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. Protein S Antigen, Plasma
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6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
PSTF
Test Workstation :
MAYO
Specimen Type:
Blood
Tube Type:
Blue top (sodium citrate) tube
Collection Volume:
2.7 mL (minimum 1.8mL) - properly filled tube. Must use appropriate sodium citrate tube based on volume of blood drawn(1.8mL or 2.7mL)
Cause for Rejection:
Gross hemolysis, Gross lipemia, Grossly icteric
Storage:
Frozen
Availability:
Sent to reference lab
Methodology:
Latex Immunoassay (LIA)
Special Instructions:
Days Performed: Mon Fri
Centrifuge, remove plasma, centrifuge plasma again
Please send 1 mL frozen citrated plasma.
If collected at an offsite location, send by a STAT Courier to Hospital lab.
Lab/Phone:
330-543-8418
TAT:
1-3 days
Additional Info:
Reference Range:
TOTAL
Males: 80-160%
Females:
<50 years: 70-160%
> or =50 years: 80-160%
FREE
Males: 65-160%
Females:
<50 years: 50-160%,/ul>
> or =50 years: 65-160%
Normal, full-term newborn infants or healthy premature infants may have decreased levels of total protein S (15-50%); but because of low levels of C4b-binding protein, free protein S may be normal or near the normal adult level (> or =50%). Total protein S reaches adult levels by 90 to 180 days postnatal.
CPT Code:
85305, 85306
Panel Includes:
Total Protein S; Free Protein S
Protein S Antigen, Plasma
Test ID/Workstation :
PSTF
Specimen Type:
Blood
Tube Type:
Blue top (sodium citrate) tube
Collection Volume:
2.7 mL (minimum 1.8mL) - properly filled tube. Must use appropriate sodium citrate tube based on volume of blood drawn(1.8mL or 2.7mL)
Cause for Rejection:
Gross hemolysis, Gross lipemia, Grossly icteric
Storage:
Frozen
Availability:
Sent to reference lab
Methodology:
Latex Immunoassay (LIA)
Special Instructions:
Days Performed: Mon Fri
Centrifuge, remove plasma, centrifuge plasma again
Please send 1 mL frozen citrated plasma.
If collected at an offsite location, send by a STAT Courier to Hospital lab.
Lab/Phone:
330-543-8418
TAT:
1-3 days
Additional Info:
Reference Range:
TOTAL
Males: 80-160%
Females:
<50 years: 70-160%
> or =50 years: 80-160%
FREE
Males: 65-160%
Females:
<50 years: 50-160%,/ul>
> or =50 years: 65-160%
Normal, full-term newborn infants or healthy premature infants may have decreased levels of total protein S (15-50%); but because of low levels of C4b-binding protein, free protein S may be normal or near the normal adult level (> or =50%). Total protein S reaches adult levels by 90 to 180 days postnatal.
CPT Code:
85305, 85306
Panel Includes:
Total Protein S; Free Protein S
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