Streptococcus pneumoniae IgG Ab, 23 serotypes
| 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. Streptococcus pneumoniae IgG Ab, 23 serotypes | |
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| 3. | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
SPIGG
Test Workstation :
MAYO
Specimen Type:
Blood
Tube Type:
Red top (no anticoagulant) tube
Collection Volume:
1.5 mL (1.0 mL minimum)
Cause for Rejection:
Gross hemolysis, Gross lipemia
Storage:
Refrigerated
Availability:
Sent to Reference Laboratory
Methodology:
Microsphere Photometry
Lab/Phone:
330-543-8418
TAT:
4-6 days
Additional Info:
Reference Range: Results are reported in mcg/mL
Serotype 1 (1) > or = 2.3
Serotype 2 (2) > or = 1.0
Serotype 3 (3) > or = 1.8
Serotype 4 (4) > or = 0.6
Serotype 5 (5) > or = 10.7
Serotype 8 (8) > or = 2.9
Serotype 9N (9) > or = 9.2
Serotype 12F (12) > or = 0.6
Serotype 14 (14) > or = 7.0
Serotype 17F (17) > or = 7.8
Serotype 19F (19) > or = 15.0
Serotype 20 (20) > or = 1.3
Serotype 22F (22) > or = 7.2
Serotype 23F (23) > or = 8.0
Serotype 6B (26) > or = 4.7
Serotype 10A (34) > or = 2.9
Serotype 11A (43) > or = 2.4
Serotype 7F (51) > or = 3.2
Serotype 15B (54) > or = 3.3
Serotype 18C (56) > or = 3.3
Serotype 19A (57) > or = 17.1
Serotype 9V (68) > or = 2.6
Serotype 33F (70) > or = 1.7
Days Performed: Mon-Fri 8AM
CPT Code:
86317 x22
