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H & E Sections/Punch Biopsy/Shave
See Histopathology, Skin Biopsy, Light Microscopy

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H. flu Antibody
See Haemophilus influenzae Type b Antibody, Vaccine Response

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H. influenzae Type b Antibody
See Haemophilus influenzae Type b Antibody, Vaccine Response

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H. influenzae Type b Antigen, CSF
See Bacterial Antigen Profile

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H. pylori Antibody
See Helicobacter pylori IgA, IgG, OR IgM Antibody

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H. pylori Antigen, Stool
See Helicobacter pylori Antigen, Stool

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H. pylori IgA
See Helicobacter pylori IgA Antibody

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H. pylori IgG
See Helicobacter pylori IgG Antibody

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H. pylori IgM
See Helicobacter pylori IgM Antibody

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Haemophilus influenzae Type b Antibody, Vaccine Response		Test Code: HIBB
CPT:	86684
Alternate Name:	HIB Antibody; H. flu Antibody; H. influenzae Type b Antibody
Methodology:	Enzyme-Linked Immunosorbent Assay (ELISA)
Testing Schedule:	Routine, Mon-Fri ONLY
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
Refrigerate Please indicate on Requisition Form if specimens are pre- or post- vaccination.
Reference Range:
< 0.15 mg/L
Clinical Utility:
Useful to access vaccine response.

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Hageman Factor
See Factor Activity Assays

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Haldol®
See Haloperidol

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Haloperidol		Test Code: HALDB
Includes:	•Haloperidol •Reduced Haloperidol
CPT:	80173
Alternate Name:	Haldol®
Methodology:	Liquid Chromatography / Tandem Mass Spectrometry (LC-MS/MS)
Testing Schedule:	Routine, Mon-Fri ONLY
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	2 mL serum
Container:	Red top tube, no serum separator
Special Instructions and/or Comments:
Refrigerate
Reference Range:
•Haloperidol: 5-16 ng/mL •Reduced Haloperidol:10-80 ng/mL
Clinical Utility:
Useful for optimizing dosage, monitoring.

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Hanging Drop for Trichomonas vaginalis
See Trichomonas vaginalis Preparation

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Hantavirus Antibody
See Hantavirus Antibody Profile

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Hantavirus Antibody Profile		Test Code: HANT
Includes:	•Total antibodies to: •Sin Nambre hantavirus •Seoul hantavirus (rat-borne hemorrhagic fever virus) •Puumala hantavirus (European hemorrhagic fever virus)
CPT:	84182 (x3)
Alternate Name:	Hantavirus Antibody; Sin Nombre Hantavirus
Methodology:	Strip Immunoblot Assay
Testing Schedule:	Routine, 2 times per week
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	2 mL serum
Container:	Gold top (serum separator) tube
Reference Range:
Non reactive:Negative
Clinical Utility:
Useful to clinically support the diagnosis of Hantavirus infection since depending on the type

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Hantavirus Antibody Profile		Test Code: HANTB
Includes:	Hantavirus IgG, and Hantavirus IgG Samples that screen positive for IgM are reflexed at an additional charge to Sin Nobre Virus (SNV specific IgG and IgM antibodies. If a sample screens positive for both IgG and IgM it will be reflexed at an additional charge for Sin Nobre Virus specific IgG aned IgM antibodies.
CPT:	86790 (x2) Reflex testing: Sin Nobre IgG= 86790 Sin Nobre IgM=86790
Methodology:	ELISA
Testing Schedule:	Routine, daily
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
•Centrifuge tube, refrigerate
Reference Range:
Hantavirus IgG and Hantavirus IgM=1.11
Clinical Utility:
Useful for diagnosing Sin Nobre Virus. Sin Nobre Virus is a form of hantavirus that auded hantavirus pulmonary syndrome, a severe and possib ly fatal form of acute respiratory distress.

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Haptoglobin		Test Code: HAPT
CPT:	83010
Methodology:	Rate Nephelometry
Testing Schedule:	Routine, 3 times per week
Report Available:	2-4 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Reference Range:
34-200 mg/dL
Clinical Utility:
Decreased levels occur with intravascular hemolysis or extravascular hemolysis. Increased levels occur with acute or chronic inflammatory response, tissue destruction, and malignant neoplasms. An isolated result may not be very helpful due to the wide normal range. However, if the baseline “normal” value is known, a low value can be used to confirm a hemolytic episode.

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HAV Ab, IgM
See Hepatitis A Antibody, IgM

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HAV Ab, Total
See Hepatitis A Antibody, Total

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HAV IgG/IgM
See Hepatitis A Profile

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Hb A1c
See Hemoglobin A1c

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Hb A2
See Hemoglobin A2

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HbcAb, IgM
See Hepatitis B Core Antibody, IgM

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HBcAb, Total
See Hepatitis B Core Antibody, Total

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HBeAb
See Hepatitis Be Antibody

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HBeAg
See Hepatitis Be Antigen

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HbF
See Hemoglobin F

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HbsAb
See Hepatitis B Surface Antibody
See Hepatitis B Surface Antibody

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HBsAg
See Hepatitis B Surface Antigen

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HBV DNA PCR
See Hepatitis B DNA Viral Load, PCR

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HBV Profile
See Hepatitis B Profile

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HC2 HPV
See HPV DNA

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hCG, Beta Subunit
See Beta Human Chorionic Gonadotropin, Serum

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hCG, Quantitative
See Beta Human Chorionic Gonadotropin, Serum

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hCG, Qualitative, Urine
See Beta Human Chorionic Gonadotropin, Urine

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hCG, Urine
See Beta Human Chorionic Gonadotropin, Urine

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Hct
See Hematocrit, Whole Blood

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HCV Antibodies
See Hepatitis C Antibody Profile

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HCV Serology
See Hepatitis C Antibody Profile

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HCV Genotype
See Hepatitis C Genotype

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HCV Viral Load, bDNA
See Hepatitis C Viral Load, RT-PCR

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HDL
See HDL Cholesterol, Direct

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HDL Cholesterol, Direct		Test Code: HDLD
CPT:	83718
Alternate Name:	Alpha-Lipoprotein Cholesterol; HDL; High Density Lipoprotein
Methodology:	Elimination/catalase, 2-point kinetic
Testing Schedule:	Routine, daily
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Collection:	Patient should be maintaining a stable weight, considered normal, for a least 1 week.Wait 4-8 weeks after a myocardial infarction or a traumatic episode. Patient should fast for 12-14 hour (nothing by mouth except water and any essential medications).
Reference Range:
<20 years: >35 mg/dL >20 years >40 mg/dL SPECIAL NOTE: Reference ranges are reflective of the NCEP Adult Treatment Panel III Guidelines. • LOW (Increased Risk of CHD): ...... <40 mg/dL • HIGH (Protects for CHD): ................ > 60 mg/dL
Clinical Utility:
Useful for cardiovascular risk assessment.

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HDV
See Hepatitis D (Delta Agent) Antibody Profile

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Heat Precipitate Fibrinogen
See Fibrinogen, Plasma

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Heavy Metal Profile, Blood		Test Code: HMSB
Includes:	•Arsenic •Cadmium •Lead •Mercury
CPT:	82175, 82300, 83655, 83825
Methodology:	Inductively Coupled Plasma - Mass Spectrometry (ICP- MS)
Testing Schedule:	Routine, daily
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	2.5 mL EDTA whole blood
Container:	Royal Blue top trace metal tube, lavender label
Special Instructions and/or Comments:
•Store as whole blood in original tube. •DO NOT centrifuge, aliquot or freeze. •Refrigerate only.
Reference Range:
•Arsenic:......................................... < 0.07 µg/mL •Cadmium:...................................... < 5.0 ng/mL •Lead:.............................................. < 10 mcg/dL ...Pediatrics ( < 15 years):.. > 20mcg/dL ...Adults ( > 16 years):....... > 70mcg/dL •Mercury:........................................ < 10 ng/mL •Toxic Concentration:......................> 50 ng/mL
Clinical Utility:
Useful for detecting metal toxicity.

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Heavy Metal Profile, 24-Hour Urine		Test Code: HMSCR
Includes:	•Volume Measurement •Collection Period •Arsenic, Urine •Cadmium, Urine •Lead, Urine •Mercury, Urine
CPT:	82175, 82300, 83655, 83825
Methodology:	Inductively coupled plasma Mass spectrometry (ICP-MS)
Testing Schedule:	Routine, daily
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	25 mL aliquot of a well mixed 24-Hour urine collection
Container:	24-Hour plastic urine container, no preservative
Collection:	NOTE:Patient should not consume fish or other seafood for a 48 hour period prior to start of collection. • High concentrations of gadolinium and iodine are known to interfere with most metals tests. If either gadolinium or iodine containing contrast media has been administered, a specimen cannot be collected for 96 hours. •Instruct the patient to void at the beginning of the collection period and discard the specimen. •Collect all urine including the final specimen voided at the end of the collection period. •Refrigerate during collection. •Container must be labeled with the patient’s name.
Special Instructions and/or Comments:
•Instruct patient not to void directly into container. •Transport to the laboratory promptly.
Reference Range:
See report.
Clinical Utility:
Useful for detecting metal toxicity.

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Heavy Metal Profile, Occupational Exposure, Random Urine		Test Code: HMSRU
Includes:	•Arsenic, Urine •Cadmium, Urine •Lead, Urine •Mercury, Urine
CPT:	82175, 82300, 83655, 83825
Methodology:	Inductively coupled plasma Mass spectrometry (ICP-MS), Enzymatic Colorimetric Assay
Testing Schedule:	Routine, daily
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	10 mL random urine
Special Instructions and/or Comments:
Refrigerate
Reference Range:
See report.
Clinical Utility:
Useful for, screening potentially exposed workers for heavy metal toxicity in settings where a 24-hour collection is problematic.

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Helicobacter pylori Antigen, Stool		Test Code: HPAGS
CPT:	87338
Alternate Name:	H. pylori Antigen, Stool
Methodology:	Enzyme-Linked Immunosorbent Assay (ELISA)
Testing Schedule:	Routine, 3 times per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	5 g fresh stool
Container:	Sterile plastic container
Special Instructions and/or Comments:
•Freeze entire specimen.Once frozen, transport specimen submerged in dry ice. •Watery, diarrheal specimens are inappropriate for testing. •Stools in transport media, swabs or preservatives are NOT acceptable.
Reference Range:
Negative
Clinical Utility:
Useful for an aid in the diagnosis of Helicobacter pylori Monitoring the eradication of Helicobacter pylori after therapy (in most) situations, confirmation of eradication is not mandatory) The utility of this test in asymptomatic individuals is not known, but testing for Helicobacter pylori in such individuals is not generally recommended.

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Helicobacter pylori IgA Antibody		Test Code: HYIGA
CPT:	86677
Alternate Name:	• H. pylori Antibody • H. pylori IgA • Campylobacter
Methodology:	Enzyme-Linked Immunosorbent Assay (ELISA)
Testing Schedule:	Routine, 3 times per week
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
Refrigerate
Reference Range:
•No antibody detected:.................. < 12.5 U/mL •Equivocal:........................................12.6-19.9 U/mL •Antibody detected:....................... > 20.0 U/mL
Clinical Utility:
Useful for, screening for Helicobacter pylori infection

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Helicobacter pylori Ig Antibody		Test Code: HYIGG
CPT:	86677
Alternate Name:	H. pylori Antibody; H. pylori IgG
Methodology:	Chemiluminescent Immunoassay
Testing Schedule:	Routine, 2 times per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
Refrigerate
Reference Range:
•No Antibody detected: <0.91 •Equivocal:0.91-1.09 •Antibody detected:>1.09
Clinical Utility:
Supports the serodiagnosis of Helicobacter pylori infection.

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Helicobacter pylori IgM Antibody		Test Code: HPIGM
CPT:	86677
Alternate Name:	• H. pylori Antibody • H. pylori, IgM • Campylobacter
Methodology:	Enzyme-Linked Immunosorbent Assay (ELISA)
Testing Schedule:	Routine, daily
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
Refrigerate
Reference Range:
•No antibody detected: ..................<30.0 U/mL •Equivocal:.......................................30.1-39.9 U/mL •Antibody detected: .................... > 40.0 U/ml
Clinical Utility:
Useful for screening for Helicobacter pylori infection

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Hema-Chek®
See Occult Blood, Stool

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Hemocult®, Stool
See Occult Blood, Stool

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Hematocrit, Body Fluid		Test Code: FHCT
CPT:	85014
Methodology:	Automated Analyzer
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL body fluid
Container:	Lavender top (EDTA) tube
Reference Range:
Not established, must be interpreted with clinical findings.

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Hematocrit, Whole Blood		Test Code: HCT
CPT:	85014
Alternate Name:	Hct; Microhematocrit; Packed Cell Volume; PCV
Methodology:	Automated Analyzer
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1.5 mL whole blood OR 300-500 µL in Lavender BD Microtainer™ tube
Container:	Lavender top (EDTA) tube OR lavender top BD Microtainer™ tube for capillary collection
Reference Range:
See table.Hematocrit Age % Age % 0-3 days 46-60 6 months - 2 years 30-40 4-7 days 49-54 3 years 29-43 8-28 days 45-51 4-10 years 32-42 1 month 39-45 11 years 34-44 2 months 30-37 >15 years - female 36-47 3 months 29-43 >15 years male 40-54
Critical Values:
•<3 days: <36% or >66% •4-60 days <27% or >55% •>60 days: <25% or >55%
Clinical Utility:
Used in the evaluation of anemias, polycythemias and blood loss.

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Hemochromatosis Genotype
See Hemochromatosis DNA

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Hemochromatosis DNA Mutation		Test Code: HCHR
Includes:	Detects two mutations C284 and H63D. Presence of the S65C mutation is reported only when it is observed as part of the C2824/S65C genotype.
CPT:	83890,83896 (X2), 83898 (X2), 83912
Alternate Name:	Hemochromatosis Genotype Hemochromatosis PCR Hereditary Hemochromatosis Mutation Hemochromatosis HFE Gene Analysis
Methodology:	Polymerase Chain Reaction (PCR)
Testing Schedule:	Routine, Monday-Friday ONLY
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	Volume:3 mL EDTA whole blood
Container:	Lavender top (EDTA) tube
Special Instructions and/or Comments:
•Collect Monday-Friday ONLY before 1400, no holidays.Specimens must arrive in the laboratory no later than 1600. •Store as whole blood in original tube at room temperature. •DO NOT centrifuge, aliquot, refrigerate or freeze.
Reference Range:
See report.
Clinical Utility:
• Establishing or confirming the clinical diagnosis of Heretary Hemochromatoses in adults, but because of concerns of the overall penetrance of these mutations, this testing is not recommended for population screening • Testing of asymptomatic individuals with increased blood test of iron stores (increased percent saturation of transferrin or serum ferritin)

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Hemoglobin A1c w/eAG		Test Code: HA1CG
Includes:	• Hemoglobin A1c (HA1C) • Estimated average glucose (eAG)
CPT:	83036
Alternate Name:	Fast Hemoglobins; Glycosylated Hemoglobin; HbA1c
Methodology:	High Performance Liquid Chromatography (HPLC) NOTE: This methodology will detect certain types of hemoglobin variants when present. When detected, these will be noted on the report. Occasionally, certain hemoglobin variants will interfere with HbA1c analysis. In these instances, an alternate methodology will be substituted. This may result in a delay in the routine turnaround time.
Testing Schedule:	Routine, Mon-Sat
Report Available:	1-3 days (may be delayed if hemoglobin variants detected)
Specimen Requirements:
Minimum Volume:	2 mL whole blood
Container:	Lavender top (EDTA) tube
Special Instructions and/or Comments:
•Store as whole blood in original tube. •DO NOT centrifuge, aliquot or freeze. •Refrigerate only.
Reference Range:
HA1C <7%
Clinical Utility:
The Hemoglobin A1c assay, expressed as the percent of hemoglobin that is glycated, measures chronic glycemia and is widely used to judge the adequacy of diabetes treatment and adjust therapy. Day-to-day management is guided by self monitoring of capillary glucose concentrations, expressed in units consistent with venous glucose measurements (mg/dL).

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Hemoglobin A2		Test Code: HEA2
Alternate Name:	Hb A2
Methodology:	Column Chromatography
Testing Schedule:	Routine, 1 time per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	1 mL whole blood
Container:	Lavender top (EDTA) tube
Special Instructions and/or Comments:
•Store as whole blood in original tube. •DO NOT centrifuge, aliquot or freeze. •Refrigerate only.
Reference Range:
1.5% to 3.5% NOTE:Elevated levels are most commonly associated with beta-thalassemia minor, where values are in the range of 3.6% to 8.0%.
Clinical Utility:
Screen for beta thalassemia. Note that iron deficiency can result in decreased Hb-A2 levels and, therefore, may lead to a normal Hb-A2 level even in affected patients.

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Hemoglobin, Body Fluid		Test Code: FHGB
CPT:	85018
Methodology:	Automated Analyzer
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL body fluid
Container:	Lavender top (EDTA) tube
Reference Range:
Not established, must be interpreted with clinical findings.

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Hemoglobinopathy Screen		Test Code: HGEL
Includes:	•Hemoglobin Screen with Interpretation •Quantitation of Hemoglobin A1, A2 & F •Reflexed when appropriate on abnormal screens citrate agar electrophoresis
CPT:	83021, Reflexed when appropriate.83020
Alternate Name:	Hemoglobin electrophresis, Thalassemia Screen, Sickle Cell Screen, Sickle C Prep
Methodology:	HPLC
Testing Schedule:	Routine, 2-3 times per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	2 mL whole blood
Container:	Lavender top (EDTA) tube
Special Instructions and/or Comments:
•Store as whole blood in original tube. •DO NOT centrifuge, aliquot or freeze.
Reference Range:
Adults: •Hb A....................................1:94.0% to 98.5% •Hb F:...................................0.0% to 2.0% •Hb A2:................................1.5% to 4.0% Children (6 months to 4 years): •Hb A1:.................................89% to 95.5% •Hb F:...................................3.0% to 7.0% •Hb A2:.................................1.5% to 4.0% Abnormalities are followed by automatic reflex Citrate Agar Acid electrophoresis.
Clinical Utility:
For characterization of hemoglobin variants.

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Hemoglobin F		Test Code: HEMF
CPT:	83030
Alternate Name:	Fetal Hemoglobin; Hemoglobin, Fetal; HbF
Methodology:	Alkali Denaturation
Testing Schedule:	Routine, 1 time per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	1 mL whole blood
Container:	Lavender top (EDTA) tube
Special Instructions and/or Comments:
•Store as whole blood in original tube. •DO NOT centrifuge, aliquot or freeze. •Refrigerate only.
Reference Range:
•Birth to 4 days:70.0% to 84.0% •5-29 days: 63.0% to 77.0% •30-59 days: 42.0% to 64.0% •2-5 months: 7.0% to 39.0% •6 months to 4 years:2.1% to 7.0% •5 years to adult:<2.0% NOTE:Elevated adult levels are commonly associated with Thalassemias or Hereditary Persistence of Hemoglobin F (HPFH).
Clinical Utility:
Utilized as a follow-up to abnormalities detected by the Hemoglobin Electrophoresis screen.

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Hemoglobin, Fetal
See Hemoglobin F

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Hemoglobin, Plasma		Test Code: PLHE
CPT:	83051
Alternate Name:	Free Hemoglobin
Methodology:	Spectrophotometry
Testing Schedule:	Routine, daily
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	2 mL plasma
Container:	Lavender top (EDTA) tube
Collection:	Collect blood with 19 gauge needle to avoid hemolysis.
Special Instructions and/or Comments:
Refrigerate
Reference Range:
>18 years:............ 0-15 mg/dL
Clinical Utility:
Useful for determining whether hemolysis is occurring from a transfusion reaction or mechanical fragmentation of red blood cells.

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Hemoglobin, Whole Blood		Test Code: HGB
CPT:	85018
Alternate Name:	Hgb
Methodology:	Automated Analyzer
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1.5 mL whole blood OR 300-500 µL in BD Microtainer™ tube
Container:	Lavender top (EDTA) tube OR lavender top BD Microtainer™ tube for capillary collection
Reference Range:
Hemoglobin Age g/dL Age g/dL 0-3 days 15.6-20.2 > =1 year 8.9-13.5 4-7 days 16.4-18.0 >= 2 years 9.2-13.8 8-28 days 15.0-17.1 > =3 years 10.2-14.8 > =1 month 13.0-15.0 4-5 years 10.3-14.9 >=2 months 10.0-12.4 > =6 years 10.6-15.2 >=3 months 9.9-14.5 > =11 years 11.1-15.7 >=6 months 9.5-14.1 >=15 years female 12.0-16.0 >=15 years male 13.5-18.0
Critical Values:
•<3 days: <12.0 g/dL or >22.0 g/dL •-4-60 days: <9.0 g/dL or >20.0 g/dL •>60 days: <8.0 g/dL or >20.0 g/dL
Clinical Utility:
Used in the evaluation of anemias, polycythemias, blood loss and hemolysis.

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Hemogram
See CBC with Automated Differential

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Heparin Ab by SR
See Heparin Antibody, Serotonin Release

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Hempsiderin, Urine		Test Code: HEMO
CPT:	83070
Alternate Name:	Hemosiderin, Random Urine
Methodology:	Rous Method
Testing Schedule:	Routine, daily
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	13 mL random urine
Container:	Plastic Urine Container
Special Instructions and/or Comments:
Freeze specimen in plastic cup or tube.
Reference Range:
Negative (reported as positive or negative)
Clinical Utility:
Useful for detecting hemosiderinuria, secondary to excess hemolysis as a incompatible blook transfusions, severe acute hemolytic anemia, or hemochromatosis.

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Heparin Associated Platelet Antibody		Test Code: HAPAB
Includes:	Determination of total antibodies to the PF4-Heparin complex, which have been implicated in the pathogensis of Heparin Induced Thrombocytopenia (HIT).
CPT:	86023
Alternate Name:	Heparin Dependent Platelet Antibody; Heparin Inducted Platelet Antibody; HIT Ab Replaces:HIPA (Heparin Induced Platelet Aggregation)
Methodology:	Enzyme-Linked Immunoasorbent Assay (ELISA)
Testing Schedule:	Daily, 7 days/week Specimens must be received in the laboratory by 1100 to ensure same day turnaround time for results.
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	2 mL plasma, split equally into 2 separate plastic aliquot tubes and FROZEN immediately
Container:	1 Blue top (sodium citrate) tube
Collection:	See special handling instructions for “Coagulation Studies”, listed under Specimen Collection, Preparation, and Handling Section.
Special Instructions and/or Comments:
•Immediately centrifuge the specimens at 1500-1700 X G for 10 minutes.Avoiding the buffy coat, carefully remove the plasma from the cells using a plastic aliquot pipette.Aliquot the plasma into the required number of plastic aliquot tubes and label with “citrated plasma” labels. Freeze the aliquoted specimens at –40 to –60°C.Once frozen, transport the specimens submerged in dry ice. Causes for Rejection: •Extended transport time to laboratory •Clotted specimens •Hemolyzed specimens •Blue top sodium citrate tubes insufficiently filled •Aliquots not received frozen on dry ice •Frozen aliquots not clearly identified as “citrated plasma”
Reference Range:
NOTE:Since the diagnosis of HIT is truly a CLINICAL diagnosis, the results obtained in the Heparin-PF4 ELISA should be interpreted within that context. ELISA Ab Index: •<0.90: Not detected.No evidence of antibodies to PF4-Heparin complex by ELISA.Results should be interpreted in light of clinical presentation and in conjunction with other laboratory findings.These results do not support, but cannot completely rule out the diagnosis of HIT. If clinical suspicion for HIT is strong, a follow-up specimen in 24-72 hours may be warranted. •0.90 - 1.39: Equivocal.Results are borderline for antibodies to PF4-Heparin complex by ELISA.If the clinical presentation supports a diagnosis of HIT, it may be warranted to repeat the test in 24 – 72 hours since antibody levels may rise rapidly. •>1.39: Detected.Presence of antibodies to PF4-Heparin complex by ELISA.Results should be interpreted in light of the clinical presentation and in conjunction with other laboratory findings.These results may support the clinical diagnosis of HIT.
Clinical Utility:
Determination of total antibodies to the PF4-Heparin complex, which have been implicated in the pathogensis of Heparin Induced Thrombocytopenia (HIT).Heparin Dependent Platelet Antibody

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Heparin Induced Platelet Antibody
See Heparin Associated Platelet Antibody

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Heparin Level, Low Molecular Weight, Plasma		Test Code: LMWH
CPT:	85520
Alternate Name:	Dalteparin®; Enoxaparin®; Fragmin®; Lovenox®
Methodology:	Anti-Xa Assay
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL citrated plasma
Container:	Full blue top (sodium citrate) tube
Collection:	See special handling instructions for “Coagulation Studies”, listed under Specimen Collection, Preparation, and Handling Section
Special Instructions and/or Comments:
• Transport the specimen to the laboratory immediately. • If testing cannot be performed within 2 hours of collection, centrifuge at 3000 rpm for 15 minutes, transfer plasma to plastic aliquot tube and freeze.Once frozen, transport specimen submerged in dry ice. • Test cannot be utilized for patients receiving unfractionated heparin.
Reference Range:
Therapeutic Range:0.5-1.0 units/mL NOTE: Based upon testing peak levels 3-4 hours post subcutaneous injections while on a twice-daily dose regimen.
Clinical Utility:
Used to measure the amount of low molecular weight heparin in the blood and to determine if the drug concentration is within the therapeutic range.

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Heparin Level, Unfractionated, Plasma		Test Code: HEPL
CPT:	85520
Methodology:	Anti-Xa Assay
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL citrated plasma
Container:	Full blue top (sodium citrate) tube
Collection:	See special handling instructions for “Coagulation Studies”, listed under Specimen Collection, Preparation, and Handling Section
Special Instructions and/or Comments:
•Transport the specimen to the laboratory immediately. •If testing cannot be performed within 2 hours of collection, centrifuge at 3000 rpm for 15 minutes, transfer plasma to plastic aliquot tube and freeze.Once frozen, transport specimen submerged in dry ice. NOTE: Test cannot be utilized for patients receiving low molecular weight heparin.
Reference Range:
•Therapeutic Range: 0.3-0.7 units/mL. •Concurrent with Thrombolytic Therapy: not established/suggest 0.1-0.3 units/mL
Critical Values:
>0.7 units/mL
Clinical Utility:
Used to measure the amount of unfractionated heparin in the blood and to determine if the drug concentration is within the therapeutic range.

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Heparin Resistance Profile		Test Code: HPRP
Includes:	•Antithrombin III Activity •Factor VIII Activity •Fibrinogen •Heparin Level, Unfractionated •Partial Thromboplastin Time, Activated (APTT)
CPT:	85300, 85240, 85384, 85520, 85730
Methodology:	See individual test listings
Testing Schedule:	Routine, 1 time per week
Report Available:	5-7 days (individual components resulted as performed)
Specimen Requirements:
Minimum Volume:	2 mL prepared “platelet poor plasma” split equally into 4 plastic aliquot tubes and FROZEN immediately
Container:	4 Blue top (sodium citrate) tubes
Collection:	See special handling instructions for “Coagulation Studies”, listed under Specimen Collection, Preparation, and Handling Section
Special Instructions and/or Comments:
•Testing is contraindicated for patients on Heparin or Coumadin therapy. •Preparation and submission of “platelet poor plasma” is critical for accurate test performance and interpretation. See collection note above. Causes for rejection: •Extended transport time to laboratory •Clotted specimens •Hemolyzed specimens •Blue top sodium citrate tubes insufficiently filled •Aliquots not received frozen on dry ice •Frozen aliquots not clearly identified as “platelet poor plasma”
Reference Range:
See individual test listings.

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Hepatic Function Panel
See Liver Function Panel
See Liver Function Panel, Neonatal (<15 days old)

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Hepatitis A Antibody, IgM		Test Code: HIGM
CPT:	86709
Alternate Name:	HAV Ab, IgM; Anti-HAV, IgM
Methodology:	Chemiluminescent Microparticle Enzyme Immunoassay (CMIA)
Testing Schedule:	Routine, 2 times per week
Report Available:	3-5 days
Special Instructions and/or Comments:
The Department of Health requires mandatory reporting of any positive result.
Reference Range:
Negative:No antibody detected NOTE:A negative result suggests no current or recent exposure to Hepatitis A virus (HAV).
Clinical Utility:
The presence of IgM antibody to Hepatitis A virus is evidence for acute Hepatitis A.

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Hepatitis A Antibody, Total		Test Code: HIGG
CPT:	86708
Alternate Name:	Anti-HAV, Total; HAV Ab, Total
Methodology:	Microparticle Enzyme Immunoassay (MEIA)
Testing Schedule:	Routine, 2 times per week
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube.
Reference Range:
Negative:No antibody detected NOTE:A negative result suggests no previous exposure or immunity to Hepatitis A virus (HAV).
Clinical Utility:
Useful for evaluating hepatitis A.

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Hepatitis A, B, C
See Hepatitis Profile, Comprehensive

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Hepatitis A IgG/IgM
See Hepatitis A Profile

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Hepatitis A Profile		Test Code: HAP
Includes:	•Hepatitis A Antibody, Total •Hepatitis A Antibody IgM •Interpretation of results
CPT:	86708, 86709
Alternate Name:	HAP; HAV IgG/IgM; Hepatitis A IgG/IgM
Methodology:	See individual test listings
Testing Schedule:	Routine, 2 times per week
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	2 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
The Department of Health requires mandatory reporting of any positive IgM result.
Reference Range:
•Total antibody: negative •IgM antibody: negative Hepatitis A Interpretation Chart Total Antibody IgM Specific Interpretation N N No evidence of recent or past exposure to or infection with Hepatitis A virus; patient is not infectious. Patient is not immune and is susceptible to primary acute Hepatitis A virus infection. P P Acute primary stage of Hepatitis A virus infection; patient is potentially infectious P N Consistent with past infection with or exposure to Hepatitis A virus; patient is immune and not infectious Clinical Utility: The presence of IgM antibody to Hepatitis A virus is evidence for acute Hepatitis A. The presence of Hepatitis A total antibodies in the absence of IgM antibodies implies immunity.

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Hepatitis B Antibody
See Hepatitis B Surface Antibody

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Hepatitis B Core Antibody, IgM		Test Code: AHBM
CPT:	86705
Alternate Name:	Anti-Hbc IgM; HbcAb IgM
Methodology:	Chemiluminescent Microparticle Enzyme Immunoassay (CMIA)
Testing Schedule:	Routine, 2 times per week
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
The Department of Health requires mandatory reporting of any positive result.
Reference Range:
Negative: No antibody detected. NOTE:A negative result suggests no recent or current infection with Hepatitis B virus (HBV).
Clinical Utility:
IgM antibody to hepatitis B core antigen is a reliable marker for acute Hepatitis B viral infection.

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Hepatitis B Core Antibody, Total		Test Code: AHBG
CPT:	86704
Alternate Name:	Anti-HBc; HbcAb, Total
Methodology:	Chemiluminescent Microparticle Enzyme Immunoassay (CMIA)
Testing Schedule:	Routine, 2 times per week
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Reference Range:
Negative: No antibody detected NOTE:A negative results suggests no previous exposure to or infection with Hepatitis B Virus (HBV).
Clinical Utility:
Used in the differential diagnosis of Hepatitis B infection in conjunction with other serologic markers.

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Hepatitis B DNA, PCR
See Hepatitis B DNA Viral Load, PCR

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Hepatitis B DNA Viral Load, PCR		Test Code: HBVVL
Includes:	• Hepatitis B Virus DNA UltraQuant • HBV DNA UltraQuant
CPT:	87517
Alternate Name:	• HBV DNA PCR: Hepatitis B DNA, PCR • Hepatitus B Virus DNA Viral Load
Methodology:	Polymerase Chain Reaction, Calculation
Testing Schedule:	Routine, daily
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	2 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
and/or Comments: •Centrifuge, transfer to plastic aliquot tube and freeze.Once frozen, transport specimen submerged in dry ice.
Reference Range:
Hepatitus B Virus DNA UltraQuant...... < 100 copies/mL HBV DNA UltraQuant..........................< 19 IU/mL
Clinical Utility:
Useful for Quantitation of HBV DNA in human Serum Monitoring progression of chronic HBV Infection. Predicting and monitoring of effectiveness of antiviral therapy

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Hepatitis B Immune Status
See Hepatitis B Surface Antibody

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Hepatitis B Profile		Test Code: HBP
Includes:	•Hepatitis B Surface Antigen (HbsAg) •Hepatitis B Surface Antibody (HbsAb) •Hepatitis B Core Antibody, Total (HbcAb, Total) •Hepatitis B Core Antibody, IgM (HbcAb, IgM) •Interpretation of results •Reflexed when appropriate: •Hepatitis B Surface Antigen Neutralization Confirmation on initial positive screens
CPT:	87340, 86706, 86704, 86705, Reflexed when appropriate:87341
Alternate Name:	HBV Profile; Hepatitis B Virus Profile
Methodology:	See individual test listings.
Testing Schedule:	Routine, 2 times per week
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	3 mL serum
Container:	2 Gold top (serum separator) tubes
Special Instructions and/or Comments:
The Department of Health requires mandatory reporting of a comfirmed positive HBsAg or a positive HbcAb IgM result.
Reference Range:
See individual test listings and the Hepatitis B interpretation chart.Hepatitis B Interpretations HBeAg HbsAb HbcAb Total HbcAb IgM Interpretations – – – – No evidence of current, recent, or past exposure to or infection with Hepatitis B virus (HBV); patient is not infectious. Patient is not immune and is presumed susceptible to primary infection with HBV. + – – – Suggests late incubation or very early stage of acute primary infection with Hepatitis B virus, patient is infectious. Follow-up testing to monitor disease course may be warranted. + – + + Generally indicates recent, acute Hepatitis B virus infection; patient is infectious. May also suggest the possibility of chronic infection, when low levels of HbcAb, IgM persisst for a 6- to 18- month period. Follow-up testing in approximately 6 months may be warranted. + – + – May suggest either early stage of convalescence from acute HBV infection or may also indicate chronic infection with a possible carrier state. Hepatitis Be antigen and Be antibody testing may be of possible diagnostic significance; patient is infectious. – – + + Suggest the convalescent “core window” stage of acute primary Hepatitis B infection; patient is potentially infectious. – + + + Suggest early recovery from acute infection with Hepatitis B virus; patient is immune and not infectious. – + + – Suggests recovery from active or subclinical Hepatitis B virus infection; patient is immune and not infectious. – – + – Presence of low titers of total core antibody in the absence of core IgM antibody or other Hepatitis B virus serologic markers suggest past infection in which HbsAb has disappeared. HBIG prophylaxis is usually not indicated with this pattern. – + – – May indicate resolved infection with loss of total HbcAb, immunization with vaccine, or passive transfer HbsAb (eg, gamma globulin, transfusion, or placental transfer); patient is immune and not infectious. + + + + May indicate any of the following: presence of “heterotypic” HBeAb, chronic HBV infection, especially active or advanced disease, early convalescence of acute infection, especially when HbsAb is present in low levels; patient is infectious. HBeAg and HBeAb testing may be of possible diagnostic significance. Clinical Utility: Differential diagnosis of Hepatitis and to stage Hepatitis B infection. IgM antibody to Hepatitis B core antigen is a reliable marker for acute Hepatitis B viral infection. Presence of Hepatitis B surface antibody is an indicator of clinical recovery and subsequent immunity to Hepatitis B virus. This test is useful for evaluation of possible immunity in individuals who are at increased risk for exposure to Hepatitis B, ie., hemodialysis unit personnel, venipuncturists, etc. Evaluation of the need for hepatitis B immune globulin after needlestick injury. Evaluation of the need for Hepatitis B vaccine, and to follow immune status after hepatitis B vaccine. Hepatitis B surface antigen is the earliest indicator of the presence of acute infection and is also indicative of chronic infection.

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Hepatitis B Surface Antibody		Test Code: AHBS
CPT:	86706
Alternate Name:	Antibody to Hepatitis B Surface Antigen; Anti-HbsAg; HbsAb; HBs Antibody; Hepatitis B Antibody; Hepatitis B Immune Status
Methodology:	Chemiluminescent Microparticle Enzyme Immunoassay (CMIA)
Testing Schedule:	Routine, 3-5 times per week
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Reference Range:
NOTE: As noted in the MMWR report, November 1991, Volume 40, detectable antibody levels of 10 mIU/mL or greater reflect a protective antibody response.
Clinical Utility:
Used to monitor vaccination status and effectiveness.

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Hepatitis B Surface Antigen		Test Code: HBSA
Includes:	•Hepatitis B Surface Antigen (HbsAg) •Reflexed when appropriate: •Hepatitis B Surface Antigen Neutralization
CPT:	87340, Reflexed when appropriate:87341
Alternate Name:	Australian Antigen; HAA; HbsAg; Hepatitis-Associated Antigen; Serum Hepatitis Marker
Methodology:	Chemiluminescent Microparticle Enzyme Immunoassay (CMIA)
Testing Schedule:	Routine, daily
Report Available:	1-3 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
The Department of Health requires mandatory reporting of any confirmed positive result.
Reference Range:
Negative: not detected NOTE:A negative result suggests no recent, current, or chronic infection with Hepatitis B Virus (HBV).
Clinical Utility:
Hepatitis B surface antigen is the earliest indicator of the presence of acute infection, and is also indicative of chronic infection

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Hepatitis B Virus Profile
See Hepatitis B Profile

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Hepatitis Be Antibody		Test Code: AHBE
Includes:	: NOTE:Test is best utilized in patients previously documented to be HBsAg positive and in conjunction with the performance of an HBeAg.
CPT:	86707
Alternate Name:	Anti-Hbe; HBeAb
Methodology:	Enzyme Immunoassay (EIA)
Testing Schedule:	Routine, Monday-Friday ONLY
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
Centrifuge, transfer to plastic aliquot tube and freeze.Once frozen, transport specimen submerged in dry ice.
Reference Range:
Negative: No antibody detected
Clinical Utility:
Useful for recognition of resolution of hepatitis B infection with seroconverison of HBeAg to anti HBe.

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Hepatitis Be Antigen		Test Code: HBEA
Includes:	NOTE:Test is best utilized on patients previously documented to be HbsAg positive and in conjunction with performance of an HBeAb.
CPT:	87350
Alternate Name:	HBeAg
Methodology:	Enzyme Immunoassay (EIA)
Testing Schedule:	Routine, Monday-Friday ONLY
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	1 mL frozen serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
Centrifuge, transfer to plastic aliquot tube and freeze. Once frozen, transport specimen submerged in dry ice. NOTE: Testing is contradicted if the patient has recent ly tested negative for HbsAg. Hepatitis Be antigen and Be antibody are found only in association with Hepatitis B infection. Presence or absence of these markers provides useful information on status of individuals known to be HbsAg positive.
Reference Range:
Negative.
Clinical Utility:
Useful for the diagnosis and monitoring of hepatitis B virus Infectivity.Recognition of resolution of Hepatitis B infection with seroconversion of HBeAg to Hepatitis Be antibody (anti-HBe).

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Hepatitis C Antibody by Immunoblot
See Hepatitis C Antibody, RIBA Analysis

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Hepatitis C Antibody Profile		Test Code: HCP
Includes:	•Hepatitis C (HCV) Antibody Screen •Reflexed when appropriate: HCV RIBA
CPT:	86803, Reflexed when appropriate:86804
Alternate Name:	Anti-HCV; HCV Antibodies; HCV Serology
Methodology:	•HCV Antibody Screen: Chemiluminescent Microparticle Enzyme Immunoassay (CMIA) •Reflex Confirmation:Recombinant Antigen Immunoblot Assay (RIBA)
Testing Schedule:	Routine, 5 times per week
Report Available:	2-4 days (may be extended if RIBA required)
Specimen Requirements:
Minimum Volume:	2 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
The Department of Health requires mandatory reporting of any confirmed positive result.
Reference Range:
Negative: no antibody detected by EIA antibody screen. NOTE: Repeatedly reactive screens S/Co <10.0 will automatically be confirmed by RIBA.These are preliminary until RIBA results are available and final interpretation is made.See HCV Interpretation Chart. HCV Interpretation Chart: HCV EIA and HCV RIBA EIA RIBA Interpretation Negative Not required. Patient is not infected or if infected has not yet developed antibodies Positive S/Co <3.9 Positive. Response pattern confirms exposure to Hepatitis C virus Patient has been exposed to HCV. These assays cannot distinguish between acute, resolved past, or chronic infection. Results should be interpreted in light of clinical presentations and in conjunction with other laboratory findings. HCV antigen quantitation by PCR may be helpful. Positive S/Co <3.9 Indeterminate or equivocal. Pattern does not meet criteria for positive assay. With the reported pattern of results, HCV exposure cannot be substantiated. Repeat and/or follow-up testing is suggested. Positive S/Co <3.9 Negative. No HCV specific response pattern noted. Suggests false-positive screening EIA test. Repeat testing advised if clinical findings are discordant with laboratory results. Positive S/Co <3.9 Not required per CDC guidelines Patient has been exposed to HCV. These assays cannot distinguish between acute, resolved past, or chronic infection. Results should be interpreted in light of clinical presentations and in conjunction with other laboratory findings. HCV antigen quantitation by PCR may be helpful. Clinical Utility: Assess exposure to hepatitis C virus infection. HCV antibodies are typically not detected until approximately 14 weeks after exposure (or 5 weeks after appearance of the first biochemical marker of illness); absence of these antibodies after this period is strong evidence against HCV infection. Confirmatory testing by RIBA is recommended for all ‘weakly reactive’ EIA samples (i.e. S/Co <10.0).

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Hepatitis C Antibody,HCVS Analysis		Test Code: RIBA
Includes:	NOTE:This assay is not intended for use as a screening test and should not be used as a substitution for routine HCV antibody testing.
CPT:	86804
Alternate Name:	Hepatitis C Antibody by Immunoblot; Hepatitis C RIBA
Methodology:	Recombinant Antigen Immunoblot Assay (RIBA)
Testing Schedule:	Routine, 2 times per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
•Centrifuge, transfer to plastic aliquot tube and freeze.Once frozen, transport specimen submerged in dry ice. •The Department of Health requires mandatory reporting of any positive result.
Reference Range:
Negative:No antibody detected
Clinical Utility:
Useful for comfirmation on positive Hepatitis C Antibody patients

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Hepatitis C Genotype		Test Code: HCVGN
Includes:	HCV Viral Load by PCR AND if appropriate Hepatitis C Genotyping by Line Probe Assay NOTE: The hepatitis C viral load must be greater than 1000 copies/mL for accurate genotyping to occur
CPT:	87522, 87902
Alternate Name:	HCV Genotype
Methodology:	Line Probe Assay (LIPA)
Testing Schedule:	Routine, Monday-Friday ONLY
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	8 mL plasma
Container:	4 White top (EDTA) tubes Alternate specimen: 4 Lavender top (ETDTA) tubes FOR LAVENDER TUBES ONLY: Centrifuge within 6 hours of collection and aliquot plasma to 4 separate plastic tuvbes. Freeze. Once frozen transport to lab on dry ice.
Special Instructions and/or Comments:
Must be processed within 6 hours of collection FOR WHITE TOP (EDTA) TUBES: Centrifuge specimen, DO NOT ALIQUOT. Freeze 2 tubes and refrigerate 2 tubes. Once frozen, transport specimen submerged in dry ice. A HCV viral load of 1000 copies/mL or greater is required for specimen to be valid. NOTE: The HCV Genotype results will not be reported when the viral load of the sample is <1000 copies/mL
Reference Range:
Subtypes that can be detected include: 1, 1a, 1b, 1c, 2, 2a, 2b, 2c, 2d, 3, 3a, 3b, 3c, 3d, 3f, 3g, 3h, 4a, 4b, 4c, 4e, 4f, 4g, 4h, 4i, 4k, 5a, 6, 6a, 6b
Clinical Utility:
Current surveys indicate that genotypes 1a, 1b, 2a, 2b and 3a account for almost all HCV patients in Western Europe, Canada and the United States; whereas, types 1b, 2a, and 2b are found in Japan and the Far West. Clinical outcomes are genotype-dependent and differ with regard to disease severity and responses to interferon (IFN) therapy. A better long-term response to IFN was observed with genotypes 2a, and 2b (52%) and with 3a and 3b (74%) than with types 1a and 1b (29%). Other factors associated with favorable interferon response are low pretreatment viral load and the absence of liver cirrhosis.

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Hepatitis C, Qualitative, RT-PCR		Test Code: HCVQL
CPT:	87521
Methodology:	Transcription Mediated Amplification
Testing Schedule:	Routine, daily
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	2 mL frozen plasma
Container:	lavender top (EDTA) tube
Special Instructions and/or Comments:
•DO NOT submit heparinized specimens. •Must be processed within 4 hours of collection. •Centrifuge, aseptically transfer plasma to plastic aliquot tube and freeze.Once frozen, transport specimen submerged in dry ice.
Reference Range:
Not Detected
Clinical Utility:
Detects presence of Hepatitis C Virus RNA down to 10 IU/mL, to diagnose Hepatitis C Virus infection.

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Hepatitis C RIBA
See Hepatitis C Antibody, RIBA Analysis

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Hepatitis C Viral Load, RT-PCR		Test Code: HCVLD
CPT:	87522
Alternate Name:	HCV Viral Load, RT-PCR Hepatitis C Viral Load Real Time RT-PCR Replaces:Hepatitis C Viral Load, bDNA
Methodology:	Real Time RT-PCR, COBAS Ampified/COBAS TaqMan 48, FDA Approved
Testing Schedule:	Routine, 2 times per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	4 mL EDTA plasma
Container:	2 White EDTA OR 2 Lavender top (EDTA) tubes.
Special Instructions and/or Comments:
•DO NOT submit heparinized specimens. •Must be processed within 6 hours of collection. •Centrifuge, white EDTA and refrigerate. •Centrifuge lavender EDTA, aseptically transfer plasma to plastic aliquot tube, freeze.
Reference Range:
• < 43 IU/mL • < 1.63 logIU/mL
Clinical Utility:
Quantitates Hepatitis C Virus down to 43 IU/mL to monitor viral load in established Hepatitis C infected individuals.

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Hepatitis Delta Serology
See Hepatitis D (Delta Agent) Antibody Profile

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Hepatitis Panel, Acute		Test Code: AHEP
Includes:	•Hepatitis A Antibody, IgM (HAV Ab, IgM) •Hepatitis B Surface Antigen (HbsAg) •Hepatitis B Core Antibody, IgM (HbcAb, IgM) •Hepatitis C (HCV) Antibody Screen •Interpretation of results •Reflexed when appropriate: •Hepatitis B Surface Antigen Neutralization •HCV RIBA
CPT:	80074, Reflexed when appropriate: 86804
Alternate Name:	Acute Hepatitis Panel
Methodology:	See individual test listings
Testing Schedule:	Routine, 2 times per week
Report Available:	3-5 days (may be extended if RIBA required)
Specimen Requirements:
Minimum Volume:	3 mL serum
Container:	2 Gold top (serum separator) tubes
Reference Range:
See individual test listings.
Clinical Utility:
Comprehensive assessment of suspected hepatitis A and B and C infection in at-risk patients.

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Hepatitis Profile
See Hepatitis Profile, Comprehensive

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Hepatitis Profile, Comprehensive		Test Code: HEP
Includes:	•Hepatitis B studies: •Hepatitis B Surface Antigen (HbsAg) •Hepatitis B Surface Antibody (HbsAb) •Hepatitis B Core Antibody, Total (HbcAb, Total) •Hepatitis B Core Antibody, IgM (HbcAb, IgM) ......•Reflexed when appropriate: •Hepatitis B Surface Antigen Neutralization •Hepatitis A studies: •Hepatitis A Antibody, Total (HAV Ab, Total) •Hepatitis A Antibody, IgM (HAV Ab, IgM) •Hepatitis C studies: •Hepatitis C (HCV) Antibody Screen •Reflexed when appropriate: •HCV RIBA Confirmation
CPT:	80074, 86706, 86704, 86708, Reflexed when appropriate: 87341, 86804
Alternate Name:	Hepatitis A, B, C; Hepatitis Profile
Methodology:	See individual test listings.
Testing Schedule:	Routine, 2 times per week
Report Available:	3-5 days (may be extended if RIBA required)
Specimen Requirements:
Minimum Volume:	3 mL serum
Container:	2 Gold top (serum separator) tubes
Reference Range:
See individual test listings and interpretation charts for Hepatitis A, B, and C.
Clinical Utility:
Comprehensive assessment ofsuspected Hepatitis A, B and C infection in at-risk patients

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HER2/NEU FISH
See Histopathology, FISH Procedures

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Hereditary Hemochromatosis Mutation
See Hemochromatosis DNA Mutation Heroin
See Opiates, Quantitative, Blood
See Opiates, Qualitative, Urine

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HerpeSelect
See Herpes Simplex Virus IgG Antibody Profile

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Herpes Culture
See Culture, Viral, Herpes Simplex, Rapid

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Herpes Simplex 1 and 2 Culture
See Culture, Viral, Herpes Simplex, Rapid with Typing

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Herpes Simplex Virus IgG Antibody Profile		Test Code: HSVGP
Includes:	HSV-1 and HSV-2 IgG type specific antibodies
CPT:	86695, 86696
Alternate Name:	HerpeSelect; HSV 1 and 2 Antibodies; HSV IgG; HSV Screen
Methodology:	Enzyme-Linked Immunosorbent Assay (ELISA)
Testing Schedule:	Routine, 1-2 times per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Reference Range:
ELISA antibody index: •No antibody detected: <0.90 •Equivocal:<0.90-<1.10 •Antibody detected:>1.10
Clinical Utility:
Herpes Simplex produces several different conditions in man, most often occurring at the oral mucocutaneous junction with the formation of cold sores. This test code provides differentiation of Type 1 or Type 2 Herpes.

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Herpes Simplex Virus IgM Antibody Profile		Test Code: HSVMB
Includes:	HSV-1 and HSV-2 IgM antibodies
CPT:	86694 (x2)
Alternate Name:	HSV 1 and 2 IgM; HSV IgM
Methodology:	Indirect Fluorescent Antibody (IFA)
Testing Schedule:	Routine, 1 time per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Reference Range:
Negative: Not detected NOTE:Unlike the HSV IgG 1 and 2 type specific assays, the HSV 1 and 2 IgM assays are not type specific and cross-reactivity may occur.

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Herpes Simplex Virus, PCR, Cerebrospinal Fluid		Test Code: HSVPR
Includes:	NOTE: Same specimen may be used for enterovirus, PCR if FROZEN •Herpes Simplex Virus I (HSVI) •Herpes Simplex Virus II (HSVII) NOTE: Specimens grossly contaminated with blood may inhibit PCR and produce false-negative results.
CPT:	87801
Methodology:	HSV, CSF by PCR Methodology:Realtime PCR
Testing Schedule:	Routine daily, STAT testing available Mon-Sun.
Report Available:	1-3 days
Specimen Requirements:
Minimum Volume:	1.2 mL cerebrospinal fluid
Container:	Sterile conical tube
Special Instructions and/or Comments:
Refrigerate DO NOT centrifuge or aliquot
Reference Range:
Not detected
Clinical Utility:
Detects presence of Herpes Simplex DNA down to 150 copies/mL to aid in the diagnosis of HSV infections. Sensitivity and specificity is superior to viral culture.

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Herpes Virus-6, Ab Profile		Test Code: H6GM
Includes:	• Herpesvirus-6 Human IgG Antibodies • Herpesvirus-6 Human IgM Antibodies
CPT:	86790 X2
Methodology:	IFA
Testing Schedule:	Routine daily
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
Refrigerate
Reference Range:
•Herpesvirus-6 IgG Antibodies .....<1:8 titer •Herpesvirus-6 IgM Antibodies.....<1:4 titer

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Herpes Zoster
See Varicella-Zoster DFA

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Herpes Zoster Antibody
See Varicella-Zoster IgG Antibody, Immune Status

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Herpes Zoster Screen for Immune Status
See Varicella-Zoster IgG Antibody, Immune Status

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Herpetic Lesion Scraping
See Cytopathology, Direct Smears

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Heterophile Agglutinin Test
See Mononucleosis Screen

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Hexagonal Phase Phospholipid Neutralization		Test Code: HPPL
CPT:	85597
Alternate Name:	Staclot LA™
Methodology:	Clot Based Assay
Testing Schedule:	` Routine,1 time per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	2 mL prepared “platelet poor plasma”, split equally into 2 plastic aliquot tubes and FROZEN immediately
Container:	2 Blue top (sodium citrate) tubes
Collection:	See special handling instructions for “Coagulation Studies”, listed under Specimen Collection, Preparation, and Handling Section
Special Instructions and/or Comments:
•Testing is contraindicated for patients on Heparin or Coumadin therapy. •Preparation and submission of “platelet poor plasma” is critical for accurate test performance and interpretation.See collection note above. Causes for rejection: •Extended transport time to laboratory •Clotted specimens •Hemolyzed specimens •Blue top sodium citrate tubes insufficiently filled •Aliquots not received frozen on dry ice •Frozen aliquots not clearly identified as “platelet poor plasma”
Reference Range:
•<8 seconds: A normal or negative Staclot LA™ and shows no evidence of LUA in this type of assay.A negative result does not necessarily rule out the presence of an LUA or an APL antibody.Due to the heterogeneity associated with Lupus Anticoagulants, performance of two or more difference LUA assays may significantly enhance LUA detection and interpretation. •>8 seconds: A positive Staclot LA™ and indicates that the presence of LUA is suggested. Results should be interpreted in light of clinical history and in conjunction with other laboratory findings.
Clinical Utility:
Lupus Anticoagulant antibodies are heterogeneous; if DRVVT is negative, Lupus Anticoagulant Hexagonal phase will increase the possibility of detecting the inhibitor.

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Hgb
See Hemoglobin, Whole Blood

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Hgb Electrophoresis
See Hemoglobin Electrophoresis 5-HIAA
See 5-Hydroxyindoleacetic Acid,Quantitative, 24-Hour Urine

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HIB Antibody
See Haemophilus influenzae Type b Antibody, Vaccine Response

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High Density Lipoprotein
See HDL Cholesterol, Direct

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High Molecular Weight Kininogen		Test Code: HMWK
Alternate Name:	HMW Kininogen, Fitzgerald Factor
Methodology:	Clot Based Assay
Testing Schedule:	Routine, 1 time per week
Report Available:	7-10 days
Specimen Requirements:
Minimum Volume:	2 mL plasma, split equally into 2 plastic aliquot tubes and FROZEN immediately
Container:	2 Blue top (sodium citrate) tubes
Collection:	See special handling instructions for “Coagulation Studies”, listed under Specimen Collection, Preparation, and Handling Section
Special Instructions and/or Comments:
•Testing is contraindicated for patients on Heparin or Coumadin therapy. •Immediately centrifuge at 1500-1700 X G for 10 minutes.Avoiding the buffy coat, carefully remove the plasma from the cells using a plastic pipette.Aliquot the plasma into the required number of plastic aliquot tubes and label with “citrated plasma” labels. •Freeze the aliquoted specimens at -40° to -60°C.Once frozen, transport the specimens submerged in dry ice. Causes for rejection: •Extended transport time to laboratory •Clotted specimens •Hemolyzed specimens •Blue top sodium citrate tubes insufficiently filled •Aliquots not received frozen on dry ice •Frozen aliquots not clearly identified as “platelet poor plasma”
Reference Range:
65-135%
Clinical Utility:
Useful to explain a prolonged PTT in the presence of normal concentrations of all other clotting factors.

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High Sensitivity CRP
See C-Reactive Protein, High Sensitivity

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HIPA (Heparin Induced Platelet Aggregation)
See Heparin Associated Platelet Antibody

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HIS Profile
See Humoral Immune Status Profile

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Histamine, Plasma		Test Code: HISTA
CPT:	83088
Methodology:	Enzyme Immunoassay (EIA)
Testing Schedule:	Routine, 1 time per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	1 mL EDTA plasma
Container:	Lavender top (EDTA) tube
Special Instructions and/or Comments:
Centrifuge, transfer to plastic aliquot tube and freeze. Once frozen, transport specimen submerged in dry ice.
Reference Range:
<1 ng/mL
Clinical Utility:
Evaluating patiens for diseases of immediate Hypersensitivity or mast cell proliferation (mastocytosis).

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Histone Antibody
See Histone Autoantibody

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Histone Autoantibody		Test Code: HRAN
CPT:	83516
Alternate Name:	• Anti-Histone Antibody • Histone Antibody • Drug induced lupus
Methodology:	ELISA
Testing Schedule:	Routine, 2 times per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
•Refrigerate NOTE: Histone antibodies can be present in both systemic lupus erythamatosis (SLE) and in drup induced lubus (DIL(). When considering a diagnosis of DIL, histone antibodies should be preformed in parallell withdouble stranded DNA autoantibodies.
Reference Range:
< 1 Unit = Negative 1.0 to 1.5 Units = Borderline >1.5 Units = Positive
Clinical Utility:
Useful for evaluating patients suspected of having drug induced lupus erythematosis (DIL)

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Histone Reactive ANA
See Histone Autoantibody

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Histopathology
Includes:	•Gross examination only, AND/OR •Gross and microscopic examination and diagnosis •Reflexed when appropriate: •Decalcification •Special Stains •Immunohistochemistry Antibodies •Histochemical Staining •Electron Microscopy NOTE:Imprints may be made if the tissue is fresh and unfixed, and if indications for imprints exist.
CPT:	88300, 88302, 88304, 88305 , 88307, 88309 Reflexed when appropriate:88311, 88312, 88313, 88314, 88342, 88319, 88318, 88348
Alternate Name:	Biopsy; Gross and Microscopic Pathology; Microscopic Section; Pathologic Examination; Pathology; Surgical Pathology; Tissue Examination; Tissue Pathology
Methodology:	Histopathological evaluation performed by board certified pathologist. Testing Schedule:Routine, Monday-Friday (contact laboratory for “pathologist on call” for off hours)
Report Available:	1-3 days
Specimen Requirements:
Minimum Volume:	Entire specimen of fresh tissue or tissue fixed in phosphate-buffered formalin or other appropriate fixative.
Container:	Jars of assorted size containing 10% buffered formalin, in appropriate rates to size of specimen.Fresh specimens should be wrapped in a sterile gauze pad moistened with sterile saline in an air tight container.
Collection:	Specimens are to be placed immediately in fixative, unless special needs such as frozen section exist.Use approximately 20 times as much fixative solution as the bulk of the tissue.Small tissues such as those from bronchoscopic biopsy, bladder biopsy, and endometrium can be ruined in a short time by drying.
Special Instructions and/or Comments:
•Consult the Pathology Department at 610-402-8163 prior to beginning the procedure for specific instructions. •Submit specimen with a completed Tissue Requisition (HNL-31) Form and include client history and source of specimen.
Reference Range:
Results interpreted by pathologist.Histopathology, Autopsy

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Histopathology, Bone Biopsy, Osteomalacia
Includes:	•Plastic embedding •Thin sections of undecalcified bone biopsies •H & E stain •Tetracycline labeling
CPT:	88318
Alternate Name:	Tetracycline Labeling
Methodology:	Histopathological evaluation performed by board certified pathologist.
Testing Schedule:	Routine, Monday-Friday only
Report Available:	21 days
Specimen Requirements:
Minimum Volume:	2 mm bone
Container:	Plastic container obtained by contacting our Histology Department at 610-402-8162.
Collection:	Physician must obtain a vial containing ethanol alchoholfixative from the Histology Laboratory.
Special Instructions and/or Comments:
•Transport to the laboratory immediately. •Histopathology Requisition (HNL-31) Form must be submitted with specimen. NOTE: The procedure must be scheduled with the Histology Laboratory.

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Histopathology, Breast Biopsy
Includes:	•Immediate gross exam •Frozen tissue section (if necessary) •Estrogen receptor assay (if necessary) •Progesterone receptor assay (if necessary) •Routine histopathology
CPT:	88305
Alternate Name:	Biopsy, Breast; Mammotone/Needle Biopsy, Breast
Methodology:	Histopathological evaluation performed by board certified pathologist.
Testing Schedule:	Routine, daily
Report Available:	1-2 days
Specimen Requirements:
Minimum Volume:	1 g tumor tissue trimmed free of excess fat and blood plus sufficient tumor to establish histologic diagnosis.
Container:	Fresh specimens of breast tissue for frozen sections should be sent in a clean, dry container, and placed in the hands of a pathologist or histotechnician. For routine histology, place in 10% formalin.
Special Instructions and/or Comments:
•Family/personal history and clinical information must be provided on the Tissue Requisition (HNL-31) Form.Make note of prior biopsy or trauma, current or recent pregnancy, if nipple discharge is present and/or if lesion was detected by palpation, mammography, or both.Tumor location may be especially important for lesions in proximity to the nipple, where nipple duct adenoma (florid papillomatosis) may occur. •For needle localization studies, the original mammograms with x-rays of the needle localization are desirable. •Transport to the laboratory immediately upon removal.

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Histopathology, FISH Procedures
Includes:	Detection of HER2/NEU by FISH
CPT:	8827188274, 88365
Alternate Name:	HER2/NEU FISH
Methodology:	Fluorescence In situ Hybridization (FISH)
Testing Schedule:	Routine, Monday-Friday only
Report Available:	3-4 days
Specimen Requirements:
Container:	1 Paraffin block of tumor
Special Instructions and/or Comments:
Consultation with a pathologist is necessary to ensure proper testing.Histopathology, Frozen Tissue Section

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Histopathology, Gross Examination,Surgical Specimens
Includes:	Gross examination and description by pathologist
CPT:	88300
Methodology:	Histopathological evaluation performed by board certified pathologist.
Testing Schedule:	Routine, Monday-Friday only
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	Plastic container or bag large enough to contain specimen.

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Histopathology, Immunofluorescent Studies Biopsy
Includes:	Fluorescent stains for immunoglobulins, complement, fibrin, and routine histopathology
CPT:	88346
Alternate Name:	Direct Immunofluorescent Studies Biopsy (DIF)
Methodology:	Histopathological evaluation performed by board certified pathologist.
Testing Schedule:	Routine, Monday-Friday only
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	Biopsied material submitted in special fixative (Michels) as soon as possible following removal; volume determined by surgeon.
Container:	Michels solution (available from laboratory gross rooms/RRL at all sites) NOTE: Container must be labeled with patient’s full name, room number, and date.
Special Instructions and/or Comments:
•Consult the pathologist prior to biopsy procedure for specific instructions and proper fixative. •Submit specimen with a completed Tissue Requisition (HNL-31) Form and IMFL Form which must include operative diagnosis and source of specimen.Please contact the Histology Department at 610-402-8162.
Reference Range:
Negative

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Histopathology, Immunoperoxidase Procedures
Includes:	Antigen localization in tissue sections
CPT:	88342
Alternate Name:	Immunohistochemistry; PAP; Peroxidase Anti-Peroxidase
Methodology:	Histopathological evaluation performed by board certified pathologist.
Testing Schedule:	Routine, Monday-Friday only
Report Available:	1-3 days
Special Instructions and/or Comments:
Consultation with a pathologist is recommended to ensure proper testing.

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Histopathology, Lymph Node Biopsy
Includes:	•Microscopic examination of frozen sections •Paraffin and/or plastic sections •Touch preparations NOTE: Immunoperoxidase studies for immunoglobulin heavy and light chains are best done on unfixed snap frozen cryostat sections rather than on paraffin sections.
CPT:	88305
Methodology:	Histopathological evaluation performed by board certified pathologist.
Testing Schedule:	Routine, daily
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	Lymph node or other tissues suspected of harboring lymphoma, ideally submitted fresh with in minutes of the biopsy; volume determined by the surgeon.
Container:	Saline moistened sponge or Petri dish
Collection:	NOTE: DO NOT place specimen in fixative if it can be delivered immediately to the laboratory. Diagnostic difficulties in diseases of lymph nodes are compounded by poor fixation and improper handling. Lymph node biopsies should be immediately delivered to the Histology Laboratory, uncut, and in a small sterile jar. Requests for all examinations, including bacteriology, should accompany the specimen.All such specimens should be brought to the immediate attention of a pathologist. Bone marrow and other body fluid smears are commonly needed for appropriate work-up.
Special Instructions and/or Comments:
•Submit specimen with a completed Tissue Requisition (HNL-31) Form. •Transport to the laboratory immediately.
Reference Range:
Results interpreted by Hematopathologist.

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Histopathology, Muscle Biopsy
Includes:	•Routine morphologic diagnosis •Special tests are requested by physician
CPT:	88305, 88313, 88314 (x4), 88319
Alternate Name:	Skeletal Muscle Biopsy
Methodology:	Histopathological evaluation performed by board certified neuropathologist.
Testing Schedule:	Routine, Monday-Friday only; must be scheduled 24 hours in advance
Report Available:	14 days
Specimen Requirements:
Minimum Volume:	Please call Histology Laboratory at 610-402-8162 for procedure/protocol.
Collection:	Selection of muscle to biopsy: In known muscle disease, area should be selected which indicates clinical signs of involvement but has not reached “end-stage” atrophy.Avoid a muscle recently needled for EMG study because the latter may cause local reactive inflammation difficult to distinguish from focus of polymyositis.
Special Instructions and/or Comments:
•Submit specimen with a completed Tissue Requisition (HNL-31) Form.Pathologist needs clinical data which includes serum CK (CPK) level and electromyography (EMG) findings.Clinical history, laboratory findings, and site of biopsy are essential to interpretation and should be indicated on form. •Specially trained technicians will assist in collecting specimens. •Transport to the laboratory immediately. NOTE:A small portion of the fresh material will be stored deep frozen for possible later use as tissue for biochemical assays (eg, quantitative of glycogen or certain enzymes).

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Histopathology, Myocardial Biopsy
Includes:	H & E stain Special stains as appropriate
CPT:	88305
Alternate Name:	Mycardial Antibody Biopsy
Methodology:	Histopathological evaluation performed by board certified pathologist.
Testing Schedule:	Routine, Monday-Friday only
Report Available:	Paraffin: 1 day EM: 1 week
Specimen Requirements:
Minimum Volume:	Entire heart tissue biopsy submitted fresh in 10% neutral buffered formalin as soon as possible following removal.
Container:	Plastic container with 10% buffered formalin AND gluteraldehyde for EM studies
Special Instructions and/or Comments:
•Consult the pathologist prior to the biopsy procedure for specific instructions. •Tissue Requisition (HNL-31) Form must state operative diagnosis and source of specimen. •If specimen needs additional fixative, contact our Histology Department at 610-402-8162. •Maintain specimen in fixative at room temperature; maintain saline sponge specimen refrigerated.

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Histopathology, Nerve Biopsy
Includes:	•Histochemistry •Electron microscopy/teased preparation •Routine morphologic diagnosis NOTE:Special tests as requested by physician.
CPT:	88348, 88313 (x3), 88314(x3), 88305, 88362
Alternate Name:	Sural Nerve
Methodology:	Histopathological evaluation performed by board certified neuropathologist.
Testing Schedule:	Routine, Monday-Friday only; must be scheduled with laboratory 24 hours in advance.
Report Available:	3 weeks
Specimen Requirements:
Minimum Volume:	Contact our Histology Department at 610-402-8162 for instructions.

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Histopathology, Placenta Examination
Includes:	•Gross examination only, AND/OR •Gross and microscopic examination and diagnosis
CPT:	88307
Alternate Name:	Placental Tissue Examination
Methodology:	Histopathological evaluation performed by board certified pathologist.
Testing Schedule:	Routine, Monday-Friday only
Report Available:	1-3 days
Specimen Requirements:
Minimum Volume:	Entire fresh tissue or tissue fixed in phosphate buffered formalin.
Container:	Large plastic container with lid
Collection:	Placental tissue should be placed in 10% phosphate buffered formalin or sent to the laboratory fresh and chilled if bacterial, viral, or Chlamydia cultures or special procedures are requested.
Special Instructions and/or Comments:
Refrigerate fresh tissue
Reference Range:
Results interpreted by board certified pathologist.

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Histopathology, Pneumocystis carinii Preparation
Includes:	Methenamine silver stain
CPT:	88312
Alternate Name:	Pneumocystis carinii Stain
Methodology:	Histopathological evaluation performed by board certified pathologist.
Testing Schedule:	Routine, Monday-Friday only
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	Lung biopsy, transthoracic needle aspirate, bronchopulmonary lavage, OR induced sputum technique (volume determined by the surgeon)
Container:	Sterile container OR clean glass slides
Collection:	When inoculating needle aspirate on slides, single drops should be applied and allowed to air dry without spreading.Biopsy specimens should be submitted fresh.Jar or slides must be labeled with patient’s full name, date and time.
Special Instructions and/or Comments:
Submit specimen with a completed Tissue Requisition (HNL-31) Form.

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Histopathology, Renal Biopsy
Includes:	•H & E stain •Renal panel •Immunofluorescent studies •Electron microscopy NOTE:Light microscopy, immunofluorescence and electron microscopy are complementary and necessary in most cases, each supplying additional, helpful information.
CPT:	88305, 88313 (x2), 88346, 88348:
Alternate Name:	Kidney Biopsy
Methodology:	Histopathological evaluation performed by board certified pathologist.
Testing Schedule:	Routine, Monday-Friday only
Report Available:	1 week
Specimen Requirements:
Minimum Volume:	3 fresh kidney tissue specimens (needle), no added fixative
Container:	Sterile Petri dish/Send Out kit
Collection:	Specimen obtained during ultrasound •One core in 10% formalin (Paraffin) •Second core in glutaraldehyde (EM) •One core in zeuss (IMFL)
Special Instructions and/or Comments:
•Submit specimen with a completed Tissue Requisition (HNL-31) Form AND an additional form for Referral Testing.Form can be requested by contacting our Pathology Department at 610-402-8163.Clinical history and laboratory findings are essential to interpretation and should be noted on the form(s). •Consult our Histology Department at 610-402-8163 prior to beginning the procedure for specific instructions.

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Histopathology, Skin Biopsy, Immunofluorescence
Includes:	•Anti-IgG •Anti-IgA •Anti-IgM •Anti-C3 •Anti-C1q •Antialbumin •Anti-fibrinogen •Anti-kappa •Lambda light chains immunofluorescence
CPT:	88346 for each antibody
Alternate Name:	Bullous Pemphigoid Antibodies; Dermatitis Herpetiformis Antibodies; DIF; Intercellular Antibody Basement Membrane Antibody; LE Antibodies; Lupus Band Test; Pemphigus Antibodies; Skin Biopsy Antibodies; Skin Biopsy For Bullous or Collagen Disease; Skin Biopsy for Pemphigoid; Skin Biopsy for Pemphigus
Methodology:	Histopathological evaluation performed by board certified pathologist.
Testing Schedule:	Routine, Monday-Friday only
Report Available:	1-3 days
Specimen Requirements:
Minimum Volume:	3 mm2 skin punch biopsy
Container:	Vial containing Mischel’s fixative
Collection:	Obtaining biopsies: •If pemphigus or bullous pemphigoid is suspected and fresh lesions are present: obtain a 3 mm biopsy at the edge of the bulla. •If only old lesions are available: obtain biopsy from adjacent area. •If dermatitis herpetiformis is suspected or both bullous pemphigoid and dermatitis herpetiformis are suspected: obtain not only lesion biopsy, but also biopsy of uninvolved area around lesions.Repeated biopsies are sometimes necessary to confirm dermatitis herpetiformis. •If systemic lupus erythematosus or discoid LE is suspected: obtain biopsy of sun-exposed normal skin, preferably of the wrist, for diagnosis of SLE.Biopsies from lesions may be positive in both SLE and discoid LE while normal appearing sun-exposed skin yields positive findings in SLE only.Lesions older than 6 weeks should be biopsied in SLE.In vasculitis, lesions for biopsy should be less than 24 hours old. NOTE: Biopsy must be kept moist on saline soaked gauze or filter paper.
Special Instructions and/or Comments:
•Consult the laboratory prior to obtaining specimen. •DO NOT place specimen in formalin.Fixation in N-ethylmaleimide requires subsequent removal of fixative and frozen section. •Submit specimeh with a completed Tissue Requisition (HNL-31) Form. •Transport to the laboratory immediately on wet ice.
Reference Range:
No deposition of immunoglobulins, complement, or fibrinogen.

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Histopathology, Skin Biopsy, Light Microscopy
Includes:	Microscopic examination
CPT:	88304
Alternate Name:	H & E Sections/Punch Biopsy/Shave
Methodology:	Histopathological evaluation performed by board certified pathologist.
Testing Schedule:	Routine, Monday-Friday only
Report Available:	1-3 days
Specimen Requirements:
Minimum Volume:	1 mm skin biopsy/punch biopsy/shave
Container:	Container with formalin
Collection:	•Place skin biopsy in formalin immediately. •Label with patient’s name, biopsy site, and date. •Submit specimen with a completed Tissue Requisition (HNL-31) Form. •Maintain specimen at room temperature.

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Histopathology, Surgical Pathology Consultation, Outside Slides
Includes:	Microscopic evaluation
CPT:	88321
Alternate Name:	Outside Slide Review, Surgical Pathology; Referred Slides Consultation, Surgical Pathology
Methodology:	Histopathological evaluation performed by board certified pathologist.
Testing Schedule:	Routine, Monday-Friday only
Report Available:	1-2 days after receipt of slides NOTE:If urgent, can be read upon receipt
Special Instructions and/or Comments:
The attendingphysician may directly request the necessary material from the outside hospital or laboratory, or may ask our Pathology Department at 610-402- 8140 to initiate the request.A copy of the outside pathological report should be enclosed with the slides in addition to a Tissue Requisition (HNL-31) Form.

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Histopathology, Touch Prep Imprint
Includes:	•Gross examination •Specimen evaluation •Interpretation
CPT:	88161, Reflexed when appropriate, 88342
Alternate Name:	TP Consult; Touch Prep
Methodology:	Histopathological evaluation performed by board certified pathologist.
Testing Schedule:	Routine, daily (call laboratory for “pathologist on-call” for off hours)
Report Available:	20-45 minutes
Specimen Requirements:
Minimum Volume:	Fresh tissue, no added fixative, or fluid; volume determined by the surgeon
Container:	Sterile towel, sterile Petri dish, or empty sterile jar
Special Instructions and/or Comments:
•After normal hours: call laboratory for “pathologist on call” prior to specimen collection (to allow travel time). •Submit specimen with a completed Frozen Section Requisition (LAB-30) Form. •Check the Touch Prep Box.

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Histoplasma Antigen, Serum		Test Code: SRHAG
CPT:	87385
Methodology:	Enzyme Immunoassay (EIA)
Testing Schedule:	Routine, daily
Report Available:	2-4 days
Specimen Requirements:
Minimum Volume:	Volume:2 mL serum
Container:	Gold top (serum separator) tube
Reference Range:
Specimen Result <0.6 ng/ml None Detected Negative <1.9 ng/ml Positive,borderline 20.-9.9ng/ml Positive, weak 10-79.9 ng/ml Positive, moderate >20.0 ng/ml Positive, high Clinical Utility: Useful for assessment of acute pulmonary or disseminated Histoplasma capsulatum infection (histoplasmosis), as well as for monitoring therapy response (assessing improvement and/or diagnosing relapse).

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Histoplasma Antigen, Urine		Test Code: UHAG
CPT:	87385
Methodology:	Enzyme Immunoassay (EIA)
Testing Schedule:	Routine, 4 times per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	10 mL random urine
Container:	Plastic urine tube
Special Instructions and/or Comments:
Refrigerate
Reference Range:
Specimen Result <0.6 ng/ml None Detected Negative <1.9 ng/ml Positive,borderline 20.-9.9ng/ml Positive, weak 10-79.9 ng/ml Positive, moderate >20.0 ng/ml Positive, high Clinical Utility: Useful for assessment of acute pulmonary or disseminated Histoplasma capsulatum infection (histoplasmosis), as well as for monitoring therapy response (assessing improvement and/or diagnosing relapse).

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HIT Ab
See Heparin Associated Platelet Antibody

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HIV Antibody
See HIV-1 and 2 Antibody Profile

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HIV Proviral DNA
See HIV-1 DNA, PCR, QualitativeHIV Screen
See HIV-1 and 2 Antibody ProfileHIV WB
See HIV-1 Antibody, Western Blot

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HIV Western Blot
See HIV-1 Antibody, Western Blot

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HIV-1 and 2
See HIV-1 and 2 Antibody Profile

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HIV-1 and 2 Antibody Profile		Test Code: HIV12
Includes:	•HIV-1 and 2 Antibody Screen •Reflexed when appropriate: HIV-1 Western Blot Confirmation on initial positive screens which includes: HIV-1 IgG Antibodies-IB, gp 16/120, p65, p55, p51, gp41, p40, p31, p24, p18
CPT:	86703, Reflexed when appropriate, 86689
Alternate Name:	HIV 1 and 2; HIV Antibody; HIV Screen; HTLV-III Antibody; Human Immunodeficiency Virus Serology
Methodology:	HIV-1 and 2 Antibody Screen: Enzyme Immunoassay (EIA) Reflex Confirmation:Western Blot (WB)
Testing Schedule:	Routine, daily
Report Available:	2-4 days (may be extended if Western Blot required)
Specimen Requirements:
Minimum Volume:	2 mL serum
Container:	Gold top (serum separator) tube SPECIMEN MUST BE RECEIVED IN THE ORIGINAL VACUTAINER TUBE ALIQUOT TUBES WILL NOT BE ACCEPTED
Special Instructions and/or Comments:
•Specimen must be received in the original Vacutainer tube. Aliquot tubes will not be accepted. •The laboratory assumes that appropriate consent and pretest counseling have been performed by the physician prior to the request for testing.Consent forms should remain on the patient’s chart, DO NOT send to the laboratory. •The Department of Health requires mandatory reporting of any confirmed positive result.
Reference Range:
•Negative: no antibody detected by HIV-1 and 2 Antibody Screen. •Repeatedly reactive screens will automatically be confirmed by Western Blot.These are preliminary until Western Blot results are available and final interpretation is made.
Clinical Utility:
HIV-1 is the causative agent of AIDS (acquired immune deficiency syndrome) in humans. The HIV virus infects T-lymphocytes, resulting in immune deficiencies, manifested in such diseases as Kaposi’s sarcoma, pneumonia, and various infections. HIV-2 is a comparable T-lymphocytic retrovirus that is less virulent, but is becoming more widespread worldwide. HIV-2 is more common outside of the United States, but cases have been reported in the U.S. This test code provides an initial combo enzyme immunoassay screening test for HIV-1 and HIV-2, reflexing to HIV-1 western blot.

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HIV-1 Antibody, Western Blot		Test Code: WBHIV
Includes:	NOTE:Not intended for use as a screening test and should not be substituted for routine HIV-1 serology. NOTE: This test is automatically ordered when the HIV 1/2 ETA screen is resulted as positive
CPT:	86689
Alternate Name:	HIV-1 WB HIV-1 Western Blot HIV-1 Antibodies + Bands (IB)
Methodology:	Western Blot
Testing Schedule:	3 times per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
•Centrifuge, transfer to plastic aliquot tube and freeze.Once frozen, transport specimen submerged in dry ice.
Reference Range:
Negative:No antibody detected. HIV Interpretation Chart: HIV-1 and 2 EIA and HIV-1 Western Blot EIA Western Blot Interpretation Nonreactive / negative Not required Patient is not infected, or if infected has not yet developed antibodies Repeatedly reactive Positive; response pattern confirms HIV-1 infection Patient is infected with HIV-1 and must be considered potentially infectious to others. Post-test counseling is required Repeatedly reactive Indeterminate or equivocal; pattern does not meet criteria for positive assay With the reported pattern of results, HIV-1 infection cannot be substantiated. Repeat testing is suggested Repeatedly reactive Negative, no HIV-1 specific response pattern noted Suggests false-positive screening EIA test. Repeat testing is advised if clinical findings are discordant with laboratory results Negative ( reported as negative, intermediate, or negative) Special Notes: • The HIV-1 Western Blot is best used as a followup to specimens repeatedly reactive on an initial EIA antibody screen • This assay is not intended for use as a screening test • Criteria for a positive result includes the presence of antibodies to at least two of the following HIV specific proteins: p24 (core), gp41 (envelope)
Clinical Utility:
Useful for confirmation on positive HIV antibody tests.

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HIV-1 DNA, PCR, Qualitative		Test Code: HVPCR
CPT:	87535
Alternate Name:	HIV Proviral DNA
Methodology:	Polymerase Chain Reaction (PCR)
Testing Schedule:	Routine, 2 times per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	Adults:.................5 mL whole blood Infants:.................2 mL whole blood
Container:	Adults: ..........2 lavender top (EDTA) tubes OR 2 yellow top (ACD) tubes Infants: .........capillary collection in 3 full lavender top BD Microtainer™ tubes
Special Instructions and/or Comments:
• Store whole blood in original tube. • DO NOT centrifuge, aliquot, refrigerate or freeze. • Store and transport at room temperature (ambient) ONLY
Reference Range:
Not detected.
Clinical Utility:
Detects the presence of HIV-1 Proviral DNA down to 35 copies/million cells in peripheral blood mononuclear cells that could potentially reactivate in HIV-1 positive patients with undetectable viral loads (following antiretroviral therapy). Also detects proviral DNA in individuals recently exposed to HIV but prior to production of HIV-specific antibodies (including neonates of HIV positive mothers, accidental HIV exposure).

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HIV-1 Genotype Profile		Test Code: HIVGN
Includes:	•HIV-1 Viral Load, PCR, Ultrasensitive •Reflexed when appropriate: •Additional HIV-1 Viral Load quantitation when ultrasensitive values are >100,000 copies/mL •HIV-1 Genotype when HIV-1 Viral Load is >1,000 copies/mL
CPT:	87536:, Reflexed when appropriate:87536, 87901
Methodology:	•Reverse Transcription Polymerase Chain Reaction (RT-PCR) COBAS Amplicor HIV-1 Monitor Test, Version 1.5 •Rapid Polymerase Chain Reaction (RT-PCR) with DNA Sequencing
Testing Schedule:	Routine, Monday-Friday
Report Available:	10-14 days
Specimen Requirements:
Minimum Volume:	8 mL plasma
Container:	4 white top (EDTA) plastic tubes
Special Instructions and/or Comments:
•DO NOT submit heparinized specimens. •Must be processed within 6 hours of collection. •Centrifuge specimen.DO NOT aliquot.Freeze 2 tubes and refrigerate 2 tubes.Once frozen, transport specimen submerged in dry ice. •A HIV-1 Viral Load of $1,000 copies/mL is required for the specimen to be valid. NOTE:No HIV-1 Genotype results will be reported on specimens with <1,000 copies/mL
Reference Range:
See report.
Clinical Utility:
Useful for, quantifying HIV-1 viral load and, if appropriate,determining key HIV mutations (genotype) associated with drug resistance. As a guide for intiating or changing antiviral treatment regimens.

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HIV-1 Phenosense		Test Code: HIVPS
CPT:	87904 (X10), 87903
Alternate Name:	HIV-1 Phenotype
Methodology:	Transfection, Luciferase Activity
Testing Schedule:	Routine, daily
Report Available:	14 - 25 days
Specimen Requirements:
Minimum Volume:	3 mL EDTA plasma
Container:	2 lavender top (EDTA tubes) Collection: • For best results, viral loads should be collected either at the same time or within 2 weeks prior to collection. • Results of HIV viral load must be at least 500 copies/mL Special Instructions
Special Instructions and/or Comments:
•Centrifuge specimen within 1/2 hour of collection •Transfer serum/plasma to plastic aliquot tube and freeze. Once frozen, transport submerged in dry ice.
Reference Range:
Accompanies Report

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HIV-1 RNA Branched Chain DNA, Viral Load
See HIV-1 Viral Load, RT-PCR

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HIV-1 Viral Load, RT-PCR		Test Code: HIV1L
CPT:	87536 Replaces: HIV-1 Viral Load, PCR Ultrasensitive & Reflex. HIV-1 RNA Branched Chain DNA, Viral Load
Methodology:	Real time Reverse Transcription Polyerase Chain Reaction RT-PCR utilizing COBAS® AmpliPrep/COBAS® TaqMan® HIV-1 test
Testing Schedule:	Routine, Monday-Friday only
Report Available:	1-3 days
Specimen Requirements:
Minimum Volume:	4 mL plasma
Container:	2 White top (EDTA) plastic tubes OR 3 lavender top (EDTA) tubes
Special Instructions and/or Comments:
•DO NOT submit heparinized specimens. For white top tubes: •Must be processed within 6 hours of collection. •Centrifuge specimen. DO NOT aliquot. •Refrigerate. For lavender top tubes: •Must be processed within 6 hours of collection. •Centrifuge, aseptically transfer to plastic aliquot tube and refrigerate.
Reference Range:
•<48 copies/mL Assay range 48-10,000,000 copies/mL
Clinical Utility:
Quantitates HIV-1 virus RNA down to 48 copies/mL to monitor viral load in established HIV-1 infected individuals.This assay provides an assessment of viral load prior to initiation of therapy and is helpful in early detection of potential therapeutic failure and/or disease progression.

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HLA-B27		Test Code: HLB27
CPT:	86812 Related Information: See HLA Typing Single Human Leukocyte Class I Antigen Other Than B27; Tissue Typing
Alternate Name:	B27; HLA-Antigen B27
Methodology:	Flow Cytometry
Testing Schedule:	Routine, Monday-Friday only
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	10 mL whole blood
Container:	Yellow top (ACD) tube
Special Instructions and/or Comments:
•Collect Monday-Thursday ONLY before 1400, no holidays.Specimens must arrive in the laboratory no later than 1600. •Store as whole blood in original tube at room temperature. •DO NOT centrifuge, aliquot, refrigerate or freeze.
Clinical Utility:
Evaluate spondylarthritis and other disorders associated with this antigen. Over 90% of ankylosing spondylitis (AS) patients, 75% of Reiter syndrome patients and 80% of patients with reactive arthritis (ReA) are HLAB27-positive.

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HLA-B5701		Test Code: B5701
CPT:	83890, 83893 X3, 83896 X3, 83898, 83912
Alternate Name:	• Abacavir hypersensitivity • HLA antigen 57 • HLA antigen B 5701
Methodology:	PCR/sequence specific oligonucleotide probes (SSOP)
Testing Schedule:	Routine, Monday-Friday only
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	7 mL whole blood
Container:	2 Lavender top (EDTA) tubes
Special Instructions and/or Comments:
•Collect Monday-Thursday ONLY , no holidays. •Store as whole blood in original tube at room temperature. •DO NOT centrifuge, aliquot, refrigerate or freeze.
Reference Range:
Negative
Clinical Utility:
To determine the presence of B57 antigen

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HMW Kininogen
See High Molecular Weight Kininogen

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Homocysteine, Plasma		Test Code: HCYS
CPT:	83090
Alternate Name:	Fasting Homocysteine; Plasma Homocysteine; Total Homocysteine; Quantitative Homocysteine
Methodology:	Chemiluminescent Immunoassay
Testing Schedule:	Routine, 2 times per week
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	1 mL frozen plasma
Container:	Lavender top (EDTA) tube
Collection:	•Place tube onto wet ice immediately after collection.Specimen MUST remain on ice until processing •Deliver to lab within 5 hours. •Fasting patient preferred. •Centrifuge, transfer equally into 2 plastic aliquot tubes and freeze.Once frozen, transport specimen submerged in dry ice.
Special Instructions and/or Comments:
•Transport to the laboratory immediately. •Must be processed and frozen within 5 hours of collection.
Reference Range:
<15 years.............................<11umol/L 15-65 years......................... <16 umol/L >65 years.............................<21umol/L
Clinical Utility:
Predictor of risk for ischemic stroke and myocardial infarction. Homocysteine is elevated in patients with cobalamin and/or folate deficiency, and is more sensitive than serum cobalamin and serum folate concentrations in diagnosing these vitamin deficiencies.

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24-Hour BJP
See Free Light Chains, Quantitative, 24-Hour Urine

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24-Hour FLC
See Free Light Chains, Quantitative, 24-Hour Urine

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24-Hour Microalbumin
See Microalbumin, 24-Hour Urine

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24-Hour Urine Creatinine Clearance
See Creatinine Clearance, 24-Hour Urine

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HPV
See HPV DNA

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HPV by Hybrid Capture
See HPV DNA

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HPV DNA		Test Code: HPV DNA
Includes:	•Reflex HPV DNA High Risk on ASCUS only •HPV DNA High Risk as a primary screening in combination with ThinPrep®PapTest out of vial. •HPV DNA High Risk Only (for specimens sent without a ThinPrep®PapTest.
CPT:	87621
Alternate Name:	HPV DNA High Risk DNA with Pap
Methodology:	HPV DNA Hybrid Capture II
Testing Schedule:	Routine, 3 times per week
Report Available:	5-10 Business days
Specimen Requirements:
Minimum Volume:	4mL from ThinPrep Vial Exfoliated cells collected according to the ThinPrep® liquid based specimen preparation guidelines
Container:	ThinPrep Vial OR Digene HC2 Cervical Sampler ThinPrep vials filled with Preservcyte™fluid
Collection:	•Vials MUST be labeled with patients full name ( First initial and last name is not acceptable.) •See special instructions for “Cytobrush/Spatula Collection” listed under Specimen Collection Preparation and Handling Section of the Lab Handbook •Transport ThinPrep vials within one week of collection
Special Instructions and/or Comments:
•Submit specimen with a completed cytology requisition form (HNL-30) or one of the laboratory appropriate electronic forms •Ancillary Test Options (out of vial) are preformed only from a ThinPrep® vial. •Maturation Index, if desired, must be obtained from a lateral vaginal wall scrape. •Patient should avoid douches for 48-72 hours prior to collection NOTE:The following additional criteria are required or Ancillary Test Options OUT OF VIAL: •HPV DNA:There must be a minimum of 4 mL of fluid available after processiong the ThinPrep Pap Test •HPV DNA:The specimen cannot be older that 30 days. For Digene HC2 Cervical Sampler : •Collect specimen using the Digene HC2 Cervical Sampler Kit.Follow collection instructions in package insert •Kits can be requested by contacting our Customer Care Department at 610-402-8170 •Maintain specimen at room temperature •Speciumen is stable for 2 weeks at room temperature •Submit specimen with a completed Cytology Gen •Requisition (HNL-30) Form
Reference Range:
HPV DNA not detected
Clinical Utility:
Useful for detecting the presence or absence of 13 HPV High risk types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) down to approximately 5000 HPV genomes per sample.

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HsCRP
See C-Reactive Protein, High Sensitivity

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HSV 1 and 2 Antibodies
See Herpes Simplex Virus IgG Antibody Profile
See Herpes Simplex Virus IgM Antibody Profile

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HSV 1 and 2 Culture
See Culture, Viral, Herpes Simplex, Rapid with Typing

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HSV 1 and 2 IgM HSV IgM
See Herpes Simplex Virus IgM AntibodyProfile

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HSV, CSF by PCR
See Herpes Simplex Virus, PCR Cerebrospinal Fluid

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HSV Culture
See Culture, Viral, Herpes Simplex,Rapid

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HSV IgG
See Herpes Simplex Virus IgGAntibody Profile

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HSV Screen
See Herpes Simplex Virus IgG Antibody Profile

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HTLV I/II Virus Antibody Profile		Test Code: HT12P
Includes:	•HTLV I/II Antibody Screen •Reflexed when appropriate: •HTLV I/II Antibody, Latex Immunoassay with bands on initial positive screens.
CPT:	86790 Reflexed when appropriate: 86689
Alternate Name:	Human T-Lymphocyte Virus I/II Antibody
Methodology:	HTVL I/II Antibody Screen:Enzyme-Linked Immunosorbent Assay (ELISA) Reflex Confirmation:Latex Immunoassay
Testing Schedule:	Routine, 2 times per week
Report Available:	2-4 days
Specimen Requirements:
Minimum Volume:	2 mL serum
Container:	Gold top (serum separator) tube
Reference Range:
Non reactive
Clinical Utility:
Useful for Laboratory evaluation of patients with proven or suspected ATL or HAM/TSP. Screening of blood, bone marrow, and solid organ donors for asymptomatic infection with HTLV-1 or HTLV-II.

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Hu Antibody
See Neuronal Nuclear Autoantibody,Serum
See Neuronal Nuclear

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Human Chorionic Gonadotropin,Urine
See Beta Human Chorionic Gonadotropin, Urine

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Human Complement
See Complement, C3

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Human Immunodeficiency Viru Serology
See HIV-1 and 2 Antibody Profile

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Human Papilloma Virus
See Cytopathology, HPV DNA Only (without ThinPrep®)
See Cytopathology, Cervical/Vaginal (ThinPrep®) with Reflex HPV DNA

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Human Papilloma Virus
See HPV DNA

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Human T-Lymphocyte Virus I/II Antibody
See HTLV I/II Virus Antibody Profile

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Humoral Immune Status Profile		Test Code: HIS
Includes:	•Diphtheria IgG Antibody •Haemophilus influenzae type b IgG Antibody •IgG subclasses 1-4 •IgA subclasses 1 & 2 •Pneumococcal Antibody Profile, Vaccine Response •Quantitative Immunoglobulins IgG, IgA, IgM •Tetanus IgG Antibody
CPT:	86648, 86684, 82787 (x4), 86329 (x2), 6317 (x23), 82784 (x3), 86774
Alternate Name:	HIS Profile
Methodology:	See individual test listings.
Testing Schedule:	Routine, 2 times per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	5 mL serum
Container:	5 Gold top (serum separator) tubes
Reference Range:
See individual test listings.
Clinical Utility:
Assessment of humoral immunity through evaluation of quantitative immunoglobulin levels, as well as antibody response to immunization.

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Hydatid Larva
See Parasite Identification

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Hydrocortisone
See Cortisol, Serum18-Hydroxy B Steriod
See 18-Hydroxycorticosterone

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18-Hydroxycorticosterone		Test Code: 18HC
CPT:	82542
Alternate Name:	18-OH-Corticosterone; 18-Hydroxy B Steriod
Methodology:	HPLC Tandem, Mass Spectrometry
Testing Schedule:	Routine, 1 time per week
Report Available:	7-10 days
Specimen Requirements:
Minimum Volume:	2 mL frozen serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
•Must be processed and frozen within 1 hour of collection. •Centrifuge, transfer to plastic aliquot tube and freeze.Once frozen, transport specimen submerged in dry ice.
Reference Range:
AGE RANGE (ng/dL Premature (26-28 Weeks) Day 4 10-670 Premature (31-35 Weeks) Day 4 57-410 Full Term 5-220 31 days - 11 months 5-220 12-23 months 18-155 24 months-9 years 6-85 10-14 years 10-72 Adults: 9-58 5-46 Adults 8:00 AM Supine 5-46 Adults 8:00 AM Upright 5-46
Clinical Utility:
Increased excretion of 18-hydroxycortisol has been Proposed as a specific biochemical marker for differential diagnosis of primary aldosteronism.

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Hydrocodone, Blood		Test Code: BHCD
Includes:	Identification and quantitation of hydrocodone
CPT:	83925
Methodology:	GC/MS
Testing Schedule:	Routine, 1 time per week
Report Available:	1-2 weeks
Specimen Requirements:
Minimum Volume:	e: 2 mL whole blood
Container:	Gray top (sodium fluoride) OR lavender (EDTA)tube
Reference Range:
Therapeutic:30-250ng/mL
Clinical Utility:
Useful for of drug use for compliance or evaluate toxicity in an overdose situation.

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5-Hydroxyindoleacetic Acid, Quantitative, 24-Hour Urine		Test Code: HIAAQ
Includes:	•Volume Measurement •Collection Period •5-Hydroxyindolacetic Acid, Urine
CPT:	83497, 81050
Alternate Name:	5-HIAA
Methodology:	Liquid Chromatography / Tandem Mass Spectrometry (LC-MS/MS)
Testing Schedule:	Routine, Monday-Friday ONLY
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	20 mL aliquot of a well mixed 24-Hour urine collection
Container:	24-Hour plastic urine container. Add 25 mL of 50% acetic acid at beginning of collection.
Collection:	Patients should not eat avocados, bananas, butternuts, cantaloupe, dates, eggplant, grapefruit, hickory nuts, honeydew, kiwi fruit, melons, nuts, pecans, pineapple, plantain, plums, tomatoes, or walnuts for a 48-hour period prior to start of collection. •Instruct the patient to void at the beginning of the collection period and discard the specimen. •Collect all urine including the final specimen voided at the end of collection period. •Refrigerate during collection. •Container must be labeled with the patient’s name.
Special Instructions and/or Comments:
•Transport to the laboratory promptly. •Requisition must state date and time collection began and date and time collection was completed.
Reference Range:
Adults:<6 mg/24 Hours
Clinical Utility:
Useful for, Biochemical diagnosis and monitoring of intestinal carcinoid syndrome.

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17-Hydroxypregnenolone		Test Code: PREGN
CPT:	84143
Alternate Name:	17-OH Pregnenolone
Methodology:	HPLC-Tandem Mass Spectrometry
Testing Schedule:	Routine, 3 times per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
Centrifuge, transfer to plastic aliquot tube and freeze.Once frozen, transport specimen submerged in dry ice.
Reference Range:
Adults:53-357 ng/L
Clinical Utility:
17-hydroxypregnenelone levels have been shown to remain in the normal range in patients with Cushing.Levels can be suppressed with dexamethasone inhibition and increased with exogenous ACTH stimulation. Levels during the follicular phase of the menstrual cycle tend to be higher than during the luteal phase. 17-hydroxypregnenelone levels have been shown to be elevated in patients with idiopathic hirsutism.

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17-Hydroxyprogesterone		Test Code: 17OHP
CPT:	83498
Alternate Name:	Progesterone, 17-Alpha- Hydroxy; 17 OH- Progesterone
Methodology:	Liquid Chromatography- Tandem Mass Spectrometry (LC-MS/MS)
Testing Schedule:	Routine, Monday-Friday ONLY
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Red top tube, no serum separator
Special Instructions and/or Comments:
Refrigerate
Reference Range:
Accompanies Report
Clinical Utility:
Useful for, the analysis of 17-hydroxyprogesterone is 1 of the 3 analytes along with cortisol and androstenedione, that constitutes the best screening test for congenital adrenal hyperplasia (CAH), caused by either 11- or 21-hydroxylase deficiency. Analysis for 17-hydroxyprogesterone is also useful as part of a battery of tests to evaluate females with hirsutism or infertility.Both can result from adult-onset CAH.

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Hypercoagulability Profile
See Thrombotic Risk Profile

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Hypersensitivity Pneumonitis Profile		Test Code: HYPP
Includes:	Antibodies to: •Alternaria tenuis IgG Antibody •Aspergillus fumigatus Total Antibody •Auerobasidium pullulans IgG Antibody •Cladosporium herbarum IgG Antibody •Micropolyspora faeni Total Antibody •Mixed Feathers IgG Antibody •Penicillium notatum IgG Antibody •Phoma spp IgG Antibody •Pigeon Droppings IgG Antibody •Saccharomonospora viridis Total Antibody •Thermoactinomyces candidus Total Antibody •Thermoactinomyces sacchari Total Antibody •Thermoactinomyces vulgaris Total Antibody •Trichoderma viride IgG Antibody
CPT:	86001 (x8), 86606, 86609 (X5)
Alternate Name:	Farmer’s Lung
Methodology:	Double Diffusion (DD), Immunocap
Testing Schedule:	Routine, daily
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	3 mL serum
Container:	2 Gold top (serum separator) tubes
Special Instructions and/or Comments:
Refrigerate
Reference Range:
See report.
Clinical Utility:
Support the clinical diagnosis of hypersensitivity pneumonitis

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Hypertension Converting Enzyme
See Renin Activity