Updates to ELEVENTH EDITION Catalog of Services and Fees:

14TH EDITION Catalog of Services - Update # 4
July 2012
Test Code Test Name Page(s) Update New Information
BLOD0376 Antithyroid Antibody Panel 53, 158 Specimen requirements 2.0 mL serum or EDTA plasma (1.0 mL minimum).
Separate from cells as soon as possible.
BLOD0315 Antithyroid Peroxidase Antibody 53, 158 Specimen requirements 2.0 mL serum or EDTA plasma (1.0 mL minimum).
Separate from cells as soon as possible.
BLOD0585 Digoxin 82 Specimen Requirements: Trough levels most reproducible; draw within 30 minutes
prior to next dose.
BLOD0139
Hepatitis C Virus Genotype,
Serum
107 New Test Information Hepatitis C Virus Genotype, Serum
by RT‐PCR WITH Fluorescent Probe Hybridization
2.0 mL frozen serum (1.0 mL minimum). Specimen MUST
be drawn in a gel barrier/serum separator tube. Serum
drawn in a plain red top tube is NOT acceptable and
plasma is NOT acceptable. Centrifuge and freeze serum
within 6 hours. THIS TEST REQUIRES ITS OWN FROZEN
ALIQUOT.
Stability: Frozen only
Note:*Specimen should contain a recommended
minimum HCV viral load of 1,000 IU/mL.
**This test is for research use only.
CPT Code: 87902
Fee: $385.00
BLOD0640 Immune Deficiency Panel 1 113 CPT Codes CPT Codes: 86360, 86355, 86357, 86359 (delete 88187)
BLOD0641 Immune Deficiency Panel 2 114 CPT Codes CPT Codes: 86360, 86355, 86359 (delete 88187)
BLOD0654 Immune Deficiency Panel 3 114 CPT Codes CPT Codes: 86360, 86359 (delete 88187)
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14 TH EDITION TEST CATALOG Update #4
July 2012
Test Code Test Name Page(s) Update New Information
BLOD0314 Islet Cell Antibody 116, 134 Test Name Islet Cell Pancreatic Antibody Reflex to Titer
NBLD0203 Joint Fluid Cell Count and
117 Specimen requirements: 2.0 mL joint fluid in potassium EDTA (1.0 mL minimum).
Differential
NBLD0203 Joint Fluid Cell Count and
117 Specimen requirements: 2.0 mL joint fluid in potassium EDTA (1.0 mL minimum).
Differential
NBLD0210 Joint Fluid Crystals 117 Specimen requirements: Send refrigerated
BLOD0335 Legionella pneumophila, IgM 120 CPT Code units CPT Code: 86713(2)
NBLD0042 Varicella zoster PCR, CSF 167 Test code Test Code unavailable.
Fee Schedule Update #4
Test Code Test Name Page(s) Update New Information
BLOD0148 Aldosterone 1 Client Fee: Fee: $116.00
NBLD0044 Aldosterone, 24 Hour Urine 1 Client Fee: Fee: $116.00
BLOD0144 HIV-1 Genotypic Drug Resistance 12 Client Fee: Fee: $1009.30
BLOD0499 Renin 18 Client Fee: Fee: $110.00
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