Strep Culture
| 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. Strep Culture | |
| 2. | |
| 3. | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
STREP
Test Workstation :
MMIC2
Specimen Type:
Throat swab, Rectal swab, Vaginal swab
Tube Type:
Dual rayon Swab can be used for throat if collected for Group A Ag also, or Eswab can be used for all specimen types.
Collection Volume:
Swab
Storage:
Ambient
Availability:
Daily
Methodology:
Culture
Special Instructions:
These cultures are screened for Group A Streptococcus only! Orders must state specific site of specimen. If patient has a positive Group A antigen test, a Strep culture is not necessary. Antibiotic sensitivities will be performed only on nonrespiratory sites.
Lab/Phone:
330-746-9623
TAT:
48 hours
Additional Info:
Preliminary report available after 24 hours
CPT Code:
87081
Synonyms:
Throat Culture for Strep; Strep Screen Culture
