Influenza A/B, Qualitative NAAT

Laboratory : Microbiology

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. Influenza A/B, Qualitative NAAT
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

IDFLU/MMIC2

Specimen Type:

Nasopharyngeal swab

Tube Type:

1 NPH flocked swab (dry or placed in M4)

Collection Volume:

1 NPH flocked swab

Cause for Rejection:

Incorrect swab received (e.g. oropharyngeal or Eswab). Swab received in inappropriate transport media (not approved VTM such as M4 media). Swab/sample received beyond stability limits for testing.

Storage:

Direct NP swab: - Room Temp: 2 hours; 2-8°C (refrig.): up to 24 hours; NP swab in VTM: - Room Temp: 8 hours; 2-8°C (refrig): up to 24 hours

Availability:

24/7

Methodology:

Isothermal nucleic acid amplification.

Special Instructions:

Collect NPH swab specimen using standard respiratory swab collection processes. Label and transport to the laboratory for testing as soon as possible. Transport and store refrigerated at 2-8°C. If sample is placed in viral transport medium (VTM), do NOT use the pneumatic tube system. Alternatively, dry swabs can be sent using the pneumatic tube system.

Lab/Phone:

330-746-9623

TAT:

2 hours

CPT Code:

87502-QW

Synonyms:

Influenza, Flu