Fat, Feces (Qualitative and Quantitative)

Centralized Core Laboratory - Mayo Clinic Laboratories : Send Out

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. Fat, Feces (Qualitative and Quantitative)
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

FATF

Test Workstation :

MAYO

Specimen Type:

Stool

Tube Type:

Stool container

Collection Volume:

Qualitative: min 5 grams. Quantitative: Entire 24, 48 or 72 hour stool collection (send all stool); entire collection must contain at least 5 grams.

Storage:

Frozen

Availability:

Sent to reference lab

Methodology:

Nuclear Magnetic Resonance (NMR) Spectroscopy

Special Instructions:

For Qualitative requests, please indicate that stool is a RANDOM collection. For Quantitative requests (24, 48 or 72 hour stool), mark each container with patient information and date and time collection started and finished, and number of containers (ex., 1 of 4). For 3 days prior to and during the collection period: no barium, no laxatives, no synthetic fat substitutes or fatblocking nutritional supplements. The use of diaper rash ointments will falsely elevate test results.

Lab/Phone:

330-543-8418

TAT:

1-3 days

Additional Info:

Ref. range:

> or = 18 years: 2-7 g/24 hrs

Reference values have not been established for patients who are <18 years of age

Random Collection: All ages: 0-19% fat

CPT Code:

82710

Synonyms:

Fecal Fat, Qualitative Fecal Fat, Quantitative

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Fat, Feces (Qualitative and Quantitative)

Centralized Core Laboratory - Mayo Clinic Laboratories : Send Out

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