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Test Code PREFUG PROFILE NEW AMERICAN ASSESSMENT

Important Note

Tests included are: CBC, Differential, Hepatitis B Antibody, Hepatitis B Surface Antigen, Hepatitis B Core Antibody, Hold SST Tube, LeadSyphilis Serology, Varicella IgG Antibody and Hemoglobin and Thalassemia Evaluation.

Test subject to Medicare National Coverage Determination (NCD).  See individual tests.

This test is subject to reflex testing, see Laboratory Reflex Testing Policy, you have the option to decline reflex testing if you believe it is not medically necessary. If HBAG is positive a confirmation will be performed at an additional charge. Syphilis Serology  is also subject to reflex testing. If the  the Treponemal AB is reactive or equivocal a Syphilis Ab (at MML) is performed if that is reactive an RPR.RPR titer or Syphilis TP-PA is performed.

When ordering a custom panel, Medicare requires the clinician confirm each test in the panel is medically necessary for the patient’s treatment. By regulation, annually we will send a physician acknowledgement letter to ordering clinicians requesting a signature attesting to medical necessity review.

Additional Codes

Primary ID

Epic Code

Mayo Access ID

PREFUG

LAB2213 N/A

 

Specimen Information

Container

Specimen

Temperature

Collect Vol

Submit Vol

Minimum Vol

Stability
Serum Separator Tube Serum

Refrigerate

12 mL

6 mL 5 mL 7 days
Lavender (EDTA) Tube Whole Blood

Refrigerate

7 mL 7 mL 3.5 mL 2 days

Both containers are necessary for testing.

Test Schedule / Analytical Time / Test Priority

Monday – Friday / 3 days / Not available STAT

Method

See individual tests.

CPT(s)

See individual tests.

Instrumentation

See individual tests.

Reference Range

See individual tests. 

Section

Chemistry-1

Performing Location

University of Vermont Medical Center

Is the UVMMC lab NY State Certified to perform this testing?  Yes/No

Yes

LOINC Code Information

See individual tests.  C