Giardia and Cryptosporidium Screen
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
| Address: |
| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
| Ph: ( ) - Fax: ( ) - |
| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Giardia and Cryptosporidium Screen | |
| 2. | |
| 3. | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
OPSCR
Test Workstation :
MIC2
Specimen Type:
500mg (marble sized amount) of solid stool or 1 mL liquid stool in sterile container or in Cary-Blair medium.
Minimum Volume:
Formed stool minimum volume is 250mg (pea sized amount). Liquid stool minimum volume is 0.5 mL.
Cause for Rejection:
Reject if Stool is >2 hours at room temperature, or >24 hours at 28C or Frozen. Sticks left in container will dry out stool.
Storage:
Refrigerated 2-8 C for <24 hours.
Availability:
Mon-Sun (0700-1600)
Methodology:
Immunochromatographic Assay
Lab/Phone:
330-543-8406
TAT:
48 hours
Additional Info:
Test only screens for the presence of Giardia and Cryptosporidium antigen in stool. If the physician suspects parasitic infection other than Giardia or Cryptosporidium, call Microbiology (330-543-8412) and request send out test Ova and Parasite Microscopy, Concentrate, and Permanent Smear (LAB3201).
CPT Code:
87328 X2
Synonyms:
Ova and Parasite screen
