Technical Update • December 2010
Cleveland Clinic Laboratories is dedicated to keeping you updated and informed about recent testing changes. That's why we are
happy to provide this technical update on a monthly basis.
Recently changed tests are bolded, and could include revisions to methodology, reference range, days performed or CPT code.
For your convenience, tests are listed alphabetically and the order and billing codes are provided.
If you wish to compare the new information with previous test demographics, refer to the Test Directory, which can be accessed at
clevelandcliniclabs.com.
Deleted tests and new tests are listed separately. Please update your database as necessary. For additional detail,
contact Client Services at 216.444.5755 or 800.628.6816 or via email at [email protected].
Laboratories
2 Acylglycines, Quantitative Urine 2 Allergen, Ampicilloyl IgE 2 Allergen, Blueberry IgE 2 Allergen, Chili Pepper IgE 2 Alpha Galactosidase, Leukocytes 7 CA 72-4
3 Cathartic Laxative, Urine 3 CMT Evaluation Complete 3 CMT Evaluation Partial 7 Complement C3, Fluid 7 Complete Ataxia Evaluation 3 Diagnostic CFTR Intron 8 3 Fatty Acid Profi le of Lipids 7 Fee Increase
3 Fragile X Syndrome DNA Analysis 7 HCG, Fluid
3 Herpes Simplex Type 1 and 2 IgG Antibodies 3 Hyperoxaluria, Urine
6 Immunoglobulin Heavy Chain Using Biomed-2 PCR Primers 6 Immunoglobulin Kappa Chain Using Biomed-2 PCR Primers 4 KIT Gene Mutation AML
4 Lefl unomide as Metabolite
7 NeoCerebellar Degeneration Paraneoplastic Profi le 4 NeoComplete Paraneoplastic Profi le with Recombx 4 NeoEncephalitis Paraneoplastic Profi le with Recombx
Test Update
Page #
Order CodeBiling Code
Name Change
New T
est
Test Discontinued
Special Information
Specimen R
equirement
Component Change
Methodology
Reference Range
Days P
erformed/R
epor
ted
CPT
Summary of Changes
by Test Name
Summary of Changes
by Test Name
4 NMP22 Bladder Tumor Marker 7 Pain Panel Drug Screen 4 Pipecolic Acid, Serum 4 Pipecolic Acid, Urine 4 Prealbumin
4 Protein Electrophoresis, Serum 4 Protein Electrophoresis, Serum with IFE 5 Purine and Pyrimidine Panel
5 Quant Pain Panel, Urine 7 Rheumatoid Factor, Body Fluid 5 Syphilis IgG (T pallidum) 5 Syphilis IgG with Confi rmation
6 T-Cell Receptor Beta using Biomed-2 PCR Primers 5 Vitamin B6
Test Update
Page #
Test Changes
Test Name Order Code Billing Code Change Effective Date
Acylglycines,
Quantitative Urine UACYLG 83755 Reference Range: Ethylmalonic Acid: 0.5 - 20.2 mg/g Creat
2-Methylsuccinic Acid: 0.4 - 13.8 mg/g Creat
Glutaric Acid: 0.6 - 15.2 mg/g Creat
Isobutyrylglycine: 0.00 - 11.0 mg/g Creat n-Butyrylglycine: 0.1 - 2.1 mg/g Creat 2-Methylbutyrylglycine: 0.3 - 7.5 mg/g Creat Isovalerylglycine: 0.3 - 14.3 mg/g Creat n-Hexanolyglycine: 0.2 - 1.9 mg/g Creat n-Octanoylglycine: 0.1 - 2.1 mg/g Creat 3-Phenylpropionylglycine: 0.00 - 1.1 mg/g Creat Suberylglycine: 0.00 - 11.0 mg/g Creat trans-Cinnamoylglycine: 0.2 - 14.7 mg/g Creat
Dodecanedioic Acid: (12:0): 0.00 - 1.1 mg/g Creat
Tetradecanedioic Acid: (14:0): 0.00 - 1.0 mg/g Creat
Hexadecanedioic Acid: (16.0): 0.00 - 1.0 mg/g Creat
11/30/2010
Allergen,
Ampicilloyl IgE AMPCIL 83046 Specimen Requirement: 0.1Refrigerated mL serum from a serum separator tube,
Days Performed: Monday - Friday Reported: 1 - 3 days
11/30/2010
Allergen,
Blueberry IgE BLUBRY 83961 Specimen Requirement: 0.1Refrigerated mL serum from a serum separator tube,
Days Performed: Monday - Friday Reported: 1 - 3 days
11/30/2010
Allergen, Chili Pepper IgE
CHILI 82946 Specimen Requirement: 0.1 mL serum from a serum separator tube, Refrigerated
Days Performed: Monday - Friday Reported: 1 - 3 days
11/30/2010
Alpha Galactosidase, Leukocytes
AGAL 87795 Methodology: Fluorimetry (FLM)
Reference Range: ≥23.1 nmol/h/mg protein
Test build may need to be modifi ed
12/2/2010
Order CodeBiling Code
Name Change
New T
est
Test Discontinued
Special Information
Specimen R
equirement
Component Change
Methodology
Reference Range
Days P
erformed/R
epor
Test Name Order Code Billing Code Change Effective Date Cathartic Laxative,
Urine
UCATH 83316 Effective Date: Revised from 11/1/10
Includes:
Desacetyl Bisacodyl (Bisacodyl diphenol), Rhein, Emodin, Aloe-Emodin
Test build may need to be modifi ed
Specimen Requirement:
5 mL urine in a clean container, Refrigerated
Methodology:
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS) Days Performed: Wednesday
Reported: 4 - 10 days 12/6/2010 CMT Evaluation Complete CMTCOM 82413 CPT: 83891, 83896x11, 83898x143, 83900, 83901x9, 83904x143, 83909x17, 83914x11 12/1/2010 CMT Evaluation Partial CMTEVL 82114 CPT: 83891, 83896x11, 83898x68, 83900, 83901x9, 83904x68, 83909x12, 83914x11 12/1/2010 Diagnostic CFTR Intron 8
CFTR 80937 Clinical Information: Poly(T) analysis is performed refl exively for those individuals identifi ed as R117H-positive since poly(T) modifi es the clinical effects for R117H. This is consistent with the ACOG/ACMG recommendations and their goal of offering screening to identify couples at risk for having a child with CF. Additionally, poly(T) testing is ordered in certain diagnostic situations (e.g. congenital bilateral absence of the vas deferens (CVBAVD) and idiopathic pancreatitis). Days Performed: Monday - Friday
Reported: 6 - 10 days
1/13/2011
Fatty Acid Profi le of Lipids
CFA 76258 Specimen Requirement: 1 mL serum from a serum separator tube;
Remove serum from cells within 45 minutes and freeze
1/20/2011 Fragile X Syndrome
DNA Analysis
FRAGIL 82365 Specimen Requirement: 3 mL whole blood in an EDTA lavender top tube, Ambient
Days Performed: Monday
Reported: 15 - 23 days
1/13/2011
Herpes Simplex Type 1 and 2 IgG Antibodies
HSVG12 82513 Methodology: Multiplex Reference Range:
Herpes Simplex IgG 1: Negative: <0.91 AI
Equivocal: 0.9 - 1.0 AI Positive: >1.0 A1
Herpes Simplex IgG 2: Negative: <0.91 AI
Equivocal: 0.9 - 1.0 AI Positive: >1.0 AI Days Performed: Sunday - Friday Reported: 1 - 4 days
1/6/2011
Hyperoxaluria, Urine UHYPER 87816 Reference Range: Glycolate:
Age: 0 - 31 Days: 0-57 mg/g Creat
Age: 1 - 5 Months: 0-54 mg/g Creat
Age: 6 - 12 Months: 0-60 mg/g Creat
Age: 1 - 5 Years: 0-89 mg/g Creat
Age: ≥ 6 Years: 0-78 mg/g Creat
Glycerate:
Age: 0 - 31 Days: 0-38 mg/g Creat
Age: 1 - 5 Months: 0-71 mg/g Creat
Age: 6 - 12 Months: 0-56 mg/g Creat
Age: 1 - 5 Years: 0-17 mg/g Creat
Age: ≥ 6 Years: 0-8 mg/g Creat
Glyoxylate:
Age: 0 - 31 Days: 0.0-7.9 mg/g Creat
Age: 1 - 5 Months: 0.0-11.4 mg/g Creat
Age: 6 - 12 Months: 0.0-5.5 mg/g Creat
Age: 1 - 5 Years: 0.0-3.9 mg/g Creat
Age: ≥ 6 Years: 0.0-2.9 mg/g Creat
Oxalate:
Age: 0 - 31 Days: 0-301 mg/g Creat
Age: 1 - 5 Months: 0-398 mg/g Creat
Age: 6 - 12 Months: 0-280 mg/g Creat
Age: 1 - 5 Years: 0-128 mg/g Creat
Age: 6 - 10 Years: 0-72 mg/g Creat
Age: ≥11 Years: 0-56 mg/g Creat
11/30/2010
Test Changes (cont.)
Test Name Order Code Billing Code Change Effective Date KIT Gene
Mutation AML
KITAML 84158 Specimen Requirement: 7 mL whole blood in an EDTA lavender top tube; Ambient
Methodology: Polymerase Chain Reaction (PCR), Sequencing
1/13/2011
Lefl unomide
as Metabolite LEFLUN 83212 Days Performed:Reported: 4 - 5 days Sunday - Saturday 1/6/2011 NeoComplete Paraneoplastic Profi le with Recombx NEOPAR 82398 CPT: 83516, 83519x3, 83520, 84181, 84182x6, 86255 12/2/2010 NeoEncephalitis Paraneoplastic Profi le with Recombx
CEPHAL 82188 Includes: anti-CV2, anti-Hu, anti-Ma, anti-Ta, GAD Antibodies, VGKC Antibodies, Amphiphysin, NMDA Receptor (NR1)
Specimen Requirement: 3 mL serum from a red top tube, Refrigerated
Methodology: Enzyme-Linked Immunosorbent Assay (ELISA), Western Blot (WB), Immunoprecipitation, Indirect Fluorescent Antibody (IFA) Reference Range: anti-CV2: Negative anti-Hu: Negative anti-Ma: Negative anti-Ta: Negative VGKC Antibodies: Negative Amphiphysin: Negative
GAD Antibodies: Initial run at neat; negative = 0; If result is positive, sample is diluted and reference ranges are as follows: Negative: 1 - 600
Borderline: 600 - 1200 Positive: >1200
NMDA Receptor (NR1): Negative Days Performed: Monday - Thursday
Reported: 29 - 30 days
CPT: 83519, 83520, 84182x2, 83516, 84181, 86255
12/23/2010
NMP22 Bladder
Tumor Marker NMP22 79588 Days Performed: Wednesday, SaturdayReported: 2 - 6 days 1/3/2011 Pipecolic Acid,
Serum
PIPE 84130 Reference Range:
0 - 1 week: 3.75 - 10.8 nmol/mL
>1 week: 0.7 - 2.5 nmol/mL
11/30/2010
Pipecolic Acid, Urine UPIPE 84129 Reference Range:
0 - 6 months: 9.81 - 84.5 nmol/mg creat
>6 months: 0.15 - 13.6 nmol/mg creat
11/30/2010
Prealbumin PREALB 32108 Methodology: Immunoturbidimetric Assay Days Performed: Sunday - Saturday
Reported: 1 - 2 days
12/1/2010
Protein Electrophoresis, Serum
SEPG 84165 Special information: When a M Protein is present, the calculation of the percent change from a previous M Protein result will no longer be performed.
12/21/2010
Protein Electrophoresis, Serum with IFE
SEPGRX 82257 Special information: When a M Protein is present, the calculation of the percent change from a previous M Protein result will no longer be performed.
Test Name Order Code Billing Code Change Effective Date Purine and
Pyrimidine Panel
UPURPY 82921 Reference Range:
Uracil:
Age: 0 - 2 Years: < 32 mmol/mol crt
Age: 3 - 5 Years: < 21 mmol/mol crt
Age: 6 - 11 Years: < 17 mmol/mol crt
Age: 12 - 99 Years: < 12 mmol/mol crt
Uric Acid:
Age: 0 - 2 Years: 359 - 2644 mmol/mol crt
Age: 3 - 5 Years: 185 - 1134 mmol/mol crt
Age: 6 - 11 Years: 199 - 1034 mmol/mol crt
Age: 12 - 99 Years: 49 - 692 mmol/mol crt
Hypoxanthine:
Age: 0 - 2 Years: < 99 mmol/mol crt
Age: 3 - 5 Years: < 59 mmol/mol crt
Age: 6 - 11 Years: < 52 mmol/mol crt
Age: 12 - 99 Years: < 29 mmol/mol crt
Xanthine:
Age: 0 - 2 Years: < 66 mmol/mol crt
Age: 3 - 5 Years: < 40 mmol/mol crt
Age: 6 - 11 Years: < 32 mmol/mol crt
Age: 12 - 99 Years: < 20 mmol/mol crt
12/20/2010
Quant Pain
Panel, Urine UQNTPP 82347 Test Name:Order Code: Previously Pain Panel with MethadonePreviously PAINME Components:
Cannabinoid (marijuana), Amphetamine, Methamphetamine, Benzoylecognine (Cocaine), Codeine, Morphine, Dihydrocodeine, Hydrocodone, Oxycodone, Hydromorphone, Oxymorphone (Opiates), Methadone, EDDP (methadone metabolite), Tramadol,
Desmethyltramadol (Tramadol metabolite), Propoxyphene, Norpropoxyphene (Propoxyphene metabolite), Fentanyl, Norfentanyl (Fentanyl metabolite), Creatinine, pH, Specifi c Gravity, Oxidants
Special Information: For medical purposes only; not valid for forensic use. Confi rmation testing is not included with this analysis
Specimen Requirement: 10 mL unpreserved random urine in a clean container, Refrigerated
Methodology: Liquid Chromatography - Tandem Mass Spectrometry (LC-MS/MS)
Performed: Monday, Wednesday Reported: 3 - 7 days
CPT: 82145x2, 82520, 80299, 83840x2, 83925x12, 82646
12/6/2010
Syphilis IgG (T pallidum)
SYPHG 84565 Reference Range:
Non-Reactive: ≤0.8 AI Weakly Reactive: 0.9 - 5.9 AI
Reactive: ≥6.0 AI
12/8/2010
Syphilis IgG with Confi rmation
SYPHGX 84566 Special Information: Patients > 6 months of age:
A weakly reactive or reactive Syphilis IgG (SYPHG) result will be confi rmed by RPR at an extra cost.
A non-reactive RPR result will have FTA, Syphilis IgG Confi rmation test (FTAABS) performed at an extra fee.
A reactive RPR result will have a RPR quant with titer (RPRQNT) performed at an extra fee.
Patients <6 months of age:
A weakly-reactive or reactive SYPHG result will be reported without confi rmation.
Reference Range: Non-reactive:≤0.8 AI Weakly Reactive: 0.9 - 5.9 AI Reactive: ≥6.0 AI
Test build may need to be modifi ed
12/8/2010
Vitamin B6 VITB6 84207 Reference Range: 20.0 - 125.0 nmol/L 11/15/2010
Test Changes (cont.)
Test Name Order Code Billing Code Test Information Effective Date Immunoglobulin
Heavy Chain Using Biomed-2 PCR Primers
IGHPCR 87960 Specimen Requirement:
10 mm square fresh tissue in clean container, Ambient *OR* 10 mm square frozen tissue in clean container; Fresh or frozen tissues should be delivered to Surgical Pathology.*OR*
Paraffi n-embedded tissue block, Ambient. Deliver to Anatomic Pathology. *OR*
2 mL bone marrow in an EDTA lavender top tube, Refrigerated *OR* 8 mL whole blood in an EDTA lavender top tube, Refrigerated *OR* 6 μg extracted DNA, Frozen
Methodology: Polymerase Chain Reaction (PCR), Capillary Electrophoresis (CE)
Reference Range: Negative
Days Performed: Tuesday, Thursday
Reported: 10 - 14 days
CPT: 83891, 83898x3, 83909x3, 83912
Price: $725.00 (non-discountable)
12/1/2010
Immunoglobulin Kappa Chain Using Biomed-2 PCR Primers
IGKPCR 87954 Specimen Requirement:
10 mm square fresh tissue in clean container, Ambient *OR* 10 mm square frozen tissue in clean container; Fresh or frozen tissues should be delivered to Surgical Pathology. *OR*
Paraffi n-embedded tissue block, Deliver to Anatomic Pathology, Ambient *OR*
2 mL bone marrow in an EDTA lavender top tube, Refrigerated *OR* 8 mL whole blood in an EDTA lavender top tube, Refrigerated *OR* 6 μg extracted DNA, Frozen
Methodology: Polymerase Chain Reaction (PCR), Capillary Electrophoresis (CE)
Reference Range: Negative
Days Performed: Tuesday, Thursday
Reported: 10 - 14 days
CPT: 83891, 83900, 83901x4, 83909x2, 83912
Price: $725.00 (non-discountable)
12/1/2010
T-Cell Receptor Beta using Biomed-2 PCR Primers
TCRB 87965 Specimen Requirement:
10 mm square tissue in a clean container; Deliver to Surgical Pathology, Frozen *OR*
10 mm square paraffi n embedded tissue block; Deliver to Anatomic Pathology, Ambient *OR*
2 mL bone marrow in an EDTA lavender top tube, Refrigerated *OR* 2 mL body fl uid in a clean container; Fluid must contain at least 3 million cells, Refrigerated *OR*
5 mL whole blood in an EDTA lavender top tube, Refrigerated *OR* 6 μg extracted DNA, Frozen
Methodology: Polymerase Chain Reaction (PCR), Capillary Electrophoresis (CE)
Reference Range: Negative
Days Performed: Tuesday, Thursday
Reported: 10 - 14 days
CPT: 83891, 83898, 83900, 83901x3, 83909x3, 83912
Price: $725.00 (non-discountable)
Discontinued Tests
Test Name Order Code Billing Code Test Information Effective Date
CA 72-4 CA724 81300 This test will no longer be available. 11/24/2010 Complement C3, Fluid FC3 78200 This test will no longer be available. Suggest ordering Body Fluid, Misc
(FMISCT)
12/1/2010 Complete
Ataxia Evaluation
ATAXIA 82115 This test will no longer be available. 1/6/2011 HCG, Fluid FHCG 77928 This test will no longer be available. Suggest ordering Body Fluid, Misc
(FMISCT)
12/1/2010 NeoCerebellar
Degeneration Paraneoplastic Profi le
CERDEG 82187 This test will no longer be available. 1/6/2011
Pain Panel
Drug Screen PAINPL 81505 This test will no longer be available. Suggest ordering Quant Pain Panel, Urine (UQNTPP) 12/6/2010 Rheumatoid Factor,
Body Fluid FRF 78219 This test will no longer be available. Suggest ordering Body Fluid, Misc (FMISCT) 12/1/2010
