Broad Range Microbiology PCR
| PATIENT INFO |
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| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
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| Additional Report to: |
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| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Broad Range Microbiology PCR | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
LAB4567
Specimen Type:
Fresh Frozen tissue, body fluid (non-bloody), paraffin embedded tissue. Eswab is acceptable.
Tube Type:
Sterile container
Collection Volume:
Fresh frozen tissue, paraffin embedded tissue, or non-bloody body fluid accepted.
Cause for Rejection:
Blood, serum, plasma, stool, formalin tissue not acceptable. Reject if collected in swabs other than Eswabs
Storage:
Tissue, body fluid-Frozen, paraffin embedded tissue- Room temp
Availability:
Sent to Reference Laboratory (University of Washington)
Methodology:
Polymerase Chain Reaction (PCR); Next Generation sequencing
Special Instructions:
Specify Broad Range PCR:
Bacterial PCR (reflex to Next Generation Sequencing for polymicrobial specimens)
Fungal PCR
AFB PCR (including nontuberculous Mycobacteria)
Bacterial PCR (reflex to Next Generation Sequencing for polymicrobial specimens)
Fungal PCR
AFB PCR (including nontuberculous Mycobacteria)
Lab/Phone:
330-543-8412
Additional Info:
Bacterial PCR -respiratory and genitourinary samples may also be submitted and will include reflexed testing to Next Generation sequencing. Eswab is the only validated swab specimen that is acceptable.
Fungal PCR- BAL or skin scrapings also acceptable.
AFB PCR- sputum tested for MTB Complex and/or M. avium complex only.
Fungal PCR- BAL or skin scrapings also acceptable.
AFB PCR- sputum tested for MTB Complex and/or M. avium complex only.
CPT Code:
Bacterial PCR or Fungal PCR CPT code 87801; MTB PCR -87556, Non Tuberculosis PCR- 87551; Next Gen. Bacterial Sequencing -87801
Synonyms:
Bacterial PCR, Fungal PCR, Mycobacterial PCR, AFB PCR
