed, add 86352 Interferon Beta Neutralizing Antibody titer
0051531 Interferon gamma by MAFD IFNG DO

Remarks:
CPT Code(s): 83520
0051536 Interleukin 1 beta by MAFD IL1B DO

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Remarks:
CPT Code(s): 83520
0051393 Interleukin-1-Receptor-Associated Kinase-4 (IRAK-4) Deficiency Screen IRAK-4

Patient Preparation: Collect control specimen from a healthy individual unrelated to patient.
Specimen Required: Collect: Green (sodium heparin) (patient) AND green (sodium heparin) (control). Also acceptable: Yellow (ACD solution A). Patient and control
specimens must be collected within 48 hours of test performance.
Specimen Preparation: Transport 4 mL whole blood (patient) AND 4 mL whole blood (control) in original collection tubes. (Min: 2 mL (patient)
AND 2 mL (control)) Do not refrigerate or freeze. LIVE LYMPHOCYTES REQUIRED.
Remarks:
Unacceptable Conditions: Refrigerated or frozen specimens. Specimens in transport longer than 48 hours.
CPT Code(s): 86353 x2 Lymphocyte Transformation; 83520 x3 Cytokine
0051588 Interleukin 2 by MAFD IL2 DO

Remarks:
CPT Code(s): 83520
0051529 Interleukin 2 Receptor (Soluble) by MAFD IL2R DO

Remarks:
CPT Code(s): 83520

Remarks:
CPT Code(s): 83520

CPT Code(s): 83520

Remarks:
CPT Code(s): 83520

Page | 294
Remarks:
CPT Code(s): 83520

Remarks:
CPT Code(s): 83520

Remarks:
CPT Code(s): 83520

Remarks:
CPT Code(s): 83520
2004680 Interleukin 28 B (IL28B)-Associated Variants, 2 SNPs IL28B

Methodology: Qualitative Polymerase Chain Reaction/Qualitative Fluorescence Monitoring
CPT Code(s): 83891 Isolation; 83900 Mulitplex amplification; 83896 x4 Nucleic acid probes; 83912 Interpretation and report - Additional CPT code modifiers
Intraepidermal Nerve Fiber Density Analysis

Methodology: Microscopy/Immunohistochemistry
Specimen Required: Collect: Obtain Nerve Fiber Fixative Collection Kit prior to collection procedure (ARUP supply #44191). Available online through eSupply using
ARUP Connect™ or contact Client Services at (800) 522-2787. Special fixatives are required; Collection instructions are provided with the kit.
Skin punch biopsies from lower extremity (one biopsy from the distal leg and one from the proximal thigh).
Specimen Preparation: Transport two 3 mm skin punch biopsies.
Remarks: Submit clinical history.
Unacceptable Conditions: Specimens in inappropriate fixative or improper temperature. Specimens that are not collected according to the
collection instructions provided in collection kit.
Stability: Ambient: Unacceptable; Refrigerated: 2 weeks; Frozen: Unacceptable
CPT Code(s): 88342 x2 PGP 9.5; 88356 x2 Morphometric Analysis, Nerve. Additional billing may apply if special studies are indicated.
0070210 Intrinsic Factor Blocking Antibody IFBA

Unacceptable Conditions: Grossly hemolyzed or severely lipemic specimens.
CPT Code(s): 86340
0090695 Iodide, Serum or Plasma IODIDE SP

Methodology: Ion Chromatography
Page | 295
Specimen Preparation: Separate serum or plasma from cells ASAP. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min:
0.5 mL)
CPT Code(s): 82491
0092487 Iodine, 24 Hour, Urine IODINE URN

Patient Preparation: Gadolinium, iodine, and barium are known to interfere with most metals tests. If gadolinium, iodine, or barium containing
contrast media has been administered, a specimen cannot be collected for 96 hours.
Specimen Required: Collect: 24-hour urine collection in clean, plastic urine container(s) with no metal cap(s) or glued insert(s).
Specimen Preparation: Refrigerate specimen within 4 hours of completion of 24-hour collection. Transfer 10 mL aliquot from a well-mixed 24-
hour urine collection to ARUP Standard Transport Tubes. (Min: 3 mL)
Remarks: 24-hour volume is required on test request form for processing.
CPT Code(s): 83789
2002992 Iodine, Random, Urine IODINE RAN

Methodology: Inductively Coupled Plasma-Mass Spectrometry
Patient Preparation: If gadolinium-containing contrast media has been administered, a specimen cannot be collected for 48 hours.
Specimen Required: Collect: Random urine. Collect in clean plastic container(s) with no metal cap(s) or glued insert(s).
Stability: Ambient: 4 months; Refrigerated: 4 months; Frozen: 4 months
CPT Code(s): 83789
2006184 Iodine, Serum IODINE S

has been administered, specimen should not be collected for 48 hours.
Specimen Required: Collect: Royal blue (no additive)
Specimen Preparation: Separate from cells within 1 hour. Transfer 1 mL serum to an ARUP Trace Element-Free Transport Tube (ARUP supply
#43116). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 0.3 mL)
Storage/Transport Temperature: Refrigerated. Also acceptable: Frozen or room temperature.
CPT Code(s): 83789
0091180 Ipecac Use Markers, Serum or Plasma - Screen with Reflex to Confirmation/Quantitation IPECAC SP
(Min: 0.8 mL)
CPT Code(s): 80101; if positive, add 82542
0091419 Ipecac Use Markers, Urine - Screen with Reflex to Confirmation/Quantitation IPECAC UR
0092482 Iron, 24-Hour Urine IRON URN

Methodology: Quantitative Inductively Coupled Plasma-Emission Spectrometry
Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metals tests. If gadolinium or iodine
containing contrast media has been administered, a specimen should not be collected for 48 hours.
Specimen Required: Collect: 24-hour urine. Specimen must be collected in a clean plastic container with no metal cap(s) or glued insert(s) and should be refrigerated
during collection.
Specimen Preparation: Specimen must be refrigerated within 4 hours of completion of 24-hour collection. Transfer one 10 mL aliquot from a
well-mixed 24-hour urine collection to ARUP Standard Transport Tubes. (Min: 1 mL) No preservative. Record total volume and collection
duration on transport tube and test request form.
CPT Code(s): 83540
0020420 Iron & Iron Binding Capacity FEIBC

Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL) Avoid hemolysis. Also acceptable: Heparinized plasma.
Page | 296
Unacceptable Conditions: Grossly hemolyzed specimens. EDTA plasma.
Stability: After separation from cells: Ambient: 4 days; Refrigerated: 1 week; Frozen: 3 months
CPT Code(s): 83540 Iron, total; 83550 Iron, binding capacity
0028250 Iron, Liver FE LIVER

Specimen Required: Collect: Liver tissue obtained with an 18 gauge needle.
Specimen Preparation: Transport at least a 1 cm long specimen. Tissue can be fresh, paraffin-embedded, or dried. Also acceptable: Formalin-
fixed. Specimens should be stored and transported in a metal-free container such as a royal blue (no additive).
Remarks: Age is required on test request form in order to calculate iron index.
Unacceptable Conditions: Specimens less than 0.25 mg (dry weight). Specimens stored or shipped in saline.
Stability: In paraffin block, preserved (formalin), or dried: Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Indefinitely
Fresh tissue: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: Indefinitely
CPT Code(s): 83540
0020037 Iron, Plasma or Serum FE

Unacceptable Conditions: Specimens collected from patients receiving deferoxamine (wait six hours after last dose). Specimens containing
EDTA, sodium/fluoride, oxalate, or sodium citrate. Grossly hemolyzed specimens.
CPT Code(s): 83540
2004782 Iron, Random Urine IRON RAN U

Methodology: Quantitative Inductively Coupled Plasma-Emission Spectrometry
Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metals tests. If either gadolinium or iodine
containing contrast media has been administered, a specimen should not be collected for 4 days.
Specimen Required: Collect: Random urine. Specimen must be collected in a clean plastic container.
Specimen Preparation: Transfer 2 mL random urine to an ARUP Standard Transport Tube. (Min: 0.5 mL)
CPT Code(s): 83540
0049110 Iron Stain IRON STAIN

Specimen Required: Collect: Lavender (EDTA) or bone marrow.
Specimen Preparation: Transfer 4 unfixed, air-dried, unstained, non-anticoagulated or EDTA smears, or core touch preps to a metal free container.
(Min: 1 mL)
Unacceptable Conditions: Fixed smears.
CPT Code(s): 88313
0050138 Islet Cell Cytoplasmic Antibody, IgG ANTI-ISLET

CPT Code(s): 86341
2000271 Isohemagglutinin Titer, IgG IRL ISO G

Specimen Preparation: Do not freeze red cells. Transport 7 mL whole blood. (Min: 3 mL)
CPT Code(s): 86900 ABO; if blood type is A add: 86941 Anti-B titer; if blood type is B, add: 86941 Anti-A titer; if blood type is O, add: 86941 Anti-A titer;
86941 Anti-B titer. If blood type is AB, no additional titers will be performed.
2000280 Isohemagglutinin Titer, IgG & IgM IRL ISO MG

CPT Code(s): 86900 ABO; if blood type is A add: 86941 x2 Anti-B titer; if blood type is B, add: 86941 x2 Anti-A titer; if blood type is O, add: 86941 x2 Anti-A
titer; 86941 x2 Anti-B titer. If blood type is AB, no additional titers will be performed.
Page | 297
2000270 Isohemagglutinin Titer, IgM IRL ISO M
Specimen Preparation: Do not freeze red cells. Transport 7 mL whole blood. (Min: 3 mL)
CPT Code(s): 86900 ABO; if blood type is A add: 86941 Anti-B titer; if blood type is B, add: 86941 Anti-A titer; if blood type is O, add: 86941 Anti-A titer;
86941 Anti-B titer. If blood type is AB, no additional titers will be performed.
0090144 Isopropanol (Includes Acetone) ISOP

Specimen Preparation: Do not freeze whole blood. Separate serum or plasma from cells within 2 hours. Transfer 3 mL serum or plasma to an
Specimens collected in gray (sodium fluoride/potassium oxalate) may be transported in the original container.
whole blood)
CPT Code(s): 84600
0091314 Isotretinoin, Serum or Plasma ISOTRETINO

Specimen Preparation: Protect from light. Separate from cells within 2 hours. Transfer 3 mL serum or plasma to an ARUP Amber Transport Tube.
(Min: 1.2 mL)
CPT Code(s): 82491
0098519 Itraconazole, Quantitation by LC-MS/MS ITRACONAZ

Patient Preparation: Specimens for trough levels should be obtained just before or within 15 minutes of next dose. Specimens for peak levels
should be obtained within 15-30 minutes after the end of I.V. infusion, or 45-60 minutes after an IM injection, or 90 minutes after oral intake.
Unacceptable Conditions: Serum separator tubes. Hemolyzed or lipemic specimens.
CPT Code(s): 80299
2002357 JAK2 Exon 12 Mutation Analysis by PCR JAK2 EX12

Specimen Preparation: Do not freeze. Transport 5 mL whole blood (Min: 1 mL) OR 3 mL bone marrow (Min: 1 mL)..
Unacceptable Conditions: Serum. Frozen specimens. Clotted or grossly hemolyzed specimens. Specimens collected in anticoagulants other than
EDTA.
CPT Code(s): 83891 Isolation; 83898x2 Amplification; 83894 x2 Gel separation; 83912 Interpretation and report - Additional CPT code modifiers may be
0051245 JAK2 Gene, V617F Mutation, Qualitative JAK2

Specimen Preparation: Do not freeze. Transport 5 mL whole blood (Min: 1 mL) OR 3 mL bone marrow (Min: 1 mL)..
Unacceptable Conditions: Serum. Specimens collected in anticoagulants other than EDTA. Frozen specimens. Clotted or grossly hemolyzed
specimens.
CPT Code(s): 83891 Isolation; 83900 Multiplex; 83914 Mutation identification; 83894 Gel separation; 83912 Interpretation and report.
0040168 JAK2 Gene, V617F Mutation, Quantitation JAK2 QNT

Specimen Preparation: Transport 5 mL whole blood. (Min: 1 mL)..
Unacceptable Conditions: Bone marrow, serum, or plasma. Frozen or clotted whole blood. Specimens collected in anticoagulants other than
EDTA. Severely hemolyzed specimens.
CPT Code(s): 83891 Isolation; 83898 x2 Amplification; 83896 Nucleic Acid Probe; 83912 Interpretation and report
2005602 JAK2 Gene, V617F Mutation, Quantitative with Reflex to MPL, Codon 515 Mutation Detection, Quantitative JAK2 RFLX
Page | 298
Unacceptable Conditions: Bone marrow, plasma, or serum. Whole blood collected in anticoagulants other than EDTA. Frozen specimens. Clotted
or grossly hemolyzed specimens.
CPT Code(s): 83891 Isolation; 83898 x2 Amplification; 83896 Nucleic acid probe; 83912 Interpretation and report. If reflexed, add 83898 Amplification; 83904
Sequencing; 83912 Interpretation and report. - Additional CPT code modifiers may be required for procedures performed to test for oncologic or
2005689 Japanese Encephalitis Virus Antibodies, IgG and IgM by ELISA JPN GM
Unacceptable Conditions: Contaminated or heat-inactivated specimens
CPT Code(s): 86790 X 2
2005687 Japanese Encephalitis Virus Antibody, IgG by ELISA JPN G

Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 6 months (avoid repeated freeze/thaw cycles).
CPT Code(s): 86790
2005685 Japanese Encephalitis Virus Antibody, IgM by ELISA JPN M

Unacceptable Conditions: Contaminated or heat-inactivated specimens
CPT Code(s): 86790
0099169 JC Virus by PCR JC VIRUS

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA) or serum separator tube. OR CSF or urine.
Specimen Preparation: Separate serum or plasma from cells. Transfer 1 mL serum, plasma, CSF or urine to a sterile container. (Min: 0.5 mL)
Stability: Ambient: 8 hours; Refrigerated: 5 days; Frozen: 30 days
CPT Code(s): 87798
0099592 Jo-1 Antibody, IgG ANTI-JO

Specimen Required: Collect: Serum separator tubes.
Tube. (Min: 0.2 mL)
Stability: After separation from the cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)
CPT Code(s): 86235
2001976 Juvenile Polyposis (SMAD4) Deletion/Duplication SMAD4 DD

0051510 Juvenile Polyposis (SMAD4) Sequencing SMAD4 SEQ

Methodology: Polymerase Chain Reaction/ Sequencing
CPT Code(s): 83891 Isolation; 83898 x12 Amplification; 83904 x10 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report- Additional
Page | 299
2001971 Juvenile Polyposis (SMAD4) Sequencing and Deletion/Duplication SMAD4 FGA
CPT Code(s): Sequencing: 83891 Isolation; 83898 x12 Amplification; 83904 x10 Sequencing; 83909 Capillary electrophoresis; Del/Dup; 83896 Nucleic Acid
Probes; 83914 Extension; 83898 Amplification; 83909 Capillary electrophoresis; 83912 Interpretation and report -Additional CPT code modifiers
2004984 Juvenile Polyposis Syndrome (BMPR1A) Deletion/Duplication BMPR1A DD

2004988 Juvenile Polyposis Syndrome (BMPR1A) Sequencing BMPR1A FGS

2004992 Juvenile Polyposis Syndrome (BMPR1A) Sequencing and Deletion/Duplication BMPR1A FGA
DelDup: 83896 x13 Nucleic Acid Probes; 83898 x13 Amplification; 83914 x13 Extension; 83909 Capillary electrophoresis - Additional CPT
0055629 Kaposi Sarcoma-Associated Herpesvirus/Human Herpesvirus 8 HHV-8

Specimen Preparation: Transport 100 mg or 0.5-2.0 cm3 tissue.
OR formalin fix (10 percent neutral buffered formalin) and paraffin embed tissue. Transport tissue block..
Storage/Transport Temperature: Tissue: Frozen on dry ice.
Tissue Block: Room temperature. Ship in cooled container during summer months.
Unacceptable Conditions: Tissue on slides. Specimens fixed/processed in heavy-metal based (B-4 or B-5) fixatives.
Stability: Tissue: Ambient: Unacceptable; Refrigerated: 2 hours; Frozen: 1 year
Tissue Block: Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable
CPT Code(s): 87798
2002888 Kappa/Lambda Light Chain Panel by in situ Hybridization, Paraffin K/L ISH
specimens.
0055167 Kappa/Lambda Quantitative Free Light Chains with Ratio, Serum KAP/LAM F
Tube. (Min: 0.5 mL)
Unacceptable Conditions: Plasma. Room temperature specimens.
CPT Code(s): 83883 Kappa; 83883 Lambda
2003981 Kappa Light Chains by Immunohistochemistry KAPPA IHC

Page | 300
CPT Code(s): 88342
0051644 Kell K/k Antigen (KEL) Genotyping KEL

arranged by contacting ARUP Client Services at (800) 522-2787. OR
amniotic fluid.
OR Whole Blood: Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B).
amniocytes filled with culture media. Backup cultures must
be retained at the client's institution until testing is complete.

is available on the ARUP Web site or by contacting ARUP Client Services at (800) 522-2787.
CPT Code(s): 83891 Isolation; 83898 Amplification; 83896 x2 Nucleic acid probes; 83912 Interpretation and report. Additional CPT code modifiers may be
required for procedures preformed to test for oncologic or inherited disorders.
0098627 Keppra® (Levetiracetam) KEPPRA

Specimen Required: Collect: Plain red. Also acceptable: Lavender (EDTA), pink (K2EDTA), or green (sodium or lithium heparin).
CPT Code(s): 80299
2003978 Keratin 903 (K903) High Molecular Weight by Immunohistochemistry K903 IHC
CPT Code(s): 88342
0091507 Ketamine and Metabolite, Serum or Plasma KETAMINE S

CPT Code(s): 82492
Page | 301
0020034 Ketones, Serum or Plasma KETONE-S
Stability: After separation from cells: Ambient: 2 hours; Refrigerated: 48 hours; Frozen: 1 week
CPT Code(s): 82009
0080650 17-Ketosteroids, Urine 17 KETO

Specimen Required: Collect: 24-hour urine. Refrigerate during collection.
Specimen Preparation: Transfer 4 mL aliquot from a well-mixed 24-hour urine collection to an ARUP Standard Transport Tube or ARUP supply
#48098 (ARUP Standard Transport Tube with 12 mg Sulfamic Acid) (Min: 3 mL). Record total volume and collection time interval on transport
tube and test request form. Adequate refrigeration is the most important aspect of specimen preservation. Preservation can be enhanced by
adjusting the pH to 2-4 by addition of 6 mol/L HCl or by using ARUP supply #48098, available online through e Supply using ARUP Connect™
or by contacting ARUP Client Services at (800) 522-2787.
Note: use caution when adjusting with 6 mol/L HCl as a pH of less than 2 will decrease analyte stability.
Stability: Ambient: 4 hours; Refrigerated: 2 weeks; Frozen: 1 month
CPT Code(s): 83586
2004519 Ki-67, MIB-1, by Immunohistochemistry MIB1 IHC

CPT Code(s): 88342
2007182 Ki-67 with Interpretation by Immunohistochemistry KI-67 IP

Specimen Preparation: Formalin fix (10 percent neutral buffered formalin) and paraffin embed specimen. Protect paraffin block and/or slides from
excessive heat. Transport tissue block or 5 unstained (3-5 micron thick sections), positively charged slides in a tissue transport kit (ARUP supply
#47808). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800)522-2787.(Min. 3 slides). If
sending precut slides, do not oven bake.
Room temperature. Also acceptable: Refrigerated. Ship in cooled container during summer months.
Remarks: This test code includes pathologist interpretation. Include surgical pathology report. IMMUNOHISTOCHEMISTRY ORDERING AND
SUBMISSION DETAILS: Submit electronic request. If you do
not have electronic ordering capability, use an ARUP Immunohistochemistry Stain Form (#32978) with an ARUP client number. For additional
technical details, please contact ARUP Client Services at
(800) 522-2787.
Unacceptable Conditions: Paraffin block with no tumor tissue remaining. Specimens fixed in B-5 or Bouin's fixative.
CPT Code(s): 88360
0020805 Kidney Stone Risk Panel II, Urine KID 2

Methodology: Quantitative Spectrophotometry/Quantitative Enzymatic
Specimen Required: Collect: 24-hour urine using Kidney Stone/Supersaturation Urine Collection Kit (ARUP supply# 46007). Available online through eSupply using
ARUP Connect™ or contact Client Services at (800) 522-2787. Refrigerate during collection.
Specimen Preparation: Specimen should be delivered to laboratory ASAP following collection. Freeze specimens immediately after aliquoting.
Do not exceed 4 mL in tubes. Transport four separate 4 mL aliquots from a well-mixed 24-hour urine collection according to the following
specifications:
1st aliquot: Dispense 4 mL of specimen into the Sulfamic Acid Tube. Mix well, then freeze.
2nd aliquot: Dispense 4 mL of specimen into the Sodium Carbonate Tube. Mix well, then freeze.
3rd aliquot: Dispense 4 mL of specimen into an Unpreserved Tube. Mix well, then freeze.
4th aliquot: Dispense 4 mL of specimen into an Unpreserved Tube. Mix well, then freeze.
Stability: Ambient: Unacceptable; Refrigerated: 12 hours (after collection is complete); Frozen: 3 weeks
CPT Code(s): 82340 Calcium; 82436 Chloride; 82507 Citric acid; 82131 Cystine; 83735 Magnesium; 83945 Oxalate; 84105 Phosphorus; 84133 Potassium;
84300 Sodium; 84560 Uric acid
0020843 Kidney Stone Risk Panel, Urine KID

Specimen Required: Collect: 24-hour urine. Use Kidney Stone/Supersaturation Urine Collection Kit (ARUP supply# 46007). Available online through eSupply using
ARUP Connect™ or contact Client Services at (800) 522-2787. Refrigerate during collection.
Do not exceed 4 mL in tubes. Transport four separate 4 mL aliquots from a well-mixed 24-hour urine collection according to the following
specifications:
Page | 302
1st aliquot: Dispense 4 mL of specimen into the Sulfamic Acid Tube. Mix well, then freeze.
2nd aliquot: Dispense 4 mL of specimen into the Sodium Carbonate Tube. Mix well, then freeze.
3rd aliquot: Dispense 4 mL of specimen into an Unpreserved Tube. Mix well, then freeze.
4th aliquot: Dispense 4 mL of specimen into an Unpreserved Tube. Mix well, then freeze.)
Stability: Ambient: Unacceptable; Refrigerated: 12 hours (after collection is complete); Frozen: 3 weeks
CPT Code(s): 82507 Citric acid; 83945 Oxalate; 84560 Uric acid; 82340 Calcium
0040137 KIT (D816V) Mutation by PCR KIT-F

Transport tissue (frozen, paraffin blocks) in a tissue transport kit (ARUP supply #47808) available online through eSupply using ARUP
Connect™or contact ARUP Client Services at (800) 522-2787.
CPT Code(s): 83891 Isolation; 83898 x2 Amplification; 83914 Mutation identification; 83894 Gel separation; 83912 Interpretation and report. Additional CPT
2002437 KIT Mutations in AML by Fragment Analysis and Sequencing KIT AML
Methodology: Polymerase Chain Reaction/Fragment Analysis/Sequencing
Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA). OR bone marrow (EDTA).
hemoloyzed specimens.
CPT Code(s): 83891 Isolation; 83898 x2 Amplification; 83896 Nucleic acid probe ; 83894 Gel separation; 83904 Sequencing, 83909 Capillary electrophoresis;
83912 Interpretation and report; - Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited
disorders.
2002695 KIT Mutations, Melanoma KIT MELAN

Methodology: Polymerase Chain Reaction/High Resolution Melting
tissue block or 6 unstained 5 micron slides. (Min: 4 slides)
Unacceptable Conditions: Specimens fixed/processed in alternative fixatives (alcohol, Prefer®). Decalcified specimen. Less than 25 percent
tumor.
CPT Code(s): 88381 Microdissection; 83907 Lysis; 83898 x2 Amplification; if additional exons are required, add 83898 Amplification times number of exons
tested; 83912 Interpretation and report - Additional CPT code modifiers may be required for procedures performed to test for oncologic or
0040105 Kleihauer-Betke Stain for Fetal Hemoglobin KB

Methodology: Semi-Quantitative Acid Elution Eosin Stain/Microscopy
Unacceptable Conditions: Frozen specimens. Specimens collected after Rh immunoglobulin administered. Clotted specimens.
CPT Code(s): 85460
0040248 KRAS Mutation Detection KRAS

tissue block or 5 unstained 5 micron slides. (Min: 3 slides)
Unacceptable Conditions: Specimens fixed/processed in alternative fixatives (alcohol, Prefer®). Frozen specimens.Decalcified specimen. Less
than 25 percent tumor.
CPT Code(s): 88381 Microdissection; 83907 Lysis; 83898 x2 Amplification; 83904 x2 Sequencing; 83912 Interpretation and report - Additional CPT code
2001932 KRAS Mutation Detection with Reflex to BRAF Codon 600 Mutation Detection KRAS RFLX
Page | 303
Specimen Preparation: Formalin fix (10 percent neutral buffered formalin) and paraffin embed tissue. Protect paraffin block from excessive heat.
Transport tissue block or 5 unstained 5 micron slides. (Min: 3 slides). Transport block and/or slide(s) in a tissue transport kit (ARUP supply #
47808) available online through eSupply using ARUP Connect™or contact ARUP Client Services at (800) 522-2787.
Unacceptable Conditions: Frozen specimens. Specimens fixed/processed in alternative fixatives (alcohol, Prefer ®) or heavy metal fixatives (B-4
or B-5). Less than 25 percent tumor in tissue. Decalcified specimens.
CPT Code(s): 88381 Microdissection; 83907 Lysis; 83898 x2 Amplification; 83904 x2 Sequencing; 83912 Interpretation and report, if reflexed, add 83898
Amplification; 83904 Sequencing; 83912 Interpretation and report - Additional CPT code modifiers may be required for procedures performed to
test oncologic or inherited disorders.
2003182 Lacosamide, (Vimpat®) Serum or Plasma LACOSA SP

Storage/Transport Temperature: Refrigerated: Also acceptable: Room temperature or frozen.
CPT Code(s): 80299
0020413 Lactate Dehydrogenase, Isoenzymes LDISO

Methodology: Quantitative Enzymatic/Electrophoresis
Specimen Required: 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
Stability: After separation of cells: Ambient: 1 week; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 83625 LD isoenzymes; 83615 Total LD
0020006 Lactate Dehydrogenase, Serum or Plasma LDH

Specimen Preparation: Allow serum tube to clot completely at room temperature. Separate serum or plasma from cells ASAP or within 2 hours of
Unacceptable Conditions: Specimens collected in EDTA, potassium oxalate, or sodium fluoride. Hemolyzed specimens.
Stability: Ambient: 1 week; Refrigerated: 4 days; Frozen: 6 weeks
UUHC Specimens: Ambient: 48 hours; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 83615
0020505 Lactate Dehydrogenase Total, Body Fluid LDH-FL

Unacceptable Conditions: Breast milk, salivary fluid, or sputum. Specimens collected in EDTA, potassium oxalate, or sodium fluoride.
Hemolyzed specimens. Specimens too viscous to be aspirated by instrument.
Stability: After separation from cellular material: Ambient: 1 week; Refrigerated: 4 days; Frozen: 6 weeks
UUHC Specimens: After separation from cellular material: Ambient: 48 hours; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 83615
0020504 Lactic Acid, Body Fluid LA-FL

Specimen Required: Collect: Body fluid. Collect on ice.
Specimen Preparation: Separate and ship supernatant. Centrifuge and separate to remove cellular material. Transport 1 mL body fluid. (Min: 0.2
mL)
Stability: After separation from cellular material: Ambient: Unacceptable; Refrigerated: 24 hours; Frozen: 1 month
CPT Code(s): 83605
0020516 Lactic Acid, CSF LA-CF

Specimen Required: Collect: CSF. Collect on ice.
Specimen Preparation: Separate and ship supernatant. Centrifuge and separate to remove cellular material. Transport 0.5 mL CSF. (Min: 0.2 mL)
Stability: After separation from cellular material: Ambient: Unacceptable; Refrigerated: 8 hours; Frozen: 1 month
CPT Code(s): 83605
0020045 Lactic Acid, Plasma LA

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Patient Preparation: Patient should be fasting and at complete rest. Patient should avoid any exercise of the arm or hand before or during
collection. Draw the specimen without the use of a tourniquet or within three minutes of applying the tourniquet, but before releasing the
tourniquet.
Specimen Required: Collect: Gray (sodium fluoride/potassium oxalate). Collect blood without stasis. Collect on ice.
Specimen Preparation: Immediately chill specimen; do not freeze whole blood. Centrifuge specimen within 15 minutes of collection. Transport 1
mL plasma. (Min: 0.2 mL)
Unacceptable Conditions: EDTA, citrate, or iodoacetate as anticoagulants. Tubes less than half full.
Stability: After separation from cells: Ambient: 8 hours; Refrigerated: 2 weeks; Frozen: 1 month
CPT Code(s): 83605
0061164 Lactoferrin, Fecal by ELISA FECLACTO

ARUP Connector contact Client Services at (800) 522-2787. (Min: 1 g) Also acceptable: Place 5 g stool in enteric transport media (Cary-Blair)
(ARUP Supply #29799). Available online through eSupply using ARUP Connectcontact ARUP Client Services at (800) 522-2787.
Unacceptable Conditions: Specimens in any transport media than indicated above.
Stability: Unpreserved: Ambient: 1 hour; Refrigerated: 1 week; Frozen: 1 week
Preserved: Ambient: 1 week; Refrigerated: 1 week; Frozen: 1 week
CPT Code(s): 83630
0020407 Lactose Tolerance LACTOL

Patient Preparation: Recommend drawing specimens for baseline (fasting), 30 minutes, 60 minutes, 120 minutes, and 180 minutes after lactose
load. Fasting patient should be given 50 g lactose in 200-300 mL water consumed in five to 10 minutes. Note: If severe lactose deficiency is
suspected, the dose should be lowered.
Specimen Required: Collect: Gray (sodium fluoride/potassium oxalate). Collect separate tube for each timed point.
Specimen Preparation: Separate plasma from cells ASAP or within 2 hours of collection. Transfer 1 mL plasma for each time point to individual
ARUP Standard Transport Tubes. (Min: 0.5 mL per timed determination)
Stability: After separation from cells: Ambient: 24 hours; Refrigerated: 72 hours; Frozen: 1 year
CPT Code(s): 82951 Tolerance test (GTT); 82952 x2 Tolerance test, each additional beyond three specimens
2003984 Lambda Light Chains by Immunohistochemistry LAMBDA IHC

CPT Code(s): 88342
0080940 Lamellar Body Counts LBC

Methodology: Quantitative Automated Cell Count
Patient Preparation: Amniocentesis preferred.
Specimen Preparation: Do not centrifuge. Transport 1 mL amniotic fluid. (Min: 0.25 mL)
Unacceptable Conditions: Frozen specimens. Vaginal pools containing mucous. Specimens that contain meconium. Grossly hemolyzed
specimens.
CPT Code(s): 83664
2003987 Laminin by Immunohistochemistry LAMIN IHC

CPT Code(s): 88342
0090177 Lamotrigine LAMOT

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Specimen Preparation: Separate serum or plasma from cells and refrigerate ASAP or within 2 hours of collection. Transfer 1 mL serum or plasma
to an ARUP Standard Transport Tube. (Min: 0.3 mL)
Stability: After separation from cells: Ambient: 1 month; Refrigerated: 6 weeks; Frozen: 6 weeks
CPT Code(s): 80299
0020257 LDL Cholesterol, Direct LDL D

Methodology: Quantitative Detergent Solubilization/ Enzymatic
CPT Code(s): 83721
0050021 LDL Subclasses LDL SUBC

Patient Preparation: Patient should be fasting for 12 hours prior to collection.
Specimen Preparation: Separate from cells ASAP or within 2 hours of collection. Transfer 1 mL serum or plasma to an ARUP Standard Transport
Tube. (Min: 0.2 mL)
Unacceptable Conditions: Heparinized plasma. Specimens from patients receiving heparin.
CPT Code(s): 83701 Lipoprotein subclasses; 82465 Cholesterol
2007346 Lead Analysis, Hair LEADHAIR

Specimen Preparation: Transfer 500 mg hair to an ARUP Trace Element-Free Transport Tube (ARUP supply #43116) available online through
CPT Code(s): 83655 Lead; 80103 Tissue preparation
2007348 Lead Analysis, Nails LEADNAIL

Methodology: Quantitative Inductively Coupled Plasma/Mass Spectrometry
Specimen Required: Collect: Nails.
Specimen Preparation: Transfer 500 mg nails to an ARUP Trace Element-Free Transport Tube (ARUP supply #43116) available online through
CPT Code(s): 83655 Lead; 80103 Tissue preparation
0020745 Lead, Blood (Capillary) LEAD CAP

Patient Preparation: Clean puncture site well with soap and water before collection procedure begins.
Specimen Required: Collect: Lavender Microtainer™ (EDTA).
Specimen Preparation: Invert specimen 10 times to prevent clot formation. Transport 0.5 mL whole blood. (Min: 0.3 mL)
Remarks: Lead requisition form required (ARUP form #32990-Barcode; #32991-No Barcode).
Stability: If the specimen is drawn and stored in the appropriate container, the lead values do not change with time.
CPT Code(s): 83655
0020098 Lead, Blood (Venous) LEAD-WB

Specimen Required: 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)
CPT Code(s): 83655
0025016 Lead, Industrial Exposure Panel, Adults LEAD-IND

Methodology: Quantitative Inductively Coupled Plasma-Mass Spectrometry/Hematofluorometry
Patient Preparation: Collect from patient aged 16 years or older.
Specimen Required: 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: 2 mL)
Unacceptable Conditions: Frozen specimens. Heparin anticoagulant. Hemolyzed or clotted specimens.
CPT Code(s): 83655 Lead; 84202 Zinc Protoporphyrin
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0025060 Lead, Urine LEAD U
CPT Code(s): 83655
0080200 Lecithin-Sphingomyelin Ratio L-S

Methodology: Quantitative Chromatography
Specimen Preparation: Do not centrifuge. Transport 10 mL amniotic fluid. (Min: 4 mL)
Stability: Ambient: 1 hour; Refrigerated: 48 hours; Frozen: 1 year
CPT Code(s): 83661
0093304 Leflunomide (Teriflunomide), Blood LEFLUNO B

Methodology: Quantitative High Performance Liquid Chromatography/Mass Spectrometry
Specimen Required: Collect: Gray (sodium fluoride/potassium oxalate) or lavender (EDTA).
CPT Code(s): 80299
0093302 Leflunomide (Teriflunomide), Serum or Plasma LEFLUNO SP

Specimen Required: Collect: Plain red. Also acceptable: Lavender (EDTA), pink (K2EDTA), green (sodium heparin), or gray (sodium fluoride/potassium oxalate).
0.45 mL)
CPT Code(s): 80299
0093306 Leflunomide (Teriflunomide), Urine LEFLUNO U

Specimen Preparation: Transfer 1 mL urine to an ARUP Standard Transport Tube. (Min: 0.45 mL).
CPT Code(s): 80299
0050376 Legionella pneumophila Antibody (Type 1), IgG by IFA LEGAB IFA
CPT Code(s): 86713
0050273 Legionella pneumophila Antibody (Type 1), IgM by IFA LEGAB1M

Specimen Preparation: Separate serum from cell ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport
Unacceptable Conditions: Contaminated, heat-inactivated, hemolyzed, severely lipemic specimens.
CPT Code(s): 86713
0050365 Legionella pneumophila Antibody (Types 1-6), IgG by IFA LEGAB

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CPT Code(s): 86713
0050274 Legionella pneumophila Antibody (Types 1-6), IgM by IFA LEGAB1-6M

Specimen Preparation: Separate serum from cell ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport
CPT Code(s): 86713
0070322 Legionella pneumophila Antigen, Urine LEGAG-U

Specimen Preparation: Mix specimen well. Transfer 4 mL urine to an ARUP Standard Transport Tube. (Min: 1 mL)
CPT Code(s): 87449
2004598 Legionella pneumophila DFA LEGIONFA

Specimen Required: Collect: Pericardial fluid or respiratory specimens.
Specimen Preparation: Fluid: Prepare two duplicate slides. OR transfer 1 mL fluid to a sterile container.
Tissue: Transfer tissue to a sterile container and place on gauze moistened with sterile non-bacteriostatic saline to prevent drying.
Storage/Transport Temperature: Refrigerated. OR frozen if transport occurs more than 48 hours after collection.
Unacceptable Conditions: Non-respiratory specimens. Specimens in preservatives or viral transport medium.
Stability: Fluid or Tissue: Ambient: 12 hours; Refrigerated: 48 hours; Frozen: 1 week
Slides: Ambient: 1 week; Refrigerated: 1 week; Frozen: 1 week
CPT Code(s): 87278
0056105 Legionella Species by PCR LEGION PCR

Specimen Required: Collect: Respiratory specimen: Bronchoalveolar lavage (BAL), bronchial brushings, nasopharyngeal swab, sputum, tracheal aspirates or pleural
fluid.
CPT Code(s): 87541
0060113 Legionella Species, Culture MC LEGION

Specimen Required: 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.
Storage/Transport Temperature: Refrigerated. For non-blood specimens: If delay in transport (greater than 48 hours), transport frozen.
Unacceptable Conditions: Stool, urine, wounds, or other non-respiratory sites. Dry specimens. Specimens in preservatives or viral transport
medium (M4, UTM).
2002945 Legius Syndrome (SPRED1) Sequencing and (NF1) Sequencing Exon 22 (Exon 17) LS FGS
Specimen Required: Collect: Contact ARUP's genetic counselor at (800) 242-2787, extension 2141, prior to test submission.
CPT Code(s): 83891 Isolation; 83898 x10 Amplification; 83904 x10 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation
0051726 Leishmania Antibody, IgG (Visceral Leishmaniasis) LEISH IGG

Methodology: Semi-Quantitative Immunoassay
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Unacceptable Conditions: Serum or plasma containing glycerol or other viscous materials. Hemolyzed specimens.
CPT Code(s): 86717
0070263 Leptin LEP

Patient Preparation: Patient should fast overnight prior to collection.
Unacceptable Conditions: Non-fasting specimens. Icteric specimens.
CPT Code(s): 83520
0050786 Leptospira Antibody LEPTO IHA

Methodology: Semi-Quantitative Indirect Hemagglutination
CPT Code(s): 86720
0055233 Leptospira Antibody, IgM by Dot Blot LEPTO M

Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum or plasma to an ARUP Standard
acute specimens. Please mark specimen plainly as acute or convalescent.
Unacceptable Conditions: Contaminated, heat-inactivated, hemolyzed, severely lipemic specimens. Any other body fluid.
CPT Code(s): 86720
0060158 Leptospira Culture MC LEPTO

Methodology: Culture
Patient Preparation: CSF or blood should be collected within first week of illness; urine after the first week of illness.
Specimen Required: Collect: Testing performed for UUHC and local Utah clients only.
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. OR blood
in heparin, sodium oxalate, Bactec® Blood Culture bottles or other commercial blood culture bottles. (Min: 1 mL). OR CSF or urine.
Specimen Preparation: Blood: Transport whole blood in SPS, heparin or sodium oxalate tube, or blood culture bottles. (Min: 1 mL)
CSF: Transfer 0.5 mL CSF in sterile container. (Min: 0.1 mL)
Urine: Dilute 1 mL urine 1:10 in 1 percent bovine serum albumin within one hour of collection. (Min: 0.1 mL)
Remarks: Specimen source required. Leptospiras may not survive in acidic urine.
Unacceptable Conditions: Clotted whole blood or whole blood submitted in anticoagulant other than those listed above. Urine not diluted with
bovine serum albumin within 1 hour of collection or urine in preservative. Frozen or refrigerated specimens.
Stability: SPS tube: Ambient: 6 days; Refrigerated: Unacceptable; Frozen: Unacceptable
Others: Ambient: 24 hours; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 87081 Culture, presumptive; 87166 Darkfield exam without collection
0080301 Leucine Aminopeptidase (LAP), Serum LAP B

Specimen Required: Collect: Serum separator tube. Also acceptable: Green (sodium or lithium heparin), lavender (EDTA), pink (K2EDTA), or lt. blue (sodium citrate).
hours of collection. Transport 1 mL serum or plasma. (Min: 0.5 mL)
Stability: Ambient: 4 days; Refrigerated: 1 week; Frozen: 3 weeks
CPT Code(s): 83670
0095244 Leukemia/Lymphoma Phenotyping (Comprehensive - Bone Marrow) LEUK BM

Specimen Required: Collect: Bone marrow.
Specimen Preparation: Transport 1 mL heparinized bone marrow. (Min: 0.5 mL)*
*Minimum volume dependent on cellularity.
Remarks: Provide Wright's stained smear, clinical history, differential diagnosis, and any relevant pathology reports.
Unacceptable Conditions: Small volume specimens collected in yellow (ACD solution A or B). Frozen specimens. Clotted or hemolyzed
specimens. Specimens greater than 48 hours old.
CPT Code(s): 88184 Technical component only first marker and 88185 Each additional marker; AND 88187 Interpretation for 2-8 markers or 88188
Interpretation for 9-15 markers or 88189 Interpretation for 16 or more markers.
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0095243 Leukemia/Lymphoma Phenotyping (Comprehensive - Miscellaneous) LEUK MS
Specimen Required: Collect: Tissue or fluid.
Specimen Preparation: Tissue: Suspend 100 mg fresh tissue in tissue culture media (e.g., RPMI 1640). (Min: 100 mg)
Fluid: Transport 10-100 mL fresh fluid. (Min: 10 mL)
Storage/Transport Temperature: Refrigerated on refrigerant pack. Specimen must be received within 24 hours of collection for optimal viable
testing.
Remarks: Provide specimen source, clinical history, differential diagnosis, and any relevant pathology reports. In general, a minimum of 10,000
viable cells is required for flow cytometry phenotyping with a very limited number of antibodies. All specimens, regardless of quality, will be
processed and analyzed. Supplying clinical and diagnostic information is especially important with low count specimens to help ensure the most
appropriate antibody combinations are evaluated before the specimen is depleted of cells.
Unacceptable Conditions: Frozen specimens. Clotted specimens. Specimens greater than 48 hours old.
CPT Code(s): 88184 First marker and 88185 Each additional marker; AND 88187 Interpretation for 2-8 markers or 88188 Interpretation for 9-15 markers or
88189 Interpretation for 16 or more markers.
0096299 Leukemia/Lymphoma Phenotyping (Comprehensive - Whole Blood) LEUK-WB

Specimen Required: Collect: Green (sodium heparin), lavender (EDTA), or pink (K2EDTA).
Remarks: Provide CBC, Wright's stained smear, clinical history, differential diagnosis, and any relevant pathology reports.
Unacceptable Conditions: Frozen specimens. Clotted or hemolyzed specimens. Specimens greater than 48 hours old.
Stability: Ambient: 48 hours; Refrigerated: 48 hours; Frozen Unacceptable
CPT Code(s): 88184 First marker and 88185 Each additional marker; AND 88187 Interpretation for 2-8 markers or 88188 Interpretation for 9-15 markers or
88189 Interpretation for 16 or more markers.
2004359 Leukocyte Adhesion Deficiency Panel LAD PAN

Remarks: Client must supply a CBC and a differential with the whole blood specimen. The differential must include eosinophil and basophil
counts. Specimen must be analyzed within 48 hours of collection.
Unacceptable Conditions: Clotted specimens. Frozen or room temperature specimens. Specimens greater than 48 hours.
CPT Code(s): 86356 CD11b; 86356 CD15; 86356 CD18
0049000 Leukocyte Alkaline Phosphatase LAP

Specimen Preparation: Protect from light and pack accordingly to avoid breakage. Transport 5 mL whole blood (Min: 1 mL) AND 6 unfixed,
well-prepared smears (Min: 6 smears)
Storage/Transport Temperature: Room temperature. Send Sunday through Thursday only. Whole blood must be received within 24 hours of
collection; smears must be received within 72 hours preparation.
Unacceptable Conditions: Specimens collected in EDTA. Poorly prepared smears (too thick or no feather edge). Broken or fixed smears.
Stability: Blood: Ambient: 24 hours
Unfixed Smears: Ambient: 72 hours
CPT Code(s): 85540
0099603 Leukocyte Lysosomal Enzyme WCELL

Methodology: Enzyme Activity
(Enzymatic)
Specimen Required: Collect: Green (sodium or lithium heparin). Collect Monday-Thursday only.
Specimen Preparation: Before sending specimen, contact ARUP Referral Testing at (800) 242-2787, extension 5145 for additional instructions.
Transport 8 mL whole blood (Min: 2 mL). Specimen must be received at performing laboratory within 24 hours of collection.
Remarks: Patient history must be provided.
CPT Code(s): 82657 Enzyme cell activity; 82658 Enzyme cell activity radioactive
0091351 Levodopa, Serum or Plasma LEVODOP

Specimen Preparation: Transfer 2 mL serum or plasma to an ARUP Standard Transport Tube and freeze immediately. (Min: 0.5 mL)
Remarks:
CPT Code(s): 80299
0090148 Librium and Nordiazepam LIB

Methodology: High Performance Liquid Chromatography/Gas Chromatography
Page | 310
Stability: After separation from cells: Ambient: 4 hours; Refrigerated: 24 hours; Frozen: 5 days
CPT Code(s): 80154 Librium; 80154 Nordiazepam
0090155 Lidocaine LIDO

Patient Preparation: Draw specimens 12 hours after initiating therapy for arrhythmia prophylaxis, then every 24 hours thereafter.
Specimen Required: Collect: Plain red. Also acceptable: green (sodium heparin).
Specimen Preparation: Separate serum from cells immediately. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Stability: After separation from cells: Ambient: 1 week; Refrigerated: 1 week; Frozen: 1 month
CPT Code(s): 80176
0091197 Lidocaine & Metabolite, Serum or Plasma LIDOCAIN

CPT Code(s): 80176
0091198 Lidocaine and Metabolite, Urine LIDOCAI UR

Specimen Preparation: Transfer1 mL urine to an ARUP Standard Transport Tube. (Min: 0.4 mL)
CPT Code(s): 80176
0097328 Limulus Amebocyte Lysate (LAL) LAL

Methodology: Quantitative Chromogenic Assay
Specimen Required: Collect: Aqueous solution used in patient management.
Specimen Preparation: Transfer 5 mL aqueous solution to ARUP Standard Transport Tubes. (Min: 3 mL)
Unacceptable Conditions: Body fluid. Glass vials.
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: No stability available
CPT Code(s): Not applicable for non-biological specimens
0020715 Lipase, Fluid LIP FL

Stability: Ambient: 1 week; Refrigerated: 1 week; Frozen: 1 year
CPT Code(s): 83690
0020014 Lipase, Serum or Plasma LIP

Unacceptable Conditions: Body Fluids (refer to Lipase, Fluid, ARUP test code 0020715). Specimens collected in EDTA, oxalate/fluoride or
citrate, or in tubes with glycerol lubricated stoppers.
Stability: After separation from cells: Ambient: 1 week; Refrigerated: 1 week; Frozen: 1 year
CPT Code(s): 83690
0080467 Lipid Associated Sialic Acid LASA

Transfer 0.5 mL serum to an ARUP Standard Transport Tube. (Min: 0.2 mL)
CPT Code(s): 84275
0020421 Lipid Panel CRISK

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Unacceptable Conditions: Body Fluid (refer to Chylomicron Screen, Body Fluid, ARUP test code 0098457).
CPT Code(s): 80061
0020468 Lipid Panel, Extended CRISK E

Patient Preparation: Patient must fast for 12-15 hours prior to collection.
Unacceptable Conditions: Body Fluid (refer to Chylomicron Screen, Body Fluid, ARUP test code 0098457).
CPT Code(s): 80061 Lipid panel; 83721 LDL-cholesterol measured
0092252 Lipid Peroxides (TBARS), Serum LIPID PER

Patient Preparation: Patient should be fasting 8-12 hours prior to collection. Patient may have water. It is not necessary to discontinue
nutritional supplements.
Specimen Required: Collect: Plain red or red/gray tiger.
Specimen Preparation: Allow specimen to clot at room temperature for 20-30 minutes. Separate from cells. Protect from light. Transfer 3 mL
serum to an ARUP Amber Transport Tube. (Min: 3 mL)
Unacceptable Conditions: Hemolyzed specimens. Specimens not protected from light.
CPT Code(s): 82491
0099174 Lipoprotein (a) LIPO A

(K2EDTA).
Unacceptable Conditions: Body Fluids.
CPT Code(s): 83695
0080503 Lipoprotein Electrophoresis LIPOELECT

Methodology: Qualitative Electrophoresis/Quantitative Enzymatic/Detergent Solubilization
Patient Preparation: Patient should be fasting for 12-15 hours.
Specimen Preparation: Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL) Store and ship refrigerated. DO NOT FREEZE.
Unacceptable Conditions: Heparin and frozen samples. Body fluids.
Stability: After separation from cells: Ambient: 24 hours; Refrigerated: 10 days; Frozen: Unacceptable
CPT Code(s): 83700
0080570 Lipoprotein Electrophoresis with Qualitative Band Assessment LIPOELECTB

Patient Preparation: Patient should be fasting for 12-15 hours.
Specimen Preparation: Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL) Store and ship refrigerated. DO NOT
FREEZE
Remarks: Patient should be fasting for 12-15 hours. Store and ship refrigerated. DO NOT FREEZE.
Unacceptable Conditions: Body fluids (refer to Chylomicron Screen, Body Fluid, ARUP test code 0098457). Heparinized specimens. Frozen
specimens.
Stability: After separation from cells: Ambient: 24 hours; Refrigerated: 10 days; Frozen: Unacceptable
CPT Code(s): 83700
0081055 Lipoprotein-Associated Phospholipase A2 (PLAC®) PLAC

Specimen Required: Collect: Serum separator tube or plasma separator tube. Also acceptable: Lavender (EDTA) or pink (K2EDTA).
Specimen Preparation: Allow serum specimen to clot completely at room temperature. Transport 1 mL serum or plasma. (Min: 0.2 mL)
Unacceptable Conditions: Whole blood. Frozen or room temperature specimens.
Stability: After separation from cells: Ambient: 4 hours; Refrigerated: 1 week; Frozen: Unacceptable
CPT Code(s): 83698
2002086 Listeria Antibody, CSF by CF LIST CSF

Methodology: Complement Fixation
Specimen Preparation: Transfer 1 mL CSF to an ARUP standard transport tube. (Min: 0.5 mL)
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Stability: Ambient: Undetermined; Refrigerated: 2 weeks; Frozen: 1 month
CPT Code(s): 86609
0099529 Listeria Antibody, Serum by CF LISTERIA

CPT Code(s): 86609
0020038 Lithium, Serum or Plasma LI

Patient Preparation: Specimens are commonly drawn approximately 12 hours after last dose of lithium taken.
Specimen Required: Collect: Serum separator tube or green (sodium heparin).
Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.2 mL)
Unacceptable Conditions: Specimens collected in lithium heparin or sodium fluoride/potassium oxalate. Grossly hemolyzed specimens.
CPT Code(s): 80178
0055241 Liver-Kidney Microsome - 1 Antibody, IgG LKM1 IGG

Tube. (Min: 0.5 mL)
CPT Code(s): 86376
0099270 Liver-Kidney Microsome Antibody, IgG LIVER-KID

Unacceptable Conditions: Severely hemolyzed or lipemic specimens.
CPT Code(s): 86376
2004539 LMNA-Related Disorders (LMNA) Deletion/Duplication LMNA DD

2004543 LMNA-Related Disorders (LMNA) Sequencing LMNA FGS

CPT Code(s): Sequencing: 83891 Isolation; 83898 x12 Amplification; 83904 x12 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report
2002697 Loeys-Dietz Syndrome (TGBR1 & TGBR2) Deletion/Duplication LDS DELDUP

2002705 Loeys-Dietz Syndrome (TGFBR1 & TGFBR2) Sequencing LDS FGS

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2002701 Loeys-Dietz Syndrome (TGFBR1 & TGFBR2) Sequencing & Deletion/Duplication LDS FGA
Methodology: Polymerase Chain Reaction/Multiplex Ligation-dependent Probe Amplification/Sequencing
CPT Code(s): Sequencing: 83891 Isolation; 83898 x17 Amplification; 83904 x18 Sequencing; 83909 Capillary electrophoresis. Del/Dup: 83896 Nucleic Acid
Probes; 83898 Amplification; 83914 Extension; 83909 Capillary electrophoresis; 83912 Interpretation and report - Additional CPT code modifiers
2006232 Long QT Syndrome (LQTS) Panel, 12 Genes LQTS PANEL

0090181 Lorazepam LORAZ

Stability: After separation from cells: Ambient: 12 hours; Refrigerated: 5 days; Frozen: 2 weeks
CPT Code(s): 80154
0091295 Loxapine, Serum or Plasma LOXAPIN SP

CPT Code(s): 80299
0091499 Loxapine, Urine LOXAPIN U

Specimen Preparation: Protect from light. Transfer 3 mL urine to an ARUP Amber Transport Tube. (Min: 1 mL)
CPT Code(s): 80299
0091200 LSD, Serum or Plasma - Screen with Reflex to Confirmation/Quantitation LSD SP

Methodology: Qualitative Immunoassay/Quantitative High Performance Liquid Chromatography-Tandem Mass Spectrometry
Specimen Preparation: Separate from cells within 2 hours of draw. Protect specimen from light. Transfer 3 mL serum or plasma to an ARUP
Amber Transport Tube. (Min: 1.1 mL)
Unacceptable Conditions: Specimens that have not been protected from light. Glass containers or serum separator tubes.
Stability: Ambient: 2 weeks; Refrigerated: 1 month; Frozen: 1 month
0091224 LSD, Urine - Screen with Reflex to Confirmation/Quantitation LSD URN

Methodology: Qualitative Immunoassay/Quantitative Liquid Chromatography-Tandem Mass Spectrometry
Specimen Preparation: Protect from light. Transfer 2 mL urine to an ARUP Amber Transport Tube. (Min: 0.85 mL)
Unacceptable Conditions: Specimens not protected from light. Specimens submitted in glass containers.
CPT Code(s): 80101 Drug screen; if positive add 82542
Page | 314
2006029 Lung Cancer Mutation Reflexive Panel LUNG RFLX
Specimen Preparation: Formalin fix (10% neutral buffered formalin) and paraffin embed tissue. Transport tissue block or 5 unstained 5 micron
slides. AND 6 tissue scrolls (tissue shavings) 10 microns thick in a tissue transport kit (ARUP supply #47808). Available online through eSupply
using ARUP ConnectTM or contact ARUP Client Services at (800) 522-2787. (Min: 3 slides AND 6 tissue scrolls) Protect specimens from
excessive heat
Storage/Transport Temperature: Room temperature or refrigerated. Ship in cooled container during summer months
Remarks: Include surgical pathology report. Tissue block will be returned after testing
Unacceptable Conditions: Insufficient tumor in tissue. Decalcified specimens. Specimens fixed/processed in alternative fixatives (alcohol,
Prefer®). Frozen specimens
CPT Code(s): 88381 Microdissection; 83907 Lysis; 83898 x2 Amplification; 83904 x2 Sequencing; 83912 Interpretation and report.
If reflexed to EGFR by PCR, add 83898 x2 Amplification; 83892 Digestion; 83909 Separation and identification; 83896 x2 Nucleic acid probes;
83912 Interpretation and report.
If reflexed to EML4/ALK Translocation by RT-PCR, add 83907 Lysis; 83891 Isolation; 83902 Reverse Transcription; 83898 x3 Amplification;
83894 x3 Gel Separation; 83912 Interpretation and report
Additional CPT code modifiers may be required for procedures performed to test oncologic or inherited disorders
0030181 Lupus Anticoagulant Reflexive Panel LUPUS R

Specimen Required: Collect: Light blue (sodium citrate). Refer to Specimen Handling at aruplab.com for hemostasis/thrombosis specimen handling guidelines.
Unacceptable Conditions: Serum. Anticoagulants other than indicated. Clotted, hemolyzed, or non-frozen specimens.
Stability: Ambient: 4 hours; Refrigerated: 4 hours; Frozen at -20°C or below: 3 months; Frozen at -70°C or below: 18 months
CPT Code(s): 85610 Prothrombin time (PT); 85730 Partial Thromboplastin Time (PTT); 85613 dRVVT. If PTT is abnormal, add 85670 Thrombin Time. If
Thrombin time is abnormal, add 85635 Reptilase Time. If Reptilase Time is normal, add PTT Heparin Neutralization 85730 and 85525. If PTT
Heparin Neutralization is abnormal, add 85732 PTT 1:1 mix. If PTT 1:1 mix is abnormal, add 85597 Platelet neutralization procedure (PNP). If
dRVVT is abnormal, add 85613 dRVVT 1:1 mix. If dRVVT 1:1 mix is abnormal, perform 85613 dRVVT confirmation. If PNP and dRVVT conf
are normal, add 85598 Hexagonal Phospholipid Neutralization.
0050119 Lupus Comprehensive Reflexive Panel LUPUS COMP

Methodology: Quantitative Immunoturbidimetry/Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent
Antibody/Quantitative Chemiluminescent Immunoassay/Semi-Quantitative Multiplex Bead Assay
Specimen Preparation: Allow specimen to clot for 30 to 60 minutes at room temperature. Separate serum from cells ASAP or within 2 hours of
collection. Transfer 4 mL serum to an ARUP Standard Transport Tube and freeze immediately. (Min: 2 mL)
Unacceptable Conditions: Plasma. Specimens left to clot while refrigerated. Contaminated, hemolyzed, or severely lipemic specimens.
Stability: After separation from cells: Ambient: 1 hour; Refrigerated: 24 hours, Frozen: 2 weeks
CPT Code(s): 86431 RF; 86160 C3; 86160 C4; 86038 ANA; if reflexed add 86039 ANA titer; if reflexed add 86235 RNP; 86235 Smith; 86235 SSA; 86235
SSB; 86235 Scl-70; 86376 TPO; 86225 dsDNA; if dsDNA reflexed, add 86256 dsDNA titer.
0070193 Luteinizing Hormone and Follicle Stimulating Hormone LH/FSH

Specimen Required: Collect: Plain red or plasma separator tube.
CPT Code(s): 83001 FSH; 83002 LH
2005166 Luteinizing Hormone, Pediatric LH PED

Methodology: Quantitative Electrochemiluminescent Technology
(Electrochemiluminescent Immunoassay)
Specimen Preparation: Separate serum from cells within one hour. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.2 mL)
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 200 days
CPT Code(s): 83002
0070093 Luteinizing Hormone, Serum LH

CPT Code(s): 83002
0096056 Lymphocyte Antigen and Mitogen Proliferation Panel LAM

Methodology: Cell Culture
Patient Preparation: Collect control specimen from a healthy individual unrelated to patient at approximately the same time as and under
similar conditions to the patient.
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Specimen Required: Collect: Green (sodium heparin) (patient) AND green (sodium heparin) (control). Also acceptable: Yellow (ACD Solution A) (patient) AND
yellow (ACD Solution A) (control). Patient and control specimens must be collected within 48 hours of test performance.
Specimen Preparation: Transport 10 mL whole blood (patient) AND 10 mL whole blood (control) in original collection tubes. (Min: 7 mL
(patient) AND 7 mL (control)) Do not refrigerate or freeze. LIVE LYMPHOCYTES REQUIRED.
Infant Minimum: 3 mL (patient) AND 7 mL (control).
Remarks:
Unacceptable Conditions: Yellow (ACD Solution B). Refrigerated or frozen specimens. Specimens in transport longer than 48 hours.
CPT Code(s): 86353 x5 Lymphocyte transformation
0051584 Lymphocyte Antigen and Mitogen Proliferation Panel with Cytokine Response to Mitogens, 12 Cytokines LAM CYT 12
Methodology: Cell Culture/Multiplex Bead Assay
Specimen Required: Collect: Green (sodium heparin) (patient) AND green (sodium heparin) (control). Also acceptable: Yellow (ACD solution A) (patient) AND
yellow (ACD solution A) (control). Patient and control specimens must be
collected within 48 hours of test
(patient) AND 14 mL (control)) Do not refrigerate or freeze. LIVE CELLS REQUIRED.
Remarks:
CPT Code(s): 86353 x 5 Lymphocyte transformation; 83520 x 12 Cytokines
0051587 Lymphocyte Antigen and Mitogen Proliferation Panel with Cytokine Response to Mitogens, Monokines LAM MONO
collected within 48 hours of test performance.
Remarks:
0051585 Lymphocyte Antigen and Mitogen Proliferation Panel with Cytokine Response to Mitogens, TH1 Cytokines LAM TH1 CY
yellow (ACD solution A) (control). Patient and control specimens must be collected within 48 hours of test performance.
Remarks:
0051586 Lymphocyte Antigen and Mitogen Proliferation Panel with Cytokine Response to Mitogens, TH2 Cytokines LAM TH2 CY
Remarks:
0096055 Lymphocyte Antigen Proliferation LAPP

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Specimen Required: Collect: Green (sodium heparin) (patient) AND green (sodium heparin) (control). Also acceptable: Yellow (ACD Solution A) (patient) AND
yellow (ACD Solution A) (control). Patient and control specimens must be collected within 48 hours of test performance.
Remarks:
0096043 Lymphocyte Mitogen Proliferation LMP

Patient Preparation: Collect control specimen from a healthy individual unrelated to patient.
Remarks:
CPT Code(s): 86353 x3 Lymphocyte transformation
0095854 Lymphocyte Subset Panel 1 - CD4 Absolute Count Only ABS4

Remarks: Specimens must be analyzed within 72 hours of collection in EDTA or within 48 hours of collection in heparin. Some medications may
affect immunophenotyping results and should be listed on the patient test request form.
This test is not approved for New York State Clients.
Unacceptable Conditions: Frozen or refrigerated specimens. Specimens older than 72 hours in EDTA or 48 hours in heparin. Clotted or
Stability: Ambient: 72 hours in EDTA, 48 hours in heparin; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 86361
0095885 Lymphocyte Subset Panel 2 - CD4 Percent and Absolute CD4

Remarks: Specimens must be analyzed within 72 hours of collection in EDTA or within 48 hours of collection in heparin. Some medications may
affect immunophenotyping results and should be listed on the patient test request form.
This test is not approved for New York State Clients.
CPT Code(s): 86361 Absolute CD4 count
0095853 Lymphocyte Subset Panel 3 - T-Cell Subsets (CD4 and CD8), Absolute Counts Only ABS
Remarks: Specimens must be analyzed within 72 hours of collection in EDTA or within 48 hours in heparin. Some medications may affect
immunophenotyping results and should be listed on the patient test request form.
This test is not approved for New York State clients.
CPT Code(s): 86359 T-Cells, Total count; 86360 Absolute CD4 and CD8 counts with ratio
0095950 Lymphocyte Subset Panel 4 - T-Cell Subsets Percent and Absolute, Whole Blood TSHORT
Remarks: Specimens must be analyzed within 72 hours of collection in EDTA or 48 hours in heparin. Some medications may affect
immunophenotyping results and should be provided on the test request form.
New York State Clients: Only EDTA specimens may be submitted and must be analyzed within 30 hours of collection.
Unacceptable Conditions: BAL specimens (refer to ARUP test code 0093420). Frozen or refrigerated specimens. Specimens older than 72 hours
in EDTA or 48 hours in heparin. Clotted or hemolyzed specimens.
Page | 317
New York State Clients: BAL specimens (refer to ARUP test code 0093420). Specimens collected in heparin. EDTA specimens older than 30
hours. Frozen or refrigerated specimens. Clotted or hemolyzed specimens.
New York State Clients: EDTA Ambient: 30 hours; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 86359 T-Cells, Total count; 86360 Absolute CD4 and CD8 counts with ratio
0095892 Lymphocyte Subset Panel 5 - Total Lymphocyte Enumeration TIMMUNPAN

Remarks: Specimens must be analyzed within 72 hours of collection in EDTA or 48 hours in heparin. Some medications may affect
immunophenotyping results and should be listed on the test request form.
New York State Clients: Specimens collected in heparin. Frozen or refrigerated specimens. EDTA specimens older than 30 hours. Clotted or
New York State Clients: EDTA: Ambient: 30 hours; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 86355 B-Cells, Total count; 86357 NK cells, Total count; 86359 T-Cells, Total count; 86360 Absolute CD4 and CD8 counts with ratio
0095862 Lymphocyte Subset Panel 6 - Total Lymphocyte Enumeration with CD45RA and CD45RO TEXTENDED
Remarks: Specimens must be analyzed within 72 hours of collection in EDTA or within 48 hours in heparin. Some medications may affect
CPT Code(s): 86355 B-Cells, Total count; 86357 NK cells, Total count; 86359 T-Cells, Total count; 86360 Absolute CD4 and CD8 counts with ratio; 86356
CD4; 86356 CD45RA; 86356 CD45RO
0095899 Lymphocyte Subset Panel 7 - Congenital Immunodeficiencies PIP

Remarks: Specimens must be analyzed within 72 hours of collection in EDTA and within 48 hours of collection in heparin. Some medications
may affect immunophenotyping results and should be listed on the patient test request form.
New York State Clients: EDTA: Ambient: 30 hours, Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 86355 B-Cells, Total count; 86357 NK cells, Total count; 86359 T-Cells, Total count; 86360 Absolute CD4 and CD8 counts with ratio; 86356
CD4; 86356 CD45RA; 86356 CD45RO; 86356 CD2; 86356 HLA-DR
0093420 Lymphocyte Subset Panel 4 - T-Cell Subsets Percent and Ratio, Bronchoalveolar Lavage LYMBAL
Specimen Required: Collect: Bronchoalveolar lavage (Bronch Wash or BAL).
Specimen Preparation: Transfer 4 mL bronchoalveolar lavage to a sterile container. (Min: 3 mL)
Unacceptable Conditions: Whole blood (refer to ARUP test code 0095950). Excess mucus, excess peripheral blood, or too few lymphocytes.
Frozen or room temperature specimens. Specimens older than 48 hours. Contaminated specimens.
Stability: Ambient: Unacceptable, Refrigerated: 48 hours, Frozen: Unacceptable
CPT Code(s): 86356 CD3; 86356 CD4; 86356 CD8
0095949 Lymphocyte Transplantation CD3 CD3

Patient Preparation: Draw specimen before administering immunosuppressive medications.
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Remarks: THIS TEST IS FOR TRANSPLANT PATIENTS ONLY. WBC and lymph percent results with the same draw date and time as
the CD3 specimen must be provided by the client. Specimens must be analyzed within 48 hours of collection. Some medications may affect
of collection.
Unacceptable Conditions: Clotted, hemolyzed, frozen, or refrigerated specimens. Specimens older than 48 hours.
New York State Clients: Clotted, hemolyzed, frozen, or refrigerated specimens. EDTA specimens older than 30 hours and heparin specimens
older than 48 hours.
CPT Code(s): 86356 CD3; 86356 ALPHA/BETA
0095798 Lymphocyte Transplantation Profile LYMPHPRO

Patient Preparation: Draw specimen before administering immunosuppressive medications.
Specimen Required: Collect: Green (sodium or lithium heparin), lavender (EDTA) or pink (K2EDTA).
Remarks: Specimens must be analyzed within 48 hours of collection. Some medications may affect immunophenotyping results and should be
listed on the patient test request form.
THIS TEST IS FOR TRANSPLANT PATIENTS ONLY. WBC and lymphocyte percent results with the same draw date and time as the
Lymphocyte Transplantation Profile specimen must be provided by client.
of collection.
New York State Clients: Clotted, hemolyzed, frozen, or refrigerated specimens. EDTA specimens older than 30 hours and heparin specimens
older than 48 hours.
CPT Code(s): 86356 CD2; 86356 CD3; 86356 CD4; 86356 CD8; 86356 CD19; 86356 ALPHA/BETA
2001635 Lymphocytic Choriomeningitis (LCM) Virus Antibodies, IgG & IgM LCM SER
Tube. (Min 0.2 mL) Parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of the acute specimens.
2001628 Lymphocytic Choriomeningitis (LCM) Virus Antibodies, IgG & IgM, CSF LCM CSF
Specimen Preparation: Transfer 1 mL CSF to an ARUP Standard Transport Tube. (Min 0.2 mL)
Unacceptable Conditions: Contaminated, hemolyzed, or heat-inactivated specimens.
2001633 Lymphocytic Choriomeningitis (LCM) Virus Antibody, IgG LCM G SER

CPT Code(s): 86727
2001629 Lymphocytic Choriomeningitis (LCM) Virus Antibody, IgG, CSF LCM G CSF
Specimen Preparation: Transfer 0.75 mL CSF to an ARUP Standard Transport Tube. (Min 0.2 mL)
CPT Code(s): 86727
2001634 Lymphocytic Choriomeningitis (LCM) Virus Antibody, IgM LCM M SER

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CPT Code(s): 86727
2001630 Lymphocytic Choriomeningitis (LCM) Virus Antibody, IgM, CSF LCM M CSF
Specimen Preparation: Transfer 0.75 mL CSF to an ARUP Standard Transport Tube. (Min 0.2 mL)
CPT Code(s): 86727
0098880 Lymphogranuloma Venereum (LGV), Differentiation Antibody Panel, MIF LYMPH VEN
Methodology: Micro Immunofluorescence
CPT Code(s): 86631x8 per Species; 86632 x4 per Isotype
2002650 Lymphoma (Aggressive) Panel by FISH FISH ALYMP

Remarks: If cell pellets or dropped cytogenetics slides are submitted, a processing fee will not apply. This test must be ordered using Cytogenetic
test request form #43099 or through your ARUP interface.
2003990 Lysozyme (Muramidase) by Immunohistochemistry LYSOZY IHC

CPT Code(s): 88342
0050367 Lysozyme, Serum or Body Fluid LYSO

Specimen Required: Collect: Serum separator tube, CSF, tears, or other body fluid. (Urine not accepted.)
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum OR 0.5 mL CSF, tears OR other
body fluid to an ARUP Standard Transport Tube. (Min: 0.4 mL)
Unacceptable Conditions: Urine.
CPT Code(s): 85549
0050368 Lysozyme, Urine LYSOZ U

Specimen Preparation: Transfer 3 mL aliquot from a well-mixed random urine collection to an ARUP Standard Transport Tube. (Min: 0.5 mL)
CPT Code(s): 85549
2004464 Macroamylase Determination MACROAMY

Methodology: Quantitative Ultrafiltration/Quantitative Enzymatic
Specimen Required: Collect: Plasma separator tube, serum separator tube, or plain red.
Unacceptable Conditions: Specimens containing calcium chelating anticoagulants such as citrates, EDTA, or oxalates.
CPT Code(s): 82150 Amylase; 84999 Monomeric amylase
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0020765 Macroprolactin MACROPRO
Specimen Preparation: Allow specimen to clot completely at room temperature. Transfer 1 mL serum or plasma to an ARUP Standard Transport
Tube. (Min: 0.5 mL)
0051674 Macular Degeneration, Age-Related, 2 DNA Markers AMD

0020105 Magnesium, Fecal FECMG

Specimen Required: Collect: 24-hour or random stool.
Specimen Preparation: Mix specimen well and transfer a 5 g stool to an unpreserved stool transport vial (ARUP Supply #40910). Available online
through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 1 g). Do not add saline or water to liquefy
specimen. Indicate total time and weight.
Unacceptable Conditions: Formed or viscous stools.
Stability: Ambient: 1 hour; Refrigerated: 1 week; Frozen: 1 month
CPT Code(s): 83735
0020039 Magnesium, Plasma or Serum MG

Unacceptable Conditions: Specimens collected in EDTA, oxalate/fluoride. Hemolyzed specimens.
Stability: After separation from cells: Ambient: 1 week; Refrigerated: 1 week; Frozen: 1 year
CPT Code(s): 83735
0092079 Magnesium, RBC MG RBC

Specimen Preparation: Centrifuge whole blood and separate RBCs. Transfer 2 mL RBCs to an ARUP Trace Element-Free Transport Tube (ARUP
supply #43116). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 0.6 mL)
Unacceptable Conditions: Frozen. Clotted or grossly hemolyzed specimens.
Stability: After separation from plasma: Ambient: 1 week; Refrigerated: 2 weeks; Frozen: Unacceptable
CPT Code(s): 83735
0020477 Magnesium, Urine UMG

Specimen Required: Collect: 24-hour urine. Refrigerate during collection. Also acceptable: Random urine.
Specimen Preparation: Adjust pH to 1 by adding 6M HCl (approximately 10 mL HCl/24-hour specimen based on normal adult output of 1000-
2000 mL/24 hours. Pediatric specimens will require less than 10 mL to reach the correct pH). Record total volume and collection time interval on
transport tube and test request form.
Transfer 4 mL aliquot of urine from a well-mixed 24-hour collection to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Unacceptable Conditions: Specimens containing preservatives other than HCl. Specimen submitted in metal containers.
Stability: Ambient: 1 week (if acidified); Refrigerated: 1 week; Frozen: 1 year
CPT Code(s): 83735
0051356 Malaria Antibody, IgG MALARIA AB

Unacceptable Conditions: Contaminated, heat-inactivated, hemolyzed, icteric, lipemic, or turbid specimens.
CPT Code(s): 86750
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2004963 Malaria Detection and Speciation, Qualitative by Real-Time PCR MALARIAPCR
Stability: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 1 week
CPT Code(s): 87798 P. falciparum; 87798 P. vivax; 87798 P. ovale; 87798 P. malariae; 87798 P. knowlesi
2001547 Malaria, Rapid Screen and Giemsa Stain BLD PARA

Methodology: Qualitative Immunochromatography/Stain
Specimen Preparation: Transport 5 mL whole blood (Min: 1 mL) AND five (5) thin blood smears (unstained, unfixed) AND five (5) thick smears
(unstained, unfixed). Thin and thick
blood smears should be prepared immediately or within 1 hour after collection. Extended exposure to EDTA anticoagulants can result in altered
parasite
morphology. Thin smears are made as per routine hematology differentials. Thick smears are made by dropping 10 to 20 µL of blood onto a slide
and
spreading it into a dime-sized area with a glass, wooden, or plastic applicator.
For instructions on preparation of thick and thin smears, see http://www.dpd.cdc.gov/dpdx/HTML/DiagnosticProcedures.htm. Label and transport
slides in
slide holders. Specimen must be received within 24 hours of collection.
Remarks: Rapid diagnosis of malaria is critical for appropriate patient management. Specimens for Malaria and Babesia are for confirmation only
from clients outside of the immediate Salt Lake City, Utah area. Travel history required.
Unacceptable Conditions: Whole blood in anticoagulants other than EDTA or K2EDTA.
Stability: Whole blood: Ambient: 24 hours; Refrigerated: Unacceptable; Frozen: Unacceptable.
Slides: Ambient: 1 week; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 87899 Rapid screen; 87207 Stain
2007254 Manganese, RBC MANG RBC

supply #43116). Available online through eSupply using ARUP Connect ™ or contact ARUP Client Services at (800) 522-2787. (Min: 0.3 mL)
Stability: Ambient: Undetermined; Refrigerated: Undetermined; Frozen: Unacceptable
CPT Code(s): 83785
0099265 Manganese, Serum MANG

discontinue nutritional supplements, vitamins, minerals, and non-essential over-the-counter
medications (upon the advice of their physician).
Specimen Preparation: Do not allow serum to remain on cells. Centrifuge and pour off serum. Transfer 2 mL serum to an ARUP Trace Element-
522-2787. (Min: 0.5 mL)
Unacceptable Conditions: Separator tubes. Specimens that are not separated from the red cells, or clot, within 6 hours. Hemolyzed specimens.
CPT Code(s): 83785
0025070 Manganese, Urine MANG U

CPT Code(s): 83785
0099272 Manganese, Whole Blood MANG WB

Page | 322
CPT Code(s): 83785
0051692 Mannose Binding Lectin MBL

Standard Transport Tube. (Min 0.2 mL)
Storage/Transport Temperature: Frozen. Separate specimens must be submitted when multiple tests are ordered. Also acceptable:
Refrigerated.
Unacceptable Conditions: Specimens collected in EDTA or citrate. Contaminated or heat-inactivated specimens.
CPT Code(s): 83520
0040005 Manual Differential DIFF

Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA). OR unstained whole blood smears.
Specimen Preparation: Specimens must be well mixed prior to making smears. Transport 3 mL whole blood OR 2 unstained whole blood smears.
(Min: 0.5 mL OR 2 smears)
Stability: Whole Blood: Ambient: 8 hours; Refrigerated: 24 hours; Frozen: Unacceptable
Smears: Ambient: 24 hours; Refrigerated: 72 hours; Frozen: Unacceptable
CPT Code(s): 85007
0090662 Maprotiline Quantitation MAPRO QNT

Stability: Ambient: 2 weeks; Refrigerated: 25 days; Frozen: 1 year
CPT Code(s): 82491
2005589 Marfan Syndrome, FBN1 Sequencing FBN1 FGS

2005580 Marfan Syndrome, FBN1 Deletion/Duplication FBN1 DD

CPT Code(s): 83891 Isolation; 83896 x65 Nucleic acid probes; 83898 x65 Amplification; 83914 x65 Extension; 83909 Capillary electrophoresis ; 83912
Interpretation and report. Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders.
2005584 Marfan Syndrome, FBN1 Sequencing and Deletion/Duplication FBN1 FGA

Del/Dup: 83896 x65 Nucleic acid probes; 83898 x65 Amplification; 83914 x65 Extension; 83909 Capillary Electrophoresis -Additional CPT code
2003993 Mast Cell Tryptase by Immunohistochemistry MASTCT IHC

CPT Code(s): 88342
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0081293 Maternal Screening, Sequential, Specimen #1 MS SEQ-1
Patient Preparation: This test requires a nuchal translucency (NT) measurement that has been performed by a certified
ultrasonographer. The ultrasonographer MUST be certified to perform NT measurements by one of the following agencies: Fetal Medicine
Foundation (FMF) or Nuchal Translucency Quality Review (NTQR). To avoid possible test delays for an ultrasonographer that is new to our
database, please contact the genetic counselor at 800-242-2787 extension 2141 prior to sending specimen.
If an NT is unobtainable, order Maternal Serum Screening, Integrated (ARUP test codes 0081062 and 0081064), which can be interpreted without
an NT value.
Specimen must be drawn between 11 weeks, 0 days and 13 weeks, 6 days gestation (Crown-Rump length (CRL) must be 4.2-8.5 cm).
Tube. (Min: 1 mL)
Remarks: The sequential maternal screen also requires the following information: a crown-rump length measurement (cm),
ultrasonographer's name and certification number, date of ultrasound, patient's date of birth, current weight, due date, number of fetuses present,
patient's race, if the patient requires insulin, if there is a known family history of neural tube defects, if the patient has had a previous pregnancy
with a chromosome abnormality, if the patient is taking valproic acid or carbamazepine (Tegretol®), physician's name and phone number, and for
in vitro fertilization pregnancies, the age of the egg donor.
Unacceptable Conditions: A crown rump length greater than 8.5 cm. Plasma. Specimens exposed to repeated freeze/thaw cycles. Hemolyzed
specimens.
CPT Code(s): 84702 HCGMS; 84163 PAPP-A
0081294 Maternal Screening, Sequential, Specimen #2 MS SEQ-2

Patient Preparation: Requires a previously submitted first trimester specimen, Maternal Screening, Sequential, Specimen #1 (ARUP test
code 0081293). Specimen must be drawn between 15 weeks, 0 days and 22 weeks, 6 days gestation.
Tube. (Min: 1 mL)
Remarks: The patient demographic information provided with the Sequential, Specimen #1 will be used to calculate the risks for this report. No
new demographic information is required.
Unacceptable Conditions: Plasma. Specimens exposed to repeated freeze/thaw cycles. Hemolyzed specimens.
CPT Code(s): 82105 AFP; 84702 HCG; 82677 Estriol; 86336 Inhibin A
0080108 Maternal Serum Screen, Alpha Fetoprotein, hCG, and Estriol AFP MS3
Patient Preparation: Specimen must be drawn between 14 weeks, 0 days and 24 weeks, 6 days gestation.
Tube. (Min: 0.5 mL)
Remarks: The following information is required and must accompany the sample in order for testing to be interpreted: patient's date of
birth, current weight, due date, dating method (US, LMP), number of fetuses present, patient's race, if the patient requires insulin, if there is a
known family history of neural tube defects, if the patient has had a previous pregnancy with a chromosome abnormality, if the patient is taking
valproic acid or carbamazepine (Tegretol®), physician's name and phone number; and for in vitro fertilization pregnancies, the age of the egg
donor.
CPT Code(s): 82105 AFP; 84702 hCG; 82677 Estriol
0080269 Maternal Serum Screen, Alpha Fetoprotein, hCG, Estriol, and Inhibin A AFP MS4
Tube. (Min: 1 mL)
Remarks: The following information is required and must accompany the sample for test interpretation: patient's date of birth, current
weight, due date, dating method (US, LMP), number of fetuses present, patient's race, if the patient requires insulin, if there is a known family
history of neural tube defects, if the patient has had a previous pregnancy with a chromosome abnormality, if the patient is taking valproic acid or
carbamazepine (Tegretol®), physician's name and phone number; and for in vitro fertilization pregnancies, the age of the egg donor.
CPT Code(s): 82105 AFP; 84702 hCG; 82677 Estriol; 86336 Inhibin A
0080434 Maternal Serum Screen, Alpha Fetoprotein (Only) MS ONLY

Tube.
Page | 324
Remarks: The following information is required and must accompany the specimen in order for testing to be interpreted: patient's date of
birth, current weight, due date, dating method (US, LMP), number of fetuses present, patient's race, if the patient requires insulin, if there is a
known family history of neural tube defects, if the patient has had a previous pregnancy with a chromosome abnormality, if the patient is taking
valproic acid or carbamazepine (Tegretol®), physician's name and phone number; and for in vitro fertilization pregnancies, the age of the egg
donor.
CPT Code(s): 82105
0081150 Maternal Serum Screen, First Trimester MS FT

Patient Preparation: This test requires a nuchal translucency (NT) measurement that has been performed by a certified
ultrasonographer. The ultrasonographer MUST be certified to perform NT measurements by one of the following agencies: Fetal Medicine
Foundation (FMF) or Nuchal Translucency Quality Review (NTQR). To avoid possible test delays for an ultrasonographer who is new to our
database, please contact the genetic counselor at 800-242-2787 extension 2141 prior to sending specimen.
If an NT is unobtainable, order Maternal Serum Screening, Integrated (ARUP test codes 0081062 and 0081064), which can be interpreted without
an NT value.
Specimen must be drawn in the first trimester between 11 weeks, 0 days and 13 weeks, 6 days. (Crown-Rump length (CRL) must be between 4.2-
8.5 cm). Patient History information is required
Tube. (Min: 1 mL)
Remarks: The First Trimester Maternal Screen also requires the following information: a crown-rump length measurement (cm),
ultrasonographer's name and certification number, date of ultrasound, patient's date of birth, current weight, due date, number of fetuses present,
patient's race, if the patient has had a previous pregnancy with a chromosome abnormality, physician's name and phone number; and for in vitro
fertilization pregnancies, the age of the egg donor.
Unacceptable Conditions: A crown-rump length greater than 8.5 cm. Plasma. Specimens exposed to repeated freeze/thaw cycles. Hemolyzed
specimens.
CPT Code(s): 84702 HCGMS; 84163 PAPP-A
0081062 Maternal Serum Screening, Integrated, Specimen #1 MS INT-1

Patient Preparation: The nuchal translucency (NT) measurement is preferred; however, the Integrated Maternal Screen can be interpreted with
or without a NT measurement. If performed, the NT measurement must be obtained between 10 weeks, 3 days and 13 weeks, 6 days gestation
(Crown-Rump length (CRL) must be 3.6-8.5 cm). The NT measurement must also be performed by an ultrasonographer that is certified by one of
the following agencies: Fetal Medicine Foundation (FMF) or Nuchal Translucency Quality Review (NTQR). To avoid possible test delays for an
ultrasonographer that is new to our database, please contact the genetic counselor at (800) 242-2787 extension 2141 prior to sending specimen.
Serum-only specimens may be drawn between 10 weeks, 0 days and 13 weeks, 6 days gestation. Crown-Rump length (CRL) must be 3.2-8.5 cm.
The specimen collection and ultrasound date may be different.
Tube. (Min: 0.3 mL)
Remarks: This test also requires the following information: The patient's date of birth, current weight, number of fetuses present, patient's race,
if the patient requires insulin, if there is a known family history of neural tube defects, if the patient has had a previous pregnancy with a
chromosome abnormality, if the patient is taking valproic acid or carbamazepine (Tegretol®), physician's name and phone number, For in vitro
fertilization pregnancies, include the age of the egg donor at donation.
In addition to the above:
If a NT measurement is performed: the date of ultrasound, the CRL measurement, the NT measurement and the name and certification number
of the sonographer is required.
or
If no NT measurement is performed: a due date or CRL measurement with the date of ultrasound is required.
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 30 days
CPT Code(s): 84163
0081064 Maternal Serum Screening, Integrated, Specimen #2 MS INT-2

Patient Preparation: Requires a previously submitted first trimester specimen, Maternal Serum Screening, Integrated, Specimen #1
(ARUP test code 0081062). Specimen must be drawn between 15 weeks, 0 days and 22 weeks, 6 days gestation.
Tube. (Min: 1 mL)
Remarks: The patient demographic information provided with the Integrated, Specimen #1 will be used to calculate the risks for this report. No
new demographic information is required.
CPT Code(s): 82105 AFP; 84702 HCG; 82677 Estriol; 86336 Inhibin A
2003016 MDM2 Gene Amplification by FISH MDM2 FISH

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Specimen Preparation: Formalin fix (10 percent neutral buffered formalin) and paraffin-embed tissue. Transport tissue block or 5 unstained 5
CPT Code(s):
88368 x2
2005848 MDM2 by Immunohistochemistry MDM2 IHC

electronic ordering capability, use an ARUP Immunohistochemistry Stain Form (#32978) and include an ARUP client number. For additional
technical details, contact ARUP Client Services at (800) 522-2787.
CPT Code(s): 88342
0050375 Measles (Rubeola) Antibodies, IgG and IgM MEASLE PAN

Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Chemiluminescent Immunoassay
CPT Code(s): 86765 Measles Ab, IgG; 86765 Measles Ab, IgM
0050380 Measles (Rubeola) Antibody, IgG MEASLES G

Unacceptable Conditions: CSF (refer to Measles (Rubeola) Antibody, IgG, CSF, ARUP test code 0054440). Body fluids, plasma, urine.
Contaminated, heat-inactivated, hemolyzed, lipemic or severely icteric specimens.
CPT Code(s): 86765
0054440 Measles (Rubeola) Antibody, IgG, CSF MEASLGCSF

Unacceptable Conditions: Specimens other than CSF. Contaminated or heat-inactivated specimens.
CPT Code(s): 86765
0099597 Measles (Rubeola) Antibody, IgM MEASLES M

CPT Code(s): 86765
0054441 Measles (Rubeola) Antibody, IgM, CSF MEASLMCSF

CPT Code(s): 86765
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0065055 Measles (Rubeola) Virus Culture V MEASLES
Specimen Required: Collect: Nasopharyngeal aspirate or washing, throat swab, conjunctival swab, lung tissue, CSF, or urine.
CPT Code(s): 87252 Tissue culture; 87254 Shell vial
0051205 Medium Chain Acyl-CoA Dehydrogenase (ACADM) 2 Mutations MCADPCR

0051758 Medium Chain Acyl-CoA Dehydrogenase Deficiency (ACADM) Sequencing MCAD FGS
CPT Code(s): 83891 Isolation; 83898 x 12 Amplification; 83904 x 12 Sequencing; 83909 capillary electrophoresis; 83912 Interpretation and report. - Additional
2003996 Melan A by Immunohistochemistry MELANA IHC

CPT Code(s): 88342
0020226 Melanin, Urine UMEL

Specimen Preparation: Protect from light during collection, storage, and shipment.. Transfer a 4 mL aliquot (Min: 2.5 mL) from a well-mixed
urine collection to an ARUP Amber Transport Tube
(ARUP Supply #13654). Available online through eSupply using ARUP Connect™or contact ARUP Client Services at (800) 522-2787.
Remarks:
Unacceptable Conditions: Specimens exposed to light.
CPT Code(s): 81005
0098819 Melanocyte Stimulation Hormone, Alpha MSH ALPHA

Patient Preparation: Patient should not be on any steroid, ACTH, or hypertension medication, if possible, for at least 18 hours prior to
specimen collection.
Specimen Preparation: Separate plasma from cells and freeze ASAP or within 2 hours of collection. Transport 3 mL plasma.
Unacceptable Conditions: Serum.
Stability: Ambient: Unacceptable; Refrigerated: Unacepptable; Frozen: Acceptable
CPT Code(s): 83519
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0098818 Melanocyte Stimulation Hormone, Beta MSH BETA
Patient Preparation: Patient should not be on any steroid, ACTH, or hypertension medication, if possible, for at least 18 hours prior to
specimen collection.
Specimen Preparation: Separate plasma from cells and freeze ASAP or within 2 hours of collection. Transport 3 mL plasma.
Remarks:
CPT Code(s): 83519
0098817 Melanocyte Stimulation Hormone, Gamma MSH GAMMA

Patient Preparation: Patient should not be on any steroid, ACTH, or hypertension medication if possible, for at least 48 hours prior to specimen
collection.
Specimen Preparation: Separate plasma from cells and freeze ASAP or within 2 hours of collection. Transport 3 mL plasma. (Min: 1 mL)
CPT Code(s): 83519
2003935 Melanoma Antibody, HMB45 by Immunohistochemistry HMB 45 IHC

CPT Code(s): 88342
0098816 Melatonin MELATONIN

Specimen Preparation: Allow plain red tube to sit for 15-20 min at room temperature for proper clot formation. Centrifuge and separate serum or
plasma from cells ASAP or within 2 hours of collection. Transfer 2 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Remarks: Melatonin concentrations depend on age and on circadian rhythm, with maximum concentration at night between 1:00-3:00 a.m.
Unacceptable Conditions: Serum separator tube (SST). Hemolyzed or lipemic specimens.
CPT Code(s): 83519
2001765 Meningoencephalitis Panel, CSF with Reflex to HSV Type 1 and Type 2 Glycoprotein G-Specific Ab, IgG MENINGCSFR
Immunoassay
Unacceptable Conditions: Serum or plasma. Contaminated or heat-inactivated specimens.
CPT Code(s): 86651 x2 CE G/M; 86652 x2 EEE G/M; 86653 x2 ST LE G/M; 86654 x2 WEE G/M; 86789 WNV IgG; 86788 WNV IgM; 86765 x2 Measles
G/M; 86735 x2 Mumps G/M; 86787 x2 VZV G/M; 86727 x2 LCM G/M; 86694 HSV MC; 86694 HERP I/II; if reflexed, add 86695 HERP I;
86696 HERP II
2001764 Meningoencephalitis Panel, Serum with Reflex to HSV Type 1 and Type 2 Glycoprotein G-Specific Ab, IgG MENING R
Immunoassay
Unacceptable Conditions: CSF. Contaminated, heat-inactivated, hemolyzed, or icteric specimens.
CPT Code(s): 86651 x2 CE G/M; 86652 x2 EEE G/M; 86653 x2 STE G/M; 86654 x2 WEE G/M; 86789 WNV IgG; 86788 WNV IgM; 86765 x2 Measles G/M;
86735 x2 Mump G/M; 86787 x2 VZV G/M; 86727 x2 LCM G/M; 86694 HSV MC; 86694 Herp I/II; if reflexed, add 86695 Herp I; 86696 Herp II
2002756 Meperidine and Metabolite - Confirmation/Quantitation - Serum or Plasma MEPER SP

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freeze/thaw cycles.
CPT Code(s): 83925
2002760 Meperidine and Metabolite - Confirmation/Quantitation - Urine MEPER UR

CPT Code(s): 83925
0091110 Mephenytoin & Metabolite, Serum or Plasma MEPHEN SP

Specimen Required: Collect: One 7 mL plain red, gray (sodium fluoride/potassium oxalate), green (sodium heparin), lavender (EDTA), or pink (K2EDTA).
Storage/Transport Temperature: 2 mL serum or plasma at 2-8°C. (Min: 1 mL) Submit specimen in an ARUP Standard Transport Tube.
Remarks: Remove serum or plasma from cells ASAP.
CPT Code(s): 80299
0091214 Mephenytoin & Metabolite, Urine MEPHEN UR

Storage/Transport Temperature: 2 mL urine at 20-25°C. (Min: 1 mL) Submit sample in an ARUP Standard Transport Tube.
CPT Code(s): 80299
0090231 Mephobarbital MEPHOBAR

Stability: After separation from cells: Ambient: 24 hours; Refrigerated: 10 days; Frozen: 10 days
CPT Code(s): 82205
0090526 Meprobamate, Blood MEPRO BLD

Stability: After separation from cells: Ambient: 1 week; Refrigerated: 1 month; Frozen: 3 months
CPT Code(s): 83805
0091084 Mercaptopurine Quantitation, Serum or Plasma MERCAP SP

CPT Code(s): 80299
0091272 Mercury, Hair MERCUR H

Specimen Preparation: Transfer 500 mg hair, tied at the root ends, to a trace metal free or acid washed plastic container.
Stability: Ambient: Undetermined; Refrigerated: Undetermined; Frozen: Undetermined.
CPT Code(s): 83825
0091248 Mercury, Nails MERCUR N

Specimen Required: Collect: Fingernails.
Specimen Preparation: Transfer 500 mg fingernails to a trace metal-free or acid-washed plastic container. (Min: 500 mg)
CPT Code(s): 83825
0090666 Mercury, Tissue MERCURY TI

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Specimen Preparation: Transfer 10 g tissue to a trace metal free or acid washed plastic container. (Min: 5 g)
CPT Code(s): 83825
0025050 Mercury, Urine MERCURY U

MRI studies). Acid preserved urine
CPT Code(s): 83825
0099305 Mercury, Whole Blood HG B

discontinue nutritional supplements, vitamins, minerals, and non-essential over-the-counter medications (upon the advice of their physician), and
Stability: Mercury is volatile; concentration may reduce after seven or more days of storage.
CPT Code(s): 83825
2005528 Metals, Joint Fluid MET FLUID

Unacceptable Conditions: Fluid collected after administration of a gadolinium (Gd) containing contrast media (may occur with MRI studies).
Separator tubes or gels.
CPT Code(s): 82495 Chromium; 83018 Cobalt
0050184 Metanephrines, Plasma (Free) META PF

Patient Preparation: Epinephrine and epinephrine-like drugs may affect results, and should be discontinued for at least 72 hours prior to
specimen collection, if possible. Collect the specimen after the patient has rested for 15 minutes
in a supine position.
Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or green (sodium or lithium heparin). Collect specimen and place in ice bath.
Specimen Preparation: Centrifuge within 1 hour. Transfer 2 mL plasma to an ARUP Standard Transport Tube and freeze immediately. (Min: 1
mL) Avoid hemolysis.
Remarks:
Unacceptable Conditions: Plasma separator tubes. Body fluids other than EDTA or heparinized plasma. Non-frozen or icteric specimens.
CPT Code(s): 83835
0080436 Metanephrines, Urine META UF

Specimen Preparation: Transfer a 4 mL aliquot from a well-mixed 24-hour or random collection to an ARUP Standard Transport Tube. (Min: 1.5
mL) Stability can be enhanced by adjusting the pH to 2-3 by using an acid such as 6 mol/L HCl. A pH lower than 2 may cause assay interference.
CPT Code(s): 83835
0092390 Metformin Quantitation, Serum or Plasma METFORM SP

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Stability: After separation from cells: Ambient: 1 month; Refrigerated: 1 month; Frozen: 1 month
CPT Code(s): 80299
2002928 Metformin Quantitation, Urine METFORM U

CPT Code(s): 80299
0090699 Methadone and Metabolite - Confirmation/Quantitation - Serum or Plasma METHADO SP

freeze/thaw cycles.
CPT Code(s): 83840
0090362 Methadone and Metabolite - Confirmation/Quantitation - Urine CDCO METH

CPT Code(s): 83840
0091553 Methane, Whole Blood METHANE B

Specimen Required: Collect: Gray (sodium fluoride /potassium oxalate).
Specimen Preparation: Mix well and chill. Transfer 4 mL whole blood to an ARUP Standard Transport Tube. (Min: 1 mL)
Storage/Transport Temperature: CRITICAL REFRIGERATED.
Remarks:
Stability: Ambient: 24 hours; Refrigerated: 20 days Frozen: Unacceptable
CPT Code(s): 84600
0090165 Methanol METHANOL

Specimen Required: Collect: Plain red. Also acceptable: Lavender (EDTA), pink (K2EDTA), green (sodium heparin), gray (sodium fluoride/potassium oxalate).
Specimen Preparation: Do not freeze whole blood. Separate serum or plasma from cells within two hours of collection. Transfer 3 mL serum or
plasma to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Specimens collected in gray (sodium fluoride/potassium oxalate) may be transported in the original container.
whole blood)
CPT Code(s): 84600
2006299 Methaqualone Quantitation, Urine METHAQ UR

Methodology: Quantitative Gas Chromatography/Mass Spectrometry
CPT Code(s): 80299
0091090 Methaqualone, Serum or Plasma, Quantitation METHAQ SP

CPT Code(s): 82542
0091091 Metharbital & Metabolite, Serum or Plasma METHARB SP

CPT Code(s): 82205
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0091332 Metharbital & Metabolite, Urine METHAR URN
CPT Code(s): 82205
0091493 Methocarbamol (Robaxin®), Serum or Plasma METHOCAR S

CPT Code(s): 80299
0091492 Methocarbamol, Urine METHOCAR U

Stability: Ambient: 5 days; Refrigerated: 2 weeks; Frozen: 2 weeks
CPT Code(s): 80299
2005405 Methotrexate, Sensitive METREXSN

Methodology: Quantitative Immunoassay
Specimen Required: Collect: Plain red. Also acceptable: Green (sodium heparin), lavender (EDTA), pink (K2EDTA), or gray (sodium fluoride/potassium oxalate)
Specimen Preparation: Protect from light during collection, storage, and shipment. Separate serum from cells within 2 hours of collection.
Transfer 3 mL serum to an ARUP Amber Transport Tube. (Min: 1 mL)
Unacceptable Conditions: Serum separator tubes. Specimens not protected from light.
CPT Code(s): 80299
0090146 Methsuximide and Normethsuximide METHSUX

Stability: After separation from cells: Ambient: 5 days; Refrigerated: 2 weeks; Frozen: 1 month
CPT Code(s): 83858 Methsuximide; 80299 Normethsuximide
0091276 Methyldopa, Serum or Plasma METHYLDOP

Specimen Required: Collect: Green (sodium heparin), or lavender (EDTA).
Specimen Preparation: Separate serum or plasma from cells within 2 hours. Transfer 2 mL serum or plasma to an ARUP Standard Transport Tube
and freeze immediately. (Min: 0.7 mL)
Storage/Transport Temperature: CRITICAL FROZEN. Separate samples must be submitted when multiple tests are ordered.
CPT Code(s): 80299
0055655 Methylenetetrahydrofolate Reductase (MTHFR) 2 Mutations MTHFR PCR

CPT Code(s): 83891 Isolation; 83900 Molecular diagnostics; 83896 x4 Nucleic acid probe; 83912 Interpretation and report - Additional CPT code modifiers
0091477 Methylhippuric Acid, Urine METHHIP U

Methodology: Quantitative Ion Chromatography/Colorimetry
(Colorimetry/Ion Chromatography)
CPT Code(s): 82570 Creatinine; 83921 Organic acid
0083918 Methylmalonic Acid (MMA) Quantitation, Urine MMA U

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Specimen Preparation: Transfer a 4 mL aliquot from a well-mixed 24-hour or random urine collection to an ARUP Standard Transport Tube and
refrigerate or freeze immediately. (Min: 0.5 mL) Record total volume and collection time interval on transport tube and test request form.
CPT Code(s): 83921
2005255 Methylmalonic Acid, Serum or Plasma (Metabolic Disorders) MMA METD

Specimen Preparation: Centrifuge and remove serum or plasma from cells within 2 hours of collection. Immediately transfer 2 mL serum or
plasma to an ARUP Standard Transport Tube and
refrigerate or freeze. (Min: 1 mL)
Unacceptable Conditions: Room temperature specimens. Grossly hemolyzed or lipemic specimens.
CPT Code(s): 83921
0099431 Methylmalonic Acid, Serum or Plasma (Vitamin B12 Deficiency) MMA QNT-P
Specimen Preparation: Centrifuge and remove serum or plasma from cells within 2 hours of collection. Transfer 2 mL serum or plasma to an
ARUP Standard Transport Tube and refrigerate or freeze immediately. (Min: 1 mL)
Unacceptable Conditions: Room temperature specimens. Grossly hemolyzed or lipemic specimens.
CPT Code(s): 83921
2003114 Methylphenidate & Metabolite - Confirmation/Quantitation - Serum or Plasma METHPHENSP

Patient Preparation: Collect specimen 1-6 hours after dose administration.
Standard Transport Tube and freeze within 6 hours of collection. (Min: 1 mL)
Remarks:
Unacceptable Conditions: Lt. blue (sodium citrate). Hemolyzed specimens.
CPT Code(s): 80299
2003115 Methylphenidate and Metabolite - Confirmation/Quantitation - Urine METHPHENUR

CPT Code(s): 80299
0091088 Methyprylon, Serum or Plasma METHYPR SP

CPT Code(s): 80299
0091497 Methyprylon, Urine METHYPR U

CPT Code(s): 82491
0091344 Metoclopramide, Serum or Plasma METOCLOPRA

Specimen Preparation: Protect from light. Transfer 2 mL serum or plasma to an ARUP Amber Transport Tube. (Min: 1 mL)
Unacceptable Conditions: Serum separator tubes. Specimens not protected from light.
CPT Code(s): 80299
0091465 Metoclopramide, Urine METOCLO UR

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CPT Code(s): 80299
0091453 Metoprolol (Lopressor®), Serum or Plasma METOPRO SP

Unacceptable Conditions: Separator tubes.\
CPT Code(s): 80299
0091452 Metoprolol (Lopressor®), Urine METOPRO U

CPT Code(s): 80299
0090276 Mexiletine MEXIL

Transport Tube. (Min:0.5 mL)
CPT Code(s): 80299
0050203 Microalbumin, Urine ALB/CRT

Specimen Required: Collect: 24-hour urine. Refrigerate during collection. Also acceptable: Random or other timed urine.
Specimen Preparation: Transfer 1 mL aliquot of urine from a well-mixed collection to an ARUP Standard Transport Tube. (Min: 0.5 mL) Record
Stability: Ambient: 4 hours; Refrigerated: 1 week; Frozen: 3 months (avoid repeated freeze/thaw cycles)
CPT Code(s): 82570 Creatinine; 82043 Microalbumin
2002301 Microarray Family Study by FISH ARRAY FAM

Specimen Preparation: Transport 5 mL whole blood in original collection tube. (Min: 2 mL)
CPT Code(s): 88271 DNA probe each; 88273 Chromosomal in situ hybridization 10-30 cells each; 88291 Interpretation and report - Additional CPT code
2002366 Microarray Genomic, Fetal ARRAY FE

Methodology: Genomic Microarray
Specimen Required: Collect: Amniotic fluid OR CVS in cytogenetics tissue media (ARUP Supply #32788). If cytogenetics tissue media is not available, collect in
plain RPMI, Hanks solution, saline, or ringers.
AND green (sodium heparin) from mother and father.
Specimen Preparation: Do not freeze specimen or expose to extreme temperatures. Do not place in formalin.
Transport 35-45 mL amniotic fluid in sterile centrifuge tubes or sterile container (Min: 10 mL) OR 20-30 mg CVS in a sterile, screw-top container
filled with tissue culture transport medium (Min: 5 mg).
AND transport 10 mL each from mother and father of whole blood. (Min: 5 mL each).
Specimen(s) and completed test request form(s), including clinical indication, must be received within 48 hours of collection.
Storage/Transport Temperature: Room temperature (all specimens).
Remarks: The maternal and paternal specimens are used to interpret abnormalities found on the fetal specimen as appropriate. The maternal
specimen is also used to rule out MCC contamination.
Unacceptable Conditions: Bloody amniotic fluid. Frozen or fixed specimens.
Stability: Ambient: 48 hours; Refrigerated: Acceptable but not ideal; Frozen: Unacceptable
CPT Code(s): 88235 Tissue culture amniotic fluid or CVS; 88386 x6 Array based evaluation of multiple molecular probes 251 through 500 probes; 83891 x2
isolation or extraction of highly purified nucleic acid - Additional CPT codes modifiers may be required for procedures performed to test for
0051740 Microsatellite Instability (MSI), HNPCC/Lynch Syndrome, by PCR MSI PCR

Specimen Required: Collect: Tumor AND normal epithelial tissue.
tissue block(s) or 10 unstained 5-micron slides (5 tumor and 5 normal epithelial). (Min: 3 tumor tissue and 3 normal epithelial tissue slides)
Transport block(s) and/or slide(s) in a tissue transport kit (ARUP supply #47808) available online through eSupply using ARUP Connect™ or
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Unacceptable Conditions: Specimens fixed/processed in alternative fixatives (alcohol, Prefer®). Frozen specimens. Decalcified specimens. Less
than 25 percent tumor or less than 50 percent normal epithelial tissue.
CPT Code(s): 83907 x2 Lysis; 83891 x2 Isolation; 83898 x7 Amplification; 83909 Capillary electrophoresis; 83912 Interpretation and report - Additional CPT
2003111 Microsporidia DFA MICROFA

Specimen Preparation: Preserve 5g stool in 10 percent formalin (ARUP supply #16355) within one hour of collection. Available online through
eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 1g)
Unacceptable Conditions: Unpreserved stool.
CPT Code(s): 87299
0060050 Microsporidia Stain by Modified Trichrome MICROST

Methodology: Qualitative Stain
Specimen Preparation: Preserve 5 g stool in 10% formalin (ARUP Supply #16355) within 1 hour of collection. Available online through eSupply
using ARUP Connectcontact ARUP Client Services at (800) 522-2787. (Min: 1 g)
Unacceptable Conditions: Unpreserved stool or specimens in any other preservative than indicated above.
CPT Code(s): 87207 Stain; 87015 Concentration
0091543 Midazolam Quantitation, Serum or Plasma MIDAZOLA

CPT Code(s): 80154
0049302 Mismatch Repair by Immunohistochemistry MSI

Methodology: Qualitative Immunohistochemistry
Specimen Preparation: Formalin fix (10 percent neutral buffered formalin is preferred) and paraffin embed specimen. If sending precut slides, do
not oven bake. Transport tissue block or 15 unstained (3-5 micron thick sections), positively charged slides in a tissue transport kit (ARUP supply
#47808) available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.(Min: 12 slides). Protect
paraffin block and/or slides from excessive heat.
Remarks: Only tissue that is clearly carcinoma (established by histological criteria) should be tested. Include surgical pathology report. Submit
electronic request. If you do not have electronic ordering capability, use an ARUP requisition form complete with an ARUP client number. For
additional technical details, please contact ARUP Client Services at (800) 522-2787.
4 or B-5). Depleted or no tumor in tissue. Specimens submitted with non-representative tissue type.
2005270 Mismatch Repair by Immunohistochemistry with Reflex to MLH1 Promoter Methylation MSI MLH1
Methodology: Qualitative Immunohistochemistry/Qualitative Real-time Polymerase Chain Reaction
Specimen Preparation: Formalin fix (10 percent neutral buffered formalin is preferred) and paraffin embed tissue. If sending precut slides, do not
oven bake. Transport tissue block or 20 unstained (3-5 micron thick sections), positively charged slides in a tissue transport kit (ARUP supply
#47808). Available online through eSupply using ARUP ConnectTM or contact ARUP Client Services at (800) 522-2787. (Min: 15 slides).
Protect paraffin block and/or slides from excessive heat.
Remarks: Include surgical pathology report. Submit electronic request. If you do not have electronic ordering capability, use an ARUP requisition
form complete with an ARUP client number. For additional technical details, contact ARUP Client Services at (800) 522-2787.
Unacceptable Conditions: Less than 25 percent tumor. Specimens fixed or processed in alternative fixatives (alcohol, Prefer®) or heavy metal
fixatives (B-4 or B-5). Depleted or no tumor in tissue. Decalcified specimens.
CPT Code(s): 88342 x4; if reflexed, add 88381 Microdissection; 83907 Lysis; 83896 x2 Nucleic Acid Probes; 83898 x2 Amplification; 83912 Interpretation and
report - Additional CPT code modifiers may be required for procedures performed to test oncologic or inherited disorders.
2002327 Mismatch Repair by Immunohistochemistry with Reflex to BRAF Codon 600 Mutation and MLH1 Promoter MSI REFLEX
Methylation
Methodology: Qualitative Immunohistochemistry/Qualitative Real-time Polymerase Chain Reaction
Specimen Preparation: Formalin fix (10 percent neutral buffered formalin is preferred) and paraffin embed tissue. If sending precut slides, do not
oven bake. Transport tissue block or 20 unstained (3-5 micron thick sections), positively charged slides in a tissue transport kit (ARUP supply
#47808). Available online through eSupply using ARUP ConnectTM or contact ARUP Client Services at (800) 522-2787. (Min: 15 slides).
Protect paraffin block and/or slides from excessive heat.
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Remarks: Include surgical pathology report. Submit electronic request. If you do not have electronic ordering capability, use an ARUP requisition
form complete with an ARUP client number. For additional technical details, please contact ARUP Client Services at (800) 522-2787..
Unacceptable Conditions: Less than 25 percent tumor. Specimens fixed/processed in alternative fixatives (alcohol, Prefer®). Decalcified
specimens.
CPT Code(s): 88342 x4; if reflexed, add: 83907 Lysis; 88381 Microdissection; 83898 Amplification; 83904 Sequencing; 83912 Interpretation and report; if
further reflexed, add 83896 x2 Nucleic Acid Probes; 83898 x2 Amplification; 83912 Interpretation and report - Additional CPT code modifiers
may be required for procedures performed to test oncologic or inherited disorders.
2006050 Mitochondrial Disorders (108 Nuclear Genes) Sequencing MT N SQ

Specimen Required: Collect: Lavender (EDTA) or green (sodium heparin). Peripheral blood required.
Remarks: Submit the Patient History Form for Mitochondrial Disorders Studies with the Electronic Packing List.
CPT Code(s): 83891 Isolation; 83894 Gel electrophoresis; 83900 Amplification; 83898 x2 Amplification; 83901 x106 Amplification; 83904 x108 Mutation
identification; 83909 x4 Capillary electrophoresis; 83912 Interpretation and report
2006878 Mitochondrial Disorders (108 Nuclear Genes) Sequencing and Deletion/Duplication MT N SQDD
CPT Code(s): 83891 Isolation; 83894 Gel electrophoresis; 83900 Amplification; 83898 x2 Amplification; 83901 x106 Amplification; 83904 x108 Mutation
identification; 83909 x4 Capillary electrophoresis; 88386 probes 251 through 500; 83912 Interpretation and report
2006065 Mitochondrial Disorders (mtDNA) Sequencing MT SEQ

CPT Code(s): 83891 Isolation; 83894 x2 Gel electrophoresis; 83898 x6 Amplification; 83904 x37 Mutation identification; 83909 x2 Capillary electrophoresis;
83912 Interpretation and report
2006872 Mitochondrial Disorders (mtDNA) Sequencing and Deletion/Duplication MT SEQDD

CPT Code(s): 83891 Isolation; 83894 x2 Gel electrophoresis; 83898 x6 Amplification; 83904 x37 Mutation identification; 83909 x2 Capillary electrophoresis;
88386 probes 251 through 500; 83912 Interpretation and report
2006054 Mitochondrial Disorders Panel (mtDNA and 108 Nuclear Genes) Sequencing and Deletion/Duplication MT PANEL
CPT Code(s): 83891 Isolation; 83894 x3 Gel electrophoresis; 83898 x8 Amplification; 83900 Amplification; 83901 x106 Amplification; 83904 x145 Mutation
identification; 83909 x6 Capillary electrophoresis; 88386 251 through 500 probes; 83912 Interpretation and report
2006061 Mitochondrial Genome (mtDNA and 108 Nuclear Genes) Deletion/Duplication MT DD

CPT Code(s): 83891 Isolation; 88386 251 through 500 probes
0050065 Mitochondrial M2 Antibody, IgG (ELISA) AMA

(Min: 0.3 mL)
Unacceptable Conditions: Plasma. Contaminated, hemolyzed, grossly icteric, or severely lipemic specimens.
CPT Code(s): 83516
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2007209 F-Actin and Mitochondrial M2 Antibodies, IgG by ELISA with Reflex to Smooth Muscle Antibody (SMA), ACTIN/M2 R
IgG by IFA
Tube. (Min: 0.3 mL)
Unacceptable Conditions: Non-serum, heat-inactivated, contaminated, grossly icteric, severely lipemic, grossly hemolyzed specimens or inclusion
of fibrin clot..
CPT Code(s): 83516 M2 IgG; 83516 F-Actin IgG; if reflexed, add 86256 SMA, IgG titer.
2002499 MLH1 Promoter Methylation, Paraffin MLH1PCR

Methodology: Real-Time Polymerase Chain Reaction/Fluorescence Resonance Energy Transfer
tissue block or 5 unstained 5 micron slides. (Min: 3 slides). Transport block and/or slide(s) in a tissue transport kit (ARUP supply # 47808)
Unacceptable Conditions: Frozen specimens. Specimens fixed/processed in alternative fixatives (alcohol, Prefer®) or heavy metal fixatives (B-4
or B-5). Decalcified specimens.
CPT Code(s): 88381 Microdissection; 83907 Lysis; 83896 x2 Nucleic Acid Probes; 83898 x2 Amplification; 83912 Interpretation and report. Additional CPT
code modifiers may be required for procedures performed to test oncologic or inherited disorders.
0050446 MLL-AFF1 (MLL-AF4) Translocation, t(4;11) by RT-PCR MLL-AF4

Specimen Preparation: Transport 5 mL whole blood (Min: 1 mL). OR 3 mL bone marrow (Min: 1 mL). Specimens must be received within 48
hours of collection due to lability of RNA.
Stability: Ambient: 1 hour; Refrigerated: 2 days; Frozen: Unacceptable
0051755 Molar Pregnancy, 16 DNA Markers MOL PREG

Specimen Required: Collect: Products of conception.
Specimen Preparation: Formalin fix and paraffin embed tissue containing areas of villi and of decidua. In some cases, decidua may not be present
in sufficient amounts, and a maternal blood sample may be requested. Transport tissue block.
Storage/Transport Temperature: Room temperature. Ship in a cooled container during the summer months.
Unacceptable Conditions: Paraffin block with no tissue remaining. Specimens fixed in formalin substitute.
CPT Code(s): 83907 x2 Lysis; 83891 x2 Isolation; 83898 x32 Amplification; 83909 Capillary electrophoresis; 83912 Interpretation and report. - Additional CPT
0091450 Molindone Quantitation, Urine MOLINDON U

Specimen Preparation: Transfer 5 mL urine to ONE transport container. (Min: 2.1 mL)
Stability: Ambient: 1 week; Refrigerated: 1 week; Frozen: 19 days
CPT Code(s): 80299
0091451 Molindone, Serum or Plasma MOLINDON

Specimen Preparation: Separate from cells within 2 hours of draw. Transfer 5 mL serum or plasma to ARUP Standard Transport Tubes. (Min: 2.1
mL)
Stability: Ambient: 1 week; Refrigerated: 1 week; Frozen: 19 days
CPT Code(s): 80299
0091280 Molybdenum, Serum or Plasma MOLYBDEN

Specimen Required: Collect: Royal blue (no additive) or royal blue (EDTA) .
Specimen Preparation: Transfer 1 mL serum or plasma to an ARUP Trace Element-Free Transport Tube (ARUP supply #43116). Available online
through eSupply using ARUP Connector contact
ARUP Client Services at (800) 522-2787. (Min: 0.5 mL).
CPT Code(s): 83018
Page | 337
0050615 Monoclonal Protein Detection Quantitation and Characterization, SPEP, IFE, IgA, IgG, IgM, Serum IFE
Methodology: Qualitative Immunofixation Electrophoresis/Quantitative Capillary Electrophoresis/Quantitative Nephelometry
Tube. (Min: 0.5 mL)
CPT Code(s): 82784 x3 Gamma-globulins: IgA, IgG, IgM; 84165 Electrophoretic fractionation and quantitation; 86334 Immunofixation electrophoresis; 84160
Total protein by refractometer
2002715 Monoclonal Protein Detection, Quantitation, Characterization, SPEP, IFE, IgA, IgG, IgM, FLC IFE FLC
Methodology: Qualitative Immunofixation Electrophoresis/Quantitative Capillary Electrophoresis/Quantitative Nephelometry
Tube. (Min: 0.5 mL)
Unacceptable Conditions: Plasma. Room temperature specimens.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 2 weeks
CPT Code(s): 82784 x3 Gamma-globulins: IgA, IgG, IgM; 84165 Electrophoretic fractionation and quantitation; 86334 Immunofixation electrophoresis; 84160
Total protein by refractometer; 83883 Kappa; 83883 Lambda
0091545 Moricizine, Serum or Plasma MORICIZIN

0.7 mL)
CPT Code(s): 80299
0051223 Motor and Sensory Neuropathy Evaluation with Immunofixation Electrophoresis and Reflex to ANNA Titer and MSN COMP
ANNA Immunoblot
Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody/Qualitative Immunoblot/Quantitative
Nephelometry/Quantitative Capillary Electrophoresis/Qualitative Immunofixation Electrophoresis
Tube. (Min: 2 mL)
Unacceptable Conditions: Plasma, CSF, or other body fluids. Room temperature specimens. Contaminated, heat-inactivated, hemolyzed, severely
Stability: Ambient: Unacceptable; Refrigerated: 2 weeks; Frozen: 1 year
CPT Code(s): 83516 x5 Asialo-GM1; 84160 Total Protein; 82784 IgA; 82784 IgG; 82784 IgM; 84165 Electrophoresis; 86334 IFE; 83516 MAG IgM ELISA;
83516 SGPG IgM; 86255 ANNA; if reflexed, add 86256 ANNA titer; 83516 Immunoblot
0051224 Motor and Sensory Neuropathy Evaluation with Reflex to ANNA Titer and ANNA Immunoblot MSN EVAL
Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/ Semi-Quantitative Indirect Fluorescent Antibody/ Qualitative Immunoblot
Tube. (Min: 1 mL)
CPT Code(s): 83516 x5 Asialo-GM1; 83516 MAG IgM ELISA; 83516 SGPG IgM
86255 ANNA; if reflexed, add 86256 ANNA titer and 83516 Immunoblot
0051225 Motor Neuropathy Panel MSN PAN

Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Quantitative Nephelometry/Quantitative Capillary Electrophoresis/Qualitative
Immunofixation Electrophoresis
Tube. (Min: 2 mL)
Remarks:
CPT Code(s): 83516 x5 Asialo-GM1; 84160 Total Protein; 82784 IgA; 82784 IgG; 82784 IgM; 84165 Electrophoresis; 86334 IFE; 83516 MAG IgM ELISA;
83516 SGPG IgM
2005545 MPL codon 515 Mutation Detection by Pyrosequencing, Quantitative MPL

Methodology: Polymerase Chain Reaction/Quantitative Pyrosequencing
Page | 338
Unacceptable Conditions: Bone marrow, plasma, or serum. Specimens collected in anticoagulants other than EDTA. Frozen specimens. Clotted or
grossly hemolyzed specimens.
CPT Code(s): 83891 Isolation; 83898 Amplification; 83904 Sequencing; 83912 Interpretation and report - Additional CPT code modifiers may be required for
0050707 MPO/PR-3 (ANCA) Antibodies MPO/PR3

Tube. (Min: 0.2 mL)
CPT Code(s): 83516 Myeloperoxidase Ab; 83516 Serine Protease 3
2004002 Muc-1 by Immunohistochemistry MUC1 IHC

CPT Code(s): 88342

CPT Code(s): 88342

CPT Code(s): 88342
2003999 Muc-5AC by Immunohistochemistry MUC5AC IHC

CPT Code(s): 88342
0051448 Mucolipidosis, Type IV (MCOLN1) 2 Mutations MCOLN1

Page | 339
CPT Code(s): 83891 Isolation; 83892 x2 Digestion; 83900 Amplification multiplex; 83914 x2 Mutation identification; 83909 Separation and identification;
disorders.
0051449 Mucolipidosis, Type IV (MCOLN1) 2 Mutations, Fetal MCOL FE

or inherited disorder.
0081357 Mucopolysaccharides, Quantitative, Urine MPS QNT

Patient Preparation: Morning void is preferred.
Specimen Preparation: Transfer 10 mL urine to ARUP Standard Transport Tubes and freeze immediately. (Min: 5 mL)
Unacceptable Conditions: Contaminated specimens. Specimens containing preservatives.
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 1 month (avoid repeated freeze/thaw cycles)
CPT Code(s): 83864
0081352 Mucopolysaccharides Screen - Electrophoresis & Quantitation, Urine MPS SCREEN

Methodology: Electrophoresis/Spectrophotometry
Patient Preparation: Morning void preferred.
Specimen Preparation: Freeze specimen immediately. Transport 20 mL urine. (Min: 10 mL)
Unacceptable Conditions: Specimens containing preservatives.
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 1 month (avoid repeated freeze/thaw cycles)
CPT Code(s): 83866 Screen; 83864 Quantitation
2005346 Multiple Endocrine Neoplasia Type 1 (MEN1) Deletion/Duplication MEN1 DD

2005359 Multiple Endocrine Neoplasia Type 1 (MEN1) Sequencing MEN1 FGS

CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders
2005360 Multiple Endocrine Neoplasia Type 1 (MEN1) Sequencing and Deletion/Duplication MEN1 FGA
DelDup: 83896 x9 Nucleic acid probes; 83898 x9 Amplification; 83914 x9 Extension; 83909 Capillary electrophoresis - Additional CPT code
Page | 340
0051390 Multiple Endocrine Neoplasia Type 2 (MEN2), RET Gene Mutations by Sequencing MEN2 SEQ
CPT Code(s): 83891 Isolation; 83898 x 8Amplification; 83904 x 8 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report
0051492 Multiple Endocrine Neoplasia, Type 2B (RET) 2 Mutations MEN 2 B

CPT Code(s): 83891 Isolation; 83898 x2 Amplification; 83896 x2 Nucleic acid probes; 83912 Interpretation and report. Additional CPT code modifiers may be
2002294 Multiple Myeloma Panel by FISH FISH MMP

Specimen Preparation: Transfer 3 mL bone marrow to a green (sodium heparin) (Min: 1 mL). OR transport 5 mL whole blood (Min: 2 mL).
This test must be ordered using Cytogenetic test request form #43099 or through ARUP interface. Submit the Patient History for Cytogenetics
CPT Code(s): 88271 x6 DNA Probe; 88275 x6 Chromosomal in situ hybridization, 100-300, cells; 88291 Interpretation and report - Additional CPT code
2003975 MUM1/IRF4 by Immunohistochemistry IRF4 IHC

CPT Code(s): 88342
0050390 Mumps Virus Antibody, IgG MUMPS

Unacceptable Conditions: CSF (refer to Mumps Virus Antibody IgG, CSF, ARUP test code 0054442). Body fluids, plasma, urine. Contaminated,
heat-inactivated, hemolyzed, lipemic, or severely icteric specimens.
CPT Code(s): 86735
0054442 Mumps Virus Antibody IgG, CSF MUMPSCSF

Stability: Ambient: 8 hours; Refrigerated: 2 weeks; Frozen 1 year
CPT Code(s): 86735
0099589 Mumps Virus Antibody, IgM MUMPS IGM

Unacceptable Conditions: Contaminated, hemolyzed, heat-inactivated, or severely lipemic specimens.
CPT Code(s): 86735
Page | 341
0054443 Mumps Virus Antibody IgM, CSF MUMPSMCSF
CPT Code(s): 86735
0065056 Mumps Virus Culture V MUMPS

Patient Preparation: Collect during first 3 days of illness. If collecting urine, use first morning void.
Specimen Required: Collect: CSF (in meningitis), nasopharyngeal swab, parotid gland duct swab, saliva, throat swab, or urine.
Specimen Preparation: Fluid: Transfer specimen to a sterile container. Transfer 2 mL fluid to a sterile container. (Min: 0.5 mL).Also acceptable:
Transfer to viral transport media (ARUP supply #12884). Available online through eSupply using ARUP Connect™ or contact ARUP Client
Services at (800) 522-2787.
CPT Code(s): 87252 Tissue Culture; 87254 Shell vial
Muscle/Nerve Pathology Special Studies

Specimen Required: Collect: Obtain Muscle/Nerve Biopsy Kit prior to collection (ARUP Supply #40923). Available online through eSupply using ARUP Connect™
or contact Client Services at (800) 522-2787. Special fixatives are required, prior to collection procedure.
Muscle/nerve tissue.
Specimen Preparation: Transport muscle/nerve tissue.
Storage/Transport Temperature: Tissue for special studies: Frozen.
Tissue for light microscopy (10% NB Formalin) and electron microscopy (2.5% glutaraldehyde): Room temperature. Send Sunday
through Thursday only.
Remarks: Collection/submission instructions must be followed. Submit clinical history and a preliminary report if applicable.
Unacceptable Conditions: Specimens that are not collected according to the collection instructions provided in collection kit. Specimens in
inappropriate or frozen fixatives. Frozen specimens that have been thawed.
Stability: Special Studies: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 24 hours.
Microscopy: Ambient: Acceptable; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 88305 x2 Level IV surgical pathology and/or 88314 histochemical stain on frozen section each stain: 88319 Determinative histochemical, each
stain and/or 88348 electron microscopy.
2004011 Muscle-Specific Actin (MSA) by Immunohistochemistry MUSA IHC

CPT Code(s): 88342
2005640 Muscle Weakness Autoimmune Reflexive Panel MUWA R PAN

Methodology: Quantitative Radioimmunoassay/Semi-Quantitative Radioreceptor Assay/Quantitative Radiobinding Assay/Qualitative Radiobinding Assay/Semi-
Quantitative Flow Cytometry/Semi-Quantitative Indirect Fluorescent Antibody
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transport 2 mL serum. (Min: 1 mL)
CPT Code(s): 83519 ACHR Binding Ab; 83519 ACHR Blocking Ab; if reflexed, add 88182TC ACHR Modulating Ab; 83516 Titin Ab; 83519 VGCC Ab;
83519 VGKC Ab; 86255 STM screen; if reflexed, add 86256 STM titer
2004911 MUTYH-Associated Polyposis (MUTYH) 2 Mutations MYH SEQ

2006307 MUTYH-Associated Polyposis (MUTYH) 2 Mutations with Reflex to Sequencing MUTYH RFLX
Page | 342
CPT Code(s): 83891 Isolation; 83898 x2 Amplification; 83904 x2 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report. If reflexed, add
83898 x14 Amplification; 83904 x14 Sequencing; 83909 Capillary electrophoresis - Additional CPT code modifiers may be required for
procedures performed to test for oncologic or inherited disorders
2006191 MUTYH-Associated Polyposis (MUTYH) Sequencing MUTYH FGS

2006195 MUTYH-Associated Polyposis (MUTYH) Sequencing Reflex Bill and Tracking MUTYH FGR
CPT Code(s): 83898 x14 Amplification; 83904 x14 Sequencing; 83909 Capillary electrophoresis -Additional CPT code modifiers may be required for
2002345 MYC (8q24) Gene Rearrangement by FISH LSIMYCFISH

2007227 MYCN (N-MYC) Gene Amplification by FISH NMYC FISH

0060063 Mycobacterium tuberculosis Amplified Detection , CSF MC MTDCSF

Methodology: Qualitative Transcription Mediated Amplification (Gen-Probe®)
Specimen Preparation: Transfer 1 mL CSF to a sterile container. (Min: 0.5 mL)
Unacceptable Conditions: Bloody specimens.
CPT Code(s): 87556
0060095 Mycobacterium tuberculosis Amplified Direct Detection MC MTD

Methodology: Qualitative Transcription Mediated Amplification (Gen-Probe®)
Patient Preparation: Three sputum specimens should be collected at 8-24 hour intervals (24 hours when possible) and should include at least
one first morning specimen. An individual order must be submitted for each specimen.
Specimen Required: Collect: Respiratory specimens: Bronchoalveolar lavage (BAL), pleural fluid, sputum. Respiratory specimen processed by NaOH NALC digestion
decontamination procedure. Unprocessed specimen is preferred.
Specimen Preparation: Unprocessed specimens: Transport 5-10 mL respiratory specimen in a sterile container. (Min: 1 mL). Label as
unprocessed.
Processed specimens: Transport 2-5 mL digested/decontaminated respiratory specimen in a sterile container. (Min: 1 mL). Identify method used
for digestion and provide smear results.
Remarks: Specimen source required. To perform this test it is essential to know whether or not the submitted specimen has been processed
(digestion and decontamination procedure). If it has, smear results must be provided as a comment on the test order or requisition.
Delayed turnaround time will occur when the required information is not provided.
Unacceptable Conditions: Grossly bloody specimens. Pericardial fluid, or tissue (fresh or paraffin block). Specimens processed by Alpha-Tec
Systems. For CSF refer to Mycobacterium tuberculosis Amplified Detection, CSF (ARUP test code 0060063).
Stability: Unprocessed: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 2 weeks
Page | 343
Processed: Ambient: Unacceptable; Refrigerated: 72 hours; Frozen: 2 weeks
CPT Code(s): 87556
0051698 Mycobacterium tuberculosis Antibody, IgG by ELISA TB IGG

Specimen Preparation: Allow specimen to clot completely at room temperature. Separate serum from cells ASAP or within 2 hours of
collection.Transfer 0.5 mL serum to in an ARUP Standard Transport Tube. (Min: 0.05 mL) Parallel testing is preferred and convalescent
CPT Code(s): 86609
0060771 Mycobacterium tuberculosis Complex Speciation MC MTSP

Specimen Required: Collect: Actively growing M. tuberculosis complex in pure culture.
Unacceptable Conditions: Mixed cultures or non-viable organisms. Agar plate.
CPT Code(s): 87150
0090213 Mycophenolic Acid MPA

CPT Code(s): 80299
2002173 Mycophenolic Acid and Metabolite, Serum MYCO ACID

Methodology: Quantitative Tandem Mass Spectrometry
Unacceptable Conditions: Separator tubes. Grossly hemolyzed specimens.
Stability: Ambient: Undetermined; Refrigerated: 2 weeks; Frozen: Undetermined
CPT Code(s): 80299
2003294 Mycoplasma hominis Culture, Urogenital Source MC MYCO

Specimen Required: Collect: Cervical, urethral or vaginal swab, or semen or urine.
Specimen Preparation: Place swab or specimen in Mycoplasma transport media (UTM) (ARUP supply #12884). Available online through eSupply
using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 0.5 mL) Also acceptable: Any transport media validated for
Mycoplasma/Ureaplasma transport, such as M4 (DO NOT USE M4 RT). Place each specimen in an individually sealed bag.
Storage/Transport Temperature: Frozen on dry ice.
Unacceptable Conditions: Non-urogenital sources. M4 RT, swabs in bacterial transport media, or dry swabs.
Stability: Ambient: 8 hours; Refrigerated: 48 hours in Mycoplasma transport media; Frozen at -70°C: 1 month
CPT Code(s): 87109
0050399 Mycoplasma pneumoniae Antibodies, IgG & IgM MYCO PAN

CPT Code(s): 86738 Mycoplasma IgG; 86738 Mycoplasma IgM
0050697 Mycoplasma pneumoniae Antibodies Seroconversion Panel, IgG & IgM MYCO SERO
Specimen Required: Collect: Serum separator tube (acute) AND serum separator tube (convalescent).
Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 0.5 mL serum (acute) AND 0.5 mL serum
(convalescent) to individual ARUP Standard Transport Tubes. (Min: 0.1 mL each) Mark specimens clearly as "acute" or "convalescent" with
appropriate draw dates. If acute specimen was previously tested by ARUP, convalescent specimen must be submitted within 30 days if
seroconversion comparison testing is desired.
Remarks: Testing will not be performed unless both acute and convalescent specimens are available.
CPT Code(s): 86738 x2 Mycoplasma IgG (acute/convalescent); 86738 x2 Mycoplasma IgM (acute/convalescent)
Page | 344
2006330 Mycoplasma pneumoniae Antibody, IgA MYCO A
Specimen Required: Collect: Plain red or SST
Specimen Preparation: Transfer 1 mL serum to an ARUP Standard Transport Tube and freeze immediately. (Min: 0.6 mL).
CPT Code(s): 86738
0050397 Mycoplasma pneumoniae Antibody, IgG MYCO-G

CPT Code(s): 86738
0050398 Mycoplasma pneumoniae Antibody, IgM MYCO-M

CPT Code(s): 86738
0060256 Mycoplasma pneumoniae by PCR MPNEUMOPCR

Specimen Required: Collect: Respiratory specimen: Bronchoalveolar lavage (BAL), bronchial brushings, nasopharyngeal swab, sputum, tracheal aspirates or pleural
fluid. OR CSF.
Specimen Preparation: CSF: Transfer 1 mL CSF to a sterile container. (Min: 0.5 mL).
Fluid: Transfer 2 mL respiratory specimen to a sterile container. (Min: 0.5 mL) Also acceptable: Transfer to viral transport media (ARUP supply
#12884). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787
Stability: Ambient: 24 hours; Refrigerated: 5 days; Frozen: 1 year.
CPT Code(s): 87581
2004412 Myelin Associated Glycoprotein (MAG) Antibodies, IgM and Sulfate-3-Glucuronyl Paragloboside (SGPG) MAG/SGPG
Antibodies, IgM
Tube. (Min: 0.1 mL)
Unacceptable Conditions: Urine. Contaminated, heat-inactivated, hemolyzed, icteric, or severely lipemic specimens.
0051285 Myelin Associated Glycoprotein (MAG) Antibody, IgM MAGM ELISA

Tube. (Min: 0.1 mL)
Unacceptable Conditions: Urine. Contaminated, heat inactivated, hemolyzed, severely lipemic specimens.
CPT Code(s): 83516
0080515 Myelin Basic Protein MBP

Specimen Preparation: Transport 1 mL CSF. (Min: 0.3 mL) Avoid hemolysis.
CPT Code(s): 83873
2002709 Myelodysplastic Syndrome (MDS) Panel by FISH FISH MDS P

Page | 345
Remarks: If cell pellets or dropped cytogenetics slides are submitted, a processing fee will not apply.
This test must be ordered using Cytogenetic test request form (#43099) or through your ARUP interface.
0050526 Myeloperoxidase Antibody MPO-AB

Tube. (Min: 0.2 mL)
CPT Code(s): 83516
2004014 Myeloperoxidase (MPO) by Immunohistochemistry MYELOP IHC

CPT Code(s): 88342
0049030 Myeloperoxidase Stain MY PEROX

Specimen Required: Collect: Lavender (EDTA) or green (sodium or lithium heparin) or heparinized aspirate of bone marrow.
Specimen Preparation: Transport 6 unfixed, air-dried, and unstained push smears AND 5 mL whole blood (smears should be made from the blood
submitted). OR 6 unfixed, air-dried, and unstained bone marrow aspirate smears.
Storage/Transport Temperature: Room temperature. Blood specimens must be received within 24 hours of collection; testing must be performed
Unacceptable Conditions: Frozen specimens. Peripheral blood smears older than one week. Anticoagulated blood or bone marrow sent without
well-prepared unfixed smears if greater than 48 hours old.
CPT Code(s): 88319
2002360 Myeloproliferative Disorders Panel by FISH FISH MPD P

This test must be ordered using Cytogenetic test request form #43099 or through your ARUP interface. Submit the Patient History for
Cytogenetics (Chromosome) Studies form with the electronic packing list (available at http://www.aruplab.com/genetics/forms.php).
0050742 Myocardial Antibody, IgG with Reflex to Titer MYO R

CPT Code(s): 86255 Myocardial; if reflexed, add 86256 Myocardial titer
2004017 Myogenin (Myf4) by Immunohistochemistry MYF4 IHC

Page | 346
CPT Code(s): 88342
2004031 Myoglobin by Immunohistochemistry MYOGL IHC

CPT Code(s): 88342
0020224 Myoglobin, Serum MYOG-S

Specimen Required: Collect: Plain red or serum separator tube. Also acceptable: Green (sodium or lithium heparin), lavender (EDTA), or pink (K2EDTA).
CPT Code(s): 83874
0020223 Myoglobin, Urine MYOG-U

Specimen Required: Collect: Random or 24-hour urine. Refrigerate during collection.
Specimen Preparation: Mix well and adjust pH to 8-9 by adding 10% Na2CO3 (Myoglobin is unstable in urine, unless the pH is 8.0-9.0)
immediately after collection. Transfer 1 mL aliquot from a random or 24-hour collection to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Stability: pH 8-9: Ambient: 1 hour; Refrigerated: 72 hours; Frozen: 1 month
CPT Code(s): 83874
2004034 Myosin by Immunohistochemistry MYOSIN IHC

CPT Code(s): 88342
2005176 Myositis-Specific Panel (15 Antibodies) MYOSIT PAN

Methodology: Qualitative Enzyme Immunoassay/Immunoprecipitation
Specimen Required: Collect: Plain red or serum separator tube. Also acceptable: Lavender (EDTA).
Specimen Preparation: Separate from cells. Transfer 4 mL serum to an ARUP Standard Transport Tube. (Min: 2 mL) Also acceptable: Plasma.
Stability: Ambient: 1 week; Refrigerated: 2 weeks; Frozen: Indefinitely
CPT Code(s): 86235 Jo-1; 86235 U1snRNP; 86235 SSA-52 kd; 83516 EJ; 83516 OJ; 83516 PL-7; 83516 PL-12; 83516 Mi-2; 83516 SRP; 83516 Ku; 83516
U2snRNP; 83516 U3 RNP Fib; 83516 PM/Scl; 83516 P155/140; 83516 P140
0070500 N-Telopeptide, Cross-Linked, Serum NTX SERUM

Unacceptable Conditions: Severely hemolyzed specimens.
CPT Code(s): 82523
0070062 N-Telopeptide, Cross-Linked, Urine NTX

Patient Preparation: For monitoring therapy, a baseline specimen should be collected prior to initiation of therapy. Subsequent specimens for
comparison should be collected at the same time of day as the baseline specimen.
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Specimen Required: Collect: Second-morning void or 24-hour urine. Refrigerate during collection. Collect without preservative.
Specimen Preparation: Transfer a 1 mL aliquot of urine from a well-mixed, second-morning void or 24-hour collection to an ARUP Standard
Unacceptable Conditions: Specimens contaminated with blood or extensive hemolysis.
Stability: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 2 years
CPT Code(s): 82523
0091487 Nalbuphine, Serum or Plasma - Screen with Reflex to Confirmation/Quantitation NUBAIN SP

0091486 Nalbuphine, Urine - Screen with Reflex to Confirmation/Quantitation NUBAIN URN

0091590 Naphthalene and Metabolite, Serum or Plasma NAPHTHAL S

Methodology: Gas Chromatography/High Performance Liquid Chromatography
Specimen Preparation: Transfer 4 mL of serum or plasma to an ARUP Standard Transport Tube. (Min: 2 mL)
0091591 Naphthalene and Metabolite, Urine NAPHTHAL U

Methodology: Quantitative Gas Chromatography/High Performance Liquid Chromatography
Specimen Preparation: Transfer 6 mL urine to ONE transport container; ensure that container remains tightly sealed. (Min: 2.6 mL)
0091346 Naproxen, Serum or Plasma NAPROXE

0.2 mL)
Stability: After separation from cells: Ambient: 1 week; Refrigerated: 2 weeks; Frozen: 10 months
CPT Code(s): 80299
0091099 Naproxen, Urine NAPROX UR

CPT Code(s): 80299
2005023 Narcolepsy (HLA-DQB1*06:02) Genotyping NARCOLEPSY

CPT Code(s): 83891 Isolation; 83898 Amplification; 83912 Interpretation and report - Additional CPT code modifiers may be required for procedures
Page | 348
2005593 Natalizumab Antibodies NATAL ABS
Methodology: Qualitative Bridging Enzyme-Linked Immunosorbent Assay
Specimen Required: Collect: Plain red. Also acceptable: Serum separator tube.
Specimen Preparation: Allow blood to clot at room temperature for 30 minutes. Separate serum from cells within 1 hour. Transfer 1 mL serum to
an ARUP Standard Transport Tube. (Min: 1 mL)
Stability: Ambient: Unacceptable; Refrigerated: 2 Weeks; Frozen: 2 Weeks
CPT Code(s): 83516
0092404 Natural Killer Cell Enumeration NK CELLS

Remarks: Specimens must be analyzed within 72 hours of collection in EDTA or within 48 hours of collection in heparin. Some medication may
affect immunophenotyping results and should be provided on the patient test request form.
CPT Code(s): 86357 NK cells, Total count
2004360 Natural Killer Cell Panel NK PAN

of collection.
New York State Clients: Frozen or refrigerated specimens. EDTA specimens older than 30 hours or heparin specimens older than 48 hours.
Clotted or hemolyzed specimens.
New York State Clients: Ambient: EDTA specimens: 30 hours, Heparin specimens: 48 hours; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 86356 CD2; 86356 CD3; 86356 CD5; 86356 CD7; 86356 CD8; 86356 CD16; 86356 CD56; 86356 CD57
0099685 Neisseria gonorrhoea Antibodies, Total GC-AB

Specimen Preparation: Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.15 mL) Mark specimens plainly as acute or
convalescent.
Unacceptable Conditions: Plasma. Contaminated, icteric, lipemic, or turbid specimens.
CPT Code(s): 86171
0060244 Neisseria gonorrhoeae by Amplified Detection (APTIMA®) GCAMD

Specimen Required: Collect: Endocervical or vaginal swab, first catch urine, or male urethral swabs . Collect in APTIMA® Combo 2 Assay transport media (ARUP
supply: Swabs #28907, Urine #28908). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-
2787. Refer to Sample Collection for the Diagnosis of STD under Specimen Handling at www.aruplab.com for specific specimen collection and
Stability: Unpreserved Urine: Ambient: 24 hours; Refrigerated: 24 hours; Frozen: Unacceptable. APTIMA® Transport Media: Swab: Ambient:
2 months; Refrigerated: 2 months; Frozen: 12 months Urine: Ambient: 1 month; Refrigerated: 1 month; Frozen: 12 months
CPT Code(s): 87591
0060223 Neisseria gonorrhoeae DNA Probe GCDNAP

Specimen Required: Collect: Endocervical or male urethral swabs. Collect in Gen-Probe® Pace 2 collection and transport kit (ARUP supply: Female kit: #12575, Male
kit: #12576). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.
Unacceptable Conditions: Specimens in any transport media other than indicated above. Specimen in swab transport media without a swab. Gross
presence of blood in the specimen.
Stability: Ambient: 1 week; Refrigerated: 1 week; Frozen: 1 month.
CPT Code(s): 87590
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2001603 Neisseria meningitidis Tetravalent Antibodies (Serogroups A, C, W-135 and Y), IgG NMENING
0099108 Nelfinavir, Antiretroviral Level, HPLC NELFINAVIR

Patient Preparation: Interactions of this drug with other drugs administered concurrently can markedly alter the level of this protease inhibitor
drug.
Specimen Required: Collect: Plain red, green (sodium heparin), or lavender (EDTA).
Unacceptable Conditions: Room temperature or refrigerated samples. Serum separator tubes.
CPT Code(s): 80299
0093000 Neoplastic Mature T-Cell Evaluation by Flow Cytometry NEO T-CELL

Storage/Transport Temperature: Room temperature. Specimen should be received within 24 hours of collection for optimal viability.
Remarks: If previous leukemia/lymphoma phenotyping was performed, but not at ARUP, the outside flow cytometry report and histograms (if
possible) should accompany the specimen. In addition, provide CBC, Wright's stained smear, clinical history, differential diagnosis, and any
relevant pathology reports.
CPT Code(s): 88184 First marker; 88185 x10 each additional marker; 88188 Interpretation for 9-15 markers
0098195 Neopterin, Serum NEO LEVEL

Patient Preparation: Patient should fast overnight (12 hours) prior to collection.
Specimen Preparation: Protect from light. Allow serum tube to sit for 15-20 minutes at room temperature for proper clot formation. Centrifuge and
separate serum from cells ASAP or within 2 hours of collection. Transfer 2 mL serum to an ARUP Amber Transport Tube. (Min: 0.5 mL)
Unacceptable Conditions: Specimens not protected from light. Grossly hemolyzed or lipemic specimens.
CPT Code(s): 83519
2001952 Neurofibromatosis Type 1 (NF1) Deletion/Duplication NF1 DELDUP

CPT Code(s): 83891 Isolation; 83896 x52 Nucleic acid probes; 83898 x52 Amplification; 83914 x52 Extension; 83909 x2 Capillary electrophoresis; 83912
(2012 codes: 81407 MOPATH PROCEDURE LEVEL 8 (deldup >50 exons))
2007159 Neurofibromatosis Type 1 (NF1) Sequencing NF1 FGS

CPT Code(s): 83891 Isolation; 83898 x72 Amplification; 83904 x72 Sequencing; 83909 x2 Capillary electrophoresis, 83912 Interpretation and report -
2007154 Neurofibromatosis Type 1 (NF1) Sequencing and Deletion/Duplication NF1 FGA

CPT Code(s): Sequencing: 83891 Isolation; 83898 x72 Amplification; 83904 x72 Sequencing; 83909 x2 Capillary electrophoresis, 83912 Interpretation and
report.
Del/Dup: 83896 x52 Nucleic acid probes; 83898 x52 Amplification; 83914 x52 Extension; 83909 Capillary electrophoresis - Additional CPT
2004049 Neurofilament by Immunohistochemistry NEUROF IHC

Page | 350
CPT Code(s): 88342
2004230 Neurokinin A (Substance K) NEUROKIN

Patient Preparation: Patient must be fasting 10-12 hours prior to collection. Antacid medication or medications that may affect intestinal
motility should be discontinued, if possible, for at least 48 hours prior to specimen collection.
Specimen Required: Collect: GI preservative tube. Order ARUP supply #47190 online through eSupply using Connect or contact ARUP Client Services at 800-522-
2787.
Specimen Preparation: Separate from cells within 1 hour of draw. Transfer 5 mL plasma to an ARUP Standard Transport Tube and freeze
Unacceptable Conditions: Thawed specimens. Specimens not collected in GI preservative tube.
CPT Code(s): 83519
0098198 Neuron Specific Enolase NSE

Specimen Preparation: Allow specimen to clot completely at room temperature. Separate serum from cells immediately to avoid release of NSE
from blood cells. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Unacceptable Conditions: Plasma. Hemolyzed specimens.
Stability: Ambient: Unacceptable; Refrigerated: 24 hours; Frozen: 1 year (avoid repeated freeze/thaw cycles)
CPT Code(s): 86316
0081226 Neuron Specific Enolase, CSF NSE CSF

Specimen Preparation: Transfer 0.5 mL CSF to an ARUP Standard Transport Tube and freeze immediately.)
Stability: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 6 months (avoid repeated freeze/thaw cycles)
CPT Code(s): 86316
2004052 Neuron Specific Enolase, Polyclonal (NSE P) by Immunohistochemistry NSE IHC

CPT Code(s): 88342
0051090 Neuronal Antibodies (Hu, Ri, Yo, Amphiphysin) IgG by Immunoblot NEURONAL
Tube. (Min: 0.5 mL)
CPT Code(s): 83516
0098726 Neuronal Cell Antibodies, CSF NEURON CSF

Stability: Ambient: Unacceptable; Refrigerated: 2 weeks; Frozen: Indefinitely
CPT Code(s): 83520
0099465 Neuronal Cell Antibodies, Serum NEURON-SER

Page | 351
Stability: Ambient: Unacceptable; Refrigerated: 2 weeks; Frozen: Indefinitely
CPT Code(s): 83520
0051088 Neuronal Nuclear Antibodies (ANNA) IgG, Immunoblot, Serum ANNAG IB

Tube. (Min: 0.5 mL)
CPT Code(s): 83516
0050904 Neuronal Nuclear Antibody (ANNA) IgG by IFA with Reflex to Titer & Immunoblot, Serum ANNAR
Methodology: Semi-Quantitative Indirect Fluorescent Antibody/Qualitative Immunoblot
CPT Code(s): 86255 ANNA; if reflexed, add 86256 ANNA titer and 83516 Immunoblot
0050912 Neuronal Nuclear Antibody (ANNA) Titer IgG by IFA, Serum ANNAGIFA
CPT Code(s): 86256
2006162 Neuronal Nuclear Antibody (Hu) by IFA with Reflex to Titer and Western Blot, CSF NNAB CSF
Methodology: Qualitative Immunofluorescence Assay/Quantitative Western Blot
(Indirect Fluorescent Antibody/Western Blot)
Specimen Required: Collect: CSF
CPT Code(s): 86255 ANNA; if reflexed, add 86256 Titer; 84181 Western blot
2004046 Neuronal Nuclei (NeuN) by Immunohistochemistry NEUN IHC

CPT Code(s): 88342
0055506 Neutrophil-Associated Antibodies ANTI-NEU

Tube and freeze. (Min: 0.5 mL)
Storage/Transport Temperature: Frozen (on dry ice).
CPT Code(s): 86021
0096657 Neutrophil Oxidative Burst Assay (DHR) DHR

Specimen Required: Collect: Green (sodium or lithium heparin) (patient) AND green (sodium or lithium heparin) (control). Patient and control specimens must be
Specimen Preparation: Transport 3 mL whole blood (patient) AND 3 mL whole blood (control) in original collection tubes. Do not refrigerate or
freeze. LIVE NEUTROPHILS REQUIRED.
Page | 352
Remarks:
CPT Code(s): 86352
0092168 Niacin (Vitamin B3) NIACIN B3

Specimen Preparation: Protect from light. Transfer 4 mL plasma to an ARUP Amber Transport Tube and freeze immediately. (Min: 1 mL)
Unacceptable Conditions: Thawed specimens or specimens not protected from light. Grossly hemolyzed or lipemic specimens.
CPT Code(s): 84591
0099452 Nickel, Serum NICKEL

Specimen Preparation: Centrifuge; do not allow serum to remain on cells. Transfer 2 mL serum to an ARUP Trace Element-Free Transport Tube
(ARUP supply #43116). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 0.5
mL)
CPT Code(s): 83885
0025045 Nickel, Urine NICKEL U

urine alone, during and after collection, preserves specimens adequately, if
tested within 14 days of collection.
CPT Code(s): 83885
0092361 Nicotine and Metabolites, Serum or Plasma NICOTINESP

Specimen Required: Collect: Plain red, green (sodium heparin), lavender (EDTA), pink (K2EDTA), or SST.
Unacceptable Conditions: Plasma or whole blood collected in lt. blue (sodium citrate). Specimens exposed to repeated freeze/thaw cycles.
CPT Code(s): 83887
0092356 Nicotine and Metabolites, Urine NICOTINEUR

CPT Code(s): 83887
0051458 Niemann-Pick, Type A (SMPD1) 4 Mutations SMPD1

0051459 Niemann-Pick, Type A (SMPD1) 4 Mutations, Fetal SMPD1 FE

Page | 353
0091394 Nitrazepam, Serum or Plasma NITRAZEPAM

CPT Code(s): 80154
0091496 Nitrazepam, Urine NITRAZ U

CPT Code(s): 80154
0091563 Nitrofurantoin, Serum or Plasma NITROFURAN

CPT Code(s): 80299
0092493 Nitrogen, Total 48, 72, or 96 Hours, Fecal NITRO FEC

Methodology: Quantitative Dumas Combustion
Patient Preparation: Boric acid and barium interfere with test procedure.
Specimen Required: Collect: 48, 72, or 96 hour stool collection.
Specimen Preparation: Transport entire 48, 72, or 96 hour stool collection. (Min: 10 g)
Remarks: Length of collection period is required.
Stability: 1 week; Refrigerated: 1 week; Frozen: 3 years
CPT Code(s): 84999
0092140 Nitrogen, Total, Urine NITRO UR

Methodology: Quantitative Dumas Combustion
Specimen Required: Collect: 24-hour urine.
Specimen Preparation: Transfer 10 mL aliquot from a well-mixed 24-hour urine collection to ARUP Standard Transport Tubes. (Min: 2 mL) Do
not use preservatives.
Remarks: 24 hour volume required.
Stability: Ambient: 1 week; Refrigerated: 1 week; Frozen: 3 years
CPT Code(s): 84999
2005164 N-methyl-D-Aspartate Receptor Antibody, IgG, CSF with Reflex to Titer NMDA G CSF
CPT Code(s): 86255 NMDA IgG CSF; if reflexed add 86256 NMDA IgG CSF titer
Page | 354
2004221 N-methyl-D-Aspartate Receptor Antibody, IgG, Serum with Reflex to Titer NMDA IGG
Tube. (Min: 0.2 mL)
Unacceptable Conditions: CSF or plasma. Contaminated, hemolyzed, or severely lipemic specimens.
CPT Code(s): 86255 NMDA; if reflexed add 86256 NMDA titer
0080281 NMP22® NMP22

Patient Preparation: Testing with the Matritech NMP22® should not be performed on patients who have had a total cystectomy or an invasive
procedure, such as cystoscopy or catheterization of the urethra, within five days.
Specimen Required: Collect: Single void of urine between midnight and noon. Urine stabilization kit required (ARUP Supply #12594). Available online through
eSupply using ARUP Connect™ or by contacting ARUP Client Services at (800) 522-2787. Immediately following collection, add urine to
NMP22® Urine Stabilizer Vial.
Specimen Preparation: Immediately following collection, transfer 5 mL urine to NMP22® Urine Stabilizer Vial (ARUP Supply #12594).
Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. Stabilized specimen should be
blue/green in color.)
Unacceptable Conditions: Urine not stabilized in NMP22® Urine Stabilizer Vial.
CPT Code(s): 86316
2002043 NMR LipoProfile® Test NMRLIPO

Methodology: Quantitative Nuclear Magnetic Resonance Spectroscopy
Patient Preparation: 12 hour fasting is preferred, but not required.
Specimen Required: Collect: Clot Activator Tube (ARUP supply #40484). Available online through eSupply using ARUP Connect or contact ARUP Client Services at
(800) 522-2787. Also acceptable: Plain red or lavender (EDTA).
Specimen Preparation: Gently invert tube to mix contents and allow to clot at room temperature for 30 minutes. Separate serum or plasma from
cells within 6 hours. Transfer 4 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 2 mL)
Unacceptable Conditions: Specimens more than 10 days old. Separator tubes.
CPT Code(s): 83704 LDL-P; 80061 Lipid panel
2003323 NMR LipoProfile®, Particle Analysis Only LIPO PRO

Methodology: Quantitative Nuclear Magnetic Resonance Spectroscopy
Patient Preparation: 12 hour fast is preferred but not required.
Specimen Required: Collect: Clot Activator Tube (ARUP supply #40484). Available online through eSupply using ARUP Connect or contact ARUP Client Services at
(800) 522-2787. Also acceptable: Plain red or lavender (EDTA).
Specimen Preparation: Gently invert tube to mix contents and allow to clot at room temperature for 30 minutes. Separate serum or plasma from
cells within 6 hours. Transfer 2 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 1 mL)
Unacceptable Conditions: Specimens more than 10 days old. Separator tubes.
CPT Code(s): 83704
0060093 Nocardia Culture and Gram Stain MC NOC

Specimen Required: Collect: Aspirate, fluid, respiratory specimen, or tissue.
Specimen Preparation: Fluid: Transfer to a sterile container. Tissue: Place on gauze moistened with sterile non-bacteriostatic saline to prevent
drying and transport in sterile container.
Remarks: Culture also detects other actinomycetes (Streptomyces, Rhodococcus, Gordona, Tsukamurella, etc.). Identification is by DNA
sequencing for most isolates.
To submit a Nocardia isolate for identification, order Aerobic Organism Identification (ARUP test code 0060115). To submit a Nocardia isolate
for identification AND susceptibility, order Aerobic Organism Identification with Reflex to Susceptibility (ARUP test code 0065070).
CPT Code(s): 87070
2005386 Non-Criteria Antiphospholipid Syndrome (APS) Antibody Panel APS PAN

Specimen Preparation: Separate serum from cells ASAP or within two hours of collection. Transfer 1.5 mL serum to an ARUP Standard Transport
Tube. (Min: 0.9 mL)
Unacceptable Conditions: Urine or plasma. Contaminated, heat-inactivated, grossly hemolyzed, icteric, or lipemic specimens.
CPT Code(s): 86148 x3 aPS IgG, IgM, & IgA; 83520 x9 aPE, aPG, aPI IgG, IgM, & IgA
0051805 Noonan Syndrome (PTPN11) Sequencing PTPN11 FGS

Page | 355
2004189 Noonan Syndrome (PTPN11) Sequencing with Reflex to (SOS1) Sequencing NS REFLEX
CPT Code(s): PTPN11 Sequencing: 83891 Isolation; 83898 x15 Amplification; 83904 x15 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation
and report.
If reflexed to SOS1 Sequencing: 83898 x25 Amplification; 83904 x25 Sequencing; 83909 Capillary electrophoresis - Additional CPT code
2004195 Noonan Syndrome (SOS1) Sequencing SOS1 FGS

CPT Code(s): Sequencing: 83891 Isolation; 83898 x25 Amplification; 83904 x25 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report -
0051281 Norovirus Group 1 and 2 Detection by RT-PCR NORO PCR

Specimen Preparation: Transfer 1 mL stool to an unpreserved stool transport vial (ARUP Supply #40910). Available online through eSupply
using ARUP Connector contact ARUP Client Services at (800) 522-2787. (Min: 0.5 mL).
0090074 Nortriptyline NORT HPLC

Patient Preparation: If amitriptyline is administered, order Amitriptyline and Nortriptyline (ARUP test code 0090158).
CPT Code(s): 80182
0040174 NPM1 Mutation by PCR and Fragment Analysis NPM1-F

Specimen Preparation: Whole blood: Transport 5 mL. (Min: 1 mL) OR Bone marrow: Transport 3 mL. (Min: 1 mL) OR FFPE tumor tissue:
Formalin fix (10 percent neutral buffered formalin) and paraffin embed tissue. Protect from excessive heat. Transport tissue block or four 10-
micron shavings. Tissue block will be returned after testing. Transport block(s) and/or shavings in a tissue transport kit (ARUP supply #47808)
Storage/Transport Temperature: Whole blood OR Bone marrow: Refrigerated. FFPE tumor tissue: Room temperature or refrigerated. Ship in
cooled container during summer months.
CPT Code(s): 83891 Isolation; 83898 Amplification; 83896 Nucleic acid probe; 83909 Capillary electrophoresis; 83912 Interpretation and report. Additional
CPT code modifiers may be required for procedures performed to test for oncologic disorders.
2003123 NRAS Mutation Detection by Pyrosequencing NRAS

tissue block or 5 unstained 5 micron slides. (Min: 3 slides). Transport block and/or slide(s) in a tissue transport kit (ARUP supply # 47808)
Unacceptable Conditions: Frozen specimens. Specimens fixed/processed in alternative fixatives (alcohol, Prefer®) or heavy metal fixatives (B-4
0050639 Nuclear Antibody (ANA) by IFA, IgG ANA-IFA

Specimen Preparation: Separate serum from cells ASAP. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.15 mL)
Page | 356
Stability: After separation from cells: Ambient 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)
CPT Code(s): 86039
0080235 5'Nucleotidase 5NUCL

Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.2 mL) Avoid hemolysis.)
Unacceptable Conditions: Room temperature specimens greater than 4 hours old.
Stability: Ambient: 4 hours; Refrigerated: 1 week; Frozen: 2 weeks (avoid repeated freeze/thaw cycles)
CPT Code(s): 83915
0020374 Occult Blood, Fecal FECBLD

Patient Preparation: The following items should be avoided for 7 days prior to and during collection: Non-steroidal anti-inflammatory drugs
such as ibuprofen, naproxen, or aspirin (if ingesting more than one adult aspirin per day).
The following items should be avoided for 3 days prior to and during collection: Vitamin C supplements in excess of 250 mg a day, citrus juices,
citrus fruits, or red meats. Acetaminophen (Tylenol) can be taken.
ARUP Connect™or contact ARUP Client Services at (800) 522-2787. (Min: 1 g)
Unacceptable Conditions: Gastric specimens, refer to Occult Blood, Gastric (ARUP test code 0060310). Specimens in media or preservatives.
Stability: Ambient: 1 hour; Refrigerated: 36 hours; Frozen: 72 hours
CPT Code(s): 82270
0020588 Occult Blood, Fecal (1-3 Determinations) FBLD

Specimen Preparation: Transport 5 g stool OR stool on occult card. (Min: 1 g)
Storage/Transport Temperature: Stool: Refrigerated.
Occult Card: Room temperature.
Unacceptable Conditions: Specimens in preservative. Frozen specimens.
Stability: Stool: Ambient: Unacceptable; Refrigerated: 24 hours; Frozen: Unacceptable
Occult Card: Ambient: 2 weeks
CPT Code(s): 82270
2007190 Occult Blood, Fecal by Immunoassay FOB IA

Methodology: Quantitative Immunoassay
Specimen Preparation: Patient will dip sampling bottle transfer wand into stool collection and place back into sampling bottle (ARUP Supply
#49952. Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.
Unacceptable Conditions: Unpreserved stool.
CPT Code(s): 83520
0060310 Occult Blood, Gastric GASBLD

Patient Preparation: Limit ingestion of raw fruits and vegetables and incompletely cooked meat.
Specimen Required: Collect: Gastric fluid.
Specimen Preparation: Transfer 1 mL gastric fluid to an ARUP Standard Transport Tube (ARUP Supply #43115). (Min: 0.5 mL)
Unacceptable Conditions: Fecal specimens. refer to Occult Blood, Fecal (ARUP test code 0020374).
CPT Code(s): 82271 Occult Blood; 83986 Gastric Fluid ph
2004061 Octamer Transcription Factor-2 (Oct 2) by Immunohistochemistry OCT2 IHC

CPT Code(s): 88342
2004058 Octamer Transcription Factor-3 and -4 (Oct 3/4) by Immunohistochemistry OCT3/4 IHC
Page | 357
CPT Code(s): 88342
2005656 Ogden Syndrome (NAA10) Sequencing Exon 2 NAA10 SEQ

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA) or yellow (ACD Solution A or B)
CPT Code(s): Sequencing: 83891 Isolation; 83898 Amplification; 83904 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report -
Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders
0098833 Olanzapine OLANZ

Specimen Preparation: Separate serum or plasma from cells within 2 hours of collection. Transport 2 mL serum or plasma. (Min: 1 mL)
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 2 weeks
CPT Code(s): 80299
0080440 Oligoclonal Band Profile OLIGO

Methodology: Qualitative Isoelectric Focusing/Electrophoresis/Nephelometry
Specimen Required: Collect: CSF AND serum separator tube. Serum specimen should be drawn within 48 hours of CSF collection.
Transport 1.5 mL CSF. (Min: 0.7 mL) AND transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Remarks: Specimens must be assayed together for interpretation.
CPT Code(s): 83916 Oligoclonal immune (Oligoclonal bands); 82784 IgG, serum; 82784 IgG CSF; 82040 Albumin, serum; 82042 Albumin, CSF
0081135 Oligoclonal Bands in CSF and Serum OLIGOB

Methodology: Qualitative Isoelectric Focusing/Electrophoresis
Specimen Required: Collect: CSF AND serum separator tube. Serum specimen should be drawn within 48 hours of CSF collection.
Transport 1.5 mL CSF (Min: 0.7 mL) AND transfer 1 mL serum to an ARUP Standard Transport Tube (Min: 0.5 mL).
Remarks: Specimens must be assayed together for interpretation.
CPT Code(s): 83916
0092354 Opiates - Confirmation/Quantitation - Serum or Plasma OPIS SP

freeze/thaw cycles.
CPT Code(s): 83925
0090364 Opiates - Confirmation/Quantitation - Urine CDCO OPI

CPT Code(s): 83925
2005096 Opiates, Screen Only, Urine OPI SCR UR

CPT Code(s): 80101
Page | 358
2005093 Opiates, Screen with Reflex to Confirmation, Urine OPI RFX UR
Methodology: Qualitative Enzyme Immunoassay/Quantitative Liquid Chromatography-Tandem Mass Spectrometry
0099289 Organic Acids, Plasma ORG AC P

Specimen Preparation: Separate plasma from cells within one hour of collection. Transfer 3 mL plasma to an ARUP Standard Transport Tube.
(Min: 2 mL)
Remarks: Clinical information is needed for appropriate interpretation. Additional required information includes age, gender, diet (e.g. TPN
CPT Code(s): 83918
0098389 Organic Acids, Urine ORG AC

CPT Code(s): 83918
0060720 Organism Identification by 16S rDNA Sequencing MC BACSEQ

Methodology: 16S rDNA Sequencing
Specimen Required: Collect: Actively growing isolated organism, in pure culture.
Specimen Preparation: Transport sealed container with pure culture on agar slant or in bacterial transport media.
Remarks: Specimen source required. Indicate suspected pathogen. For suspected agents of bioterrorism, Salmonella, or Shigella, notify your state
department of health and refer isolates to your state laboratory for identification. For identification of Shiga-like toxin producing E. coli, order test
E. coli Shiga-like toxin by EIA (ARUP test code 0060047).
CPT Code(s): 87153
2004892 Ornithine Transcarbamylase Deficiency (OTC) Deletion/Duplication OTC DELDUP

2004901 Ornithine Transcarbamylase Deficiency (OTC) Sequencing OTC FGS

2004896 Ornithine Transcarbamylase Deficiency (OTC) Sequencing and Deletion/Duplication OTC FGA
Del/Dup: 83896 x10 Nucleic Acid Probes; 83898 x10 Amplification; 83914 x10 Extension; 83909 Capillary electrophoresis - Additional CPT
0092458 Orotic Acid and Orotidine, Urine OROTIC ACI

Specimen Required: Collect: First-morning urine is preferred.
Specimen Preparation: Urine must be refrigerated or frozen within 24 hours of collection Transport 2 mL urine. (Min: 1 mL)
Page | 359
Remarks:
Unacceptable Conditions: Urine specimens containing preservatives. Room temperature specimens.
Stability: Ambient: Unacceptable; Refrigerated: 24 hours; Frozen: 2 weeks (avoid repeated freeze/thaw cycles)
0098122 Osmolality, Fecal FEC OSMO

Methodology: Quantitative Freezing Point
Specimen Required: Collect: Liquid stool.
Specimen Preparation: Do not add saline or water to liquefy sample. Transfer 5 mL liquid stool to an unpreserved stool transport vial (ARUP
Supply #40910). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 0.5 mL)
Remarks:
Unacceptable Conditions: Formed stool. Specimens in media or preservatives.
CPT Code(s): 84999
0020046 Osmolality, Serum or Plasma OSMO

Methodology: Freezing Point
CPT Code(s): 83930
0020228 Osmolality, Urine UOSMO

Methodology: Freezing Point
Specimen Preparation: Transfer 1 mL aliquot from a well-mixed random urine to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Unacceptable Conditions: Urine collected with preservatives.
CPT Code(s): 83935
2002257 Osmotic Fragility, Erythrocyte OSM FRG

Specimen Required: Collect: Green (sodium or lithium heparin) or Lavender (EDTA).
Specimen Preparation: Transport 2 unfixed, air-dried, and unstained smears to accompany the collected blood (smears should be made from the
blood submitted) (Min: 2 smears). AND 5 mL whole blood (Min: 1 mL). Specimens should be refrigerated within 30 minutes after collection..
CPT Code(s): 85555
0020728 Osteocalcin by Electrochemiluminescent Immunoassay OSTEO NMID

Specimen Preparation: Allow serum tube to sit for 15-20 minutes at room temperature for proper clot formation. Centrifuge and separate serum or
plasma from cells ASAP or within 2 hours of collection. Transfer 0.5 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.3 mL)
CPT Code(s): 83937
2002277 Ova and Parasite Exam, Body Fluid or Urine OPBF

Methodology: Qualitative Concentration/Microscopy
Patient Preparation: Urine: If S. haematobium is suspected, collect at midday or 24-hour collection in a container without preservative. Peak
egg excretion occurs between noon and 3 p.m.
Specimen Required: Collect: Body fluid or urine.
Specimen Preparation: Transfer 4 mL body fluid or urine to an ARUP Standard Transport Tube (ARUP Supply #43115). (Min: 1 mL)
Remarks: Specimen source required. Filariasis, detection may occur in urine from patients with chyluria and patients treated with
diethylcarbamazine.
Stability: Body Fluid: Ambient: Unacceptable; Refrigerated: 72 hours; Frozen: Unacceptable
Urine: Ambient:3 days; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 87177 Ova & parasite; 87209 Trichrome stain
2002272 Ova & Parasite Exam, Fecal (Immunocompromised or Travel History) OPFEC
Methodology: Qualitative Concentration/Trichrome Stain/Microscopy
Patient Preparation: Specimens analyzed to determine the efficacy of treatment should be collected three to four weeks after completion of
therapy. Antibiotics may affect results of exam.
Specimen Required: Collect: Stool. Recommended collection: 3 separate stool specimens within a 10-day period (an individual order must be submitted for each
specimen).
Specimen Preparation: Preserve each stool collection in 10% formalin AND modified PVA (ARUP Supply #16355) within one hour of collection.
Remarks: Indicate suspected parasites.
Page | 360
Unacceptable Conditions: Rectal swabs. Multiple specimens (more than one in 24 hours). Unpreserved specimens. Specimens containing barium,
oil, or urine.
CPT Code(s): 87177 Ova & parasite; 87209 Trichrome stain
0099384 Ovarian Antibody Screen with Reflex to Titer OVARIAN AB

Methodology: Semi-Quantitative Immunofluorescence
0090708 Oxalate, Serum or Plasma OXALA SP

Unacceptable Conditions: Specimens collected in gray (potassium oxalate/sodium fluoride).
Stability: Ambient: 5 days; Refrigerated: 1 week; Frozen: 1 week
CPT Code(s): 83945
0020482 Oxalate, Urine UOXAL

Patient Preparation: Patient should avoid ingestion of vitamin C prior to collection.
Specimen Preparation: Thoroughly mix entire collection (24-hour or random) in one container
2) Adjust pH to 1.5-2 with 6M HCl (approximately 10 mL HCl/24-hour specimen based on normal adult output of 1000-2000 mL/24 hours.
Pediatric specimens will require less than 10 mL to reach correct pH).
3) Transfer 4 mL aliquot of adjusted urine to an ARUP Standard Transport Tube. (Min: 1.5 mL)
4) Record total volume and collection time interval on transport tube and test request form. This information is required for test
interpretation.)
Unacceptable Conditions: Specimens with no preservative or with a pH greater than 3.
CPT Code(s): 83945
0091387 Oxazepam, Serum or Plasma OXAZEP

CPT Code(s): 80154
0098834 Oxcarbazepine Metabolite OXCARB

Stability: After separation from cells: Ambient: 6 weeks; Refrigerated: 6 weeks; Frozen: 3 months (avoid repeated freeze/thaw cycles)
CPT Code(s): 80299
2005103 Oxycodone/Oxymorphone Screen Only, Urine OXY SCR UR

CPT Code(s): 80101
2005100 Oxycodone/Oxymorphone Screen with Reflex to Confirmation, Urine OXY RFX UR

Methodology: Qualitative Enzyme Immunoassay/Quantitative Liquid Chromatography-Tandem Mass Spectrometry
2002984 Oxygen Dissociation (P50) by Hemoximetry HEMOX

Methodology: Spectrophotometry/Clark Electrode
Page | 361
Patient Preparation: A control specimen needs to be sent with the patient specimen. The control specimen needs to be drawn from a healthy,
non-smoking, individual who is not biologically related to the patient.
Specimen Required: Collect: Lavender (EDTA) (patient) AND lavender (EDTA) (control). Collect control specimen within 30 minutes of patient specimen and keep
specimens together at all times.
Specimen Preparation: Refrigerate immediately after collection. Transport 5 mL whole blood (patient) AND 5 mL whole blood (control). (Min: 1
mL (patient) AND 1 mL (control)) Label the control tube as "Control for [patient name]".
Storage/Transport Temperature: Refrigerated. Send Sunday-Thursday only. Specimens should be received within 24 hours of collection. Ship
patient and control specimens together.
Unacceptable Conditions: Frozen or room temperature specimens. Specimens submitted without a control.
Stability: Ambient: Unacceptable; Refrigerate: 72 hours; Frozen: Unacceptable
CPT Code(s): 82820
2004064 p16 by Immunohistochemistry P16 IHC

CPT Code(s): 88342
2004067 p21 (Waf1/Cip 1) by Immunohistochemistry P21 IHC

Storage/Transport Temperature: Ship in cooled container during summer months.
CPT Code(s): 88342
2004070 p27 (Kip1) by Immunohistochemistry P27 IHC

CPT Code(s): 88342

CPT Code(s): 88342
2005542 P57 by Immunohistochemistry P57 IHC

Page | 362
CPT Code(s): 88342

CPT Code(s): 88342
2004076 P504S (AMACR) by Immunohistochemistry P504S IHC

Remarks: : IMMUNOHISTOCHEMISTRY ORDERING AND SUBMISSION DETAILS: Submit electronic request. If you do not have
CPT Code(s): 88342
0049250 p53 with Interpretation by Immunohistochemistry P53 IP

Specimen Preparation: Formalin fix (10 percent neutral buffered formalin is preferred) and paraffin embed specimen. Protect paraffin block and /
or slides from excessive heat. Transport tissue block or 5 unstained (3-5 micron thick sections), positively charged slides in a tissue transport kit
(ARUP supply #47808) available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min. 3
slides).If sending precut slides, do not oven bake.
Remarks: This test code includes pathologist interpretation. Include surgical pathology report. IMMUNOHISTOCHEMISTRY ORDERING
AND SUBMISSION DETAILS: Submit electronic request. If you do not have electronic ordering capability, use an ARUP
Immunohistochemistry Stain Form (#32978) with an ARUP client number. For additional technical details, please contact ARUP Client Services
at (800) 522-2787.
Unacceptable Conditions: Paraffin block with no tumor tissue remaining; specimens fixed in B-5 or Bouin's fixative.
CPT Code(s): 88360
2004094 Paired Helical Filament-Tau (PHF-Tau) by Immunohistochemistry PHFTAU IHC

Storage/Transport Temperature: Ship in cooled container during summer months.
CPT Code(s): 88342
2006478 Paliperidone Quantitation, Serum or Plasma PALIP SP

Page | 363
Stability: Ambient: 2 weeks; Refrigerated: 2 weeks; Frozen: 7 Months
CPT Code(s): 80299
2003433 Pan Cytokeratin (AE1,3) by Immunohistochemistry AE1,3 IHC

CPT Code(s): 88342
2004232 Pancreastatin PANCREA

Patient Preparation: Patient must be fasting 10-12 hours prior to collection. Patient should not be on any medications that may influence
insulin levels, if possible, for at least 48 hours prior to collection.
Specimen Required: Collect: GI preservative tube. Order ARUP supply #47190 online through eSupply using Connect or contact ARUP Client Services at 800-522-
2787.
Specimen Preparation: Separate from cells within 1 hour of draw and transfer 2 mL plasma to an ARUP Standard Transport Tube and freeze
Unacceptable Conditions: Thawed specimens. Specimens not collected in GI preservative tube.
CPT Code(s): 83519
0080526 Pancreatic Elastase, Fecal PAN-ELAST

ARUP Connector contact ARUP Client Services at (800) 522-2787. (Min: 1 g)
Unacceptable Conditions: Stool in media or preservative. Swabs.
CPT Code(s): 83520
0099436 Pancreatic Polypeptide PAN POLY

Patient Preparation: Patient should be fasting for 10 hours prior to collection of specimen.
Specimen Preparation: Allow specimen to sit in collection tube for 15-20 minutes at room temperature for proper clot formation. Centrifuge and
separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Unacceptable Conditions: Plasma. Severely hemolyzed or lipemic specimens.
CPT Code(s): 83519
2002016 Pancreatitis, Hereditary (PRSS1) Sequencing PRSS1 FGS

2002005 Pancreatitis, Idiopathic (CFTR, PRSS1, SPINK1) Sequencing IP SEQ PAN

CPT Code(s): 83891 Isolation; 83898 x41 Amplification; 83904 x41 Sequencing; 83909 x2 Capillary electrophoresis, 83912 Interpretation and report -
Page | 364
2002012 Pancreatitis, Idiopathic (SPINK1) Sequencing SPINK1 FGS
2002461 Pancreatobiliary FISH PF

Methodology: Fluorescence in situ Hybridization/Computer Assisted Analysis/Microscopy
Specimen Required: Collect: Bile or pancreatic duct brushings, biliary stent, fine needle aspirates, or pancreatic juices.
Specimen Preparation: Place specimen in Cytolyt® or PreservCyt® fixative vial. If the specimen is a brushing, submit the brush in the fixative.
Label specimen with the patient's first and last name, date of birth, specimen source, medical record number (or other unique identifier), and
collection date.
Remarks: Completed Cytology request form required.
Unacceptable Conditions: Specimens not collected in Cytolyt® or PreservCyt® fixative.
CPT Code(s): 88367 x3; If manual: 88368 x3
2006247 Parainfluenza 1-4 by RT-PCR PARAFLUPCR

Specimen Required: Collect: Bronchoalveolar lavage (BAL), nasal wash, nasopharyngeal swab or sputum.
CPT Code(s): 87801
0051068 Parainfluenza Virus 1 Antibody, IgG PARA 1G

CPT Code(s): 86790
0051070 Parainfluenza Virus 1 Antibody, IgM PARA 1M

CPT Code(s): 86790

CPT Code(s): 86790

CPT Code(s): 86790
Page | 365
CPT Code(s): 86790

CPT Code(s): 86790
0051084 Parainfluenza Virus Antibodies (1, 2, 3), IgG & IgM PARA ABS
Unacceptable Conditions: Plasma. Bacterially contaminated, heat-inactivated, hemolyzed, lipemic, or turbid specimens.
0091448 Paraldehyde and Metabolite, Urine PARALD URN

Specimen Preparation: Immediately process specimen after collection and store at frozen conditions both post-collection and during
transport. Transfer 2 mL urine to an ARUP Standard Transport Tube. (Min: 0.7 mL)
Remarks: CRITICAL FROZEN. Immediately process specimen after collection and store at frozen conditions both post-collection and during
transport.
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: Undetermined
CPT Code(s): 82492
0091449 Paraldehyde, Serum or Plasma PARALDEHY

Specimen Required: Collect: Gray (potassium oxalate/sodium fluoride) or plain red.
Specimen Preparation: Separate plasma or serum from cells ASAP. Transfer 2 mL plasma or serum to an ARUP Standard Transport Tube and
freeze immediately. (Min: 0.5 mL).
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: Undetermined
CPT Code(s): 82000
0091464 Paramethadione, Serum or Plasma PARAMETHAD

CPT Code(s): 82492
0091463 Paramethadione, Urine PARAMETH U

CPT Code(s): 82492
0092107 Paraneoplastic Pemphigus Antibody Screen PARA PEMPH

Page | 366
CPT Code(s): 88347 x4 Cell surface, BMZ, portal tracts, Intercalated discs
0051226 Paraneoplastic Syndrome Antibody Panel with Reflex to ANNA Titer, PCCA Titer and Neuronal NEOPLASTIC
Immunoblot
CPT Code(s): 86255 ANNA; if reflexed, add 86256 ANNA titer and 83516 Immunoblot; 86255 Purkinje cell screen; if reflexed, add 86256 Purkinje titer
0060247 Parasite Examination, Macroscopic ECTO

Methodology: Qualitative Macroscopy/Microscopy
Specimen Required: Collect: Ecto parasite larvae/worm. If scabies is suspected, scrape the skin from the leading edge of the lesion.
Specimen Preparation: Parasite: Immerse parasite in 5-10 mL of 70-80 percent ethanol in a clean container.
Scrapings: Place in 2-3 mL of 70-80 percent ethanol in a clean container.
Unacceptable Conditions: Stool. Unpreserved specimens. Specimens in preservative other than ethanol.
CPT Code(s): 87168
0049025 Parasites Smear (Giemsa Stain), Blood GIEMSA

Methodology: Stain
Specimen Preparation: Transport 5 mL whole blood (Min: 1 mL) AND five (5) thin blood smears (unstained, unfixed) AND five (5) thick smears
(unstained, unfixed). Thin and thick blood smears should be prepared immediately or within 1 hour after collection. Extended exposure to EDTA
anticoagulants can result in altered parasite morphology. Thin smears are made as per routine hematology differentials. Thick smears are made by
dropping 10 to 20 µL of blood onto a slide and spreading it into a dime-sized area with a glass, wooden, or plastic applicator.
For instructions on preparation of thick and thin smears, see http://www.dpd.cdc.gov/dpdx/HTML/DiagnosticProcedures.htm. Label and transport
slides in slide holders. Specimen must be received within 24 hours of collection.
Storage/Transport Temperature: Room Temperature.
Remarks: Rapid diagnosis of malaria is critical for appropriate patient management. Specimens for Malaria and Babesia are for confirmation only
from clients outside of the immediate Salt Lake City, Utah area. Travel history required.
Unacceptable Conditions: Whole blood in anticoagulants other than EDTA or K2EDTA.
Stability: Whole blood: Ambient: 24 hours; Refrigerated: Unacceptable; Frozen: Unacceptable
Slides: Ambient: 1 week; Refrigerated: Unacceptable; Frozen: Unacceptable
CPT Code(s): 87207
0060046 Parasitology Stain by Modified Acid-Fast PARAST

Methodology: Qualitative Concentration/Stain
Specimen Preparation: Preserve 5 g stool in 10 percent formalin (ARUP Supply #16355). Available online through eSupply using ARUP
Connector contact ARUP Client Services at (800) 522-2787. (Min: 5 mL)
Unacceptable Conditions: Specimens other than stool.
CPT Code(s): 87015 Concentration; 87207 Stain
0091461 Parathion, Serum or Plasma PARATHI SP

Storage/Transport Temperature: CRITICAL FROZEN. Separate specimens must be submitted when multiple test are ordered.
CPT Code(s): 82492
0091460 Parathion, Urine PARATHI U

Storage/Transport Temperature: CRITICAL FROZEN. Separate specimens must be submitted when multiple test are ordered.
CPT Code(s): 82492
0095611 Parathyroid Hormone, CAP CAP

Methodology: Immunoradiometry
Specimen Preparation: Separate plasma from cells within one hour of collection. Transfer 2 mL plasma to an ARUP Standard Transport Tube and
freeze immediately. (Min: 2 mL)
Unacceptable Conditions: Thawed specimens. Specimens not collected in lavender (EDTA). Specimens not frozen within one hour of collection.
CPT Code(s): 83970
Page | 367
2001491 Parathyroid Hormone, Fine Needle Aspiration (FNA) PTH FNA
Specimen Required: Collect: Fine needle aspiration in saline. Also acceptable: Non-viscous body fluids. Also acceptable: Specimens collected in green (sodium or
lithium heparin) or lavender (EDTA).
Specimen Preparation: Specimen must be non-viscous and free of particulate matter. Centrifuge to remove cellular material. Transport 0.5 mL
saline needle rinse. (Min: 0.5 mL)
Unacceptable Conditions: Breast milk and, salivary fluid. Specimens too viscous to be aspirated by the instrument.
CPT Code(s): 83970
0070346 Parathyroid Hormone, Intact PTH-INT

Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA). Also acceptable: Green (sodium or lithium heparin) or serum separator tube.
Do not collect in EDTA if ordering Parathyroid Hormone Intact Molecule with Calcium (ARUP test code 0070172).
Specimen Preparation: Allow serum specimen to clot fully at room temperature. Transfer 2 mL serum or plasma to an ARUP Standard
Remarks: If requesting Ionized Calcium with PTH, submit two separate specimens. Refer to Calcium, Ionized, Serum (ARUP test code 0020135)
for requirements.
Unacceptable Conditions: Body Fluid (refer to Parathyroid Hormone, FNA, ARUP test code 2001491). Urine.
CPT Code(s): 83970
0070172 Parathyroid Hormone, Intact with Calcium PTHI

Specimen Required: Collect: Plain red or serum separator tube. Also acceptable: Green (sodium or lithium heparin).
Specimen Preparation: Allow serum specimen to clot fully at room temperature before centrifuging. Transfer 2 mL serum or plasma to an
Remarks: If requesting Ionized Calcium with PTH, submit two separate specimens. Refer to Calcium, Ionized, Serum (ARUP test code 0020135)
for requirements.
Unacceptable Conditions: Body Fluid (refer to Parathyroid Hormone, FNA, ARUP test code 2001491). Specimens collected in EDTA.
CPT Code(s): 83970 Parathyroid hormone, intact; 82310 Calcium total
2004118 Parathyroid Hormone (PTH) by Immunohistochemistry PTH IHC

Unacceptable Conditions: Specimens submitted with non-representative tissue type. Depleted specimens
CPT Code(s): 88342
0093014 Parathyroid Hormone-Related Peptide (PTHrP) PTH RELPEP

Methodology: Quantitative Immunoradiometry
Stability: After addition of aprotinin and separation from cells: Ambient: Unacceptable; Refrigerated: 72 hours; Frozen: 3 months
CPT Code(s): 83519
2005731 Parechovirus Detection by RT-PCR PEHV PCR

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), serum separator tube or CSF.
Specimen Preparation: Separate serum or plasma from cells. Transfer 1 mL plasma, serum or CSF to a sterile container. (Min: 0.5 mL)
CPT Code(s): 87798
0050596 Parietal Cell Antibody, IgG PCA

Methodology: Qualitative Indirect Fluorescent Antibody
Page | 368
CPT Code(s): 86255
0090786 Paroxetine Quantitation, Serum or Plasma PAROXE SP

(Min: 0.7 mL)
Stability: Ambient: 1 week; Refrigerated: 11 days; Frozen: 19 months
CPT Code(s): 80299
0091226 Paroxetine Quantitation, Urine PAROX URN

CPT Code(s): 80299
0090778 Paroxetine Quantitation, Whole Blood PAROXE B

CPT Code(s): 80299
2004366 Paroxysmal Nocturnal Hemoglobinuria, High Sensitivity, RBC PNH RBC

Patient Preparation: New York State Clients: Testing is only approved for the Paroxysmal Nocturnal Hemoglobinuria Panel (ARUP test code
2005006).
Remarks: Specimens must be analyzed within 4 days of collection.
Unacceptable Conditions: Bone marrow. Clotted, hemolyzed, or frozen specimens. Specimens older than 4 days.
CPT Code(s): 86356 Glycophorin; 86356 CD59
2005006 Paroxysmal Nocturnal Hemoglobinuria Panel, RBC and WBC PNH PAN
Patient Preparation: New York State Clients: Only whole blood testing is acceptable. Specimen must be analyzed within 24 hours of
collection if ambient or within 48 hours of collection if refrigerated.
Unacceptable Conditions: Bone marrow. Clotted or hemolyzed specimens. Specimens older than 72 hours. Frozen specimens. New York State
Clients: Bone marrow. Clotted or hemolyzed specimens. Specimens older than 24 hours ambient or older than 48 hours refrigerated.
Stability: Ambient: 24 hours; Refrigerated: 72 hours; Frozen: Unacceptable. New York State Clients: Ambient: 24 hours; Refrigerated: 48 hours.
Frozen: Unacceptable
CPT Code(s): 86356 CD14; 86356 CD15; 86356 CD24; 86356 CD33; 86356 FLAER; 86356 CD59; 86356 Glycophorin
2005003 Paroxysmal Nocturnal Hemoglobinuria, WBC PNH WBC

Patient Preparation: New York State Clients: Testing is only approved for the Paroxysmal Nocturnal Hemoglobinuria Panel (ARUP test code
2005006).
Unacceptable Conditions: Bone marrow. Clotted or hemolyzed specimens. Specimens older than 72 hours.
CPT Code(s): 86356 CD14; 86356 CD15; 86356 CD24; 86356 CD33; 86356 FLAER
0030235 Partial Thromboplastin Time PTT

Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection and freeze. Transfer 1 mL platelet-poor plasma to an
ARUP Standard Transport Tube.
Unacceptable Conditions: Serum. Specimens refrigerated or at room temperature for greater than four hours. Clotted or hemolyzed specimens.
Page | 369
CPT Code(s): 85730
0065121 Parvovirus B 19 Antibody, IgG PARVO G

Standard Transport Tube. (Min: 0.3 mL) Parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of
the acute specimens. Mark specimens plainly as "acute" or "convalescent."
Unacceptable Conditions: Contaminated, heat-inactivated, hemolyzed, hyperlipemic, or icteric serum.
CPT Code(s): 86747
0065122 Parvovirus B 19 Antibody, IgM PARVO M

CPT Code(s): 86747
0065120 Parvovirus B19 Antibodies, IgG and IgM PARVO

CPT Code(s): 86747 Parvovirus IgG; 86747 Parvovirus IgM
0065109 Parvovirus B19 Antibodies Seroconversion, IgG and IgM PARVO SERO
Specimen Required: Collect: Serum separator tube (acute) AND serum separator tube (convalescent). Also acceptable: Lavender (EDTA) or green (sodium or lithium
heparin).
Specimen Preparation: Separate serum or plasma from cells ASAP or within 2 hours of collection. Transfer 0.5 mL serum or plasma (acute) AND
0.5 mL serum or plasma (convalescent) to individual ARUP Standard Transport Tubes. (Min: 0.3 mL each) If acute specimen was previously
tested by ARUP, convalescent specimen must be submitted within 30 days if seroconversion comparison testing is desired. Mark specimens
plainly as "acute" or "convalescent" with appropriate draw dates.
Storage/Transport Temperature: Refrigerated..
Remarks: Testing will not be performed unless both acute and convalescent specimens are available.
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 5 days; Frozen: 1 year (avoid repeated freeze/thaw cycles)
CPT Code(s): 86747 x2 Parvovirus IgG (acute & convalescent); 86747 x2 Parvovirus IgM (acute & convalescent)
0060043 Parvovirus B19 by PCR PARVPCR

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or serum separator tube. OR amniotic fluid, CSF, tissue, or synovial fluid.
Specimen Preparation: Separate serum or plasma from cells. Transfer 1 mL serum, plasma, amniotic fluid, CSF, or synovial fluid to a sterile
container. (Min: 0.5 mL)
Tissue: Transfer to a sterile container and freeze immediately. Also acceptable: Formalin fixed and paraffin embedded tissue.
Storage/Transport Temperature: Paraffin Embedded Tissue: Room temperature. Transport in a Tissue Transport Kit (ARUP supply #47808),
available online through eSupply using ARUP Connect ™ or contact
ARUP Client Services at (800) 522-2787.All others: Frozen.
Unacceptable Conditions: Bone marrow (refer to Parvovirus B19, by PCR, Bone Marrow (ARUP test code 0060028). Heparinized specimens.
Stability: Fresh Tissue: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 6 months
Paraffin Embedded Tissue: Ambient: Indefinitely; Refrigerated: 2 weeks; Frozen: Unacceptable
All others: Ambient: 8 hours; Refrigerated: 72 hours; Frozen: 6 months
CPT Code(s): 87798
0060028 Parvovirus B19, by PCR, Bone Marrow PARVPCR B

Specimen Required: Collect: Bone marrow aspirate in lavender (EDTA) or pink (K2EDTA).
Specimen Preparation: Do not freeze specimen. Transport 1 mL bone marrow. (Min: 0.5 mL)
Unacceptable Conditions: Frozen specimens. Heparinized specimens.
CPT Code(s): 87798
2000137 Pathology ThinPrep Pap Request GT REQUEST
Page | 370
Patient Preparation: 1. For premenopausal patients, obtain specimens during the second half of the menstrual period to avoid contamination by
obscuring blood.
2. Instruct the patient not to douche or engage in sexual intercourse within 24 hours of the procedure.
Specimen Required: Collect: 1. Label the vial(s) with the patient's first and last name, date of birth, and specimen source before beginning the procedure.
fully as possible.
4. Follow the instructions for the specific collection kit and device used.
Supplies: This test requires a ThinPrep® Pap Test collection kit, which may be ordered separately through ARUP Client Services (800) 522-2787
or (801) 583-2787. Also required: ARUP Cytology test request form and a permanent marker.
Collection Procedure: After visualization of the cervix is accomplished, collect the sample. Obtain an adequate sampling from the cervix using a
broom-type (e.g., Wallach) collection device or endocervical brush/plastic spatula combination.
BROOM (Kit 12587): Insert the central bristles of the broom into the endocervical canal deep enough to allow the shorter bristles to fully contact
the ectocervix. Push gently, and rotate the broom in a clockwise direction five times. Rinse the broom-type collection device as quickly as possible
into the PreservCyt® Solution vial by pushing the broom into the bottom of the vial 10 times, forcing the bristles apart. As a final step, swirl the
collection device vigorously to further release material. Discard the collection device.
BRUSH/SPATULA (Kit 40624): Obtain an adequate sampling from the ectocervix using a plastic spatula. Rinse the spatula as quickly as
possible into the PreservCyt® Solution vial by swirling the spatula vigorously in the vial 10 times. Discard the spatula. Insert the brush into the
cervix until only the bottom most fibers are exposed. Slowly rotate or turn one-half turn in one direction. DO NOT OVER-ROTATE. Rinse the
brush as quickly as possible in the PreservCyt® Solution by rotating the device in the solution while pushing against the vial wall. Swirl the brush
vigorously to further release material. Discard the brush.
For all kits, tighten the cap so the torque line on the cap passes the torque line on the vial. Record the patient's information and medical history on
the ARUP Cytology test request form. Place the vial and test request form in a specimen bag for transport to the laboratory.
Unacceptable Conditions: Frozen specimens, Specimens not collected in a ThinPrep® Pap Test collection kit or specimens submitted in an
expired collection kit
Stability: Ambient: 3 weeks; Refrigerated; 3 weeks; Frozen; Unacceptable
CPT Code(s): 88142 (manual screening) or 88143 (manual screening with rescreening) if reviewed by pathologist 88141
2004082 Pax-5 by Immunohistochemistry PAX5 IHC

CPT Code(s): 88342
0040113 PAX-FKHR Translocation by RT-PCR PAX

tissue block..
Storage/Transport Temperature: Room temperature or refrigerated.. Ship in cooled container during summer months.
Unacceptable Conditions: No tumor in tissue. Specimens fixed/processed in alternative fixatives (alcohol, Prefer®). Frozen specimens.
Decalcified specimens. Tissue on slides.
CPT Code(s): 83891 Isolation; 83907 Lysis; 83902 Reverse transcription; 83898 x3 Amplification; 83896 x3 Nucleic acid probes; 83912 Interpretation and
2006291 PAX2 by Immunohistochemistry PAX2 IHC

electronic ordering capability, use an ARUP Immunohistochemistry Stain Form (#32978); include an ARUP client number. For additional
technical details, please contact ARUP Client Services at (800) 522-2787.
CPT Code(s): 88342
2001999 PCA3 - Prostate Cancer Biomarker PCA3

Page | 371
Methodology: Transcription-Mediated Amplification/Hybridization Protection Assay
Specimen Required: Collect: Urine. Collect according to PCA3 specimen collection kit instructions (ARUP Supply # 45682). Available online through eSupply using
ARUP Connect or contact ARUP Client Services at (800) 522-2787.
Specimen Preparation: Transfer two 2 mL aliquots of urine to individual GenProbe APTIMA® Tubes. (Min: 2 mL/each tube.)
Remarks: Complete patient clinical and therapeutic history, including diagnostic information, is required.
Unacceptable Conditions: Specimens not collected in a PCA3 urine collection kit. Less than 2 ml of urine in each tube.
Stability: Ambient: Unacceptable; Refrigerated: up to 4 days is acceptable, but not preferred; Frozen: Indefinitely
CPT Code(s): 83891 x2 Isolation; 83892 x2 Digestion; 83896 x2 Nucleic acid probes; 83898 x2 Amplification; 83902 x2 Reverse transcription; 83912
2004085 PD-1 by Immunohistochemistry PD1 IHC

CPT Code(s): 88342
0091558 Pemoline, Serum or Plasma PEMOLIN

CPT Code(s): 80299
0092001 Pemphigoid Panel - Epithelial Basement Membrane Zone IgG & IgA, BP180 & BP230 IgG Antibodies PGOID PAN
Methodology: Enzyme-Linked Immunosorbent Assay/Indirect Fluorescent Antibody
CPT Code(s): 88347 x3 (monkey esophagus (IgG BMZ) and human split skin (IgG and IgA BMZ)); 83516 x2 BP 180 and BP 230
0092106 Pemphigus IgA Antibodies IGA PEMPHI

CPT Code(s): 88347 x2 Substrates (monkey esophagus and intact human skin)
0090650 Pemphigus Panel - IgG Epithelial Cell Surface Antibodies and Levels of IgG Desmoglein 1 and Desmoglein 3 PEMPHI PAN
Antibodies, Serum
Methodology: Enzyme-Linked Immunosorbent Assay/Indirect Fluorescent Antibody
CPT Code(s): 88347 x2 Cell surface; 83516 Desmoglein 1; 83516 Desmoglein 3
0091403 Pentachlorophenol, Serum or Plasma PENTACH SP

Specimen Preparation: Transfer 4 mL plasma to an ARUP Standard Transport Tube. (Min: 1 mL) Also acceptable: Serum.
CPT Code(s): 82441
0091402 Pentachlorophenol, Urine PENTACHL U

Methodology: Quantitative Gas Chromatography/Colorimetry
Page | 372
Patient Preparation: Collect before the last shift of the work week.
Stability: Ambient: 1 week; Refrigerated: 1 week; Frozen: 1 year
CPT Code(s): 82441
0091522 Pentazocine Quantitation, Serum or Plasma PENTAZ SP

CPT Code(s): 83925
0091123 Pentazocine, Urine PENTAZ URN

CPT Code(s): 83925
0090225 Pentobarbital PENTO

Stability: After separation from cells: Ambient: 3 months; Refrigerated: 3 months; Frozen: 1 year
CPT Code(s): 82205
0049045 Periodic Acid Schiff Stain PAS

Methodology: Stain
Specimen Required: Collect: Whole Blood: Lavender (EDTA), pink (K2EDTA), or green (sodium or lithium heparin).
OR Bone Marrow: Heparinized aspirate.
OR Paraffin: Block or slides.
Specimen Preparation: Whole Blood: Transport 7 mL whole blood (Min: 1 mL) AND 6 unfixed smears (Min: 6 smears).
OR Bone Marrow: Transport 1 mL heparinized aspirate (Min: 1 mL) AND 6 unfixed smears (Min: 6 smears).
OR Paraffin: Protect from excessive heat. Transport paraffin block or 4 four micron slides (Min: 4 slides)
Storage/Transport Temperature: All Specimens: Room temperature. Must be received within 24 hours of collection; testing must be performed
Paraffin: Ship in cooled container during the summer months. Send Sunday-Thursday only.
Unacceptable Conditions: Fixed smears.
Stability: Peripheral Blood/Bone Marrow: Ambient: 24 hours
Paraffin: Indefinitely
CPT Code(s): 88313
0099985 Perphenazine PERP

Patient Preparation: Measure at least two weeks after initiating treatment. Collect specimens eight to 12 hours after oral dose.
Specimen Required: Collect: Plain red. Also acceptable: Lavender (EDTA), pink (K2EDTA or K3EDTA), or green (sodium or lithium heparin). Also acceptable (avoid
if possible): Serum separator tube or plasma separator tube (follow preparation instructions below).
Specimen Preparation: Separate serum or plasma from cells within 6 hours of collection. Transfer 2 mL serum or plasma to an ARUP Amber
Transport Tube. (Min: 1 mL)
SST or PST: Serum or plasma in a gel separator tube stored at room temperature is acceptable if separated from the gel within 6 hours. Serum or
plasma in a gel separator tube stored refrigerated is acceptable if separated from the gel within 2 hours.
CPT Code(s): 84022
0020507 pH, Body Fluid PH-FL

Methodology: pH Electrode
Specimen Preparation: Mix well. Transfer 4 mL body fluid to an ARUP Standard Transport Tube. (Min: 2 mL)
Unacceptable Conditions: Highly viscous specimens.
Stability: Ambient: 1 hour; Refrigerated: 24 hours; Frozen: 6 months
CPT Code(s): 83986
0020518 pH, Fecal FEC-PH

Methodology: Quantitative pH Indicator Strips/Quantitative pH Meter
Page | 373
Specimen Preparation: Transfer 5 g stool to an unpreserved stool transport vial (ARUP Supply #40910) and freeze immediately. Available online
through eSupply using ARUP Connector contact ARUP Client Services at (800) 522-2787. (Min: 1 g)
Remarks:
Unacceptable Conditions: Diapers. Specimens containing barium. Specimens in media or preservatives.
CPT Code(s): 83986
0020305 pH, Urine UA PH

Methodology: Reflectance Spectrophotometry
Remarks: Record collection time on test request form.
CPT Code(s): 83986
0091578 Phenacemide, Serum PHENACEM S

CPT Code(s): 80299
0091445 Phenacemide, Urine PHENACE U

CPT Code(s): 80299
0091457 Phenazopyridine, Serum or Plasma PHENAZO SP

CPT Code(s): 80299
0091456 Phenazopyridine, Urine PHENAZO U

CPT Code(s): 82491
0091304 Phenmetrazine, Serum or Plasma PHENMETRAZ

0.1 mL)
CPT Code(s): 80299
0091238 Phenmetrazine, Urine PHENMETR U

CPT Code(s): 80299
0090230 Phenobarbital PHNO

Unacceptable Conditions: Separator tubes or gels, lavender (EDTA), or gray (sodium fluoride/potassium oxalate). Hemolyzed specimens.
Stability: After separation from cells: Ambient: 2 days; Refrigerated: 6 months; Frozen: 6 months
CPT Code(s): 80184
Page | 374
0091551 Phenobarbital, Free and Total, Serum or Plasma PHENOBAR
(Min: 1.7 mL)
Remarks: Remove serum or plasma from cells within 2 hours.
CPT Code(s): 80184
0091565 Phenobarbital, Free, Serum or Plasma PHENOBAR F

CPT Code(s): 80184
0091260 Phenol Exposure, Urine PHENOL U

Methodology: Quantitative Gas Chromatography/Colorimetry
Specimen Required: Collect: Urine collected at end of work shift.
Remarks: Preservative-free urine specimens are recommended.
Unacceptable Conditions: Urine specimens preserved with Benzoic Acid.
CPT Code(s): 84600 Phenol; 82570 Creatinine
0020391 Phenolphthalein, Fecal PHENO FEC

Specimen Preparation: Transfer 5 g stool to an unpreserved stool transport vial (ARUP Supply #40910) and freeze immediately. Available online
through eSupply using ARUP Connector contact ARUP Client Services at (800) 522-2787. (Min: 1 g)
Remarks:
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 48 hours
CPT Code(s): 84999
2003237 PhenoSense® Entry PHENOENTRY

Remarks: Indicate patient's most recent viral load and viral load collection date. If viral load is less than 1,000 copies, testing MAY NOT be
performed.
CPT Code(s): 87903
2003235 PhenoSense® Integrase Inhibitor PHENOINTEG

Specimen Required: Collect: Lavender (EDTA) or plasma preparation tube (PPT)
Remarks: Indicate patient's most recent viral load and viral load collection date. If viral load is less than 500 copies, testing MAY NOT be
performed.
CPT Code(s): 87903
0091418 Phenothiazines, Serum or Plasma - Screen with Reflex to Confirmation/Quantitation PHENOTH SP

Methodology: Qualitative Gas Chromatography/Quantitative Gas Chromatography-Mass Spectrometry
0091417 Phenothiazines, Urine - Screen with Reflex to Confirmation/Quantitation PHENOTHI U

Methodology: Qualitative Gas Chromatography/Quantitative Gas Chromatography-Mass Spectrometry
Page | 375
0091391 Phensuximide, Serum or Plasma PHENSUXIMI

CPT Code(s): 80299
0091444 Phensuximide, Urine PHENSUX UR

CPT Code(s): 80299
0080336 Phenylalanine & Tyrosine PHE/TYR

Specimen Preparation: Transfer 0.5 mL plasma to an ARUP Standard Transport Tube. (Min: 0.25 mL)
CPT Code(s): 82131 Phenylalanine; 84510 Tyrosine
0080315 Phenylalanine Monitoring, Plasma QNTPHE

Specimen Preparation: Separate plasma from cells ASAP or within 2 hours of collection. Transfer 0.5 mL plasma to an ARUP Standard Transport
CPT Code(s): 82131
0091455 Phenylpropanolamine, Serum or Plasma PHENYLPR S

0.5 mL)
CPT Code(s): 80299
0091454 Phenylpropanolamine, Urine PHENYLPR U

CPT Code(s): 80299
0090090 Phenytoin DIL

Specimen Preparation: Allow serum specimen to clot completely at room temperature to ensure complete clot formation has taken place prior to
centrifugation. Separate serum from cells ASAP or within 2 hours of collection. For plasma specimens, ensure centrifugation is adequate to
remove platelets. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.2 mL)
Unacceptable Conditions: Specimens collected in separator tubes, sodium fluoride, potassium oxalate, EDTA tubes. Hemolyzed specimens.
Stability: After separation from cells: Ambient: 2 days; Refrigerated: 1 month; Frozen: 5 months
CPT Code(s): 80185
0090141 Phenytoin, Free and Total FDIL

1 mL)
SST: Serum in a gel separator tube stored at room temperature is acceptable if separated from the gel within 2 hours. Serum in a gel separator tube
stored refrigerated is acceptable if separated from the gel within 1 hour.
Page | 376
Stability: After separation from cells: Ambient: 4 days; Refrigerated: 4 days; Frozen: 1 month
CPT Code(s): 80185 Phenytoin, total; 80186 Phenytoin, free
0051590 Phosphatidylcholine Antibodies, IgG, IgM & IgA PHOSCHOPAN

Tube. (Min: 0.3 mL)
Unacceptable Conditions: Plasma or other body fluids. Contaminated, heat-inactivated, hemolyzed, or icteric specimens.
0051622 Phosphatidylethanolamine Antibodies, IgG, IgM and IgA PHOSETHPAN

0080275 Phosphatidylglycerol PG
Methodology: Qualitative Immune Agglutination
Specimen Preparation: Freeze immediately. Transport 1 mL amniotic fluid. (Min: 0.5 mL)
Storage/Transport Temperature: Refrigerated. If transport is longer than four hours, send frozen.
CPT Code(s): 84081
0051623 Phosphatidylglycerol Antibodies, IgG, IgM and IgA PHOSGLYPAN

0051624 Phosphatidylinositol Antibodies, IgG, IgM and IgA PHOSINOPAN

2006495 Phosphatidylserine Antibodies, IgG and IgM PHOSSER GM

Tube. (Min: 0.3 mL)
Unacceptable Conditions: Plasma, other body fluids, heat-inactivated, contaminated, grossly icteric, grossly hemolyzed, or severely lipemic
specimens
0050905 Phosphatidylserine Antibodies, IgG, IgM, and IgA PHOS AB

CPT Code(s): 86148 Phos G; 86148 Phos M; 86148 Phos A
0020042 Phospholipids, Serum or Plasma LIP-P

Patient Preparation: Patient should fast for 12 hours prior to collection.
Tube. (Min: 0.5 mL)
Stability: After separation from cells: Ambient: 8 hours; Refrigerated: 1 month; Frozen: 1 month
Page | 377
CPT Code(s): 84311
0020028 Phosphorus, Inorganic, Plasma or Serum PHOS

Unacceptable Conditions: Hemolyzed specimens. Specimens collected in sodium fluoride/potassium oxalate, citrate.
CPT Code(s): 84100
0020478 Phosphorus, Urine UPHOS

Specimen Required: Collect: 24-hour urine. Refrigerate specimen during collection. Also acceptable: Random urine.
Specimen Preparation: Mix entire 24-hour collection. Adjust pH to 1.5-2.0 by adding 6M HCl in 1 mL increments. Transfer one 3 mL aliquot
from a well-mixed 24-hour collection to an ARUP Standard Transport Tube. (Min: 0.5 mL) Record total volume, collection time interval, and pH
on transport tube and test request form.
CPT Code(s): 84105
2004510 PIK3CA Mutation Detection PIK3CA

Specimen Preparation: Formalin fix (10 percent neutral buffered formalin) and paraffin embed tissue. Protect from excessive heat. Transport block
or 5 unstained 5 micron slides. (Min: 3 slides) Transport block and/or slide(s) in a tissue transport kit (ARUP supply # 47808) available online
Unacceptable Conditions: No tumor in tissue. Specimens fixed/processed in alternative fixatives (alcohol, Prefer®) or heavy metal fixatives (B-4
0060051 Pinworm PINW

Specimen Required: Collect: Collect perianal material on paddle (ARUP Supply # 45572). Available online through eSupply using ARUP Connect™ or contact ARUP
Client Services at (800) 522-2787.
Specimen Preparation: Transport collection device.
Unacceptable Conditions: Frosted or colored tape. Specimens in media or preservatives. Stool.
CPT Code(s): 87172
0091491 Piroxicam (Feldene), Serum or Plasma PIROXIC SP

Specimen Preparation: Protect from light. Separate serum or plasma from cells ASAP. Transfer 1 mL serum or plasma to an ARUP Amber
Unacceptable Conditions: Separator tubes. Specimens not light protected.
CPT Code(s): 80299
0091490 Piroxicam (Feldene), Urine PIROXIC U

Specimen Preparation: Protect from light. Transfer 1 mL urine to an ARUP Amber Transport Tube. (Min: 0.2 mL)
CPT Code(s): 80299
2004097 Placental Alkaline Phosphatase (PLAP) by Immunohistochemistry PLAP IHC

CPT Code(s): 88342
Page | 378
0098781 Plasminogen Activator Inhibitor 1, Activity PAI-1
Methodology: Bioimmunoassay
Patient Preparation: Collect specimen between 8 a.m. and 12 p.m.
Specimen Preparation: Centrifuge plasma. Within 1 hour of draw, transfer 1.5 mL platelet-poor plasma to an ARUP Standard Transport Tube and
freeze. (Min: 1 mL)
Remarks:
Unacceptable Conditions: Serum. Hemolyzed specimens or specimens that have been thawed and refrozen.
Stability: Ambient: 1 hour; Refrigerated: Unacceptable; Frozen: 2 months
CPT Code(s): 85415
2004980 Plasminogen Activator Inhibitor-1, PAI-1 (SERPINE1) Genotyping PAI-1 GENO

0030190 Plasminogen Activity PLG

Unacceptable Conditions: Serum. Specimens collected in sodium fluoride, EDTA, or heparin. Non-frozen, hemolyzed, or icteric specimens.
CPT Code(s): 85420
0030160 Platelet Aggregation Studies PLTAG

Methodology: Aggregation
Patient Preparation: Fast from midnight until specimen is drawn in a.m.
Specimen Required: Collect: Hemostasis/Thrombosis laboratory must be called at (801) 583-2787 extension 2151 to schedule testing before sample is drawn. Lt.
blue (sodium citrate) AND lavender (EDTA) or pink (K2EDTA).
Specimen Preparation: Transport 45 mL whole blood (sodium citrate) AND 5 mL whole blood (EDTA). Specimen must be received within one
hour of draw.
Storage/Transport Temperature: CRITICAL AMBIENT.
Remarks: Include list of current medications and most recent platelet count.
Unacceptable Conditions: Specimens not collected at ARUP (500 Chipeta Way, Salt Lake City, UT). Specimens that have been centrifuged or
refrigerated.
0051050 Platelet Antibodies, Indirect PLT ABSCRN

Patient Preparation: For newborns less than 30 days old, collect specimen from the mother.
Specimen Required: Collect: Plain red, lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A).
Standard Transport Tube and freeze. (Min: 0.5 mL)
Storage/Transport Temperature: Frozen. Also acceptable: Refrigerated if maintained at temperature for 48 hours or less.
Unacceptable Conditions: Microbially contaminated, heat-inactivated, hemolyzed, or lipemic specimens.
CPT Code(s): 86022
0051718 Platelet Antibodies, Indirect with Reflex to Identification PLT R

Patient Preparation: For newborns less than 30 days old, collect specimen from the mother.
Specimen Required: Collect: Plain red, lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A).
Storage/Transport Temperature: Frozen. Also acceptable: Refrigerated if maintained at temperature for 48 hours or less.
Unacceptable Conditions: Microbially contaminated, heat-inactivated, hemolyzed, or lipemic specimens.
2007237 Platelet Antibody (Glycoprotein) Plasma/Eluate PLT AB GP

Specimen Required: Collect: Yellow (ACD solution A) Also acceptable: EDTA
Specimen Preparation: Transport 40 mL whole blood if platelet count is less than 100,000 or 10 mL if platelet count is greater than 100,000.
Storage/Transport Temperature: Critical refrigerate.
Stability: Ambient: Unacceptable; Refrigerated: 4 days; frozen: Unacceptable
CPT Code(s): 86022 x3 Platelet antibodies; 86023 x3 Immunoglobulin assay
0051309 Platelet Antigen 1 Genotyping (HPA-1) HPA1

Page | 379
Specimen Required: Collect: Two T-25 flasks at 80% confluency of cultured amniocytes. If the client is unable to culture amniocytes, this can be arranged by
contacting ARUP Client Services at (800) 522-2787. Or amniotic fluid.
amniocytes. Backup cultures must be retained at the client's
institution until testing is complete.
OR Whole Blood: Transport 3 mL whole blood. (Min: 1 mL)
Amniotic Fluid: Room temperature.
Whole Blood: Room temperature.

contacting ARUP Client Services at (800) 522-2787. Or amniotic fluid.

contacting ARUP Client Services at (800) 522-2787.
Or amniotic fluid.

Or amniotic fluid.

Page | 380
Specimen Required: Collect: Collect: Two T-25 flasks at 80% confluency of cultured amniocytes. If the client is unable to culture amniocytes, this can be arranged
by contacting ARUP Client Services at (800) 522-2787.
Or amniotic fluid.

Or amniotic fluid.

Or amniotic fluid.
0051308 Platelet Antigen Genotyping Panel HPA PAN

Or amniotic fluid.
CPT Code(s): 83891 Isolation; 83898 x7 Amplification; 83896 x14 Nucleic acid probes; 83912 Interpretation and report - Additional CPT code modifiers may
Page | 381
0095614 Platelet Associated Antibodies, Direct Assay PAIG
Remarks: Specimens must be analyzed within 48 hours of collection. Required amount of blood may be dependent on platelet count.
0040235 Platelets PLT

CPT Code(s): 85049
2003040 PM/Scl-100 Antibody, IgG, by Immunoblot with Reflex to ANA IFA PM/SCL
Methodology: Semi-Quantitative Immunoblot/Semi-Quantitative Indirect Fluorescent Antibody
CPT Code(s): 83516 PM/Scl-100; if reflexed add 86039 ANA IFA
2002363 PML/RAR FISH FISH PML

This test must be ordered using Cytogenetic test request form #43099 or through your ARUP interface. Submit the Patient History for
Cytogenetics (Chromosome) Studies Form with the electronic packing list (available at http://www.aruplab.com/genetics/forms.php).
CPT Code(s): 88271 DNA probe; 88275 Interphase in situ hybridization 100-300; 88291 Interpretation and report - Additional CPT codes modifiers may be
2002871 PML-RARA Translocation, t(15;17) by RT-PCR, Quantitative PML QNT

hours of collection due to lability of RNA....
2004103 Pneumocystis jiroveci by Immunohistochemistry PNEUMO IHC

slides in a tissue transport kit (ARUP supply #47808). Available online through eSupply using ARUP Connector contact ARUP Client Services at
(800) 522-2787. (Min: 2 slides). If sending precut slides, do not oven bake.
CPT Code(s): 88342
2006254 Pneumocystis jirovecii by PCR PCP PCR

Specimen Required: Collect: Respiratory specimen: Bronchoalveolar lavage (BAL), bronchial wash, or sputum.
Specimen Preparation: Transfer 2 mL respiratory specimen to a sterile container. (Min: 0.5 mL). Also acceptable: Transfer to viral transport media
(ARUP supply #12884). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. Place
each specimen in an individually sealed bag.
Page | 382
CPT Code(s): 87798
0060052 Pneumocystis jirovecii DFA PNEUMST

Specimen Required: Collect: Respiratory specimen: Bronchial washing, bronchoalveolar lavage (BAL), or induced sputum.
Specimen Preparation: Transfer 5 mL respiratory specimen to a sterile container. (Min: 0.5 mL) Place each specimen in an individually sealed
bag.
Unacceptable Conditions: Tissues. Formalinized specimens. Slides or swabs.
CPT Code(s): 87281
0060054 Poliovirus Antibodies POLIO

Specimen Preparation: Separate serum from cells within 2 hours of collection. Transport 1 mL serum. (Min: 0.2 mL)
CPT Code(s): 86658 x3 Poliovirus (1, 2, and 3)
0090789 Polychlorinated Biphenyls, Blood POLYCHL B

Stability: Ambient: 2 weeks; Refrigerated: 4 months; Frozen: 4 months
CPT Code(s): 82441
0090800 Polychlorinated Biphenyls, Serum or Plasma POLYCHL SP

Specimen Required: Collect: Plain red. Lavender, EDTA) is acceptable, but not preferred
(Min: 1.2 mL)
CPT Code(s): 82441
0099550 Porphobilinogen (PBG) Deaminase, Erythrocyte PBG-D

Methodology: Quantitative Enzymatic/Fluorometry
Unacceptable Conditions: Body fluid other than EDTA preserved whole blood. Clotted specimens.
CPT Code(s): 82657
0080260 Porphobilinogen (PBG), Urine PBGQT

Methodology: Quantitative Ion Exchange Chromatography/Spectrophotometry
Specimen Required: Collect: Random or 24-hour urine. Refrigerate 24-hour specimens during collection.
Specimen Preparation: Protect from light. Transfer 8 mL aliquot from a random or well-mixed 24-hour collection to ARUP Amber Transport
Tubes. (Min: 3.5 mL) Record total volume and collection time interval on transport tube and test request form.
CPT Code(s): 84110
2002181 Porphyrins and Porphobilinogen (PBG), Urine PORUFPBGU

Methodology: High Performance Liquid Chromatography/Ion Exchange Chromatography/Quantitative Spectrophotometry
Specimen Preparation: Protect from light. Transfer 8 mL aliquot to an ARUP Amber Transport Tube. (Min: 4 mL) Record total volume and
collection time interval on transport tube and test request form.
CPT Code(s): 84120 Porphyrins, urine; 84110 PBG, urine
Page | 383
0099824 Porphyrins, Fecal POR FECES
Specimen Preparation: Protect from light during collection, storage, and shipment. Freeze specimen and wrap in foil immediately after
collection. Transport 5 g stool. (Min: 1 g)
Unacceptable Conditions: Complete timed collections (24-72 hour). Specimens stored in one gallon cans or other large containers. Liquid stool.
CPT Code(s): 84126
2002058 Porphyrins, Fractionation & Quantitation, Urine PORURINE

Specimen Preparation: Protect from light. Transfer 4 mL aliquot of urine to an ARUP Amber Transport Tube. (Min: 2 mL) Record total volume
and collection time interval on transport tube and test request form.
CPT Code(s): 84120
0080429 Porphyrins, Serum Total POR S

Methodology: Quantitative Fluorometry
Specimen Preparation: CRITICAL: Protect from light during collection, storage, and shipment. Separate serum from cells within 1 hour of
collection. Transfer 2 mL serum to an ARUP Amber Transport Tube. (Min: 1 mL)
Remarks:
Unacceptable Conditions: Body fluids other than serum. Frozen whole blood. Hemolyzed specimens.
CPT Code(s): 84311
2006593 Porphyrins, Total with Reflex to Fractionation and Quantitation, Plasma PORPH TOT
Methodology: Qualitative Extraction/Scanning Spectrofluorometry/Quantitative High Performance Liquid Chromatography
Patient Preparation: Patient should abstain from alcohol for 24 hours prior to collection
Specimen Required: Collect: Green (sodium heparin). Also acceptable: lavender (EDTA)
Specimen Preparation: Protect from light. Transfer 3 mL plasma to an ARUP Amber Transport Tube and freeze immediately. (Min: 1 mL)
Remarks: Include a current list of patient medications
Unacceptable Conditions: Separator tubes. Specimens not protected from light. Thawed specimens
CPT Code(s): 84311 Porphyrins, Total; if reflexed, add 82492 Porphyrins, Fractionation
2001739 Posaconazole, Quantitation by LC-MS/MS POSACON AF

Patient Preparation: Blood levels may be affected by other concurrent medications, patient conditions, fat intake at dosing, and other factors.
Specimen Preparation: Transfer 1 mL serum to an ARUP Standard Transport Tube and freeze. (Min: 0.6 mL)
Unacceptable Conditions: Serum separator tubes. Hemolyzed or lipemic specimens.
CPT Code(s): 80299
0020380 Potassium, Fecal FE-K

Specimen Required: Collect: 24-hour or random stool.
Specimen Preparation: Transfer a 5 g stool to an unpreserved stool transport vial (ARUP Supply #40910). Available online through eSupply using
ARUP Connect™ or contact Client Services at (800) 522-2787. (Min: 1 g) Mix 24-hour collection well. Do not add saline or water to liquefy
specimen.
Stability: Ambient: 1 hour; Refrigerated: 2 weeks; Frozen: 6 months
CPT Code(s): 84999
0020155 Potassium, Fluid K FL

Unacceptable Conditions: Breast milk and salivary fluid. Specimens collected in citrate, EDTA, potassium oxalate, or sodium fluoride.
Contaminated or hemolyzed specimens. Specimens too viscous to be aspirated by instrument.
Stability: After separation from cellular material: Ambient: 2 weeks; Refrigerated: 2 weeks; Frozen: 6 months
CPT Code(s): 84999
0020002 Potassium, Plasma or Serum K

Page | 384
Patient Preparation: Patient should avoid exercise of arm or hand before and during collection.
Unacceptable Conditions: Urine (refer to Potassium, Urine, ARUP test code 0020849). Specimens collected in citrate, EDTA, potassium oxalate,
or sodium fluoride. Hemolyzed specimens.
CPT Code(s): 84132
0020849 Potassium, Urine UK

Specimen Required: Collect: 24-hour or random urine without additives. Refrigerate during collection.
Specimen Preparation: Transfer a 1 mL aliquot of urine from a well-mixed collection to an ARUP Standard Transport Tube. (Min: 0.2 mL)
CPT Code(s): 84133
0090672 Prazepam (Assayed as Nordiazepam) PRAZE

CPT Code(s): 80154
0091489 Prazosin (Minipress), Serum or Plasma PRAZOSI SP

CPT Code(s): 80299
0091488 Prazosin, Urine PRAZOSI UR

Methodology: Qualitative High Performance Liquid Chromatography
Specimen Preparation: Transfer 3 mL urine at to an ARUP Standard Transport Tube. (Min: 1.2 mL)
CPT Code(s): 80299
0050435 Prealbumin, Serum PREALB

Methodology: Immunoturbidimetry
Specimen Required: Collect: Serum separator tube. Also acceptable: lavender (EDTA), pink (K2EDTA), or green (sodium or lithium heparin).
CPT Code(s): 84134
0098573 Prednisolone, Serum or Plasma PREDNISOLO

Patient Preparation: Patient should not be on any corticosteroid or ACTH therapy, other than Prednisolone, if possible, for at least 48 hours
prior to collection of specimen.
Specimen Preparation: Separate serum or plasma from cells within 1 hour of collection. Transfer 3 mL serum or plasma to an ARUP Standard
Transport Tube and freeze immediately. (Min: 1 mL)
Remarks: Avoid multiple freeze thaw cycles.
Unacceptable Conditions: Specimens that have been thawed and refrozen.
CPT Code(s): 83519
2004263 PreDx™ Diabetes Risk Profile DIAB RISK

Methodology: Immunoassay/Enzymatic/High Performance Liquid Chromatography
Patient Preparation: Patient must be 18 years of age or older. Patient should fast for at least 10 hours prior to collection.
Specimen Required: Collect: Serum separator tube AND lavender (EDTA). Serum separator tube should be collected before EDTA tube. ARUP Standard
Transport Tube should be frozen prior to collection.
Specimen Preparation: Serum: Gently invert 5 times following collection; allow specimen to clot at least 30-40 minutes (not more than 60) in a
vertical position at room temperature. Centrifuge for 15-20 minutes between 1100 g and 1300 g. Transfer 3 mL serum to a FROZEN ARUP
Standard Transport Tube and freeze immediately. (Min: 1 mL)
Page | 385
EDTA Whole Blood: Gently invert 8-10 times following collection. Transfer 3 mL whole blood to a FROZEN ARUP Standard Transport Tube
and freeze immediately. (Min: 1 mL)
Unacceptable Conditions: Hemolyzed specimens. Specimens from patients less than 18 years of age.
CPT Code(s): 82728 Ferritin; 82947 Glucose; 83036 HbA1c; 84238 IL2RA; 83520 Adiponectin; 83525 Insulin; and 86141 CRP
2002554 Pregabalin, Serum or Plasma PREGAB

(Min: 0.4 mL)
CPT Code(s): 82542
2006536 Pregabalin, Urine PREGAB UR

Specimen Required: Collect: Urine
Storage/Transport Temperature: Refrigerated. Also acceptable: Room temperature and Frozen.
CPT Code(s): 80299
0092334 Pregnenolone by LC-MS/MS, Serum or Plasma PREGNLONE

Specimen Preparation: Separate serum or plasma cells ASAP or within 2 hours of collection. Transfer 0.5 mL serum or plasma to an ARUP
CPT Code(s): 84140
0099043 Prekallikrein Factor, Activity PREKALL

Remarks:
CPT Code(s): 85292
0095044 Prenatal Reflexive Panel PRENATAL A

Methodology: Hemagglutination/Solid Phase/Chemiluminescent Immunoassay/Automated Cell Count
Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA) AND serum separator tube.
Specimen Preparation: Transport 10 mL whole blood in the original container(s) AND transfer two 2 mL aliquots of serum to individual ARUP
Standard Transport Tubes.
Storage/Transport Temperature: Whole Blood: Room temperature.
Serum: Refrigerated.
Unacceptable Conditions: Frozen whole blood. Clotted whole blood.
CPT Code(s): 86592 RPR, if reflexed add 86593 RPR Titer; 86317 Rub IgG; 86900 ABO 86901 Rh; 86850 Antibody screen, if reflexed add 86870 Ab
Identification; 86880 Direct Coombs; 86906 Rh Phenotype; 85025 CBC; 87340 Hep B SAG, if reflexed add 87341
2004199 Primary Carnitine Deficiency (SLC22A5) Deletion/Duplication PCD DELDUP

0051682 Primary Carnitine Deficiency (SLC22A5) Sequencing PCD FGS

Specimen Required: Collect: Contact ARUP's genetic counselor at (800) 242-2787 ext. 2946 prior to test submission.
Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B) tube. Also acceptable: Two T-25 flasks of cultured fibroblasts to 80%
confluence. If the client is unable to culture fibroblasts, this can be arranged by contacting ARUP Client Services at (800) 522-2787.
Specimen Preparation: Transport 3 mL whole blood (Min: 1 mL). OR fill two T-25 flasks with culture media (Min: One T-25 flask). Backup
cultures must be retained at the client's institution until testing is complete.
Storage/Transport Temperature: Whole blood: Refrigerated.
Cultured fibroblasts: Room temperature.
CPT Code(s): 83891 Isolation; 83898 x10 Amplification; 83904 x10 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report. - Additional
Page | 386
2004203 Primary Carnitine Deficiency (SLC22A5) Sequencing and Deletion/Duplication PCD FGA
CPT Code(s): Sequencing: 83891 Isolation; 83898 x10 Amplification; 83904 x10 Sequencing; 83909 Capillary electrophoresis;
DelDup: 83896 Nucleic acid probes; 83898 Amplification; 83914 Extension; 83909 Capillary electrophoresis; 83912 Interpretation and report -
0090202 Primidone and Metabolite PRIM

Specimen Preparation: Allow specimen to clot completely at room temperature. Separate serum from cells within 2 hours of collection. Transfer 1
mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.8 mL)
CPT Code(s): 80188 Primidone; 80184 Phenobarbital
0050083 proBrain Natriuretic Peptide, NT PRO BNP

Specimen Required: Collect: Serum separator tube, pink (K2EDTA), or green (ammonium or lithium heparin).
plasma from cells ASAP or within 2 hours of collection. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube.(Min: 0.5 mL)
Unacceptable Conditions: Specimens collected in containers other than specified above.
CPT Code(s): 83880
0090151 Procainamide and NAPA PROC

Specimen Preparation: Separate serum from cells within 2 hours of collection. Transfer 1 mL serum or plasma to an ARUP Standard Transport
Tube. (Min: 0.5 mL)
Unacceptable Conditions: EDTA plasma. Gray (sodium fluoride/potassium oxalate) or separator tubes or gels.
CPT Code(s): 80192
0020763 Procalcitonin PCT

Methodology: Immunofluorescence
Patient Preparation: The same specimen type (serum, plasma) should be used throughout the patient's clinical course.
Specimen Preparation: Allow serum toto sit for 15-20 minutes for proper clot formation and to ensure the absence of fibrin in the serum which can
interfere with this assay. Separate serum or plasma from cells within 2 hours of collection. Transfer 2 mL serum or plasma to an ARUP Standard
Unacceptable Conditions: Specimens collected in citrate anticoagulant.
CPT Code(s): 84145
0091426 Prochlorperazine (Compazine®), Serum or Plasma PROCHLORP

CPT Code(s): 84022
0091427 Prochlorperazine (Compazine®), Urine PROCHL UR

CPT Code(s): 84022
2004106 Procollagen I by Immunohistochemistry PROCOL IHC

Page | 387
CPT Code(s): 88342
0070236 Procollagen Type I Intact N-Terminal Propeptide PINP

Specimen Required: Collect: Serum separator tube or plain red. Collect all specimens at the same time of day; there is a diurnal variation of PINP and values are higher
at night.
plasma from cells ASAP or within 2 hours of collection. Transfer 0.5 mL serum (Min: 0.2 mL) to an ARUP Standard Transport Tube.
CPT Code(s): 83519
0070110 Progesterone PROGES

Specimen Preparation: Allow specimen to clot completely at room temperature before centrifuging. Separate serum from cells ASAP or within 2
hours of collection. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.2 mL)
Unacceptable Conditions: Specimens submitted in lavender (EDTA), green (lithium or sodium heparin), lt. blue (sodium citrate), or gray (sodium
fluoride/potassium oxalate). Specimens shipped in gel separator tube.
Stability: After separation from cells: Ambient: 8 hours: Refrigerated: 1 week; Frozen: 3 months
CPT Code(s): 84144
2004525 Progesterone Receptor (PR) by Immunohistochemistry PR IHC

CPT Code(s): 88342
0070112 Proinsulin PROINS

Patient Preparation: Patient must fast for 12-15 hours prior to collection.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 3 months (avoid repeated freeze/thaw cycles)
CPT Code(s): 84206
0070256 Proinsulin/Insulin Ratio PRO INS

Methodology: Quantitative Chemiluminescent Immunoassay/Quantitative Enzyme-Linked Immunosorbent Assay
Patient Preparation: Patient must be fast for 12-15 hours prior to collection.
Transport Tube and freeze immediately. (Min: 0.8 mL)
Unacceptable Conditions: Heparinized plasma. Vitreous or I.V. fluids.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 3 months (avoid repeated freeze/thaw cycles)
CPT Code(s): 84206 Proinsulin; 83525 Insulin
0070115 Prolactin PROLAC

Tube. (Min: 0.5 mL)
CPT Code(s): 84146
2004109 Prolactin by Immunohistochemistry PROLAC IHC

Page | 388
CPT Code(s): 88342
0020724 Prolactin Macroadenoma PROLAC MAC

Tube.
CPT Code(s): 84146
0091439 Promazine, Serum or Plasma PROMAZ SP

Specimen Preparation: Protect from light. Transfer 4 mL serum or plasma to an ARUP Amber Transport Tube. (Min: 2 mL)
CPT Code(s): 84022
0091438 Promazine, Urine PROMAZ UR

CPT Code(s): 84022
0091556 Promethazine Quantitative, Serum or Plasma PROMETHAZ

CPT Code(s): 84022
0091473 Promethazine Quantitative, Urine PROMETHA U

CPT Code(s): 84022
0090186 Propafenone PROPAFEN

CPT Code(s): 80299
0091538 Propylene Glycol, Serum or Plasma PROPY GLY

Specimen Preparation: Separate from cells within 2 hours of collection. Transfer 2 mL serum or plasma to an ARUP Standard Transport Tube.
(Min: 0.7 mL)
CPT Code(s): 84600
Page | 389
0091079 Propylene Glycol, Urine PRO GLY UR
Specimen Preparation: Transport 4 mL urine. (Min 0.5 mL)
CPT Code(s): 84600
2004112 Prostate Specific Antigen by Immunohistochemistry PSA IHC

CPT Code(s): 88342
2002930 Prostate Specific Antigen, Complexed PSA COMP

Specimen Preparation: Transfer 1.0 mL serum to an ARUP standard transport tube. (Min: 0.5 mL)
Unacceptable Conditions: Hemolyzed specimens. Any specimens other than serum.
CPT Code(s): 84152
0080206 Prostate Specific Antigen, Free Percentage (Includes Free PSA and Total PSA) PSA FP
Specimen Required: Collect: Serum separator tube or plasma separator tube. Also acceptable: Plain red, green (sodium or lithium heparin), lavender (EDTA), or pink
(K2EDTA).
Unacceptable Conditions: Grossly hemolyzed specimens. Vaginal washings.
CPT Code(s): 84153 PSA, total; 84154 PSA, free
0070121 Prostate Specific Antigen, Total PSA

(K2EDTA).
CPT Code(s): 84153
0070234 Prostate Specific Antigen, Total - Medicare Screening PSA SCN

(K2EDTA).
CPT Code(s): G0103
0080264 Prostate Specific Antigen, Total with Reflex to Free PSA (Includes Free Percentage) TPSAR
Specimen Required: Collect: Plasma separator tube or serum separator tube. Also acceptable: Plain red, green (sodium or lithium heparin), lavender (EDTA), or pink
(K2EDTA).
CPT Code(s): 84153 PSA, total; if reflexed, add 84154 PSA, free
0098581 Prostate Specific Antigen, Ultrasensitive PSA ULTRA

Page | 390
(K2EDTA).
CPT Code(s): 84153
0070120 Prostatic Acid Phosphatase PAP

Patient Preparation: Specimen should be obtained before rectal examination, biopsy, prostatectomy or prostatic massage, since manipulation of
the prostate gland may lead to elevated PAP levels persisting up to 24-48 hours.
Specimen Preparation: Allow specimen to clot completely at room temperature. Transfer 1 mL serum to an ARUP Standard Transport Tube.
(Min: 0.5 mL)
Remarks:
Unacceptable Conditions: Specimens refrigerated more than 24 hours or left at room temperature more than 3 hours.
CPT Code(s): 84066
2004079 Prostatic Acid Phosphatase (PAP) by Immunohistochemistry PAP IHC

CPT Code(s): 88342
0030182 Protein C and S Panel, Functional C/S PANEL

Remarks: Include list of medications.
CPT Code(s): 85303 Protein C functional; 85306 Protein S functional
0030116 Protein C & S Panel, Total, Antigen C/S TOTAL

CPT Code(s): 85302 Protein C; 85305 Protein S
0030113 Protein C, Functional PROT C F

Remarks:
CPT Code(s): 85303
2003386 Protein C, Functional with Reflex to Protein C, Total and Protein S, Free with Reflex to Protein S, Total PROT C/S R
Methodology: Clotting/Enzyme-Linked Immunosorbent Assay/Microlatex Particle-Mediated Immunoassay
Remarks:
Unacceptable Conditions: Serum. Non-frozen or hemolyzed specimens. Anticoagulants other than citrate.
Stability: Ambient: 2 hours; Refrigerated: 4 hours; Frozen: 1 Month
CPT Code(s): 85303 Protein C Functional; 85306 Protein S Free; if Protein C Functional is reflexed add 85302 Protein C, Total Antigen ; if Protein S Free is
reflexed, add: 85305 Protein S Total
Page | 391
0030041 Protein C, Functional with Reflex to Protein C, Total Antigen PROT CF R
Methodology: Clotting/Enzyme-Linked Immunosorbent Assay
Remarks:
Unacceptable Conditions: Serum. Non-frozen or hemolyzed specimens. Anticoagulants other than citrate.
CPT Code(s): 85303 Protein C Functional; if reflexed add 85302 Protein C, Total Antigen
0030111 Protein C, Total Antigen PROT C

CPT Code(s): 85302
0050590 Protein Electrophoresis, CSF CSF ELECT

Specimen Preparation: Transport 1 mL CSF. (Min: 0.5 mL)
CPT Code(s): 84157 Total protein CSF; 84166 Protein, electrophoresis fractionation and quantitation; other fluids with concentration
0050640 Protein Electrophoresis, Serum SPEP

Methodology: Quantitative Capillary Electrophoresis
Tube. (Min: 0.5 mL)
Remarks:
CPT Code(s): 84160 Total protein; 84165 Electrophoretic fractionation
2002109 Protein Electrophoresis with Reflex to Immunofixation Electrophoresis Monoclonal Protein Detection, SPEP REFLEX
Quantitation & Characterization, IgA, IgG, & IgM, Serum
Methodology: Quantitative Capillary Electrophoresis/Qualitative Immunofixation Electrophoresis/Quantitative Nephelometry
Tube. (Min: 0.5 mL)
CPT Code(s): 84160 Total protein; 84165 Electrophoretic fractionation; if reflexed add 82784 x3 IgA, IgG, and IgM and 86334 IFE
2004091 Protein Gene Product (PGP) 9.5 by Immunohistochemistry PGP P IHC

CPT Code(s): 88342
0098894 Protein S Free, Antigen PRO S FREE

Remarks:
CPT Code(s): 85306
2002269 Protein S, Free Antigen with Reflex to Protein S, Total Antigen PRS FREE R
Page | 392
Remarks:
CPT Code(s): 85306; if reflexed, add: 85305
0030114 Protein S, Functional PROT S F

CPT Code(s): 85306
0030112 Protein S, Total Antigen PROT S

CPT Code(s): 85305
0020502 Protein, Total, Body Fluid TP-FL

Unacceptable Conditions: CSF (Refer to Protein, Total, CSF, ARUP test code 0020514). Breast milk and salivary fluid. Specimens too viscous to
be aspirated by instrument.
CPT Code(s): 84157
0020514 Protein, Total, CSF CFP

Methodology: Reflectance Spectrophotometry
Patient Preparation: Specimens should be collected prior to the intrathecal administration of contrast media.
Specimen Preparation: Centrifuge and remove supernatant within 4 hours of collection. Refrigerate if specimen will not be analyzed within 4
hours; Transport 1 mL CSF. (Min: 0.2 mL)
Unacceptable Conditions: Specimens containing intrathecal contrast media. Hemolyzed specimens.
CPT Code(s): 84157
0020029 Protein, Total, Serum or Plasma TP

Patient Preparation: Tourniquet application should be minimal.
Specimen Required: Collect: Plasma separator tube or serum separator tube.e.
Unacceptable Conditions: Body Fluid (refer to Total Protein, Body Fluid, ARUP test code 0020502). Urine (refer to Total Protein, Urine, ARUP
test code 0020479).
Stability: After separation from cells: Ambient: 4 hours; Refrigerated: 1 month; Frozen: 6 months
CPT Code(s): 84155
0020479 Protein, Total, Urine UTP

Specimen Required: Collect: 24-hour urine with no additive. Refrigerate during collection. Also acceptable: Random urine.
Specimen Preparation: Transfer 4 mL aliquot of urine from a well-mixed collection to an ARUP Standard Transport Tube. (Min: 1 mL) Record
Unacceptable Conditions: Specimens collected in acid (such as those previously preserved with HCl).
CPT Code(s): 84156
2004411 Prothrombin Antibodies, IgG & IgM PROTHROMPN

Specimen Required: Collect: Serum separator tube or lt. blue (sodium citrate).
Unacceptable Conditions: Hemolyzed, grossly icteric, or lipemic specimens.
CPT Code(s): 0030T x2
Page | 393
0051302 Prothrombin Antibody, IgG PROTHROM G
CPT Code(s): 0030T
0051303 Prothrombin Antibody, IgM PROTHROM M

CPT Code(s): 0030T
0056060 Prothrombin (F2) G20210A Mutation PT PCR

CPT Code(s): 83891 Isolation; 83898 Amplification; 83896 Nucleic acid probe; 83912 Interpretation and report - Additional CPT code modifiers may be
0030215 Prothrombin Time PT

Specimen Preparation: Separate plasma from cells within 24 hours. Transfer 1 mL platelet-poor plasma to an ARUP Standard Transport Tube.
(Min: 0.5 mL)
Unacceptable Conditions: Serum. Clotted, hemolyzed, or refrigerated specimens.
CPT Code(s): 85610
0030224 Prothrombin Time/International Normalized Ratio PT INR

Specimen Required: Collect: Lt. blue (sodium citrate)
Unacceptable Conditions: Serum. Refrigerated, clotted, or hemolyzed specimens.
CPT Code(s): 85610
2005898 Protocadherin 19 (PCDH19) Sequencing PCDH19

Methodology: Polymerase chain Reaction/Sequencing
Stability: Ambient: 3 weeks; Refrigerated: Unacceptable; Frozen Unacceptable
CPT Code(s): 83891 Isolation, 83898 x11 Amplification, 83904 x11 Sequencing, 83909 x11 Capillary electrophoresis, 83912 Interpretation and report
0090106 Protriptyline PROTRIP

CPT Code(s): 80299
0020159 Pseudocholinesterase, Dibucaine Inhibition PCHE PHENO

Patient Preparation: Specimen must be drawn prior to surgery or more than two days following surgery. Do not draw in recovery room.
Specimen Required: Collect: Serum separator tube, green (sodium or lithium heparin), lavender (EDTA), or pink (K2EDTA).
collection. Transport 1 mL serum or plasma. (Min: 0.25 mL)
Unacceptable Conditions: Lt. blue (sodium citrate) or gray (oxalate/fluoride). Whole blood.
CPT Code(s): 82638 Dibucaine number; 82480 Total
0020167 Pseudocholinesterase, Total CHE-P

Page | 394
Patient Preparation: Specimen must be drawn prior to surgery or more than two days following surgery. Do not draw in recovery room.
hours of collection. Transport 0.5 mL serum or plasma. (Min: 0.1 mL)
Remarks: Plasma values are slightly lower than serum.
Unacceptable Conditions: Whole blood on clot. Hemolyzed specimens.
CPT Code(s): 82480
0091443 Pseudoephedrine, Serum or Plasma PSEUDO SP

0.5 mL)
CPT Code(s): 80299
0091442 Pseudoephedrine, Urine PSEUDO UR

CPT Code(s): 80299
2004115 PTEN by Immunohistochemistry PTEN IHC

electronic ordering capability, use an ARUP Immunohistochemistry Stain Form (form #32978) with an ARUP client number. For additional
technical details, please contact ARUP Client Services.
CPT Code(s): 88342
2002726 PTEN-Related Disorders (PTEN) Deletion/Duplication PTENDELDUP

2002722 PTEN-Related Disorders (PTEN) Sequencing PTEN FGS

2002470 PTEN-Related Disorders (PTEN) Sequencing and Deletion/Duplication PTEN FGA

CPT Code(s): Sequencing: 83891 Isolation; 83898 x12 Amplification; 83904 x12 Sequencing; 83909 capillary electrophoresis. Del/Dup: 83896 Nucleic Acid
Probes; 83898 Amplification; 83914 Extension; 83909 Capillary Electrophoresis; 83912 Interpretation and report - Additional CPT code
Page | 395
2003401 Pulmonary Arterial Hypertension (BMPR2) Deletion/Duplication BMPR2 DD
2003410 Pulmonary Arterial Hypertension (BMPR2) Sequencing BMPR2 FGS

CPT Code(s): Sequencing: 83891 Isolation; 83898 x16 Amplification; 83904 x16 Sequencing; 83909 capillary electrophoresis; 83912 Interpretation and report -
2003405 Pulmonary Arterial Hypertension (BMPR2) Sequencing and Deletion/Duplication BMPR2 FGA
CPT Code(s): Sequencing: 83891 Isolation; 83898 x16 Amplification; 83904 x16 Sequencing; 83909 Capillary electrophoresis. Del/Dup: 83896 Nucleic acid
probes; 83898 Amplification; 83914 Extension; 83909 Capillary electrophoresis; 83912 Interpretation and report - Additional CPT code modifiers
0059444 Purkinje Cell Cytoplasmic Antibody by IFA with Reflex to Titer & Immunoblot PCCA R
Tube. (Min: 0.5 mL)
CPT Code(s): 86255; if reflexed, add 86256 Titer; 83516 Immunoblot
2006167 Purkinje Cell (Yo) Antibody by IFA with Reflex to Titer and Western Blot, CSF PURK AB
Methodology: Qualitative Immunofluorescence Assay/Quantitative Western Blot
(Indirect Fluorescent Antibody/Western Blot)
Specimen Preparation: Transport 0.8 mL CSF. (Min: 0.5 mL)
CPT Code(s): 86255 PCCA; if reflexed, add 86256 Titer; 84181 Western blot
0070213 Pyridinium Crosslinks (Total), Urine PYD

Patient Preparation: First-morning void.
Specimen Preparation: Transfer 3.5 mL aliquot from a well-mixed, first-morning urine to an ARUP Standard Transport Tube. (Min: 0.5 mL)
CPT Code(s): 82523
0080342 Pyridinoline & Deoxypyridinoline by HPLC PYD & DPD

Patient Preparation: First morning void.
Specimen Preparation: Transfer 8 mL urine to ARUP Standard Transport Tubes. (Min: 4 mL)
Unacceptable Conditions: Random urine.
CPT Code(s): 82523
0091547 Pyridostigmine (Mestinon), Serum or Plasma PYRIDOSTIG

Specimen Preparation: Transfer 5 mL serum or plasma to ARUP Standard Transport Tubes and freeze immediately. (Min: 2.2 mL)
Unacceptable Conditions: Separator tubes. Thawed specimens.
CPT Code(s): 82491
Page | 396
0080290 Pyruvate Kinase PK
Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA). Also acceptable: Green (sodium heparin) or yellow (ACD Solution A or B).
CPT Code(s): 84220
0080310 Pyruvic Acid PYRU

Specimen Required: Collect: Whole blood using either a syringe or Vacutainer® pink (K2EDTA), Vacutainer® lavender (EDTA), or Vacutainer® green (sodium or
lithium heparin).
Specimen Preparation: 1) Immediately after blood is drawn, add exactly 1 mL whole blood to a chilled pyruvate collection tube containing 2 mL
8% (w/v) perchloric acid. (ARUP supply #16567). Available online through eSupply using ARUP Connect™ or contact Client Services at (800)
522-2787.
2) Mix well for 30 seconds then place in an ice bath for 10 minutes.
3) Centrifuge for 10 minutes at 1500 x g.
4) Decant 2 mL supernatant to an ARUP Standard Transport Tube and freeze. (Min: 1 mL)
Unacceptable Conditions: If less than 1 mL of blood is added to collection tube, pH of the supernatant will be too low for testing to be performed.
CPT Code(s): 84210
0080312 Pyruvic Acid, CSF PYRU CSF

Specimen Preparation: 1) Immediately after CSF is collected, add exactly 1 mL CSF to a chilled pyruvate collection tube containing 2 mL 8%
(w/v) perchloric acid. (ARUP supply #16567). Available online through eSupply using ARUP Connect™ or contact Client Services at (800) 522-
2787.
2) Mix well for 30 seconds then place in an ice bath for 10 minutes.
3) Centrifuge for 10 minutes at 1500 x g.
4) Decant 2 mL supernatant to an ARUP Standard Transport Tube and freeze. (Min: 1 mL)
Unacceptable Conditions: CSF not prepared as indicated in specimen preparation instructions.
CPT Code(s): 84210
0051729 QuantiFERON®-TB Gold In Tube QFTG-TB IT

Methodology: Cell Culture/Semi-Quantitative Enzyme-Linked Immunosorbent Assay
Specimen Required: Collect: At altitudes from sea level to 2,650 feet: Whole blood directly into each of the three tubes in the QuantiFERON®-TB (Standard) Gold
In-Tube collection kit (ARUP supply #45112). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at
(800) 522-2787.
At altitudes from 2,650-3,350 feet: Collect 3 mL whole blood using a syringe. Transfer 1 mL (Min: 0.8 mL, Max 1.2 mL) to each of the three
tubes in QuantiFERON®-TB (Standard) Gold In-Tube collection kit. (ARUP supply #45112).
At altitudes from 3,350-6,150 feet: Whole blood directly into each of the three tubes in the QuantiFERON®-TB (High Altitude)Gold In-Tube
collection kit (ARUP supply #46261). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-
2787.
At altitudes above 6,150 feet: Collect 3 mL whole blood using a syringe. Transfer 1 mL (Min: 0.8 mL, Max 1.2 mL) to each of the three tubes in
QuantiFERON®-TB (High Altitude) Gold In-Tube collection kit.
Tubes should be between 17°C and 25°C (63°F to 77°F) at the time of blood filling.
Specimen Preparation: Immediately after filling tubes, shake them ten (10) times just firmly enough to ensure the entire inner surface of the tube is
coated with blood, to solubilize antigens on tube walls. Over-energetic shaking may cause gel disruption and could lead to aberrant results.
After mixing, incubate upright at 37 ° C for 16-24 hours (within 16 hours of collection).
After incubation, centrifuge for 15 minutes at 2000-3000 RCF (g).
Transport plasma in each of the 3 original collection tubes.
Remarks: Further information on mixing QuantiFERON®-TB Gold In-Tube collection tubes and an instructional video can be found at:
http://www.aruplab.com/Specimen-Handling/SpecialSpecimenCollection/quantiferon.jsp
Unacceptable Conditions: Room temperature specimens. Specimens that have not been centrifuged.
Stability: After incubation and centrifugation: Ambient: 2 hours; Refrigerated: 4 weeks; Frozen: 4 months
CPT Code(s): 86480
2001627 QuantiFERON®-TB Gold In Tube & Mycobacterium tuberculosis Antibody, IgG TB PAN
Methodology: Cell Culture/Quantitative Enzyme-Linked Immunosorbent Assay
Specimen Required: Collect: At altitudes from sea level to 2,650 feet: Whole blood directly into each of the three tubes in the QuantiFERON®-TB (Standard) Gold
In-Tube collection kit (ARUP supply #45112). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at
(800) 522-2787.
At altitudes from 2,650-3,350 feet: Collect 3 mL whole blood using a syringe. Transfer 1 mL (Min: 0.8 mL, Max 1.2 mL) to each of the three
tubes in QuantiFERON®-TB (Standard) Gold In-Tube collection kit. (ARUP supply #45112).
At altitudes from 3,350-6,150 feet: Whole blood directly into each of the three tubes in the QuantiFERON®-TB (High Altitude)Gold In-Tube
collection kit (ARUP supply #46261). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-
2787.
At altitudes above 6,150 feet: Collect 3 mL whole blood using a syringe. Transfer 1 mL (Min: 0.8 mL, Max 1.2 mL) to each of the three tubes in
QuantiFERON®-TB (High Altitude) Gold In-Tube collection kit.
Tubes should be between 17°C and 25°C (63°F to 77°F) at the time of blood filling.
Specimen Preparation: Immediately after filling tubes, shake them ten (10) times just firmly enough to ensure the entire inner surface of the tube is
coated with blood, to solubilize antigens on tube walls. Over-energetic shaking may cause gel disruption and could lead to aberrant results.
After mixing, incubate upright at 37 ° C for 16-24 hours (within 16 hours of collection).
Page | 397
After incubation, centrifuge for 15 minutes at 2000-3000 RCF (g).
Transport plasma in each of the 3 original collection tubes.
Remarks: Further information on mixing QuantiFERON-TB Gold In-Tube collection tubes and an instructional video can be found at:
http://www.aruplab.com/Specimen-Handling/SpecialSpecimenCollection/quantiferon.jsp
Unacceptable Conditions: Room temperature specimens. Specimens that have not been centrifuged.
Stability: After incubation and centrifugation: Ambient: 2 hours; Refrigerated: 4 weeks; Frozen: 4 months
CPT Code(s): 86480 QuantiFERON, 86609 IgG ELISA
2003118 Quetiapine (Seroquel®), Serum or Plasma QUETIAP

Stability: Ambient: 1 week; Refrigerated: 1 month; Frozen: 1 month
CPT Code(s): 80299
0090245 Quinidine QUIN

Specimen Preparation: Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.5 mL) For serum, ensure complete clot
formation has taken place prior to centrifugation.
Unacceptable Conditions: Gray (sodium fluoride/potassium oxalate). Hemolyzed specimens.
Stability: After separation from cells: Ambient: 8 hours; Refrigerated: 7 days; Frozen: 14 days
CPT Code(s): 80194
0091572 Quinine, Serum or Plasma QUININE SP

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA). Also acceptable: Plain red.
0.22 mL)
CPT Code(s): 84228
0091227 Quinine, Urine QUININ UR

CPT Code(s): 84228
0099132 Rabies Antibody, IgG (Vaccine Response) RABIES

Unacceptable Conditions: Plasma or CSF. Hemolyzed, icteric, or lipemic specimens.
CPT Code(s): 86790
0050302 Raji Cell Immune Complex Assay RAJI

Specimen Preparation: Let stand for 2 hours, then separate serum from cells within 1 hour and freeze immediately. Transport 3 mL serum. (Min:
0.5 mL)
Unacceptable Conditions: Non-frozen specimens. Specimens exposed to repeated freeze/thaw cycles.
CPT Code(s): 86332
0091569 Ranitidine (Zantac®), Serum or Plasma RANITIDI

CPT Code(s): 80299
0091424 Ranitidine (Zantac®), Urine RANITI UR

Page | 398
CPT Code(s): 80299
2002730 RASA1-Related Disorders (RASA1) Sequencing RASA1 FGS

2006519 Recurrent Gastrointestinal Distress Profile RGID PRO

Methodology: Quantitative ImmunoCAP® Fluorescent Enzyme Immunoassay/Semi-Quantitative EliA® Fluorescent Enzyme Immunoassay
Specimen Required: Collect: Serum separator tube. Also acceptable: plasma separator tube (EDTA or heparin).
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen 1 year
CPT Code(s): 86003 x12 IgE specific allergens; 83516 x4 Semiquantitative immunoassay
0040270 Red Blood Cell Count RBC

Specimen Preparation: Mix well immediately after draw. Transport 3 mL whole blood. (Min: 0.25 mL)
CPT Code(s): 85041
0020373 Reducing Substances, Fecal FECRED

Methodology: Semi-quantitative Colorimetry
Unacceptable Conditions: Diapers. Stool containing barium. Specimens in media or preservatives.
Stability: Ambient: Unacceptable; Refrigerated: 36 hours; Frozen: 1 week
CPT Code(s): 84376
2004124 Renal Cell Carcinoma (RCC) Antigen by Immunohistochemistry RCC IHC

Specimen Preparation: Formalin fix (10% neutral buffered formalin is preferred) and paraffin embed specimen (cells must be prepared into a
cellblock). Protect paraffin from excessive heat. Transport tissue block or 5 unstained (3-5 micron thick sections), on positively charged slides
(Min: 2 slides). If sending precut slides, do not oven bake.
CPT Code(s): 88342
0020144 Renal Function Panel RENAL

Methodology: Quantitative Chemiluminescent Immunoassay/Quantitative Enzyme-Linked Immunosorbent Assay
Unacceptable Conditions: Specimens collected in citrate, EDTA, or oxalate.
CPT Code(s): 80069
Page | 399
Renal Pathology Special Studies
Specimen Required: Collect: Obtain Renal Biopsy kit prior to collection procedure (ARUP supply #40460). Available online through eSupply using ARUP Connect™
or contact ARUP Client Services at (800) 522-2787. Special fixatives are required.
Renal biopsy.
Specimen Preparation: Transport renal biopsy according to kit instructions.
Remarks: Submit clinical history and a preliminary report if applicable.
Unacceptable Conditions: Specimens submitted without glomeruli. Specimens with inappropriate fixative. Specimens that are not collected and
submitted according to instructions provided in collection kit.
CPT Code(s): 88305 Level IV surgical pathology and/or 88346 Immunofluorescent, each antibody and/or 88348 Electron microscopy.
0070105 Renin Activity RENIN

Patient Preparation: Supine: 1. Specimen should be obtained between 8 a.m. and 10 a.m. (after at least two hours in supine position); 2.
Normal sodium diet (100-200 mEq/day) for at least three days; 3. Take no medications known to affect renin-aldosterone system.
Upright: 1. Specimen should be obtained before noon (after at least two hours in upright position; seated or standing); 2. Normal sodium diet
(100-200 mEq/day) for at least three days; 3. Take no medications known to affect renin-aldosterone system.
Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA). Do not collect in refrigerated tubes.
Specimen Preparation: Separate plasma from cells. Transfer 2 mL plasma to an ARUP Standard Transport Tube and freeze immediately. (Min: 1.2
mL)
Unacceptable Conditions: Serum. Specimens collected in citrate, heparin, or oxalate. Hemolyzed or refrigerated specimens.
CPT Code(s): 84244
2001575 Renin, Direct RENIND

Methodology: Quantitative Immunoradiometry
Patient Preparation: Supine: 1. Specimen should be obtained between 8 a.m. and 10 a.m. (after at least two hours in supine position); 2.
Normal sodium diet (100-200 mEq/day) for at least three days; 3. Take no medications known to affect renin-aldosterone system.
Upright: 1. Specimen should be obtained before noon (after at least two hours in upright position; seated or standing); 2. Normal sodium diet
(100-200 mEq/day) for at least three days; 3. Take no medications known to affect renin-aldosterone system.
Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA). Do not collect in refrigerated tubes.
Specimen Preparation: Separate plasma from cells ASAP. Transfer 2 mL plasma to an ARUP Standard Transport Tube and freeze immediately.
(Min: 1 mL)
Unacceptable Conditions: Serum. Specimens collected in citrate, heparin, or oxalate. Hemolyzed or refrigerated specimens.
CPT Code(s): 84244
0030295 Reptilase Time with Reflex to Reptilase Time 1:1 Mix REP
Remarks:
CPT Code(s): 85635 Reptilase time; if reflexed add 85635 Reptilase time 1:1 mix
0060122 Respiratory Culture and Gram Stain MC RESP

Patient Preparation:
Specimen Required: Collect: Respiratory specimen: Sputum, tracheal aspirate, bronchial wash. Acceptable for Neonates: Gastric aspirate.
Specimen Preparation: Swab: Place into bacterial transport media.
Fluid: Transfer to a sterile container. Place each specimen in an individually sealed bag.
Remarks: Specimen source required. Refer to Bordetella pertussis Culture (ARUP test code 0060117), Corynebacterium diphtheriae Culture
(ARUP test code 0060360), or Legionella Species, Culture (ARUP test code 0060113) for special instructions, if requested.
Unacceptable Conditions: Multiple specimens (more than one in 24 hours). Dry specimens or poor quality sputum (presence of greater than 10
epithelial cells per 100x field).
CPT Code(s): 87070
0051087 Respiratory Syncytial Virus Antibodies, IgG & IgM RSV PAN
Tube. (Min: 0.05 mL) Parallel testing is preferred and convalescent specimens must be received within 30 days of receipt of the acute specimens.
Mark specimens plainly "acute" and "convalescent."
Page | 400
0051085 Respiratory Syncytial Virus Antibody, IgG RSV G
CPT Code(s): 86756
0051086 Respiratory Syncytial Virus Antibody, IgM RSV M

CPT Code(s): 86756
0060288 Respiratory Syncytial Virus DFA RSV

Specimen Required: Collect: Respiratory specimen: Nasopharyngeal aspirate, swab, or washing, or tracheal aspirate.
CPT Code(s): 87280
0060764 Respiratory Virus Mini Panel by RT-PCR RESPMINI

Specimen Required: Collect: Respiratory specimen: Bronchoalveolar lavage (BAL), nasal wash, nasopharyngeal swab, or pleural fluid.
media (ARUP Supply #12884). Available online through eSupply using ARUP Connector contact ARUP Client Services at (800) 522-2787.
CPT Code(s): 87502 Influenza A & B; 87798 RSV
0060289 Respiratory Viruses DFA RSPFA

Unacceptable Conditions: Dry swabs. Slides.
CPT Code(s): 87276 Influenza A; 87275 Influenza B; 87279 x3 Parainfluenza (1,2,3); 87280 RSV; 87260 Adenovirus; 87299 Human Metapneumovirus
2002565 Respiratory Viruses DFA with Reflex to Respiratory Virus Mini Panel by RT-PCR RSPFAPCR
Specimen Required: Collect: Nasal aspirate or nasopharyngeal swab.
Unacceptable Conditions: Calcium alginate, dry or wood swabs. Slides.
CPT Code(s): 87276 Influenza A; 87275 Influenza B; 87279 x3 Parainfluenza (1,2,3); 87280 RSV; 87260 Adenovirus; 87299 Human Metapneumovirus; if
reflexed add 87502 Influenza A & B; 87798 RSV
0060281 Respiratory Viruses DFA with Reflex to Viral Culture, Respiratory RSPFAC
Page | 401
Unacceptable Conditions: Calcium alginate, dry or wood swabs. Slides.
CPT Code(s): 87276 Influenza A; 87275 Influenza B; 87279 x3 Parainfluenza (1,2,3); 87280 RSV; 87260 Adenovirus; 87299 Human Metapneumovirus; if
reflexed add 87252 Tissue culture. If definitive identification from culture required, add 87253.
2001504 Respiratory Viruses Rapid Culture V RESPC

Specimen Preparation: Fluid: Transfer specimen to a sterile container. Also acceptable: Transfer to viral transport media (ARUP Supply #12884).
Available online through eSupply using ARUP Connector contact ARUP Client Services at (800) 522-2787.
CPT Code(s): 87254
0050698 Reticulin Antibody, IgA with Reflex to Titer RETIC R

CPT Code(s): 86255 Reticulin; if reflexed add 86256 Reticulin titer
0098878 Reticulin Antibody, IgG with Reflex to Titer RETIC IGG

Specimen Required: Collect: Plain red or serum separator tube (SST).
Stability: Ambient: 1week; Refrigerated: 2 weeks; Frozen: 1 month
0040263 Reticulocytes, Cellular Hb CHR

CPT Code(s): 85046
0040022 Reticulocytes, Percent & Number RETICULOCY

Specimen Preparation: Do not freeze. Transport 3 mL whole blood . (Min: 0.5 mL)
CPT Code(s): 85045
2007095 Retinitis Pigmentosa/Leber Congenital Amaurosis Deletion/Duplication, 53 Genes RP DD

Remarks: Submit the Patient History Form for Retinitis Pigmentosa/Leber Congenital Amaurosis with the Electronic Packing List.
CPT Code(s): 83891 Isolation; 88386 probes 251 through 500; 83912 Interpretation and report
Page | 402
2007085 Retinitis Pigmentosa/Leber Congenital Amaurosis Panel, Sequencing and Deletion/Duplication, 53 Genes RP PANEL
CPT Code(s): 83891 Isolation; 83909 x3 Capillary electrophoresis; 83898 x3 Amplification; 83904 x53 Sequencing; 88386 probes 251 through 500 ; 83912
2007091 Retinitis Pigmentosa/Leber Congenital Amaurosis Sequencing, 53 Genes RP SEQ

CPT Code(s): 83891 Isolation; 83909 x3 Capillary electrophoresis; 83898 x3 Amplification; 83904 x53 Sequencing; 83912 Interpretation and report
0050467 Retinol Binding Protein RBP

Tube. (Min: 0.5 mL) Plasma is not recommended.
CPT Code(s): 83883
0051618 Rett Syndrome (MECP2), Deletion and Duplication RETTDELDUP

Methodology: Multiplex Ligation-dependent Probe Amplification
CPT Code(s): 83891 Isolation; 83896 Nucleic acid probes; 83914 Extension; 83898 Amplification; 83909 Capillary electrophoresis; 83912 Interpretation and
report.
0051614 Rett Syndrome (MECP2), Full Gene Analysis RETT FGA

Methodology: Sequencing/Multiplex Ligation-dependent Probe Amplification
CPT Code(s): Rett sequencing: 83891 Isolation; 83898 x6 Amplification; 83904 x6 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and
report. RETT MLPA: 83896 Nucleic acid probe; 83914 Extension; 83898 Amplification; 83909 Capillary electrophoresis.
0051378 Rett Syndrome (MECP2), Full Gene Sequencing RETT FGS

CPT Code(s): 83891 Isolation; 83898 x6 Amplification; 83904 x6 Sequencing; 83909 Capillary electrophoresis; 83912 Interpretation and report.
0013014 Rh Type Only IRL-RH

Transport 7 mL whole blood. (Min: 5 mL)
CPT Code(s): 86901
0050421 RhCc Antigen (RHCE) Genotyping RH C

OR Whole Blood in lavender (EDTA), pink(K2EDTA), or yellow (ACD Solution A or B).

amniocytes filled with culture media. Backup cultures must be retained the client's institution until testing is complete.
Page | 403
CPT Code(s): 83891 Isolation; 83896 x4 Nucleic acid probes; 83898 x2 Amplification; 83912 Interpretation and report Additional CPT code modifiers may be
0051368 RhD Antigen (RhD) Genotyping RHD


CPT Code(s): 83891 Isolation; 83898 x3 Amplification; 83896 x6 Nucleic acid probes; 83912 Interpretation and report Additional CPT code modifiers may be
0050423 RhEe Antigen (RHCE) Genotyping RH E


CPT Code(s): 83891 Isolation; 83896 x2 Nucleic acid probes; 83898 Amplification; 83912 Interpretation and report - Additional CPT code modifiers may be
2003277 Rheumatoid Arthritis Panel RA PAN

Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Immunoturbidimetry
Specimen Preparation: Allow serum to clot completely at room temperature before centrifuging. Transfer 2 mL serum to an ARUP Standard
Transport Tube. (Min: 1 mL) Serum is the only acceptable specimen type for this assay without a disclaimer.
CPT Code(s): 86200 CCP IgG; 86431 Rheumatoid Factor
2003278 Rheumatoid Arthritis Panel with Reflex to Rheumatoid Factors, IgA, IgG, and IgM by ELISA RA PAN R
Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Quantitative Immunoturbidimetry/Quantitative Enzyme-Linked Immunosorbent Assay
Specimen Preparation: Allow serum to clot completely at room temperature before centrifuging. Transfer 1 mL serum to an ARUP Standard
Transport Tube. (Min: 0.8 mL) Serum is the only acceptable specimen type for this test without a disclaimer.
Page | 404
Remarks:
Unacceptable Conditions: Plasma, miscellaneous body fluid, or urine. Contaminated, heat-inactivated, hemolyzed, icteric, or severely lipemic
specimens.
CPT Code(s): 86200 CCP IgG; 86431 Rheumatoid Factor; if reflexed, add 83516 x2 RF IgG/IgA and 86431 RF IgM
0050465 Rheumatoid Factor RA

(K2EDTA).
Specimen Preparation: Allow specimen to clot completely at room temperature. Transfer 0.5 mL serum or plasma to an ARUP Standard Transport
Tube. (Min: 0.5 mL)
Unacceptable Conditions: Body Fluid (refer to Rheumatoid Factor, Body Fluid, ARUP test code 2003347). Hemolyzed specimens.
Stability: After separation from cells: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 2 weeks (should not be thawed more than once)
CPT Code(s): 86431
2003347 Rheumatoid Factor, Body Fluid RA-FL

Stability: After separation from cells: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 2 weeks (should not be thawed more than once)
CPT Code(s): 86431
0051298 Rheumatoid Factors, IgA, IgG, and IgM by ELISA RF PAN

Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Quantitative Enzyme-Linked Immunosorbent Assay.
Unacceptable Conditions: Contaminated, hemolyzed, or lipemic specimens.
CPT Code(s): 83516 x2 RF IgG/IgA and 86431 RF IgM
0099249 Ribosomal P Protein Antibody RIBPP

Tube. (Min: 0.2 mL)
CPT Code(s): 83516
0050371 Rickettsia rickettsii (Rocky Mountain Spotted Fever) Antibodies, IgG & IgM by IFA RMSF G/M
CPT Code(s): 86757 RMSF IgG; 86757 RMSF IgM
0050369 Rickettsia rickettsii (Rocky Mountain Spotted Fever) Antibody, IgG RMSF G
CPT Code(s): 86757
0050372 Rickettsia rickettsii (Rocky Mountain Spotted Fever) Antibody, IgM RMSF M
Page | 405
CPT Code(s): 86757
0050384 Rickettsia typhi (Typhus Fever) Antibodies, IgG & IgM by IFA TYPHU G/M
CPT Code(s): 86757 Typhus fever IgG; 86757 Typhus fever IgM
0050381 Rickettsia typhi (Typhus Fever) Antibody, IgG by IFA TYPHU G

CPT Code(s): 86757
0050383 Rickettsia typhi (Typhus Fever) Antibody, IgM by IFA TYPHU M

Unacceptable Conditions: Contaminated, hemolyzed, or severely lipemic, specimens.
CPT Code(s): 86757
0092055 Risperidone & Metabolite, Serum or Plasma RISPERIDO

Specimen Required: Collect: Plain red, lavender (EDTA), pink (K2EDTA), or green (sodium heparin).
(Min: 0.4 mL)
CPT Code(s): 80299
2003382 Ristocetin-Induced Platelet Aggregation RIPA

Methodology: Qualitative Aggregation
Patient Preparation: Patient must fast from midnight until specimen is drawn in a.m. Patient may drink water.
Specimen Required: Collect: Hemostasis/Thrombosis laboratory must be called at (801) 583-2787 extension 2151 to schedule testing before specimen is drawn.
Lt. blue (sodium citrate). AND lavender (EDTA) or pink (K2EDTA).
Specimen Preparation: Specimen must be received within one hour of draw. Transport 15 mL whole blood (lt. blue) AND 5 mL whole blood
(EDTA). ((Min: 15 mL whole blood (lt. blue) AND 5 mL whole blood (EDTA)).
Remarks: Include list of current medications and most recent platelet count.
Unacceptable Conditions: Specimens not collected at ARUP's Red Butte Clinic. Specimens that have been centrifuged or refrigerated.
CPT Code(s): 85576
2001601 RNA Polymerase III Antibody, IgG RNA POL 3

Tube. (Min: 0.2 mL)
CPT Code(s): 83516
0050470 RNP (U1) (Ribonucleic Protein) (ENA) Antibody, IgG RNP

Tube. (Min: 0.2 mL)
CPT Code(s): 86235
Page | 406
0065067 Rotavirus and Adenovirus 40-41 Antigens ROTAD
CPT Code(s): 87425 Rota; 87301 Adeno
0065088 Rotavirus Antigen by EIA ROTA

CPT Code(s): 87425
0050552 Rubella Antibodies, IgG and IgM RUBE G/M

Unacceptable Conditions: Urine. Contaminated, heat-inactivated, or hemolyzed specimens.
CPT Code(s): 86317 Rubella, IgG; 86762 Rubella, IgM
0050771 Rubella Antibody, IgG RUBEIGG

CPT Code(s): 86317
0050551 Rubella Antibody, IgM RUBEIGM

received within 30 days from receipt of acute specimens. Mark specimens plainly as "acute" or "convalescent."
CPT Code(s): 86762
2003176 Rufinamide, Serum or Plasma RUFIN SP

Specimen Required: Collect: Plain red. Also acceptable: Lavender (K2 or K3EDTA), or pink (K2EDTA).
(Min: 0.5 mL)
CPT Code(s): 80299
0050444 RUNX1-RUNX1T1 (AML1-ETO) Translocation, t(8;21) by RT-PCR AML1-ETO

hours of collection due to lability of RNA...
clotted specimens.
2004127 S-100 Protein by Immunohistochemistry S100 IHC

Page | 407
cellblock). Protect paraffin from excessive heat. Transport tissue block or 5 unstained (3-5 micron thick sections), on positively charged slides
(Min: 2 slides). If sending precut slides, do not oven bake.
CPT Code(s): 88342
2001766 S-100B Protein, Serum S 100B

CPT Code(s): 86316
0050564 Saccharomyces cerevisiae Antibodies, IgG & IgA SC PAN

Tube. (Min: 0.3 mL)
2005432 Sal-like 4 (SALL4) by Immunohistochemistry SALL4 IHC

CPT Code(s): 88342
0090251 Salicylate Assay SALIC

CPT Code(s): 80196
2001586 Salmonella typhi Antibodies SALMONELLA

Unacceptable Conditions: Contaminated, heat-inactivated, hemolytic, icteric, lipemic, or turbid specimens.
0099113 Saquinavir Antiretroviral Serum Level, HPLC SAQUINAVIR

Patient Preparation: Specimens collected just before or within 15 minutes of the next dose represent the trough levels. Specimens collected
within 15-30 minutes after the end of I.V. infusion or 45-60 minutes after an IM injection or 90 minutes after oral intake represent the peak levels.
Interactions of this drug with other drugs administered concurrently can markedly alter the level of this protease inhibitor drug.
Unacceptable Conditions: Room temperature or refrigerated specimens. Serum separator tubes.
CPT Code(s): 80299
Page | 408
0099411 Schistosoma Antibody, IgG SCHIS
Tube (Min: 0.1 mL).
CPT Code(s): 86682
2006462 Scleroderma Antibodies Panel SCLER PAN

Methodology: Semi-Quantitative Enzyme Immunoassay/Indirect Fluorescent Antibody/Immunoprecipitation
Specimen Required: Collect: Serum Separator tube.
Specimen Preparation: Transfer 3 mL serum to an ARUP Standard Transport Tube (Min: 1.5 mL)
Storage/Transport Temperature: Refrigerated. Also acceptable: Room Temperature or frozen
Stability: Ambient: 1 week; Refrigerated: 1 month, Frozen: 3 months
CPT Code(s): 86039 ANA Titer; 86235 Scl-70; 86235 U1 RNP; 86235 RNA; 86256 Centromere; 83516 Th/To; 83516 U3 RNP Fib; 86235 PM/Scl
0050599 Scleroderma (Scl-70) (ENA) Antibody, IgG SCLER

Tube. (Min: 0.2 mL)
CPT Code(s): 86235
2005896 SCN1A-Related Seizure Disorders (SCN1A), Sequencing and Deletion/Duplication SCN1A COM
Methodology: Polymerase Chain Reaction/Sequencing/Multiplex Ligation-Dependent Probe Amplification
CPT Code(s): 83891 Isolation, 83892 Digestion, 83896 x26 Nucleic acid probes, 83898 x29 Amplification, 83900 Multiplex amplification, 83901 x24
Amplification, 83903 x21 Mutation scanning, 83904 x16 Sequencing, 83909 Capillary electrophoresis, 83912 Interpretation and report
0091559 Scopolamine, Serum or Plasma SCOPOLAM

Specimen Preparation: Separate serum from cells within 2 hours. Transfer 3 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 1.5
mL)
CPT Code(s): 80299
2006948 SDHB with Interpretation by Immunohistochemistry SDHB IP

Protect paraffin block and/or slides from excessive heat. Transport tissue block or 6 unstained (3- to 5- micron thick sections), positively charged
slides in a tissue transport kit (ARUP Supply #47808) available online through eSupply using AUP Connect™ or contact ARUP Client Services at
(800)522-2787. (Min. 2 slides) If sending precut slides, do not oven bake.
Remarks: IMMUNOHISTOCHEMISTRY ORDERING AND SUBMISSION DETAILS: Submit electronic request. For additional technical
details, please contact ARUP Anatomic Pathology at (801)581-2507.
CPT Code(s): 88360
0091389 Secobarbital, Serum or Plasma SECOBARBIT

Specimen Required: Collect: Plain red or lavender (EDTA)
CPT Code(s): 82205
0091437 Secobarbital, Urine SECOBA URN

CPT Code(s): 82205
Page | 409
0099772 Secretin SECRETIN
Patient Preparation: Patient should be fasting for 10-12 hours prior to collection of specimen. Medications affecting intestinal motility or
insulin levels should be discontinued, if possible 48 hours prior to collection.
Specimen Required: Collect: GI preservative tube (ARUP supply #47531). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services
at (800) 522-2787. Tubes for this test are provided at a cost of $30 each.
Specimen Preparation: Separate plasma from cells within 10 minutes. Transfer 3 mL plasma to an ARUP Standard Transport Tube and freeze
Unacceptable Conditions: Specimens not collected in a GI preservative tube.
CPT Code(s): 83519
0040325 Sedimentation Rate, Westergren (ESR) WEST

Specimen Required: Collect: Black (sodium citrate).
Storage/Transport Temperature: Room temperature. Deliver to lab immediately. Specimen should be run within four hours of collection.
Unacceptable Conditions: Frozen specimens. Hemolyzed or clotted specimens.
CPT Code(s): 85651
2006410 Selection of Retrieved Archived Tissue APBLOCKSEL

Methodology: Block evaluation and selection for ancillary testing
Specimen Required: Collect: Paraffin Block from a case performed by ARUP / Department of Pathology at University of Utah Hospital.
Remarks: This test is for the selection of a block from a case performed, and blocks retained at ARUP Laboratories and/or Department of
Pathology for University of Utah Hospital.
Unacceptable Conditions: Any case performed elsewhere or if there is not enough usable tissue in the block for requested testing.
CPT Code(s): 88363
0025023 Selenium, Serum SE S

Specimen Required: Collect: Royal blue (no additive) or Royal Blue (EDTA)
522-2787. (Min: 0.5 mL)
CPT Code(s): 84255
0025067 Selenium, Urine SE-U

CPT Code(s): 84255
0028325 Semen Analysis, Post Vasectomy SEMEN PV

Specimen Required: Collect: Semen.
Specimen Preparation: Transfer entire semen specimen to an ARUP Standard Transport Tube (ARUP Supply #43115).
CPT Code(s): 89310
Page | 410
0051222 Sensory Neuropathy Antibody Panel with Reflex to PCCA Titer, ANNA Titer and Neuronal Immunoblot SENSORY
Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody/Qualitative Immunoblot
Tube. (Min: 1 mL)
Unacceptable Conditions: Other body fluids. Contaminated, heat-inactivated, hemolyzed, or lipemic specimens.
CPT Code(s): 83516 MAG IgM ELISA; 83516 SGPG IgM; 86255 ANNA screen; if reflexed, add 86256 ANNA titer. 86255 Purkinje cell screen; if reflexed,
add 86256 Purkinje cell titer. If either screen is reflexed, also add 83516 immunoblot
2003243 Septin 9 (SEPT9), Methylated DNA Detection by Real-Time PCR SEPTIN 9

Specimen Required: Collect: Lavender (EDTA). Collect a minimum of 10 mL whole blood. Also acceptable: Collection kits available upon request (ARUP supply
#46270). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.
Specimen Preparation: Allow whole blood to sit for 30 minutes post draw. Within 4 hours of collection, spin (1350 g ) for 12 minutes.
Transfer plasma to a 15 mL conical tube. Spin plasma for another 12 minutes at the same speed. Transfer 4 mL of plasma to a 4 mL
cryovial tube or any freezable specimen transport tube. (Min: 4 mL).
Remarks: Accurate test performance requires following specimen preparation instructions.
Unacceptable Conditions: Refrigerated or room temperature plasma. Whole blood, serum, or stool. Less than 4 mL of plasma.
CPT Code(s): 83891 Extraction; 83892 Enzyme digestion; 83896 x3 Nucleic Acid Probes; 83900 Amplification, multiplex; 83912 Interpretation and report -
Additional CPT code modifiers may be required for procedures performed to test oncologic or inherited disorders.
0050527 Serine Protease 3 Antibody PR3

Tube. (Min: 0.2 mL)
CPT Code(s): 83516
2005629 Serotonin Release Assay (Heparin Dependent Platelet Antibody), Low Molecular Weight Heparin SRA LMWH
Methodology: Qualitative Serotonin Release Assay
CPT Code(s): 86022
2005631 Serotonin Release Assay (Heparin Dependent Platelet Antibody), Unfractionated Heparin SRA UFH
Methodology: Qualitative Serotonin Release Assay
CPT Code(s): 86022
0080397 Serotonin, Serum SEROT-SER

Specimen Preparation: Spin and separate within one hour. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.3 mL)
Unacceptable Conditions: Specimens other than serum. Non-frozen specimens.
CPT Code(s): 84260
0080395 Serotonin, Whole Blood SEROT-WB

Specimen Preparation: Place on ice. Transfer 3 mL whole blood to an ARUP Serotonin Transport Tube containing ascorbic acid (ARUP supply
#16568). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 1 mL) Mix well.
Specimen must be preserved and frozen within 2 hours of collection.
Remarks: Serotonin, Serum (ARUP test code 0080397) is recommended for patients that are difficult to draw.
Unacceptable Conditions: Non-frozen specimens. Specimens other than whole blood.
Stability: After transfer to Serotonin Transport Tube: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 1 month
CPT Code(s): 84260
0098745 Sertraline SERTRALINE

Page | 411
CPT Code(s): 80299
0099375 Sex Hormone Binding Globulin SHBG

Unacceptable Conditions: Specimens collected in lavender (EDTA) or pink (K2EDTA). Grossly hemolyzed specimens.
CPT Code(s): 84270
2006258 Sexually Transmitted Disease Panel 1 STD PANEL1

Specimen Required: Collect: Endocervical or vaginal swab, or first catch female urine. Collect in APTIMA®Combo 2 Assay transport media (ARUP supply: Swabs
#28907, Urine #28908) OR cervical brush in ThinPrep® transport Pap test media (ARUP supply #42711). Available online through eSupply using
ARUP Connect™ or contact Client Services at (800) 522-2787. Refer to "Sample Collection for the Diagnosis of STD" under Specimen Handling
at www.aruplab.com for specific specimen collection and transport instructions.
Specimen Preparation: Transfer swab or urine to APTIMA® Combo 2 Assay transport media. (Min: 2 mL urine)OR Vortex™ Pap test media and
transfer a 1 mL aliquot to APTIMA® Combo 2 transport media. To reduce the potential for contamination, ThinPrep® specimens should be
poured off, using sterile technique, into the APTIMA® Specimen Transfer Tube prior to cytology testing.
Remarks: The Trichomonas vaginalis assay is FDA approved for specimens from female patients only. Specimen source is required.
Stability: Unpreserved Urine: Ambient: 24 hours; Refrigerated: 24 hours; Frozen: Unacceptable
UnpreservThinPrep® Media: Ambient: 1 month; Refrigerated: 1 month; Frozen: Unacceptable
APTIMA®Transport Media: Swab: Ambient: 2 months; Refrigerated: 2 months; Frozen: 6 months
Urine: Ambient: 1 month; Refrigerated: 1 month; Frozen: 6 months
ThinPrep: Ambient: 2 weeks; Refrigerated: 1 month; Frozen: 6 months
CPT Code(s): 87491 C. trachomatis; 87591 N. gonorrhoeae; 87798 Trichomonas vaginalis
0049180 Sezary Cell Exam SEZARY

Methodology: Stain
Specimen Preparation: Transport 5 mL whole blood AND 6 unfixed, air-dried, and unstained push smears made from the blood submitted. (Min: 1
mL AND 6 unfixed smears).
Storage/Transport Temperature: Room temperature. Specimens should be received within 24 hours of collection. Testing must be performed
CPT Code(s): 85060
2006242 Short QT Syndrome Panel, 3 Genes SQTS PANEL

2006240 Shwachman-Diamond Syndrome (SBDS) Sequencing SBDS FGS

Stability: Ambient: 1 week, Refrigerated: 1 week, Frozen: Unacceptable
report.
2002098 Signal Recognition Particle (SRP) Antibody SRP

Methodology: Immunoprecipitation
CPT Code(s): 83516
0091539 Silicon, Serum or Plasma SILICON SP

Methodology: Quantitative Inductively Coupled Plasma-Atomic Emission Spectrometry
Specimen Required: Collect: Royal blue top tube, plastic (EDTA, no additive).
Page | 412
Specimen Preparation: Separate serum or plasma from cells within 2 hours. Transfer 2 mL serum or plasma to an ARUP Trace Element-Free
Transport Tube (ARUP supply #43116). (Min: 0.7 mL)
CPT Code(s): 84285
0091077 Silicon, Urine SILICON UR

Patient Preparation: Avoid exposure to gadolinium-based contrast media for 48 hours prior to specimen collection
Specimen Required: Collect: Random urine in a trace metal-free or acid-washed container.
Specimen Preparation: Transport 6 mL urine. (Min: 2.7 mL)
Unacceptable Conditions: Glass containers.
CPT Code(s): 84285
0091222 Silver, Serum or Plasma SILVER SP

Specimen Required: Collect: Royal blue (no additive or EDTA).
Specimen Preparation: Protect from light during collection, storage, and shipment. Transfer 1 mL serum or plasma to a foil-wrapped ARUP
Trace Element-Free Transport Tube (ARUP supply #43116). Available online through eSupply using ARUP Connect™ or contact ARUP Client
Services at (800) 522-2787. (Min: 0.5 mL)
Unacceptable Conditions: Specimens not protected from light. Separator gels or tubes.
Stability: Ambient: 2 weeks (when foil-wrapped); Refrigerated: 2 weeks; Frozen: 2 weeks
CPT Code(s): 83789
0091228 Silver, Urine SILVER URN

Patient Preparation: Avoid exposure to gadolinium-based contrast media for 48 hours prior to specimen collection.
Specimen Required: Collect: Random urine in a trace metal-free container.
Specimen Preparation: Transfer 1 mL urine to a foil-wrapped ARUP Trace Element-Free Transport Tube (ARUP supply #43116). (Min: 0.5 mL)
Protect from light.
CPT Code(s): 83789
0091229 Silver, Whole Blood SILVER BLD

Specimen Preparation: Protect from light. Transport 1 mL whole blood. (Min: 0.5 mL)
Unacceptable Conditions: Specimens not protected from light. Heparinized specimens. Clotted specimens.
CPT Code(s): 83789
2004137 Simian Virus 40 (SV-40) by Immunohistochemistry SV40 IHC

CPT Code(s): 88342
0098467 Sirolimus by Tandem Mass Spectrometry RAPAMUNE

CPT Code(s): 80195
2006403 Smad4 by Immunohistochemistry SMAD4 IHC

Page | 413
CPT Code(s): 88342
0050085 Smith (ENA) Antibody, IgG SMITH

Tube. (Min: 0.2 mL)
CPT Code(s): 86235
2004130 Smooth Muscle Actin (SMA) by Immunohistochemistry SMA IHC

CPT Code(s): 88342
0020379 Sodium, Fecal FE-NA

Specimen Required: Collect: Liquid random stool.
Specimen Preparation: Transfer a 5 g stool to an unpreserved stool transport vial (ARUP Supply #40910). Available online through eSupply using
ARUP Connector contact Client Services at (800) 522-2787. (Min: 1 g) Do not add saline or water to liquefy specimen.
Stability: Ambient: 1 hour; Refrigerated: 2 weeks; Frozen: 6 months
CPT Code(s): 84302
0020154 Sodium, Fluid NA FL

Unacceptable Conditions: Breast milk and salivary fluid. Specimens collected in sodium citrate or sodium fluoride. Contaminated or hemolyzed
specimens. Specimens too viscous to be aspirated by instrument.
Stability: After separation from cellular material: Ambient: 4 days; Refrigerated: 2 weeks; Frozen: 6 months
CPT Code(s): 84302
0020001 Sodium, Plasma or Serum NA

Unacceptable Conditions: Body Fluid (refer to Sodium, Fluid, ARUP test code 0020154). Urine (refer to Sodium, Urine, ARUP test code
0020851). Specimens collected in potassium oxalate, sodium citrate, or sodium fluoride.
CPT Code(s): 84295
0020851 Sodium, Urine U NA

Specimen Preparation: Transport 1 mL aliquot of urine from a well-mixed collection. (Min: 0.2 mL) Record total volume and collection time
Unacceptable Conditions: pH adjusted urine specimens.
CPT Code(s): 84300
Page | 414
0030126 Soluble Fibrin Monomer SFM
Methodology: Qualitative Hemagglutination
Remarks: Activation of specimen due to poor venipuncture technique may cause false-positive results.
Unacceptable Conditions: Serum. Hemolyzed or heat-inactivated specimens.
CPT Code(s): 85366
0055235 Soluble Liver Antigen Antibody, IgG SLA

CPT Code(s): 83516
0081284 Soluble Mesothelin Related Peptides (MESOMARK®) MESO

Because MESOMARK® is a test approved by the FDA as a Humanitarian Use Device, testing should be ordered using the following
procedure(s):
1. The ordering physician must register with the Internal Review Board (IRB) for MESOMARK® testing. Go to www.fdi.com/mesomark to
obtain IRB certification online.
2. The test should be ordered using the ARUP requisition form. The full name of the ordering physician must be included on the ARUP form to
ensure timely testing of the specimen. Specimens submitted with incomplete information may delay specimen testing.
3. Physicians are instructed as follows: ARUP does not accept specimens directly from physician offices. ARUP only accepts specimens from
established clients. To send a specimen to ARUP, contact your local hospital/reference lab to determine if they are an ARUP client and can send
the specimen. If they cannot send the specimens to ARUP, contact ARUP Client Services at (800) 522-2787 to find an ARUP client in your area.
4. Forms and information about MESOMARK® testing, and IRB registration, may be accessed at www.fdi.com/mesomark.
5. ARUP will receive specimens via usual shipping routes, from designated clients. When the specimen arrives, with an accompanying requisition,
the physician's full name will be logged in, if present. If the ordering physician's full name is not present, the specimen is placed on EXCEPT after
evaluation by the Special Chemistry department. The Special Chemistry lab will then contact Fujirebio Diagnostics, Inc. (FDI), who will then
contact the physician for certification. FDI will then notify ARUP in Special Chemistry of completed certification. Special Chemistry will proceed
with testing after certification is completed by the physician.
Collect: Serum separator tube or plain red.
Specimen Preparation: Allow specimen to clot completely at room temperature. Transport 0.2 mL serum. (Min: 0.1 mL)
CPT Code(s): 86316
0070283 Soluble Transferrin Receptor STR

Specimen Required: Collect: Serum separator tube or plasma separator tube. Also acceptable: green (sodium or lithium heparin), lavender (EDTA), or pink (K2EDTA).
Unacceptable Conditions: Contaminated, severely hemolyzed, icteric, or lipemic specimens.
CPT Code(s): 84238
0098192 Somatostatin SOMAT

Methodology: Quantitative Extraction/Radioimmunoassay
Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA). Collect in a pre-chilled tube.
Specimen Preparation: Separate plasma from cells ASAP or within 2 hours of collection. Transfer 1.8 mL plasma to an ARUP Standard
Transport Tube and freeze immediately. (Min: 0.6 mL)
Remarks: CRITICAL FROZEN. Additional specimens must be submitted when multiple tests are ordered. Spin, separate, and freeze
plasma immediately. Do not thaw.
Unacceptable Conditions: Thawed specimens. Grossly hemolyzed or lipemic specimens.
CPT Code(s): 84307
Page | 415
2004133 Somatostatin by Immunohistochemistry SOMATO IHC
CPT Code(s): 88342
0090301 Sotalol SOT

Transport Tube. (Min: 0. 5 mL)
Storage/Transport Temperature: 2 mL serum or plasma at 2-8°C. (Min: 0.8 mL) Submit specimen in an ARUP Standard Transport Tube.
Remarks: Avoid use of separator tubes and gels.
CPT Code(s): 80299
2005906 Special Stain, Acid Fast AFB SS

Methodology: Special Stain
charged slides in a tissue transport kit (ARUP supply #47808). Available online through eSupply using ARUP ConnectTM or contact ARUP
Client Services at (800) 522-2787. (Min: 1 slide).
Remarks: HISTOLOGY SPECIAL STAINS SUBMISSION DETAILS: Submit electronic request. If you do not have electronic ordering
capability, use an ARUP Anatomic Pathology Form (#32960) with an ARUP client number. For additional technical details, contact ARUP Client
Services at (800) 522-2787.
CPT Code(s): 88312
2005981 Special Stain, Alcian Blue - Periodic Acid-Schiff (PAB) PAB SS

charged slides in a tissue transport kit (ARUP supply #47808). Available online through eSupply using ARUP Connect™ or contact ARUP Client
Services at (800) 522-2787. (Min: 1 slide).
Services at (800) 522-2787.
CPT Code(s): 88313
2005900 Special Stain, Alcian Blue pH 2.5 AB 2.5 SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005903 Special Stain, Alcian Blue with Hyaluronidase AB W/H SS

Page | 416
Services at (800) 522-2787.
CPT Code(s): 88313
2005909 Special Stain, Bielschowski BIEL SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005918 Special Stain, Calcium (Von Kossa) CALCIUM SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005921 Special Stain, Colloidal Iron COL FE SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005924 Special Stain, Congo Red CONGO R SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005927 Special Stain, Copper (Rhodanine) COPPER SS

Page | 417
Services at (800) 522-2787.
CPT Code(s): 88313
2005930 Special Stain, Elastin ELASTIN SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005933 Special Stain, Fibrin FIBRIN SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005936 Special Stain, Fite FITE SS

Services at (800) 522-2787.
CPT Code(s): 88312
2005939 Special Stain, Fontana-Masson FONTANA SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005942 Special Stain, Giemsa GIEMSA SS

Page | 418
Services at (800) 522-2787.
CPT Code(s): 88312
2005948 Special Stain, Gram GRAM SS

Services at (800) 522-2787.
CPT Code(s): 88312
2005951 Special Stain, Gridleys GRIDLEY SS

Services at (800) 522-2787.
CPT Code(s): 88312
2005945 Special Stain, Grocott's Methenamine Silver (GMS) GMS SS

Services at (800) 522-2787.
CPT Code(s): 88312
2005912 Special Stain, Halls Bile BILE SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005954 Special Stain, Iron IRON SS

Page | 419
Services at (800) 522-2787.
CPT Code(s): 88313
2005957 Special Stain, Jones JONES SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005960 Special Stain, Luxol Fast Blue LFB SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005966 Special Stain, Melanin Bleach MEL BL SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005969 Special Stain, Methyl Green Pyronin (MPG) MGP SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005963 Special Stain, Modified Giemsa (Diff-Quick) M GIEMS SS

Page | 420
Services at (800) 522-2787.
CPT Code(s): 88312
2005972 Special Stain, Mucicarmine MUCI SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005975 Special Stain, Nissl Substance NISSL SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005978 Special Stain, Oil Red O OIL RED SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005984 Special Stain, Periodic Acid-Schiff (PAS) PAS SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005990 Special Stain, Periodic Acid-Schiff (PAS), Fungus PASF SS

Page | 421
Services at (800) 522-2787.
CPT Code(s): 88312
2005987 Special Stain, Periodic Acid-Schiff (PAS) with Diastase PAS W D SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005993 Special Stain, Phosphotungstic Acid-Hematoxylin (PTAH) PTAH SS

Services at (800) 522-2787.
CPT Code(s): 88313
2005996 Special Stain, Reticulin RETIC SS

Services at (800) 522-2787.
2005999 Special Stain, Steiner STEINER SS

Services at (800) 522-2787.
CPT Code(s): 88312
2006002 Special Stain, Thioflavin S THIO S SS

Page | 422
Services at (800) 522-2787.
CPT Code(s): 88313
2006008 Special Stain, Toluidine Blue TOL BLU SS

Services at (800) 522-2787.
CPT Code(s): 88313
2006011 Special Stain, Trichrome TRI SS

Remarks: SPECIAL STAINS SUBMISSION DETAILS: Submit electronic request. If you do not have electronic ordering capability, use an
ARUP Anatomic Pathology Form (#32960) with an ARUP client number. For additional technical details, contact ARUP Client Services at (800)
522-2787.
CPT Code(s): 88313
2006014 Special Stain, Urate Crystals URATE SS

Services at (800) 522-2787.
CPT Code(s): 88313
0020304 Specific Gravity, Urine UA SP GR

Methodology: Refractometer/Reflectance Spectrophotometry
Specimen Preparation: Transport 10 mL aliquot from a well-mixed urine collection. (Min: 1 mL)
Stability: Ambient: 1 hour; Refrigerated: 24 hours; Frozen: 6 months
CPT Code(s): 81002
0099542 Sperm Antibodies, IgA & IgG SPERM AB

Methodology: Immunobead
(Immunoassay)
Unacceptable Conditions: Room temperature specimens. Seminal fluid.
CPT Code(s): 89325 IgA; 89325 IgG
Page | 423
0098359 Sporothrix Antibody, Serum SPORO AB
Stability: Ambient: Unacceptable; Refrigerated: 2 months; Frozen: 3 years
CPT Code(s): 86671
0081054 Squamous Cell Carcinoma Antigen, Serum SCC

Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 4 months; Frozen: 4 months
CPT Code(s): 86316
2007222 SS18 (SYT) (18q11) Gene Rearrangement by FISH SYT FISH

0050691 SSA (Ro) (ENA) Antibody, IgG SSA

Tube. (Min: 0.2 mL)
CPT Code(s): 86235
0050692 SSB (La) (ENA) Antibody, IgG SSB

Tube. (Min: 0.2 mL)
CPT Code(s): 86235
0099528 ssDNA Antibody, IgG DNA SS

Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum an ARUP Standard Transport Tube.
(Min: 0.1 mL)
CPT Code(s): 86226
0098895 St. Louis Encephalitis Antibody, IgG by IFA, CSF STL G CSF
CPT Code(s): 86653
0050507 St. Louis Encephalitis Antibody, IgG by IFA, Serum ST LOUIS

Page | 424
CPT Code(s): 86653
0098899 St. Louis Encephalitis Antibody, IgM by IFA, CSF STL M CSF
CPT Code(s): 86653
0098732 St. Louis Encephalitis Antibody, IgM by IFA, Serum STL M SER
CPT Code(s): 86653
2002270 ST2, Soluble ST2

Specimen Required: Collect: Serum separator tube, plain red, lavender (EDTA) or pink (K2EDTA).
hours of collection. Transport 1 mL serum or plasma. (Min: 0.2 mL) Avoid repeated freeze/thaws.)
Unacceptable Conditions: Specimen types other than serum or plasma. Specimens stored or transported at room temperature for more than 48
hours.
CPT Code(s): 83520
0092582 Stachybotrys chartarum/ATRA Panel II STACHPANII

CPT Code(s): 86003; 86671 x2
0060124 Staphylococcus Surveillance Culture MC STAPH

Specimen Required: Collect: Any site or fluid.
Specimen Preparation: Fluid: Transfer specimen to a sterile container.
Swab: Place in bacterial transport media.
Remarks: Specimen source preferred. All Staphylococcus aureus isolates are screened for methicillin susceptibility.
0060134 Stool Culture and E. coli Shiga-like Toxin by EIA MC SSC

Specimen Preparation: Preserve 5 mL stool in enteric transport media (Cary-Blair) immediately (ARUP supply #29799). Available online through
Unacceptable Conditions: Multiple specimens (more than one in 24 hours). Delayed transport without use of appropriate preservative.
Stability: Unpreserved: Ambient: 2 hours; Refrigerated: Unacceptable; Frozen: Unacceptable
Preserved: Ambient: 72 hours; Refrigerated: 72 hours; Frozen: Unacceptable
CPT Code(s): 87045 Salmonella/Shigella culture; 87046 Campylobacter culture
0060135 Stool Culture, Campylobacter MC CAMP

CPT Code(s): 87046
Page | 425
0060136 Stool Culture, Vibrio MC VIB
CPT Code(s): 87046
0060137 Stool Culture, Yersinia MC YERS

Unacceptable Conditions: Multiple specimens (more than one in 24 hours).Delayed transport without use of appropriate preservative.
CPT Code(s): 87046
0060126 Streptococcus (Group A) Culture MC STREP

Specimen Required: Collect: Throat swab.
Specimen Preparation: Place swab in bacterial transport media.
CPT Code(s): 87081 presumptive identification. If definitive identification is required, add 87077.
0028903 Streptococcus (Group A) Rapid with Reflex to Culture STREP SCN

Methodology: Immunoassay/Culture
Specimen Required: Collect: Throat swabs using a Rayon or Dacron® swab with a plastic shaft.
Specimen Preparation: Transport two throat swabs, either dry or in a liquid transport system containing Modified Stuart's Medium (e.g., culturette
or culturette II).
Unacceptable Conditions: Calcium alginate swabs or swabs with a wooden shaft. Frozen specimens.
CPT Code(s): 87880 Direct test; if reflexed, add 87081 Culture
0060705 Streptococcus Group B by PCR GBS PCR

Specimen Required: Collect: Rectal or vaginal swab.
Specimen Preparation: Transfer swab to Liquid Stuart media (ARUP supply: #43875). Available online through eSupply using ARUP Connect™
or contact ARUP Client Services at (800) 522-2787.
CPT Code(s): 87653
0050725 Streptococcus pneumoniae Antibodies, IgG (14 serotypes) PNEUMO AB

Specimen Required: Collect: Serum separator tube. Post-immunization specimen should be drawn 30 days after immunization and, if shipped separately, must be
received within 60 days of pre-immunization specimen.
Tube. (Min: 0.25 mL) MARK SPECIMENS CLEARLY AS "PRE" OR "POST" SO SPECIMENS WILL BE SAVED AND TESTED
SIMULTANEOUSLY.
2005779 Streptococcus pneumoniae Antibodies, IgG (23 Serotypes) PNEUMO 23

SIMULTANEOUSLY.
Storage/Transport Temperature: Refrigerated. "Pre" and "post" pneumococcal vaccine specimens can be submitted separately or together for
testing.
Page | 426
2005791 Streptococcus pneumoniae Antibodies, IgG, Conjugate Vaccine (12 serotypes) PNEUMO 12
received within 60 days of pre-immunization specimen
SIMULTANEOUSLY.
testing
Unacceptable Conditions: Plasma or other body fluids. Contaminated, hemolyzed, or severely lipemic specimens
CPT Code(s): 86317 X 12
2005790 Streptococcus pneumoniae Antibodies, IgG, Polysaccharide Vaccine (11 serotypes) PNEUMO 11
SIMULTANEOUSLY.
testing.
CPT Code(s): 86317 X 11
0060228 Streptococcus pneumoniae Antigen, Urine SPN AG

Specimen Preparation: Mix specimen well. Transfer 4 mL urine to an ARUP Standard Transport Tube. (Min: 1 mL)
Stability: Stability: Ambient: 24 hours; Refrigerated: 2 weeks; Frozen: 2 weeks
CPT Code(s): 87899
0061162 Streptococcus pneumoniae Antigen, CSF SPN CSF

Unacceptable Conditions: Specimen types other than CSF.
Stability: Stability: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 1 week
CPT Code(s): 87899
0050642 Streptococcus pyogenes, Group A Antibody (Streptozyme®) with Reflex to Titer STZ R
Methodology: Semi-Quantitative Hemagglutination
CPT Code(s): 86403 Streptococcus screen; if reflexed add 86406 Streptococcus titer
0050095 Streptolysin O Antibody (ASO) ASO

Tube. (Min: 0.4 mL)
Unacceptable Conditions: Heparinized plasma. Hemolyzed specimens.
CPT Code(s): 86060
0050746 Striated Muscle Antibody, IgG with Reflex to Titer STM R

CPT Code(s): 86255 Striated muscle; if reflexed, add 86256 Striated muscle titer
0099564 Strongyloides Antibody, IgG by ELISA, Serum STRONGY

Specimen Preparation: Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min. 0.05 mL)
Page | 427
Unacceptable Conditions: Bacterially contaminated, heat-inactivated, hemolyzed, icteric, or lipemic specimens.
CPT Code(s): 86682
0091574 Strychnine STRYCHNI S

CPT Code(s): 82101
0091075 Strychnine, Quantitative, Urine STRYCH UR

CPT Code(s): 82491
0098275 Substance P, EIA SUB P

Specimen Preparation: Separate serum from cells within 10 minutes. Transfer two 1 mL aliquots of serum into ARUP Standard Transport Tubes
and freeze immediately. (Min: 0.5 mL per aliquot)
CPT Code(s): 83520
0049040 Sudan Black B Stain SUDAN

Methodology: Stain
Specimen Required: Collect: Lavender (EDTA) or green (sodium or lithium heparin). OR heparinized bone marrow aspirate.
Specimen Preparation: Blood: Transport 5 mL whole blood AND 6 unfixed, air-dried, and unstained push smears made from the blood submitted.
(Min: 1 mL AND 6 unfixed smears).
OR Bone Marrow: Transport 1 mL heparinized aspirate AND 6 unfixed, air-dried, and unstained bone marrow aspiarate smears. (Min: 1 mL
AND 6 unfixed smears)
Storage/Transport Temperature: Room temperature. Specimens should be received within 24 hours of collection; testing must be performed
Unacceptable Conditions: Stool. Fixed blood or bone marrow smears.
CPT Code(s): 88313
0051284 Sulfate-3-Glucuronyl Paragloboside (SGPG) Antibody, IgM SGPG

Tube. (Min: 0.1 mL)
Unacceptable Conditions: Plasma or urine. Contaminated, heat-inactivated, hemolyzed, icteric, or severely lipemic specimens.
CPT Code(s): 83516
0081102 Sulfate, Urine U SO4

Specimen Preparation: Transfer 4 mL urine to an ARUP Standard Transport Tube. (Min: 2 mL) Record total volume and collection time on tube
and test request form.
Unacceptable Conditions: Room temperature specimens. Any sample except urine.
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable unless pH is less than 2, then 1 week; Frozen: 1 month
CPT Code(s): 84392
0091568 Sulfhemoglobin, Whole Blood SULFHEMOGL

Patient Preparation: Collect during or at end of work shift.
Specimen Preparation: DO NOT FREEZE. Transfer 1 mL whole blood to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Remarks:
Unacceptable Conditions: Room temperature or frozen specimens.
Stability: Ambient: Undetermined; Refrigerated: 2 weeks; Frozen: Unacceptable
CPT Code(s): 83060
0020044 Sulfonamides (Sulfas) SULFA

Page | 428
Patient Preparation: Draw peak specimen 2 hours post dose.
Remarks: Indicate which sulfa drug is being administered.
CPT Code(s): 80299
2004279 Sulfonylurea Hypoglycemics Panel (Qualitative), Serum or Plasma SULFON PAN

Specimen Preparation: Separate from cells within 2 hours of draw and transfer 1 mL serum or plasma (Min: 0.4 mL) into an ARUP Standard
Transport Tube.
Storage/Transport Temperature: Frozen; refrigerated and ambient also acceptable.
CPT Code(s): 83788
0091100 Sulfonylurea Hypoglycemics Panel (Quantitative), Urine SULFON UR

Methodology: Quantitative Liquid Chromatography/Tandem Mass Spectrometry
Storage/Transport Temperature: Refrigerated. Also acceptable: Frozen
CPT Code(s): 82542
2004139 Synaptophysin by Immunohistochemistry SYNAPT IHC

CPT Code(s): 88342
0040114 SYT-SSX t(X;18) Translocations by RT-PCR SYT-SSX

Specimen Preparation: Formalin fix (10 percent neutral buffered formalin) and paraffin embed tissue. Protect from excessive heat. Transport 4 ten
micron shavings. Also acceptable: Tissue block; will be returned after testing..
Unacceptable Conditions: No tumor in tissue. Specimens fixed/processed in alternative fixatives (alcohol, Prefer®) or heavy metal fixatives.
Decalcified specimens. Tissue on slides.
CPT Code(s): 83891 Isolation; 83902 Reverse transcription; 83898 x2 Amplification; 83912 Interpretation and report - Additional CPT code modifiers may be
0093199 T-Cell Clonality by Flow Cytometry Analysis of TCR V-Beta TCR V-BETA
Storage/Transport Temperature: Room temperature. Specimen should be received within 24 hours of collection for optimal viability.
Remarks: Previous leukemia/lymphoma phenotyping is required. If prior studies were not performed at ARUP, the outside flow cytometry report
and histograms must accompany the specimen. If outside reports and histograms are not provided, a Neoplastic T-cell Evaluation test (ARUP test
code 0093000) will be added, at an additional cost. In addition, please provide CBC, Wright's stained smear, clinical history, differential
diagnosis, and any relevant pathology reports.
Stability: Ambient: 48 hours; Refrigerated 48 hours; Frozen: Unacceptable
CPT Code(s): 88184 First marker; 88185 x23 Each additional marker; 88189 Interpretation for 16 or more markers.
2004148 T-cell Intracytoplasmic Antigen (TIA-1) by Immunohistochemistry TIA1 IHC

Page | 429
CPT Code(s): 88342
0070135 T3 Uptake T3 UP
Specimen Preparation: Allow serum to clot completely at room temperature. Separate serum or plasma from cells ASAP or within 2 hours of
Stability: After separation of cells: Ambient: 24 hours; Refrigerated: 8 days; Frozen: 3 months
CPT Code(s): 84479
0090612 Tacrolimus by Tandem Mass Spectrometry TACRO

CPT Code(s): 80197
2003133 Tapentadol and Metabolite - Confirmation/Quantitation - Serum or Plasma TAPENTA SP

freeze/thaw cycles.
CPT Code(s): 83925
2003128 Tapentadol and Metabolite - Confirmation/Quantitation - Urine TAPENTA UR

Stability: Ambient: 1 week; Refrigerated: 1 month; Frozen: 3 years.
CPT Code(s): 83925
0049060 Tartrate Resistant Acid Phosphatase Stain TRAP

Specimen Required: Collect: Lavender (EDTA) or green (sodium or lithium heparin) or heparinized aspirate of bone marrow.
Specimen Preparation: Transport 6 unfixed, air-dried, and unstained push smears AND 5 mL whole blood (smears should be made from the blood
submitted). OR transport 6 unfixed, air-dried, and unstained bone marrow aspirate smears. Protect from light.
Remarks: Blood specimens must be received within 24 hours of collection; testing must be performed within 48 hours of collection.
well-prepared unfixed smears if greater than 48 hours.
CPT Code(s): 88319
2004160 Tartrate-Resistant Acid Phosphatase (TRAP) by Immunohistochemistry TRAP IHC

CPT Code(s): 88342
0051428 Tay-Sachs (HEXA) 7 Mutations HEXA

Page | 430
CPT Code(s): 83891 Isolation; 83892 x2 Enzymatic digestion; 83900 Amplification multiplex (first two amplifications); 83901 x3 Amplification multiplex
(each additional amplification); 83914 x7 Mutation identification; 83909 Separation and identification; 83912 Interpretation and report -
0051429 Tay-Sachs (HEXA) 7 Mutations, Fetal HEXA FE

CPT Code(s): 83891 Isolation; 83892 x2 Digestion; 83900 Multiplex amplification (first two amplifications); 83901 x3 Additional amplification; 83914 x7
Extension; 83909 Capillary electrophoresis; 83912 Interpretation and report. FCC: 83900 Multiplex amplification (first two sequences); 83901
x14 Additional amplification; 83909 Capillary electrophoresis. If MCC MAT (0050608) is performed: 83891 Isolation; 83900 Multiplex
amplification; 83901 x14 Additional amplification; 83909 Capillary electrophoresis; 83912 Interpretation and report - Additional CPT code
0055596 T-Cell Clonality Assessment by Restriction Fragment-Southern Blot Hybridization TCRFSBHF

Methodology: Restriction Fragment Southern Blot Hybridization
Specimen Required: Collect: Lavender (EDTA) or bone marrow (EDTA) OR fresh tissue.
Specimen Preparation: : Whole blood: Transport 5 mL (Min: 1 mL) OR Bone marrow: Transport 3 mL (Min: 1 mL) OR Fresh tissue: Freeze
immediately. Transport 100 mg or 0.5-2.0 cm3 tissue.
Stability: Whole blood OR Bone marrow: Ambient: 24 hours; Refrigerated: 5 days; Frozen: Unacceptable Fresh tissue: Ambient:
Unacceptable; Refrigerated: 2 hours; Frozen: 1 year
CPT Code(s): 83891 Isolation; 83892 x3 Digestion; 83894 Gel Electrophoresis; 83897 Southern transfer; 83896 Nucleic acid probe; 83912 Interpretation and
0055567 T-Cell Clonality Screening by PCR T CELL-F

Specimen Required: Collect: Lavender (EDTA) or bone marrow (EDTA) OR tissue.
Specimen Preparation: Whole blood: Transport 5 mL (Min: 1 mL) OR Bone marrow: Transport 3 mL (Min: 1 mL)OR Fresh tissue: Freeze
immediately. Transport 100 mg or 0.5-2.0 cm3 tissue OR FFPE tumor tissue: Formalin fix (10 percent neutral buffered formalin) and paraffin
Unacceptable Conditions: Serum. Frozen whole blood or bone marrow. Clotted or grossly hemolyzed specimens. Specimens fixed/processed in
alternative fixatives or heavy metal fixatives (B-4 or B-5) or tissue sections on slides. Decalcified specimens.
Stability: Whole blood OR Bone marrow: Ambient: 24 hours; Refrigerated: 5 days; Frozen: Unacceptable Fresh Tissue: Ambient:
Unacceptable; Refrigerated: 2 hours; Frozen: 1 year FFPE tumor tissue: Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable
CPT Code(s): 83891 Isolation; 83898 x4 Amplification; 83896 x3 Nucleic acid probes; 83909 x4 Capillary electrophoresis; 83912 Interpretation and report -
2006284 T-Cell Clonality Screening by PCR with Reflex to T-Cell Clonality Assessment by Restriction Fragment- TCELL RFLX
Southern Blot Hybridization
Methodology: Polymerase Chain Reaction/Capillary Electrophoresis/Restriction Fragment Southern Blot Hybridization
Specimen Required: Collect: Lavender (EDTA) OR bone marrow (EDTA) OR fresh tissue.
Specimen Preparation: Whole blood: Transport 5 mL (Min: 1 mL)OR Bone marrow: Transport 3 mL (Min: 1 mL) OR Fresh tissue: Freeze
immediately. Transport 100 mg or 0.5-2.0 cm3 tissue.
Stability: Whole blood OR Bone marrow: Ambient: 24 hours; Refrigerated: 5 days; Frozen: Unacceptable Fresh Tissue: Ambient:
Unacceptable; Refrigerated: 2 hours; Frozen: 1 year
CPT Code(s): 83891 Isolation; 83898 x4 Amplification; 83896 x3 Nucleic acid probes; 83909 x4 Capillary electrophoresis; 83912 Interpretation and report. If
reflexed, add 83892 x3 Enzymatic digestion; 83894 Gel separation; 83897 Southern transfer; 83896 Nucleic acid probe; 83912 Interpretation and
0055346 TCF3-PBX1 (E2A-PBX1) Translocation, t(1;19) by RT-PCR E2A PBX1

Methodology: Reverse Transcription Polymerase Chain Reaction/Polymerase Chain Reaction
hours of collection due to lability of RNA.
Page | 431
CPT Code(s): 83891 Isolation; 83902 Reverse transcription; ; 83898 x2 Amplification; 83896 x4 Nucleic acid probes; 83912 Interpretation and report -
2004142 TdT by Immunohistochemistry TDT IHC

CPT Code(s): 88342
0050775 Teichoic Acid Antibodies TEICHOIC

Methodology: Semi-Quantitative Immunodiffusion
Tube. (Min: 0.4 mL)
CPT Code(s): 86329
0025009 Tellurium, Urine TE U

CPT Code(s): 83018
0091386 Temazepam TEMAZEPAM

CPT Code(s): 80154
0091561 Terbutaline, Serum or Plasma TERBUTALIN

(Min: 4 mL)
Stability: Ambient: 2 weeks; Refrigerated: 1 month; Frozen: 1 month
CPT Code(s): 80299
0070130 Testosterone, Adult Male TESTOS

Patient Preparation: Collect specimen between 6-10 a.m.
Specimen Required: Collect: Serum separator tube or green (lithium heparin).
Specimen Preparation: Transport 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.5 mL) Also acceptable: EDTA plasma.
CPT Code(s): 84403
0070102 Testosterone, Bioavailable and Sex Hormone Binding Globulin (Includes Total Testosterone), Adult Male BIO T
The concentrations of free and bioavailable testosterone are derived from mathematical expressions based on constants for the binding of
testosterone to albumin and/or sex hormone binding globulin.
Page | 432
CPT Code(s): 84403 Total testosterone; 84270 SHBG
0081057 Testosterone, Bioavailable & Sex Hormone Binding Globulin (Includes Total Testosterone), Females or BIO T MASS
Children
Methodology: Quantitative High Performance Liquid Chromatography-Tandem Mass Spectrometry/Electrochemiluminescent Immunoassay
The concentrations of free and bioavailable testosterone are derived from mathematical expressions based on constants for the binding of
testosterone to albumin and/or sex hormone binding globulin.
Remarks: This test is suggested for women and children due to an improved sensitivity of testosterone by LC-MS/MS.
CPT Code(s): 84403 Total testosterone; 84270 SHBG
0081058 Testosterone, Females or Children TESTOS MAS

CPT Code(s): 84403
0070111 Testosterone Free, Adult Male FREE T2

Total Testosterone and SHBG are measured and free testosterone is estimated from these measurements.
CPT Code(s): 84402
2003246 Testosterone, Free, Adult Males by ED/LC-MS/MS FREE T TMS

Specimen Preparation: Separate from cells ASAP or within 2 hours of collection. Transport 1 mL serum or plasma. (Min: 0.4 mL)
CPT Code(s): 84402
2004246 Testosterone Free & Total by ED/LC-MS/MS (Free) and LC-MS/MS (Total), Adult Males TE F&T ED
mL)
CPT Code(s): 84402 Testosterone Free, 84403 Testosterone Total
0070109 Testosterone, Free and Total (Includes Sex Hormone Binding Globulin), Adult Male FREE T
The concentration of free testosterone is derived from a mathematical expression based on the constant for the binding of testosterone to sex
hormone binding globulin.
Specimen Preparation: Separate serum or plasma from cells immediately after collection. Transfer 1 mL serum or plasma to an ARUP Standard
Page | 433
CPT Code(s): 84403 Total testosterone, 84270 SHBG
0081056 Testosterone, Free & Total (Includes Sex Hormone Binding Globulin), Females or Children TESTOS F&T
The concentration of free testosterone is derived from a mathematical expression based on the constant for the binding of testosterone to sex
hormone binding globulin.
CPT Code(s): 84403 Total testosterone, 84270 SHBG
0081059 Testosterone Free, Females or Children TESTOS FR

Total Testosterone and SHBG are measured and free testosterone is estimated from these measurements.
CPT Code(s): 84402
2004772 Testosterone, Urine TESTOS UR

Specimen Preparation: Do not use additives or preservatives. Transfer one 5 mL aliquot from a well-mixed 24-hour collection to ARUP Standard
Transport Tubes. (Min: 2.1 mL) Record total volume on transport tube and test request form.
CPT Code(s): 84403
0050535 Tetanus Antibody, IgG TETANUS

Specimen Required: Collect: Serum separator tube. "Post" specimen should be drawn 30 days after immunization.
Tube. (Min: 0.2 mL) "Pre" and "post" vaccine specimens can be submitted separately or together for testing; if shipped separately, "post"
specimen must be received within 60 days of "pre" specimen. Mark specimens clearly as "Pre-Vaccine" or "Post-Vaccine".
CPT Code(s): 86317
0025019 Thallium, Urine THALU

CPT Code(s): 83018
0099610 Thallium, Whole Blood THALB

CPT Code(s): 83018
Page | 434
0051508 Thanatophoric Dysplasia, Types 1 and 2 (FGFR3) 13 Mutations, Fetal TD PAN FE
Maternal Specimen: Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B).
Interpretation and report. FCC: 83900 Multiplex amplification; 83901 x14 Additional amplification; 83909 Capillary electrophoresis. For MCC
Maternal cell (0050608) add: 83891 Isolation; 83900 Multiplex amplification; 83901 x14 Additional amplification; 83909 Capillary
electrophoresis; 83912 Interpretation and report - Additional CPT Codes may be required for procedures performed to test for oncologic or
0051506 Thanatophoric Dysplasia, Types 1 and 2 (FGFR3) 13 Mutations TD PAN

0090265 Theophylline THEO

0.2 mL)
Remarks: Lipemic specimens may cause an underestimation of Theophylline level
Unacceptable Conditions: Lipemic specimens
Stability: After separation from cells: Refrigerated: 3 months; Frozen: 3 months
CPT Code(s): 80198
0090064 Thiocyanate, 24-Hour Urine THIO-U 24

Specimen Preparation: Transport 25 mL aliquot from a well-mixed, 24-hour urine. (Min: 2 mL) Record total volume and collection time on
transport tube and test request form.
Unacceptable Conditions: Collection time less than 6 hours.
CPT Code(s): 84430
0090063 Thiocyanate, Random Urine THIO-U

Specimen Preparation: Mix specimen well. Transport 20 mL aliquot of urine. (Min: 2 mL)
CPT Code(s): 84430
0090061 Thiocyanate, Serum THIO

Stability: After separation from cells: Ambient: 5 days; Refrigerated: 5 days; Frozen: 5 days
CPT Code(s): 84430
Page | 435
2002575 Thiopurine Metabolites THIOP MET
Methodology: Qualitative High Pressure Liquid Chromatography
(High Performance Liquid Chromatography)
Specimen Preparation: Transport 5 mL whole blood (Min: 2 mL)
Remarks: Include drug name and dosage.
0092066 Thiopurine Methyltransferase, RBC TPMT RBC

Methodology: Enzymatic/High Performance Liquid Chromatography
Unacceptable Conditions: Specimens collected in sodium fluoride/potassium oxalate (gray). Hemolyzed, frozen, or room temperature specimens.
CPT Code(s): 82657 Enzymatic
0099904 Thiothixene THIOT

Remarks: Separate serum or plasma from cells ASAP. Avoid use of separator tubes and gels.
Stability: After separation from cells: Ambient: 24 hours; Refrigerated: 5 days; Frozen: 1 month (avoid freeze/thaw cycles)
CPT Code(s): 80299
0030260 Thrombin Time with Reflex to Thrombin Time 1:1 Mix TT

CPT Code(s): 85670 Thrombin time; if reflexed, add 85670 Thrombin time 1:1 mix
0030268 Thrombotic Risk (Acquired) Reflexive Panel HYPERCOAG

Methodology: Electromagnetic Clot Detection/Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Immunoturbidimetry/Quantitative Enzymatic
Specimen Required: Collect: Lt. blue (sodium citrate) for lupus and d-dimer. AND serum separator tube for cardiolipin. AND serum separator tube OR green (sodium
or lithium heparin) for homocysteine.
Specimen Preparation: Transfer two 2 mL aliquots of platelet-poor plasma. AND 2 mL serum. AND 1 mL plasma to individual ARUP Standard
Transport Tubes.
CPT Code(s): 85610 PT-D; 85730 PTT-D; 85613 dRVVT; 86147 X2 Cardiolipin G/M; 85379 D-dimer; 83090 Homocysteine. If PTT is abnormal, add 85670
Thrombin Time. If Thrombin time is abnormal, add 85635 Reptilase Time. If Reptilase Time is normal, add PTT Heparin Neutralization 85730
and 85525. If PTT Heparin Neutralization is abnormal, add 85732 PTT 1:1 mix. If PTT 1:1 mix is abnormal, add 85597 Platelet neutralization
procedure (PNP). If dRVVT is abnormal, add 85613 dRVVT 1:1 mix. If dRVVT 1:1 mix is abnormal, perform 85613 dRVVT confirmation. If
PNP and dRVVT conf are normal, add 85598 Hexagonal Phospholipid Neutralization.
0056200 Thrombotic Risk, DNA Panel THROMDNA

Specimen Required: Collect: Lavender (EDTA) or pink (K2 EDTA). Also acceptable: Yellow (ACD Solution A), lt. blue (sodium citrate), or green (sodium or lithium
heparin).
Unacceptable Conditions: Serum. Frozen specimens. Clotted or severely hemolyzed specimens.
CPT Code(s): Refer to individual components.
Page | 436
0030133 Thrombotic Risk, Inherited Etiologies (Most Common) with Reflex to Factor V Leiden THROM COM
Methodology: Electromagnetic Clot Detection/Quantitative Enzymatic/Polymerase Chain Reaction/Fluorescence Monitoring
Patient Preparation: Fasting specimen preferred for homcysteine (green, sodium or lithium heparin).
Specimen Required: Collect: Lt. blue (sodium citrate) AND lavender (EDTA) or pink (K2EDTA) AND green (sodium or lithium heparin).
Specimen Preparation: Transport two 2 mL aliquots platelet-poor plasma (sodium citrate) (Min: 1 mL/aliquot) AND 1 mL plasma (sodium or
lithium heparin) (Min: 0.4 mL) AND 5 mL whole blood (EDTA).
Storage/Transport Temperature: Platelet-poor Plasma: CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are
ordered.
Plasma: Frozen.
Whole Blood: Refrigerated.
CPT Code(s): 85730 PTT; 85240 F8; 83090 tHcy; 83891 Isolation; 83898 Amplification; 83896 Nucleic acid probes; 83912 Int/report; 85307 APC; if reflexed,
add 83891 Isolation; 83898 Amplification; 83896 Nucleic acid probes; 83912 Int/report - Additional CPT code modifiers may be required for
0030177 Thrombotic Risk, Inherited Etiologies (Uncommon) THROMUNCOM

Methodology: Electromagnetic Clot Detection/Microlatex Particle-Mediated Immunoassay/Chromogenic Assay
Specimen Preparation: Transfer two 2 mL aliquots of platelet-poor plasma to ARUP Standard Transport Tubes. (Min: 1 mL/aliquot)
Unacceptable Conditions: Serum or non-sodium citrate plasma. Room temperature specimens.
CPT Code(s): 85610 PT; 85730 PTT; 85303 Protein CF; 85306 Protein S free; 85300 Antithrombin
0050105 Thyroglobulin Antibody ATHYG

Specimen Preparation: Transfer 0.5 mL serum to an ARUP Standard Transport Tube. (Min: 0.3 mL) Also acceptable: Heparinized plasma.
Unacceptable Conditions: EDTA plasma. Grossly hemolyzed or lipemic specimens.
Stability: After separation from cells: Ambient 48 hours; Refrigerated: 1 week; Frozen: 6 months
CPT Code(s): 86800
2004145 Thyroglobulin by Immunohistochemistry THYRO IHC

CPT Code(s): 88342
2006550 Thyroglobulin by LC-MS/MS, Serum or Plasma THYROG MS

Specimen Required: Collect: Serum separator tube or green (sodium or lithium heparin), Potassium EDTA
Specimen Preparation: Separate from cells: Transport 1.5 mL serum or plasma. (Min: 0.7 mL)
Storage/Transport Temperature: Refrigerated or Frozen.
Unacceptable Conditions: Samples left ambient for greater than 1 day
Stability: After separation from cells: Ambient: 1 day; Refrigerated: 1 week; Frozen: 1 year
CPT Code(s): 84432
0020753 Thyroglobulin, Fine Needle Aspiration (FNA) THYROG FNA

Specimen Required: Collect: Fine needle aspiration in saline. Also acceptable: Non-viscous body fluids.
Specimen Preparation: Centrifuge to remove cellular material. Specimen must be non-viscous and free of particulate matter. Transport 0.5 mL
saline needle rinse. (Min: 0.5 mL) Also acceptable: Heparinized specimens.
Unacceptable Conditions: Breast milk and salivary fluid. Specimens containing EDTA. Viscous specimens.
CPT Code(s): 84432
Page | 437
2006685 Thyroglobulin, Serum or Plasma with Reflex to LC-MS/MS or CIA THYROGRFX
Methodology: Quantitative Chemiluminescent Immunoassay/High Performance Chromatography-Tandem Mass
Unacceptable Conditions: EDTA or K2EDTA Plasma. Any fluid other than noted above. (See Thyroglobulin, Fine Needle Aspiration (FNA)
(ARUP test code 0020753) for ordering alternate fluids).
CPT Code(s): 86800 Thyroglobulin antibody; 84432 Thyroglobulin reflex
0050645 Thyroid Antibodies THYRO

Unacceptable Conditions: Grossly hemolyzed or lipemic specimens. EDTA plasma.
CPT Code(s): 86376 Thyroid peroxidase antibody; 86800 Thyroglobulin antibody
0070141 Thyroid Panel T7

Specimen Required: Collect: Serum separator tube or plasma separator tube. Also acceptable: Lavender (EDTA), pink (K2EDTA), or green (sodium or lithium
heparin).
Stability: After separation of cells: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 1 month
CPT Code(s): 84479 T3 Uptake; 84436 Thyroxine
0050075 Thyroid Peroxidase (TPO) Antibody AMICR

Specimen Required: Collect: Serum separator tube. Also acceptable: Lavender (EDTA), pink (K2 EDTA), or green (sodium or lithium heparin).
CPT Code(s): 86376
0070116 Thyroid Releasing Hormone (TRH) Stimulation of Prolactin, 0 Minutes PROLAC 0

Specimen Required: Collect: Serum separator tube or plasma separator tube. Also acceptable: Green (sodium or lithium heparin). Collect separate tube for each timed
specimen.
collection. Transfer 1 mL serum or plasma per timed specimen to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Stability: After separation of cells: Ambient: 8 hours; Refrigerated: 48 hours; Frozen: 3 months
CPT Code(s): 84146

specimen.
CPT Code(s): 84146

specimen.
CPT Code(s): 84146

specimen.
Page | 438
CPT Code(s): 84146
0070269 Thyroid Releasing Hormone (TRH) Stimulation of TSH, Panel TSH STIM
Patient Preparation: Collect specimens at 0, 30, and 60-minute intervals, post TRH administration (three timed specimens).
Specimen Required: Collect: Serum separator tube or plasma separator tube. Collect separate tube for each time point. Also acceptable: Lavender (EDTA) or green
(sodium or lithium heparin).
collection. Transfer 1 mL serum or plasma per interval to individual ARUP Standard Transport Tubes. (Min: 0.5 mL/interval)
CPT Code(s): 80438
0070145 Thyroid Stimulating Hormone TSH

CPT Code(s): 84443
0070225 Thyroid Stimulating Hormone 3rd Generation TSH 3

CPT Code(s): 84443
2002734 Thyroid Stimulating Hormone Receptor Antibody (TRAb) TR AB

Specimen Preparation: Allow serum separator to sit for 15-20 minutes at room temperature for proper clot formation. Centrifuge and separate
serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.3 mL)
Unacceptable Conditions: Plasma. Grossly hemolyzed or lipemic specimens.
CPT Code(s): 83520
2006108 Thyroid Stimulating Hormone with reflex to Free Thyroxine TSHREFLEX

CPT Code(s): 84443; if reflexed 84439
0099430 Thyroid Stimulating Immunoglobulin TSI

Methodology: Quantitative Bioassay/Quantitative Chemiluminescent Immunoassay
CPT Code(s): 84445
2004166 Thyroid Transcription Factor (TTF-1) by Immunohistochemistry TTF1 IHC

Page | 439
CPT Code(s): 88342
Thyrotropin Releasing Hormone
0070140 Thyroxine T4
Specimen Required: Collect: Serum separator tube or plasma separator tube. Also acceptable: Lavender (EDTA).
CPT Code(s): 84436
0099728 Thyroxine Antibody ANTI-T4

Methodology: Quantitative Radiobinding Assay
Unacceptable Conditions: Glass containers. Grossly hemolyzed or lipemic specimens.
CPT Code(s): 83519
0070410 Thyroxine Binding Globulin TBG

Unacceptable Conditions: Plasma, tissue or urine. Grossly hemolyzed or lipemic specimens.
CPT Code(s): 84442
0093244 Thyroxine, Free by Equilibrium Dialysis/HPLC-Tandem Mass Spectrometry FT4 ED-TMS

CPT Code(s): 84439
0070138 Thyroxine, Free (Free T4) FT4

Specimen Required: Collect: Serum separator tube or plasma separator tube. Also acceptable: Green (sodium or lithium heparin) or lavender (EDTA).
CPT Code(s): 84439
0091541 Tiagabine, Serum or Plasma TIAGABIN S

Patient Preparation: Trough collection.
Specimen Required: Collect: Plain red or green (sodium or lithium heparin).
Storage/Transport Temperature: Room temperature. Also acceptable: Refrigerated or frozen
CPT Code(s): 80299
2006502 Tick Identification with Reflex to Borrelia Species by PCR (Lyme Disease) TICK ID
Methodology: Qualitative Microscopy/Qualitative Real-Time Polymerase Chain Reaction
Specimen Required: Collect: Full intact tick, dead
Specimen Preparation: Transport tick in 70 percent ethanol in an ARUP Standard Transport Tube. (Min: 1 tick)
Storage/Transport Temperature: Room temperature. Also acceptable: Refrigerated
Unacceptable Conditions: Dry specimens. Preservative other than 70 percent ethanol.
0091585 Tin Total, Serum or Plasma TIN SP

Page | 440
CPT Code(s): 83018
0091423 Tin Total, Urine TIN UR

Specimen Required: Collect: Random urine in trace metal free or acid washed plastic container.
CPT Code(s): 83018
0091555 Tin, Total, Whole Blood TIN BLD

Specimen Required: Collect: Royal blue (Trace metal-free EDTA).
Unacceptable Conditions: Clotted specimens.
Stability: 2 weeks; Refrigerated: 2 weeks; Frozen: 2 weeks
CPT Code(s): 83018
0060127 Tissue Culture and Gram Stain MC TIS

Specimen Required: Collect: Tissue or biopsy.
Specimen Preparation: Transfer tissue to a sterile container and place on gauze moistened with sterile non-bacteriostatic saline to prevent drying.
Also acceptable: Transfer to anaerobe transport media (ARUP supply #16426). Available online through eSupply using ARUP Connect™ or
Unacceptable Conditions: Formalinized specimens. Dry specimens.
CPT Code(s): 87070 Aerobic culture, 87176 Homogenization
0099187 Tissue Plasminogen Activator, Antigen TPA AG

Specimen Preparation: Separate plasma from cells and freeze ASAP. Transfer 1 mL platelet-poor plasma to an ARUP Standard Transport Tube.
(Min: 0.5 mL)
Unacceptable Conditions: Serum. Specimens collected in sodium fluoride or heparin.
CPT Code(s): 85415
0097772 Tissue Thromboplastin Inhibition Test TTIT

Specimen Preparation: Transfer 1 mL plasma to an ARUP Standard Transport Tube. (Min: 0.5 mL)
CPT Code(s): 85705
0056009 Tissue Transglutaminase Antibody, IgG TTG G

Tube. (Min: 0.5 mL)
Unacceptable Conditions: Plasma. Hemolyzed or severely lipemic specimens.
CPT Code(s): 83516
0097709 Tissue Transglutaminase (tTG) Antibody, IgA TTG

Tube. (Min: 0.3 mL)
Unacceptable Conditions: Plasma or urine. Contaminated, heat-inactivated, or severely hemolyzed specimens.
CPT Code(s): 83516
0050734 Tissue Transglutaminase (tTG) Antibody, IgA with Reflex to Endomysial Antibody, IgA by IFA EMA R
Page | 441
Tube. (Min: 0.3 mL)
Unacceptable Conditions: Urine or plasma. Contaminated, heat-inactivated, or severely hemolyzed specimens.
CPT Code(s): 83516 tTG IgA; if reflexed, add 86256 EMA IgA by IFA
0091434 Titanium, Serum or Plasma TITANIU SP

Specimen Required: Collect: Royal blue top tube (EDTA or no additive).
Specimen Preparation: Separate serum or plasma from cells within 2 hours. Transfer 1 mL serum or plasma to an ARUP Trace Element-Free
Transport Tube (ARUP supply #43116). (Min: 0.5 mL)
CPT Code(s): 83018
0091433 Titanium, Urine TITANIU UR

Specimen Required: Collect: Random urine in a trace metal free or acid washed plastic container.
CPT Code(s): 83018
2005636 Titin Antibody TITIN AB

Specimen Required: Collect: Plain red or serum separator tube
Tube. (Min. 0.5 mL)
Storage/Transport Temperature: Refrigerated. Also acceptable: Frozen
Unacceptable Conditions: Moderately icteric serum
Stability: After separation from cells: Ambient: 2 hours; Refrigerated: 1 week; Frozen: 1 month (avoid multiple freeze/thaw cycles)
CPT Code(s): 83516
0090315 Tobramycin, Peak Level TOBRAP

Patient Preparation: Draw 30 minutes following completion of infusion.
Unacceptable Conditions: Specimens collected in citrate or oxalate/fluoride anticoagulants, or separator tubes. Hemolyzed specimens.
CPT Code(s): 80200
0090270 Tobramycin, Random Level TOBRA

Specimen Preparation: Separate serum or plasma from cells. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Unacceptable Conditions: Citrate, oxalate/fluoride, or separator tubes. Hemolyzed specimens.
CPT Code(s): 80200
0090320 Tobramycin, Trough Level TOBRAT

Patient Preparation: Draw 5-90 minutes before next infusion.
Specimen Preparation: Separate serum or plasma from cells. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Unacceptable Conditions: Citrate, oxalate/fluoride, or separator tubes. Hemolyzed specimens.
CPT Code(s): 80200
0091112 Tocainide Quantitation, Serum or Plasma TOCAIN SP

Specimen Required: Collect: red, gray (sodium fluoride/potassium oxalate), green (sodium heparin), or lavender (EDTA).
Specimen Preparation: Separate serum or plasma from cells ASAP. Transfer 2 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 1
mL)
CPT Code(s): 80299
0091218 Tocainide Quantitation, Urine TOCA URN

Page | 442
CPT Code(s): 80299
0091534 Tolbutamide, Serum or Plasma TOLBUTAM S

CPT Code(s): 80299
0051589 Toll-Like Receptor Function Assay TLR

Remarks:
0091536 Toluene TOLUENE SP

CPT Code(s): 84600
0091535 Toluene Quantitation, Whole Blood TOLUEN BLD

CPT Code(s): 84600
0070390 Topiramate TOPIR

CPT Code(s): 80201
0050772 TORCH Antibodies, IgG TORCH IGG

Transfer 2 mL serum to an ARUP Standard Transport Tube. (Min: 1 mL) Parallel testing is preferred and convalescent specimens must be
CPT Code(s): 86644 CMV IgG; 86694 HSV IgG; 86317 Rubella IgG; 86317 Toxoplasma IgG
0050665 TORCH Antibodies, IgM TORCH M

Specimen Preparation: Transfer 2 mL serum to an ARUP Standard Transport Tube. (Min: 1 mL) Parallel testing is preferred and convalescent
CPT Code(s): 86645 CMV IgM; 86694 HSV IgM; 86762 Rubella IgM; 86778 Toxoplasma IgM
2002550 Total Inhibin T INHIBIN

Page | 443
CPT Code(s): 83520
0092212 Toxic Shock Syndrome Antibody, MAID TOXSHOCKAB

Methodology: Multi-Analyte Immunodetection
(Multiplex Bead Assay)
Specimen Preparation: Separate serum from cells ASAP. Transfer 0.5 mL serum to an ARUP Standard Transport Tube. (Min: 0.25 mL)
0096372 Toxic-Shock Syndrome Panel, MAID TOXIC SHOC

Methodology: Qualitative Multi-Analyte Immunodetection
(Multiplex Bead Assay)
Specimen Required: Collect: Pure culture of Staphylococcus aureus.
Specimen Preparation: Transport safely contained, pure culture in a sealed container.
0099090 Toxocara Antibody IgG by ELISA TOXOCARA

Specimen Preparation: Separate serum from cells ASAP. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.15 mL) Acute and
convalescent specimens must be labeled as such; parallel testing is preferred and convalescent specimens must be received within 30 days from
receipt of the acute specimens. Please mark specimen plainly as "acute" or "convalescent."
CPT Code(s): 86682
0050521 Toxoplasma gondii Antibodies, IgG and IgM TOXO PAN

Unacceptable Conditions: Urine. Contaminated, heat-inactivated or grossly hemolyzed specimens.
CPT Code(s): 86317Toxoplasma IgG; 86778 Toxoplasma IgM
2007064 Toxoplasma gondii Antibody, IgA by ELISA TGONDI IGA

Specimen Required: Collect: Plain red
Storage/Transport Temperature: Refrigerated. Also acceptable: Ambient and frozen
CPT Code(s): 86777
0050770 Toxoplasma gondii Antibody, IgG TOXEIGG

Unacceptable Conditions: Urine. Contaminated, heat-inactivated, or grossly hemolyzed specimens.
CPT Code(s): 86317
0050557 Toxoplasma gondii Antibody, IgM TOXEIGM

received within 30 days from receipt of the acute specimens. Mark specimen plainly as "acute" or "convalescent."
Unacceptable Conditions: Urine. Contaminated, heat-inactivated, or grossly hemolyzed specimens.
CPT Code(s): 86778
2004157 Toxoplasma gondii by Immunohistochemistry TOXOPL IHC

Page | 444
CPT Code(s): 88342
0055591 Toxoplasma gondii by PCR TOXOPCR

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA) or serum separator tube. OR Amniotic fluid, CSF, ocular fluid or tissue.
Specimen Preparation: Separate serum or plasma from cells. Transfer 1 mL serum, plasma, amniotic fluid, CSF or ocular fluid to a sterile
container. (Min: 0.5 mL) OR Tissue: Transfer to a sterile container and freeze immediately.
All Others: Ambient: 8 hours; Refrigerated: 5 days; Frozen: 3 months
CPT Code(s): 87798
0092534 Toxoplasma gondii IgG Antibody, ELISA (CSF) TGONDI IGG

Specimen Preparation: Transport 0.5 mL CSF. (Min: 0.25 mL)
CPT Code(s): 86777
2002573 TPMT Genotype TPMT GENO

Storage/Transport Temperature: Refrigerated. Also acceptable: Room temperature
Stability: Ambient: 8 days; Refrigerated: 1 month; Frozen: Unacceptable
CPT Code(s): 83907 Lysis; 83898x3 Amplification; 83896x6 Nucleic Acid Probes; 83912 Interpretation and report.
2002764 Tramadol and Metabolites - Confirmation/Quantitation - Serum or Plasma TRAMAD SP

freeze/thaw cycles.
CPT Code(s): 83925
2002736 Tramadol and Metabolites - Confirmation/Quantitation - Urine TRAMAD UR

Specimen Preparation: Transfer 2 mL urine with no additives or preservatives an ARUP Standard Transport Tube. (Min: 1 mL)
CPT Code(s): 83925
0050570 Transferrin, Serum TRNSF

Unacceptable Conditions: Specimens collected in EDTA. Hemolyzed specimens.
CPT Code(s): 84466
0051690 Transforming Growth Factor beta, Plasma TGFB PLA

Specimen Required: Collect: Green (lithium heparin).
Tube. (Min 0.3 mL)
Page | 445
Remarks:
CPT Code(s): 83520
0051694 Transforming Growth Factor beta, Serum TGFB SER

Tube. (Min 0.3 mL)
Remarks:
CPT Code(s): 83520
0051272 Transplantation (ImmuKnow®) Immune Cell Function Assay TICFA

Methodology: Cell Culture/Quantitative Chemiluminescent Immunoassay
Specimen Required: Collect: Green (sodium heparin). Specimen must be collected within 30 hours of test performance.
Specimen Preparation: Transport 3 mL whole blood in original collection tube. (Min: 0.5 mL) LIVE LYMPHOCYTES REQUIRED.
Storage/Transport Temperature: CRITICAL ROOM TEMPERATURE. Do not refrigerate or freeze.
CPT Code(s): 86352
0091432 Tranylcypromine, Serum or Plasma TRANYLCYPR

Specimen Preparation: Separate serum or plasma from cells immediately. Transfer 2 mL serum or plasma to an ARUP Standard Transport Tube.
(Min: 1 mL)
CPT Code(s): 80299
0091431 Tranylcypromine, Urine TRANYLC UR

CPT Code(s): 80299
0090316 Trazodone TRAZO

Specimen Required: Collect: Plain red. Also acceptable: Lavender (K2 or K3EDTA) or pink (K2EDTA ).
Stability: After separation from cells: Ambient: 12 hours; Refrigerated: 1 week; Frozen: 1 week
CPT Code(s): 80299
0050777 Treponema pallidum Antibody by TP-PA MHA

Methodology: Semi-Quantitative Particle Agglutination
Unacceptable Conditions: CSF or other body fluids.
CPT Code(s): 86780
0050477 Treponema pallidum Antibody (FTA-ABS), Serum, IgG by IFA with Reflex to Treponema pallidum Antibody by FTA
TP-PA
Methodology: Semi-Quantitative Indirect Fluorescent Antibody/Semi-Quantitative Particle Agglutination
Tube. (Min: 0.2 mL)
Unacceptable Conditions: CSF, plasma, or other body fluids. Contaminated, hemolyzed, or severely lipemic specimens.
CPT Code(s): 86780; if reflexed, add additional 86780
0050920 Treponema pallidum Antibody, IgG by ELISA SYPH G

Page | 446
CPT Code(s): 86780
0055273 Treponema pallidum Antibody, IgG by IFA (CSF) FTA CSF G

Unacceptable Conditions: Serum. Contaminated, heat-inactivated, or hemolyzed specimens.
CPT Code(s): 86780
2003095 Treponema pallidum Antibody, IgG by Immunoblot SYPH G IB

Unacceptable Conditions: Other body fluids.
CPT Code(s): 86780
0050921 Treponema pallidum Antibody, IgM by ELISA SYPH M

CPT Code(s): 86780
0093067 Treponema pallidum Antibody Panel (FTA-ABS) IgG & IgM FTA G/M
Methodology: Qualitative Immunofluorescence Assay
Patient Preparation: Collect from child less than 12 months of age.
Unacceptable Conditions: Adult specimens or specimens collected from children older than 12 months of age.
0050471 Treponema pallidum (Rapid Plasma Reagin) with Reflex to Titer RPRT
Methodology: Semi-Quantitative Charcoal Agglutination
Tube. (Min: 0.25 mL) Also acceptable: Plasma, if testing is completed within 48 hours of collection.
CPT Code(s): 86592 RPR; if reflexed, add 86593 RPR titer
0050478 Treponema pallidum (Rapid Plasma Reagin) with Reflex to Titer and TP-PA Confirmation RPR PAN
Methodology: Semi-Quantitative Charcoal Agglutination/Semi-Quantitative Particle Agglutination
Tube. (Min: 0.25 mL) Do not freeze. Also acceptable: Plasma, if testing is completed within 48 hours of collection.
CPT Code(s): 86592 RPR; if reflexed, add 86593 RPR titer and TP-PA 86780
0050011 Treponema pallidum (Rapid Plasma Reagin) with Reflex to Titer, FTA-ABS and TP-PA RPR FTA
Methodology: Semi-Quantitative Charcoal Agglutination/Semi-Quantitative Indirect Fluorescent Antibody/Semi-Quantitative Particle Agglutination
Tube. (Min: 0.5 mL)
Unacceptable Conditions: CSF or plasma. Contaminated, hemolyzed, or severely lipemic specimens.
CPT Code(s): 86592 RPR; if reflexed, add 86593 RPR titer; 86780 FTA; if reflexed add TP-PA 86780
Page | 447
0050206 Treponema pallidum (VDRL), Cerebrospinal Fluid with Reflex to Titer VDRL CSF
Methodology: Semi-Quantitative Flocculation
Unacceptable Conditions: Plasma, serum, or other body fluids.
CPT Code(s): 86592 Treponema pallidum screen; if reflexed, add 86593 Treponema pallidum titer
0093093 Treponema pallidum (VDRL), Serum with Reflex to Titer VDRL SERU
Methodology: Semi-Quantitative Flocculation
Tube (Min: 0.25 mL)
Unacceptable Conditions: CSF or other body fluids. Contaminated, heat-inactivated, hemolyzed, or severely lipemic specimens.
CPT Code(s): 86592 Treponema pallidum screen; if reflexed, add 86593 Treponema pallidum titer
0091104 Triazolam & Metabolite Quantitation, Serum or Plasma TRIAZO SP

CPT Code(s): 80154
0050787 Trichinella Antibody by ELISA TRICH

CPT Code(s): 86784
0091566 Trichloroacetic Acid TRICHLOR S

CPT Code(s): 83918
0091475 Trichloroacetic Acid, Urine TRICHLOR U

Patient Preparation: Collect specimen at end of shift, end of work week.
Storage/Transport Temperature: Refrigerated. Also acceptable: Room temperature or Frozen.
CPT Code(s): 83921 Organic acid
2005506 Trichomonas vaginalis by Amplified Detection TVAG AMD

Specimen Required: Collect: Endocervical or vaginal swab, or first catch female urine. Collect in APTIMA® Combo 2 Assay transport media (ARUP supply: Swabs
#28907, Urine #28908) OR cervical brush in ThinPrep® transport Pap test media (ARUP supply #42711). Available online through eSupply
using ARUP Connect™ or contact Client Services at (800) 522-2787. Refer to Sample Collection for the Diagnosis of STD under Specimen
Specimen Preparation: Transfer swab or urine to APTIMA® Combo 2 Assay transport media. (Min: 2 mL urine) OR Vortex™ Pap test media and
transfer a 1 mL aliquot to APTIMA® Combo 2 transport media. To reduce the potential for contamination ThinPrep® specimens should be
poured off, using sterile technique, into the APTIMA® Specimen Transfer Tube prior to cytology testing.
Remarks: This assay is FDA approved for specimens from female patients only. Specimen source required.
Stability: Unpreserved Urine: Ambient: 24 hours; Refrigerated: 24 hours; Frozen: Unacceptable
ThinPrep® Media: Ambient: 1 month; Refrigerated: 1 month; Frozen: Unacceptable
APTIMA® Transport Media: Swab: Ambient: 2 months; Refrigerated: 2 months; Frozen: 6 months
Urine: Ambient: 1 month; Refrigerated: 1 month; Frozen: 6 months
ThinPrep: Ambient: 2 weeks; Refrigerated: 1 month; Frozen: 6 months
CPT Code(s): 87798
0090307 Tricyclic Antidepressant Detection S TAD

Page | 448
0.5 mL)
CPT Code(s): 80101
0090154 Tricyclic Antidepressant Identification Quantitative, Serum TADID

CPT Code(s): 80100 if negative; if positive use the appropriate CPT code(s) for drug identified as follows: 80152 Amitripyline; 80182 Nortriptyline; 80174
Imipramine; 80160 Desipramine; 80166 Doxepin; 80299 Nordoxepin; 80299 Protriptyline; 80299 Clomipramine; 80299 Norclomipramine.
0091354 Trifluoperazine, Serum or Plasma TRIFLUOPER

Specimen Required: Collect: Plain red, gray (sodium fluoride/potassium oxalate), green (sodium heparin), lavender (EDTA) or pink (K2 EDTA).
(Min: 2.2 mL)
Unacceptable Conditions: Separator tubes
CPT Code(s): 84022
0091101 Trifluoperazine, Urine TRIFLU UR

CPT Code(s): 84022
0020713 Triglycerides, Fluid TRG FL

CPT Code(s): 84478
0020040 Triglycerides, Serum or Plasma TRG

Patient Preparation: Fasting specimen is preferred.
Unacceptable Conditions: Body Fluid (refer to Triglycerides, Fluid, ARUP test code 0020713).Collection tubes with glycerol-lubricated stoppers.
CPT Code(s): 84478
0091399 Trihexyphenidyl, Serum or Plasma TRIHEXYPHE

CPT Code(s): 80299
0091398 Trihexyphenidyl, Urine TRIHEX URN

CPT Code(s): 80299
0093243 Triiodothyronine, Free by Equilibrium Dialysis/HPLC-Tandem Mass Spectrometry FT3 ED-TMS

Page | 449
CPT Code(s): 84481
0070133 Triiodothyronine, Free (Free T3) FT3

Specimen Required: Collect: Serum separator tube or plasma separator tube. Also acceptable: Lavender (EDTA) or pink (K2EDTA).
CPT Code(s): 84481
0070188 Triiodothyronine, Reverse RT3

CPT Code(s): 84482
0070474 Triiodothyronine, Total (Total T3) T3 TOTAL

Specimen Required: Collect: Plasma separator tube or serum separator tube. Also acceptable: Lavender (EDTA), pink (K2EDTA), or green (sodium or lithium
heparin).
CPT Code(s): 84480
0091421 Trimethadione and Metabolite Quantitation, Serum or Plasma TRIMETH SP

Specimen Preparation: Separate from cells within 2 hours. Transfer 2 mL serum or plasma to an ARUP Standard Transport Tube. (Min 0.5 mL)
CPT Code(s): 80299
0091420 Trimethadione and Metabolite Quantitation, Urine TRIMETH UR

CPT Code(s): 80299
0091396 Trimethoprim, Serum or Plasma TRIMETHOPR

(Min: 0.4 mL)
Stability: Ambient:1 month; Refrigerated: 1 month; Frozen: 1 month
CPT Code(s): 80299
0091501 Trimethoprim, Urine TRIMETHO U

Methodology: High Performance Thin Layer Chromatography
CPT Code(s): 80299
0091107 Trimipramine & Metabolite Quantitation, Serum or Plasma TRIMIP SP

Specimen Required: Collect: Plain red, gray (sodium fluoride/potassium oxalate), green (sodium heparin), lavender (EDTA), or pink (K2 EDTA).
Specimen Preparation: Separate serum or plasma from cells ASAP. Transfer 3 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 1
mL)
CPT Code(s): 80299
Page | 450
0091213 Trimipramine & Metabolite Quantitation, Urine TRIMIP UR
CPT Code(s): 80299
0093370 Trofile Co-Receptor Tropism Assay TROFILE

Methodology: Recombinant virus, single replication
Remarks: Indicate viral load and viral load collection date on the test request form. If viral load is less than 1,000 copies, testing MAY NOT be
performed.
CPT Code(s): 87999
2004747 Trofile™ DNA Co-Receptor Tropism Assay TROF DNA

Methodology: CD4 Cell Culture Assay for Phenotypic Recombinant-virus Co-receptor Tropism
Specimen Preparation: Transfer 4 mL whole blood to an ARUP Standard Transport Tube and freeze immediately. (Min: 4 mL)
Stability: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen at -20°C: 2 weeks; Frozen at -70°C: Indefinitely.
CPT Code(s): 87999
2002093 Tropheryma whipplei DNA, Qualitative RT PCR T WHIPPLEI

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or yellow (ACD solution A or B). Also acceptable: CSF or tissue.
Specimen Preparation: Transport 0.7 mL whole blood or CSF. (Min: 0.3 mL) Tissue: Transport 3 mm tissue in an ARUP Standard Transport
Tube with sterile saline to prevent drying. (Min: 3 mm)
Storage/Transport Temperature: Refrigerated. Tissue: Frozen.
Stability: Ambient: 48 hours; Refrigerated: 1 week; Frozen: Whole blood: Unacceptable, CSF or Tissue: 1 month
CPT Code(s): 87798
0090613 Troponin I TNI

Specimen Required: Collect: Plasma separator tube.
Specimen Preparation: Remove plasma from cells ASAP or within 2 hours of collection. Specimen must be free of particulate matter including
fibrin which can interfere with the assay. Avoid transferring material from the white blood cell/platelet layer located just above the red blood cells.
Transport 1 mL plasma. (Min: 0.5 mL)
Unacceptable Conditions: Serum. Specimens exposed to repeated freeze/thaw cycles.
CPT Code(s): 84484
0098803 Troponin T TROPONIN T

Specimen Required: Collect: Serum separator tube, pink (K2EDTA), green (lithium heparin), or lt. blue (sodium citrate).
Specimen Preparation: Separate serum or plasma from cells ASAP. Transfer 0.5 mL serum or plasma to an ARUP Standard Transport Tube. (Min:
0.5 mL)
Unacceptable Conditions: Specimens collected in potassium oxalate or sodium fluoride. Grossly hemolyzed specimens.
CPT Code(s): 84484
0051076 Trypanosoma cruzi Antibody, IgG CHAGAS G

Methodology: Semi-Quantitative Immunoassay
specimens plainly as acute or convalescent.
CPT Code(s): 86753
0051075 Trypanosoma cruzi Antibody, IgM CHAGAS M

specimens plainly as acute or convalescent.
Page | 451
CPT Code(s): 86753
0020383 Trypsin, Fecal TRYP F

Methodology: Semi-quantitative Film Digestion
Remarks:
Unacceptable Conditions: Diapers. Specimens containing barium.
CPT Code(s): 84488
0070003 Trypsin-Like Immunoreactivity TRYPSIN

Specimen Required: Collect: Serum separator tube or plain red. Also acceptable: lavender (EDTA) or pink (K2EDTA).
plasma from cells ASAP or within 2 hours of collection. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.3 mL)
Unacceptable Conditions: Heparinized specimens. Hemolyzed or lipemic specimens.
CPT Code(s): 83519
0099173 Tryptase TRYPT

CPT Code(s): 83520
0099590 Tryptophan TRYP

Methodology: Liquid Chromatography-Mass Spectrometry
Patient Preparation: Patient should fast overnight prior to collection (or at least 4 hours after a meal).
Specimen Preparation: Separate plasma from cells ASAP or within 2 hours of collection. Transfer 2 mL plasma to a polypropylene tube and
freeze. (Min: 0.3 mL)
Remarks:
CPT Code(s): 82131
0051539 Tumor Necrosis Factor - alpha TNFA DO

Remarks:
CPT Code(s): 83520
0050547 Twin Zygosity Testing TWIN ZYG

Specimen Required: Collect: From each twin: Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B). Also acceptable: Buccal brushes.
Specimen Preparation: From each twin: Transport 3 mL whole blood (Min: 1 mL) Also acceptable: 2 buccal brushes.
CPT Code(s): 83891 Isolation; 83900 Multiplex amplification; 83901 x14 Additional amplification; 83909 Capillary electrophoresis; 83912 Interpretation and
report
0010672 Type & Screen TS

Patient Preparation: Testing is limited to the University of Utah Health Sciences Center, Primary Children's Medical Center (10432), and
Intermountain Shriners Hospital (10367) only.
New specimen required every 72 hours.

Specimen Preparation: DO NOT FREEZE red cells. Transport 7 mL whole blood. Refer to Specimen Handling at www.aruplab.com for
additional labeling requirements.
Remarks:
Page | 452
CPT Code(s): 86900 ABO; 86901 Rh; 86850 AB screen
0080355 Tyrosine, Plasma TYRO

Specimen Preparation: Separate plasma from cells ASAP or within 2 hours of collection. Transfer 0.5 mL plasma to an ARUP Standard Transport
CPT Code(s): 84510
2004169 Ubiquitin by Immunohistochemistry UBIQUI IHC

CPT Code(s): 88342
0051332 UDP Glucuronosyltransferase 1A1 (UGT1A1) Genotyping UGT1A1

CPT Code(s): 83891 Isolation; 83898 Amplification; 83909 Capillary electrophoresis; 83912 Interpretation and report
2004172 Ulex Europaeus Agglutinin 1 (UEA-1) by Immunohistochemistry ULEX IHC

CPT Code(s): 88342
0060714 Unusual Organism Culture MC UORG

Specimen Required: Collect: Please contact Bacteriology (801) 583-2787 at extension 2350 for specimen collection and transport instructions.
Storage/Transport Temperature: Please contact Bacteriology (801) 583-2787 at extension 2350 for specimen collection and transport instructions.
CPT Code(s): 87070
2005207 Urea Clearance UNCL

Specimen Required: Collect: 24-hour urine (refrigerate during collection). AND plasma preparation tube or serum separator tube, collected within 48 hours of initiating
urine collection.
Specimen Preparation: Transfer one 3 mL aliquot of urine from a well-mixed 24-hour collection to an ARUP Standard Transport Tube. (Min: 0.5
mL) AND transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.2 mL) Record total volume and collection time interval
on transport tube and test request form.
Unacceptable Conditions: Random urine collections.
CPT Code(s): 84545
0020183 Urea Nitrogen, Fluid FL UN

Specimen Preparation: Centrifuge and separate to remove cellular material. Transport 1 mL body fluid. (Min: 0.2 mL)
CPT Code(s): 84520
Page | 453
0020023 Urea Nitrogen, Serum or Plasma BUN
Unacceptable Conditions: Specimens containing sodium fluoride.
CPT Code(s): 84520
0020480 Urea Nitrogen, Urine UUN

Specimen Preparation: Transfer 3 mL aliquot from a well-mixed 24-hour collection to an ARUP Standard Transport Tube. (Min: 0.5 mL) Record
Unacceptable Conditions: Urine collected with acid. Specimens stored at room temperature.
CPT Code(s): 84540
0065031 Ureaplasma Species and Mycoplasma hominis Culture V UREA

Specimen Required: Collect: Body fluid, CSF, respiratory, semen, cervical or urethral swab, tissue or urine.
Specimen Preparation: Place swab or 0.5 mL of fluid (Min: 0.3 mL). in Mycoplasma/Ureaplasma transport media (UTM) (ARUP supply #12884)
immediately. Available online through eSupply using ARUP Connect™or contact ARUP Client Services at (800) 522-2787. Also acceptable: Any
transport media validated for Mycoplasma/Ureaplasma transport such as M4 (DO NOT USE M4 RT).
Storage/Transport Temperature: Frozen. Transport specimen on dry ice.
Unacceptable Conditions: M4 RT or bacterial transport media. Non-patient specimens. Dry swabs. Specimens not preserved in
Mycoplasma/Ureaplasma transport media.
Stability: Ambient: 8 hours; Refrigerated: 48 hours in Mycoplasma/Ureaplasma transport media; Frozen at -70°C: 1 month
CPT Code(s): 87109
0020513 Uric Acid, Body Fluid URIC-FL

Stability: After separation from cellular material: Ambient: 24 hours; Refrigerated: 5 days; Frozen: 6 months
CPT Code(s): 84560
0020026 Uric Acid, Serum or Plasma URIC

Unacceptable Conditions: Body Fluid (refer to Uric Acid, Body Fluid, ARUP test code 0020513).Urine (refer to Uric Acid, Urine, ARUP test
code 0020481).
CPT Code(s): 84550
0020481 Uric Acid, Urine UURIC

Specimen Required: Collect: 24-hour urine. Refrigerate specimen during collection. Also acceptable: Random urine.
Specimen Preparation: Urine pH must be adjusted to greater than 8.0. If pH is less than or equal to 8.0, adjust pH to greater than 8.0 by adding 5
percent NaOH. Mix well and allow entire 24-hour collection to stand for 15 minutes. Recheck pH and readjust if necessary. Transfer one 3 mL
aliquot from a well-mixed 24-hour collection to an ARUP Standard Transport Tube. (Min: 0.5 mL) Record total volume, collection time interval,
and pH on transport tube or aliquot tube and on test request form.
Unacceptable Conditions: Specimens with pH less than 8.0. Urine collected with acid.
Stability: Ambient: 4 days; Refrigerated: 4 days; Frozen: 2 weeks
CPT Code(s): 84560
0020350 Urinalysis, Complete UA

Methodology: Reflectance Spectrophotometry/Microscopy
Specimen Preparation: Transport 10 mL aliquot from a well-mixed random urine. (Min: 3 mL)
Unacceptable Conditions: Gray (boric acid). Frozen specimens.
CPT Code(s): 81001
0060131 Urine Culture MC U

Specimen Required: Collect: Midstream urine, catheter, cystoscopic, or suprapubic urine.
Page | 454
Specimen Preparation: Transfer urine to a sterile container or boric acid transport tube. (Min: 1 mL).
Storage/Transport Temperature: Unpreserved: Refrigerated.
Boric Acid Transport Tube: Room temperature.
Remarks: Specimen source required. Indicate if specimen was collected by invasive method.
Gram stain is performed by request only.
Results indicate colony count plus identification of significant isolates.
Unacceptable Conditions: Urine from catheter bag. Multiple (more than one in 24 hours), 24-hour, or pooled specimens. Foley catheter tips
(syringe with needle attached). Delayed transport of unpreserved urine (greater than two hours at room temperature or greater than 24 hours
refrigerated).
Stability: Unpreserved: Ambient: 2 hours; Refrigerated: 24 hours; Frozen: Unacceptable.
Boric Acid Tube: Ambient: 48 hours; Refrigerated: 48 hours; Frozen: Unacceptable.
CPT Code(s): 87088
0081145 Urine Supersaturation Profile URINE SAT

Methodology: Quantitative Spectrophotometry/Quantitative Enzymatic/Quantitative Ion-Selective Electrode
Specimen Required: Collect: 24-hour urine. Use Kidney Stone/Supersaturation Urine Collection Kit (ARUP supply #46007). Available online through eSupply using
ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. Refrigerate during collection.
Do not exceed 4 mL in tubes. Transport four
separate 4 mL aliquots from a well-mixed 24-hour urine collection according to the following specifications:
1st aliquot (pH 1.5-2): Transfer 4 mL urine to the sulfamic acid tube. Mix well, then freeze.
2nd aliquot (pH 9): Transfer 4 mL urine to the sodium carbonate tube. Mix well, then freeze.
3rd aliquot: Transfer 4 mL urine to an unpreserved tube. Mix well, then freeze.
4th aliquot: Transfer 4 mL urine to an unpreserved tube. Mix well, then freeze.
If collection kit is unavailable, transport four 4 mL unadjusted aliquots of urine.
Unacceptable Conditions: Any specimen other than 24 hour urine collection.
CPT Code(s): 82340 Calcium; 82436 Chloride; 82507 Citrate; 82570 Creatinine; 84560 Uric; 83735 Magnesium; 83945 Oxalate; 84105 Phosphate; 84133
Potassium; 84300 Sodium; 84392 Sulfate; and 83986 pH.
8100600 UroVysion™ FISH UF

Methodology: Fluorescence in situ Hybridization/Computer Assisted Analysis/Microscopy
Patient Preparation: Indications: The UroVysion™ Bladder Cancer Kit (UroVysion™ Kit) is designed to detect aneuploidy for chromosomes
3, 7, 17, and loss of the 9p21 locus via fluorescence in situ hybridization (FISH) in urine specimens from persons with hematuria suspected of
having bladder cancer. Results from the UroVysion™ Kit are intended for use, in conjunction with and not in lieu of current standard diagnostic
procedures, as an aid for initial diagnosis of bladder carcinoma in patients with hematuria and subsequent monitoring for tumor recurrence in
patients previously diagnosed with bladder cancer.
Specimen Required: Collect: A minimum of 35 mL of voided urine specimens.
Supplies: Urine collection system and transport tube, Saccomanno, ThinPrep® UroCyte Urine Collection Kit or PreservCyt® fixative, and a
Cytology test request form. UroVysion™ FISH Collection Kits fixative can be ordered through ARUP Client Services at (800) 522-2787 or (801)
583-2787 extension 2170.
Collection Procedure: For purposes of obtaining the greatest yield of diagnostic material, a second-morning, clean-catch voided urine specimen
should be collected, if possible. Mix voided urine 2:1 with Saccomanno or PreservCyt® fixative and transfer to a screw-top transport tube. If there
is more than 60 mL of urine, the remaining urine can be submitted in an additional container of Saccomanno or PreservCyt® fixative. The
specimen should be labeled with the patient's first and last name, date of birth, specimen source, medical record number (or other unique
identifier), and collection date. Submit the specimen along with the completed Cytology request form to the Cytopathology Laboratory. Specimen
needs to be stored and transported refrigerated. The specimen must be accompanied by a Cytology test request form with the requested test
marked and pertinent clinical history recorded.
Unacceptable Conditions: Refrigerated specimens not fixed in Saccomanno or PreservCyt®. Urine volume less than 35 mL.
Stability: Refrigerated: 72 hours (must be fixed with Saccomanno or PreservCyt® fixative)
CPT Code(s): 88121; If manual: 88120
2005416 Urticaria-Induced Basophil Activation UIBA

Tube. (Min: 0.5 mL)
Unacceptable Conditions: Specimens other than serum. Serum separator tubes. Contaminated, grossly hemolyzed, or lipemic specimens.
Stability: After separation from cells: Ambient: 30 minutes; Refrigerated: Unacceptable; Frozen: 1 year (avoid repeated freeze/thaw cycles)
CPT Code(s): 88184 Flow cytometry; 88185 x2 each additional marker
2005413 Urticaria-Inducing Activity UIA

Methodology: Semi-Quantitative Ex Vivo Challenge/Cell Culture/Quantitative Enzyme-Linked Immunosorbent Assay
Patient Preparation: Patients taking calcineurin inhibitors should stop their medication for 72 hours prior to draw. Patients on prednisone
should be off medication for 2 weeks prior to draw.
Stability: After separation from cells: Ambient: 30 minutes; Refrigerated: Unacceptable; Frozen: 1 year (avoid repeated freeze/thaw cycles)
CPT Code(s): 86352
Page | 455
2005415 Urticaria-Inducing Activity with Thyroid Antibodies and Stimulating Hormone UIAT
Methodology: Semi-Quantitative Ex Vivo Challenge/Cell Culture/Quantitative Enzyme-Linked Immunosorbent Assay/Quantitative Chemiluminescent
Immunoassay
Patient Preparation: Patients taking calcineurin inhibitors should stop their medication 72 hours prior to draw. Patients on prednisone should be
off their medication for 2 weeks prior to draw.
tube and freeze immediately (Min: 0.5 mL) AND transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Storage/Transport Temperature: First Specimen: CRITICAL FROZEN. Separate specimens must be submitted for this multiple test panel.
Second Specimen: Refrigerated.
Stability: First Specimen: After separation from cells: Ambient: 30 minutes; Refrigerated: Unacceptable; Frozen: 1 year (avoid repeated
freeze/thaw cycles)
Second Specimen: After separation from cells: Ambient: 24 hours; Refrigerated: 1 Week; Frozen: 6 months
CPT Code(s): 86352 Cell function assay with stim; 86800 Thyroglobulin antibody; 84443 Thyroid stimulating hormone; 86376 Thyroid peroxidase antibody
0065153 Vaginal Pathogens DNA Direct Probes VAGP

Specimen Required: Collect: Vaginal fluid. Collect in BD Affirm™ VPIII Ambient Temperature Transport System (ARUP Supply #29624). Available online through
eSupply using ARUP Connect™ or contact Client Services at (800) 522-2787.
Specimen Preparation: Transport swab in BD Affirm™ VPIII Ambient Temperature Transport System.
CPT Code(s): 87480 Candida species DNA probe; 87510 Gardnerella vaginalis DNA probe; 87660 Trichomonas vaginalis DNA Probe
0090290 Valproic Acid VPA

Unacceptable Conditions: citrate, EDTA, or oxalate anticoagulants or separator tubes.
CPT Code(s): 80164
0099310 Valproic Acid, Free and Total VPA-F

1 mL)
SST: Serum in a gel separator tube stored at room temperature is acceptable if separated from the gel within 2 hours. Serum in a gel separator tube
stored refrigerated is acceptable if separated from the gel within 1 hour.
CPT Code(s): 80164 VPA, total; 80164 VPA, free
0091286 Vanadium Quantitation, Serum or Plasma VANADIU SP

Specimen Preparation: Transfer 1 mL serum or plasma to an ARUP Trace Element-Free Transport Tube (ARUP supply #43116) immediately.
Available online through eSupply using ARUP Connector contact ARUP Client Services at (800) 522-2787. (Min: 0.5 mL)
CPT Code(s): 83018
0091592 Vanadium Quantitation, Urine VANADIU U

Methodology: Quantitative Graphite Furnace Atomic Absorption Spectroscopy/Colorimetry
Patient Preparation: Avoid exposure to gadolinium-based contrast media for 48 hours prior to specimen collection. Collect at end of last shift,
at end of work week.
Specimen Required: Collect: Urine in a trace metal-free or acid-washed container.
Storage/Transport Temperature: Refrigerated. Room Temperature and Frozen also acceptable.
Stability: Ambient: 1 week; Refrigerated: 1 week; Frozen: 2 weeks
CPT Code(s): 82570 Creatinine, other source; 83018 Heavy metal, quantitative
0090325 Vancomycin, Peak Level VANP

Patient Preparation: Draw specimen 1-2 hours following completion of infusion.
Unacceptable Conditions: Gray (sodium fluoride/potassium oxalate), lavender (EDTA), lt. blue (sodium citrate), or separator tubes. Grossly
hemolyzed, icteric, or lipemic specimens.
Page | 456
CPT Code(s): 80202
0090285 Vancomycin, Random Level VAN

Unacceptable Conditions: Gray (sodium fluoride/potassium oxalate), Lavender (EDTA), lt. blue (sodium citrate), or separator tubes. Grossly
CPT Code(s): 80202
0090330 Vancomycin, Trough Level VANT

Patient Preparation: Draw 10 minutes before next infusion.
Unacceptable Conditions: Gray (sodium fluoride/potassium oxalate), lavender (EDTA), lt. blue (sodium citrate), or separator tubes. Grossly
CPT Code(s): 80202
0060363 Vancomycin-Resistant Enterococcus (VRE) Culture MC VRE

Specimen Required: Collect: Rectal swab.
Specimen Preparation: Transport swab in bacterial transport media.
Remarks: All Enterococcus isolates are screened for vancomycin resistance.
0080470 Vanillylmandelic Acid (VMA) & Homovanillic Acid (HVA), Urine VH

Specimen Preparation: Transfer 4 mL aliquot from a well mixed 24-hour or random collection to an ARUP Standard Transport Tube. (Min: 1 mL)
CPT Code(s): 83150 HVA; 84585 VMA
0080421 Vanillylmandelic Acid (VMA), Urine VMA U

CPT Code(s): 84585
0095263 VAP Cholesterol VAP CHOL

Methodology: Ultra Centrifugation
Remarks: Specimen must not go through a freeze/thaw cycle.
Unacceptable Conditions: Frozen serum separator tubes.
Stability: Ambient: Unacceptable; Refrigerated: 1 week; Frozen at -20°C: 28 days; Frozen at -70°C: 1 year
CPT Code(s): 83701 Lipoprotein subclasses; 84478 Triglycerides
0050167 Varicella-Zoster Virus Antibody, IgG VZE

Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum an ARUP Standard Transport Tube.
(Min: 0.1 mL) Parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of the acute specimens.
Unacceptable Conditions: CSF (refer to Varicella-Zoster Virus Antibody, IgG, CSF, ARUP test code 0054444). Body fluids, plasma, urine.
Contaminated, heat-inactivated, hemolyzed, lipemic, or severely icteric specimens.
CPT Code(s): 86787
Page | 457
0054445 Varicella-Zoster Virus Antibody, IgM by ELISA (CSF) VZMCSF
CPT Code(s): 86787
0060042 Varicella-Zoster Virus by PCR VZVPCR

Specimen Required: Collect: Lavendar (EDTA), pink (K2EDTA) or serum separator tube. OR CSF, ocular fluid, tissue or vesicle fluid.
Specimen Preparation: Transfer 1 mL serum, plasma, CSF or ocular fluid to a sterile container. (Min: 0.5 mL)
Vesicle Fluid: Transfer to viral transport media (ARUP supply #12884). Available online through eSupply using ARUP Connect™ or contact
ARUP Client Services at (800) 522-2787.
All others: Ambient: 24 hours; Refrigerated: 5 days; Frozen: 3 months
CPT Code(s): 87798
0060290 Varicella-Zoster Virus DFA VZVFA

Patient Preparation: Collect vesicle specimen during first 3 days of rash.
Specimen Required: Collect: Vesicle swab, tissue, or skin scrapings. Swab should be rolled in base of fresh vesicle to obtain cells.
Specimen Preparation: Immediately transfer specimen to viral transport media (ARUP Supply #12884) and refrigerate (extremely temperature
sensitive). Available online through eSupply using ARUP Connector contact ARUP Client Services at (800) 522-2787.
CPT Code(s): 87290
0060282 Varicella-Zoster Virus DFA with Reflex to Varicella-Zoster Virus Culture VZVFAC
Patient Preparation: Collect vesicle specimen during first three days of rash.
Specimen Required: Collect: Vesicle fluid or swab, tissue, or skin scrapings. Swab should be rolled in base of fresh vesicle to obtain cells.
Unacceptable Conditions: Bone marrow CSF, or whole blood. Calcium alginate, dry, or wood swabs.
CPT Code(s): 87290 DFA if reflexed, add 87252 Tissue culture; 87254 Shell vial
0099314 Varicella-Zoster Virus Antibody, IgM VZM

CPT Code(s): 86787
0060283 Varicella-Zoster Virus and Herpes Simplex Virus DFA with Reflex to Varicella-Zoster Virus Culture and VZV HSVFAC
Herpes Simplex Virus Culture
Patient Preparation: Collect vesicle specimen during first 3 days of rash.
Specimen Required: Collect: Vesicle fluid or swab, tissue, or skin scrapings. Swab should be rolled in base of fresh vesicle to obtain cells.
CPT Code(s): 87290 VZV; 87274 HSV 1; 87273 HSV 2; if reflexed, add 87252 x2 Tissue culture; 87254 Shell vial; 87253 IP stain
0050162 Varicella-Zoster Virus Antibodies, IgG and IgM VZV PAN

Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Chemiluminescent Immunoassay
Page | 458
Unacceptable Conditions: See individual components.
CPT Code(s): 86787 VZ IgG; 86787 VZ IgM
0054444 Varicella-Zoster Virus Antibody, IgG, CSF VZECSF

CPT Code(s): 86787
0092660 Vascular Endothelial Growth Factor VEG FACTOR

Tube. (Min: 0.3 mL)
CPT Code(s): 83520
2004175 Vascular Endothelial Growth Factor C (VEGF-C) by Immunohistochemistry VEGFC IHC

CPT Code(s): 88342
0099435 Vasoactive Intestinal Peptide VIP

CPT Code(s): 84586
0090832 Venlafaxine and Metabolite, Serum or Plasma VENLAFAX S

(Min: 0.5 mL)
CPT Code(s): 80299
0030070 Venous Thromboembolism (VTE), Qualitative VTE

Specimen Required: Collect: Lt. blue (sodium citrate).Refer to Specimen Handling at aruplab.com for hemostasis/thrombosis specimen handling guidelines.
Specimen Preparation: Separate plasma from cells within 2 hours of collection. Transfer 1 mL platelet poor plasma to an ARUP Standard
Transport Tube (Min 0.5 mL)
CPT Code(s): 85380
Page | 459
0091429 Verapamil, Serum or Plasma VERAPAMIL
Specimen Required: Collect: Plain red or green (sodium or lithium heparin).
Specimen Preparation: Transfer 3 mL serum or plasma to an ARUP Standard Transport Tube. (Min 1 mL)
Stability: Ambient: 2 weeks; Refrigerated: 1 month; Frozen: 18 months
CPT Code(s): 80299
0091430 Verapamil, Urine VERAPA URN

Stability: Ambient: 2 weeks; Refrigerated: 1 month; Frozen: 18 months
CPT Code(s): 80299
2004208 Very Long-Chain Acyl-CoA Dehydrogenase Deficiency (ACADVL) Deletion/Duplication VLCAD DD

2002001 Very Long-Chain Acyl-CoA Dehydrogenase Deficiency (ACADVL) Sequencing VLCAD FGS
2004212 Very Long-Chain Acyl-CoA Dehydrogenase Deficiency (ACADVL) Sequencing and Deletion/Duplication VLCAD FGA
CPT Code(s): Sequencing: 83891 Isolation; 83898 x11 Amplification; 83904 x11 Sequencing; 83909 Capillary electrophoresis; DelDup: 83896 Nucleic acid
probes; 83898 Amplification; 83914 Extension; 83909 Capillary electrophoresis; 83912 Interpretation and report -Additional CPT code modifiers
2004250 Very Long-Chain and Branched-Chain Fatty Acids Profile VLCFA

Patient Preparation: Adults: Fasting specimen preferred.
Infants and children: Draw specimen prior to feeding or 2-3 hours after a meal.
Specimen Required: Collect: Green (sodium or lithium heparin) or lavender (EDTA).
Specimen Preparation: Separate plasma from cells. Transfer 0.5 mL plasma to an ARUP Standard Transport Tube and freeze immediately. (Min:
0.2 mL)
Remarks: Clinical information is needed for appropriate interpretation. Additional required information includes age, gender, diet (e.g.TPN
Unacceptable Conditions: Room temperature specimens greater than 24 hours. Refrigerated specimens greater than 48 hours. Specimens exposed
to more than one freeze/thaw cycle.
CPT Code(s): 82726
2004178 Villin by Immunohistochemistry VILLIN IHC

CPT Code(s): 88342
Page | 460
2004181 Vimentin by Immunohistochemistry VIMENT IHC
CPT Code(s): 88342
2006498 Viral Culture, Non-Respiratory V VIRAL N

Specimen Required: Collect: Eye swab, lesion, stool, tissue (brain, colon, kidney, liver, etc.), or urine.
Specimen Preparation: Fluid or Stool: Transfer to sterile, leak-proof container.
Swabs or Tissue: Place in viral transport media (ARUP Supply #12884). Available online through eSupply using ARUP Connect™ or contact
ARUP Client Services at (800) 522-2787
CPT Code(s): 87252 Tissue culture. If definitiveidentification required, add 87253.
2006496 Viral Culture, Non-Respiratory, and Cytomegalovirus Rapid Culture V VIC N

Specimen Required: Collect: Eye swab, lesion, tissue (brain, colon, kidney, liver, etc.), or urine.
Specimen Preparation: Fluid: Transfer to sterile, leak-proof container.
Swabs or Tissue: Place in viral transport media (ARUP Supply #12884). Available online through eSupply using ARUP Connect™or contact
ARUP Client Services (800) 522-2787. Place each specimen in a separate, individually sealed bag.
CPT Code(s): 87252 Tissue Culture; 87254 Shell vial. If definitive identification required, add 87253.
2006499 Viral Culture, Respiratory V VIRAL R

Specimen Required: Collect: Bronchoalveolar lavage (BAL), nasopharyngeal aspirate, swab, or washing, or tracheal aspirate, sputum, throat, tissue (lung, etc.).
Swabs or Tissue: Place in viral transport media (ARUP Supply # 12884). Available online through eSupply using ARUP Connect ™or contact
ARUP Client Services at (800) 522-2787. Place each specimen in a separate, individually sealed bag.
CPT Code(s): 87252 Tissue culture. If definitive identification required, add 87253.
2006497 Viral Culture, Respiratory, and Cytomegalovirus Rapid Culture V VIC R

Specimen Required: Collect: Bronchoalveolar lavage (BAL), nasopharyngeal aspirate, swab, or washing, or tracheal aspirate, sputum, throat, tissue (lung, etc.).
Swabs or Tissue: Place in viral transport media (ARUP Supply # 12884). Available online through eSupply using ARUP Connect ™or contact
ARUP Client Services at (800) 522-2787. Place each specimen in a separate, individually sealed bag.
CPT Code(s): 87252 Tissue Culture; 87254 Shell vial. If definitive identification required, add 87253.
2007063 Viral Meningitis Panel by PCR, Cerebrospinal Fluid PCR PAN1

Specimen Preparation: Transport 1ml CSF to a sterile container. (Min: 0.5 mL)
CPT Code(s): 87498 EV by RT-PCR; 87529 HSV by PCR; 87798 Parechovirus by RT-PCR
2007062 Viral Meningoencephalitis Panel by PCR, Cerebrospinal Fluid PCR PAN2

Specimen Preparation: Transport 1 mL CSF in a sterile container. (Min: 0.5 mL)
Page | 461
CPT Code(s): 87496 CMV by PCR; 87798 EBV by PCR: 87529 HSV by PCR; 87798 VZV by PCR
2002028 Virilization Panel 1 VIRIL PANEL

Specimen Required: Collect: Serum separator tube or green (sodium or lithium heparin). Collect between 6-10 a.m. Also acceptable: Lavender (EDTA).
CPT Code(s): 82157 Androstenedione; 82626 Dehydroepiandrosterone; 84403 Total Testosterone
2002281 Virilization Panel 2 VIRIL PAN2

CPT Code(s): 82157 Androstenedione; 83498 17-Hydroxyprogesterone; 84403 Testosterone; 82626 Dehydroepiandrosterone
0020056 Viscosity, Serum VIS-S

Methodology: Quantitative Viscometry
Unacceptable Conditions: Clotted or hemolyzed specimens.
CPT Code(s): 85810
0020054 Viscosity, Whole Blood VIS

Methodology: Quantitative Viscometry
Specimen Required: Collect: Lavender (EDTA), pink (K2 EDTA), or green (sodium or lithium heparin).
Specimen Preparation: DO NOT FREEZE. Transport 3 mL whole blood. (Min: 0.6 mL)
CPT Code(s): 85810
0080525 Vitamin A (Retinol), Serum or Plasma VIT A

Patient Preparation: Patient should fast for 12 hours and abstain from alcohol for 24 hours prior to collection.
Specimen Required: Collect: Green (sodium or lithium heparin) or serum separator tube. Also acceptable: Lavender (EDTA) or pink (K2EDTA).
Specimen Preparation: Protect from light during collection, storage, and shipment. Spin and pour off within 1 hour of collection. Transfer 1
mL serum or plasma to an ARUP Amber Transport Tube immediately. (Min: 0.2 mL) Avoid hemolysis.
Unacceptable Conditions: Whole blood or body fluids other than serum or plasma.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 1 month; Frozen: 1 year
CPT Code(s): 84590
0080389 Vitamin B1 (Thiamine), Plasma VIT B1 P

Specimen Required: Collect: Green (sodium or lithium heparin), lavender (EDTA), or pink (K2 EDTA).
Specimen Preparation: Separate plasma from cells within one hour of collection. Protect from light within one hour of collection, and during
storage and transport. Transfer 3 mL plasma to an ARUP Amber Transport Tube. (Min: 0.2 mL)
Unacceptable Conditions: Hemolyzed specimens or specimens other than heparin or EDTA plasma.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 1 week; Frozen at -20°C: 6 months
CPT Code(s): 84425
0080388 Vitamin B1 (Thiamine), Whole Blood VIT B1 WB

Specimen Preparation: Protect from light within one hour of collection and during storage and shipment. Transfer 3 mL whole blood to an ARUP
Unacceptable Conditions: Any specimen other than whole blood. Glass tubes. Clotted or non-frozen specimens.
CPT Code(s): 84425
0081123 Vitamin B2 (Riboflavin) VITA B2

Specimen Required: Collect: Green (sodium or lithium heparin) or plasma separator tube.
Specimen Preparation: Protect from light within one hour of collection, and during storage and shipment. Transfer 1 mL plasma to an ARUP
Storage/Transport Temperature: CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are requested.
Remarks:
Page | 462
Unacceptable Conditions: Specimens collected in EDTA provide a lower value of riboflavin concentration, therefore EDTA is not acceptable.
Serum, whole blood, or body fluids. Non-frozen, hemolyzed, or lipemic specimens.
CPT Code(s): 84252
0080111 Vitamin B6 (Pyridoxal 5-Phosphate) VIT B6

Patient Preparation: Collect specimen after an overnight fast.
Specimen Required: Collect: Green (sodium or lithium heparin) or plasma separator tube. Also acceptable: Plain red.
Specimen Preparation: Protect from light during collection, storage, and shipment. Separate plasma or serum from cells ASAP or within 2 hours
of collection. Transfer 1 mL plasma or serum to an ARUP Amber Transport Tube and freeze immediately. (Min: 0.5 mL)
Unacceptable Conditions: Any specimens other than heparinized plasma or serum. Non-frozen specimens. Serum separator tubes. Specimens
collected in EDTA yield a higher pyridoxal 5'-phosphate concentration; therefore, EDTA is not acceptable. Hemolyzed specimens.
CPT Code(s): 84207
2003184 Vitamin B7 (Biotin) B7

Methodology: Bioassay
Specimen Preparation: Allow specimen to clot for 30 minutes and separate from cells. Transfer 2 mL serum to an ARUP Amber Transport Tube
and freeze immediately. Protect from light. (Min: 1 mL)
Unacceptable Conditions: Grossly hemolyzed specimens. Thawed specimens or specimens not protected from light.
CPT Code(s): 84591
0070150 Vitamin B12 B12

Specimen Preparation: Protect from light during collection, storage, and shipment. Allow specimen to clot completely at room temperature.
Transfer 1 mL serum or plasma to an ARUP Amber Transport Tube. (Min: 0.5 mL)
CPT Code(s): 82607
0070160 Vitamin B12 & Folate B12/FOL

Specimen Preparation: Protect from light during collection, storage, and shipment. Allow serum to clot completely at room temperature before
centrifuging. Transfer 2 mL serum to an ARUP Amber Transport Tube. (Min: 0.5 mL)
CPT Code(s): 82607 Vitamin B12; 82746 Folate, serum
0070260 Vitamin B12 Binding Capacity B12B

Specimen Preparation: Protect from light during collection, storage, and shipment. Transfer 1 mL serum to an ARUP Amber Transport Tube.
(Min: 0.1 mL)
CPT Code(s): 82608
0055662 Vitamin B12 with Reflex to Methylmalonic Acid, Serum (Vitamin B12 Deficiency) B12 MMA
Methodology: Quantitative Chemiluminescent Immunoassay/Quantitative High Performance Liquid Chromatography-Tandem Mass Spectrometry
Specimen Preparation: Protect from light during collection, storage and shipment. Centrifuge and remove serum from cells within 2 hours of
collection. Transfer 2 mL serum to an ARUP Standard Transport Tube and refrigerate or freeze immediately. (Min: 1.5 mL)
Unacceptable Conditions: Plasma. Room temperature specimens. Grossly hemolyzed or lipemic specimens.
CPT Code(s): 82607 Vitamin B12; if reflexed, add 83921 MMA
2006982 Vitamin B5 (Pantothenic Acid), Serum VIT B5 S

Methodology: Quantitative Cell Based Assay
Specimen Preparation: Transfer 1 mL serum to an ARUP Amber Transport Tube. Protect from light. (Min: 0.5 mL)
Unacceptable Conditions: Grossly hemolyzed or lipemic specimens. Specimens not light protected.
CPT Code(s): 84591
0080380 Vitamin C, Plasma VIT C

Specimen Required: Collect: Green (sodium or lithium heparin). Also acceptable: Lavender (EDTA).
Page | 463
Specimen Preparation: Centrifuge immediately. Transfer 2 mL plasma to a collection tube containing 40 mg oxalic acid (ARUP supply #16569).
Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 1.3 mL)Mix and freeze
within 1 hour of collection. Adequate preservation is 20 mg oxalic acid to 1 mL plasma.
Remarks: The oxalic acid preservative may interfere with other tests.
Unacceptable Conditions: Body fluids other than plasma. Hemolyzed plasma. Non-frozen specimens. Specimens not preserved with oxalic acid.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen (with oxalic acid preservative added): 2 months
CPT Code(s): 82180
0080385 Vitamin D, 1, 25-Dihydroxy VIT D 1,25

Specimen Required: Collect: Serum separator tube or plain red. Also acceptable: Lavender (EDTA) or pink (K2EDTA).
Specimen Preparation: Allow serum separator or plain red tube to sit for 15-20 minutes at room temperature for proper clot formation. Centrifuge
and separate serum or plasma from cells ASAP or within 2 hours of collection. Transfer 2 mL serum or plasma to an ARUP Standard Transport
Tube. (Min: 1 mL)
CPT Code(s): 82652
0080379 Vitamin D, 25-Hydroxy VIT D 25

Specimen Preparation: Transfer 1 mL serum or heparinized plasma to an ARUP Standard Transport Tube. (Min: 0.3 mL)
CPT Code(s): 82306
0080521 Vitamin E, Serum or Plasma VIT E

Patient Preparation: Patient should fast for 12 hours and abstain from alcohol for 24 hours prior to collection.
Specimen Required: Collect: Green (sodium or lithium heparin) or serum separator tube. Also acceptable: Lavender (EDTA) or pink (K2EDTA).
Specimen Preparation: Protect from light during collection, storage, and shipment. Separate serum or plasma from cells within 1 hour of
collection. Transfer 1 mL serum or plasma to an ARUP Amber Transport Tube. (Min: 0.2 mL) Avoid hemolysis.
Unacceptable Conditions: Whole blood or body fluids other than serum or plasma.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 1 month; Frozen at -20°C: 1 year
CPT Code(s): 84446
0099225 Vitamin K1, Serum VIT K

Patient Preparation: Patient should fast overnight for 12 hours and should not consume alcohol for 24 hours prior to blood draw.
Specimen Required: Collect: Plain red or serum separator tube. Also acceptable: Lavender (EDTA) or pink (K2EDTA).
Specimen Preparation: Protect from light within one hour of collection and during storage and shipment. Transfer 2 mL serum or plasma to an
Unacceptable Conditions: Any specimen other than serum or EDTA plasma. Hemolyzed specimens.
Stability: After separation from cells: Ambient: Unacceptable; Refrigerated: 1 month; Frozen: 6 months
CPT Code(s): 84597
0092628 Voltage-Gated Calcium Channel (VGCC) Antibody VGCC AB

Tube. (Min: 0.2 mL)
Unacceptable Conditions: Plasma. Hemolyzed or grossly lipemic specimens.
Stability: After separation from cells: Ambient: 8 hours; Refrigerated: 2 weeks; Frozen: Indefinitely
CPT Code(s): 83519
2004890 Voltage-Gated Potassium Channel (VGKC) Antibody VGKC AB

Specimen Preparation: Separate serum from cells within 1 hour. Transfer 4 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Unacceptable Conditions: Plasma. Grossly lipemic or icteric specimens.
Stability: After separation from cells: Ambient: Less than 72 hours; Refrigerated: 2 weeks; Frozen: 1 month (avoid repeated freeze/thaw cycles)
CPT Code(s): 83519
2002988 von Hippel-Lindau (VHL) Deletion/Duplication VHL DELDUP

CPT Code(s): 83891 Isolation; 83896 Nucleic Acid Probes; 83898 Amplification; 83914 Extension; 83909 Capillary Electrophoresis; 83912 Interpretation
Page | 464
2002970 von Hippel-Lindau (VHL) Sequencing VHL FGS
2002965 von Hippel-Lindau (VHL) Sequencing and Deletion/Duplication VHL FGA

CPT Code(s): Sequencing: 83891 Isolation; 83898 x3 Amplification; 83904 x3 Sequencing; 83909 capillary electrophoresis. Del/Dup: 83896 Nucleic Acid
Probes; 83898 Amplification; 83914 Extension; 83909 Capillary Electrophoresis; 83912 Interpretation and report - Additional CPT code
2005476 von Willebrand Disease, Platelet Type (GP1BA) 4 Mutations GP1BA SEQ
Methodology: Polymerase Chain Reaction/Sequencing/Fragment Analysis
CPT Code(s): 83891 Isolation; 83898 x2 Amplification; 83904 Sequencing; 83909 x2 Capillary electrophoresis; 83912 Interpretation and report - Additional
2005480 von Willebrand Disease, Type 2A (VWF) Sequencing Exon 28 with Reflex to 9 Exons VWF2A SEQ
CPT Code(s): 83891 Isolation; 83898 x3 Amplification; 83904 Sequencing x3; 83909 Capillary electrophoresis; 83912 Interpretation and report. If reflexed to 9
additional exons, add 83898 x9 Amplification; 83904 x9 Sequencing; 83909 Capillary electrophoresis - Additional CPT code modifiers may be
2005486 von Willebrand Disease, Type 2B (VWF) Sequencing VWF2B SEQ

2005490 von Willebrand Disease, Type 2M (VWF) Sequencing VWF2M SEQ

2005494 von Willebrand Disease, Type 2N (VWF) Sequencing VWF2N SEQ

0030250 von Willebrand Factor Activity (Ristocetin Cofactor) RCF

Methodology: Platelet Agglutination
Stability: Ambient: 4 hours; Refrigerated: Unacceptable; Frozen: at -20°C: 3 months; Frozen at -70°C: 6 months
CPT Code(s): 85245
0030285 von Willebrand Factor Antigen VWF/AG

Page | 465
Remarks:
CPT Code(s): 85246
2007136 von Willebrand Factor Collagen Binding VWF C BIND

Specimen Required: Collect: Light blue (citrated).
Specimen Preparation: Transfer 0.5 mL citrated plasma to an ARUP Standard Transport Tube. (Min: 0.2 mL)
CPT Code(s): 85246
0092281 von Willebrand Factor Multimers VWF MULTI

Unacceptable Conditions: Serum. Specimens collected in wrong anticoagulant. Clotted, hemolyzed, or non-frozen specimens.
Stability: Ambient: 4 hours; Refrigerated: Unacceptable; Frozen at -70°C: 6 months; Frozen at -20°C: 2 weeks
CPT Code(s): 85247
0030284 von Willebrand Modified Panel VW PANEL 2

Methodology: Platelet Agglutination/Microlatex Particle-Mediated Immunoassay
CPT Code(s): 85246 vWF/Ag; 85245 vWF/RCF
0030002 von Willebrand Multimeric Panel VW MUL PAN

Methodology: Electrophoresis/Western Blot/Clotting/Microlatex Particle-Mediated Immunoassay/Platelet Agglutination
CPT Code(s): 85247 VW Mul; 85240 F8; 85246 VWF/AG; 85245 vWF/RCF
0030125 von Willebrand Panel VW PANEL

Methodology: Clotting/Platelet Agglutination/Microlatex Particle-Mediated Immunoassay
Remarks:
Stability: Ambient: 4 hours; Refrigerated: Unacceptable; Frozen at -20 °C: 3 months; Frozen at -70°C: 6 months
CPT Code(s): 85240 F8; 85246 vWF/Ag; 85245 vWF/RCF
2003387 von Willebrand Panel with Reflex to von Willebrand Multimeric Analysis VW PANEL R
Methodology: Electrophoresis/Western Blot/Clotting/Microlatex Particle-Mediated Immunoassay/Platelet Agglutination
CPT Code(s): 85240 F8; 85246 vWF/AG; 85245 RCF; If reflexed add 85247 vW Multi
2001737 Voriconazole, Quantitation by LC-MS/MS VORICON AF

Patient Preparation: Specimens collected just before or within 15 minutes of the next dose represent the TROUGH levels. Specimens obtained
within 15-30 minutes after the end of I.V. infusion or 45-60 minutes after an IM injection or 90 minutes after oral intake represent the PEAK
level.
Unacceptable Conditions: Separator tubes. Hemolyzed or lipemic specimens.
CPT Code(s): 80299
2004358 Warfarin Genotyping Plus WARF PLUS

Page | 466
CPT Code(s): 83891 Isolation; 83892 Enzymatic Digestion; 83900 Amplification; 83901 Additional Amplification x13; 88384 Array-based evaluation of
multiple molecular probes; 11 through 50; 83912 Interpretation and report. Additional CPT code modifiers may be required for procedures
performed to test for oncologic or inherited disorders
0051370 Warfarin Sensitivity (CYP2C9 and VKORC1 ) 3 Mutations WARF GENO

CPT Code(s): 83891 Isolation; 83892 Enzymatic Digestion; 83900 Amplification; 83901 Additional Amplification x13; 88384 Array-based evaluation of
multiple molecular probes, 11 through 50; 83912 Interpretation and report. Additional CPT code modifiers may be required for procedures
performed to test for oncologic or inherited disorders
0090805 Warfarin, Serum or Plasma WARF SP

Specimen Preparation: Separate serum or plasma from cells within two hours of collection. Transfer 2 mL serum or plasma to an ARUP Standard
CPT Code(s): 80299
0091230 Warfarin, Urine WARFARIN U

CPT Code(s): 80299
0013030 Warm Auto Adsorption AD-WARM

Specimen Required: Collect: Plain red AND lavender (EDTA) or pink (K2 EDTA).
Transport 10 mL whole blood (plain red) AND 7 mL whole blood (EDTA) in original collection tubes.
Pediatric: Transport 3 mL whole blood (plain red) AND 2 mL whole blood (EDTA) in original collection tubes.
Remarks:
CPT Code(s): 86970 Pretreatment red cells/drugs/chemicals; 86978 Adsorption
0013025 Warm Triple Adsorption AD-TRIPLE

Patient Preparation: Test is performed on patients with warm autoantibodies who have been pregnant or transfused within the past 3 months.
Specimen Required: Collect: Plain red AND lavender (EDTA).
Transport 10 mL whole blood (plain red) AND 7 mL whole blood (EDTA) in original collection tubes.
Pediatric: Transport 3 mL whole blood (plain red) AND 2 mL whole blood (EDTA) in original collection tubes.
Remarks:
CPT Code(s): 86970 x3 Pretreatment red cells/drugs/chemicals; 86978 x3 Adsorption
0050228 West Nile Virus Antibodies, IgG & IgM by ELISA, CSF WNILE CSF
CPT Code(s): 86789 WNV IgG, 86788 WNV IgM
0050226 West Nile Virus Antibodies, IgG & IgM by ELISA, Serum WNILE SER
CPT Code(s): 86789 WNV IgG, 86788 WNV IgM
Page | 467
0050238 West Nile Virus Antibody, IgG by ELISA, CSF WNIL IGG
CPT Code(s): 86789
0050234 West Nile Virus Antibody, IgG by ELISA, Serum WNILE IGG
CPT Code(s): 86789
0050239 West Nile Virus Antibody, IgM by ELISA, CSF WNIL IGM
CPT Code(s): 86788
0050236 West Nile Virus Antibody, IgM by ELISA, Serum WNILE IGM
Unacceptable Conditions: Plasma. Contaminated, hemolyzed, heat-inactivated, or severely lipemic specimens.
CPT Code(s): 86788
0050229 West Nile Virus RNA by RT-PCR WNILE PCR

Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA) or serum separator tube. OR CSF.
Specimen Preparation: Separate serum or plasma from cells.
Transfer 1 mL serum, plasma or CSF to a sterile container. (Min: 0.5 mL)
CPT Code(s): 87798
0098897 Western Equine Encephalitis Antibody, IgG by IFA, CSF WEST G CSF
CPT Code(s): 86654
0050514 Western Equine Encephalitis Antibody, IgG by IFA, Serum WESTERN

CPT Code(s): 86654
Page | 468
0098730 Western Equine Encephalitis, Antibody, IgM by IFA, CSF WEST M CSF
CPT Code(s): 86654
0098734 Western Equine Encephalitis Antibody, IgM by IFA, Serum WEST M SER
CPT Code(s): 86654
0040320 White Blood Cell Count WBC

Specimen Required: Collect: One 5 mL lavender (EDTA) or pink (K2 EDTA).
Specimen Preparation: Mix specimens thoroughly to avoid clotting of specimen.
Storage/Transport Temperature: 5 mL whole blood at 2-8°C. (Min: 0.25 mL of thoroughly mixed whole blood)
Unacceptable Conditions: Frozen or clotted specimens.
Stability: Ambient: 1 day; Refrigerated: 3 days; Frozen: Unacceptable
CPT Code(s): 85048
2004184 Wilms Tumor (WT-1), N-terminus by Immunohistochemistry WT1 IHC

CPT Code(s): 88342
0020598 Wilson Disease Screening Panel, Serum WILSON D

Methodology: Quantitative Immunoturbidimetry/Quantitative Inductively Coupled Plasma-Mass Spectrometry
Specimen Preparation: Centrifuge and pour off serum ASAP or within 2 hours of collection. Do not allow serum to remain on cells. Transfer 4 mL
serum to an ARUP Standard Transport Tube. (Min: 2.5 mL)
Unacceptable Conditions: Separator tubes. Specimens that are not separated from the red cells or clot.
CPT Code(s): 82390 Ceruloplasmin; 82525 Copper; 82525 Copper, free (direct)
0060132 Wound Culture and Gram Stain MC W

Specimen Required: Collect: Aspirate or purulent material. OR swab.
Specimen Preparation: Aspirate fluid: Transfer to a sterile container.
Purulent Material: Transfer to a sterile tube or anaerobe transport media.
Swab: Place in bacterial transport media.
Unacceptable Conditions: Syringes with needle attached. Dry swabs.
CPT Code(s): 87070
2005766 WT1 Mutation Detection by Sequencing WT1

Unacceptable Conditions: Serum or plasma. Specimens collected in anticoagulants other than EDTA. Frozen specimens. Clotted or severely
hemolyzed specimens
Page | 469
CPT Code(s): 83891 Isolation; 83898 x2 Amplification; 83894 Gel separation; 83904 x2 Sequencing, 83912 Interpretation and report - Additional CPT code
2004434 X Chromosome Ultra-High Density Microarray, 954 Genes X ARRAY

Specimen Required: Collect: Contact ARUP's genetic counselor at (800) 242-2787, extension 2141 prior to test submission.
Remarks: Submit the Patient History Form for X Chromosome Array Studies with the Electronic Packing List. Disease specific patient history
forms are available at www.aruplab.com/genetics/forms.php.
CPT Code(s): 83891 Isolation; 88386 x4 Array-based evaluation of multiple molecular probes, 251-500
2006352 X-Chromosome Inactivation Analysis XCI

Methodology: Restriction Enzyme Digestion/Polymerase Chain Reaction/Fragment Analysis
CPT Code(s): 83891 Isolation; 83892 x2 digestion; 83898 x3 Amplification; 83909 Capillary Electrophoresis; 83912 Interpretation and report - Additional CPT
0091383 Xylenes (Total), Serum or Plasma XYLENE PAN

Specimen Required: Collect: Lavender (EDTA) or plain red. Also acceptable: Gray (sodium fluoride/potassium oxalate).
CPT Code(s): 84600
0020609 Xylose Absorption Test (Adult - 25g dose) XYLOSE

Patient Preparation: Patient should fast for 8 hours (Min: 4 hours) prior to administration of xylose.
Specimen Required: Collect: Fasting serum, five-hour urine, and two-hour serum according to the following instructions.
Specimen Preparation: 1. Just prior xylose administration, patient should empty his or her bladder (DO NOT collect this urine).
2. Just prior to xylose administration, collect first serum specimen (Min: 0.5 mL). Allow serum to clot completely at room temperature. Separate
serum from cells ASAP or within 2 hours of collection. Label this specimen as "FASTING SERUM" and prepare for transport.
3. Give adults 25 g D-xylose in 250 mL water. Encourage the patient to drink an additional 250 mL water following the xylose dose. The patient
may have water as desired, but no other food or fluids. Smoking should be prohibited. The patient should rest in a chair or on a bed until
completion of test. Mild diarrhea is common following xylose ingestion.
4. Immediately following the xylose dose, collect all urine for the next five hours. Measure and record the volume, mix well, and remove a 5 mL
aliquot (Min: 3 mL) and prepare for transport. Label this specimen as "FIVE-HOUR URINE." Record the total volume and the xylose dose given
on the urine aliquot tube.
5. Two hours after administration of xylose dose, collect the second serum specimen (Min: 0.5 mL). Allow serum to clot completely at room
temperature. Separate serum from cells ASAP or within 2 hours of collection. Label this specimen as "TWO-HOUR SERUM" and prepare for
transport.
6. Record the xylose dose given and the total volume of the five-hour urine on the test request form.
Failure to include all required information will result in delay of turnaround time.
Remarks: The fasting serum specimen does not have a reference interval since it is used as a blank for the two-hour serum sample.
For children, refer to Xylose Absorption Test (Child) (ARUP test code 0020612).
Unacceptable Conditions: Non-fasting specimens. Whole blood or unspun clot tubes. Grossly hemolyzed serum.
CPT Code(s): 84620
0020615 Xylose Absorption Test (Adult - 5g dose) XYL-5G

Patient Preparation: Patient should fast for 8 hours (Min: 4 hours) prior to administration of xylose.
Specimen Required: Collect: Fasting serum, five-hour urine, and two-hour serum according to the following instructions.
3. Give adults 5 g D-xylose in 250 mL water. Encourage the patient to drink an additional 250 mL water following the xylose dose. The patient
may have water as desired, but no other food or fluids. Smoking should be prohibited. The patient should rest in a chair or on a bed until
completion of test. Mild diarrhea is common following xylose ingestion.
5. Two hours after administration of xylose dose, collect the second serum specimen (Min: 0.5 mL). Allow serum to clot completely at room
temperature. Separate serum from cells ASAP or within 2 hours of collection. Label this specimen as "TWO-HOUR SERUM" and prepare for
transport.
Failure to include all required information will result in delay of turnaround time.
For children, refer to Xylose Absorption Test (Child) (ARUP test code 0020612).
Page | 470
CPT Code(s): 84620
0020612 Xylose Absorption Test (Child) XYLOSE P

Patient Preparation: Children are defined as less than 17 years old for purposes of this test. Patient should fast for 8 hours (Min: 4 hours) prior
to administration of xylose.
Specimen Required: Collect: Fasting serum, five-hour urine, and one-hour serum according to the following instructions.
3. Give children 0.5 g D-xylose per kilogram of body weight, up to 25 g; give xylose in water (5 mL of water per 0.5 g of xylose, up to 250 mL
water). Encourage the patient to drink additional water following the xylose dose. The patient may have water as desired, but no other food or
fluids. The patient should rest in a chair or on a bed until completion of test. Mild diarrhea is common following xylose ingestion.
5. One hour after administration of xylose dose, collect the second serum specimen (Min: 0.5 mL). Allow serum to clot completely at room
temperature. Separate serum from cells ASAP or within 2 hours of collection. Label this specimen as "ONE-HOUR SERUM" and prepare for
transport.
-If unable to collect pediatric urine samples, testing will be completed with a disclaimer, provided both serum specimens are received.
-Failure to include all required information will result in delay of turnaround time.
CPT Code(s): 84620
2001778 Y Chromosome Microdeletion Y CHROM

Methodology: Polymerase Chain Reaction/Electrophoresis
Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA). Also acceptable: Yellow (ACD Solution A or B), lt. blue (sodium citrate), green (sodium or
lithium heparin).
Unacceptable Conditions: Serum. Frozen specimens. Severely hemolyzed specimens.
CPT Code(s): 83891 Isolation; 83900 Amplification, 83901 x8 Multiplex amplification; 83909 Capillary electrophoresis; 83912 Interpretation and report -
2004769 Yeast Differentiation by PNA FISH YST FISH

Methodology: Qualitative Peptide Nucleic Acid Fluorescence in situ Hybridization
Specimen Required: Collect: Client laboratory identified positive blood culture bottle with yeast from an automated or manual system.
Specimen Preparation: Transfer 5 mL aliquot of blood from yeast-positive blood culture bottle to a sterile transport tube. Also acceptable: A yeast-
positive blood culture bottle. (Min: 1 mL)
Remarks: Provide any stain results performed at client laboratory.
Unacceptable Conditions: Negative blood culture. Whole blood, body fluid, or slides.
CPT Code(s): 87149
0051230 Yersinia enterocolitica Antibodies, IgA and IgG by Immunoblot YER PAN
Tube. (Min: 0.2 mL)
CPT Code(s): 86793 Yersinia IgG; 86793 Yersinia IgA
0051241 Yersinia enterocolitica Antibodies, IgA, IgG, and IgM by Immunoblot YER PAN3
Tube. (Min: 0.2 mL)
CPT Code(s): 86793 Yersinia IgA; 86793 Yersinia IgG; 86793 Yersinia IgM
0051228 Yersinia enterocolitica Antibody, IgA by Immunoblot YER IGA

Tube. (Min: 0.1 mL)
Page | 471
CPT Code(s): 86793
0051229 Yersinia enterocolitica Antibody, IgG by Immunoblot YER IGG

Tube. (Min: 0.1 mL)
CPT Code(s): 86793
0051172 Yersinia enterocolitica Antibody, IgM by Immunoblot YER IGM

Tube. (Min: 0.1 mL)
CPT Code(s): 86793
0092392 ZAP-70 Analysis by Flow Cytometry ZAP-70

Specimen Required: Collect: Green (sodium heparin). Also acceptable: Lavender (EDTA) or pink (K2EDTA).
Remarks: Prior diagnosis of CLL is required. Provide CBC results and Wright's stained smear.
Unacceptable Conditions: Frozen specimens. Clotted or hemolyzed specimens. Specimens greater than 48 hours old.
CPT Code(s): 88184 First marker; 88185x2 Additional markers; 88187 Interpretation of 2-8 markers
0020605 Zinc Protoporphyrin (ZPP), Whole Blood ZPP

Methodology: Quantitative Hematofluorometry
Specimen Required: Collect: Lavender (EDTA); Royal blue, (EDTA), tan (EDTA), or pink (K2 EDTA). Use royal blue (EDTA) tube when also testing for lead.
Unacceptable Conditions: Specimens not collected in EDTA. Clotted, frozen, or hemolyzed specimens.
CPT Code(s): 84202
0020614 Zinc Protoporphyrin (ZPP), Whole Blood Industrial ZPP IND

Methodology: Quantitative Hematofluorometry
Specimen Required: Collect: Lavender (EDTA), royal blue (EDTA), or tan (EDTA). Use royal blue (EDTA) tube when also testing for lead.
Unacceptable Conditions: Specimens not collected in EDTA. Clotted, frozen, or hemolyzed specimens.
CPT Code(s): 84202
2006460 Zinc, RBC ZINC RBC

Specimen Required: Collect: Royal Blue (Trace metal-free; EDTA)
supply #43116). Available online through eSupply using ARUP Connector contact ARUP Client Services at (800) 522-2787. (Min.: 0.7 mL)
Unacceptable Conditions: Lavender top (EDTA).
Stability: Ambient: Unacceptable; Refrigerated: 1 month; Frozen: 1 month
CPT Code(s): 84630
0020097 Zinc, Serum ZINC

Patient Preparation: Diet, medication, and nutritional supplements may introduce interfering substances. Upon the advice of their physician,
patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, and nonessential over-the-counter medications for one
week prior to sample draw.
Specimen Required: Collect: Royal blue (no additives), or royal blue (EDTA).
Specimen Preparation: Do not allow serum or plasma to remain on cells. Centrifuge and pour off serum or plasma ASAP or within 2 hours of
collection. Transfer 2 mL serum or plasma to an ARUP Trace Element-Free Transport Tube (ARUP supply #43116). Available online through
Unacceptable Conditions: Separator tubes. Specimens that are not separated from the red cells or clot. Hemolyzed specimens.
CPT Code(s): 84630
2006196 Zinc Transporter 8 Antibody ZNT8 AB

Page | 472
Unacceptable Conditions: Plasma. Grossly hemolyzed specimens.
Stability: After separation from cells: Ambient: 5 days; Refrigerated: 1 week; Frozen: 3 months
CPT Code(s): 86341
0020462 Zinc, Urine ZINC U

CPT Code(s): 84630
0090667 Zinc, Whole Blood ZINC B

Methodology: Quantitative Inductively Coupled Plasma/Optical Emission Spectrometry
CPT Code(s): 84630
0091519 Ziprasidone (Geodon®), Serum or Plasma ZIPRASIDON

Methodology: Quantitative Liquid Chromatography/Mass Spectrometry
(Min: 0.4 mL)
Stability: Ambient: 2 weeks Refrigerated: 2 weeks; Frozen: 1 month
CPT Code(s): 80299
0091232 Zolpidem Quantitation, Serum or Plasma ZOLPIDE

CPT Code(s): 80299
0091151 Zolpidem, Urine - Screen with Reflex to Confirmation/Quantitation ZOLPIDEM

0097908 Zonisamide ZONI

CPT Code(s): 80299
Page | 473
www.aruplab.com | www.arupconsult.com
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Utah and its Department of Pathology
ARUP Laboratories
500 Chipeta Way
Salt Lake City, UT 84108-1221
phone: (800) 522-2787
fax: (801) 583-2712
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LABORATORY

0099746 18-Hydroxycorticosterone 18 HYDCORT

0010003 ABO Group & Rh Type IRL-ABORH

0010014 ABO-Rh Prenatal ABORH-PR

0010025 ABO-Rh Type ABORH-A

Lavender (EDTA) or pink (K2EDTA).

0060245 Acanthamoeba and Naegleria Culture ACANT

2002584 Acanthamoeba and Naegleria Culture and Stains, CSF ACANTCSF

0091533 Acetaminophen and Oxycodone Quantitation, Serum or Plasma PERCOC SP

0091404 Acetaminophen and Oxycodone Quantitation, Whole Blood PERCOCET B

0091366 Acetazolamide, Serum or Plasma ACETAZOLAM

0091374 Acetazolamide, Urine ACETAZO U

0090005 Acetone, Quantitative AC

0091322 Acetophenazine, Serum or Plasma ACETOPHEN

2001571 Acetylcholine Receptor Antibody Reflexive Panel ACHR R PAN

0080009 Acetylcholine Receptor Binding Antibody ACHRBIN

0099580 Acetylcholine Receptor Blocking Antibody ACHRBLO

0099521 Acetylcholine Receptor Modulating Antibody ACHRMOD

2006848 Acetylcholinesterase and Fetal Hemoglobin, Amniotic Fluid ACETYL AF

0051266 Achondroplasia (FGFR3) 2 Mutations AD PCR

0051265 Achondroplasia (FGFR3) 2 Mutations, Fetal AD PCR FE

0049010 Acid Hemolysin (Ham Test) HAM

0020544 Acid Phosphatase, Total, Serum ACS

0060152 Acid-Fast Bacillus (AFB) Culture and AFB Stain MC AFB

0060999 Acid-Fast Bacillus (AFB) Identification MC AFBID

0060997 Acid-Fast Bacillus (AFB) Identification with Reflex to Susceptibility MC AFBIS

0060151 Acid-Fast Bacillus (AFB) Stain Only MS AFB

2003427 ACTH by Immunohistochemistry ACTH IHC

0091246 Actifed, Serum or Plasma ACTIFED SP

2002384 Acute Myelogenous Leukemia Panel by FISH FISH AML P

0091328 Acyclovir, Serum or Plasma ACYCLOV

0091376 Acyclovir, (Zovirax®), Urine ACYCLOVI U

0040033 Acylcarnitine Quantitative Profile, Plasma ACYLCARN

0081170 Acylglycines, Quantitative, Urine ACYLGLY

0030056 ADAMTS13 Activity ADAMTS-13

2006098 Adenosine Deaminase, CSF ADA CSF

2006101 Adenosine Deaminase, Peritoneal Fluid ADA PERIT

2006096 Adenosine Deaminase, Pleural Fluid ADA PLEURA

0083001 Adenosine Deaminase, RBC ADA

0065066 Adenovirus 40-41 Antigens by EIA ADENO AG

0051077 Adenovirus Antibodies, IgG & IgM ADENO PAN

0051073 Adenovirus Antibody, IgG ADENO G

0051078 Adenovirus Antibody, IgM ADENO M

2003430 Adenovirus by Immunohistochemistry ADENOV IHC

2002088 Adenovirus DNA, Qualitative, RT-PCR ADENO QUAL

2007192 Adenovirus, Quantitative PCR ADENO QNT

0070262 Adiponectin ADIP

0092330 Adrenal Steroid Quantitative Panel by LC-MS/MS, Serum or Plasma ADSTEROID

0070010 Adrenocorticotropic Hormone ACTH

0070031 Adrenocorticotropic Hormone Stimulation, 0 Minutes CORTISOL 0

0070032 Adrenocorticotropic Hormone Stimulation, 30 Minutes CORTISOL30

0070033 Adrenocorticotropic Hormone Stimulation, 60 Minutes CORTISOL60

0060115 Aerobic Organism Identification MC ORG

0065070 Aerobic Organism Identification with Reflex to Susceptibility MC ORGIS

0020008 Alanine Aminotransferase, Serum or Plasma ALT

0050024 Albumin, Body Fluid ALB-BF

0050671 Albumin by Nephelometry ALB N

0050200 Albumin, CSF ALB CSF

0080700 Albumin, Glycated GLY ALB

0020030 Albumin, Serum or Plasma by Spectrophotometry ALB

0091312 Albuterol, Serum or Plasma ALBUTEROL

0090131 Alcohols ALCT

0020012 Aldolase, Serum ALDOLASE