Mycoplasma pneumoniae IgG Ab
| PATIENT INFO |
| Patient Name: |
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| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
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| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
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| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Mycoplasma pneumoniae IgG Ab | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
MYCOG
Test Workstation :
CLEVE
Specimen Type:
Blood
Tube Type:
Gold top SST (serum separator tube, no anticoagulant)
Collection Volume:
2.5 mL
Minimum Volume:
1.5 mL
Cause for Rejection:
Hemolyzed, lipemic or icteric specimen; drawn in incorrect tube; QNS
Storage:
Refrigerated
Availability:
Sent to Reference laboratory
Methodology:
Enzyme Immunoassay (EIA)
Special Instructions:
Do not diagnose based on M. pneumoniae IgG alone, but in conjunction with clinical evaluation and other diagnostic results.
Lab/Phone:
330-543-8418
TAT:
1-5 days
CPT Code:
86738
Panel Includes:
M. pneumoniae IgG Ab
M. pneumoniae IgG, Qual
