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Hepatitis A IgM Antibody

Infectious Disease Laboratories : Immunology

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. Hepatitis A IgM Antibody
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Test ID/Workstation :

HEPAM MAYO

Specimen Type:

Blood

Tube Type:

Gold top SST (serum separator tube, no anticoagulant)

Collection Volume:

2.5 mL (minimum 1.0 mL)

Storage:

Refrigerated

Availability:

Sent to reference lab

Methodology:

Chemiluminescence Microparticle Immunoassay (CIA)

Special Instructions:

Spin down and remove serum from clot within 24 hours. If collected at an offsite location, send by a STAT Courier to Hospital lab

Lab/Phone:

330-543-8418

TAT:

1-2 days

Additional Info:

Reference range: Negative

CPT Code:

86709

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Hepatitis A IgM Antibody

Infectious Disease Laboratories : Immunology

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