Centralized Core Laboratory - Mayo Clinic Laboratories :
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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. Homovanillic Acid, Urine
2.
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SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
HVA
Test Workstation :
MAYO
Specimen Type:
Urine
Tube Type:
Urine container
Collection Volume:
24HR URINE COLLECTION
Laboratory will aliquot 5.0 mL (minimum 2.0 mL)
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Special Instructions:
Instruct patient on 24 hour urine collection. To begin the urine collection, have the patient void. DISCARD THIS URINE SPECIMEN. This is best done with the first morning specimen. Note the time and record on the requisition. From then on collect all the urine that is voided and place in container. If more than one container is needed, please mark the first as #1 of 2 and retain on the floor until the collection is complete. The final void should be made 24 hours after the first void described earlier. The specimen should be included with the collection. Refrigerate 24 hour urines during collection. Indicate total 24hour volume. Bactrim may interfere with determination of the analyte.
Administration of Ldopa may falsely increase homovanillic acid results; it should be discontinued 24 hours prior to and during collection of specimen. The sensitivity of this test is greater on a 24hour specimen than on a random specimen. Bactrim may interfere with detection of the analyte. All patients taking Bactrim should be identified to the laboratory when this test is ordered.
Lab/Phone:
330-543-8418
TAT:
2-4 days
Additional Info:
Ref. range is age dependent; available on patient report
Collection duration and urine volume are required.
Patient's age is required.
Laboratory will add 25 mL of 50% acetic acid as preservative after collection.
For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly).
THIS TEST IS FOR 24HR COLLECTIONS ONLY. FOR RANDOM SPECIMENS PLEASE ORDER ON A MANUAL REQUISITION.
CPT Code:
83150
Homovanillic Acid, Urine
Test ID/Workstation :
HVA
Specimen Type:
Urine
Tube Type:
Urine container
Collection Volume:
24HR URINE COLLECTION
Laboratory will aliquot 5.0 mL (minimum 2.0 mL)
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Special Instructions:
Instruct patient on 24 hour urine collection. To begin the urine collection, have the patient void. DISCARD THIS URINE SPECIMEN. This is best done with the first morning specimen. Note the time and record on the requisition. From then on collect all the urine that is voided and place in container. If more than one container is needed, please mark the first as #1 of 2 and retain on the floor until the collection is complete. The final void should be made 24 hours after the first void described earlier. The specimen should be included with the collection. Refrigerate 24 hour urines during collection. Indicate total 24hour volume. Bactrim may interfere with determination of the analyte.
Administration of Ldopa may falsely increase homovanillic acid results; it should be discontinued 24 hours prior to and during collection of specimen. The sensitivity of this test is greater on a 24hour specimen than on a random specimen. Bactrim may interfere with detection of the analyte. All patients taking Bactrim should be identified to the laboratory when this test is ordered.
Lab/Phone:
330-543-8418
TAT:
2-4 days
Additional Info:
Ref. range is age dependent; available on patient report
Collection duration and urine volume are required.
Patient's age is required.
Laboratory will add 25 mL of 50% acetic acid as preservative after collection.
For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly).
THIS TEST IS FOR 24HR COLLECTIONS ONLY. FOR RANDOM SPECIMENS PLEASE ORDER ON A MANUAL REQUISITION.
CPT Code:
83150
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