We are experiencing exceptionally high volumes in our emergency rooms.
Every patient is important to us, and we are doing all we can to provide care quickly and efficiently.

BK Virus PCR, Quantitative

Molecular Diagnostics : DNA

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. BK Virus PCR, Quantitative
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

BKVQN DNA2

Specimen Type:

Plasma, Urine

Tube Type:

Purple top (EDTA) tube

Collection Volume:

2.5 mL EDTA blood, 0.5 mL urine

Storage:

Refrigerated

Availability:

Batch testing on Monday and Thursday

Methodology:

Real-Time Polymerase Chain Reaction (PCR)

Special Instructions:

Centrifuge purple top promptly and send 1 mL (minimum 0.5 mL) of EDTA plasma or urine, refrigerated.

Lab/Phone:

330-543-8722

TAT:

1-3 days

Additional Info:

Reference Range: Negative: No BK Virus Detected

CPT Code:

87799

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