IgG Synthesis and Index

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. IgG Synthesis and Index
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

SFIN

Test Workstation :

MAYO

Specimen Type:

Blood & CSF

Tube Type:

Serum-Red Top and CSF-Sterile Vial

Collection Volume:

5.0 mL (minimum 2.5 mL) serum and 1.0 mL CSF (minimum 0.5 mL)

Cause for Rejection:

Not labeling specimen with correct source such as serum or spinal fluid. Grossly Lipemic Serum

Storage:

Refrigerated

Availability:

Sent to reference lab

Methodology:

Nephelometry and Photometric

Special Instructions:

Serum and spinal fluid are required. Specimens must be obtained within 1 week of each other. Serum must be poured off in two separate vials, each containing at least 0.5 mL.

Lab/Phone:

330-543-8418

TAT:

2-5 days Performed Monday through Friday

Additional Info:

Reference ranges are available on patient report

CPT Code:

82040,82042,82784

Panel Includes:

IgG Index, CSF IgG, Serum Albumin, Serum IgG, CSF Albumin, CSF IgG/Albumin, Serum IgG/Albumin, CSF Synthesis Rate, CSF

Synonyms:

Cerebrospinal Fluid (CSF) IgG Index CSF (Cerebrospinal Fluid) Specific Protein IgG (immunoglobulinG), Albumin CSF Index CSF, Specific Protein IgG, Albumin IgG (Immunoglobulin G) Index IgG (Immunoglobulin G) Spinal Fluid IgG (Immunoglobulin G) Synthesis Rate IgG Index IgG Synthesis Rate Synthesis Rate IgG

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IgG Synthesis and Index

Centralized Core Laboratory - Mayo Clinic Laboratories : Send Out

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