NMO/AQP4 FACS, Serum
| 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. NMO/AQP4 FACS, Serum | |
| 2. | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
NMOFS
Test Workstation :
MAYO
Specimen Type:
Blood - Serum
Tube Type:
Red Top Tube (no anticoagulant)
Collection Volume:
7.5mL (minimum 5.0mL)
Storage:
Refrigerated
Availability:
Sent to Reference Laboratory
Methodology:
Flow Cytometry
Lab/Phone:
330-543-8418
TAT:
5-8 days
Additional Info:
Reference range available on patient report
CPT Code:
86053 and if reflexed 86053- titer
Panel Includes:
Reflex test is NMO/AQP4 FACS Titer, Serum
Synonyms:
AQP, AQP4, Aquaporin, Devic's Antibody, NMO(Neuromyelitis Optica), NMOIgG, Optic Neuritis Antibody
