TEST CODES & SPECIMEN REQUIREMENTS MANUAL VERSION 2.0
Test Specification Guide - Ottawa Inner City Health
Test Specification Guide - Ottawa Inner City Health
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LABORATORY <strong>TEST</strong>S<br />
(In-House and Referred-out)<br />
168 Charlotte Street<br />
Ottawa, Ontario, Canada K1N 8K6<br />
<strong>TEST</strong> <strong>CODES</strong><br />
&<br />
<strong>SPECIMEN</strong> <strong>REQUIREMENTS</strong><br />
<strong>MANUAL</strong><br />
(SECTIONS A-Z)<br />
<strong>VERSION</strong> <strong>2.0</strong><br />
______________________________________________<br />
Laboratory Director/Designee<br />
Date<br />
______________________________________________<br />
Laboratory Manager<br />
Date<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.<br />
Page 1 of 191
Reviewed & Revised September 2011<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.<br />
Page 2 of 191
BIO-<strong>TEST</strong> LABORATORY<br />
<strong>TEST</strong> SPECIFICATION GUIDE<br />
(TSG)<br />
Approved by the Laboratory Director and QC Coordinator<br />
Laboratory Director<br />
QC Coordinator<br />
Date Signature Date Signature<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.<br />
Page 3 of 191
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
A/G RATIO<br />
(ALBUMIN/ GLOBULIN<br />
RATIO)<br />
A/G<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
A1C<br />
(GLYCOSYLATED<br />
HEMOGLOBIN)<br />
(HbA1C)<br />
(HEMOGLOBIN A1C)<br />
A1C<br />
Whole Blood<br />
TAT – 1 day<br />
LAVENDER OHIP BTL<br />
ABO, RhD<br />
(ABO & TYPE)<br />
(BLOOD GROUP & RhD)<br />
(BLOOD TYPE)<br />
(Rh FACTOR)<br />
BGR<br />
Whole blood<br />
DO NOT SEPARATE<br />
TAT – 1 day<br />
LAVENDER OHIP BTL<br />
ABO, Rh(D), GENOTYPE<br />
(BLOOD GROUP, Rh(D) &<br />
GENOTYPE)<br />
(GENOTYPE)<br />
RCML<br />
Whole Blood<br />
DO NOT SEPARATE<br />
TAT – 2 days<br />
LAVENDER OHIP CML<br />
ABO & Ab SCREEN<br />
(ABO & SCREEN)<br />
(PRENATAL SCREEN)<br />
(REPEAT PRENATAL<br />
ANTIBODIES)<br />
(TYPE & SCREEN)<br />
BGR<br />
AS<br />
Whole Blood<br />
DO NOT SEPARATE<br />
● Testing includes ABO, RhD, antibody<br />
screen●<br />
TAT –1 day<br />
LAVENDER OHIP BTL<br />
ACE<br />
(ANGIOTENSIN<br />
CONVERTING ENZYME)<br />
ACE<br />
Serum<br />
Assay cannot be performed on a lipemic<br />
specimen<br />
TAT – 15 days<br />
YELLOW SST $35.00 CML<br />
ACETAMINOPHEN<br />
(TYLENOL)<br />
ACETA<br />
Serum<br />
2 mL – Minimum volume<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 10 days<br />
YELLOW SST OHIP CML<br />
ACETONE<br />
(KETONES)<br />
KETO<br />
Serum<br />
2 mL – Minimum volume<br />
YELLOW SST OHIP CML<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag labelled „Frozen Sample‟<br />
TAT – 10 days<br />
ACETONE, QUALITATIVE<br />
(KETONES QUALITATIVE)<br />
RCML<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap bottle<br />
TAT – 1 day<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 1 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ACETYCHOLINE<br />
RECEPTOR ANTIBODY<br />
(ANT-ACH RECEPTOR)<br />
AACRA<br />
Serum<br />
2 mL<br />
TAT – 30 days<br />
YELLOW SST $130.00 CML<br />
ACETYL CHOLINESTERASE<br />
(CHOLINESTERASE,<br />
PLASMA AND RBC)<br />
(RBC CHOLINESTERASE)<br />
CHOLR<br />
Red cells<br />
Centrifuge tubes<br />
Aliquot and discard plasma from lavender<br />
tubes<br />
Send red cells only<br />
Keep tubes together with an elastic<br />
TAT – 15 days<br />
2 LAVENDER OHIP CML<br />
ACETYLSALICYLIC ACID<br />
(ASA)<br />
(ASPIRIN)<br />
(SALICYLATE)<br />
SAL<br />
Serum<br />
2 mL<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 1 day<br />
PLAIN RED OHIP CML<br />
ACID FAST BACILLUS<br />
(AFB)<br />
(T.B. CULTURE)<br />
(TUBERCULOSIS CULTURE)<br />
AFB<br />
Sputum<br />
First morning specimen – submit in a sterile<br />
container<br />
Container must be tightly sealed<br />
*Use Data Entry code AFB2, if two<br />
samples received<br />
*Use Data Entry code AFB3, if three<br />
samples received<br />
N/C<br />
PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 60 days<br />
ACID PHOSPHATASE,<br />
PROSTATIC<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
ACID PHOSPHATASE<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
ACTH<br />
(ADRENOCORTICOTROPIC<br />
HORMONE)<br />
ACTH<br />
Plasma<br />
2 Ml<br />
Collect specimen in the morning<br />
Collect in a chilled lavender vacutainer tube<br />
Mix well<br />
Place on ice while waiting for<br />
centrifugation<br />
Centrifuge within 60 minutes of collection<br />
LAVENDER OHIP CML<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag labelled „Frozen Sample‟<br />
TAT – 15 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 2 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ACTIVATED PROTEIN C<br />
RESISTANCE<br />
(APCR)<br />
APROC<br />
Plasma<br />
2 mL<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 25 days<br />
LIGHT BLUE $60.00 CML<br />
ACUTE RUBELLA<br />
(RUBELLA ANTIBODY, IGM)<br />
RUBLM<br />
Collect specimen 1 to 3 weeks after onset of<br />
rash<br />
Do not centrifuge tube<br />
TAT – 5 days<br />
YELLOW SST N/C CHEO<br />
ADENOVIRUS ANTIBODY RPHL Do not centrifuge tube<br />
PLAIN RED N/C PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 25 days<br />
ADH<br />
(ANTI–DIURETIC<br />
HORMONE)<br />
(ADH VASOPRESSIN)<br />
ADH<br />
Plasma – collect in pre-chilled tube<br />
Minimum Volume required is 3 mL<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 30 days<br />
LAVENDER $75.00 CML<br />
ADRENAL ANTIBODIES<br />
ADREN<br />
Serum<br />
1 mL<br />
YELLOW SST OHIP CML<br />
TAT – 15 days<br />
ADRENOCORTICOTROPIC<br />
HORMONE<br />
See ACTH<br />
ACTH<br />
AFB<br />
(ACID FAST BACILLUS)<br />
(T.B. CULTURE)<br />
(TUBERCULOSIS CULTURE)<br />
AFB<br />
Sputum<br />
First morning specimen – submit in a sterile<br />
container<br />
Container must be tightly sealed<br />
*Use Data Entry code AFB2, if two<br />
samples received<br />
*Use Data Entry code AFB3, if three<br />
samples received<br />
N/C<br />
PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 60 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 3 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
AGGLUTINATION<br />
REACTION SCREEN<br />
(COLD AGGLUTININ<br />
SCREEN)<br />
CAGG<br />
Serum and Clot<br />
Blood drawn in a SST is not acceptable<br />
Clot at room temperature (preferable 37 o C)<br />
Centrifuge immediately upon complete clot<br />
formation<br />
Remove serum and transfer into a<br />
separation tube and send both serum and<br />
clot tube elastized together<br />
DO NOT REFRIGERATE TAT – 1 day<br />
PLAIN RED OHIP BTL<br />
AIDS<br />
(P-24, HIV)<br />
(HIV SEROLOGY)<br />
HIV<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
AGA<br />
(ANTI–GLIADIN ANTIBODY)<br />
(GLIADIN ANTIBODY)<br />
ANGLI<br />
Serum<br />
2 mL<br />
Centrifuge only<br />
Transport specimen at room temperature<br />
Transport specimen in a test labelled<br />
separate brown paper bag<br />
Testing Includes Gliadin Antibody IgA<br />
& IgG<br />
TAT – 25 days<br />
YELLOW SST $90.00 CML<br />
ALA<br />
(DELTA–AMINOLEVULINIC<br />
ACID)<br />
RCML<br />
24 Hour Urine<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
Protect from light by wrapping with<br />
aluminium foil<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 15 days<br />
OHIP<br />
CML<br />
ALANINE TRANSAMINASE<br />
(ALT)<br />
(SGPT)<br />
ALT<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
ALBUMIN<br />
ALB<br />
Serum<br />
Centrifuge only<br />
YELLOW SST OHIP BTL<br />
TAT – 1 day<br />
ALBUMIN, QUALITATIVE<br />
(PROTEIN, TOTAL<br />
QUALITATIVE)<br />
ALB1<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 2 days<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 4 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ALBUMIN QUANTITATIVE<br />
(MICROALBUMIN)<br />
24UA<br />
24 Hour Urine<br />
2-10 mL aliquots – submit in an orange or<br />
white cap container<br />
Label 1 st tube – CREATININE and<br />
Label 2 nd tube – MICROALBUMIN<br />
No preservative<br />
OHIP<br />
CML<br />
State total 24-hour volume on the OHIP<br />
requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 90 mL urine sample in<br />
the fridge until test is reported<br />
TAT –2 days<br />
ALBUMIN/GLOBULIN RATIO<br />
(A/G RATIO)<br />
A/G<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
ALBUMIN QUANTITATIVE<br />
(MICROALBUMIN)<br />
MALBU<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
Label tube – MICROALBUMIN<br />
Submit a separate sample for other urine<br />
tests<br />
TAT – 2 days<br />
OHIP<br />
CML<br />
ALCOHOL- ETHYL<br />
(ETHANOL)<br />
ALCO<br />
Blood<br />
Use an iodine swab to cleanse venipuncture<br />
site<br />
Keep vacutainer tube sealed with minimum<br />
air space<br />
DO NOT OPEN<br />
TAT- 2 DAYS<br />
GREY OHIP CML<br />
ALCOHOL- ETHYL<br />
(ETHANOL)<br />
RCML<br />
Gastric Washing<br />
Keep container closed with minimum air<br />
space<br />
TAT – 2 days<br />
OHIP<br />
CML<br />
ALCOHOL- ETHYL<br />
(ETHANOL)<br />
UAL<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 2 days<br />
OHIP<br />
CML<br />
ALCOHOL- ISOPROPYL<br />
RCML<br />
Blood<br />
Keep vacutainer tube sealed with minimum<br />
air space<br />
Use an iodine swab to cleanse venipuncture<br />
site<br />
TAT – 10 days<br />
GREY OHIP CML<br />
ALCOHOL- METHYL<br />
(METHANOL)<br />
RCML<br />
Blood<br />
Keep vacutainer tube sealed with minimum<br />
air space<br />
Use an iodine swab to cleanse venipuncture<br />
site<br />
TAT – 10 days<br />
GREY OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 5 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ALDOLASE<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
SUGGEST REQUESTING HEALTH<br />
PRACTITIONER TO ORDER CPK &<br />
ALT<br />
ALDOSTERONE<br />
ALDOS<br />
Serum<br />
Centrifuge only<br />
1 mL<br />
State in “Notes and Instructions” if the<br />
patient‟s blood was drawn while the patient<br />
was in a sitting position or in a laying down<br />
position<br />
REFRIGIRATE DURING STORAGE<br />
AND TRANSPORT<br />
Requires clinical information to indicate all<br />
drugs administered in the previous 2-week<br />
period.<br />
TAT – 21 days<br />
GOLD SST OHIP CML<br />
ALDOSTERONE<br />
RCML<br />
24 Hour Urine<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
No preservative<br />
Patient must be on normal sodium intake<br />
and not receiving diuretics for one week<br />
before urine sample is collected<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 20 days<br />
OHIP<br />
CML<br />
ALKALINE PHOSPHATASE<br />
(PHOSPHATASE ALKALINE)<br />
ALK<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
ALKALINE PHOSPHATASE<br />
ISOENZYMES<br />
(ALKALINE PHOSPHATASE<br />
FRACTIONATION)<br />
(PHOSPHATASE ALKALINE<br />
ISOENZYMES)<br />
API<br />
Serum<br />
Label 1 SST tube and<br />
1 ml tube labelled Alk. Phos. Fract.<br />
Testing includes Total Alkaline<br />
Phosphatase<br />
TAT – 2 days<br />
2 YELLOW SST OHIP CML<br />
ALLERGIC ALVEOLITIS<br />
(ALLERGIC LUNG)<br />
(BIRD FANCIERS DISEASE)<br />
(FARMERS LUNG)<br />
RCML<br />
Serum<br />
Centrifuge only<br />
**DO NOT CONFUSE WITH AVIAN<br />
PRECIPITANS**<br />
TAT – 30 DAYS<br />
1 YELLOW SST OHIP CML<br />
ALPHA–1 ANTITRYPSIN<br />
(FOR EMPHYSEMA)<br />
A1AT<br />
Serum<br />
1 mL<br />
TAT – 1 days<br />
1YELLOW SST OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 6 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ALPHA–1 ANTITRYPSIN<br />
PHENOTYPING<br />
A1ATP<br />
Serum<br />
1 mL<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 60 days<br />
1YELLOW SST $105.00 CML<br />
ALPHA FETOPROTEIN,<br />
ONCOLOGY<br />
(AFP-ONCOLOGY)<br />
AFP<br />
Serum<br />
1 mL<br />
FOR ONCOLOGY (Cancer) PATIENTS<br />
ONLY<br />
Indicate site of cancer<br />
TAT – 10 days<br />
YELLOW SST OHIP CML<br />
ALPHA FETOPROTEIN,<br />
PREGNANCY<br />
(AFP-PREGNANCY)<br />
MSS<br />
Serum<br />
2 mL<br />
DO NOT REFRIGERATE<br />
For risk assessment of open neural tube<br />
defects testing is recommended at 15-20<br />
weeks gestation<br />
YELLOW SST OHIP CHEO<br />
Complete a "Maternal Serum Screen Form”<br />
Indicate on the form "AFP ONLY"<br />
Results will be reported directly to the<br />
requesting physician by the testing location<br />
TAT – 5 days<br />
ALT<br />
(ALANINE TRANSAMINASE)<br />
(SGPT)<br />
ALT<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
1YELLOW SST OHIP BTL<br />
ALUMINUM AL Serum<br />
3 mL<br />
TAT – 15 days<br />
AMETHOPTERIN<br />
(METHOTREXATE)<br />
METH<br />
Serum<br />
2 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 10 days<br />
ROYAL BLUE<br />
no additive<br />
$40.00 CML<br />
PLAIN RED OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 7 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
AMIKACIN<br />
(GENTAMYCIN)<br />
PEAK<br />
TROUGH<br />
GAP<br />
GAT<br />
Serum<br />
1 mL<br />
Collect 'peak' specimen at end of IV<br />
infusion or 60 minutes (trough) after IM<br />
injection by physician<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
PLAIN RED OHIP CML<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 10 days<br />
AMINOACIDS-<br />
QUALITATIVE<br />
(METABOLIC SCREEN)<br />
METAB<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
State age of patient and clinical diagnosis<br />
State if patient is on a special diet<br />
FREEZE URINE AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 25 days<br />
OHIP<br />
CML<br />
AMINOACIDS-<br />
QUANTITATIVE<br />
AMINO<br />
Serum<br />
1 mL<br />
Fasting specimen preferred<br />
State if on special diet, and clinical<br />
diagnosis<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 25 days<br />
GREEN<br />
with heparin<br />
OHIP<br />
CML<br />
AMINOACIDS-<br />
QUANTITATIVE<br />
RCML<br />
24 Hour Urine<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
State age of patient and clinical diagnosis<br />
No preservative<br />
OHIP<br />
CML<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
FREEZE URINE AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
Retain a duplicate 50 mL urine sample in<br />
the freezer until test is reported<br />
TAT – 25 days<br />
AMINOGLYCOSIDES<br />
Specify whether Amikacin, Gentamycin or<br />
Tobramycin<br />
See individual listings<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 8 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
AMINOPHYLLINE<br />
(THEOPHYLLINE)<br />
(UNIPHYL)<br />
THEO<br />
Serum<br />
Centrifuge only<br />
Collect specimen 10 –12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 1 day<br />
PLAIN RED OHIP CML<br />
AMIODARONE AMIOD Plasma<br />
3 mL<br />
TAT –10 days<br />
AMITRIPTYLINE<br />
(ELAVIL)<br />
AMI<br />
Serum<br />
2 mL<br />
Collect specimen 10–12 hours after last<br />
dose<br />
Record time in hours that has elapsed<br />
between last dose and specimen collection<br />
Testing Includes Nortriptyline<br />
TAT – 15 days<br />
GREEN<br />
with heparin<br />
$45.00 CML<br />
ROYAL BLUE OHIP CML<br />
AMMONIA<br />
(NH3, NH4)<br />
<strong>TEST</strong> NO LONGER AVAILABLE LAVENDER OHIP CML<br />
AMOBARBITAL<br />
(AMYTAL)<br />
RCML<br />
Plasma<br />
5 mL<br />
TAT – 10 days<br />
GREEN<br />
with heparin<br />
OHIP<br />
CML<br />
AMOBARBITAL<br />
(AMYTAL)<br />
RCML<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 10 days<br />
OHIP<br />
CML<br />
AMOEBIC DYSENTERY<br />
SEROLOGY ANTIBODY<br />
(E.HISTOLYTICA<br />
SEROLOGY ANTIBODY)<br />
(ENTAMOEBA<br />
HISTOLYTICA ANTIBODY)<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
AMOXAPINE<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
AMPHETAMINES<br />
RCML<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 3 days<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 9 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
AMPLIFIED<br />
MYCOBACTERIUM<br />
TUBERCULOSIS DIRECT<br />
<strong>TEST</strong><br />
(AMTD)<br />
(detects MTBC rRNA)<br />
AMTD<br />
Sputum, BAL or tracheal aspirate<br />
First morning specimen – submit in a sterile<br />
container tightly sealed<br />
ONLY 1 specimen/patient permitted<br />
Unsuitable samples:<br />
1-Grossly hemolized<br />
2-Non-respiratory AFB smear negatives<br />
3-Anti-tuberculous therapy within<br />
preceding 12 months<br />
N/C<br />
PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 2 days<br />
AMYLASE<br />
(DIASTASE)<br />
AMY<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
AMYLASE<br />
(DIASTASE)<br />
24UAM<br />
24 Hour Urine<br />
10 mL aliquot – submit in an orange or<br />
white cap container<br />
No preservative<br />
OHIP<br />
CML<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 90 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 1 day<br />
AMYLASE<br />
(DIASTASE)<br />
RCML<br />
Urine<br />
10 mL random urine<br />
Submit in a white cap conical tube<br />
TAT – 1 day<br />
OHIP<br />
CML<br />
AMYLASE ISOENZYME<br />
(AMYLASE<br />
FRACTIONATION)<br />
AMYI<br />
Serum<br />
2 mL<br />
Indicate clinical problem requiring analysis<br />
TAT – 45 to 60 days<br />
YELLOW SST $60.00 CML<br />
AMYTAL<br />
(AMOBARBITAL)<br />
RCML<br />
Serum<br />
5 ml<br />
TAT – 10 days<br />
GREEN<br />
with heparin<br />
OHIP<br />
CML<br />
AMYTAL<br />
(AMOBARBITAL)<br />
RCML<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 10 days<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 10 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ANA<br />
(ANTI–NUCLEAR<br />
ANTIBODY)<br />
(ANF)<br />
(ANTI-NUCLEAR FACTOR)<br />
(CENTROMERE ANTIBODY)<br />
(SLE ANTIBODIES)<br />
ANA<br />
Serum<br />
Centrifuge only<br />
Positive results may be delayed due to<br />
interpretation by consultant<br />
TAT – 2 days<br />
YELLOW SST OHIP CML<br />
ANAFRANIL<br />
(CLOMIPRAMINE)<br />
CLOM<br />
Serum<br />
2 ml<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
Testing Includes<br />
Desmethylclomipramine dose<br />
TAT – 15 days<br />
ROYAL BLUE<br />
no additive<br />
OHIP<br />
CML<br />
ANCA–c (CYTOPLASMIC)<br />
(ANTI–NEUTROPHIL<br />
CYTOPLASMIC<br />
ANTIBODY–C)<br />
ANCAC<br />
Serum<br />
Centrifuge only<br />
TAT – 15 days<br />
YELLOW SST $75.00 CML<br />
ANCA–p (PERINUCLEAR)<br />
(ANTI–NEUTROPHIL<br />
CYTOPLASMIC<br />
ANTIBODY–P)<br />
ANCAP<br />
Serum<br />
1 mL<br />
TAT – 15 days<br />
YELLOW SST $75.00 CML<br />
ANDROGEN <strong>TEST</strong>ICULAR<br />
(<strong>TEST</strong>OSTERONE)<br />
TSTOS<br />
Serum<br />
Centrifuge only<br />
State age and sex of patient<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
ANDROSTENEDIONE ADS Serum<br />
1 mL<br />
TAT – 15 days<br />
YELLOW SST OHIP CML<br />
ANDROSTERONE<br />
NO LONGER AVAILABLE<br />
ANF<br />
see ANA<br />
ANA<br />
ANGELMAN SYNDROME<br />
(AS)<br />
See<br />
MOLECULAR GENETICS (I)<br />
RCHEO<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 11 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ANGIOTENSIN<br />
CONVERTING ENZYME<br />
(ACE)<br />
ACE<br />
Serum<br />
2 mL<br />
Do not collect with a gel separator (SST)<br />
Collect specimen after an overnight fast<br />
Assay cannot be performed on a lipemic<br />
specimen<br />
TAT – 15 days<br />
PLAIN RED $35.00 CML<br />
ANION GAP<br />
RCML<br />
Serum<br />
Centrifuge only<br />
Hemolyzed specimens are unacceptable<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
ANTABUSE<br />
NO LONGER AVAILABLE<br />
ANTIBODY<br />
IDENTIFICATION<br />
(ANTIBODY ID)<br />
(REPEAT PATIENT WITH<br />
ANTIBODIES)<br />
ABID<br />
Blood<br />
DO NOT SEPARATE<br />
Testing Includes titre if positive<br />
TAT – 2 days<br />
3 LAVENDERS OHIP CML<br />
ANTIBODY SCREEN<br />
(INDIRECT COOMBS)<br />
(REPEAT PRENATAL<br />
ANTIBODY SCREEN)<br />
ANSCR<br />
Blood<br />
DO NOT SEPARATE<br />
TAT – 1day<br />
LAVENDER OHIP BTL<br />
ANTI-CARDIOLIPIN AB<br />
(ANTI PHOSPHOLIPID)<br />
(CARDIOLIPIN ANTIBODY)<br />
ACL<br />
Serum<br />
1 mL<br />
Separate immediately after centrifugation<br />
and send frozen<br />
Collect Monday to Wednesday only<br />
TAT – 25 days<br />
PLAIN RED $55.00 CML<br />
ANTI-CYCLIC<br />
CITRULLINATED PEPTIDE<br />
(ANTI-CCP, ACCP)<br />
RCML<br />
Serum<br />
Centrifuge only<br />
TAT – 6 days<br />
YELLOW SST $50.00 CML<br />
ANTI-dsDNA ANTIBODY<br />
(ANTI-DNA)<br />
(ANTI DSDNA DOUBLE<br />
STRANDED AB)<br />
DNA<br />
Serum<br />
Centrifuge only<br />
TAT – 6 days<br />
YELLOW SST OHIP CML<br />
ANTI–DIURETIC HORMONE<br />
See ADH<br />
ADH<br />
ANTI–DNASE B RCHEO Blood RED CHEO<br />
ANTI-ENA<br />
(ENA ANTIBODY)<br />
(EXTRACTABLE NUCLEAR<br />
ENA<br />
Serum<br />
2 mL<br />
Positive results may be delayed due to<br />
confirmation<br />
YELLOW SST OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 12 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ANTIGEN)<br />
Note: Specific antigens reported only when<br />
screen is positive<br />
Testing Includes Anti–SM, Anti–RNP,<br />
Anti–LA (SS–B), Anti–Ro (SS–A), SCL–<br />
70, JO–1, Centromere<br />
TAT – 25 days<br />
ANTI–ENDOMYSIAL<br />
ANTIBODY<br />
(ENDOMYSIAL ANTIBODY)<br />
(MYSIAL ANTIBODIES)<br />
ANTEN<br />
Serum<br />
Centrifuge only<br />
TAT – 15 days<br />
YELLOW SST $55.00 CML<br />
ANTI–EPIDERMAL<br />
ANTIBODY<br />
(ANTI-SKIN ANTIBODIES)<br />
(PEMPHIGUS/PEMPHIGOID<br />
ANTIBODIES)<br />
RCML<br />
Serum<br />
Centrifuge only<br />
TAT – 25 days<br />
YELLOW SST OHIP CML<br />
ANTI–GLIADIN ANTIBODY<br />
(GLIADIN ANTIBODY)<br />
See AGA<br />
ANGLI<br />
ANTI–GLOMERULAR<br />
BASEMENT MEMBRANE<br />
(ANTI–SKIN BASEMENT<br />
MEMBRANE)<br />
AGBM<br />
Serum<br />
Centrifuge only<br />
TAT – 15 days<br />
YELLOW SST OHIP CML<br />
ANTI–HISTONE<br />
(HISTONE <strong>TEST</strong>)<br />
AHIST<br />
Serum<br />
2 mL<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 60 days<br />
YELLOW SST OHIP CML<br />
ANTI–HBs<br />
(HEPATITIS B–IMMUNE<br />
STATUS), Hep B surface Ag<br />
See HEPATITIS B<br />
SURFACE AB<br />
HBAB<br />
ANTI–INSULIN<br />
(INSULIN ANTIBODIES)<br />
RCML<br />
Serum<br />
1 ml<br />
Centrifuge only<br />
TAT – 25 days<br />
YELLOW SST OHIP CML<br />
ANTI–INTRINSIC FACTOR<br />
(INTRINSIC FACTOR<br />
ANTIBODY)<br />
IFA<br />
Serum<br />
3 mL<br />
Centrifuge only<br />
TAT – 30 days<br />
YELLOW SST OHIP CML<br />
ANTI–JO-1<br />
See ANTI-ENA<br />
ENA<br />
ANTI–LA<br />
(SS–B)<br />
see ANTI-ENA<br />
ENA<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 13 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ANTI–MICROSOMAL<br />
ANTIBODIES<br />
(ATA) (ATMA)<br />
(ANTI-THYROID<br />
ANTIBODIES)<br />
(MICROSOMAL<br />
ANTIBODIES)<br />
(MICROSOMAL THYROID<br />
ANTIBODIES)<br />
(ANTI-THYROID<br />
MICROSOMAL<br />
ANTIBODIES)<br />
(THYROGLOBULIN<br />
ANTIBODIES)<br />
(THYROID ANTIBODIES)<br />
ATA<br />
Serum<br />
Centrifuge only<br />
Positive results may be delayed due to<br />
interpretation by consultant<br />
NOTE: Not the same test as<br />
Thyroglobulin<br />
TAT – 2 days<br />
YELLOW SST OHIP CML<br />
ANTI–MITOCHONDRIAL<br />
ANTIBODY<br />
(ASMA)<br />
(ANTI-SMOOTH MUSCLE<br />
ANTIBODIES)<br />
(MITOCHONDRIAL<br />
ANTIBODIES)<br />
(SMA)<br />
(SMOOTH MUSCLE<br />
ANTIBODY)<br />
RCML<br />
Serum<br />
Centrifuge only<br />
Positive results may be delayed due to<br />
interpretation by consultant<br />
● Testing includes both anti-smooth<br />
muscle and anti-mitochondria<br />
antibodies●<br />
TAT – 2 days<br />
YELLOW SST OHIP CML<br />
ANTI–NEUTROPHIL<br />
CYTOPLASMIC<br />
ANTIBODY-C<br />
See ANCA-c<br />
CYTOPLASMIC<br />
ANCAC<br />
ANTI–NEUTROPHIL<br />
CYTOPLASMIC<br />
ANTIBODY-P<br />
See ANCA-p<br />
PERINUCLEAR<br />
ANCAP<br />
ANTI–NUCLEAR<br />
ANTIBODY<br />
See ANA<br />
ANA<br />
ANTI–PANCREATIC<br />
ISLET CELLS ANTIBODY<br />
ICA<br />
Serum<br />
2 mL<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 25 days<br />
YELLOW SST $60.00 CML<br />
ANTI–PARIETAL CELL<br />
ANTIBODIES<br />
ANTPA<br />
Serum<br />
2 mL<br />
TAT – 25 days<br />
YELLOW SST OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 14 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ANTI–PHOSPHOLIPID<br />
See<br />
ANTI–CARDIOLIPIN AB<br />
ACL<br />
ANTI-PLATELET<br />
ANTIBODIES<br />
(PLATELET ASSOCIATED<br />
ANTIBODIES)<br />
(PLATELET ASSOCIATED<br />
IGG)<br />
PLANT<br />
Blood<br />
Collect sample Monday – Thursday<br />
Complete a St. Michael‟s Hospital Form<br />
Must include responses to specific clinical<br />
information needed<br />
Store and transport at room temperature<br />
TAT – 15 days<br />
2 LAVENDER $70.00 CML<br />
ANTI–RETICULIN<br />
ANTIBODY<br />
(ANTI-RETICULIN AB)<br />
(RETICULIN ANTIBODY)<br />
RCML<br />
Serum<br />
3 ml<br />
Centrifuge only<br />
TAT 25 days<br />
YELLOW SST $60.00 CML<br />
ANTI–RNP<br />
ENA<br />
See ANTI-ENA<br />
ANTI–RO<br />
ENA<br />
See ANTI-ENA<br />
ANTI–SCL–70<br />
(SCLERODERMAL<br />
ANTIBODY)<br />
See ANTI-ENA<br />
ENA<br />
Test will only be done if ENA is positive<br />
ANTI–SM<br />
(ANTI–SMITH)<br />
See ANTI-ENA<br />
ENA<br />
ANTI–SKIN ANTIBODIES<br />
(PEMPHIGUS/PEMPHIGOID<br />
ANTIBODIES)<br />
See ANTI-EPIDERMAL<br />
ANTIBODIES<br />
RCML<br />
ANTI–SKIN BASEMENT<br />
MEMBRANE<br />
See ANTI-GLOMERULAR<br />
BASEMENT MEMBRANE<br />
AGBM<br />
ANTI–SMOOTH MUSCLE<br />
ANTIBODIES<br />
See<br />
ANTI-MITOCHONDRIAL<br />
ANTIBODIES<br />
MIT<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 15 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ANTI–SPERM ANTIBODIES<br />
(SPERM ANTIBODIES)<br />
ASPA<br />
Serum<br />
2 ml<br />
Centrifuge only<br />
TAT – 30 days<br />
YELLOW SST OHIP CML<br />
ANTI–STREPTOCCAL<br />
HYALURONIDASE<br />
ANTIBODY (ASH)<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
ANTI–STREPTOLYSIN “O”<br />
TITRE<br />
ASOT<br />
Serum<br />
1 mL<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
ANTI–THYROID ANTIBODY<br />
(ATA), (ATMA)<br />
(ANTI-THYROGLOBULIN<br />
ANTIBODIES)<br />
(ANTI-THYROID<br />
MICROSOMAL<br />
ANTIBODIES)<br />
(THYROID ANTIBODIES)<br />
(THYROGLOBULIN<br />
ANTIBODIES)<br />
See ANTI-MICROSOMAL<br />
ANTIBODIES<br />
MSA<br />
Or<br />
ATA<br />
ANTI–THROMBIN III<br />
(ANTI-THROMBIN ASSAY)<br />
(AT 3)<br />
ATIII<br />
Plasma<br />
1 mL<br />
Specify if for biological or immunological<br />
testing<br />
LIGHT BLUE OHIP CML<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 15 days<br />
ANTI-THYROID<br />
PEROXIDASE<br />
(TPO AB)<br />
(THYROID PEROXIDASE<br />
ANTIBODY)<br />
RCML<br />
Serum<br />
2 mL<br />
TAT – 15 to 25 days<br />
YELLOW SST OHIP CML<br />
ANTI-XA<br />
(LOW M.W. HEPARIN<br />
LEVEL)<br />
<strong>TEST</strong> NOT AVAILABLE AT CML<br />
Send patient to Hospital Lab<br />
APCR<br />
(ACTIVATED PROTEIN C<br />
RESISTANCE)<br />
APROC<br />
Plasma<br />
2 mL<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 30 days<br />
LIGHT BLUE $60.00 CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 16 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
APOLIPOPROTEIN<br />
APOA1<br />
APOB<br />
Plasma<br />
Monday-Wednesday only<br />
Patient must fast a minimum of 12 hours<br />
Separate plasma from red cells within 4<br />
hours<br />
Specify:<br />
A 1 – 1 mL<br />
B – 1 mL<br />
C 2 ACTIVATION - <strong>TEST</strong> NOT<br />
AVAILABLE<br />
TAT – 30 DAYS<br />
PLAIN RED<br />
$35.00<br />
$35.00<br />
CML<br />
APOLIPOPROTEIN<br />
(E-GENOTYPE)<br />
APOE<br />
Whole Blood<br />
store and send refrigerated<br />
LAVENDER $55.00 CML<br />
APOLIPOPROTEIN a<br />
(LIPOPROTEIN a)<br />
LIPOA<br />
Serum<br />
1 mL<br />
Separate within 4 hours<br />
YELLOW SST $35.00 CML<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a test labelled<br />
Separate brown paper bag<br />
TAT – 30 days<br />
ARBOVIRUS ANTIBODIES<br />
RPHL<br />
Do not centrifuge tube<br />
PHL recommends both acute and<br />
convalescent samples be taken 2 weeks<br />
apart<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
ARSENIC- HAIR<br />
ARSH<br />
Hair<br />
Clip hair close to the nape of the neck<br />
Submit in a 90 mL container<br />
TAT – 45 days<br />
$70.00 CML<br />
ARSENIC- NAIL<br />
ARSN<br />
Nails<br />
Clip nails from all fingers<br />
Submit in a 90 mL container<br />
TAT – 45 days<br />
$70.00 CML<br />
ARSENIC- 24 HOUR URINE<br />
ARS24<br />
24 Hour Urine<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
Collect specimen in acid–washed plastic<br />
container<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
$70.00 CML<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 10 to 60 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 17 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ARSENIC- RANDOM URINE<br />
ARSRU<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 30 days<br />
$70.00 CML<br />
ARTHROPODS<br />
(BUGS)<br />
(LICE)<br />
RPHL<br />
Send entire specimen in container<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
N/C<br />
PHL<br />
ASA<br />
(ACETYSALICYLIC ACID,<br />
ASPIRIN, SALICYLATE)<br />
SAL<br />
Serum<br />
2 mL<br />
Record time in hours that have elapsed<br />
between last dose and specimen taken<br />
TAT – 1 day<br />
PLAIN RED OHIP CML<br />
ASCORBIC ACID<br />
(VITAMIN C)<br />
VITC<br />
Serum<br />
5 mL<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 15 days<br />
2 YELLOW SST OHIP CML<br />
For Quebec patients:<br />
Plasma – GREEN TOP with heparin<br />
2 ml<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled ‘Frozen Sample’<br />
(protect from light)<br />
Revised June 2008 (mjh)<br />
ASH<br />
See ANTI–STREPTOCCAL<br />
HYALURONIDASE AB<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
ASMA<br />
See<br />
ANTI-MITOCHONDRIAL<br />
ANTIBODY<br />
MIT<br />
ASOT<br />
See ANTI–STREPTOLYSIN<br />
O TITRE<br />
ASOT<br />
ASPARTATE<br />
TRANSAMINASE<br />
(AST), (SGOT)<br />
(ASPARTATE<br />
AST<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 18 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
AMINOTRANSFERASE)<br />
ASPERGILLUS ANTIBODY<br />
ASPER<br />
Do not centrifuge<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 30 days<br />
PLAIN RED N/C PHL<br />
ASPIRIN, ACETYSALICYLIC<br />
ACID, SALICYLATE<br />
See ASA<br />
SAL<br />
AST<br />
(SGOT)<br />
See ASPARTATE<br />
TRANSAMINASE<br />
AST<br />
ATA<br />
See ANTI-MICROSOMAL<br />
ANTIBODIES<br />
MSA<br />
Or<br />
ATA<br />
ATIVAN<br />
RCML<br />
Serum<br />
2 mL<br />
Collect specimen 10 –12 hours after the last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen taken<br />
TAT – 15 days<br />
PLAIN RED OHIP CML<br />
ATIVAN<br />
RCML<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 15 days<br />
OHIP<br />
CML<br />
AVENTYL<br />
(NORTRIPTYLINE)<br />
NOR<br />
Serum<br />
2 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 15 days<br />
ROYAL BLUE<br />
no additive<br />
OHIP<br />
CML<br />
AVIAN PRECIPITINS<br />
RCML<br />
Serum<br />
Centrifuge only<br />
Specify antigen<br />
Each antigen billed separately<br />
TAT – 30 days<br />
YELLOW SST $35.00 CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION A Page 19 of 20<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
B–CAROTENE<br />
(CAROTENE)<br />
RCML<br />
Serum<br />
2 mL<br />
Protect from light by transferring serum into<br />
an amber transport tube<br />
TAT – 7 days<br />
YELLOW SST OHIP CML<br />
B12<br />
(VITAMIN B12)<br />
B12<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
B2 MICROGLOBULIN<br />
(BETA 2 MICROGLOBULIN)<br />
(MICROGLOBULIN)<br />
B2MIC<br />
Serum<br />
Centrifuge only<br />
TAT – 25 days<br />
YELLOW SST $50.00 CML<br />
B2 MICROGLOBULIN<br />
(BETA 2 MICROGLOBULIN)<br />
(MICROGLOBULIN)<br />
B2MIC<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
Collect & submit a FRESH urine collection.<br />
Ask patient to void, then drink a glass of<br />
water an then ONE HOUR LATER, collect<br />
a urine for submission<br />
TAT – 25 days<br />
$50.00 CML<br />
BARBITURATE SCREEN<br />
BARB<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 2 days<br />
OHIP<br />
CML<br />
BARTONELLA<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 3 weeks<br />
PLAIN RED N/C PHL<br />
BENADRYL<br />
(DIPHENHYDRAMINE<br />
HYDROCHLORIDE)<br />
RCML<br />
Serum<br />
3 ml<br />
TAT – 10 days<br />
PLAIN RED OHIP CML<br />
BENCE–JONES PROTEIN<br />
(IEP- RANDOM URINE)<br />
(Immunoelectrophoresis)<br />
(HEAVY AND LIGHT<br />
CHAINS)<br />
BENC<br />
Urine<br />
50 mL random urine<br />
Submit in an orange or white cap container<br />
No preservative<br />
First morning specimen preferred<br />
TAT – 5 days<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION B Page 1 of 7<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
BENCE–JONES PROTEIN<br />
(Immunoelectrophoresis)<br />
(HEAVY AND LIGHT<br />
CHAINS)<br />
24BJ<br />
24 Hour Urine<br />
10 mL aliquot – submit in an orange or<br />
white cap container labelled CREATININE<br />
and a 50 mL aliquot – submit in an orange<br />
or white cap container labelled BENCE<br />
JONES<br />
OHIP<br />
CML<br />
No preservative<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 5 days<br />
BENZENE (PHENOL)<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
BENZODIAZEPINE<br />
BENZ<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 2 days<br />
OHIP<br />
CML<br />
BETA 2 MICROGLOBULIN<br />
(MICROGLOBULIN)<br />
See B2 MICROGLOBULIN<br />
B2MIC<br />
BETA–Hcg, PREGNANCY<br />
(BHCG)<br />
(HUMAN CHORIONIC<br />
GONADOTROPIN)<br />
HCG<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
BETA–Hcg, ONCOLOGY<br />
(HCG FOR ONCOLOGY)<br />
See BETA-Hcg, PREGNANCY<br />
HCG<br />
Label tube “hCG for Oncology”<br />
BICARBONATE<br />
(CARBON DIOXIDE)<br />
(CO 2)<br />
(HCO 3)<br />
CO2<br />
Serum<br />
Centrifuge only<br />
Do not remove stopper<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
BILE ACIDS<br />
(BILE SALTS)<br />
BILE<br />
Serum<br />
5 ml<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 30 days<br />
2 YELLOW SST $40.00 CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION B Page 2 of 7<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
BIO AVAILABLE<br />
<strong>TEST</strong>OSTERONE<br />
(<strong>TEST</strong>OSTERONE BIO<br />
AVAILABLE)<br />
FOR MALE PATIENTS<br />
FOR FEMALE PATIENTS<br />
BIOT<br />
BIOF<br />
Serum<br />
2 mL<br />
Collect specimen in morning<br />
Free and Total Testosterone ordered, code<br />
for these tests and follow sample-processing<br />
procedure<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
T – 25 days<br />
YELLOW SST<br />
(Males)<br />
$60.00<br />
(Females)<br />
$65.00<br />
WA<br />
BILIRUBIN<br />
(BILE)<br />
UBILI<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 1 day<br />
OHIP<br />
CML<br />
BILIRUBIN, CONJUGATED<br />
(DIRECT BILIRUBIN)<br />
(BILIRUBIN<br />
FRACTIONATION)<br />
DBIL<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
* For Quebec insured patients, protect<br />
specimen from light (Montfort Hospital<br />
requirements)<br />
Revised March 2008 (am/mjh)<br />
YELLOW SST OHIP CML<br />
BILIRUBIN, TOTAL BILI Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
BILIRUBIN,<br />
UNCONJUGATED<br />
(INDIRECT BILIRUBIN)<br />
INBL<br />
Serum<br />
Centrifuge only<br />
YELLOW SST OHIP CML<br />
BIQUIN<br />
(QUINIDINE)<br />
(Q-10 METABOLITE)<br />
QUI<br />
Serum<br />
2 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 3 days<br />
PLAIN RED OHIP CML<br />
BIRD FANCIERS‟ DISEASE<br />
(ALLERGIC LUNG)<br />
(FARMERS LUNG)<br />
See<br />
ALLERGIC ALVEOLITIS<br />
RCML<br />
BLASTOMYCOSIS<br />
ANTIBODY DERMATITIDIS<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 30 days<br />
PLAIN RED N/C PHL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION B Page 3 of 7<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
BLASTOMYCOSIS<br />
CULTURE DERMATITIDIS<br />
RPHL<br />
Culture<br />
Skin scrapping<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 30 days<br />
N/C<br />
PHL<br />
BLEEDING TIME,<br />
DUKE METHOD<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
BLEEDING TIME,<br />
IVY METHOD<br />
BT<br />
Patient must go to the main testing<br />
laboratory 168 Charlotte Street, Ottawa, ON<br />
TAT –1 day<br />
OHIP<br />
BTL<br />
BLOOD CULTURE<br />
BLD1<br />
Blood<br />
Cleanse venipuncture site with iodine<br />
Wipe the tube rubber stopper with alcohol<br />
BLOOD<br />
CULTURE<br />
BOTTLE<br />
OHIP<br />
BTL<br />
Collect patient‟s blood directly into a<br />
syringe and then insert syringe into bottle<br />
for complete discharge<br />
**Refer to SCC Manual for detail<br />
instructions**<br />
Mix gently<br />
Adult – take anaerobic and aerobic culture<br />
bottles<br />
Child – take aerobic culture bottle<br />
***to be done ONLY at BIO-<strong>TEST</strong><br />
MAIN LAB***<br />
STATE THE DATE AND TIME OF<br />
COLLECTION ON THE BOTTLES<br />
A series of three collections over a period of<br />
24 to 48 hours is recommended<br />
DO NOT REFRIGERATE BOTTLES<br />
*Data Entry code BLD2, if two(2)<br />
collections submitted (4 bottles)<br />
*Data Entry code BLD3, if three(3)<br />
collections submitted (6 bottles)<br />
TAT – 5 days<br />
BLOOD FILM<br />
EXAMINATION<br />
CBC<br />
Whole Blood<br />
Abnormal results may be delayed due to<br />
interpretation by consultant<br />
TAT – 1 day<br />
LAVENDER OHIP BTL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION B Page 4 of 7<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
BLOOD GROUP and Rh(D)<br />
(ABO & TYPE, BLOOD TYPE,<br />
Rh FACTOR)<br />
See ABO, Rh(D)<br />
BGR<br />
BLOOD GROUP, Rh(D) AND<br />
GENOTYPE<br />
(GENOTYPE)<br />
See ABO, Rh(D), GENOTYPE<br />
RCML<br />
BLOOD GROUPS,<br />
(ANTIGENS)<br />
Eg. Kell, Duffy, KIDD<br />
RCML<br />
Blood<br />
DO NOT SEPARATE<br />
TAT – 2 days<br />
LAVENDER OHIP CML<br />
BLOOD, QUALITATIVE<br />
DIP<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 1 day<br />
OHIP<br />
BTL<br />
BLOOD TYPE<br />
(ABO & TYPE, BLOOD<br />
GROUP & Rh(D), Rh<br />
FACTOR)<br />
See ABO, Rh(D)<br />
BGR<br />
BORDETELLA PERTUSSIS<br />
ANTIBODY<br />
(WHOOPING COUGH)<br />
PERT<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
BORDETELLA PERTUSSIS<br />
ANTIBODY<br />
(WHOOPING COUGH)<br />
PERT<br />
Swab – State source<br />
Use the PHL Kit<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
N/C<br />
PHL<br />
BORRELIA BURGDORFERI<br />
(LYME DISEASE)<br />
LYM<br />
Do not centrifuge tube<br />
Patient‟s history and symptoms are<br />
mandatory<br />
PLAIN RED N/C PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT –15 days<br />
BROAD SPECTRUM<br />
DRUG SCREEN<br />
(BROAD SPECTRUM DRUG<br />
ANALYSIS)<br />
UDS<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Urine<br />
10 mL random urine<br />
Submit in a blue cap conical tube or orange<br />
or white cap container<br />
Test Confirmation / Broad Spectrum – code<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION B Page 5 of 7<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.<br />
OHIP<br />
CML
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
the test and Indicate in “Notes &<br />
Instructions” and on the OHIP Requisition<br />
Testing is for:<br />
Methadone, Cocaine, Morphine, Heroin,<br />
Oxycodone, Diphenhydramine, Ranitidine,<br />
Nortriptyline, Amphetamine, Ephedrine/<br />
Pseudoephedrin, Phenylpropanolamine, and<br />
Other Drugs as detected<br />
TAT – 3 days<br />
BROMIDE RCML Serum<br />
Centrifuge only<br />
TAT – 10 days<br />
BRUCELLA ANTIBODIES<br />
(WIDAL <strong>TEST</strong>)<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
YELLOW SST OHIP CML<br />
PLAIN RED N/C PHL<br />
Testing Includes Brucella Abortus and<br />
Brucella Melitensis<br />
TAT – 15 days<br />
BUGS<br />
(LICE)<br />
See ARTHROPODS<br />
RPHL<br />
BUN<br />
(UREA)<br />
24URE<br />
24 Hour Urine<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
No preservative<br />
OHIP<br />
CML<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 15 days<br />
BUN<br />
(BLOOD UREA NITROGEN,<br />
UREA)<br />
BUN<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
BUTABARBITAL<br />
RCML<br />
Urine<br />
25 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 10 days<br />
OHIP<br />
CML<br />
BUTAZOLIDINE<br />
(PHENYLBUTAZONE)<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION B Page 6 of 7<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
C1 ESTERASE INHIBITOR<br />
(COMPLEMENT C1)<br />
C1INC<br />
Serum<br />
2 mL<br />
TAT – 25 days<br />
YELLOW SST OHIP CML<br />
C1 ESTERASE INHIBITOR,<br />
FUNCTIONAL<br />
C1INF<br />
Plasma<br />
2 mL<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 30 to 60 days<br />
LIGHT BLUE $80.00 CML<br />
C1Q IMMUNE COMPLEXES<br />
(C1Q COMPLEMENT<br />
BINDING ACTIVITY)<br />
(C1Q IMMUNE COMPLEXES)<br />
(COMPLEMENT C1Q)<br />
C1Q<br />
Serum<br />
1 mL<br />
Separate from clot within 30 minutes<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 15 days<br />
YELLOW SST OHIP CML<br />
C2<br />
(COMPLEMENT C2)<br />
RCML<br />
Serum<br />
2 mL<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 30 days<br />
YELLOW SST OHIP CML<br />
C3<br />
(COMPLEMENT C3)<br />
C3<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
C4<br />
(COMPLEMENT C4)<br />
C4<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
C5<br />
(COMPLEMENT C5)<br />
RCML<br />
Serum<br />
2 mL<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
C6<br />
(COMPLEMENT C6)<br />
RCML<br />
Serum<br />
2 mL<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 30 days<br />
YELLOW SST OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 1 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CD3, CD4, CD8<br />
(LYMPHOCYTE MARKER-T<br />
CELL ONLY)<br />
(T CELL LYMPHOCYTE<br />
MARKER ONLY)<br />
CD3<br />
CD4<br />
CD8<br />
Blood<br />
Specimen collection Monday – Tuesday<br />
ONLY<br />
Store at room temperature<br />
Do not transport on ice<br />
LAVENDER OHIP CML<br />
Complete a “CML Lymphocyte Marker T<br />
Cells Only Form”<br />
FOR ALL OTHER MARKERS SEE –<br />
LYMPOHCYTE MARKERS<br />
MUST REACH MAIN LAB BY<br />
THURSDAY AT 12 NOON<br />
NOTIFY CLIENT SERVICES DEPT.<br />
PRIOR TO SENDING ON THURSDAY<br />
AM, TO ENSURE <strong>SPECIMEN</strong>S ARE<br />
SENT TO REFERENCE LAB SAME<br />
DAY<br />
TAT – 3 days<br />
CD19<br />
(LYMPHOCYTE MARKERS)<br />
(T & B CELLS)<br />
See<br />
IMMUNO PHENOTYPING<br />
C-PEPTIDE<br />
C-PEP<br />
Plasma<br />
2 mL<br />
Fasting specimen required<br />
GREEN<br />
with heparin<br />
OHIP<br />
CML<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 10 days<br />
C-REACTIVE PROTEIN<br />
(CRP)<br />
CRP<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
C-REACTIVE PROTEIN<br />
HIGH SENSITIVITY<br />
(CRP– HIGH SENSITIVITY)<br />
CRPHS<br />
Serum<br />
1 mL<br />
TAT – 15 days<br />
YELLOW SST OHIP CML<br />
CA 125<br />
(OV 125)<br />
CA125<br />
Serum<br />
Centrifuge only<br />
1 mL<br />
YELLOW SST $35.00 CML<br />
NOT to be used as a screening test<br />
Malignancy must be established<br />
TAT – 10 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 2 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CA 15-3, BREAST<br />
(CANCER ANTIGEN 15-3)<br />
(CARBOHYDRATE ANTIGEN<br />
15-3)<br />
CA15<br />
Serum<br />
1 mL each<br />
(Same as CA 27, 29)<br />
TAT - 15 days<br />
Updated billing to correct price of $35.00<br />
Revised 10 June 2008 (mjh)<br />
YELLOW SST $35.00 CML<br />
CA 19– 9, PANCREAS<br />
(CANCER ANTIGEN 19-9)<br />
(CARBOHYDRATE ANTIGEN<br />
19-9)<br />
CA199<br />
Serum<br />
1 mL<br />
TAT – 15 days<br />
Updated billing to correct price of $55.00<br />
Revised 10 June 2008 (mjh)<br />
YELLOW SST $55.00 CML<br />
CADMIUM CAD Blood<br />
Do not open tube<br />
TAT – 15 days<br />
CADMIUM SCREEN<br />
RCML<br />
24 Hour Urine<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
Collect in an acid washed container<br />
LAVENDER $40.00 CML<br />
$40.00 CML<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 15 days<br />
CAFFEINE<br />
(CAFFEINE-<br />
QUANTITATIVE)<br />
RCML<br />
Serum<br />
1 mL<br />
Collect 10 – 12 hours after last dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 10 days<br />
PLAIN RED $60.00 CML<br />
CALCITONIN<br />
CLT<br />
Serum<br />
3 mL<br />
YELLOW SST OHIP CML<br />
CALCIUM CA Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
CALCIUM, CORRECTED<br />
RCML<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 30 days<br />
Serum<br />
Centrifuge only<br />
State test in “Notes and Instructions” and<br />
on the OHIP requisition<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
YELLOW SST OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 3 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CALCIUM, IONIZED<br />
(Ca ²+, Ca++, Free Calcium)<br />
CAION<br />
Serum<br />
Allow specimen to clot for 30 minutes<br />
Centrifuge only<br />
Do not remove tube stopper<br />
Test result is invalid if specimen is exposed<br />
to air<br />
TAT – 2 days<br />
Quebec patients send-out instructions:<br />
ship chilled sample to Montfort (ice packs)<br />
YELLOW SST OHIP CML<br />
CALCIUM, URINE<br />
24UCA<br />
24 Hour Urine<br />
10 mL aliquot – submit in an orange or<br />
white cap container<br />
OHIP<br />
CML<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 90 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 2 days<br />
CALCIUM, URINE<br />
UCM<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
tube<br />
TAT – 2 days<br />
OHIP<br />
CML<br />
CALCULUS ANALYSIS<br />
(STONE ANALYSIS)<br />
STONE<br />
Submit entire specimen<br />
Indicate source<br />
TAT – 3 days<br />
OHIP<br />
CML<br />
CAMPYLOBACTER<br />
(STOOL CULTURE)<br />
Stool-1<br />
Stool<br />
Place stool in Cary–Blair transport<br />
container to the “FILL LINE”<br />
Shake to emulsify sample<br />
*Data entry code stool-2, if a second sample<br />
received<br />
*Data entry code stool-3, if a third sample<br />
received<br />
TAT - 2 days<br />
OHIP<br />
BTL<br />
CANCER ANTIGEN 15-3<br />
(CARBOHYDRATE ANTIGEN<br />
15-3)<br />
See CA 15-3, BREAST<br />
CA15<br />
CANCER ANTIGEN 19-9<br />
(CARBOHYDRATE ANTIGEN<br />
19-9)<br />
See CA 19– 9, PANCREAS<br />
CA199<br />
CANDIDA TITRE<br />
NO LONGER AVAILABLE<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 4 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CANNABIS<br />
(CANNABINOIDS SCREEN,<br />
MARIJUANA,<br />
TETRAHYDRO-<br />
CANNABINOIDS, THC)<br />
UCB<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 3 days<br />
OHIP<br />
CML<br />
CARBAMAZEPINE<br />
(TEGRETOL)<br />
CARBM<br />
Serum<br />
2 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 1 day<br />
PLAIN RED OHIP CML<br />
CARBOHYDRATE<br />
ANTIGEN 15-3<br />
(CANCER ANTIGEN 15-3)<br />
See CA 15-3, BREAST<br />
CA15<br />
CARBOHYDRATE<br />
ANTIGEN 19-9<br />
(CANCER ANTIGEN 19-9)<br />
See CA 19- 9, PANCREAS<br />
CA199<br />
CARBON DIOXIDE<br />
(CO2)<br />
See BICARBONATE<br />
CO2<br />
CARBOXYHEMOGLOBIN<br />
(CARBON MONOXIDE)<br />
RCML<br />
Blood<br />
DO NOT OPEN TUBE<br />
TAT – 10 day<br />
LAVENDER OHIP CML<br />
CARCINOEMBRYONIC<br />
ANTIGEN<br />
(CEA)<br />
CEA<br />
Serum<br />
3 mL<br />
A CEA Requisition Form completed and<br />
signed by the physician must accompany<br />
sample<br />
YELLOW SST OHIP CML<br />
Four weeks (28 days) must elapse between<br />
test requests<br />
Testing is covered by OHIP for a patient<br />
who is:<br />
(a) being treated for metastatic breast<br />
cancer<br />
(b) receiving adjuvant therapy for<br />
resected colorectal cancer<br />
(c) being treated for metastatic<br />
disease<br />
TAT - 10 to 15 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 5 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CARCINOEMBRYONIC<br />
ANTIGEN<br />
(CEA)<br />
CEAN<br />
Serum<br />
3 mL<br />
A CEA Requisition Form completed and<br />
signed by the physician must accompany<br />
sample<br />
YELLOW SST $35.00 CML<br />
Note: to be used when four weeks have<br />
NOT elapsed between CEA test requests<br />
OR when the patient does not meet the<br />
aforementioned criteria and not covered by<br />
OHIP<br />
TAT – 10 to 15 days<br />
CARDIOLIPIN ANTIBODY<br />
(ANTI PHOSPHOLIPIN)<br />
See ANTI–CARDIOLIPIN AB<br />
ACL<br />
CARNITINE, FREE / TOTAL<br />
RCML<br />
Serum<br />
Minimum Volume required: 1 mL<br />
YELLOW SST $60.00 CML<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a test labelled<br />
Separate brown paper bag<br />
TAT – 15 days<br />
CAROTENE<br />
(B–CAROTENE)<br />
RCML<br />
Serum<br />
2 mL<br />
Protect from light by transferring serum into<br />
an amber transport tube<br />
TAT – 7 days<br />
YELLOW SST OHIP CML<br />
CAT SCRATCH FEVER<br />
ANTIBODY<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
CATECHOLAMINES<br />
<strong>TEST</strong> NO LONGER<br />
AVAILABLE(Plasma)<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 6 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CATECHOLAMINES,<br />
FRACTIONATED<br />
24CAT<br />
24 Hour Urine<br />
50 mL aliquot – submit in a white cap 90<br />
ml container<br />
Refrigerate during storage and transport<br />
OHIP<br />
CML<br />
Do not add acid; pH will be adjusted in<br />
Biochemistry Dept.<br />
Do not use this sample for any other test<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL aliquot in the<br />
fridge until test is reported<br />
Testing Includes Epinephrine &<br />
Norepinephrine, Metanephrines<br />
TAT – 30 days<br />
CATECHOLAMINES,<br />
TOTAL<br />
TOTAL NO LONGER AVAILABLE,<br />
ONLY FRACTIONATED – SEE<br />
ABOVE<br />
CEA<br />
See CARCINOEMBRYONIC<br />
ANTIGEN<br />
CEA<br />
CEA<br />
See CARCINOEMBRYONIC<br />
ANTIGEN<br />
CEAN<br />
Note: to be used when four weeks have<br />
NOT elapsed between CEA test requests<br />
OR when the patient does not meet the<br />
aforementioned criteria and not covered by<br />
OHIP<br />
CELIAC DISEASE PANEL<br />
CELD<br />
Serum<br />
2 mL<br />
Testing Includes Gliadin IgG & IgA,<br />
tissue transglutaminase IgA Antibodies<br />
TAT – 30 days<br />
YELLOW SST $120.00<br />
CML<br />
TTG<br />
Screen includes or can be ordered<br />
separately:<br />
TTG – Tissue Transglutaminase/IGA<br />
$60.00<br />
ANTEN<br />
ANTI-ENDOMYSIAL AB<br />
$55.00<br />
ANGLI<br />
GLIADIN AB IGG & IGA<br />
$90.00<br />
CELONTIN<br />
(METSUXIMIDE)<br />
RCML<br />
Plasma<br />
2 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 25 days<br />
ROYAL BLUE<br />
with heparin<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 7 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CENTROMERE ANTIBODIES<br />
(ANF, ANTI–NUCLEAR<br />
ANTIBODY, SLE ANTIBODY)<br />
See ANA<br />
ANA<br />
CERULOPLASMIN<br />
(COPPER LEVELS)<br />
CERU<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
CH50<br />
(COMPLEMENT<br />
HEMOLYTIC)<br />
(HEMOLYTIC COMPLEMENT<br />
FIXATION)<br />
CH50<br />
Serum<br />
2 mL<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 15 days<br />
YELLOW SST OHIP CML<br />
CHARCOT MARIE TOOTH<br />
(CMT1A)<br />
See MOLECULAR<br />
GENETICS (III)<br />
RCHEO<br />
CHICKEN POX<br />
(VARICELLA ANTIBODY)<br />
(VARICELLA ZOSTER<br />
ANTIBODY)<br />
(ZOSTER ANTIBODY)<br />
VARI<br />
Do not centrifuge tube<br />
Public Health Laboratory recommends both<br />
acute and convalescent specimens taken two<br />
weeks apart<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
CHICKEN POX SWAB<br />
(VARICELLA ANTIBODY)<br />
(VARICELLA ZOSTER<br />
ANTIBODY)<br />
(ZOSTER ANTIBODY SWAB)<br />
VARI<br />
Swab<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
N/C<br />
PHL<br />
CHLAMYDIA, PCR<br />
UCH<br />
Urine<br />
Collect the first part of the urine stream to<br />
ensure a high organism count<br />
Void 15-20 mL (larger urine volume<br />
dilutions may result in false negative<br />
results) into one container for chlamydia<br />
and then collect urine for any other tests<br />
ordered in a second container<br />
TAT – 4 to 7 days<br />
OHIP<br />
CML<br />
CHLAMYDIA, GEN-PROBE<br />
Male<br />
Female<br />
RCHLM<br />
RCHLF<br />
Swab – state source<br />
Submit swab in chlamydia transport media<br />
with white cap<br />
Store and transport at room temperature<br />
TAT – 3 days<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 8 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CHLAMYDIA/GC<br />
(NEISSERIA<br />
GONORRHOEAE)<br />
(GC,GONOCOCCUS)<br />
UCHGC<br />
Urine<br />
Use new GEN PROBE APTIMA kit<br />
(yellow label) from PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing.<br />
Store and transport at room temperature<br />
TAT – 15 days<br />
N/C<br />
PHL<br />
CHLAMYDIA, PSITTACI<br />
(PSITTACOSIS ANTIBODY)<br />
CHLAB<br />
Do not centrifuge tube<br />
Public Health Laboratory recommends both<br />
acute and convalescent specimens taken two<br />
weeks apart<br />
PLAIN RED N/C PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing.<br />
Store and transport at room temperature<br />
TAT – 20 days<br />
CHLAMYDIA,<br />
GEN PROBE APTIMA kit from<br />
PHL<br />
PCHL<br />
Swab – state source<br />
Use new UNISEX collection kit from PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing<br />
Store and transport at room temperature<br />
TAT – 15 days<br />
N/C<br />
PHL<br />
CHLORDIAZEPOXIDE<br />
(LIBRIUM)<br />
RCML<br />
Plasma<br />
2 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 15 days<br />
GREEN<br />
with heparin<br />
OHIP<br />
CML<br />
CHLORIDE CL Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
CHLORIDE<br />
UCL<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
tube<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 9 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CHLORIDE<br />
24UCL<br />
24 Hour Urine<br />
10 mL aliquot – submit in a white cap<br />
conical tube<br />
No preservative<br />
OHIP<br />
CML<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 2 days<br />
CHLORPROMAZINE<br />
(LARGACTIL)<br />
CHLOR<br />
Serum<br />
2 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 10 days<br />
PLAIN RED OHIP CML<br />
CHOLESTEROL, FASTING<br />
CHOL<br />
Serum<br />
Centrifuge only<br />
Patient must fasting overnight<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
CHOLESTEROL, RANDOM RCHOL Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
CHOLINESTERASE<br />
(PSEUDO-<br />
CHOLINESTERASE)<br />
CHOLI<br />
Serum<br />
1 mL<br />
TAT – 5 days<br />
YELLOW SST OHIP CML<br />
CHOLINESTERASE, RBC<br />
(RBC CHOLINESTERASE)<br />
See ACETYL<br />
CHOLINESTERASE<br />
CHOL<br />
RBC<br />
CHOLINESTERASE,<br />
PHENOTYPING<br />
RCML<br />
Serum<br />
Centrifuge only<br />
TAT – 15 days<br />
YELLOW SST OHIP CML<br />
CHORIONIC<br />
GONADOTROPIN<br />
See<br />
BETA HCG PREGNANCY<br />
HCG<br />
CHORIONIC<br />
GONADOTROPIN<br />
See BETA HCG ONCOLOGY<br />
HCG<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 10 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CHROMIUM<br />
RCML<br />
Urine<br />
50 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 10 days<br />
$60.00 CML<br />
CHROMOSOME ANALYSIS<br />
(KARYOTYPING)<br />
See<br />
CYTOGENETICS <strong>TEST</strong>ING<br />
RCHEO<br />
CIRCULATING<br />
ANTICOAGULANT<br />
(LUPUS ANTICOAGULANT)<br />
(NON–SPECIFIC<br />
COAGULATION<br />
INHIBITORS)<br />
LUANT<br />
Plasma<br />
5 mL<br />
Separate immediately<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 25 days<br />
3 LIGHT BLUE OHIP CML<br />
CITRATE<br />
24CIT<br />
24 Hour Urine<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
No preservative required<br />
State 24-hour volume<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 15 days<br />
OHIP<br />
CML<br />
CK<br />
(CPK, TOTAL CK)<br />
(CREATINE<br />
PHOSPHOKINASE)<br />
CK<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
CK–MB<br />
(CK-2 MB)<br />
(CREATINE<br />
PHOSPHOKINASE-MB)<br />
NO LONGER AVAILABLE<br />
CK ELECTROPHORESIS<br />
(CK ISOENZYMES)<br />
(CK FRACTIONATION)<br />
NO LONGER AVAILABLE<br />
CLOBAZAM<br />
(FRISIUM)<br />
(DESMETHYLCLOBAZAM)<br />
CLOB<br />
Serum<br />
3 mL<br />
Separate serum and transfer to plastic tube<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 10 days<br />
PLAIN RED OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 11 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CLOMIPRAMINE<br />
(ANAFRANIL)<br />
CLOM<br />
Serum<br />
2 mL<br />
Collect specimen 10–12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
●Includes Desmethyclomipramine dose●<br />
TAT – 15 days<br />
ROYAL BLUE<br />
no additive<br />
OHIP<br />
CML<br />
CLONAZEPAM<br />
(RIVOTRIL)<br />
RIV<br />
Serum<br />
3 ml<br />
Collect specimen 10–12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 10 days<br />
ROYAL BLUE<br />
no additive<br />
OHIP<br />
CML<br />
CLOSTRIDIUM DIFFICILE<br />
CULTURE AND TOXIN<br />
STUDIES<br />
CLOS<br />
Stool<br />
Dry stool in a plain container without<br />
additive<br />
Specify culture and / or toxin studies<br />
**STORE IN FREEZER, SEND<br />
FROZEN SAMPLE**<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 5 to 10 days<br />
N/C<br />
PHL<br />
CLOT RETRACTION<br />
NO LONGER AVAILABLE<br />
CLOTTING TIME<br />
NO LONGER AVAILABLE<br />
CLOZAPINE<br />
(CLOZARIL)<br />
CLOZA<br />
PINE<br />
Plasma<br />
2 mL<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 15 days<br />
LAVENDER $60.00 CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 12 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CMV<br />
(CYTOMEGALOVIRUS<br />
ANTIBODY)<br />
CMV<br />
Do not centrifuge<br />
Public Health Laboratories recommends the<br />
collection of both acute and convalescent<br />
specimens taken two weeks apart<br />
PLAIN RED N/C PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 25 days<br />
CMV ISOLATION<br />
(CYTOMEGALOVIRUS<br />
ISOLATION)<br />
RPHL<br />
Urine/Saliva/Gastric Washing<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 20 days<br />
N/C<br />
PHL<br />
CO 2<br />
(CARBON DIOXIDE, CO 3)<br />
See BICARBONATE<br />
CO2<br />
COBALT<br />
RCML<br />
Serum<br />
Centrifuge only<br />
Minimum Volume: 2 mL<br />
TAT – 30 days<br />
ROYAL BLUE<br />
with heparin<br />
$60.00 CML<br />
COBALT<br />
RCML<br />
Urine<br />
50 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 30 days<br />
$60.00 CML<br />
COCAINE SCREEN<br />
RCML<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 2 days<br />
OHIP<br />
CML<br />
COCCIDIOIDOMYCOSIS<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
CODEINE<br />
RCML<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap conical<br />
tube<br />
State under notes and instructions “Check<br />
for Codeine”TAT – 3 days<br />
OHIP<br />
CML<br />
COLD AGGLUTININ SCREEN<br />
See AGGLUTINATION<br />
REACTION SCREEN<br />
CAGG<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 13 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
COMPLEMENT C1<br />
See<br />
C1 ESTERASE INHIBITOR<br />
C1INC<br />
COMPLEMENT C1Q<br />
(C1Q COMPLEMENT<br />
BINDING ACTIVITY)<br />
(IMMUNE COMPLEXES,<br />
C1Q)<br />
See<br />
C1Q IMMUNE COMPLEXES<br />
C1Q<br />
COMPLEMENT C2<br />
See C2<br />
RCML<br />
COMPLEMENT C3<br />
See C3<br />
C3<br />
COMPLEMENT C4<br />
See C4<br />
C4<br />
COMPLEMENT C5<br />
See C5<br />
RCML<br />
COMPLEMENT C6<br />
See C6<br />
RCML<br />
COMPLEMENT, HEMOLYTIC<br />
(HEMOLYTIC COMPLEMENT<br />
FIXATION)<br />
See CH50<br />
CH50<br />
COOMBS <strong>TEST</strong><br />
(DIRECT COOMBS)<br />
(DIRECT ANTI–GLOBULIN)<br />
(DIRECT<br />
ANTIHUMANGLOBULIN)<br />
DAHGT<br />
Blood<br />
DO NOT SEPARATE<br />
TAT – 1 day<br />
LAVENDER OHIP BTL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 14 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
COPPER CU Serum<br />
3 mL<br />
TAT – 15 days<br />
ROYAL BLUE<br />
no additive<br />
OHIP<br />
CML<br />
COPPER<br />
24COP<br />
24 Hour Urine<br />
50 mL aliquot –submit in an orange or<br />
white cap container<br />
OHIP<br />
CML<br />
Collect in an acid–washed plastic container<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 15 days<br />
COPROPORPHYRINS<br />
(PORPHYRINS)<br />
(UROPORPHYRINS)<br />
RCML<br />
24 Hour Urine<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
Keep refrigerated during collection<br />
Protect from light by wrapping in<br />
aluminium foil<br />
No preservative<br />
OHIP<br />
CML<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 15 days<br />
CORTISOL<br />
(CORTIZONE)<br />
A.M.<br />
P.M.<br />
RANDOM<br />
CORTA<br />
CORTP<br />
CORT<br />
Plasma<br />
Indicate time of collection (AM, PM,<br />
Random)<br />
Note: Collect before 10 a.m. (indicate AM)<br />
Note: Collect after 4 p.m. (indicate PM)<br />
Plasma is the preferred specimen<br />
TAT – 3 days<br />
GREEN<br />
with heparin<br />
OHIP<br />
CML<br />
CORTISOL<br />
A.M.<br />
P.M.<br />
RANDOM<br />
CORTA<br />
CORTP<br />
CORT<br />
Serum<br />
Centrifuge only<br />
Indicate time of collection (AM, PM,<br />
Random)<br />
Note: Collect before 10 a.m. (indicate AM)<br />
Note: Collect after 4 p.m. (indicate PM)<br />
TAT – 3 days<br />
YELLOW SST OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 15 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CORTISOL<br />
FREE<br />
RCML<br />
3890<br />
24 Hour Urine<br />
10 mL aliquot – submit in an orange or<br />
white cap container labelled CREATININE<br />
and a 50 mL aliquot – submit in an orange<br />
or white cap container labelled CORTISOL<br />
FREE<br />
Preserve 50 mL aliquot with 1 g of Boric<br />
acid<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 5 days<br />
OHIP<br />
CML<br />
CORTISOL<br />
TOTAL<br />
24TCO<br />
24 Hour Urine<br />
10 mL aliquot – submit in an orange or<br />
white cap container labelled CREATININE<br />
and a 50 mL aliquot – submit in an orange<br />
or white cap container labelled CORTISOL<br />
–TOTAL<br />
OHIP<br />
CML<br />
Preserve 50 mL aliquot with 1 g of Boric<br />
acid<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 5 days<br />
COUMADIN<br />
(WARFARIN)<br />
RCML<br />
Plasma<br />
Minimum volume: 3 mL<br />
Collect specimen 10–12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 15 days<br />
GREEN<br />
with heparin<br />
$45.00 CML<br />
COXSACKIE VIRUS,<br />
ISOLATION<br />
(HAND, FOOT, MOUTH<br />
DISEASE)<br />
RPHL<br />
Stool / Rectal Swab / Throat Swab<br />
Viral history sheet must be completed<br />
Stool is the preferred specimen<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
Use appropriate MOH container: Stool–<br />
Virus–TM<br />
Rectal or Throat Swab– Virus–SW<br />
TAT – 15 to 30 days<br />
N/C<br />
PHL<br />
CREATINE<br />
NO LONGER AVAILABLE<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 16 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CREATINE<br />
PHOSPHOKINASE<br />
(CPK)<br />
See CK<br />
CK<br />
CREATINE<br />
PHOSPHOKINASE-MB<br />
(CK-2 MB)<br />
See CK - MB<br />
CKF<br />
CREATININE<br />
(eGFR)<br />
eGFR<br />
Serum<br />
Centrifuge<br />
***FOR PATIENTS OVER 18 YEARS<br />
OF AGE***<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
CREATININE CREA Serum<br />
Centrifuge<br />
*** FOR PATIENTS UNDER 18<br />
YEARS OF AGE ***<br />
TAT – 1 day<br />
CREATININE<br />
CREATININE<br />
UCR<br />
24UCRE<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 2 days<br />
24 Hour Urine<br />
10 mL aliquot – submit in an orange or<br />
white cap container tube labelled<br />
CREATININE<br />
No Preservative<br />
YELLOW SST OHIP BTL<br />
OHIP BTL<br />
OHIP CML<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 90 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 1 day<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 17 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CREATININE CLEARANCE<br />
CC<br />
Serum and 24 Hour Urine<br />
1 mL serum and 10 mL urine aliquot –<br />
submit in an orange or white cap conical<br />
tube<br />
No preservative<br />
YELLOW SST OHIP CML<br />
Collect blood specimen at the beginning or<br />
end of the 24-hour urine collection<br />
State total 24-hour volume, height and<br />
weight on the OHIP Requisition, on the<br />
specimen container and in “Notes and<br />
Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
Testing Includes serum creatinine,<br />
urine creatinine<br />
TAT – 2 days<br />
CRP<br />
(C–REACTIVE PROTEIN)<br />
CRP<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
CRP– HIGH SENSITIVITY<br />
(C–REACTIVE PROTEIN<br />
HIGH SENSITIVITY)<br />
CRPHS<br />
Serum<br />
1 mL<br />
TAT – 15 days<br />
YELLOW SST OHIP CML<br />
CRYOFIBRINOGEN<br />
CRYOF<br />
Blood<br />
Do not open<br />
KEEP AT ROOM TEMPERATURE<br />
TAT – 1 day<br />
LIGHT BLUE OHIP CML<br />
CRYOGLOBULINS,<br />
QUALITATIVE<br />
CRYOG<br />
Serum<br />
2 mL<br />
Fasting specimen preferred<br />
KEEP AT ROOM TEMPERATURE<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
CRYPTOCOCCOSIS<br />
ANTIBODY<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 18 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CULTURE & SENSITIVITY<br />
BLOOD<br />
BLD1<br />
Blood<br />
Cleanse venipuncture site with iodine<br />
Wipe the tube rubber stopper with alcohol<br />
Collect patient‟s blood directly into the<br />
bottle<br />
Mix gently<br />
BLOOD<br />
CULTURE<br />
BOTTLE<br />
OHIP<br />
BTL<br />
Adult – take anaerobic and aerobic culture<br />
bottles<br />
Child – take aerobic culture bottle<br />
STATE THE DATE AND TIME OF<br />
COLLECTION ON THE BOTTLES<br />
A series of three collections over a period of<br />
24 to 48 hours is recommended<br />
*Data Entry code if two(2) collections made<br />
(4 bottles), is BLD2<br />
*Data Entry code if three(3) collections<br />
made (6 bottles), is BLD3<br />
BOTTLES SHOULD NOT BE<br />
REFRIGERATED<br />
TAT – 5 days<br />
CULTURE & SENSITIVITY<br />
EAR<br />
EYE / CONJUNTIVA<br />
NOSE / NARES<br />
misc1<br />
EYE<br />
NOSE<br />
Swab – state source<br />
Place swab in charcoal transport media<br />
*Data entry code for ear lobe, is earLob<br />
TAT – 2 days<br />
OHIP<br />
BTL<br />
CULTURE & SENSITIVITY<br />
Swab – state source<br />
Place swab in charcoal transport media<br />
OHIP<br />
BTL<br />
FEMALE G.C. ONLY<br />
CERVICAL<br />
ENDOCERVICAL<br />
GONORRHEA<br />
CX<br />
*Refer to Data Entry code sheet for specific<br />
codes<br />
Test is for N. gonorrhea only<br />
TAT – 2 days<br />
CULTURE & SENSITIVITY<br />
GENITAL<br />
CERVICAL/VAGINAL<br />
LABIA<br />
PENIS/PENILE<br />
VAGINAL<br />
VAGINAL/ANAL<br />
VAGINAL/RECTAL<br />
VULVA<br />
VAG<br />
CX<br />
PENIS<br />
VAG<br />
VagREC<br />
VULVA<br />
Swab – state source<br />
Place swab in charcoal transport media<br />
*Refer to Data Entry code sheet for specific<br />
codes<br />
Test is for N. gonorrhea, Yeast,<br />
Trichomonas and Bacterial Vaginosis<br />
TAT – 2 days<br />
OHIP<br />
BTL<br />
CULTURE & SENSITIVITY<br />
GROUP B STREP<br />
SCREEN ONLY<br />
Swab – VAGINAL, VAG/RECTAL<br />
Place swab in charcoal transport media<br />
*Refer to Data Entry Code sheet for specific<br />
codes<br />
TAT – 2 days<br />
OHIP<br />
BTL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 19 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CULTURE & SENSITIVITY<br />
ANY FLUID,<br />
Except Semen<br />
Body Fluid – state source<br />
10 mL<br />
Place fluid in a sterile container<br />
*Refer to Data Entry code sheet for specific<br />
codes<br />
TAT – 2 days<br />
OHIP<br />
BTL<br />
CULTURE & SENSITIVITY<br />
MISCELLANEOUS<br />
Includes wound, skin,<br />
all abscesses, axilla,<br />
groin, discharge, eye lid,<br />
mouth, perianal, pharynx<br />
rectal abscess, tonsil<br />
Swab – state source<br />
Place swab in charcoal transport media<br />
*Refer to Data Entry code sheets for<br />
specific codes<br />
TAT – 2 days<br />
OHIP<br />
BTL<br />
CULTURE & SENSITIVITY<br />
RECTAL / ANAL<br />
Swab – Rectal<br />
Place swab in charcoal transport media<br />
*Refer to Data Entry code sheets for<br />
specific codes<br />
TAT – 2 days<br />
OHIP<br />
BTL<br />
CULTURE & SENSITIVITY<br />
SEMEN<br />
SEMEN<br />
Semen<br />
2 mL<br />
Place in sterile container<br />
TAT – 2 days<br />
OHIP<br />
BTL<br />
CULTURE & SENSITIVITY<br />
SMEAR/SLIDE<br />
SMEAR<br />
Smear/Slide- state source<br />
For Gram Stain<br />
TAT – 2 days<br />
OHIP<br />
BTL<br />
CULTURE & SENSITIVITY<br />
SPUTUM<br />
SPUT1<br />
Sputum<br />
Deep cough specimen in sterile container<br />
Use only 1 sample per requisition<br />
*If second sample received, enter SPUT2<br />
*If third sample received, enter SPUT3<br />
TAT – 2 days<br />
OHIP<br />
BTL<br />
CULTURE & SENSITIVITY<br />
STOOL<br />
STOOL1<br />
Stool<br />
Place stool in Cary–Blair transport<br />
container to the “FILL LINE”<br />
Shake to emulsify sample<br />
*If second sample received, enter STOOL2<br />
*If third sample received, enter STOOL3<br />
TAT – 2 days<br />
OHIP<br />
BTL<br />
CULTURE & SENSITIVITY<br />
THROAT<br />
THRO<br />
Swab – Throat<br />
Place swab in charcoal transport media<br />
State if patient in allergic to penicillin in “<br />
Notes and Instructions”<br />
Test is for Beta Streptococcus Group A<br />
only<br />
TAT – 2 days<br />
OHIP<br />
BTL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 20 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CULTURE & SENSITIVITY<br />
THROAT FOR STREP<br />
THRO<br />
Swab – Throat<br />
Place swab in charcoal transport media<br />
State if patient is allergic to penicillin in “<br />
Notes and Instructions”<br />
Test is for Beta Streptococcus Group A<br />
ONLY<br />
TAT – 2 days<br />
OHIP<br />
BTL<br />
CULTURE & SENSITIVITY<br />
URETHRAL<br />
URETH<br />
Swab – Urethral – Male or Female<br />
Submit swab in charcoal transport media<br />
TAT – 2 days<br />
OHIP<br />
BTL<br />
CULTURE & SENSITIVITY<br />
URINE<br />
U<br />
Urine<br />
Collect a minimum of 10 mL of mid–stream<br />
urine in an orange or white cap container<br />
TAT – 2 days<br />
OHIP<br />
BTL<br />
CYANIDE<br />
CYAN<br />
IDE<br />
Blood<br />
10 mL<br />
TAT – 25 days<br />
2 GREEN<br />
with heparin<br />
$60.00 CML<br />
CYCLOSPORINE<br />
TRANSPLANT<br />
*Must collected and tested at Hospital<br />
where transplant performed<br />
CYCLOSPORINE,<br />
NON TRANSPLANT<br />
RCML<br />
Blood<br />
State on the tube “non–transplant”<br />
Keep cold during transport<br />
TAT – variable<br />
LAVENDER OHIP CML<br />
CYSTATIN-C<br />
(CYSTATIN 3)<br />
(GAMMA TRACE)<br />
RCHEO<br />
Plasma<br />
Spin & separate<br />
GREEN<br />
with heparin<br />
$7.20 CHEO<br />
CYSTIC FIBROSIS<br />
(CF)<br />
See<br />
MOLECULAR GENETICS (I)<br />
RCHEO<br />
CYSTINE<br />
(QUANTITATIVE)<br />
24CYS<br />
24 Hour Urine<br />
90 mL aliquot – submit in an orange or<br />
white cap container<br />
No preservative<br />
OHIP<br />
CML<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 90 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 25 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 21 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
CYSTINE SCREEN<br />
CYSTR<br />
Urine<br />
25 mL random urine<br />
Submit in an orange or white cap container<br />
Note: If screen is abnormal, quantitative<br />
will be performed<br />
TAT – 25 days<br />
OHIP<br />
CML<br />
CYSTINOSIS<br />
See<br />
MOLECULAR GENETICS (I)<br />
RCHEO<br />
CYTOGENETICS <strong>TEST</strong>ING<br />
(CHROMOSOME ANALYSIS)<br />
(KARYOTYPING)<br />
(FISH)<br />
(FLUORESCENT IN-SITU<br />
HYBRIDIZATION)<br />
RCHEO<br />
Whole Blood<br />
Adults & children > 1yr. = 5-10ml blood<br />
Newborns & infants = 2-3ml minimum<br />
Label all tubes with minimum 2 patient<br />
identifiers<br />
Submit Monday to Thursday before 4pm or<br />
Friday before noon for best results<br />
GREEN<br />
with heparin<br />
OHIP<br />
CHEO<br />
Deliver to the hospital by 14:00 hrs the day<br />
sample taken<br />
When possible, have the Courier deliver<br />
sample(s) directly to the hospital on the<br />
same day of collection<br />
Pre-package sample(s) with completed<br />
Cytogenetics Form and a copy of the OHIP<br />
requisition in a separate brown paper bag<br />
Address envelope:<br />
CHEO<br />
Attention:<br />
Chromosome Analysis<br />
Department/Cytogenetics Lab<br />
3 rd Flr. Max Keeping Wing<br />
DO NOT REFRIGERATE<br />
TAT – VARIABLE<br />
D<br />
CYTOLOGY<br />
ASPIRATION BIOPSY<br />
ASPP<br />
Slide and / or Aspiration Fluid<br />
(Slides are recommended)<br />
The physician must print the patient's name<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 22 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
Includes all aspirations and or<br />
slides from:<br />
any tumour<br />
lymph node<br />
mass<br />
neck<br />
nodule<br />
Or CYST from:<br />
Breast<br />
lymph node<br />
salivary gland<br />
thyroid<br />
on slide with a pencil<br />
Apply directly from source or by means of<br />
applicator to slide<br />
Fix slide immediately with cytospray<br />
For fluid sample in a container, fix with an<br />
equal volume of 50% alcohol to sample<br />
Complete a Cytology Form for samples<br />
Assign the same accession number if a slide<br />
or fluid is submitted from the same site<br />
Assign a separate accession number if a<br />
slide or fluid is submitted from different<br />
sites<br />
Place a barcode on the mailer for easier<br />
identification<br />
Clinical data requested on requisition must<br />
be provided<br />
Do not code the Documentation Fee for this<br />
test<br />
TAT – 5 days<br />
CYTOLOGY<br />
BRONCHIAL WASHING<br />
OR BRUSHING<br />
CYTOF<br />
Washings<br />
Place specimen in labelled container<br />
Fix washing with an equal volume of 50%<br />
alcohol to sample<br />
OHIP<br />
CML<br />
Complete a Cytology Form for sample<br />
Clinical data requested on requisition must<br />
be provided<br />
Do not code the Documentation Fee for this<br />
test<br />
TAT – 5 days<br />
CYTOLOGY<br />
BUCCAL SMEAR<br />
(FOR BARR BODIES)<br />
CYTOF<br />
Slide – Cheek Scraping<br />
The physician must collect the scraping and<br />
place on a slide<br />
Fix slide immediately with cytospray<br />
The physician must print the patient‟s name<br />
on the slide with pencil<br />
Complete a Cytology Form for sample<br />
Place a barcode on the mailer for easier<br />
identification<br />
Do not code the Documentation Fee for this<br />
test<br />
TAT – 5 days<br />
OHIP<br />
CML<br />
CYTOLOGY<br />
DIRECT SMEAR<br />
LARYNX<br />
NIPPLE DISCHARGE<br />
OPEN LESION<br />
ORAL<br />
CYTOF<br />
Slide<br />
DO NOT CONFUSE WITH ASPIRATION<br />
BIOPSY<br />
Refer to aspiration biopsy for source<br />
specification to ensure correct<br />
coding/processing<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 23 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
VULVAR<br />
The physician must print the patient's name<br />
on slide with a pencil<br />
Apply directly from source or by means of<br />
applicator to slide<br />
Fix slide immediately with cytospray<br />
Complete a Cytology Form for each sample<br />
Assign a separate accession number for<br />
each body site<br />
Place a barcode on the mailer for easier<br />
identification<br />
Clinical data requested on requisition must<br />
be provided<br />
Do not code the Documentation Fee for this<br />
test<br />
TAT – 5 days<br />
CYTOLOGY<br />
DIRECT SMEAR FOR<br />
HERPES<br />
(VIRAL INCLUSION)<br />
CYTOF<br />
Slide<br />
Scrape the lesion and place on a slide<br />
The physician must print the patient's name<br />
on slide with a pencil<br />
Apply directly from source or by means of<br />
applicator to slide<br />
Fix slide immediately with cytospray<br />
Complete a Cytology Form for sample<br />
Place a barcode on the mailer for easier<br />
identification<br />
Clinical data requested on requisition must<br />
be provided<br />
Do not code the Documentation Fee for this<br />
test<br />
TAT – 5 days<br />
OHIP<br />
CML<br />
CYTOLOGY<br />
GASTRIC WASHINGS<br />
ESOPHAGEAL<br />
GASTRIC OR<br />
ENDOMETRIAL<br />
CYTOF<br />
Gastric Washings<br />
Place specimen in labelled container<br />
Fix washing with an equal volume of 50%<br />
alcohol to sample<br />
Complete a Cytology Form for sample<br />
OHIP<br />
CML<br />
Clinical data requested on requisition must<br />
be provided<br />
No not code the Documentation Fee for this<br />
test<br />
TAT – 5 days<br />
CYTOLOGY<br />
MISCELLANEOUS FLUID<br />
OR CYST<br />
Includes:<br />
cysts from sources<br />
peritoneal fluid<br />
pleural fluid<br />
CYTOF<br />
Fluids<br />
Fluid Specimen<br />
The physician must print the patient's name<br />
on slide with a pencil<br />
For fluid sample in a container, fix with an<br />
equal volume<br />
Two slides are recommended<br />
Apply directly from source or by means of<br />
applicator to slide<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 24 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
synovial fluid<br />
Excludes, (Code as 705):<br />
breast cyst<br />
lymph nodes cyst<br />
salivary gland cyst<br />
thyroid cyst<br />
Fix slide immediately with cytospray of<br />
50% alcohol to sample<br />
Complete a Cytology Form for samples<br />
Assign the same accession number if a slide<br />
or fluid is submitted from the same site<br />
Assign a separate accession number if s<br />
slide or fluid is submitted from different<br />
sites<br />
Clinical data requested on requisition must<br />
be provided<br />
Do not code the Documentation Fee for this<br />
test<br />
TAT – 5 days<br />
CYTOLOGY, PAP SMEAR<br />
GY<br />
Slide<br />
The physician must print the patient's name<br />
on slide with a pencil<br />
OHIP<br />
BTL<br />
Fix slide immediately with cytospray<br />
Complete a Cytology Form for sample<br />
Place a barcode on the mailer for easier<br />
identification<br />
Clinical data requested on requisition must<br />
be provided<br />
Do not code the Documentation Fee for this<br />
test<br />
TAT – 2 to 5 days<br />
CYTOLOGY, PAP SMEAR<br />
MONOLAYER/THINLAYER<br />
GY<br />
30 mL M/L container<br />
The physician must print the patient's name<br />
on the container<br />
OHIP<br />
BTL<br />
Complete a Cytology Form for sample<br />
Clinical data requested on requisition must<br />
be provided<br />
Do not code the Documentation Fee for this<br />
test<br />
TAT – 2 to 5 days<br />
CYTOLOGY<br />
SPUTUM<br />
CYTOF<br />
Sputum<br />
Place specimen in labelled container<br />
Fix washing with an equal volume of 50%<br />
alcohol to sample<br />
Collect specimens on 3 consecutive<br />
mornings<br />
OHIP<br />
CML<br />
Complete a Cytology Form for each sample<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 25 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
Assign a separate accession number for<br />
each specimen<br />
Clinical data requested on requisition must<br />
be provided<br />
Do not code the Documentation Fee for this<br />
test<br />
TAT – 14 days<br />
CYTOLOGY<br />
URINE<br />
CYTOF<br />
Urine<br />
Instruct the patient to drink approximately 5<br />
glasses or more of water during a 2 hour<br />
period prior to do the test<br />
OHIP<br />
CML<br />
Patient may urinate during this 2 hour<br />
period and discard urine<br />
At the end of the 2 hour period, when the<br />
next urge to urinate arises, add a portion of<br />
this void to an equal volume of 50% alcohol<br />
Suggest specimens be collected on 3<br />
consecutive days<br />
Complete a Cytology Form for each sample<br />
Assign a separate accession number for<br />
each specimen<br />
Clinical data requested on requisition must<br />
be provided<br />
Do not code the Documentation Fee for this<br />
test<br />
TAT – 5 days<br />
CYTOMEGALOVIRUS<br />
ANTIBODY<br />
See CMV<br />
CMV<br />
CYTOMEGALOVIRUS<br />
ISOLATION<br />
CMV<br />
Urine/Saliva/Gastric Washing<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 20 days<br />
N/C<br />
PHL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION C Page 26 of 26<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
7–DEHYDROCHOLESTEROL<br />
(7DHC)<br />
7DE<br />
HYDRO<br />
Serum<br />
1 mL<br />
Protect vacutainer tube from light after<br />
collection<br />
YELLOW SST $95.00 CML<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 20 days<br />
11-DEOXYCORTISOL 11<br />
DEOXY<br />
Serum<br />
1 mL<br />
TAT – 30 days<br />
YELLOW SST $40.00 CML<br />
D. DIMER<br />
(FIBRIN DEGRADATION<br />
PRODUCTS)<br />
DDIM<br />
Plasma<br />
1 mL<br />
TAT – 5 days<br />
LIGHT BLUE OHIP CML<br />
DALMANE<br />
(FLURAZEPAM)<br />
RCML<br />
Serum<br />
3 mL<br />
(Part of Benzadiazapine screen)<br />
TAT – 10 days<br />
YELLOW SST OHIP CML<br />
DARVON<br />
(PROPOXYPHENE)<br />
RCML<br />
Urine<br />
50 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 7 days<br />
OHIP<br />
CML<br />
DEHYDRO<br />
EPIANDROSTERONE-<br />
SULPHATE<br />
(DHEA-S)<br />
(DHEA SULPHATE)<br />
DHEAS<br />
Serum<br />
Centrifuge only<br />
TAT – 2 days<br />
YELLOW SST OHIP CML<br />
DELTA–AMINOLEVULINIC<br />
ACID<br />
See ALA<br />
RCML<br />
DENGUE FEVER ANTIBODY<br />
See<br />
ARBOVIRUS ANTIBODIES<br />
RPHL<br />
DEOXYPYRIDINOLINE<br />
(DPD)<br />
RCML<br />
Urine<br />
10 mL Random MSU<br />
Collect first morning specimen<br />
Test for bone density<br />
TAT -<br />
$30.00 CML<br />
DEPAKENE<br />
(EPIVAL)<br />
(VALPROIC ACID)<br />
(DIVALPROEX)<br />
VPA<br />
Serum<br />
1 mL<br />
Collect specimen 10 –12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 1 day<br />
PLAIN RED OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION D Page 1 of 6<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
DERMATOPHYTOSIS<br />
(RINGWORM OF SCALP)<br />
(WOOD LAMPS <strong>TEST</strong>)<br />
RPHL<br />
Hair Roots<br />
Submit only root ends of at least 12 hairs<br />
Presence of certain oils or substance in hair<br />
may cause false positive fluorescence<br />
N/C<br />
PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 25 days<br />
DESIPRAMINE<br />
(NORPRAMINE)<br />
DESIP<br />
Serum<br />
2 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 15 days<br />
ROYAL BLUE<br />
no additive<br />
OHIP<br />
CML<br />
DESYREL<br />
(TRAZADONE)<br />
TRAZ<br />
Plasma<br />
3 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
GREEN<br />
with heparin<br />
OHIP<br />
CML<br />
Separate as soon as possible<br />
TAT – 15 days<br />
DHEA-S<br />
(DHEA SULPHATE)<br />
See DEHYDRO<br />
EPIANDROSTERONE-<br />
SULPHATE<br />
DHEAS<br />
DIASTASE<br />
See AMYLASE (serum)<br />
AMY<br />
DIASTASE<br />
See AMYLASE (urine)<br />
RCML<br />
DIAZEPAM<br />
(VALIUM)<br />
DIAZ<br />
Serum<br />
3 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 10 days<br />
GREEN<br />
with heparin<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION D Page 2 of 6<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
DIGOXIN<br />
(DIGITALIS)<br />
(LANOXIN)<br />
DIGOXIN–FREE<br />
DIHYDRO<strong>TEST</strong>OSTERONE<br />
(DHT)<br />
1,25–DIHYDROXY<br />
(VITAMIN D)<br />
(CALCITRIOL)<br />
25–HYDROXY<br />
(VITAMIN D)<br />
See 1,25–DIHYDROXY<br />
(VITAMIN D)<br />
25–HYDROXY<br />
(VITAMIN D)<br />
DIPHTHERIA ANTITOXIN<br />
DIG<br />
RCML<br />
DIHYD<br />
VITD<br />
VITD<br />
Serum<br />
2 mL<br />
Collect specimen 5 - 6 hours after last dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
Hemolysed specimen not acceptable<br />
TAT – 1 day<br />
Serum<br />
2 mL<br />
Testing Includes Total Digoxin<br />
TAT – 10 days<br />
Serum<br />
2 mL<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a test labelled<br />
Separate brown paper bag<br />
TAT – 30 days<br />
Serum 2 mL<br />
Serum from a SST tube is not acceptable<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a test labelled<br />
Separate brown paper bag<br />
TAT – 14 days<br />
COVERED BY OHIP<br />
Ordering physician must indicate on the<br />
requisition if the patient meets eligibility<br />
criteria for coverage.<br />
COVERED BY OHIP<br />
VITDN Serum 2 mL<br />
Serum from a SST tube is not acceptable<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a test labelled<br />
Separate brown paper bag<br />
TAT – 14 days<br />
NOT COVERED BY OHIP<br />
Patient pays.<br />
NO LONGER AVAILABLE AT PHL<br />
YELLOW SST OHIP BTL<br />
PLAIN RED OHIP CML<br />
YELLOW SST $60.00 CML<br />
PLAIN RED OHIP CML<br />
PLAIN RED OHIP CML<br />
PLAIN RED $50.00 CML<br />
DILANTIN<br />
(PHENYTOIN)<br />
DIL<br />
Serum<br />
2 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
DILANTIN, FREE<br />
RCML<br />
Serum<br />
2 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose. Record time in hours that have<br />
elapsed between last dose and specimen<br />
collection TAT – 10 days<br />
PLAIN RED OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION D Page 3 of 6<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
DIPHENHYDRAMINE<br />
See BENADRYL<br />
RCML<br />
DIRECT ANTI–HUMAN<br />
GLOBULIN<br />
(DIRECT ANTI-GLOBULIN)<br />
(DIRECT COOMBS)<br />
See COOMBS <strong>TEST</strong><br />
DAHGT<br />
DIRECT BILIRUBIN<br />
See<br />
CONJUGATED BILIRUBIN<br />
DBIL<br />
DIRECT COOMBS<br />
(DIRECT ANTI-GLOBULIN)<br />
(DIRECT ANTIHUMAN<br />
GLOBULIN)<br />
See COOMBS <strong>TEST</strong><br />
DAHGT<br />
DISOPYRAMIDE<br />
(NORPACE)<br />
RCML<br />
Plasma<br />
2 mL minimum<br />
Centrifuge and separate plasma<br />
TAT – 15 days<br />
GREEN<br />
with heparin<br />
OHIP<br />
CML<br />
DIVALPROEX<br />
(EPIVAL)<br />
(VALPROIC ACID)<br />
See DEPAKENE<br />
DEP<br />
DNA SEQUENCING<br />
HEMOGLOBINOPATHY<br />
INVESTIGATION<br />
RCML<br />
Blood<br />
DNA form must be completed by the<br />
physician<br />
Do not collect specimen until the form is<br />
completed<br />
Call Client Services at 613.789.4242 for the<br />
DNA Form<br />
To be faxed or sent<br />
TAT – 30 to 60 days<br />
LAVENDER OHIP CML<br />
DOPAMINE<br />
See CATECHOLAMINES,<br />
FRACTIONATED<br />
24CAT<br />
DORIDEN<br />
(GLUTETHIMIDE)<br />
RCML<br />
Serum<br />
3 mL<br />
TAT – 15 days<br />
YELLOW SST OHIP CML<br />
DORIDEN<br />
(GLUTETHIMIDE)<br />
RCML<br />
Urine<br />
25 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 25 days<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION D Page 4 of 6<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
DOWN'S SYNDROME<br />
SCREEN<br />
(MATERNAL SERUM<br />
SCREEN)<br />
(MSS)<br />
MSS<br />
Serum<br />
2 ML<br />
Centrifuge tube only<br />
DO NOT REFRIGERATE<br />
Testing is recommended at 15-20 weeks<br />
gestation<br />
For risk assessment of open neural tube<br />
defects<br />
Complete a "Maternal Serum Screen Form”<br />
Results will be reported directly to the<br />
requesting physician<br />
Testing includes hCG, AFP, uE3 &<br />
INHIBITIN<br />
TAT – 5 days<br />
YELLOW SST OHIP CHEO<br />
DOXEPIN<br />
(SINEQUAN)<br />
DOX<br />
Serum<br />
2 mL<br />
Collect specimen 10– 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
REFRIGERATE<br />
Testing Includes Desmethyl Doxepin<br />
TAT – 15 days<br />
ROYAL BLUE<br />
no additive<br />
OHIP<br />
CML<br />
DRUG SCREEN<br />
See BROAD SPECTRUM –<br />
DRUG SCREEN<br />
UDS<br />
DRUGS SCREEN<br />
(DRUGS OF ABUSE)<br />
(NARCOTIC SCREEN)<br />
(STREET DRUGS)<br />
(URINE TOXICOLOGY)<br />
UDSC<br />
Urine<br />
10 mL random urine<br />
Submit in a blue cap conical tube or orange<br />
or white cap container<br />
● Testing Includes: Barbiturates,<br />
Benzodiazepine, Cocaine, Cannabinoids<br />
(THC), Methadone Metabolite, Opiates ●<br />
Note: Any additional drugs, drug analysis,<br />
indicate in “Notes & Instructions” and on<br />
the OHIP Requisition<br />
TAT – 3 days<br />
OHIP<br />
CML<br />
DRUG SCREEN<br />
WITH CREATININE, pH<br />
UDS<br />
RCML<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
Note: Do not code for pH, it is included in<br />
the creatinine code<br />
TAT – 3 days<br />
OHIP<br />
CML<br />
DRUG SCREEN<br />
WITH CREATININE, pH<br />
SODIUM,<br />
POTASSIUM, and<br />
CHLORIDE<br />
UDS<br />
RCML<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
Note: Do not code for pH, it is included in<br />
the creatinine code<br />
TAT – 3 days<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION D Page 5 of 6<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
DRUG SCREEN<br />
WITH ALCOHOL<br />
UDS<br />
UAL<br />
Urine<br />
10 mL random urine<br />
Submit in a white or orange cap container<br />
TAT – 3 days<br />
OHIP<br />
CML<br />
***RITALIN = METHYLPHENADATE –<br />
must be specifically requested<br />
***ECSTACY included in confirmation<br />
testing<br />
DRUGS IN URINE<br />
AMPHETAMINES<br />
BARBITURATES<br />
(short/intermediate acting)<br />
(Phenobarbital)<br />
BENZODIAZEPINES<br />
CANNABINOIDS<br />
COCAINE<br />
ETHANOL<br />
OPIATES<br />
(morphine & codeine)<br />
(synthetic – meperidine, etc)<br />
PHENCYCLIDINE (PCP)<br />
ESTIMATED WINDOW OF<br />
DETECTION<br />
1-3 DAYS<br />
2-4 DAYS<br />
Several weeks<br />
1-3 DAYS<br />
4-30 DAYS<br />
1-3 DAYS<br />
< 24 HOURS<br />
2-3 DAYS<br />
1-2 DAYS<br />
2-3 DAYS<br />
DRUG<br />
AMPHETAMINES<br />
CANNABINOIDS<br />
COCAINE METABOLITE<br />
OPIATES<br />
PHENCYCLIDINE<br />
SAMHSA (NIDA) specifies the following<br />
threshold values for urine drug testing<br />
SCREEN (ng/ml)<br />
1,000<br />
50<br />
Threshold value for cannabinoids was<br />
changed 1Sept1994 from 100 to 50 ng/ml<br />
300<br />
300<br />
25<br />
CONFIRMATION (ng/ml)<br />
500 amphetamine<br />
500 methamphetamine<br />
15 (THC-COOH)<br />
150 (benzoylecgonine)<br />
300 morphine<br />
300 codeine<br />
25<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION D Page 6 of 6<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
E 1<br />
(ESTRONE)<br />
RCML<br />
Serum<br />
1 mL<br />
TAT – 30 days<br />
YELLOW SST OHIP CML<br />
E 2<br />
(ESTROGEN)<br />
(ESTRADIOL)<br />
(ESTROGEN- NON<br />
PREGNANT)<br />
ESTRA<br />
Serum<br />
Centrifuge only<br />
Label tube i 2000<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
E 3, PREGNANT<br />
(ESTRIOL TOTAL)<br />
NO LONGER AVAILABLE<br />
EBV<br />
(EPSTEIN–BARR VIRUS)<br />
EBV<br />
Do not centrifuge tube<br />
Public Health Laboratories recommends<br />
both acute and convalescent specimens<br />
taken 2 weeks apart<br />
PLAIN RED N/C PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
EBV TITRE<br />
(EPSTEIN-BARR VIRUS<br />
TITRE)<br />
EBVT<br />
Do not centrifuge tube<br />
Public Health Laboratories recommends<br />
both acute and convalescent specimens<br />
taken 2 weeks apart<br />
PLAIN RED N/C PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
ECG<br />
(ELECTROCARDIOGRAM)<br />
ECGT<br />
ECGP<br />
ECG<br />
G310 – Technical Component<br />
G313 – Professional Component<br />
G700 – Documentation Fee<br />
OHIP<br />
BTL<br />
Refer to location protocol for billing codes<br />
ECHINOCOCCOSUS<br />
ANTIBODY<br />
(ECHINOCOCCUS<br />
GRANULOSUS ANTIBODY)<br />
(HYDATID)<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION E Page 1 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ECHOVIRUS ISOLATION<br />
RPHL<br />
Stool/ Throat swab/ Rectal Swab<br />
Complete a PHL Form<br />
Stool is the preferred specimen<br />
Stool –VIRUS–TM<br />
Throat Swab –VIRUS–SW<br />
Rectal Swab –VIRUS–SW<br />
N/C<br />
PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 to 30 days<br />
eGFR<br />
See CREATININE<br />
eGFR<br />
E. HISTOLYTICA<br />
SEROLOGY ANTIBODY<br />
(AMOEBIC DYSENTRY<br />
SEROLOGY AB)<br />
(ENTAMOEBA<br />
HISTOLYTICA AB)<br />
RPHL<br />
E. HISTOLYTICA RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
Stool<br />
Collect two stool samples<br />
1 st in ova and parasite container<br />
2 nd in 90 mL container with orange lid<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
N/C<br />
PHL<br />
ELAVIL<br />
See AMITRIPTYLINE<br />
AMI<br />
ELECTROCARDIOGRAM<br />
See ECG<br />
ECGT<br />
ECGP<br />
ECG<br />
ELECTRON MICROSCOPY<br />
(EM)<br />
RCML<br />
Tissue<br />
Send specimen in an EM Fixative Kit<br />
Kit available from CML Purchasing<br />
Department<br />
Complete a Histology Form<br />
Send the sample and the form in a Separate<br />
brown paper bag<br />
State the name of the test and Sunnybrook<br />
Hospital on the envelope<br />
TAT – 30 days<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION E Page 2 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ELECTROPHORESIS<br />
Specify test: protein, immuno, Isoenzyme<br />
(alk phos), or hemoglobin<br />
See separate listings<br />
ENA ANTIBODY<br />
(EXTRACTABLE NUCLEAR<br />
ANTIGEN)<br />
See ANTI-ENA<br />
ENDOMYSIAL ANTIBODY<br />
See ANTI-ENDOMYSIAL<br />
ANTIBODY<br />
ENA<br />
ANTEN<br />
EOSINOPHIL COUNT EOS Whole Blood<br />
TAT – 1 day<br />
LAVENDER OHIP BTL<br />
EOSINOPHIL SMEAR<br />
(EYE, NASAL, SPUTUM,<br />
URINE)<br />
NO LONGER AVAILABLE<br />
EPIANDROSTERONE<br />
See<br />
DEHYDRO<br />
EPIANDROSTERONE-<br />
SULPHATE<br />
DHEA<br />
EPIDERMAL ANTIBODIES<br />
(PEMPHIGUS/PEMPHIGOID<br />
ANTIBODIES)<br />
See<br />
ANTI-SKIN ANTIBODIES<br />
RCML<br />
Serum<br />
2 mL<br />
TAT – 25 days<br />
YELLOW SST OHIP CML<br />
EPIVAL<br />
(VALPROIC ACID)<br />
(DIVALPROEX)<br />
See DEPAKENE<br />
DEP<br />
EPSTEIN–BARR VIRUS AB<br />
See EBV<br />
EBV<br />
EQUANIL<br />
(MEPROBAMATE)<br />
(MILTOWN)<br />
RCML<br />
Serum<br />
3 mL<br />
TAT – 10 days<br />
GREEN<br />
with heparin<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION E Page 3 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
EQUINE ENCEPHALITIS<br />
ANTIBODIES<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
ERYTHEMA INFECTIOSUM<br />
(FIFTH DISEASE)<br />
(PARVO VIRUS )<br />
(PARVO VIRUS B19)<br />
PARVO<br />
Do not centrifuge tube<br />
State Acute (IgM) or Immune (IgG)<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH procedure regarding specimen<br />
processing and transportation. Of note is<br />
that the sample must be<br />
REFRIGERATED until transported to<br />
PHL<br />
TAT – 15 days<br />
REVISED 25 June 2008 (mjh)<br />
PLAIN RED N/C PHL<br />
ERYTHROCYTE COUNT<br />
(RBC)<br />
(RED BLOOD COUNT)<br />
See BLOOD FILM<br />
EXAMINATION<br />
CBC<br />
ERYTHROPOIETIN<br />
ERYTH<br />
Serum<br />
2 mL<br />
Avoid hemolysis<br />
Separate ASAP<br />
YELLOW SST $70.00 CML<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Specimen‟<br />
TAT – 30 days<br />
ESR<br />
(SED RATE)<br />
(SEDIMENTATION RATE)<br />
ESR<br />
Blood<br />
Test must be performed within 10 hours of<br />
collection<br />
TAT – 1 day<br />
LAVENDER OHIP BTL<br />
ESTRADIOL<br />
(ESTROGEN)<br />
(ESTROGEN-NON<br />
PREGNANT)<br />
See E 2<br />
ESTRA<br />
ESTRIOL TOTAL,<br />
PREGNANT<br />
See E 3<br />
NO LONGER AVAILABLE<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION E Page 4 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ESTROGEN, NON<br />
PREGNANT<br />
(ESTRADIOL)<br />
(ESTROGEN)<br />
See E 2<br />
ESTRA<br />
ESTRONE<br />
See E 1<br />
RCML<br />
ETHANOL<br />
See ALCOHOL- ETHYL<br />
ALCO<br />
Blood<br />
ETHANOL<br />
See ALCOHOL- ETHYL<br />
UAL<br />
Urine<br />
ETHANOL<br />
See ALCOHOL- ETHYL<br />
RCML<br />
Gastric Washing<br />
ETHCHLORVYNOL<br />
(PLACIDYL)<br />
RCML<br />
Plasma<br />
1 mL<br />
TAT – 10 days<br />
GREEN<br />
with Heparin<br />
$30.00 CML<br />
ETHOSUXIMIDE<br />
(ZARONTIN)<br />
ZARO<br />
Serum<br />
1 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 3 days<br />
PLAIN RED OHIP CML<br />
ETHYLENE GLYCOL<br />
(ANTIFREEZE)<br />
RCML<br />
Blood<br />
Do not open vacutainer tube<br />
Seal sample with parafilm<br />
Submit Monday to Thursday ONLY<br />
TAT – 15 days<br />
GREY $40.00 CML<br />
ETIOCHOLANOLONE<br />
NO LONGER AVAILABLE<br />
EXTRACTABLE NUCLEAR<br />
ANTIGENS<br />
(ENA ANTIBODY)<br />
See ANTI-ENA<br />
ENA<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION E Page 5 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
FACIOSCAPULOHUMERAL<br />
MUSCULAR DYSTROPHY<br />
(FSHMD)<br />
See MOLECULAR<br />
GENETICS (III)<br />
RCHEO<br />
FACTOR V<br />
LEIDEN MUTATION<br />
(FVL) (INCLUDES APCR)<br />
FACTV<br />
Blood<br />
Do not centrifuge<br />
Lavender<br />
Unspun<br />
Label tube - Factor V Leiden<br />
1 LAVENDER<br />
1 LIGHT BLUE<br />
$75.00 CML<br />
Light Blue<br />
separate 2 mL plasma, FREEZE<br />
label tube-APC Resistance/FactorV Leiden<br />
Heparin is to be restricted one week prior to<br />
test collection<br />
Patient must contact their physician for<br />
restriction guidelines<br />
FREEZE PLASMA FROM LIGHT BLUE<br />
AND SEND FROZEN<br />
Keep lavender at room temperature, send<br />
together<br />
Send frozen plasma from the light blue<br />
vacutainer tube in a separate brown bag<br />
labelled „Frozen Sample‟<br />
NOTE:NOT The SAME AS FACTOR V<br />
TAT – 60 days<br />
FACTOR ANTIGEN<br />
VON WILLEBRAND<br />
RCML<br />
Plasma<br />
Minimum Volume: 2 mL<br />
FREEZE PLASMA AND SEND FROZEN<br />
LIGHT BLUE $60.00 CML<br />
A COPY OF OHIP REQUISITION MUST<br />
ACCOMPANY THE <strong>SPECIMEN</strong><br />
TAT – 10 DAYS<br />
FACTOR ASSAY<br />
RCML<br />
Plasma<br />
4 mL<br />
Collect samples Monday – Wednesday only<br />
Centrifuge both tubes for 15 minutes<br />
Separate immediately<br />
2 LIGHT BLUE OHIP CML<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport in a separate brown paper bag<br />
labelled „Frozen Sample‟<br />
Transport specimen on ice<br />
Indicate factors requested<br />
Factors available 2, 5, 7, 8, 9, 10, 11, 12<br />
A copy of the OHIP requisition must<br />
accompany the specimen<br />
TAT – 10 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION F Page 1 of 8<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
FACTOR 11<br />
PROTHROMBIN MUTATION<br />
RCHEO<br />
Blood<br />
Collect sample Monday – Wednesday only<br />
A form for Molecular Genetic DNA Testing<br />
must be completed by the doctor and<br />
accompany the specimen<br />
LAVENDER OHIP CHEO<br />
Form available from BIO-<strong>TEST</strong> Reporting<br />
Department<br />
Store and transport specimen at room<br />
temperature<br />
Transport in a test labelled separate brown<br />
paper bag<br />
TAT– 10 days<br />
FACTOR VIII<br />
VON WILLEBRAND<br />
FVIII<br />
Plasma<br />
2 mL<br />
Collect sample Monday – Wednesday only<br />
Centrifuge tube for 15 minutes<br />
Separate immediately<br />
LIGHT BLUE $60.00 CML<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
Transport specimen on ice<br />
A copy of the OHIP requisition must<br />
accompany the specimen<br />
TAT – 10 days<br />
FARMERS LUNG<br />
(ALLERGIC LUNG)<br />
(BIRD FANCIERS‟ DISEASE)<br />
See<br />
ALLERGIC ALVEOLITIS<br />
RCML<br />
FAT AND MEAT FIBRES<br />
MICROSCOPIC<br />
EXAMINATION<br />
RCML<br />
Faeces<br />
1g (app. tablespoon) random stool specimen<br />
FREEZE FAECES AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 25 days<br />
OHIP<br />
CML<br />
FATTY ACID, FREE<br />
RCML<br />
Serum<br />
1 mL<br />
Must fast a minimum of 12 hours<br />
YELLOW SST OHIP CML<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a test labelled<br />
separate brown paper bag<br />
TAT – 30 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION F Page 2 of 8<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
FATTY ACID, LONG CHAIN<br />
FALC<br />
Serum<br />
2 mL<br />
Note: not the same as Fatty acid, free<br />
YELLOW SST $60.00 CML<br />
FREEZE FAECES AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag Labelled „Frozen Sample‟<br />
TAT – 30 days<br />
FEBRILE AGGLUTININS<br />
RPHL<br />
Do not centrifuge tube<br />
DO NOT OPEN<br />
PLAIN RED N/C PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 25 days<br />
FECAL FAT, TOTAL<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
Revised 4 March 2008<br />
FERRITIN FERR Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
FERROUS SULPHATE<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
FETAL HEMOGLOBIN<br />
(HEMOGLOBIN F, Hgb F)<br />
(Foetal Hgb)<br />
See HEMOGLOBIN<br />
ELECTROPHORESIS<br />
HBEL<br />
FETAL KELL<br />
See MOLECULAR<br />
GENETICS (IV)<br />
RCHEO<br />
FETAL PLATELET ANTIGEN<br />
(PLA)<br />
See MOLECULAR<br />
GENETICS (IV)<br />
RCHEO<br />
FETAL RhD<br />
See MOLECULAR<br />
GENETICS (IV)<br />
RCHEO<br />
FIBRIN DEGRADATION<br />
PRODUCTS<br />
(D. DIMER)<br />
DDIM<br />
Plasma<br />
1 mL<br />
TAT – 10 days<br />
LIGHT BLUE OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION F Page 3 of 8<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
FIBRINOGEN,<br />
QUANTITATIVE<br />
FIBRI<br />
Plasma<br />
Fill tube completely<br />
Do not centrifuge<br />
TAT – 1 day<br />
LIGHT BLUE OHIP CML<br />
FIFTH DISEASE<br />
(PARVO VIRUS)<br />
(PARVO VIRUS B19)<br />
See<br />
ERYTHEMA INFECTIOSUM<br />
PARVO<br />
FIRST or SECOND<br />
TRIMESTER SCREENING<br />
(INTEGRATED PRENATAL<br />
SCREENING)<br />
(PAPP-A)<br />
Serum<br />
Adults (both maternal & paternal) 10-15ml<br />
Label all tubes with minimum 2 patient<br />
identifiers<br />
Submit Monday to Thursday before 4pm or<br />
Friday before 12 noon for best results<br />
2 SST‟s OHIP CHEO<br />
IPS1<br />
IPS2<br />
A PAPP-A form must be completed by the<br />
physician and indicate whether the test is<br />
first or second trimester<br />
1 ST sample 11-13 weeks gestation<br />
2 nd sample 15-20 weeks gestation<br />
DO NOT FREEZE OR REFRIGERATE<br />
Pre-package sample(s) with completed<br />
Molecular Genetics Form and a copy of the<br />
OHIP requisition in a separate brown paper<br />
bag<br />
When possible, have Courier deliver<br />
sample(s) at Room Temp ASAP directly to<br />
the hospital on the same day of collection<br />
Address envelope:<br />
CHEO<br />
Attention:<br />
Molecular Genetics Lab<br />
Max Keeping Wing<br />
Room W3403<br />
For IPS #1<br />
***Covered for Ontario patients ONLY,<br />
all others must pay $150.00***<br />
***WE CANNOT ACCEPT CASH***<br />
For IPS #2<br />
No charge if IPS #1 paid<br />
TAT – 3 days after 2 nd sample<br />
FISH<br />
(FLUORESCENT IN-SITU<br />
HYBRIDIZATION)<br />
See<br />
CYTOGENETICS <strong>TEST</strong>ING<br />
RCML<br />
Specify probes<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION F Page 4 of 8<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
FK-506<br />
(PROGRAF)<br />
(TACROLIMUS)<br />
RCML<br />
Whole Blood<br />
STORE AND TRANSPORT AT ROOM<br />
TEMPERATURE<br />
Collect specimen Monday to Thursday only<br />
LAVENDER OHIP CML<br />
Send the specimen and a copy of the OHIP<br />
requisition in a Priority labelled zip-lock<br />
bag<br />
Transplant hospital and transplant physician<br />
MUST be provided on the requisition or<br />
print non-transplant if indicated<br />
TAT – variable<br />
FLUID, TOTAL EXAM<br />
(JOINT FLUID)<br />
(SYNOVIAL FLUID)<br />
SYNF<br />
ASP<br />
OTHER<br />
RCML<br />
State source – synovial, knee fluid, aspirate,<br />
etc.<br />
a) Crystals & Cells – transfer to a<br />
LAVENDER tube<br />
b) Culture – transfer to an orange or white<br />
cap container<br />
c) Chemistry – transfer to a plain RED tube<br />
code test according to serum codes<br />
tests are usually protein, uric acid, glucose<br />
state tests requested in “Notes and<br />
Instructions”<br />
OHIP<br />
CML<br />
CML<br />
BTL<br />
CML<br />
Results may be delayed due to confirmation<br />
by Pathologist<br />
Testing Includes LKcs, crystals,<br />
chemistry, differential<br />
TAT – 4 days<br />
FLUORESCENT<br />
ABSORPTION <strong>TEST</strong><br />
(FTA- TREPONEMAL<br />
ANTIBODIES)<br />
(TREPONEMAL<br />
ANTIBODIES)<br />
FTA<br />
Do not centrifuge<br />
Must indicate if testing is for<br />
immigration purposes<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
FLUORIDE<br />
FLUOR<br />
Serum<br />
2 mL<br />
PLAIN RED $40.00 CML<br />
Avoid blood contact with vacutainer rubber<br />
stopper during collection<br />
TAT – 15 days<br />
FLUORIDE<br />
FLUOR<br />
Urine<br />
20 mL random urine<br />
$40.00 CML<br />
Submit in a 90 mL orange cap container<br />
TAT – 15 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION F Page 5 of 8<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
FLURAZEPAM<br />
(DALMANE)<br />
RCML<br />
Serum<br />
3 mL<br />
(Part of Benzodiazepine screen)<br />
YELLOW SST OHIP CML<br />
FLUOXITINE<br />
(PROZAC)<br />
PROZ<br />
Serum<br />
2 mL<br />
Collect sample 10 –12 hours after last dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 15 days<br />
GREEN<br />
with heparin<br />
$60.00 CML<br />
FLUVOXAMINE<br />
(LUVOX)<br />
LUVOX<br />
Serum<br />
2 mL<br />
Collect sample 10 –12 hours after last dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 15 days<br />
GREEN<br />
with heparin<br />
$60.00 CML<br />
FOLATE, RBC<br />
RBCF<br />
Blood<br />
Note: If routine hematology tests are NOT<br />
ordered, an additional lavender tube is<br />
required for hematocrit<br />
2 LAVENDER OHIP CML<br />
FOLATE SERUM: If serum folate is also<br />
ordered, then submit with the RBC folate<br />
request, and 1 mL serum labelled serum<br />
folate<br />
Testing Includes Hematocrit<br />
TAT– 2 days<br />
FOLLITROPIN<br />
(FOLLICLE STIMULATING<br />
HORMONE)<br />
(FSH)<br />
FSH<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
FRAGILE X<br />
See<br />
MOLECULAR GENETICS (I)<br />
RCHEO<br />
FREE CALCIUM<br />
(Ca ²+, Ca++)<br />
See<br />
CALCIUM, IONIZED<br />
RCML<br />
FREE HEMOGLOBIN<br />
(PLASMA HEMOGLOBIN)<br />
RCML<br />
Plasma<br />
3 mL<br />
Avoid hemolysis<br />
TAT – 10 days<br />
LAVENDER OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION F Page 6 of 8<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
FREE T3<br />
(TRIIODOTHYRONINE,<br />
FREE)<br />
FT3<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
FREE T4<br />
(THYROXINE, FREE)<br />
RFT4<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
FREE <strong>TEST</strong>OSTERONE FTES Serum<br />
Centrifuge only<br />
TAT – 4 days<br />
YELLOW SST OHIP CML<br />
FREE THYROXINE INDEX<br />
(FTI)<br />
NO LONGER AVAILABLE<br />
FREE / TOTAL PSA<br />
(PSA FREE AND TOTAL<br />
RATIO)<br />
FPSA<br />
Serum<br />
Centrifuge only<br />
Testing Includes Free & Total PSA<br />
TAT – 3 days<br />
YELLOW SST $50.00 CML<br />
FRISIUM<br />
(CLOBAZAM)<br />
CLOB<br />
Serum<br />
3 mL<br />
Separate serum and transfer to plastic tube<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 10 days<br />
PLAIN RED OHIP CML<br />
FRUCTOSAMINE FRUCT Serum<br />
1 mL<br />
TAT – 15 days<br />
FRUCTOSE<br />
FRUC<br />
Semen<br />
1 mL<br />
YELLOW SST $30.00 CML<br />
OHIP<br />
CML<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag labelled „Frozen Sample‟<br />
TAT – 15 days<br />
FSH<br />
(FOLLICLE STIMULATING<br />
HORMONE)<br />
(FOLLITRIOPIN)<br />
FSH<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
FTA<br />
(FTA- TREPONEMAL<br />
ANTIBODIES)<br />
See FLUORESCENT<br />
ABSORPTION <strong>TEST</strong><br />
FTA<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION F Page 7 of 8<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
FTI<br />
(FREE THYROXINE INDEX)<br />
NO LONGER AVAILABLE<br />
FUNGAL CULTURE<br />
MYCO<br />
Skin Scrapings, Nails, Hairs<br />
State Source<br />
Submit specimen in heavy black paper<br />
placed in a plastic transport container<br />
OHIP<br />
CML<br />
STORE AND SHIP AT ROOM<br />
TEMPERATURE<br />
TAT – 10 to 30 days<br />
FUNGAL CULTURE<br />
MYCO<br />
Sputum<br />
Submit specimen in an orange or white cap<br />
container<br />
STORE AND SHIP AT ROOM<br />
TEMPERATURE<br />
N/C<br />
PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 10 to 30 days<br />
FVL<br />
(INCLUDES APCR)<br />
See FACTOR V LEIDEN<br />
MUTATION<br />
FACTV<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION F Page 8 of 8<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
G6PD, QUANTITATIVE<br />
(GLUCOSE–6–PHOSPHATE<br />
DEHYDROGENASE)<br />
G6PD<br />
Blood<br />
Do not open tube<br />
TAT 1day<br />
LAVENDER OHIP CML<br />
G6PD, ROUTINE SCREENING<br />
(GLUCOSE–6–PHOSPHATE<br />
DEHYDROGENASE)<br />
NO LONGER AVAILABLE<br />
GABAPENTIN<br />
(NEURONTIN)<br />
GAB<br />
Serum<br />
2 mL<br />
Collect specimen 10 to 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 14 days<br />
PLAIN RED $60.00 CML<br />
GALACTOSE–1–PHOSPHATE<br />
URIDYL TRANSFERASE<br />
RCML<br />
Blood<br />
Patient age must be provided<br />
Blood transfusion within 3 months<br />
invalidates test<br />
Store and transport at 4 o C<br />
TAT – 15 days<br />
GREEN<br />
with heparin<br />
OHIP<br />
CML<br />
GAM<br />
(IMMUNO GAM)<br />
(IMMUNOGLOBULIN,<br />
QUANTITATIVE)<br />
IMM<br />
GLO<br />
Serum<br />
Centrifuge only<br />
● Testing Includes IgA, IgG, & IgM ●<br />
TAT – 2 days<br />
YELLOW SST OHIP CML<br />
GAMMA–GLUTAMYL<br />
TRANSPEPTIDASE<br />
(GGT)<br />
(GGTP)<br />
GGT<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
GAMMOPATHY SCREEN<br />
(MONOCLONAL PROTEIN)<br />
See PROTEIN<br />
ELECTROPHORESIS<br />
SPE<br />
GANGLIOSIDE ANTIBODY<br />
RCML<br />
Serum<br />
2 mL<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag labelled „Frozen Sample‟<br />
TAT – 15 days<br />
YELLOW SST OHIP CML<br />
GASTRIN<br />
GAS<br />
Serum<br />
1 mL<br />
Patient must fast minimum of 10 hours<br />
prior to collection<br />
YELLOW SST OHIP CML<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag labelled „Frozen Sample‟<br />
TAT – 25 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION G Page 1 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
GCFT<br />
(GONOCOCCAL<br />
COMPLEMENT FIXATION<br />
<strong>TEST</strong>)<br />
(GONOCCAL INFECTION)<br />
NO LONGER AVAILABLE<br />
GENOTYPE<br />
(BLOOD GROUP, Rh(D) AND<br />
GENOTYPE)<br />
See ABO, Rh(D), GENOTYPE<br />
RCML<br />
GENTAMICIN, PEAK<br />
GAP<br />
Serum<br />
1 mL<br />
Collect peak specimen at end of IV infusion<br />
Record time in minutes that has elapsed<br />
between last dose and specimen collection<br />
PLAIN RED OHIP CML<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag labelled „Frozen Sample‟<br />
TAT – 5 to 10 days<br />
GENTAMICIN, TROUGH<br />
GAT<br />
Serum<br />
1 mL<br />
Collect 60 minutes (trough) after IM<br />
injection<br />
Record time in minutes that has elapsed<br />
between last dose and specimen collection<br />
PLAIN RED OHIP CML<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag labelled „Frozen Sample‟<br />
TAT – 5 to 10 days<br />
GGT<br />
(GGPT)<br />
See GAMMA–GLUTAMYL<br />
TRANSPEPTIDASE<br />
GGT<br />
GLIADIN ANTIBODY<br />
(ANTI–GLIADIN)<br />
See AGA<br />
ANGLI<br />
GLOBULIN GLOB Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
GLUCOSE<br />
FASTING<br />
RANDOM<br />
PC (Codes for PC entry vary)<br />
IF BOTH RANDOM AND<br />
FASTING<br />
FGL<br />
RGL<br />
2GL<br />
Serum<br />
Centrifuge only<br />
*If PC sample, specify time on tube<br />
(ie 1 HR PC or 2 HR PC)<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
YELLOW SST OHIP BTL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION G Page 2 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
GLUCOSE CHALLENGE,<br />
GESTATIONAL SCREEN<br />
50g glucose load<br />
GL50PD<br />
Plasma/Serum<br />
Centrifuge only<br />
Give patient 50 g glucose drink<br />
Collect a grey or yellow top tube 1 hr after<br />
drink given<br />
Record glucose load given<br />
*Fasting Sample not required<br />
TAT – 1 day<br />
GREY<br />
Or<br />
YELLOW SST<br />
OHIP<br />
BTL<br />
GLUCOSE GESTATIONAL<br />
TOLERANCE<br />
75g glucose load<br />
**Entry code varies, depending<br />
on GTT intervals requested**<br />
GL75PD<br />
Plasma/Serum<br />
Centrifuge only<br />
Collect a fasting grey or yellow top tube<br />
Urine samples not required<br />
DO NOT COLLECT A 3 HR <strong>SPECIMEN</strong><br />
GREY<br />
Or<br />
YELLOW SST<br />
OHIP<br />
BTL<br />
Give patient 75 g glucose drink<br />
Collect a grey or yellow top tube 1 hr and 2<br />
hrs after drink consumed<br />
Record glucose load given<br />
Indicate time interval on every specimen<br />
TAT – 1 day<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION G Page 3 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
GLUCOSE TOLERANCE,<br />
STANDARD <strong>TEST</strong><br />
(NON-PREGNANT)<br />
75g glucose load<br />
**Entry code varies, depending<br />
on GTT intervals requested**<br />
UGL<br />
FGL<br />
GL1H<br />
GL2H<br />
Plasma or serum / Urine<br />
Do not centrifuge urine<br />
Centrifuge plasma/serum tubes<br />
Patient MUST be fasting<br />
Collect a fasting urine sample<br />
Collect a fasting grey or yellow top tube<br />
Give patient 75g glucose load drink<br />
Collect a grey or yellow top tube for each<br />
timed interval requested:<br />
1 hour and<br />
2 hour<br />
GREY<br />
Or<br />
YELLOW SST<br />
OHIP<br />
BTL<br />
Record glucose load given<br />
Additional hourly intervals may be<br />
requested by doctor<br />
GL3H<br />
GL4H<br />
GL5H<br />
Code only for the last hourly interval<br />
ordered:<br />
3 hour glucose requested<br />
4 hour glucose requested<br />
5 hour glucose requested<br />
GL0.5H<br />
GL1.5H<br />
GL2.5H<br />
Additional half hour intervals may be<br />
requested by the doctor<br />
Code for each interval that is collected:<br />
½ hour glucose requested<br />
1 ½ hour glucose requested<br />
2 ½ hour glucose requested<br />
Note: If fasting urine is not collected record<br />
in “Notes and Instructions” and on the<br />
OHIP requisition<br />
TAT – 1 day<br />
GLUCOSE–6–PHOSPHATE<br />
DEHYDROGENASE ASSAY<br />
See G6PD<br />
NO LONGER AVAILABLE<br />
GLUCOSE, QUALITATIVE<br />
RCML<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
tube<br />
TAT – 1 day<br />
OHIP<br />
CML<br />
GLUTETHIMIDE<br />
(DORIDEN)<br />
RCML<br />
Serum<br />
3 mL<br />
TAT – 15 days<br />
YELLOW SST OHIP CML<br />
GLUTETHIMIDE<br />
(DORIDEN)<br />
RCML<br />
Urine<br />
25 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 15 days<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION G Page 4 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
GLYCOPROTEIN ALPHA<br />
SUBUNIT<br />
(ALPHA 1 GLYCOPROTEIN)<br />
GLYCO<br />
Serum<br />
2 mL<br />
TAT – 20 days<br />
YELLOW SST $60.00 CML<br />
GLYCOSYLATED<br />
HEMOGLOBIN<br />
(HbA1C, HEMOGLOBIN A1C)<br />
See A1C<br />
A1C<br />
GOLD RCML Serum<br />
5 mL<br />
TAT - 30 days<br />
GONADOTROPIN<br />
Serum<br />
2 mL<br />
YELLOW SST OHIP CML<br />
YELLOW SST $49.00<br />
TAT – 20 days<br />
GONORRHOEAE URINE<br />
(GC,GONOCOCCUS)<br />
See CHLAMYDIA/GC<br />
UCHGC<br />
GRAM STAIN<br />
SMEAR<br />
Smear – state source<br />
Label frosted end of prepared slide with<br />
pencil<br />
TAT – 1 day<br />
OHIP<br />
BTL<br />
GROWTH HORMONE<br />
(HGH)<br />
(HUMAN GROWTH<br />
HORMONE)<br />
GH<br />
Serum<br />
2 mL<br />
Separate within 30 minutes<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown<br />
paper bag labelled „Frozen Sample‟<br />
TAT – 15 to 25 days<br />
YELLOW SST OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION G Page 5 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
5-HIAA<br />
(5-HYDROXYINDOL ACETIC<br />
ACID)<br />
(HYDROXYINDOLE)<br />
(SEROTONIN METABOLITE)<br />
5HAAA<br />
24 Hour Urine<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
Diet restrictions – avoid bananas, eggplant,<br />
pineapple, plums and walnuts for 3–4 days<br />
before collection<br />
OHIP<br />
CML<br />
Preserve aliquot with 1 mL of 6 N HCL<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 25 days<br />
5-HYDROXYTRYPTAMINE<br />
(SEROTONIN)<br />
SEROT<br />
Serum<br />
1 ml<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 35 days<br />
YELLOW SST OHIP CML<br />
17-HYDROXYCORTICO-<br />
STEROIDS<br />
(17-OH STEROIDS)<br />
NO LONGER AVAILABLE<br />
17-HYDROXY<br />
PROGESTERONE<br />
(17-OH PROGESTERONE)<br />
(PREGNANETRIOL)<br />
17HP<br />
Serum<br />
1 mL<br />
TAT – 15 to 25 days<br />
YELLOW SST OHIP CML<br />
25-HYDROXY<br />
(25-HYDROXY)<br />
(VITAMIN D)<br />
See 1,25-DIHYDROXY<br />
VITD<br />
HALCION<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION H Page 1 of 18<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
HALOPERIDOL<br />
(HALDOL)<br />
RCML<br />
Plasma<br />
3 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 15 to 25 days<br />
GREEN<br />
with heparin<br />
$40.00 CML<br />
HAM‟S <strong>TEST</strong><br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
Revised 24July2002<br />
HAND, FOOT, MOUTH<br />
DISEASE<br />
(COXSACKIE VIRUS<br />
ISOLATION)<br />
RPHL<br />
Stool / Rectal Swab / Throat Swab<br />
Viral history sheet must be completed<br />
Stool is the preferred specimen<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
N/C<br />
PHL<br />
Use appropriate MOH container:<br />
Stool – Virus – TM<br />
Rectal or Throat Swab – Virus – SW<br />
TAT – 15 to 30 days<br />
HAPTOGLOBIN<br />
HAPTO<br />
Serum<br />
Centrifuge only<br />
Avoid hemolysis<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
HbA 1 C<br />
(GLYCOSYLATED<br />
HEMOGLOBIN)<br />
(HEMOGLOBIN A1C)<br />
See A 1 C<br />
A1C<br />
HBDH<br />
(HYDROXYBUTYRATE<br />
DEHYDROGENASE)<br />
RCML<br />
Serum<br />
1 mL<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
HCG, PREGNANCY<br />
(HUMAN CHORIONIC<br />
GONADOTROPIN)<br />
See Beta-HCG, PREGNANCY<br />
HCG<br />
PREGNANCY<br />
HCG, ONCOLOGY<br />
(HUMAN CHORIONIC<br />
GONADOTROPIN)<br />
See Beta-HCG, ONCOLOGY<br />
HCG<br />
Label tube for “ Oncology only”<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION H Page 2 of 18<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
HDL CHOLESTEROL<br />
*Fasting sample<br />
(Complete Lipid Profile)<br />
*Random sample<br />
(Complete Lipid Profile)<br />
HDL<br />
RHDL<br />
Serum<br />
Centrifuge only<br />
Patient must be fasting overnight<br />
Patient not fasting<br />
YELLOW SST OHIP BTL<br />
*If ordered by itself and fasting<br />
*If ordered by itself and random<br />
HDLF<br />
RDHDL<br />
Patient fasting<br />
Patient not fasting<br />
TAT – 1 day<br />
HDL/LDL CHOLESTEROL<br />
HDL<br />
Serum – FASTING OVERNIGHT<br />
Centrifuge only<br />
Patient must be fasting overnight<br />
● Testing Includes Triglycerides, Total<br />
Cholesterol, and HDL Cholesterol ●<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
HEAVY & LIGHT CHAINS<br />
(IMMUNO<br />
ELECTROPHORESIS)<br />
(IMMUNOFIXATION)<br />
IMM<br />
IF<br />
Serum<br />
1 ml<br />
Centrifuge only<br />
TAT – 5 days<br />
YELLOW SST OHIP CML<br />
HEAVY & LIGHT CHAINS<br />
(BENCE JONES PROTEIN)<br />
(IEP)<br />
(IMMUNO<br />
ELECTROPHORESIS)<br />
BENC<br />
Urine<br />
50 mL random urine<br />
Submit in an orange or white cap container<br />
First morning sample preferred<br />
No preservative<br />
TAT – 5 days<br />
OHIP<br />
CML<br />
HEAVY & LIGHT CHAINS<br />
(IMMUNO<br />
ELECTROPHORESIS)<br />
(BENCE JONES PROTEIN)<br />
24BJ<br />
24 Hour Urine<br />
10 mL aliquot – submit in a white cap<br />
conical tube labelled CREATININE and a<br />
50 mL aliquot – submit in a 90 mL white<br />
cap container labelled IEP<br />
No preservative<br />
State total 24-hour volume on the OHIP<br />
requisition, on the specimen container and<br />
in “Note and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 5 days<br />
OHIP<br />
CML<br />
HEAVY METAL SCREEN<br />
NO SCREEN <strong>TEST</strong> AVAILABLE<br />
Dr. must order individual metals. Blood<br />
tests are more accurate than urine, but most<br />
can be done on 24hr. urine specimen. If<br />
metal not listed in this TSG (Test<br />
Specification Guide) then call CML. Test<br />
may not be covered by OHIP.<br />
OHIP<br />
CML<br />
HEINZ BODIES<br />
RCML<br />
Blood<br />
Do not open tube<br />
Part of hemolytic investigation – form<br />
available from Reference lab<br />
LAVENDER OHIP CML<br />
TAT – 15 to 25 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION H Page 3 of 18<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
HELICOBACTER PYLORI<br />
(H. PYLORI)<br />
(H. PYLORI ANTIBODY)<br />
HPYLO<br />
Serum<br />
Centrifuge only<br />
TAT – 3 days<br />
YELLOW SST OHIP PHL<br />
HEMATOCRIT<br />
See BLOOD FILM<br />
EXAMINATION<br />
CBC<br />
HEMOCHROMATOSIS<br />
(HEREDITARY<br />
HEMOCHROMATOSIS)<br />
See MOLECULAR<br />
GENETICS (II)<br />
RCHEO<br />
HEMOGLOBIN<br />
See BLOOD FILM<br />
EXAMINATION<br />
CBC<br />
HEMOGLOBIN A 1 C<br />
(GLYCOSYLATED<br />
HEMOGLOBIN)<br />
(HbA1C)<br />
See A1C<br />
A1C<br />
Blood<br />
TAT – 1 day<br />
LAVENDER OHIP BTL<br />
HEMOGLOBIN A2<br />
QUANTITATION<br />
HGBA2<br />
Blood<br />
Do not open the tube<br />
Referred to St. Joseph Hospital in Hamilton<br />
TAT – 10 days<br />
LAVENDER OHIP CML<br />
HEMOGLOBIN<br />
ELECTROPHORESIS<br />
(HGB FRACTIONATION)<br />
(HEMOGLOBIN A, A2, C, F, S)<br />
(FETAL HEMOGLOBIN)<br />
(Hgb A, Hgb A2, Hgb C, Hgb F,<br />
Hgb S)<br />
HBEL<br />
Blood<br />
Do not open tube<br />
Abnormal results may be delayed due to<br />
interpretation by consultant<br />
TAT – 2 days<br />
LAVENDER OHIP CML<br />
HEMOLYTIC COMPLEMENT<br />
FIXATION<br />
(COMPLEMENT<br />
HEMOLYTIC)<br />
See CH50<br />
CH50<br />
HEMOPEXIN<br />
RCML<br />
Plasma<br />
2 mL<br />
Collect Monday to Wednesday only<br />
TAT – 15 days<br />
PLAIN RED $60.00 CML<br />
HEMOSIDERIN<br />
HEMOS<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
First morning sample<br />
TAT – 10 days<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION H Page 4 of 18<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
HEPARIN CO FACTOR 11<br />
RCML<br />
Plasma<br />
1 mL<br />
LAVENDER $35.00 CML<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT– 20 days<br />
HEPARIN DEPENDENT<br />
ANTIBODY<br />
RCML<br />
Plasma<br />
1 mL<br />
TAT– 20 days<br />
LIGHT BLUE $60.00 CML<br />
HEPATITIS <strong>TEST</strong>S PROCESSED AT BIO-<strong>TEST</strong> QUICK REFERENCE CODING SHEET:<br />
**NEW**<br />
HEPATITIS <strong>TEST</strong>ING DETAILS<br />
Information pertaining to Hepatitis testing and coding is now displayed with the following set up:<br />
‣ A Quick Reference Coding Sheet which is set up to show:<br />
Coding when the Hepatitis request is checked off in the pre-printed section of the OHIP Requisition.<br />
Coding when the Hepatitis request is hand written on the OHIP Requisition.<br />
‣ Hepatitis Test Details are displayed as listings of test names and their corresponding codes<br />
as per their Specimen requirements.<br />
REQUISITION<br />
AS PRINTED ON THE OHIP<br />
Viral Hepatitis (check one only)<br />
Acute Hepatitis<br />
<br />
Chronic Hepatitis (Carrier)<br />
Immune status/prev. exposure<br />
Specify: Hepatitis A ____<br />
Hepatitis B ____<br />
HEPATITIS, ACUTE<br />
ACUTE<br />
Serum<br />
Centrifuge tubes only<br />
● Includes all tests associated with codes<br />
HBAG & HAIGM ●<br />
TAT – 2 days<br />
2 YELLOW SST OHIP CML<br />
HEPATITIS, CHRONIC<br />
CHRON<br />
Serum<br />
Centrifuge only<br />
All markers only 1 FULL tube needed<br />
● Includes all tests associated with codes<br />
HBAG & HEPC●<br />
TAT – 2 days<br />
YELLOW SST OHIP CML<br />
HEPATITIS A, IMMUNE<br />
(IMMUNE<br />
STATUS/PREV.EXPOSURE<br />
HEPATITIS A)<br />
IMMA<br />
Serum<br />
Centrifuge only<br />
All markers only 1 FULL tube needed<br />
● Includes all tests associated with code<br />
HEPA ●<br />
TAT – 2 days<br />
YELLOW SST OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION H Page 5 of 18<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
HEPATITIS B, IMMUNE<br />
(IMMUNE<br />
STATUS/PREV.EXPOSURE<br />
HEPATITIS B)<br />
IMMB<br />
Serum<br />
Centrifuge only<br />
All markers only 1 FULL tube needed<br />
● Includes all tests associated with code<br />
HBAB ●<br />
TAT – 2 days<br />
YELLOW SST OHIP CML<br />
HEPATITIS <strong>TEST</strong>S PROCESSED AT BIO-<strong>TEST</strong> QUICK REFERENCE CODING SHEET:<br />
PHYSICIAN’S REQUEST<br />
ORDER<br />
ENTRY<br />
CODE<br />
The codes listed below cannot be ordered in combination<br />
with the checked Hepatitis test ordered.<br />
(They are automatically included by the computer<br />
system).<br />
S PRINTED ON THE OHIP REQUISITION<br />
Viral Hepatitis (check one only)<br />
Acute Hepatitis<br />
A<br />
ACUTE<br />
(Automatically includes tests HBAG + HAIGM)<br />
<br />
Chronic Hepatitis (Carrier)<br />
CHRON<br />
(Automatically includes tests HBAG + HEPC)<br />
Immune status/prev. exposure<br />
Specify: Hepatitis A ____<br />
Hepatitis B ____<br />
IMMA<br />
IMMB<br />
(Automatically includes all tests in HEP A)<br />
(Automatically includes all tests in HEP B AB)<br />
PHYSICIAN’S REQUEST<br />
IF THE PHYSICIAN REQUEST IS HAND WRITTEN ON THE<br />
OHIP REQUISITION FOLLOW THESE <strong>CODES</strong>:<br />
ORDER<br />
ENTRY<br />
CODE<br />
PHYSICIAN’S REQUEST<br />
ORDER<br />
ENTRY<br />
CODE<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION H Page 6 of 18<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
Australian Antigen<br />
Hepatitis B Surface Antigen<br />
Hep B S Ag<br />
B Surface Antigen<br />
B. Antigen<br />
HbsAg<br />
HBAG<br />
Hepatitis A Antibody (IgG + IgM)<br />
Hep A Ab (IgG + IgM)<br />
Hep A Antibody Total<br />
Anti-HAV<br />
Hav ab (HAV AB)<br />
Hep A Total<br />
Anti-HAV IgG + IgM Total<br />
HEPA<br />
Hep B Surface Antibody<br />
Hep B Surface Ab<br />
Hep B Surface Ab Titre<br />
Hep B Titre<br />
AHBS<br />
Antibody to Hepatitis B S Antigen<br />
Antibody to Hepatitis B S Ag<br />
HBsAb<br />
Hep B Antibodies<br />
Post Hepatitis Vaccination<br />
Anti-HbsAg / Anti-HBs<br />
HBAB<br />
Hepatitis A IgM Antibody<br />
Anti-HAV IgM<br />
Hepatitis A (current infection)<br />
HAVAB-M<br />
Hep A (M)<br />
Hep A Ab (IgM)<br />
Hep A Antibody IgM<br />
Hep A IgM<br />
HAIGM<br />
Hepatitis B Core Antibody<br />
Anti – HBc<br />
Hep B Core Ab<br />
AHBC<br />
B Core<br />
HBcAb<br />
Hep Bc<br />
Hep BcAb<br />
HBIGG<br />
Hepatitis C<br />
Non A Non B<br />
Non A and Non B<br />
Anti-HCV<br />
HCV<br />
Hep C<br />
Hepatitis C Exposure<br />
Hepatitis C Screen<br />
HEPC<br />
Hepatitis B Core IgM Antibody<br />
Anti-HBc IgM<br />
AHBC – IgM<br />
Hep B Core IgM<br />
Core IgM<br />
HBIGM<br />
Hepatitis Be Antibody<br />
Anti-HBe<br />
AHBe<br />
Hep Be Antibody<br />
Hep Be Ab<br />
Be Antibody<br />
HbeAb<br />
HBEAB<br />
Hepatitis Be Antigen<br />
HBe Ag<br />
Hep Be Ag<br />
Be Antigen<br />
E antigen<br />
HBEAG<br />
Hepatitis A B Screen/Profile<br />
Hepatitis Titre<br />
Anti-HB Virus<br />
Call Doctor<br />
to clarify<br />
request<br />
HEPATITIS A ANTIBODY<br />
(IGG & IGM)<br />
(Anti-HAA IgG+IgM Total)<br />
(Anti-HAV IgG + IgM)<br />
(Anti-HAV Total, Hep A Total)<br />
(Hav ab (HAV AB))<br />
(Hep A Ab (IgG + IgM))<br />
(Hepatitis A Antibody Total)<br />
See HEPATITIS A, IMMUNE<br />
IMMA<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION H Page 7 of 18<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
HEPATITIS A IgM<br />
ANTIBODY<br />
(Anti-HAV IgM)<br />
(HAVAB-M)<br />
(Hep A (current infection))<br />
(Hep A (M), Hep A IgM)<br />
(Hep A AB (IgM))<br />
(Hep A Antibody IgM)<br />
HAIGM<br />
Serum<br />
Centrifuge only<br />
All markers only 1 FULL tube needed<br />
TAT – 2 days<br />
YELLOW SST OHIP CML<br />
HEPATITIS B CORE<br />
ANTIBODY<br />
(AHBC, Anti-HBc)<br />
(B Core, HbcAb, Hep Bc)<br />
(Hep B Core Ab, Hep BcAb)<br />
HBIGG<br />
Serum<br />
Centrifuge only<br />
All markers only 1 FULL tube needed<br />
TAT – 2 days<br />
YELLOW SST OHIP CML<br />
HEPATITIS B CORE IgM AB<br />
(AHBC-IgM, Core IgM)<br />
(Anti-HBc IgM, )<br />
(Hep B Core IgM)<br />
HBIGM<br />
Serum<br />
Centrifuge only<br />
All markers only 1 FULL tube needed<br />
TAT – 2 days<br />
YELLOW SST OHIP CML<br />
HEPATITIS B DNA<br />
(HEPATITIS B VIRUS DNA)<br />
(HEPATITIS B GENOTYPING)<br />
(HEPATITIS B VIRAL LOAD)<br />
HBDNA<br />
Serum<br />
2.5 mL<br />
Patient MUST be HepBsAg positive or<br />
PHL will not do the test<br />
PLAIN RED N/C PHL<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 10 days<br />
Revised June 2008 (mjh)<br />
HEPATITIS B SURFACE AB<br />
(AHBS, Hep B Titre)<br />
(Antibody to Hepatitis B S Ag)<br />
(Antibody to Hepatitis B S<br />
Antigen, HbsAb)<br />
(Anti-HBS, Anti-HbsAg)<br />
(Hep B Antibodies, )<br />
(Hep B Surface Ab)<br />
(Hep B Surface Ab Titre)<br />
(Hep B Surface Antibody)<br />
(Post Hepatitis Vaccination)<br />
See HEPATITIS B<br />
HBAG<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION H Page 8 of 18<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
SURFACE ANTIGEN<br />
HEPATITIS B SURFACE<br />
ANTIGEN<br />
(Australian Antigen)<br />
(B Surface Antigen)<br />
(B. Antigen, HbsAg)<br />
(Hep B S Ag)<br />
HBAG<br />
Serum<br />
Centrifuge only<br />
All markers only 1 FULL tube needed<br />
TAT – 2 days<br />
YELLOW SST OHIP CML<br />
HEPATITIS Be ANTIBODY<br />
(AHBe, Anti-Hbe, Be Antibody)<br />
(E Antibody, HbeAb)<br />
(Hep Be Ab, Hep Be Antibody)<br />
See<br />
HEPATITIS Be ANTIGEN<br />
HBEAG<br />
HEPATITIS Be ANTIGEN<br />
(Be Antigen, E Antigen)<br />
(Hbe Ag, Hep Be Ag)<br />
HBEAG<br />
Serum<br />
Centrifuge only<br />
All markers only 1 FULL tube needed<br />
TAT – 2 days<br />
YELLOW SST OHIP CML<br />
HEPATITIS B PRENATAL<br />
(HBsAg Prenatal)<br />
(Hep B Prenatal (HBSAG) only)<br />
(Maternal Hepatitis B Screening)<br />
HEPBM<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
HEPATITIS B VIRUS DNA<br />
(HEPATITIS B GENOTYPING)<br />
(HEPATITIS B VIRAL LOAD)<br />
See HEPATITIS B DNA<br />
HBDNA<br />
HEPATITIS C ANTIBODY<br />
(Anti-HCV, HCV, Hep C)<br />
(Hepatitis C Exposure)<br />
(Hepatitis C Screen)<br />
(Non A and Non B Anti–HCV)<br />
HEPC<br />
Serum<br />
Centrifuge only<br />
All markers only 1 FULL tube needed<br />
TAT – 2 days<br />
* For reactive or inconclusive Anti-HCV<br />
results, additional testing is<br />
recommended ie. HCV RNA (see below<br />
for sample requirements) accompanied<br />
by a completed OPHL Test Requisition<br />
form and a Laboratory Information<br />
Form (F-C-HE-306)<br />
YELLOW SST OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION H Page 9 of 18<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
Revised 25 June 2008 (mjh)<br />
HEPATITIS C PCR<br />
(HEPATITIS C GENOTYPING)<br />
(HEPATITIS C VIRAL LOAD)<br />
HCV<br />
HCVG<br />
Serum<br />
2.5 mL<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 10 days<br />
Revised June 2008 (mjh)<br />
PLAIN RED N/C PHL<br />
(HEPATITIS C RNA)<br />
HCV<br />
Serum<br />
2.5 mL<br />
PLAIN RED N/C PHL<br />
Two full tubes needed<br />
Centrifuge and separate within 4 hours<br />
MOH Form must include: risk factors, liver<br />
functions, current treatment<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 10 days<br />
Revised June 2008 (mjh)<br />
HEPATITIS DELTA AGENT<br />
(DELTA AGENT)<br />
HEPD<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 10 days<br />
PLAIN RED N/C PHL<br />
HEPATITIS E ANTIBODY HEPE Do not centrifuge tube<br />
PLAIN RED N/C PHL<br />
HEREDITARY<br />
HEMOCHROMATOSIS<br />
(HEMOCHROMATOSIS)<br />
See MOLECULAR<br />
GENETICS (II)<br />
HEREDITARY<br />
NEUROPATHY WITH<br />
LIABILITY TO PRESSURE<br />
PALSIES<br />
See MOLECULAR<br />
GENETICS (III)<br />
RCHEO<br />
RCHEO<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 10 days<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION H Page 10 of 18<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
HEREDITARY NON-<br />
SYNDROMIC DEAFNESS<br />
See<br />
MOLECULAR GENETICS (I)<br />
RCHEO<br />
HEROIN<br />
RCML<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
State under notes and instructions “CHECK<br />
FOR HEROIN”<br />
TAT – 3 days<br />
OHIP<br />
CML<br />
HERPES SIMPLEX,<br />
SEROLOGY<br />
RCHEO<br />
Do not centrifuge tube<br />
Data entry staff to change Ref. Acct. to<br />
005<br />
PLAIN RED N/C CHEO<br />
Public Health Laboratory recommends both<br />
acute and convalescent specimens taken two<br />
weeks apart<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
HERPES SIMPLEX,<br />
VIRAL CULTURE<br />
HER<br />
Swab<br />
Use Public Health Virus–SW canister<br />
Swab and transport media provided<br />
State source<br />
N/C<br />
CHEO<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
HETEROPHILE ANTIBODIES<br />
(MONO)<br />
(MONONUCLEOSIS SCREEN)<br />
MONOT<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
Hgb A<br />
(HGB A, HEMOGLOBIN A)<br />
(Hgb ELECT)<br />
See HEMOGLOBIN<br />
ELECTROPHORESIS<br />
HBEL<br />
Hgb A2<br />
(HGB A2, HEMOGLOBIN A2)<br />
(Hgb ELECT)<br />
See HEMOGLOBIN<br />
ELECTROPHORESIS<br />
HBEL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION H Page 11 of 18<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
Hgb C<br />
(HGB C, HEMOGLOBIN C)<br />
(Hgb ELECT)<br />
See HEMOGLOBIN<br />
ELECTROPHORESIS<br />
HBEL<br />
Hgb F<br />
(HGB F, HEMOGLOBIN F)<br />
(Hgb ELECT, FETAL HGB)<br />
(FETAL HEMOGLOBIN)<br />
See HEMOGLOBIN<br />
ELECTROPHORESIS<br />
HBEL<br />
Hgb S<br />
(HGB S, HEMOGLOBIN S)<br />
(Hgb ELECT)<br />
See HEMOGLOBIN<br />
ELECTROPHORESIS<br />
HBEL<br />
HGH<br />
(GROWTH HORMONE)<br />
(HUMAN GROWTH<br />
HORMONE)<br />
GH<br />
Serum<br />
2 mL<br />
Separate within 30 minutes<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 15 to 25 days<br />
PLAIN RED OHIP CML<br />
HHV-6<br />
See HUMAN HERPES<br />
VIRUS-6<br />
RPHL<br />
5-HIAA<br />
(5-HYDROXY-INDOL<br />
ACETIC ACID)<br />
(HYDROXYINDOLE)<br />
(SEROTONIN METABOLITE)<br />
5HAAA<br />
24 Hour Urine<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
Diet restrictions – avoid bananas, eggplant,<br />
pineapple, plums and walnuts for 3–4 days<br />
before collection<br />
OHIP<br />
CML<br />
Preserve aliquot with 1 mL of 6 N HCL<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION H Page 12 of 18<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 25 days<br />
HISTAMINE<br />
RCML<br />
Plasma<br />
2 aliquots of 1 ml<br />
Collect in pre-chilled tubes<br />
LAVENDER OHIP CML<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 30 to 60 days<br />
HISTOLOGY<br />
(PATHOLOGY)<br />
HISTO<br />
Tissue<br />
Send sample in 10% formalin solution<br />
All histology specimens must be<br />
accompanied by a completely filled<br />
Histopathology requisition indicating the<br />
specimen (organ) site and any relevant<br />
clinical information<br />
OHIP<br />
CML<br />
*For second Histo sample, user order<br />
entry code histo2<br />
TAT – 10 days<br />
HISTONE <strong>TEST</strong><br />
See ANTI-HISTONE<br />
AHIST<br />
HISTOPLASMOSIS<br />
ANTIBODY<br />
(HISTOPLASMA ANTIBODY)<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
HISTOPLASMOSIS<br />
(HISTOPLASMA<br />
CAPSULATUM)<br />
(HISTOPLASMA CULTURE)<br />
RPHL<br />
Sputum<br />
Deep cough specimen in sterile container<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
HISTOPLASMOSIS RPHL Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
MINISTRY OF HEALTH GUIDELINES<br />
N/C<br />
N/C<br />
PHL<br />
PHL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION H Page 13 of 18<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
HIV GENOTYPING<br />
RPHL<br />
The test will be performed from the viral<br />
load samples held by Public Health<br />
N/C<br />
PHL<br />
HIV Genotyping can be ordered as a follow<br />
up to a positive Viral load result<br />
The physician must directly notify MOH<br />
and send the appropriate form to have this<br />
test performed<br />
TAT – 1 month<br />
HIV<br />
(AIDS)<br />
(HIV ROUTINE)<br />
(HIV SEROLOGY)<br />
(HIV, PRENATAL)<br />
HIV<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAN RED N/C PHL<br />
HIV PCR<br />
VIRL<br />
The Viral Load form MUST be completed<br />
by the physician<br />
2 LAVENDERS N/C CHEO<br />
Blood<br />
DO NOT collect the specimen until the<br />
form is completed by the physician<br />
HIV, PRENATAL<br />
See HIV<br />
HIV<br />
HIV VIRAL LOAD<br />
(VIRAL LOAD)<br />
VIRL<br />
This test is available to only known<br />
positive HIV patients<br />
2 LAVENDER N/C CHEO<br />
The Viral Load form MUST be completed<br />
by the physician<br />
Centrifuge and separate all the plasma from<br />
the two lavender vacutainer tubes into one<br />
plastic transport tube<br />
FREEZE THE PLASMA AND SEND<br />
FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION H Page 14 of 18<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
TAT – 15 days<br />
HLA-TISSUE TYPING<br />
(HLA - A, B, C)<br />
(HLA - TYPING)<br />
(HISTOCOMPATIBILITY<br />
<strong>TEST</strong>ING)<br />
For organ/tissue<br />
Transplant purposes only<br />
RCML<br />
Blood<br />
Collect samples Monday to Wednesday<br />
ONLY<br />
Doctor's name and telephone number<br />
MUST be on requisition<br />
A questionnaire, which is available from the<br />
Bio-Test Laboratory Reporting Department<br />
must be completed<br />
4 LAVENDER OHIP CML<br />
This requires:<br />
1-Clinical information<br />
2-Type of organ transplant<br />
3-Donor‟s residency (Ontario Yes or No)<br />
Place samples, copy of OHIP requisition,<br />
and questionnaire in a Priority labelled ziplock<br />
bag for transport<br />
DO NOT REFRIGERATE – ROOM<br />
TEMPERATURE ONLY<br />
TAT – 30 days<br />
HLA–B27<br />
HLA<br />
Blood<br />
Collect samples Monday & Tuesday<br />
ONLY<br />
LAVENDER OHIP CML<br />
DO NOT REFRIGERATE<br />
TAT - 25 days<br />
HLA–B29<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
HLA–B5701<br />
HLA<br />
Whole Blood<br />
Collect samples Monday to Wednesday<br />
ONLY and keep at room temperature<br />
Send specimen with Sunnybrook requisition<br />
LAVENDER OHIP CML<br />
DO NOT REFRIGERATE<br />
TAT – To be decided by testing lab<br />
HLA - D, DR, DRW<br />
(HLA - TYPING)<br />
(HISTOCOMPATIBILITY<br />
<strong>TEST</strong>ING)<br />
For organ/tissue<br />
Transplant purposes only<br />
RCML<br />
Blood<br />
Collect samples Monday to Wednesday<br />
ONLY<br />
Doctor's name and telephone number<br />
MUST be on requisition<br />
A questionnaire, which is available from the<br />
Bio-Test Laboratory Reporting Department<br />
must be completed<br />
2 LAVENDER OHIP CML<br />
This requires:<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION H Page 15 of 18<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
1-Clinical information<br />
2-Type of organ transplant<br />
3-Donor‟s residency (Ontario Yes or No)<br />
Place samples, copy of OHIP requisition,<br />
and questionnaire in a Priority labelled ziplock<br />
bag for transport<br />
DO NOT REFRIGERATE – ROOM<br />
TEMPERATURE ONLY<br />
TAT – 30 days<br />
HOLTER MONITOR<br />
REFER PATIENT TO HOSPITAL<br />
OUTPATIENT CARDIOLOGY<br />
DIAGNOSTICS<br />
HOMOCYSTEINE<br />
HOMO<br />
Plasma<br />
2 mL<br />
LAVENDER $65.00 CML<br />
Centrifuge and separate immediately<br />
Fasting sample preferred<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 15 to 25 days<br />
HOMOGENTISIC ACID<br />
RCML<br />
Urine<br />
25 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 15 days<br />
OHIP<br />
CML<br />
HOMOVANILLIC ACID<br />
(HVA)<br />
HVA<br />
24 Hour Urine<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
OHIP<br />
CML<br />
Preserve aliquot with 1 mL of 6N HCL<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 25 days<br />
HOUSE CALLS<br />
House calls area performed in the city of<br />
Ottawa<br />
House calls are performed on an<br />
appointment<br />
Basis and can be booked by calling the<br />
main lab at 789-4242 and asking for the<br />
House Calls department<br />
$25.00 BTL<br />
H. PYLORI<br />
(H. PYLORI ANTIBODY)<br />
See<br />
HELICOBACTER PYLORI<br />
HPYLO<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION H Page 16 of 18<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
HUMAN CHORIONIC<br />
GONADOTROPIN<br />
(BHCG)<br />
See<br />
BETA-Hcg, PREGNANCY<br />
HCG<br />
HUMAN GROWTH<br />
HORMONE<br />
(HGH)<br />
See GROWTH HORMONE<br />
GH<br />
HUMAN HERPES VIRUS-6<br />
(HHV-6)<br />
RPHL<br />
Plasma<br />
Minimum 500ul<br />
DO NOT USE HEPARIN<br />
Store samples refrigerated until shipped<br />
Ship on wet ice<br />
TAT - ?<br />
EDTA OHIP PHL<br />
HUMAN PAPILLOMA VIRUS<br />
(HPV)<br />
RDYN<br />
Swab<br />
CALL REPORTING DEPARTMENT AT<br />
(613).789-4242 TO MAKE<br />
ARRANGEMENTS FOR COLLECTION<br />
IN PAP CONTAINER AND DELIVERY<br />
TO GDL (THIS METHOD OF HPV<br />
<strong>TEST</strong>ING IS NOT COVERED BY OHIP)<br />
DYN<br />
HUMAN PLACENTAL<br />
LACTOGEN<br />
(HPL)<br />
NO LONGER AVAILABLE<br />
HYDATID<br />
(ECHINOCOCCUS<br />
GRANULOSUS ANTIBODY)<br />
See ECHINOCOCCOSUS<br />
ANTIBODY<br />
RPHL<br />
HYDROXYBUTYRATE<br />
DEHYDROGENASE<br />
See HBDH<br />
RCML<br />
25-HYDROXY<br />
(VITAMIN D)<br />
See<br />
25-HYDROXY VITAMIN D<br />
VITD<br />
5-HYDROXY-INDOLE<br />
ACETIC ACID<br />
(HYDROXYINDOLE)<br />
(SEROTONIN METABOLITE)<br />
See 5-HIAA<br />
5HAAA<br />
17-OH PROGESTERONE<br />
(PREGNANETRIOL)<br />
See 17-HYDROXY<br />
PROGESTERONE<br />
17HP<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION H Page 17 of 18<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
HYDROXYPROLINE, FREE<br />
RCML<br />
24 Hour Urine<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
OHIP<br />
CML<br />
No preservative<br />
State total 24-hour volume on the OHIP<br />
requisition, on the specimen container and<br />
in “Note and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 15 days<br />
HYDROXYPROLINE, TOTAL<br />
RCML<br />
24 Hour Urine<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
OHIP<br />
CML<br />
No preservative<br />
State total 24-hour volume on the OHIP<br />
requisition, on the specimen container and<br />
in “Note and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 15 days<br />
5-OH TRYPTAMINE<br />
(SEROTONIN)<br />
See<br />
5-HYDROXYTRYPTAMINE<br />
SEROT<br />
25-OH VITAMIN D<br />
(VITAMIN D)<br />
(CALCIDIOL)<br />
See 25-HYDROXY<br />
VITAMIN D<br />
VITD<br />
HVA<br />
See HOMOVANILLIC ACID<br />
RCML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION H Page 18 of 18<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
IBUPROFEN<br />
(MOTRIN)<br />
IBU<br />
Plasma<br />
3 mL<br />
TAT – 10 days<br />
GREEN<br />
with heparin<br />
$60.00 CML<br />
IGF-1<br />
(SOMATOMEDIN-C)<br />
See INSULIN-LIKE<br />
GROWTH FACTOR-1<br />
SOMA<br />
IGG SUBCLASSES<br />
(IMMUNOGLOBULIN IGG)<br />
IGG<br />
Serum<br />
1 mL<br />
State Date of Birth<br />
● Includes IgG Total, & IgG 1 – 4 ●<br />
TAT – 25 days<br />
YELLOW SST OHIP CML<br />
IMIPRAMINE<br />
(TOFRANIL)<br />
IMIPR<br />
Serum<br />
2 mL<br />
Collect specimen 10 – 12 after last dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
● Testing Includes Desipramine ●<br />
TAT – 15 days<br />
ROYAL BLUE<br />
no additive<br />
OHIP<br />
CML<br />
IMMUNE COMPLEXES, C 1 Q<br />
(C1Q COMPLEMENT<br />
BINDING ACTIVITY)<br />
(COMPLEMENT C1Q)<br />
See C1Q IMMUNE<br />
COMPLEXEXES<br />
C1Q<br />
IMMUNO<br />
ELECTROPHORESIS<br />
(IMMUNOFIXATION)<br />
See HEAVY & LIGHT<br />
CHAINS IMMUNO<br />
ELECTROPHORESIS<br />
IMMIF<br />
IMMUNO<br />
ELECTROPHORESIS<br />
(HEAVY & LIGHT CHAINS<br />
IMMUNO)<br />
(IEP-RANDOM)<br />
See<br />
BENCE JONES PROTEIN<br />
BENC<br />
Random urine<br />
IMMUNO<br />
ELECTROPHORESIS<br />
(HEAVY & LIGHT CHAINS<br />
IMMUNO)<br />
See<br />
BENCE JONES PROTEIN<br />
24BJ<br />
24 hour urine<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION I Page 1 of 6<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
IMMUNOFIXATION<br />
(IMMUNO<br />
ELECTROPHORESIS)<br />
See HEAVY & LIGHT<br />
CHAINS IMMUNO<br />
IMMIF<br />
IMMUNOFLUORESCENCE<br />
(IF)<br />
RCML<br />
Tissue<br />
Send specimen in an IF Transport Kit<br />
Kit available from Bio-Test Supply<br />
Department<br />
This test is sent to and reported by<br />
Sunnybrook Hospital<br />
Complete a Histology Form<br />
TAT – 20 days<br />
OHIP<br />
CML<br />
IMMUNOGLOBULIN, IgA IGA Serum<br />
Centrifuge only<br />
TAT – 2 days<br />
YELLOW SST OHIP CML<br />
IMMUNOGLOBULIN, IgD RCML Serum<br />
Centrifuge only<br />
TAT – 2 days<br />
YELLOW SST OHIP CML<br />
IMMUNOGLOBULIN, IgE IGE Serum<br />
Centrifuge only<br />
TAT – 2 days<br />
YELLOW SST OHIP CML<br />
IMMUNOGLOBULIN, IgG IGG Serum<br />
Centrifuge only<br />
TAT – 2 days<br />
IMMUNOGLOBULIN, IgG<br />
SUBCLASSES<br />
RCML<br />
IMMUNOGLOBULIN, IgM IGM Serum<br />
Centrifuge only<br />
TAT – 2 days<br />
Serum<br />
1 mL<br />
State Date of Birth<br />
● Testing Includes IgG Total, & IgG 1 –<br />
4 ●<br />
TAT – 25 days<br />
YELLOW SST OHIP CML<br />
YELLOW SST OHIP CML<br />
YELLOW SST OHIP CML<br />
IMMUNOGLOBULIN,<br />
QUANTITATIVE<br />
(IMMUNO GAM)<br />
See GAM<br />
IMGLO<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION I Page 2 of 6<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
IMMUNO PHENOTYPING<br />
(LYMPHOCYTE MARKERS)<br />
(T & B CELLS)<br />
CD3<br />
CD4<br />
CD8<br />
Blood<br />
Diagnostic category must be indicated, and<br />
the corresponding tube taken<br />
DIAGNOSIS: HIV<br />
2 LAVENDER<br />
OHIP<br />
CML<br />
DIAGNOSIS:<br />
Leukaemia, Lymphoma, Lymphocytosis,<br />
Melanoma, Chronic Fatigue Syndrome<br />
3 GREEN<br />
with heparin<br />
(For CD19 (B cell marker) put “Attention:<br />
Sunnybrook”)<br />
Collect specimen Monday – Tuesday only<br />
prior to last courier pickup<br />
The specimen must be accompanied by:<br />
A physician signed "Immunophenotyping<br />
Request Form", or a photocopy of a<br />
physician signed OHIP requisition<br />
requesting Lymphocyte Markers analysis<br />
with diagnosis indicated<br />
Specimen MUST be tested within 24 hours<br />
TAT – 10 days<br />
INDERAL<br />
(PROPRANOLOL)<br />
RCML<br />
Serum<br />
3 mL<br />
Collect specimen 10 – 12 after last dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 10 days<br />
ROYAL BLUE<br />
no additive<br />
OHIP<br />
CML<br />
INDICAN<br />
NO LONGER AVAILABLE<br />
INDICES, RBC<br />
(MCV, MCH, MCHC)<br />
See BLOOD FILM<br />
EXAMINATION<br />
CBC<br />
INDIRECT BILIRUBIN<br />
(UNCONJUGATED<br />
BILIRUBIN)<br />
INBL<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
INDIRECT COOMBS<br />
(REPEAT PRENATAL<br />
ANTIBODY SCREEN)<br />
See ANTIBODY SCREEN<br />
ANSCR<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION I Page 3 of 6<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
INFECTIOUS<br />
MONONUCLEOSIS<br />
(MONO)<br />
See HETEROPHILE<br />
ANTIBODY<br />
MONOT<br />
INFLUENZA VIRUS<br />
A & B ANTIBODY<br />
INFLU<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 5 days<br />
YELLOW SST N/C PHL<br />
INHALANT ALLERGENS<br />
NO LONGER AVAILABLE<br />
INORGANIC PHOSPHATE<br />
(PHOSPHPHORUS)<br />
PHOS<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
INR<br />
(PRO TIME, PT)<br />
(PROTHROMBIN TIME)<br />
COA<br />
Blood<br />
Fill tube completely<br />
Do not centrifuge<br />
TAT – 1 day<br />
LIGHT BLUE OHIP BTL<br />
INSULIN<br />
Fasting<br />
Random<br />
INS<br />
Serum<br />
2 mL<br />
Patient must fast a minimum of 14 hours for<br />
fasting test<br />
YELLOW SST OHIP CML<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 4 days<br />
INSULIN ANTIBODIES<br />
See ANTI-INSULIN<br />
RCML<br />
INSULIN-LIKE GROWTH<br />
FACTOR-1<br />
(SOMATOMEDIN-C)<br />
(IGF-1)<br />
SOMA<br />
Serum<br />
2 mL<br />
Separate and divide serum into 2 equal<br />
aliquots (1ml/each tube aliquot)<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 15-30 days<br />
YELLOW SST $80.00 CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION I Page 4 of 6<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
INSULIN-LIKE GROWTH<br />
FACTOR-3<br />
(IGF BINDING PROTEIN 3)<br />
(IGF-BP3)<br />
SOMA<br />
Serum<br />
2 mL<br />
Separate and divide serum into 2 equal<br />
aliquots (1ml/each tube aliquot)<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 15-30 days<br />
YELLOW SST $80.00 CML<br />
INSULIN RESPONSE STUDY<br />
RCML<br />
Serum<br />
2 mL<br />
Patient must fast a minimum of 14 hours for<br />
test<br />
Indicate time samples taken<br />
Label each sample with either<br />
fasting or 2 hour:<br />
YELLOW SST OHIP CML<br />
Fasting<br />
120 min<br />
2 hours<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 4 days<br />
INTEGRATED PRENATAL<br />
SCREENING<br />
(PAPP-A)<br />
See FIRST or SECOND<br />
TRIMESTER SCREENING<br />
IPS1<br />
IPS2<br />
INTERSTITIAL CELL<br />
STIMULATING HORMONE<br />
(LH)<br />
(LUTEINIZING HORMONE)<br />
LH<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
INTRINSIC FACTOR<br />
ANTIBODIES<br />
See<br />
ANTI-INTRINSIC FACTOR<br />
IFA<br />
IODINE<br />
NO LONGER AVAILABLE<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION I Page 5 of 6<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
IRON<br />
(IRON BINDING CAPACITY)<br />
(IRON SATURATION, TIBC)<br />
(TOTAL IRON BINDING<br />
CAPACITY)<br />
IRON<br />
Serum<br />
Centrifuge only<br />
Morning sample preferred<br />
● Testing Includes IRON, TIBC,<br />
% Saturation and unsaturated iron<br />
binding capacity (UIBC)●<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
IRON, URINE<br />
RCML<br />
24 Hour Urine<br />
Collect in an acid–washed container<br />
OHIP<br />
CML<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
State total 24-hour volume on the OHIP<br />
requisition, on the specimen container and<br />
in “Note and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 15 days<br />
ISONIAZID<br />
RCML<br />
Urine<br />
50 mL random urine<br />
Submit in an orange or white cap container<br />
$30.00 CML<br />
Collect 6 hours after ISONIAZID given<br />
FREEZE URINE AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 15 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION I Page 6 of 6<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
JOINT FLUID<br />
(SYNOVIAL FLUID)<br />
See FLUID, TOTAL EXAM<br />
SYNF<br />
ASP<br />
OTHER<br />
RCML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION J Page 1 of 1<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
KARYOTYPING<br />
See<br />
CYTOGENETICS <strong>TEST</strong>ING<br />
RCHEO<br />
KETONES<br />
See ACETONE<br />
KETO<br />
KETONES QUALITATIVE<br />
See<br />
ACETONE QUALITATIVE<br />
RCML<br />
17 KETOGENIC STEROIDS<br />
(17-KGS)<br />
NO LONGER AVAILABLE<br />
17 KETOSTEROIDS, TOTAL<br />
(17-KS)<br />
NO LONGER AVAILABLE<br />
KLEIHAUER STAIN<br />
NEIRHAUS<br />
(KLEIHAUER ACID<br />
ELUTION)<br />
(KLEIHAUER-BETKE <strong>TEST</strong>)<br />
(KB <strong>TEST</strong>)<br />
RCML<br />
Whole Blood<br />
3 mL<br />
TAT – 7 days<br />
LAVENDER OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION K Page 1 of 1<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
LACTIC ACID<br />
(LACTATE)<br />
LAC<br />
Plasma<br />
2 mL<br />
Fasting specimen preferred<br />
GREY OHIP CML<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 10 days<br />
LACTIC DEHYDROGENASE<br />
(LD, LDH)<br />
LDH<br />
Serum<br />
Centrifuge only<br />
Hemolyzed specimens are not acceptable<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
LACTIC DEHYDROGENASE,<br />
ISOENZYMES<br />
(LD ISOENZYMES)<br />
(LDH ISOENZYMES)<br />
NO LONGER AVAILABLE<br />
LACTOSE TOLERANCE<br />
(LACTOSE ABSORPTION<br />
<strong>TEST</strong>)<br />
*2 Codes required<br />
LAC<br />
0.5h<br />
and<br />
LTT3<br />
Plasma<br />
Adult dose 50g lactose dissolved in 300 mL<br />
water<br />
Child Dose: 2 grams lactose per kilogram of<br />
body<br />
Weight to a maximum of 50 g<br />
Collect 5 samples: fasting, ½ h after<br />
finishing drink, then 1h, 2h, 3 hours after<br />
finishing drink<br />
TAT – 1 day<br />
GREY OHIP BTL<br />
LAMOTRIGINE<br />
(LAMICTAL)<br />
LAM<br />
Serum<br />
2 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Anti-epileptic medication<br />
PLAIN RED OHIP CML<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 15 days<br />
LANOXIN<br />
(DIGITALIS)<br />
See DIGOXIN<br />
DIG<br />
LAP<br />
(LEUCINE<br />
AMINOPEPTIDASE)<br />
Serum AND 24 Hour Urine<br />
NO LONGER AVAILABLE<br />
LAP<br />
(LEUKOCYTE ALKALINE<br />
PHOSPHATASE)<br />
(NEUTROPHIL ALKALINE<br />
PHOSPHATASE)<br />
REFER PATIENT TO LOCAL HOSPITAL<br />
TAT – 5 days<br />
OHIP<br />
LARGACTIL<br />
(CHLORPROMAZINE)<br />
CHLOR<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Dena Seeto BSc MLA QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION L Page 1 of 6<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
LATEX FIXATION<br />
(RA, RA FACTOR)<br />
(RA FIXATION)<br />
(RHEUMATOID FACTOR)<br />
ART<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
LATS<br />
(LONG ACTING THYROID<br />
STIMULATOR, TB11)<br />
(THYROTROPIN<br />
BINDING INHIBITING<br />
IMMUNOGLOBULIN)<br />
(THYROID STIMULATING<br />
ANTIBODY)<br />
(THYROID RECEPTOR<br />
ANTIBODIES)<br />
(TRAB-TSH RECEPTOR<br />
ANTIBODIES)<br />
TSA<br />
Serum<br />
Minimum volume required: 2 mL<br />
Separate within 1 hour of collection<br />
FREEZE SERUM AND SEND FROZEN<br />
Requires clinical information re:<br />
Thyroid status, presence of exophthalmos<br />
TAT – 30 days<br />
YELLOW SST $90.00 CML<br />
LCM ANTIBODY<br />
(LYMPHOCYTIC<br />
CHORIOMENINGITIS<br />
ANTIBODY)<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
LDH<br />
(LH) See<br />
LACTIC DEHYDROGENASE<br />
LDH<br />
LDH ISOENZYMES<br />
(LD ISOENZYMES)<br />
NO LONGER AVAILABLE<br />
LDL CHOLESTEROL<br />
See<br />
HDL/LDL CHOLESTEROL<br />
*If patient not fasting<br />
HDL<br />
RHDL<br />
LE CELL PREPARATION LE Blood<br />
Do not remove plasma from cells<br />
TAT – 1 day<br />
GREEN<br />
with heparin<br />
OHIP<br />
CML<br />
LE SCREEN<br />
(LE LATEX)<br />
LESCR<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
<strong>TEST</strong> NOT AVAILABLE TO QUEBEC<br />
INSURED PATIENTS<br />
YELLOW SST OHIP CML<br />
LEAD LED Blood<br />
TAT – 7 days<br />
ROYAL BLUE<br />
with heparin<br />
OHIP<br />
CML<br />
LEAD<br />
24UL<br />
24 Hour Urine<br />
50 mL aliquot submitted in an orange or<br />
white cap container<br />
OHIP<br />
CML<br />
State total 24-hour volume on the OHIP<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Dena Seeto BSc MLA QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION L Page 2 of 6<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
requisition, on the specimen container and<br />
in “Note and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 15 days<br />
LEGIONELLOSIS<br />
(LEGIONAIRES DISEASE)<br />
LEGIN<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
LEPTOSPIRA ANTIBODIES<br />
(LEPTOSPIROSIS<br />
ANTIBODIES)<br />
(WEIL‟S DISEASE)<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
LEPTOSPIROSIS, URINE<br />
NO LONGER AVAILABLE<br />
LEUCINE AMINOPEPTIDASE<br />
(LAP)<br />
Serum and 24 hour urine<br />
NO LONGER AVAILABLE<br />
LEUKOCYTE ALKALINE<br />
PHOSPHATASE<br />
(NEUTROPHIL ALKALINE<br />
PHOSPHATASE)<br />
See LAP<br />
LEUKOCYTE COUNT<br />
(WBC)<br />
See BLOOD FILM<br />
EXAMINATION<br />
CBC<br />
LH<br />
(LUTEINIZING HORMONE)<br />
See INTERSTITIAL CELL<br />
STIMULATING HORMONE<br />
LH<br />
LIBRIUM<br />
See CHLORDIAZEPOXIDE<br />
RCML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Dena Seeto BSc MLA QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION L Page 3 of 6<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
LICE<br />
(BUGS)<br />
See ARTHROPODS<br />
RPHL<br />
LIGHT CHAINS IMMUNO<br />
ELECTROPHORESIS<br />
(HEAVY & LIGHT CHAINS<br />
IMMUNO-<br />
ELECTROPHORESIS)<br />
(IEP-RANDOM)<br />
See<br />
BENCE JONES PROTEIN<br />
BENC<br />
Random urine<br />
LIGHT CHAINS IMMUNO<br />
ELECTROPHORESIS<br />
See HEAVY & LIGHT<br />
CHAINS IMMUNO<br />
ELECTROPHORESIS<br />
IMM<br />
LIPASE<br />
LIPX<br />
Serum<br />
Centrifuge only<br />
TAT – 4 days<br />
* No longer done on a STAT basis at<br />
BTL until further notice.<br />
REVISED new code 11May2010 (QCC)<br />
YELLOW SST OHIP BTL<br />
LIPID PROFILE (Fasting)<br />
LIPIDS, TOTAL (Random)<br />
See<br />
HDL/LDL CHOLESTEROL<br />
HDL<br />
RHDL<br />
LIPOPROTEIN a<br />
(APOLIPOPROTEIN a)<br />
LIPOA<br />
LIPOPROTEIN<br />
PHENOTYPING WITH<br />
ELECTROPHORESIS<br />
NO LONGER AVAILABLE<br />
LISTERIA ANTIBODY<br />
NO LONGER AVAILABLE<br />
LITHIUM<br />
RLI<br />
Serum<br />
Centrifuge only<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
YELLOW SST OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Dena Seeto BSc MLA QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION L Page 4 of 6<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
between last dose and specimen collection<br />
TAT – 1 day<br />
LONG ACTING THYROID<br />
STIMULATOR<br />
(TB11)<br />
(THYROTROPIN BINDING<br />
INHIBITING<br />
IMMUNOGLOBULIN)<br />
(THYROID STIMULATING<br />
ANTIBODY)<br />
(THYROID RECEPTOR<br />
ANTIBODIES)<br />
(TRAB-TSH RECEPTOR<br />
ANTIBODIES)<br />
See LATS<br />
TSA<br />
LORAZEPAM<br />
RCML<br />
Serum<br />
1 Ml<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 15 days<br />
PLAIN RED OHIP CML<br />
LORAZEPAM<br />
RCML<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 15 days<br />
OHIP<br />
CML<br />
L.M.W. Heparin<br />
RCML<br />
Plasma<br />
Minimum Volume required: 1 mL<br />
Separate and freeze immediately<br />
State on requisition type of heparin (drug)<br />
patient is taking<br />
TAT – 15 days<br />
LIGHT BLUE $60.00 CML<br />
LUDIOMIL<br />
(MAPROTILINE)<br />
RCML<br />
Serum<br />
2 mL<br />
Collect specimen 10–12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 15 days<br />
ROYAL BLUE<br />
no additive<br />
OHIP<br />
CML<br />
LUPUS ANTICOAGULANT<br />
(NON SPECIFIC<br />
COAGULATION<br />
INHIBITORS)<br />
See CIRCULATING<br />
ANTICOAGULANT<br />
LUANT<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Dena Seeto BSc MLA QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION L Page 5 of 6<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
LUTEINIZING HORMONE<br />
(LH)<br />
See INTERSTITIAL CELL<br />
STIMULATING HORMONE<br />
LH<br />
LUVOX<br />
See FLUVOXAMINE<br />
LUVOX<br />
LYME DISEASE<br />
(LA-2 ANTIBODIES)<br />
(OSPA ANTIBODIES)<br />
See<br />
BORRELIA BURGDORFERI<br />
LYM<br />
LYMPHOCYTE MARKERS<br />
(T & B CELLS)<br />
See<br />
IMMUNO PHENOTYPING<br />
CD3<br />
CD4<br />
CD8<br />
LYMPHOCYTIC<br />
CHORIOMENINGITIS<br />
ANTIBODY<br />
See LCM ANTIBODY<br />
RPHL<br />
LYMPHOGRANULOMA<br />
VENEREUM GROUP<br />
ANTIBODIES<br />
(LGV)<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
LYSOZYME<br />
(MURAMIDASE)<br />
NO LONGER AVAILABLE<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Dena Seeto BSc MLA QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION L Page 6 of 6<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
MACROAMYLASE<br />
RCML<br />
Serum<br />
1 mL<br />
TAT – 15 days<br />
YELLOW SST $60.00 CML<br />
MACROGLOBULIN, ALPHA 2 RCML Serum<br />
1 mL<br />
TAT – 15 days<br />
YELLOW SST OHIP CML<br />
MAGNESIUM MG Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
MAGNESIUM, RBC<br />
(RBC MAGNESIUM)<br />
RBCM<br />
Blood<br />
TAT – 15 days<br />
GREEN<br />
with heparin<br />
$30.00 CML<br />
MAGNESIUM<br />
24UMG<br />
24 Hour Urine<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
No preservative<br />
State total 24-hour volume on the OHIP<br />
requisition, on the specimen container and<br />
in “Note and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 15 days<br />
OHIP<br />
CML<br />
MAI<br />
(MYCOBACTERIUM AVIUM<br />
INTRACELLULAR)<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
GREEN<br />
with heparin<br />
N/C<br />
PHL<br />
MAI<br />
(MYCOBACTERIUM AVIUM<br />
INTRACELLULAR)<br />
RPHL<br />
Stool<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
N/C<br />
PHL<br />
MALARIA<br />
MALAR<br />
Whole Blood<br />
If test is ordered on a child, may substitute<br />
finger prick blood<br />
Prepare 4 thin smears and 4 thick smears<br />
TAT – 1 day<br />
LAVENDER OHIP BTL<br />
MALARIA PCR<br />
MALAR<br />
Whole Blood<br />
Done on microscopically negative samples<br />
but clinical history and symptoms strongly<br />
suggest malaria or following consult with<br />
Medical Microbiologist of Parasitology<br />
TAT – 1 day<br />
LAVENDER OHIP PHL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION M Page 1 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
MALARIA GENOTYPING<br />
MALAR<br />
Whole Blood<br />
DNA sequencing method for drug resistant<br />
markers of P. falciparum<br />
Only performed after consult with Medical<br />
Microbiologist of Parasitology<br />
TAT – 2 days<br />
LAVENDER OHIP PHL<br />
MANGANESE RCML Plasma<br />
3 mL<br />
TAT – 15 days<br />
MANGANESE<br />
MAPROTILINE<br />
(LUDIOMIL)<br />
RCML<br />
RCML<br />
Urine<br />
25 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 15 days<br />
Serum<br />
2 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 10 to 15 days<br />
ROYAL BLUE<br />
no additive<br />
ROYAL BLUE<br />
no additive<br />
$60.00 CML<br />
$60.00 CML<br />
OHIP CML<br />
MARFAN SYNDROME<br />
See<br />
MOLECULAR GENETICS (I)<br />
RCHEO<br />
MARIJUANA<br />
(TETRAHYDRO<br />
CANNOBINOIDS, THC)<br />
(CANNABINOIDS SCREEN)<br />
See CANNABIS<br />
MATERNAL CELL<br />
CONTAMINATION STUDIES<br />
See<br />
MOLECULAR GENETICS (I)<br />
MATERNAL SERUM SCREEN<br />
(MSS)<br />
See DOWN’S SYNDROME<br />
UCB<br />
RCHEO<br />
MSS<br />
MCAD<br />
See<br />
MOLECULAR GENETICS (I)<br />
RCHEO<br />
MCV, MCH, MCHC<br />
(INDICES, RBC)<br />
See BLOOD FILM<br />
EXAMINATION<br />
CBC<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION M Page 2 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
MEASLES – RED<br />
(RUBEOLA)<br />
MEAS<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 25 days<br />
PLAIN RED N/C PHL<br />
MELANIN<br />
RCML<br />
Urine<br />
50 mL fresh random urine<br />
Submit in an orange or white cap container<br />
Send immediately<br />
Process as Urgent due to instability of test<br />
TAT – 10 days<br />
OHIP<br />
CML<br />
MELLARIL<br />
(THIORIDAZINE)<br />
RCML<br />
Serum<br />
3 mL<br />
TAT – 10 days<br />
YELLOW SST OHIP CML<br />
MENINGOCOCCAL<br />
ANTIBODY<br />
NO LONGER AVAILABLE<br />
MEPROBAMATE<br />
(MILTOWN)<br />
See EQUANIL<br />
RCML<br />
MEPROBAMATE<br />
RCML<br />
Urine<br />
50 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 10 days<br />
OHIP<br />
CML<br />
MERCURY MERC Blood<br />
TAT – 15 days<br />
* For Quebec patients, collect 7 ml of<br />
whole blood in a GREEN top (heparin)<br />
tube. TAT is 10 days (Montfort<br />
Hospital). Fee: $14.50<br />
REVISED 25 June 2008 (mjh)<br />
MERCURY<br />
RCML<br />
24 Hour Urine<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
Collect in an acid–washed plastic container<br />
State total 24-hour volume on the OHIP<br />
requisition, on the specimen container and<br />
in “Note and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 15 days<br />
ROYAL BLUE OHIP CML<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION M Page 3 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
METABOLIC SCREEN<br />
(Urine Metabolites)<br />
METAB<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
State Date of Birth and clinical diagnosis<br />
FREEZE URINE AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT –30 days<br />
$60.00 CML<br />
METANEPHRINES,<br />
FRACTIONATED and TOTAL<br />
(NORMETANEPHRINE)<br />
24MET<br />
24 Hour Urine<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
Preserve aliquot with 1 mL of 6N HCL<br />
State total 24 hour volume on the OHIP<br />
requisition, on the specimen container and<br />
in “Note and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT –15 to 25 days<br />
OHIP<br />
CML<br />
METHADONE<br />
RCML<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 3 days<br />
OHIP<br />
CML<br />
METHEMALBUMIN<br />
RCML<br />
Whole Blood – Do not separate<br />
5 ml<br />
Hemolyzed specimens are not acceptable<br />
TAT – 10 days<br />
LAVENDER OHIP CML<br />
METHEMOGLOBIN<br />
By appointment only at local hospital<br />
METHOBARBITAL<br />
RCML<br />
Serum<br />
2 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 5 days<br />
PLAIN RED OHIP CML<br />
METHOTREXATE<br />
(AMETHOPTERIN)<br />
RCML<br />
Serum<br />
2 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 10 days<br />
PLAIN RED OHIP CML<br />
METHOTRIMEPRAMINE<br />
(NOZINAN)<br />
METHO<br />
Serum<br />
3 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 15 days<br />
PLAIN RED OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION M Page 4 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
METHYLMALONIC ACID<br />
RCML<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
Indicate Date of Birth and clinical diagnosis<br />
$105.00 CML<br />
FREEZE URINE AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 20 days<br />
METHYLPHENIDATE<br />
(RITALIN)<br />
RCML<br />
Urine<br />
25 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 15 days<br />
OHIP<br />
CML<br />
METHYPRYLON<br />
RCML<br />
Plasma<br />
5 mL<br />
Elasticise the 2 pour off tubes together<br />
TAT – 10 days<br />
2 GREEN<br />
with heparin<br />
OHIP<br />
CML<br />
METHSUXIMIDE<br />
(CELONTIN)<br />
RCML<br />
Serum<br />
2 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 15 days<br />
GREEN<br />
with heparin<br />
OHIP<br />
CML<br />
MEXILITETINE<br />
RCML<br />
Serum<br />
2 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 15 days<br />
GREEN<br />
with heparin<br />
$40.00 CML<br />
MICROALBUMIN<br />
See ALBUMIN,<br />
QUANTITATIVE URINE<br />
24UA<br />
MICROALBUMIN<br />
See ALBUMIN,<br />
QUANTITATIVE URINE<br />
MALBU<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION M Page 5 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
MICROALBUMIN/<br />
CREATININE RATIO<br />
RCML<br />
24 Hour Urine<br />
2-10 mL aliquots – submit in an orange or<br />
white cap container<br />
Label 1 st tube – CREATININE and<br />
Label 2 nd tube– MICROALBUMIN RATIO<br />
No preservative<br />
OHIP<br />
CML<br />
State total 24-hour volume on the OHIP<br />
requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 90 mL urine sample in<br />
the fridge until test is reported<br />
TAT –3 days<br />
MICROALBUMIN/<br />
CREATININE RATIO<br />
MACR<br />
Random Urine<br />
2-10 mL aliquots – submit in an orange or<br />
white cap container<br />
OHIP<br />
CML<br />
Label 1 st tube – CREATININE and<br />
Label 2 nd tube– MICROALBUMIN RATIO<br />
No preservative<br />
Submit a separate sample for other urine<br />
tests<br />
TAT –3 days<br />
MICROGLOBULIN<br />
(BETA 2 MICROGLOBULIN)<br />
See B2 MICROGLOBULIN<br />
B2MIC<br />
Serum<br />
MICROGLOBULIN<br />
(BETA 2 MICROGLOBULIN)<br />
See B2 MICROGLOBULIN<br />
B2MIC<br />
Urine random<br />
MICROSOMAL THYROID<br />
ANTIBODIES<br />
(ATA, ATMA)<br />
(ANTI-THYROID<br />
ANTIBODIES)<br />
(MICROSOMAL<br />
ANTIBODIES)<br />
(ANTI-THYROID<br />
MICROSOMAL ANTIBODIES)<br />
(THYROGLOBULIN<br />
ANTIBODIES)<br />
(THYROID ANTIBODIES)<br />
See ANTI–MICROSOMAL<br />
ANTIBODIES<br />
MSA<br />
Or<br />
ATA<br />
MILONTIN<br />
(PHENSUXIMIDE)<br />
RCML<br />
Serum<br />
3 mL<br />
TAT – 10 days<br />
YELLOW SST OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION M Page 6 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
MILTOWN<br />
(MEPROBAMATE)<br />
See EQUANIL<br />
RCML<br />
MISCELLANEOUS BLOOD<br />
GROUPS<br />
- Excluding Kell, Duffy<br />
BGCON<br />
Blood<br />
DO NOT SEPARATE<br />
TAT – 2 days<br />
LAVENDER OHIP CML<br />
MITOCHONDRIAL<br />
ANTIBODIES<br />
(ANTI-SMOOTH MUSCLE<br />
ANTIBODY, ASMA, SMA)<br />
(SMOOTH MUSCLE<br />
ANTIBODY)<br />
See<br />
ANTI-MITOCHONDRIAL<br />
ANTIBODIES<br />
MIT<br />
MOGADON<br />
(NITRAZEPAM)<br />
RCML<br />
Serum<br />
3 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 10 days<br />
ROYAL BLUE<br />
no additive<br />
OHIP<br />
CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION M Page 7 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
MOLECULAR GENETICS (I)<br />
<strong>TEST</strong>ING:<br />
Angelman Syndrome<br />
Cystic Fibrosis *<br />
Cystinosis *<br />
Fragile X<br />
Hereditary Non-Syndromic<br />
Deafness *<br />
MCAD<br />
Marfan Syndrome<br />
Maternal Cell Contamination<br />
Studies<br />
Myotopic Dystrophy TypeI *<br />
Ocularpharyngeal Muscular<br />
Dystrophy<br />
PKD autosomal dominant<br />
Pompe Disease<br />
Prader-Willi Syndrome<br />
X-inactivation<br />
RCHEO<br />
Whole Blood<br />
Adults & children > 1yr. = 10 ml blood<br />
Newborns & infants = 3 ml minimum<br />
(If sample < 3ml then use 3ml EDTA tube)<br />
Label all tubes with minimum 2 patient<br />
identifiers<br />
Submit Monday to Thursday before 4pm or<br />
Friday before 12 noon for best results<br />
DO NOT FREEZE OR REFRIGERATE<br />
Pre-package sample(s) with completed<br />
Molecular Genetics Form and a copy of the<br />
OHIP requisition in a separate brown paper<br />
bag<br />
When possible, have Courier deliver<br />
sample(s) at Room Temp ASAP directly to<br />
the hospital on the same day of collection<br />
LAVENDER OHIP CHEO<br />
* = MUST specify ethnic<br />
background<br />
Address envelope:<br />
CHEO<br />
Attention:<br />
Molecular Genetics Lab<br />
Max Keeping Wing<br />
Room W3403<br />
***Covered for Ontario patients ONLY,<br />
all others must pay $120.00***<br />
TAT - 60-90 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION M Page 8 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
MOLECULAR GENETICS (II)<br />
<strong>TEST</strong>ING:<br />
Thrombophilia<br />
Wagner Syndrome<br />
Hereditary Hemochromatosis<br />
RCHEO<br />
Whole Blood<br />
Adults & children > 1yr. = 5 ml blood<br />
Newborns & infants = 3 ml minimum<br />
(If sample < 3ml then use 3ml EDTA tube)<br />
Label all tubes with minimum 2 patient<br />
identifiers<br />
LAVENDER OHIP CHEO<br />
Submit Monday to Thursday before 4pm or<br />
Friday before 12 noon for best results<br />
DO NOT FREEZE OR REFRIGERATE<br />
Pre-package sample(s) with completed<br />
Molecular Genetics Form and a copy of the<br />
OHIP requisition in a separate brown paper<br />
bag<br />
When possible, have Courier deliver<br />
sample(s) at Room Temp ASAP directly to<br />
the hospital on the same day of collection<br />
Address envelope:<br />
CHEO<br />
Attention:<br />
Molecular Genetics Lab<br />
Max Keeping Wing<br />
Room W3403<br />
***Covered for Ontario patients ONLY,<br />
all others must pay $120.00***<br />
TAT - 60-90 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION M Page 9 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
MOLECULAR GENETICS (III)<br />
<strong>TEST</strong>ING:<br />
Myotonic Dystrophy Type II<br />
Charcot Marie Tooth<br />
(CMT1A)<br />
Spinal Muscular Atrophy<br />
Hereditary Neuropathy with<br />
Liability to Pressure Palsies<br />
(HNPP)<br />
Facioscapulohumeral<br />
Muscular Dystrophy<br />
(FSHMD)<br />
Rett Syndrome *<br />
* = All specimens require<br />
completed requisitions for DNA<br />
testing for each family member<br />
being tested<br />
RCHEO<br />
Whole Blood<br />
Adults & children > 1yr. = 15 ml blood<br />
Newborns & infants = 3 ml minimum<br />
(If sample < 3ml then use 3ml EDTA tube)<br />
Label all tubes with minimum 2 patient<br />
identifiers<br />
Submit Monday to Thursday before 4pm or<br />
Friday before 12 noon for best results<br />
DO NOT FREEZE OR REFRIGERATE<br />
Pre-package sample(s) with completed<br />
Molecular Genetics Form and a copy of the<br />
OHIP requisition in a separate brown paper<br />
bag<br />
When possible, have Courier deliver<br />
sample(s) at Room Temp ASAP directly to<br />
the hospital on the same day of collection<br />
LAVENDER OHIP CHEO<br />
Address envelope:<br />
CHEO<br />
Attention:<br />
Molecular Genetics Lab<br />
Max Keeping Wing<br />
Room W3403<br />
***Covered for Ontario patients ONLY,<br />
all others must pay $120.00***<br />
TAT - 60-90 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION M Page 10 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
MOLECULAR GENETICS (IV)<br />
<strong>TEST</strong>ING:<br />
Fetal RhD *<br />
Fetal Kell *<br />
Fetal Platelet Antigen<br />
(PLA)*<br />
RCHEO<br />
Whole Blood<br />
Adults & children > 1yr. = 5 ml blood<br />
Newborns & infants = 3 ml minimum<br />
(If sample < 3ml then use 3ml EDTA tube)<br />
Label all tubes with minimum 2 patient<br />
identifiers<br />
LAVENDER OHIP CHEO<br />
* = parental bloods required<br />
Submit Monday to Thursday before 4pm or<br />
Friday before 12 noon for best results<br />
DO NOT FREEZE OR REFRIGERATE<br />
Pre-package sample(s) with completed<br />
Molecular Genetics Form and a copy of the<br />
OHIP requisition in a separate brown paper<br />
bag<br />
When possible, have Courier deliver<br />
sample(s) at Room Temp ASAP directly to<br />
the hospital on the same day of collection<br />
Address envelope:<br />
CHEO<br />
Attention:<br />
Molecular Genetics Lab<br />
Max Keeping Wing<br />
Room W3403<br />
***Covered for Ontario patients ONLY,<br />
all others must pay $120.00***<br />
TAT - 60-90 days<br />
MONOCLONAL PROTEIN<br />
(SPE)<br />
See PROTEIN<br />
ELECTROPHORESIS<br />
SPE<br />
MONONUCLEOSIS SCREEN<br />
(MONO)<br />
(INFECTIOUS<br />
MONONUCLEOSIS)<br />
See<br />
HETEROPHILE ANTIBODY<br />
MONOT<br />
MORPHINE<br />
See DRUG SCREEN<br />
BROAD SPECTRUM<br />
UDS<br />
State under notes and instructions<br />
“CHECK FOR MORPHINE”<br />
MOTRIN<br />
See IBUPROFEN<br />
IBU<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION M Page 11 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
MRSA SCREEN <strong>TEST</strong><br />
AXILLA<br />
GROIN<br />
NASAL<br />
RECTAL<br />
Nmrsa<br />
remrsa<br />
Swab- state source<br />
Place swab in charcoal transport media<br />
*REFER TO DATA ENTRY CODE<br />
SHEET FOR SPEICIFICS<br />
TAT – 2 days<br />
OHIP<br />
BTL<br />
MSS<br />
(MATERNAL SERUM<br />
SCREEN)<br />
See DOWN’S SYNDROME<br />
MSS<br />
MUCONIC ACID<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
MUCOPOLYSACCHARIDES<br />
RCML<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
Avoid first morning collection<br />
OHIP<br />
CML<br />
FREEZE URINE AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 25 days<br />
MULTIMER - VWF<br />
RCML<br />
Plasma<br />
2 Ml<br />
Specimen MUST be kept cold at all times<br />
Immediately centrifuge and aliquot plasma<br />
LIGHT BLUE $60.00 CML<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 20 days<br />
MUMPS ANTIBODY MUM Do not centrifuge tube<br />
TAT – 5 days<br />
PLAIN RED N/C CHEO<br />
MURAMIDASE<br />
(LYSOZYME)<br />
NO LONGER AVAILABLE<br />
MYCOBACTERIUM AVIUM<br />
INTRACELLULAR<br />
See MAI<br />
RPHL<br />
plasma<br />
MYCOBACTERIUM AVIUM<br />
INTRACELLULAR<br />
See MAI<br />
RPHL<br />
stool<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION M Page 12 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
MYCOPLASMA ANTIBODIES<br />
MYC<br />
Do not centrifuge tube<br />
PHL recommends acute and convalescent<br />
samples be collected 2 weeks apart<br />
PLAIN RED N/C PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
MYCOPLASMA CULTURE<br />
(RESPIRATORY CULTURE)<br />
MYC<br />
Swab – State source<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
N/C<br />
PHL<br />
MYCOPLASMA ISOLATION<br />
(UREAPLASMA)<br />
MYC<br />
Swab/Urine/Fluid/Tissue/Semen<br />
Swab from vagina, cervix or urethra,<br />
sediment from centrifuged random urine or<br />
other fluid, or tissue in special transport<br />
media<br />
OHIP<br />
CML<br />
Do not use swabs with wooden shaft<br />
Send Monday, Tuesday, Wednesday only<br />
FREEZE FLUIDS AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 30 days<br />
MYOTOPIC DYSTROPHY<br />
TYPE I<br />
(DM1)<br />
See<br />
MOLECULAR GENETICS (I)<br />
RCHEO<br />
MYOTOPIC DYSTROPHY<br />
TYPE II<br />
(DM2)<br />
See MOLECULAR<br />
GENETICS (III)<br />
RCHEO<br />
MYOGLOBIN<br />
RCML<br />
Urine<br />
25 mL random urine<br />
Submit in an orange or white cap container<br />
First morning sample or following exercise<br />
TAT – 10 days<br />
OHIP<br />
CML<br />
MYSIAL ANTIBODIES<br />
See ANTI-ENDOMYSIAL<br />
ANTIBODY<br />
ANTEN<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION M Page 13 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
MYSOLINE<br />
(PRIMIDONE)<br />
MYS<br />
Serum<br />
Centrifuge only<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 5 days<br />
PLAIN RED OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION M Page 14 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
NAPROXENE<br />
RCML<br />
Serum<br />
2 mL<br />
Collect specimen 10 – 12 hours after the<br />
last dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 15 days<br />
PLAIN RED $60.00 CML<br />
NARCOTIC SCREEN<br />
(DRUG OF ABUSE)<br />
(STREET DRUGS)<br />
(URINE TOXICOLOGY)<br />
See DRUGS SCREEN<br />
UDSC<br />
NEIRHAUS<br />
(KLEIHAUER ACID<br />
ELUTION)<br />
(KLEIHAUER-BETKE <strong>TEST</strong>)<br />
(KB <strong>TEST</strong>)<br />
See KLEIHAUER STAIN<br />
RCML<br />
NEISSERIA GONORRHOEAE<br />
(GC, GONOCOCCUS)<br />
See CHLAMYDIA/GC<br />
GAB<br />
NEURONTIN<br />
See GABAPENTIN<br />
GAB<br />
NEUTROPHIL ALKALINE<br />
PHOSPHATASE<br />
(LEUKOCYTE ALKALINE<br />
PHOSPHATASE)<br />
See LAP<br />
Refer patient to local hospital<br />
NH3<br />
(NH4)<br />
See AMMONIA<br />
RCML<br />
NICKEL RCML Blood<br />
TAT – 30 days<br />
ROYAL BLUE<br />
with heparin<br />
$60.00 CML<br />
NICKEL<br />
RCML<br />
Urine<br />
50 mL random urine<br />
Submit in a 90 mL orange cap container<br />
TAT – 30 days<br />
$60.00 CML<br />
NICOTINE<br />
RCML<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 5 days<br />
$60.00 CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION N Page 1 of 2<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
NITRAZEPAM<br />
See MOGADON<br />
RCML<br />
NITROGEN<br />
RCML<br />
24 Hour Urine<br />
20 mL aliquot – submit in an orange or<br />
white cap container<br />
No preservative<br />
OHIP<br />
CML<br />
State total 24-hour volume on the OHIP<br />
requisition, on the specimen container and<br />
in “Note and Instructions”<br />
Retain a duplicate 90 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 20 days<br />
NON–SPECIFIC<br />
COAGULATION INHIBITORS<br />
(LUPUS ANTICOAGULANT)<br />
See CIRCULATING<br />
ANTICOAGULANT<br />
LUANT<br />
NOREPINEPHRINE<br />
See CATECHOLAMINES,<br />
FRACTIONATED<br />
24CAT<br />
NORMETANEPHRINE<br />
See METANEPHRINES,<br />
FRACTIONATED and<br />
TOTAL<br />
24MET<br />
NORPACE<br />
See DISOPYRAMIDE<br />
RCML<br />
NORPRAMINE<br />
See DESIPRAMINE<br />
DESIP<br />
NORTRIPTYLINE<br />
See AVENTYL<br />
NOR<br />
NOZINAN<br />
See<br />
METHOTRIMEPRAMINE<br />
METHO<br />
NUCLEOTIDASE<br />
(5‟ NUCLEOTIDASE) <strong>TEST</strong> NO LONGER AVAILABLE<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION N Page 2 of 2<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
17-OH STEROIDS<br />
See 17-HYDROXY<br />
CORTICOSTEROIDS<br />
24OH<br />
17-OH PROGESTERONE<br />
(PREGNANETRIOL)<br />
See 17-HYDROXY<br />
PROGESTERONE<br />
17HP<br />
OCCULT BLOOD<br />
OB1<br />
Stool<br />
Random specimen<br />
Instructions for the patient are in the kit<br />
Use code OB2 if two specimens<br />
Use code OB3 if three specimens<br />
TAT – 1 day<br />
OHIP<br />
BTL<br />
OCULOPHARYNGEAL<br />
MUSCULAR DYSTROPHY<br />
(OPMD)<br />
See<br />
MOLECULAR GENETICS (I)<br />
RCHEO<br />
OLIGOSACCHARIDES<br />
OLIGO<br />
Urine<br />
Submit in an orange or white cap container<br />
Avoid first morning collection<br />
$60.00 CML<br />
FREEZE URINE AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 25 days<br />
OLANZAPINE<br />
(ZYPREXA)<br />
OLAN<br />
ZA<br />
Serum<br />
1 ml<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 15 Days<br />
ROYAL BLUE<br />
no additive<br />
$60.00 CML<br />
OLANZAPINE<br />
(ZYPREXA)<br />
OLAN<br />
ZAU<br />
Urine<br />
5 mL random<br />
Submit in an orange or white cap container<br />
TAT – 15 Days<br />
$60.00 CML<br />
OPIATES<br />
See DRUG SCREEN<br />
UDSC<br />
OPSA<br />
See PROSTATE SPECIFIC<br />
ANTIGEN, TOTAL-DISEASE<br />
STATE<br />
OPSA<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION O Page 1 of 3<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ORGANIC ACIDS<br />
RCML<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
State age of patient and clinical diagnosis<br />
OHIP<br />
CML<br />
FREEZE URINE AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 25 days<br />
OSMOLALITY SOS Serum<br />
Centrifuge only<br />
TAT – 10 days<br />
OSMOLALITY<br />
UOS<br />
Urine<br />
This code can be used for either a random<br />
or a 24 hour urine<br />
Submit in an orange or white cap container<br />
Retain a duplicate sample in the fridge until<br />
the test is reported if the specimen is a 24<br />
hour sample<br />
TAT – 10 days<br />
YELLOW SST OHIP CML<br />
OHIP<br />
CML<br />
OSMOTIC FRAGILITY<br />
Blood<br />
Refer patient to a hospital laboratory due to<br />
time constraints of testing requirements<br />
OSTEOCALCIN<br />
OSTEO<br />
Serum<br />
2 mL<br />
YELLOW SST $60.00 CML<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 20 days<br />
OV 125<br />
See CA 125<br />
CA125<br />
OVA AND PARASITES<br />
(O&P)<br />
OVP1<br />
Stool<br />
Place approximately 1 tablespoon of stool<br />
in preservative<br />
OHIP<br />
CML<br />
Use test code OVP2 if two specimens<br />
received<br />
Use test code OVP3 if three specimens<br />
received<br />
TAT – 5 days<br />
OVARIAN ANTIBODIES<br />
OVA<br />
AB<br />
Serum<br />
1 mL<br />
TAT – 15 days<br />
YELLOW SST $60.00 CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION O Page 2 of 3<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
OXALATE<br />
24OXA<br />
24 Hour Urine<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
Preserve aliquot with 0.5 mL of 6N<br />
Hydrochloric Acid<br />
OHIP<br />
CML<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 15 days<br />
OXAZEPAM<br />
(SERAX)<br />
RCML<br />
Serum<br />
3 mL<br />
TAT – 15 days<br />
PLAIN RED OHIP CML<br />
OXYCODONE<br />
OXYCO<br />
DON<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 5 days<br />
$60.00 CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION O Page 3 of 3<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
P– 24, HIV<br />
(HIV SEROLOGY)<br />
See AIDS<br />
HIV<br />
PAPP-A<br />
(INTEGRATED PRENATAL<br />
SCREENING)<br />
See FIRST or SECOND<br />
TRIMESTER SCREENING<br />
IPS1<br />
PAP SMEAR<br />
GYN<br />
Slide<br />
The physician must print patient's name on<br />
the slide with a pencil<br />
OHIP<br />
BTL<br />
Apply cervico– vaginal (combined) smear<br />
to glass slide<br />
Fix immediately with cytospray<br />
Complete a Cytology Form<br />
Clinical data requested on requisition must<br />
be provided<br />
Various kits are available<br />
TAT – 1-3 days<br />
PAP SMEAR,<br />
MONOLAYER/THINLAYER<br />
GYN<br />
30 mL M/L container<br />
State source of specimen: cervical, vaginal,<br />
endocervical, combined<br />
OHIP<br />
BTL<br />
Ensure the head of the collection instrument<br />
(broom) is in the vial<br />
Ensure the lid of the vial is screwed on<br />
tightly to avoid leakage or loss of the<br />
material<br />
The physician must print the patient‟s name<br />
on the container<br />
Complete a Bio-Test (Blue and White)<br />
Cytology Form with all required<br />
information fields completed<br />
TAT – 1-3 days<br />
PARAINFLUENZA VIRUS<br />
ANTIBODIES<br />
INFLU<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH procedure regarding specimen<br />
processing and transportation<br />
TAT – 5 days<br />
PLAIN RED N/C PHL<br />
PARIETAL CELL<br />
ANTIBODIES<br />
PARAB<br />
Serum<br />
2 mL<br />
TAT – 15 days<br />
YELLOW SST OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION P Page 1 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
PARASITE SEROLOGY <strong>TEST</strong><br />
Information regarding requests for specific<br />
tests available through Reference Lab<br />
Consultants<br />
PARATHYROID HORMONE<br />
(PTH)<br />
PTH<br />
Serum<br />
3 mL<br />
Separate within 30 minutes<br />
PLAIN RED OHIP CML<br />
Specimen collected in a SST tube is not<br />
acceptable<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 5 days<br />
PAROXETINE<br />
(PAXIL)<br />
PAROX<br />
Plasma<br />
2 mL<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 15 days<br />
GREEN<br />
with heparin<br />
$60.00 CML<br />
PARTIAL<br />
THROMBOPLASTIN TIME<br />
(PTT)<br />
PTT<br />
Plasma<br />
Fill tube completely – Centrifuge<br />
If unexpected delay in transport to lab<br />
overnight then FREEZE PLASMA &<br />
SEND FROZEN next day<br />
LIGHT BLUE OHIP BTL<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 1 day<br />
PARVO VIRUS<br />
(FIFTH DISEASE)<br />
(PARVO VIRUS B19)<br />
See<br />
ERYTHEMA INFECTIOSUM<br />
PARVO<br />
PASTEURELLA TULARENSIS<br />
ANTIBODY<br />
(TULAREMIA)<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH procedure regarding specimen<br />
processing and transportation<br />
TAT – 25 days<br />
PLAIN RED N/C PHL<br />
PATERNITY <strong>TEST</strong>ING<br />
NO LONGER AVAILABLE<br />
*Consult Reporting Department for<br />
alternative laboratory locations<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION P Page 2 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
PATHOLOGY<br />
(HISTOLOGY)<br />
HISTO<br />
PAXIL<br />
See PAROXETINE<br />
PAROX<br />
PBG<br />
(PORPHOBILINOGEN<br />
SCREEN)<br />
RCML<br />
Urine<br />
25 mL random urine<br />
Submit in an amber light protection<br />
container<br />
Protect from light by wrapping with<br />
aluminium foil or transfer urine into an<br />
amber coloured transport tube<br />
TAT – 15 days<br />
OHIP<br />
CML<br />
PCP<br />
(PHENCYCLIDINE)<br />
UPC<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white top container<br />
OHIP<br />
CML<br />
Indicate in Notes and Instructions “CHECK<br />
FOR PHENCYCLIDINE”<br />
TAT – 3 days<br />
PEMPHIGUS/PEMPHIGOID<br />
ANTIBODIES<br />
(EPIDERMAL ANTIBODIES)<br />
See<br />
ANTI-SKIN ANTIBODIES<br />
RCML<br />
PENTOBARBITAL<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
PHADIATOP<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
PHENCYCLIDINE<br />
See PCP<br />
UPC<br />
PHENOBARBITAL<br />
PHENO<br />
Serum<br />
Centrifuge only<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 1 day<br />
PLAIN RED OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION P Page 3 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
PHENOL<br />
(BENZENE)<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
PHENOTHIAZINES,<br />
QUALITATIVE<br />
PHT<br />
Urine<br />
25 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 15 days<br />
OHIP<br />
CML<br />
PHENYLALANINE<br />
PHALA<br />
Plasma<br />
1 mL<br />
Fasting specimen<br />
State patient age and clinical diagnosis<br />
TAT – 15 to 25 days<br />
PLAIN RED OHIP CML<br />
PHENYTOIN<br />
See DILANTIN<br />
DIL<br />
PHOSPHATASE ACID,<br />
PROSTATIC<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
PHOSPHATASE ACID,<br />
TOTAL<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
PHOSPHATASE ALKALINE<br />
See<br />
ALKALINE PHOSPHATASE<br />
ALK<br />
PHOSPHATASE ALKALINE<br />
ISOENZYME<br />
(ALKALINE PHOSPHATASE<br />
FRACTIONATION)<br />
See<br />
ALKALINE PHOSPHATASE<br />
ISOENZYME<br />
API<br />
PHOSPHOLIPIDS<br />
PHLIP<br />
Serum<br />
1 mL<br />
Patient must be fasting a minimum of 14<br />
hours<br />
TAT – 7 days<br />
YELLOW SST OHIP CML<br />
PHOSPHORUS<br />
(INORGANIC PHOSPHATE)<br />
PHOS<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION P Page 4 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
PHOSPHORUS<br />
24UPH<br />
24 Hour Urine<br />
10 mL aliquot – submit in an orange or<br />
white cap container<br />
No preservative<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 90 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 2 days<br />
OHIP<br />
CML<br />
PHYTANIC ACID<br />
PHY<br />
TANIC<br />
Plasma<br />
2 mL<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 25 days<br />
GREEN<br />
with heparin<br />
$60.00 CML<br />
PINWORM EXAMINATION<br />
(ENTEROBIUS<br />
VERMICULARIS)<br />
RPW<br />
Paddle – State Source<br />
Obtain specimen from perianal area<br />
Recommend specimen be obtained early<br />
morning prior to washing due to night time<br />
migration of pinworm<br />
TAT – 2 day<br />
OHIP<br />
CML<br />
PK SCREEN<br />
(PYRUVATE KINASE)<br />
PYRUV<br />
Blood<br />
Store and send refrigerated<br />
Blood transfusion within the last 3 months<br />
will invalidate test results<br />
TAT – 25 days<br />
LAVENDER OHIP CML<br />
PKD AUTOSOMAL<br />
DOMINANT<br />
See<br />
MOLECULAR GENETICS (I)<br />
RCHEO<br />
PKU<br />
(PHENYLKETONURIA)<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
Refer patient to hospital<br />
PLACIDYL<br />
See ETHCHLORVYNOL<br />
RCML<br />
PLASMA HEMOGLOBIN<br />
See FREE HEMOGLOBIN<br />
RCML<br />
PLASMINOGEN<br />
RCML<br />
Plasma<br />
1 mL<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 10 days<br />
LIGHT BLUE OHIP CML<br />
PLATELET COUNT<br />
(THROMBOCYTE COUNT)<br />
See BLOOD FILM<br />
CBC<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION P Page 5 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
EXAMINATION<br />
PLATELET COUNT, CITRATE<br />
SAMPLE<br />
See BLOOD FILM<br />
EXAMINATION<br />
CBC<br />
Plasma<br />
Label both samples– platelet count<br />
Elasticize the two tubes together for<br />
transport<br />
TAT – 1 day<br />
LIGHT BLUE &<br />
LAVENDER<br />
OHIP<br />
BTL<br />
PLATELET ASSOCIATED<br />
ANTIBODIES<br />
(PLATELET ASSOCIATED<br />
IGG)<br />
See<br />
ANTI-PLATELET<br />
ANTIBODY<br />
PLANT<br />
PLATELET FUNCTION <strong>TEST</strong><br />
BY HOSPITAL APPOINTMENT ONLY<br />
POLIOMYELITIS VIRUS<br />
POLIO<br />
Stool/ Throat Swab/ Rectal Swab<br />
Viral history sheet must be completed<br />
Stool is the preferred sample<br />
N/C<br />
PHL<br />
Use the correct transport media<br />
Stool – VIRUS – TM<br />
Throat Swab – VIRUS – SW<br />
Rectal Swab – VIRUS – SW<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 to 30 days<br />
POMPE DISEASE<br />
See<br />
MOLECULAR GENETICS (I)<br />
RCHEO<br />
PORPHOBILINOGEN<br />
See PBG<br />
RCML<br />
PORPHYRINS, BLOOD<br />
(PORPHYRINS RBC)<br />
(PROTOPORPHYRINS)<br />
PORBL<br />
PORPB<br />
Blood<br />
Do not separate<br />
Protect from light by wrapping vacutainer<br />
tube in aluminium foil<br />
TAT – 15 days<br />
LAVENDER OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION P Page 6 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
PORPHYRINS,<br />
QUALITATIVE<br />
PORST<br />
PORPS<br />
Stool<br />
50 g (app. ½ tablespoon) random stool<br />
specimen<br />
Protect from light by wrapping with<br />
aluminium foil<br />
OHIP<br />
CML<br />
FREEZE STOOL AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 25 days<br />
PORPHYRINS,<br />
QUANTITATIVE<br />
RCML<br />
Stool<br />
50 g (app. ½ tablespoon) random stool<br />
specimen<br />
Protect from light by wrapping with<br />
aluminium foil<br />
OHIP<br />
CML<br />
Note: Quantitation performed only if<br />
qualitative screen is positive<br />
FREEZE STOOL AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 25 days<br />
PORPHYRINS,<br />
QUANTITATIVE<br />
(UROPORPHYRINS)<br />
See COPROPORPHYRINS<br />
RCML<br />
PORPHYRINS SCREEN<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
POST VAS<br />
(SEMEN ANALYSIS, POST<br />
VASECTOMY)<br />
(SEMEN POST VAS)<br />
VAS<br />
Semen<br />
Collection instructions and kits available<br />
**PATIENT DROP OFFS ONLY<br />
ACCEPTED**<br />
Sample must arrive at main testing lab on<br />
Charlotte Street only before 2 pm (Mon-Fri)<br />
TAT – 2 days<br />
OHIP<br />
BTL<br />
POTASSIUM<br />
K<br />
Plasma<br />
Hemolyzed specimens are not acceptable<br />
Enter as “K” and put “Plasma” in comments<br />
TAT – 1 day<br />
GREEN<br />
with heparin<br />
OHIP<br />
BTL<br />
POTASSIUM K Serum<br />
Hemolyzed specimens are not acceptable<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION P Page 7 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
POTASSIUM<br />
24UK<br />
24 Hour Urine<br />
10 mL aliquot – submit in an orange or<br />
white cap container<br />
No preservative<br />
OHIP<br />
CML<br />
State total 24 hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 2 days<br />
POTASSIUM<br />
URK<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 2 days<br />
OHIP<br />
CML<br />
PRADER-WILLI SYNDROME<br />
(PWS)<br />
See<br />
MOLECULAR GENETICS (I)<br />
RCHEO<br />
PREGNANCY <strong>TEST</strong><br />
PREG<br />
Urine<br />
10 mL random urine<br />
OHIP<br />
BTL<br />
Submit in an orange or white cap container<br />
First morning specimen preferred<br />
TAT – 1 day<br />
PREGNANEDIOL<br />
(PROGESTERONE)<br />
PROG<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
PREGNANETRIOL<br />
(17-OH PROGESTERONE)<br />
See 17-HYDROXY<br />
PROGESTERONE<br />
17HP<br />
PRE-NATAL SCREEN<br />
(REPEAT PRENATAL<br />
ANTIBODIES)<br />
(TYPE & SCREEN)<br />
(ABO & SCREEN)<br />
See ABO & Ab SCREEN<br />
BGR<br />
AS<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION P Page 8 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
PRE-NATAL SCREENING<br />
WITH HIV FOR PHL<br />
HIV<br />
RUBL<br />
VDRL<br />
HEPBM<br />
OR<br />
PRE<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
Complete Prenatal form must be attached<br />
Group test includes:<br />
Hepatitis B Prenatal<br />
Rubella Antibody Prenatal (done at Bio-<br />
Test)<br />
HIV Prenatal<br />
PHL Prenatal VDRL<br />
TAT – 15 days<br />
PLAIN RED<br />
YELLOW SST<br />
N/C<br />
PHL<br />
BTL<br />
PRE-NATAL SCREENING<br />
WITHOUT HIV FOR PHL<br />
RUBL<br />
VDRL<br />
HEPBM<br />
OR<br />
PRE<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
Complete Prenatal form must be attached<br />
Group test includes:<br />
Hepatitis B Prenatal<br />
Rubella Antibody Prenatal (done at Bio-<br />
Test)<br />
PHL Prenatal VDRL<br />
TAT – 15 days<br />
PLAIN RED<br />
YELLOW SST<br />
N/C<br />
PHL<br />
BTL<br />
PRIMIDONE<br />
See MYSOLINE<br />
MYS<br />
PROCAINAMIDE<br />
(PRONESTYL)<br />
PROC<br />
Serum<br />
2 mL<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 5 days<br />
PLAIN RED OHIP CML<br />
PROGESTERONE<br />
See PREGNANEDIOL<br />
PROG<br />
PROGRAF<br />
(TACROLIMUS)<br />
See FK-506<br />
RCML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION P Page 9 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
PROLACTIN PRL Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
PRONESTYL<br />
See PROCAINAMIDE<br />
PROC<br />
PROPAFENONE<br />
(RYTHMOL)<br />
PROPA<br />
Plasma<br />
2 ml<br />
Collect specimen 10 – 12 hours after the<br />
last dose<br />
Record in hours the time that have elapsed<br />
between last dose and specimen collection<br />
TAT – 15 days<br />
GREEN<br />
with heparin<br />
$60.00 CML<br />
PROPOXYPHENE<br />
See DARVON<br />
RCML<br />
PROPRANOLOL<br />
See INDERAL<br />
RCML<br />
PROSTATE SPECIFIC<br />
ANTIGEN, TOTAL-<br />
SCREENING ONLY<br />
(PSA SCREEN)<br />
(PSA TOTAL)<br />
PSA<br />
Serum<br />
Centrifuge and separate from cells within a<br />
few hours. PSA stable 48 hrs. at 4C or<br />
several weeks at -20C<br />
Cannot add PSA after 2 days since Bio-<br />
Test doesn‟t freeze samples<br />
YELLOW SST $30.00 BTL<br />
NOT COVERED BY OHIP<br />
TAT – 1 day<br />
PROSTATE SPECIFIC<br />
ANTIGEN, TOTAL-DISEASE<br />
STATE<br />
(PSA, TOTAL DISEASE<br />
STATE, OPSA)<br />
(PSA-NO CHARGE)<br />
OPSA<br />
Serum<br />
Centrifuge and separate from cells within a<br />
few hours. PSA stable 48 hrs. at 4C or<br />
several weeks at -20C<br />
Cannot add PSA after 2 days since Bio-<br />
Test doesn‟t freeze samples<br />
OHIP covered PSA<br />
Physician MUST indicate on requisition for<br />
treatment, monitoring or diagnosis of cancer<br />
Covered by OHIP, no charge<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
PROSTATE SPECIFIC<br />
ANTIGEN, FREE/TOTAL<br />
RATIO<br />
(PSA, FREE / TOTAL RATIO)<br />
FPSA<br />
Serum<br />
Centrifuge and separate from cells within a<br />
few hours<br />
● Testing Includes Total PSA ●<br />
TAT – 3 days<br />
YELLOW SST $50.00 CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION P Page 10 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
PROTEIN C<br />
(FUNCTIONAL/IMMUNOLOG<br />
ICAL)<br />
RCML<br />
PRO<br />
TEINC<br />
Plasma<br />
3 mL<br />
Coumadin should be restricted for 2 weeks<br />
prior to the test<br />
Consult with the patient‟s physician before<br />
proceeding with the test<br />
Document the call on the OHIP requisition<br />
LIGHT BLUE $75.00 CML<br />
Separate plasma immediately<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 15 to 25 days<br />
PROTEIN<br />
ELECTROPHORESIS<br />
(SPE, MONOCLONAL<br />
PROTEIN)<br />
(GAMMOPATHY SCREEN)<br />
PEL<br />
Serum<br />
1 mL<br />
● Testing Includes Total Protein and<br />
Albumin●<br />
Can detect monoclonal antibodies<br />
TAT – 5 days<br />
YELLOW SST OHIP BTL<br />
IF A QUEBEC INSURED<br />
PATIENT THEN USE THIS<br />
CODE<br />
RMFT<br />
PROTEIN<br />
ELECTROPHORESIS<br />
(PEP)<br />
(SPE- 24 HOUR)<br />
24PEL<br />
24 Hour Urine<br />
10 mL aliquot – submit in an orange or<br />
white cap container labelled<br />
“CREATININE” and a 50 mL aliquot –<br />
submit in an orange or white cap container<br />
labelled “PEP”<br />
OHIP<br />
CML<br />
No preservative<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
● Testing Includes Total Protein ●<br />
TAT – 3 days<br />
PROTEIN S, FREE<br />
PRO<br />
TEINSF<br />
Plasma<br />
2 mL<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 15 to 25 days<br />
LIGHT BLUE $40.00 CML<br />
PROTEIN S, TOTAL<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION P Page 11 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
PROTEIN, TOTAL-FLUID<br />
RCML<br />
Fluid – state source<br />
1 mL<br />
Submit in plastic transfer tube<br />
TAT – 1 day<br />
PLAIN RED OHIP CML<br />
PROTEIN, TOTAL-SERUM TP Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
PROTEIN, TOTAL<br />
QUALITATIVE<br />
(ALBUMIN, QUALITATIVE<br />
URINE)<br />
PROTEIN, TOTAL<br />
QUANTITATIVE<br />
PROTEIN, TOTAL 24 HOUR<br />
URINE<br />
RCML<br />
RCML<br />
24UP<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 2 days<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 1 day<br />
24 Hour Urine<br />
10 mL aliquot – submit in an orange or<br />
white cap container labelled “<br />
CREATININE” and a 10 mL aliquot –<br />
submit in an orange or white cap container<br />
labelled “ PROTEIN”<br />
YELLOW SST OHIP BTL<br />
OHIP CML<br />
OHIP CML<br />
OHIP CML<br />
No preservative<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 1 day<br />
PROTEUS OX– 19<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 45 days<br />
PLAIN RED N/C PHL<br />
PROTHROMBIN MUTATION<br />
See FACTOR 11<br />
PROTHROMBIN<br />
MUTATION<br />
RCHEO<br />
PROTHROMBIN TIME<br />
(PRO TIME, PT)<br />
See INR<br />
COA<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION P Page 12 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
PROTOPORPHYRINS<br />
(PORPHYRINS RBC)<br />
See PORPHYRINS, BLOOD<br />
PORBL<br />
PORPB<br />
PROTRIPTYLINE<br />
(TRIPTIL)<br />
RCML<br />
Serum<br />
2 ml<br />
Collect specimen 10 – 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 15 days<br />
ROYAL BLUE<br />
no additive<br />
OHIP<br />
CML<br />
PROZAC<br />
See FLUOXETINE<br />
PROZ<br />
PSA, TOTAL<br />
See PROSTATE SPECIFIC<br />
ANTIGEN, TOTAL-<br />
SCREENING ONLY<br />
PSA<br />
PSA, TOTAL<br />
(PSA- NO CHARGE, OPSA)<br />
See PROSTATE SPECIFIC<br />
ANTIGEN, TOTAL-DISEASE<br />
STATE<br />
OPSA<br />
PSA, FREE / TOTAL RATIO<br />
See PROSTATE SPECIFIC<br />
ANTIGEN FREE/TOTAL<br />
RATIO<br />
FPSA<br />
PSEUDOCHOLINESTERASE<br />
See CHOLINESTERASE<br />
RCML<br />
PSITTACOSIS ANTIBODY<br />
See CHLAMYDIA-PSITTACI<br />
RPHL<br />
PT<br />
(PRO TIME)<br />
(PROTHROMBIN TIME)<br />
See INR<br />
COA<br />
PTH<br />
See<br />
PARATHYROID HORMONE<br />
PTH<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION P Page 13 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
PTT<br />
See PARTIAL<br />
THROMBOPLASTIN TIME<br />
PTT<br />
PYRIDINIUM<br />
RCML<br />
Urine<br />
20 mL random urine<br />
Submit in an orange or white cap container<br />
Collect a first morning mid-stream urine<br />
sample<br />
TAT – 25 days<br />
$60.00 CML<br />
PYRIDOXAL PHOSPHATE<br />
(VITAMIN B6)<br />
B6<br />
Plasma<br />
2 mL<br />
Protect from light by wrapping in<br />
aluminium foil or transfer plasma into an<br />
amber transport tube<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 30 days<br />
LAVENDER $65.00 CML<br />
PYRUVATE KINASE<br />
See PK SCREEN<br />
PYRUV<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION P Page 14 of 14<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
QUININE<br />
(Q-10 METABOLITE)<br />
QUINN<br />
E<br />
Urine<br />
25 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 15 days<br />
$35.00 CML<br />
QUINIDINE<br />
(Q-10 METABOLITE)<br />
See BIQUIN<br />
QUI<br />
Q– FEVER ANTIBODY RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION Q Page 1 of 1<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
RA<br />
(RA FACTOR, RA FIXATION)<br />
(RHEUMATOID FACTOR)<br />
See LATEX FIXATION<br />
ART<br />
RABIES VIRUS ANTIBODIES<br />
RAB<br />
State if post-vaccination<br />
Do not centrifuge tube<br />
PLAIN RED N/C PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
RADIOALLERGOSORBENT<br />
<strong>TEST</strong><br />
(UNICAP)<br />
See RAST<br />
RAST<br />
R. AKARI<br />
(RICKETTSIAL ANTIBODY)<br />
(RMSF)<br />
(ROCKY MOUNTAIN<br />
SPOTTED FEVER)<br />
(TYPHUS MURINE<br />
ANTIBODY)<br />
RPHL<br />
Public Health Laboratory recommends both<br />
acute and convalescent specimens taken two<br />
weeks apart<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 45 days<br />
PLAIN RED N/C PHL<br />
RAPAMUNE<br />
(RAPAMYCIN)<br />
(SIROLIMUS TRANSPLANT)<br />
Sirolimus monitoring must be tested at the<br />
Hospital that performed the transplant<br />
RAPID PLASMA REAGIN<br />
(RPR, SYPHILIS)<br />
See VDRL<br />
VDRL<br />
RAST<br />
(RADIO ALLERGOSORBENT<br />
<strong>TEST</strong>, UNICAP)<br />
RAST<br />
Serum<br />
2 mL<br />
Allergens to be tested must be specified<br />
TAT – 20 days<br />
YELLOW SST $45.00/<br />
per allergen<br />
requested<br />
CML<br />
RBC CHOLINESTERASE<br />
(CHOLINESTERASE,<br />
PLASMA & RBC)<br />
See ACETYL<br />
CHOLINESTERASE<br />
CHOLR<br />
RBC MAGNESIUM<br />
See MAGNESIUM, RBC<br />
RBCM<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION R Page 1 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
RED BLOOD CELL COUNT<br />
(ERYTHROCYTE COUNT,<br />
RBC)<br />
See BLOOD FILM<br />
EXAMINATION<br />
CBC<br />
RED CELL DISTRIBUTION<br />
WIDTH<br />
(RDW)<br />
See BLOOD FILM<br />
EXAMINATION<br />
CBC<br />
RED MEASLES<br />
(RUBEOLA)<br />
MEAS<br />
Public Health Laboratory recommends both<br />
acute and convalescent specimens taken two<br />
weeks apart<br />
PLAIN RED N/C CHEO<br />
Do not centrifuge tube<br />
TAT – 25 days<br />
REDUCING SUBSTANCES RESUB Stool<br />
5 g (approx. 1 teaspoon) random stool<br />
TAT – 15 days<br />
REDUCING SUBSTANCES<br />
RCML<br />
Urine<br />
5 mL random urine<br />
Submit in a 90 mL orange cap container<br />
● Identification of Fructose, Galactose,<br />
Glucose, Lactose, Maltose, and Xylose ●<br />
FREEZE URINE AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 15 days<br />
OHIP<br />
OHIP<br />
CML<br />
CML<br />
REPEAT PRENTAL<br />
ANTIBODIES<br />
(ABO & SCREEN)<br />
(PRENATAL SCREEN)<br />
(TYPE & SCREEN)<br />
See ABO & Ab SCREEN<br />
REPEAT PRENATAL<br />
ANTIBODY SCREEN<br />
(INDIRECT COOMBS)<br />
See ANTIBODY SCREEN<br />
BGR<br />
AS<br />
ANSCR<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION R Page 2 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
RENIN ACTIVITY<br />
REN<br />
Plasma<br />
1 ml<br />
Collect at room temperature<br />
Process sample at room temperature<br />
Centrifuge sample in regular centrifuge<br />
Separate as soon as possible after<br />
centrifugation<br />
LAVENDER OHIP CML<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 15 to 25 days<br />
REOVIRUS ANTIBODY<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
RESPIRATORY CULTURE<br />
See<br />
MYCOPLASMA CULTURE<br />
MYC<br />
RETICULIN ANTIBODY<br />
See ANTI-RETICULIN<br />
ANTIBODY<br />
RETAB<br />
RETICULOCYTE COUNT RETIC Plasma<br />
TAT – 1 day<br />
LAVENDER OHIP BTL<br />
RETINOL<br />
(VITAMIN A)<br />
VITA<br />
Serum<br />
2 mL<br />
Avoid hemolysis<br />
Protect from light by transferring serum into<br />
an amber transport tube<br />
Fasting specimen preferred<br />
TAT – 15 days<br />
YELLOW SST OHIP CML<br />
RETT SYNDROME<br />
See MOLECULAR<br />
GENETICS (III)<br />
RCHEO<br />
REVERSE T 3<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
Rh FACTOR<br />
(ABO & TYPE, BLOOD TYPE)<br />
(BLOOD GROUP & Rh(D))<br />
See ABO RhD<br />
BGR<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION R Page 3 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
RHEUMATOID FACTOR<br />
(RA FACTOR, RA)<br />
(RA FIXATION)<br />
See LATEX FIXATION<br />
ART<br />
RICKETTSIAL ANTIBODY<br />
(ROCKY MOUNTAIN<br />
SPOTTED FEVER, RMSF)<br />
(TYPHUS MURINE<br />
ANTIBODY)<br />
See R.AKARI<br />
RPHL<br />
RINGWORM OF SCALP<br />
(WOOD LAMPS <strong>TEST</strong>)<br />
See DERMATOPHYTOSIS<br />
RPHL<br />
RISPERIDONE<br />
(RISPERDAL)<br />
RISP<br />
Serum<br />
2 mL<br />
TAT – 10 days<br />
YELLOW SST $60.00 CML<br />
RISTOCETIN CO FACTOR<br />
VON WILLEBRAND<br />
RIST<br />
Plasma<br />
2 mL<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
LIGHT BLUE $60.00 BTL<br />
A copy of the OHIP requisition must<br />
accompany the specimen<br />
TAT – 10 days<br />
RITALIN<br />
See METHYLPHENIDATE<br />
RCML<br />
RIVOTRIL<br />
See CLONAZEPAM<br />
RIV<br />
ROCKY MOUNTAIN<br />
SPOTTED FEVER ANTIBODY<br />
(RICKETTSIAL ANTIBODY)<br />
(TYPHUS MURINE<br />
ANTIBODY, RMSF)<br />
See R.AKARI<br />
RPHL<br />
ROHYPNOL<br />
(DATE RAPE DRUG)<br />
NOT <strong>TEST</strong>ED AT CML<br />
Try Public Health Forensic Lab<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION R Page 4 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ROTAVIRUS<br />
ROTA<br />
Faeces<br />
Use Virus Enteric Kit from PHL (empty<br />
sterile container)<br />
N/C<br />
PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
RUBELLA ANTIBODY, IGM<br />
(RUBELLA IGM)<br />
See ACUTE RUBELLA<br />
RUBLM<br />
RUBELLA ANTIBODY,<br />
IMMUNE STATUS<br />
(RUBELLA IGG)<br />
(RUBELLA ANTIBODY IGG<br />
IMMUNE)<br />
RUBL<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
RUBELLA ANTIBODY,<br />
PRENATAL<br />
RUBL<br />
Do not centrifuge tube<br />
To be sent in conjunction with Prenatal<br />
Hepatitis B, VDRL and Prenatal HIV<br />
One tube is required for all the tests<br />
TAT – 10 days<br />
YELLOW SST N/C BTL<br />
RUBEOLA<br />
See RED MEASLES<br />
MEAS<br />
RYTHMOL<br />
See PROPAFENONE<br />
PROPA<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION R Page 5 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
SALICYLATE<br />
(ASPIRIN, ASA)<br />
See<br />
ACETYLSALICYLIC ACID<br />
SAL<br />
SCLERODERMAL<br />
ANTIBODY<br />
See ANTI-ENA<br />
ENA<br />
SECOBARBITAL<br />
RCML<br />
Serum<br />
5 ml<br />
Collect the specimen 10 - 12 hours after last<br />
dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 10 days<br />
GREEN<br />
with heparin<br />
OHIP<br />
CML<br />
SEDIMENTATION RATE<br />
(SED RATE)<br />
See ESR<br />
ESR<br />
SELENIUM<br />
SELEN<br />
IUM<br />
Serum<br />
2 mL<br />
Separate serum as soon as possible<br />
This test should be ordered together with<br />
glutathione peroxidase<br />
TAT – 25 days<br />
ROYAL BLUE<br />
no additive<br />
$45.00 CML<br />
SELENIUM<br />
URINE <strong>TEST</strong> NO LONGER AVAILABLE<br />
SEMEN ANALYSIS,<br />
FOR FERTILITY<br />
FERT<br />
Semen<br />
Collection instructions and kits available<br />
**PATIENT DROP OFFS ONLY<br />
ACCEPTED BY 2PM**<br />
Sample must arrive at main testing<br />
laboratory on Charlotte Street only<br />
TAT – 1 day<br />
OHIP<br />
BTL<br />
SEMEN ANALYSIS,<br />
POST VASECTOMY<br />
(SEMEN POST VAS)<br />
See POST VAS<br />
VAS<br />
SENSITIVE TSH<br />
(THYROTROPIN, TSH)<br />
TSH<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
SERAX<br />
See OXAZEPAM<br />
RCML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION S Page 1 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
SEROTONIN<br />
See<br />
5-HYDROXYTRYPTAMINE<br />
SEROT<br />
SEROTONIN METABOLITE<br />
(HYDROXYINDOLE ACETIC<br />
ACID, HYDROXYINDOLE)<br />
See 5-HIAA<br />
5HAAA<br />
SERTRALINE<br />
(ZOLOFT)<br />
SERT<br />
Serum<br />
2 mL<br />
Patient should be on the drug 5 days prior to<br />
testing<br />
Collect the specimen 10 – 12 hours after<br />
last dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 25 days<br />
PLAIN RED $60.00 CML<br />
SEX HORMONE BINDING<br />
GLOBULIN<br />
SEXH<br />
Serum<br />
3 mL<br />
TAT – 15 to 25 days<br />
YELLOW SST $45.00 CML<br />
SGOT<br />
(AST)<br />
See ASPARATATE<br />
TRANSAMINASE<br />
AST<br />
SGPT<br />
(ALT)<br />
See ALANINE TRANSAMINE<br />
ALT<br />
SHILLINGS <strong>TEST</strong><br />
Refer Patient to Hospital for testing<br />
SICKLE CELL PREP<br />
(SICKLE CELL SCREEN)<br />
(SICKLE CELL SOLUBILITY<br />
SCREEN, SICKLEDEX)<br />
SIC<br />
Plasma<br />
Do not centrifuge<br />
TAT – 1 day<br />
LAVENDER OHIP CML<br />
SILVER<br />
SILVER<br />
Blood<br />
Prepare packed red cells<br />
Store and send frozen<br />
TAT – 20 DAYS<br />
$60.00 CML<br />
SILVER<br />
RCML<br />
24 HOUR – URINE<br />
50 mL aliquot – submit in a 90 mL white or<br />
orange cap container<br />
State total 24 hour volume<br />
TAT – 20 DAYS<br />
$60.00 CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION S Page 2 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
SILVER<br />
RCML<br />
Urine – Random<br />
10 mL random urine<br />
Submit in a white cap conical tube<br />
TAT – 20 DAYS<br />
$60.00 CML<br />
SINEQUAN<br />
See DOXEPIN<br />
DOX<br />
SIROLIMUS TRANSPLANT<br />
(RAPAMYCIN)<br />
See RAPAMUNE<br />
Sirolimus monitoring must be tested at the<br />
Hospital that performed the transplant<br />
TAT – 15 days<br />
SLE ANTIBODIES<br />
(ANTI NUCLEAR<br />
ANTIBODY, ANF)<br />
(CENTROMERE ANTIBODY)<br />
See ANA<br />
LESCR<br />
SMEAR FOR GRAM STAIN OTHER Smear – State source<br />
TAT – 1 day<br />
OHIP<br />
BTL<br />
SMEAR FOR VINCENT'S<br />
ORGANISMS<br />
THROA<br />
Swab<br />
Throat swab in clear transport medium<br />
Routinely included with throat culture and<br />
sensitivity<br />
TAT– 3 days<br />
OHIP<br />
BTL<br />
SMOOTH MUSCLE<br />
ANTIBODIES<br />
(ANTI-SMOOTH MUSCLE<br />
ANTIBODY, ASMA)<br />
(MITOCHONDRIAL<br />
ANTIBODIES, SMA)<br />
See<br />
ANTI-MITOCHONDRIAL<br />
ANTIBODIES<br />
SMA<br />
SODIUM NA Centrifuge only<br />
Hemolyzed specimens are not acceptable<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION S Page 3 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
SODIUM<br />
24UNA<br />
24 Hour Urine<br />
10 mL aliquot – submit in an orange or<br />
white cap container tube<br />
No preservative<br />
OHIP<br />
CML<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 90 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 2 days<br />
SOMATOMEDIN-C<br />
(IGF-1)<br />
See INSULIN-LIKE<br />
GROWTH FACTOR-1<br />
SOMA<br />
SPE<br />
(MONOCLONAL PROTEIN)<br />
See PROTEIN<br />
ELECTROPHORESIS<br />
SPE<br />
SPE<br />
(PEP, SPE- 24 HOUR)<br />
See PROTEIN<br />
ELECTROPHORESIS<br />
24PEL<br />
SPERM ANTIBODIES<br />
See<br />
ANTI-SPERM ANTIBODIES<br />
ASPA<br />
SPINAL MUSCULAR<br />
ATROPHY<br />
See MOLECULAR<br />
GENETICS (III)<br />
RCHEO<br />
SS– A<br />
See ANTI-ENA<br />
ENA<br />
SS– B<br />
See ANTI-ENA<br />
ENA<br />
STONE ANALYSIS<br />
See CALCULUS ANALYSIS<br />
STONE<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION S Page 4 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
STOOL, PH<br />
RCML<br />
Stool<br />
1g. (Approx. 1 teaspoon) soft or liquid<br />
random stool<br />
TAT – 15 days<br />
OHIP<br />
CML<br />
STOOL, REDUCING<br />
SUBSTANCES<br />
RESUB<br />
Stool<br />
5 g (Approx. 1 teaspoon) random stool<br />
sample<br />
TAT – 15 days<br />
OHIP<br />
CML<br />
STREET DRUGS<br />
(NARCOTIC SCREEN)<br />
(URINE TOXICOLOGY)<br />
(DRUGS OF ABUSE)<br />
See DRUG SCREEN<br />
UDSC<br />
STREPTOCOCCUS THROAT<br />
SCREEN<br />
THROA<br />
Swab<br />
Place swab in charcoal transport media<br />
TAT – 2 days<br />
OHIP<br />
BTL<br />
STREPTOZYME <strong>TEST</strong> RCML Serum<br />
2 ml<br />
TAT – 15 days<br />
YELLOW SST OHIP CML<br />
SUCROSE LYSIS<br />
Blood - NO LONGER AVAILABLE<br />
Replaced by cell marker for Paroxysmal<br />
nocturnal hemoglobinapathy<br />
SULFHEMOGLOBIN RCML Blood<br />
Collect Monday to Wednesday only<br />
TAT – 15 days<br />
LAVENDER OHIP CML<br />
SULPHONAMIDES<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
SURMONTIL<br />
(TRIMIPRAMINE)<br />
TRI<br />
Serum<br />
2 mL<br />
Collect sample 10–12 hours after last dose<br />
Record time in hours that have elapsed<br />
between last dose and specimen collection<br />
TAT – 15 days<br />
ROYAL BLUE<br />
no additive<br />
OHIP<br />
CML<br />
SYNOVIAL FLUID<br />
(JOINT FLUID<br />
See FLUID, TOTAL EXAM<br />
SYNF<br />
ASP<br />
OTHER<br />
RCML<br />
SYPHILIS<br />
(RPR, VDRL ROUTINE)<br />
(RAPID PLASMA REAGIN)<br />
See VDRL<br />
VDRL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION S Page 5 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
T CELL LYMPHOCYTE<br />
(CD3, CD4, CD8)<br />
(LYMPHOCYTE MARKER-<br />
T CELL ONLY)<br />
CD4<br />
CD8<br />
CD3<br />
Whole Blood<br />
MARKER ONLY<br />
Specimen collection Monday – Tuesday<br />
only<br />
Store and Transport at room temperature<br />
Complete a “Lymphocyte Marker Form”<br />
LAVENDER OHIP CML<br />
FOR ALL OTHER MARKERS SEE –<br />
LYMPOHCYTE MARKERS<br />
TAT – 3 days<br />
T 3 RIA<br />
(TOTAL T3)<br />
(TRIIODOTHYRONINE)<br />
RCML<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
T4 TOTAL, THYROXINE<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
TACROLIMUS<br />
(PROGRAF)<br />
See FK-506<br />
RCML<br />
TAY SACHS<br />
(BETA n-<br />
ACETYLHEXOSAMINIDASE)<br />
RCML<br />
Blood<br />
Collect specimen Monday to Wednesday<br />
only<br />
STORE AND SEND AT ROOM<br />
TEMPERATURE<br />
1 LAVENDER<br />
1 PLAIN RED<br />
1 GREEN<br />
with heparin<br />
OHIP<br />
CML<br />
**Physician must complete SKH Tay Sachs<br />
Registration Form and a Molecular<br />
Genetics Form<br />
The forms are available from the CML<br />
Problem Solving Department<br />
Send the specimens and the forms in a<br />
Priority labelled zip-lock bag<br />
Address Priority label:<br />
Hospital for Sick Kids<br />
Biochemical Genetics Laboratory<br />
555 University Ave., Toronto<br />
M5G 1X8<br />
TAT - 15 days<br />
T.B. CULTURE<br />
(TUBERCULOSIS CULTURE)<br />
(AFB)<br />
See ACID FAST BACILLUS<br />
AFB<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Dena Seeto BSc MLA QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION T Page 1 of 9<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
T & B CELLS<br />
(LYMPHOCYTHE MARKERS)<br />
See<br />
IMMUNO PHENOTYPING<br />
CD3<br />
CD4<br />
CD8<br />
TBG<br />
(THYROXINE BINDING<br />
GLOBULIN)<br />
TBG<br />
Serum<br />
1 mL<br />
TAT – 25 days<br />
YELLOW SST OHIP CML<br />
TBII<br />
(LONG ACTING THYROID<br />
STIMULATOR)<br />
(THYROTROPIN BINDING<br />
GLOBULIN)<br />
(THYROID STIMULATING<br />
ANTIBODY)<br />
(THYROID RECEPTOR<br />
ANTIBODIES)<br />
(TRAB-TSH RECEPTOR<br />
ANTIBODIES)<br />
See LATS<br />
TSA<br />
TEGRETOL<br />
See CARBAMAZEPINE<br />
CARB<br />
TELOPEPTIDE - C<br />
Fasting specimen preferred. Store and<br />
transport frozen. Non-OHIP payment<br />
requirement.<br />
YELLOW SST $60.00 CML<br />
TELOPEPTIDE– N<br />
(BONE LOSS MARKER)<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
<strong>TEST</strong>OSTERONE,<br />
BIO AVAILABLE<br />
See BIO AVAILABLE<br />
<strong>TEST</strong>OSTERONE<br />
(Males)<br />
BIOT<br />
(Female)<br />
BIOF<br />
<strong>TEST</strong>OSTERONE, FREE<br />
FTES<br />
Serum<br />
Centrifuge only<br />
State age and sex of patient<br />
TAT – 4 days<br />
YELLOW SST OHIP CML<br />
<strong>TEST</strong>OSTERONE, TOTAL<br />
(<strong>TEST</strong>ICULAR ANDROGEN)<br />
TSTOS<br />
Serum<br />
Centrifuge only<br />
State age and sex of patient<br />
TAT – 1 day<br />
YELLOW SST OHIP CML<br />
TETANUS<br />
NO LONGER AVAILABLE AT PHL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Dena Seeto BSc MLA QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION T Page 2 of 9<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
THC<br />
(CANNABOIDS)<br />
(MARIJUANA)<br />
(TETRAHYDRO<br />
CANNABINOIDS)<br />
See CANNABIS<br />
UCB<br />
THEOPHYLLINE<br />
(UNIPHYL)<br />
See AMINOPHYLLINE<br />
THEO<br />
THIAMINE<br />
(VITAMIN B 1 )<br />
RCML<br />
Whole Blood<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
LAVENDER $70.00 CML<br />
DO NOT EXPOSE TO LIGHT<br />
TAT - ?<br />
Revised as per Michelle 28Nov2008<br />
THIOCYANATE RCML Serum<br />
3 mL<br />
TAT – 10 days<br />
RED OHIP CML<br />
THIORIDAZINE<br />
See MELLARIL<br />
RCML<br />
THROMBIN TIME<br />
(THROMBIN CLOTTING<br />
TIME)<br />
RCML<br />
Plasma<br />
1 mL<br />
Must be a clean venipuncture puncture<br />
Remove tourniquet when blood starts to<br />
flow<br />
LIGHT BLUE OHIP CML<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 30 days<br />
THROMBOCYTE COUNT<br />
(PLATELET COUNT)<br />
See BLOOD FILM<br />
EXAMINATION<br />
CBC<br />
THROMBOPHILIA<br />
See MOLECULAR<br />
GENETICS (II)<br />
RCHEO<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Dena Seeto BSc MLA QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION T Page 3 of 9<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
THROMBOPLASTIN TIME,<br />
PARTIAL<br />
(PTT)<br />
See PARTIAL<br />
THROMBOPLASTIN TIME<br />
PTT<br />
THYROGLOBULIN<br />
THY<br />
Serum<br />
2 Ml<br />
Note: Not the same test as Thyroglobulin<br />
Antibodies<br />
TAT – 15 days<br />
YELLOW SST OHIP CML<br />
THYROGLOBULIN<br />
ANTIBODIES<br />
(ANTI-THYROID<br />
ANTIBODIES, ATA)<br />
(MICROSOMAL THYROID<br />
ANTIBODIES)<br />
(THYROID ANTIBODIES)<br />
(ANTI-THYROID ANTIBODY)<br />
See ANTI- MICROSOMAL<br />
ANTIBODIES<br />
MSA<br />
Or<br />
ATA<br />
THYROID PEROXIDASE<br />
ANTIBODY<br />
(TPO AB)<br />
See ANTI-THYROID<br />
PEROXIDASE<br />
RCML<br />
THYROID RECEPTOR<br />
ANTIBODIES<br />
(THYROID STIMULATING<br />
ANTIBODY)<br />
(LONG ACTING THYROID<br />
STIMULATOR, TBII)<br />
(THYROTROPIN<br />
BINDING INHIBITING<br />
IMMUNOGLOBULIN)<br />
(TRAB-TSH RECEPTOR<br />
ANTIBODIES)<br />
See LATS<br />
TSA<br />
THYROID STIMULATING<br />
ANTIBODY<br />
(LONG ACTING THYROID<br />
STIMULATOR, TBII)<br />
(THYROTROPIN<br />
BINDING INHIBITING<br />
IMMUNOGLOBULIN)<br />
(THYROID RECEPTOR<br />
ANTIBODIES)<br />
(TRAB-TSH RECEPTOR<br />
ANTIBODIES)<br />
See LATS<br />
TSA<br />
THYROTROPIN<br />
(TSH)<br />
See SENSITIVE TSH<br />
TSH<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Dena Seeto BSc MLA QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION T Page 4 of 9<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
THYROTROPIN BINDING<br />
INHIBITING<br />
IMMUNOGLOBULIN<br />
(THYROID STIMULATING<br />
ANTIBODY, TBII)<br />
(LONG ACTING THYROID<br />
STIMULATOR)<br />
(THYROID RECEPTOR<br />
ANTIBODIES)<br />
(TRAB-TSH RECEPTOR<br />
ANTIBODIES)<br />
See LATS<br />
TSA<br />
THYROXINE BINDING<br />
GLOBULIN<br />
(TBG)<br />
TBG<br />
Serum<br />
1 Ml<br />
TAT – 25 days<br />
YELLOW SST OHIP CML<br />
THYROXINE, FREE<br />
See FREE T4<br />
RFT4<br />
THYROXINE, TOTAL (T 4 )<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
TIBC<br />
(IRON SATURATION, TIBC)<br />
(TOTAL IRON BINDING<br />
CAPACITY)<br />
(IRON BINDING CAPACITY)<br />
See IRON<br />
IRON<br />
TM FLUOROPERAZINE<br />
(TRANSGLUTAMINASE IGA<br />
TISSUE)<br />
RCML<br />
Serum<br />
3 mL<br />
TAT – 15 days<br />
YELLOW SST $60.00 CML<br />
TOBRAMYCIN<br />
PEAK<br />
TROUGH<br />
RCML<br />
TOT<br />
Serum<br />
1 mL<br />
Collection of pre and post doses must be<br />
collected<br />
Collect blood prior to and I hour following<br />
I.M. injection<br />
PLAIN RED OHIP CML<br />
Record time in hours that have elapsed<br />
between doses<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 5 to 10 days<br />
TOFRANIL<br />
See IMIPRAMINE<br />
IMIPR<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Dena Seeto BSc MLA QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION T Page 5 of 9<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
TOPIRAMATE<br />
(TOPOMAX)<br />
TOPOM<br />
Serum<br />
1 mL<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 15 days<br />
YELLOW SST $60.00 CML<br />
TORCH STUDIES<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
PLAIN RED N/C PHL<br />
● Testing Includes Toxoplasmosis,<br />
Rubella, Cytomegalovirus & Herpes<br />
Serologies ●<br />
TAT – 15 days<br />
TOTAL IRON BINDING<br />
CAPACITY<br />
(IRON BINDING CAPACITY)<br />
(IRON SATURATION, TIBC)<br />
See IRON<br />
IRON<br />
TOTAL T3<br />
(TRIIODOTHYRONINE)<br />
See T3 RIA<br />
RCML<br />
TOXOPLASMOSIS<br />
ANTIBODY<br />
IgG<br />
IgM<br />
TOXO<br />
TOXOM<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
TPO AB<br />
(ANTIBODY THYROID<br />
PEROXIDASE AB)<br />
See ANTI–THYROID<br />
PEROXIDASE<br />
RCML<br />
TRANSCOBALAMINE RCML Serum<br />
2 mL<br />
TAT – 25 days<br />
YELLOW SST $60.00 CML<br />
TRANSFERRIN TRANS Serum<br />
1 mL<br />
TAT – 15 days<br />
YELLOW SST OHIP CML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Dena Seeto BSc MLA QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION T Page 6 of 9<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
TRANSFERRIN<br />
SATURATION<br />
(IRONBINDING CAPACITY)<br />
(TIBC, IRON SATURATION)<br />
(TOTAL IRON BINDING<br />
CAPACITY)<br />
See IRON<br />
IRON<br />
TRANSGLUTAMINASE<br />
IGA TISSUE<br />
See TM FLUOROPERAZINE<br />
RCML<br />
TRAZADONE<br />
See DESYREL<br />
TRAZ<br />
TREPONEMAL ANTIBODIES<br />
(FTA-TREPONEMAL<br />
ANTIBODIES)<br />
See FLUORESCENT<br />
ABSORPTION <strong>TEST</strong><br />
FTA<br />
TREPONEMA PALLIDUM<br />
IMMOBILIZATION<br />
(TPI)<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 5 days<br />
PLAIN RED N/C PHL<br />
TRIAZOLAM<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
TRICHINOSIS<br />
IMMOBILIZATION<br />
ANTIBODY<br />
(TIA)<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 5 days<br />
PLAIN RED N/C PHL<br />
TRICHOMONAS VAGINALIS<br />
(TRICH)<br />
(WET PREPARATION)<br />
VAG<br />
CER<br />
Swab – State source<br />
Place swab in a charcoal transport medium<br />
Routinely performed as part of vaginal<br />
culture and sensitivity<br />
TAT – 1 day<br />
OHIP<br />
BTL<br />
TRICYCLIC &<br />
TETRACYCLIC<br />
ANTIDEPRESSANTS<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
See SPECIFIC DRUG <strong>SPECIMEN</strong><br />
<strong>REQUIREMENTS</strong><br />
Specify:<br />
Amitriptyline, Clomipramine, Desipramine,<br />
Doxepin, Imipramine, Maprotiline,<br />
Nortriptyline, Protriptyline, Trimipramine<br />
Created by Dena Seeto BSc MLA QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION T Page 7 of 9<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
TAT – 5 days<br />
TRIGLYCERIDES<br />
TRIG<br />
Serum<br />
Centrifuge only<br />
Patient must fast overnight<br />
*RTRIG<br />
*If patient NOT fasting<br />
TAT – 1 day<br />
TRIIODOTHYRONINE,<br />
TOTAL<br />
(TOTAL T3)<br />
See T3 RIA<br />
RCML<br />
TRIIODOTHYRONINE, FREE<br />
See FREE T3<br />
FT3<br />
TRIIODOTHYRONINE,<br />
UPTAKE<br />
(T 3 UPTAKE)<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
TRIMIPRAMINE<br />
See SURMONTIL<br />
TRI<br />
TRIPLE MARKER <strong>TEST</strong><br />
<strong>TEST</strong> NOT AVAILABLE ANYMORE<br />
TRIPTIL<br />
See PROTRIPTYLINE<br />
RCML<br />
TROPONIN I<br />
Advise Doctor That We Do Not Perform<br />
This Test<br />
Send Patient Back To The Physician‟ Office<br />
If The Physician Is Not Available, Send<br />
Patient To Hospital<br />
(Possible Heart Attack Patient)<br />
TRYPSIN<br />
<strong>TEST</strong> NO LONGER AVAILABLE<br />
TRYPTASE<br />
RCML<br />
Serum<br />
1 ml<br />
Collect 1-hour post allergic reaction<br />
YELLOW SST $65.00 CML<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Dena Seeto BSc MLA QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION T Page 8 of 9<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
labelled „Frozen Sample‟<br />
TAT – 25 days<br />
TSH RECEPTOR<br />
ANTIBODIES (TRAB)<br />
LATS<br />
(LONG ACTING THYROID<br />
STIMULATOR, TB11)<br />
(THYROTROPIN<br />
BINDING INHIBITING<br />
IMMUNOGLOBULIN)<br />
(THYROID STIMULATING<br />
ANTIBODY)<br />
(THYROID RECEPTOR<br />
ANTIBODIES)<br />
See LATS<br />
TSA<br />
TSH, SENSITIVE<br />
(THYROTROPIN)<br />
See SENSITIVE TSH<br />
TSH<br />
TYLENOL<br />
See ACETAMINOPHEN<br />
ACETA<br />
TYPHUS MURINE<br />
ANTIBODY<br />
(RICKETTSIAL ANTIBODY)<br />
(ROCKY MOUNTAIN<br />
SPOTTED FEVER, RMSP)<br />
See R.AKARI<br />
RPHL<br />
TYROSINE<br />
TYRO<br />
Serum<br />
2 mL<br />
YELLOW SST $65.00 CML<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 15 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Dena Seeto BSc MLA QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION T Page 9 of 9<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
UIBC<br />
(IRON BINDING CAPACITY)<br />
(IRON SATURATION, TIBC)<br />
(TOTAL IRON BINDING<br />
CAPACITY)<br />
(TRANSFERRIN<br />
SATURATION)<br />
See IRON<br />
IRON<br />
UNICAP<br />
(RADIOALLERGOSORBENT<br />
<strong>TEST</strong>)<br />
See RAST<br />
RAST<br />
UNIPHYL<br />
(THEOPHYLLINE)<br />
See AMINOPHYLLINE<br />
THEO<br />
URATE<br />
(URIC ACID)<br />
URIC<br />
Serum<br />
Centrifuge only<br />
TAT – 1 day<br />
YELLOW SST OHIP BTL<br />
URATE<br />
(URIC ACID)<br />
24URA<br />
24UU<br />
24 Hour Urine<br />
10 mL aliquot – submit in an orange or<br />
white cap container tube<br />
OHIP<br />
BTL<br />
No preservative<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 2 days<br />
UREA<br />
(BLOOD UREA NITROGEN)<br />
See BUN<br />
BUN<br />
Serum<br />
UREA<br />
See BUN<br />
24URE<br />
24 Hour Urine<br />
UREAPLASMA<br />
See<br />
MYCOPLASMA ISOLATION<br />
MYC<br />
URIC ACID<br />
See URATE<br />
URIC<br />
Serum<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION U Page 1 of 3<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
URIC ACID<br />
See URATE<br />
24URA<br />
24UU<br />
24 Hour Urine<br />
URINALYSIS, CHEMICAL<br />
(URINALYSIS ROUTINE)<br />
DIP<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 1 day<br />
OHIP<br />
BTL<br />
URINALYSIS, MICROSCOPIC<br />
(URINALYSIS MICRO)<br />
MIC<br />
Urine<br />
10 mL random urine<br />
Submit in an orange or white cap container<br />
TAT – 1 day<br />
OHIP<br />
BTL<br />
URINE TOXICOLOGY<br />
(NARCOTIC SCREEN)<br />
(STREET DRUGS)<br />
(DRUGS OF ABUSE)<br />
See DRUGS SCREEN<br />
UDSC<br />
UROBILINOGEN<br />
UBILI<br />
Urine<br />
10 mL random urine<br />
Protect from light by transferring urine into<br />
an amber transport tube<br />
TAT – 1 day<br />
OHIP<br />
CML<br />
UROBILINOGEN<br />
Stool - NO LONGER AVAILABLE<br />
UROPORPHYRIN<br />
(PORPHYRINS)<br />
See COPROPORPHYRINS<br />
RCML<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION U Page 2 of 3<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ALL 24 HOUR URINE PRESERVATIVES ARE ADDED AT BIO<strong>TEST</strong> MAINLAB<br />
24 HOUR<br />
<strong>TEST</strong>S WITH<br />
Albumin<br />
Aldosterone<br />
Amylase<br />
Bence Jones Protein<br />
BUN (Urea)<br />
Calcium<br />
Chloride<br />
Corticosteroids<br />
Creatinine<br />
Clearance<br />
Estriol (Preg)<br />
Estrogens (Non<br />
Preg)<br />
Glucose<br />
Gold<br />
Hydrocorticosteroid<br />
Hydroxyproline<br />
URINE<br />
NO PRESERVATIVE<br />
Immunoelectrophoresis<br />
(BJP)<br />
17-Ketogenic Steroids<br />
17-Ketosteroids Total<br />
Lead<br />
Magnesium<br />
Mercury<br />
Microalbumin<br />
Nitrogen<br />
Phosphorus<br />
Porphobilinogen<br />
Potassium<br />
Pregnanediol<br />
Pregnanetriol<br />
Protein<br />
Sodium<br />
Uric Acid<br />
Zinc<br />
24 HOUR URINE<br />
PRESERVATIVE<br />
20 ml of 6N HCL<br />
15 ml of 6N HCL<br />
10 ml of 6N HCL<br />
(2ml 6N HCL to<br />
90ml of sample)<br />
1 ml of 6N HCL to<br />
90 ml of sample<br />
1g Boric Acid<br />
added to 90 ml of<br />
sample<br />
URINE<br />
<strong>TEST</strong><br />
ALA<br />
Catecholamines<br />
Copper<br />
Metanephrines<br />
VMA<br />
Homovanillic Acid<br />
Oxalate<br />
Citrate Acid<br />
Cortisol<br />
17-Ketosteroids<br />
Fractionation<br />
24 HOUR URINE<br />
PRESERVATIVE<br />
Acid washed<br />
container<br />
No preservative<br />
SEND FROZEN<br />
No preservative<br />
Protect from Light<br />
50/50 urine/70%<br />
alcohol<br />
URINE<br />
<strong>TEST</strong><br />
Aluminum<br />
Iron<br />
Creatine<br />
Cyclic AMP<br />
Porphyrins<br />
Urine cytology<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION U Page 3 of 3<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
VALPROIC ACID<br />
(EPIVAL)<br />
(DIVALPROEX)<br />
See DEPAKENE<br />
VPA<br />
VALIUM<br />
See DIAZEPAM<br />
DIAZ<br />
VANCOMYCIN, PEAK<br />
VANP<br />
Serum<br />
1 mL<br />
Indicate peak specimen<br />
PLAIN RED OHIP CML<br />
Collect peak specimen at the end of IV<br />
infusion or 60 minutes after IM injection<br />
Record time in hours that have elapsed<br />
between dose and specimen collection<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 5 to 10 days<br />
VANCOMYCIN, TROUGH<br />
VANT<br />
Serum<br />
1 mL<br />
Indicate trough specimen<br />
PLAIN RED OHIP CML<br />
Collect trough specimen 60 minutes after<br />
IM injection is complete<br />
Record time in hours that have elapsed<br />
between dose and specimen collection<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 5 to 10 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION V Page 1 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
VANILLYMANDELIC ACID<br />
(VMA)<br />
VMA<br />
24 Hour Urine<br />
10 mL aliquot – submit in an orange or<br />
white cap container labelled<br />
“CREATININE” and a 50 mL aliquot –<br />
submit in an orange or white cap container<br />
labelled “VMA”<br />
OHIP<br />
CML<br />
Preserve 50 mL aliquot with 2 mL of 6N<br />
Hydrochloric Acid<br />
Abstain from coffee, tea, cola, fruit,<br />
chocolate & vanilla 48 hours before and<br />
during collection<br />
Note: Report may be delayed for<br />
confirmation of abnormal results<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container, &<br />
in “Notes&Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 7 days<br />
VARICELLA ZOSTER<br />
ANTIBODY<br />
(VARICELLA ANTIBODY)<br />
(ZOSTER ANTIBODY)<br />
See CHICKEN POX<br />
VARI<br />
VARICELLA ZOSTER<br />
ANTIBODY<br />
(VARICELLA ANTIBODY)<br />
(ZOSTER ANTIBODY SWAB)<br />
See CHICKEN POX SWAB<br />
VARI<br />
VARIOLA, VACCINE<br />
RPHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
PLAIN RED N/C PHL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION V Page 2 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
VDRL<br />
(VDRL ROUTINE, RPR)<br />
(RAPID PLASMA REAGIN)<br />
(SYPHILIS)<br />
VDRL<br />
Do not centrifuge tube<br />
VDRL requests can be for Screen,<br />
Confirmatory or Diagnostic purposes<br />
If VDRL Screen ordered Code S17 on PHL<br />
Form<br />
If Confirmatory or Diagnostic ordered,<br />
Code S18, S08 & state information on<br />
PHL Form<br />
PLAIN RED N/C PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
VERY LOW DENSITY<br />
LIPOPROTEIN<br />
(VLDL)<br />
RCML<br />
Serum<br />
6 mL<br />
● Testing Includes Cholesterol,<br />
Triglycerides, HDL/LDL ●<br />
TAT – 10 days<br />
3 YELLOW SST OHIP CML<br />
VINCENT'S ORGANISMS<br />
See SMEAR FOR<br />
VINCENT’S ORGANISMS<br />
THROA<br />
VIRAL STUDIES VIR Do not centrifuge tube<br />
TAT – 15 days<br />
VIRAL<br />
CONTAINER<br />
N/C<br />
CHEO<br />
VIRAL STUDIES<br />
RPHL<br />
Stool<br />
5 g. (Approx. 1 teaspoon) random stool<br />
DO NOT USE CARY– BLAIR MEDIA<br />
Submit in VIRUS– TM media kit<br />
N/C<br />
PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 10 days<br />
VIRAL STUDIES<br />
(VIRUS ISOLATION)<br />
RPHL<br />
Swab – State source<br />
Submit in VIRUS– SW media kit<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 25 days<br />
N/C<br />
PHL<br />
VIRAL LOAD<br />
See HIV VIRAL LOAD<br />
VIRL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION V Page 3 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
VISCOSITY, RELATIVE<br />
QUANTITY<br />
VIS<br />
Whole Blood<br />
4 mL<br />
Do NOT centrifuge<br />
Submit Monday and Tuesday ONLY<br />
LAVENDER OHIP CML<br />
STORE AND TRANSPORT AT ROOM<br />
TEMPERATURE<br />
TAT – 15 days<br />
VITAMIN A<br />
See RETINOL<br />
VITA<br />
VITAMIN B 1<br />
See<br />
THIAMINE<br />
B6<br />
VITAMIN B 5<br />
<strong>TEST</strong> NOT AVAILABLE AT CML<br />
Revised as per Michelle(at CML)<br />
28Nov2008<br />
VITAMIN B 6<br />
See<br />
PYRIDOXAL PHOSPHATE<br />
B6<br />
VITAMIN B 12<br />
See B12<br />
B12<br />
VITAMIN C<br />
See ASCORBIC ACID<br />
VITC<br />
VITAMIN D<br />
(1,25– DIHYDROXY)<br />
(25– HYDROXY)<br />
(25– HYDROXYVITAMIN D)<br />
(CALCITRIOL)<br />
See 1,25-DIHYDROXY<br />
VITD<br />
VITAMIN E<br />
VITE<br />
Serum<br />
2 ml<br />
Protect from light by transferring serum into<br />
an amber transport tube<br />
YELLOW SST $50.00 CML<br />
FREEZE SERUM AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
TAT – 30 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION V Page 4 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
VLDL<br />
(VERY LOW DENSITY<br />
LIPOPROTEIN)<br />
(ULTRA-CENTRIFUGATION<br />
HDL/LDL)<br />
RCML<br />
Serum<br />
6 mL<br />
● Testing Includes Cholesterol,<br />
Triglycerides, HDL/LDL ●<br />
TAT – 10 days<br />
3 YELLOW SST OHIP CML<br />
VMA<br />
(VANILLYMANDELIC ACID)<br />
VMA<br />
24 Hour Urine<br />
10 mL aliquot – submit in an orange or<br />
white cap container labelled<br />
“CREATININE” and a 50 mL aliquot –<br />
submit in an orange or white cap container<br />
labelled “VMA”<br />
OHIP<br />
CML<br />
Preserve 50 mL aliquot with 2 mL of 6N<br />
Hydrochloric Acid<br />
Abstain from coffee, tea, cola, fruit,<br />
chocolate and vanilla 48 hours before<br />
collection<br />
Note: Report may be delayed for<br />
confirmation of abnormal results<br />
State total 24-hour volume on the OHIP<br />
Requisition, on the specimen container and<br />
in “Notes and Instructions”<br />
Retain a duplicate 50 mL urine sample in<br />
the fridge until test is reported<br />
TAT – 7 days<br />
VON WILLEBRAND FACTOR<br />
SCREEN<br />
VON<br />
WILL<br />
Plasma<br />
Minimum Volume required: 4 aliquots of<br />
1mL each<br />
Keep together with elastic band. Label all<br />
samples<br />
2 LIGHT BLUE $140.00<br />
CML<br />
FREEZE PLASMA AND SEND FROZEN<br />
Transport specimen in a separate brown bag<br />
labelled „Frozen Sample‟<br />
A copy of the OHIP requisition must<br />
accompany the specimen<br />
TAT – 10 days<br />
RCML<br />
Screen includes or can be ordered<br />
separately:<br />
Von Willebrand Factor 8 (Biological)<br />
$60.00<br />
VONWI<br />
LLANT<br />
Von Willebrand Factor Antigen<br />
$60.00<br />
VONWI<br />
LLRIS<br />
Von Willebrand Ristocetin Cofactor<br />
$60.00<br />
VONWI<br />
LLMUL<br />
Von Willebrand Multimers<br />
TAT – 10 days<br />
$60.00<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION V Page 5 of 5<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
WAGNER SYNDROME<br />
See MOLECULAR<br />
GENETICS (II)<br />
RCHEO<br />
WARFARIN<br />
See COUMADIN<br />
RCML<br />
WBC<br />
(LEUKOCYTE COUNT)<br />
(WHITE BLOOD CELL<br />
COUNT)<br />
See BLOOD FILM<br />
EXAMINATION<br />
CBC<br />
WEIL'S DISEASE<br />
(LEPTOSPIROSIS<br />
ANTIBODIES)<br />
See<br />
LEPTOSPIRA ANTIBODIES<br />
RPHL<br />
WEST NILE VIRUS<br />
WNV<br />
Do not centrifuge tube<br />
State the patient‟s clinical history on the<br />
PHL form and indicate acute or<br />
convalescent specimen<br />
PLAIN RED N/C PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 20 days<br />
WET PREPARATION<br />
(TRICH)<br />
See TRICHOMONAS<br />
VAGINALIS<br />
VAG<br />
CER<br />
WHITE BLOOD CELL COUNT<br />
(LEUKOCYTE COUNT, WBC)<br />
See BLOOD FILM<br />
EXAMINATION<br />
CBC<br />
WHOOPING COUGH<br />
See BORDETELLA<br />
PERTUSSIS ANTIBODY<br />
PERT<br />
Serum<br />
WIDAL <strong>TEST</strong><br />
See<br />
BRUCELLA ANTIBODIES<br />
RPHL<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION W Page 1 of 2<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
WOOD LAMPS <strong>TEST</strong><br />
(RINGWORM OF SCALP)<br />
See DERMATOPHYTOSIS<br />
RPHL<br />
WORM IDENTIFICATION<br />
RPHL<br />
Stool<br />
Submit whole specimen without<br />
contamination from other fluids<br />
N/C<br />
PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
WORM IDENTIFICATION<br />
RPHL<br />
Worm<br />
Submit whole worm without contamination<br />
from other fluids<br />
N/C<br />
PHL<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION W Page 2 of 2<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
X-INACTIVATION<br />
See<br />
MOLECULAR GENETICS (I)<br />
RCHEO<br />
XYLOSE ABSORPTION<br />
(XYLOSE TOLERANCE)<br />
Adult Test - Greater That 12<br />
Years Of Age<br />
RCML<br />
Blood<br />
Must fast 8 hours before the test<br />
Must drink 25 g Xylose dissolved in 250 ml<br />
of water followed by another 250 mL of<br />
water<br />
Collect blood 2 hours after consumption of<br />
drink<br />
GREY OHIP CML<br />
Child Test - Less Than 12<br />
years of Age<br />
Must fast 4 hours before the test<br />
Must drink 5 g Xylose dissolved in 250 ml<br />
of water followed by another 250 mL of<br />
water<br />
Collect blood 2 hours after consumption of<br />
drink<br />
TAT – 15 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION X Page 1 of 1<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
YERSINIA ANTIBODIES<br />
RPHL<br />
Specify full panel (9 strains) or routine (3<br />
strains)<br />
PLAIN RED N/C PHL<br />
Do not centrifuge tube<br />
MINISTRY OF HEALTH GUIDELINES<br />
Refer to the General Information Page for<br />
the MOH Procedure regarding specimen<br />
processing and transportation<br />
TAT – 15 days<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION Y Page 1 of 1<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
ZARONTIN<br />
See ETHOSUXIMIDE<br />
ZARO<br />
ZINC ZNC Serum<br />
2 mL<br />
TAT – 15 days<br />
ROYAL BLUE<br />
Without additive<br />
OHIP<br />
CML<br />
ZINC<br />
RCML<br />
24 Hour Urine<br />
50 mL aliquot – submit in an orange or<br />
white cap container<br />
Collect 24-hour specimen in plastic acid–<br />
washed container<br />
OHIP<br />
CML<br />
State total 24-hour volume on the OHIP<br />
Requisition on the specimen container and<br />
in “Notes and Instructions”<br />
TAT – 15 days<br />
ZINC PROTOPORPHYRINS<br />
ZPP<br />
Whole Blood<br />
Protect from light, wrap in foil<br />
Do not centrifuge<br />
LAVENDER $60.00 CML<br />
Collect Monday – Thursday only<br />
TAT – 15 days<br />
ZOLOFT<br />
See SERTRALINE<br />
RCML<br />
ZOSTER ANTIBODY<br />
(VARICELLA ANTIBODY)<br />
(VARICELLA ZOSTER<br />
ANTIBODY)<br />
See CHICKEN POX<br />
VARI<br />
Blood<br />
ZOSTER ANTIBODY<br />
(VARICELLA ANTIBODY)<br />
(VARICELLA ZOSTER<br />
ANTIBODY)<br />
See CHICKEN POX<br />
VARI<br />
Swab<br />
ZYPREXA<br />
See OLANZAPINE<br />
RCML<br />
Serum<br />
ZYPREXA<br />
See OLANZAPINE<br />
RCML<br />
Urine<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Vedrana Vaskovic QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION Z Page 1 of 1<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
<strong>TEST</strong> CODE <strong>SPECIMEN</strong> REQUIREMENT VACUTAINER BILLING LOC<br />
1,25-DIHYDROXY<br />
(25-HYDROXYVITAMIN D)<br />
(VITAMIN D)<br />
(CALCITRIOL)<br />
See SECTION D3<br />
5-HIAA<br />
(5-HYDROXYINDOL<br />
ACETIC ACID)<br />
(HYDROXYINDOLE)<br />
(SEROTONIN METABOLITE)<br />
See SECTION H1<br />
5-HYDROXYTRYPTAMINE<br />
(SEROTONIN)<br />
See SECTION H1<br />
VITD<br />
5HAAA<br />
SEROT<br />
7-DEHYDROCHOLESTEROL<br />
(7DHC)<br />
See SECTION D1<br />
7DE<br />
HYDRO<br />
11-DEOXYCORTISOL<br />
See SECTION D1<br />
11–<br />
DEOXY<br />
17-OH STEROIDS<br />
(17-HYDROXY<br />
CORTICOSTEROIDS)<br />
See SECTION H1<br />
17-OH PROGESTERONE<br />
(PREGNANETRIOL)<br />
(17-HYDROXY<br />
PROGESTERONE)<br />
See SECTION H1<br />
17-KGS<br />
(17-KETOGENIC STEROIDS)<br />
See SECTION K1<br />
24OH<br />
17HP<br />
RCML<br />
17-KS<br />
(17 KETOSTEROIDS, TOTAL)<br />
See SECTION K1<br />
17KET<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Michael Halsall QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
SECTION Numbers Page 1 of 1<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
REVISION HISTORY<br />
This information is required for annual review as well as for each new version of this document.<br />
Change(s) made (delete these table<br />
Version Review & Revision<br />
DATE<br />
contents below for your own lab<br />
# by management<br />
method<br />
November<br />
24, 2011<br />
August 25,<br />
2011<br />
August 9,<br />
2011<br />
June 13,<br />
2011<br />
April 7,<br />
2011<br />
<strong>2.0</strong> Dena Seeto<br />
QC Coordinator<br />
<strong>2.0</strong> Dena Seeto<br />
QC Coordinator<br />
<strong>2.0</strong> Vedrana Vaskovic<br />
QC Coordinator<br />
<strong>2.0</strong> Vedrana Vaskovic<br />
QC Coordinator<br />
<strong>2.0</strong> Vedrana Vaskovic<br />
QC Coordinator<br />
L2: LATS went from $65 to $90,<br />
added Thyroid Receptor Antibodies<br />
and TRAB-TSH Receptor Antibodies<br />
to common names, added Freeze<br />
serum; L5: added Thyroid Receptor<br />
Antibodies and TRAB-TSH Receptor<br />
Antibodies to Long Acting Thyroid<br />
Stimulator common names; T2:<br />
added Thyroid Receptor Antibodies<br />
and TRAB-TSH Receptor Antibodies<br />
to TBII common names; T4: added<br />
Thyroid Receptor Antibodies as a<br />
test, added Thyroid Receptor<br />
Antibodies and TRAB-TSH Receptor<br />
Antibodies to Thyroid Stimulating<br />
Antibody common names; T5: added<br />
Thyroid Receptor Antibodies and<br />
TRAB-TSH Receptor Antibodies to<br />
Thryotropin Binding Inhibiting<br />
Immunoglobulin common names;<br />
T6-T8: reprinted due to adding tests;<br />
T9: added TSH Receptor Antibodies<br />
(TRAB) as a test<br />
L1: Lactose Tolerance Test requires<br />
2 Codes and the 5 samples collected<br />
were made more clear<br />
A12: Anticardiolipin requires a red<br />
top and frozen, T2: Telopeptide-N no<br />
longer available, Telopeptide-C<br />
available<br />
L1: Lamotrigine covered by OHIP<br />
R3:Reverse T3 Test no longer<br />
available<br />
C4: added transport instructions for<br />
Montfort ( on ice pack)<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Dena Seeto BSc MLA QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
March 28,<br />
2011<br />
<strong>2.0</strong> Vedrana Vaskovic<br />
QC Coordinator<br />
Jan 11,<br />
2011<br />
<strong>2.0</strong> Vedrana Vaskovic<br />
QC Coordinator<br />
20Dec2010 <strong>2.0</strong> Vedrana Vaskovic<br />
QC Coordinator<br />
18Oct2010 <strong>2.0</strong> Vedrana Vaskovic<br />
QC Coordinator<br />
24Sep2010 <strong>2.0</strong> Vedrana Vaskovic<br />
QC Coordinator<br />
30August<br />
10<br />
<strong>2.0</strong> Vedrana Vaskovic<br />
QC Coordinator<br />
19July10 <strong>2.0</strong> Vedrana Vaskovic<br />
QC Coordinator<br />
8July10 <strong>2.0</strong> Vedrana Vaskovic<br />
QC Coordinator<br />
7July10 <strong>2.0</strong> Vedrana Vaskovic<br />
QC Coordinator<br />
29June10 <strong>2.0</strong> Vedrana Vaskovic<br />
QC Coordinator<br />
29June10 <strong>2.0</strong> Vedrana Vaskovic<br />
QC Coordinator<br />
A6: changed Aldosterone<br />
requirement from freeze to<br />
refrigerate<br />
A14: changed Anti-Microsomal code<br />
from ATA/MSA to ATA, changed<br />
the Anti-Mitochondrial Antibody<br />
code from MIT to RCML<br />
Z1: Changed collection requirement<br />
for Royal Blue WITHOUT additive<br />
D3: Vitamin D added new insurance<br />
requirements. C9: changed storage<br />
and transportation requirements for<br />
Chlamydia<br />
Changed collection requirements to<br />
“Two full tubes” in order to collect<br />
enough serum<br />
HCV-RNA Section H page 10<br />
17- Hydroxycorticosteroids, 17-<br />
Ketosteroids, 17-Ketogenic Steroids<br />
test no longer available as per<br />
reference lab<br />
CD3, CD4, CD8 Lymphocyte marker<br />
T- Cell only, Immunophenotyping<br />
Lymphocyte markers, T Cell<br />
Lymphocyte: Submit specimen<br />
Monday to Tuesday Only.<br />
Viscosity: Revision to specimen<br />
requirements and handling: 4ml,<br />
whole blood, lavender vacutainer, do<br />
not centrifuge, submit Mon-Tue<br />
only.<br />
Revisions made from June 29-July7<br />
affected the formatting of the TSG<br />
document. Mistake was caught only<br />
after releasing the revisions to ~30<br />
clients. Correct formatting has been<br />
re-established and the proper TSG<br />
updates are to be sent out again.<br />
Apolipoprotein C 2 Activation<br />
Test no longer available<br />
Revised HLA-B27 Test Specimen<br />
Collection to viable for 24hrs<br />
Revised E2 Estradiol test to code<br />
L310.Note: All Estradiol (17β or<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Dena Seeto BSc MLA QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
29June10 <strong>2.0</strong> Vedrana Vaskovic<br />
QC Coordinator<br />
29June10 <strong>2.0</strong> Vedrana Vaskovic<br />
QC Coordinator<br />
29June10 <strong>2.0</strong> Vedrana Vaskovic<br />
QC Coordinator<br />
11May10 <strong>2.0</strong> Michael Halsall<br />
QC Coordinator, MLT<br />
29Mar10 <strong>2.0</strong> Michael Halsall<br />
QC Coordinator, MLT<br />
26Mar10 <strong>2.0</strong> Michael Halsall<br />
QC Coordinator, MLT<br />
11Feb10 <strong>2.0</strong> Michael Halsall<br />
QC Coordinator, MLT<br />
8Feb10 <strong>2.0</strong> Michael Halsall<br />
QC Coordinator, MLT<br />
28Jan10 <strong>2.0</strong> Michael Halsall<br />
QC Coordinator, MLT<br />
8Jan10 <strong>2.0</strong> Michael Halsall<br />
QC Coordinator, MLT<br />
16Dec09 <strong>2.0</strong> Michael Halsall<br />
QC Coordinator, MLT<br />
23Sep2009 <strong>2.0</strong> Michael Halsall<br />
QC Coordinator, MLT<br />
otherwise to be done at CML)<br />
Added back Glucose-6-Phosphate<br />
Dehydroenase (G-6-PD) Quantitative<br />
Test as per CML new code 9973<br />
LE Serum Level: not available to<br />
Quebec insured patients<br />
Protein S Total, and Ammonia<br />
(NH3, NH4) no longer available at<br />
CML<br />
Revised HLA-B27 collection dates &<br />
Lipase billing code to “LIPX”<br />
Updated Celiac Disease Panel to<br />
include separate pricing available<br />
Added Human Herpes Virus-6<br />
(HHV-6)<br />
Amended Calcium, ionized to<br />
include (aka, Free Calcium)<br />
BLOOD CULTURE to be done<br />
ONLY at Bio-Test Main Lab<br />
Diphtheria and Tetanus anti-toxin<br />
serology testing NO LONGER<br />
AVAILABLE AT PHL<br />
First of Second Trimester Screening<br />
specimen requirement changed to<br />
Serum and vacutainer changed to<br />
2SST’s<br />
PEP code changed to PEL & all<br />
Quebec insured patients use RMFT<br />
CKMB, CK & LD Isoenzymes,<br />
Lipoprotein Electrophoresis, G6PD,<br />
Indicans & Eosinophil smears no<br />
longer available at CML<br />
2009-01-30 <strong>2.0</strong> Asif Malik, Lab Mgr. Prepared & adapted<br />
2007-09-19 1.3 Asif Malik, Lab Mgr. Reviewed & Revised<br />
2006-02-20 1.2 Asif Malik, Lab Mgr. Reviewed & Revised<br />
2004-01-21 1.1 Asif Malik, Lab Mgr. Reviewed & Revised<br />
2002-11-02 1.0 Asif Malik, Lab Mgr. Prepared & adopted<br />
Laboratory Tests (In-House and Referred-out)<br />
Tests Codes & Specimen Requirements Manual (TSG)<br />
Complete Manual<br />
Title; Section A-Z (plus Number-1)<br />
J:\Test Specification Guide (TSG) Version <strong>2.0</strong>.doc<br />
<strong>TEST</strong> SPECIFICATION GUIDE (TSG)<br />
Created by Dena Seeto BSc MLA QC Coordinator<br />
BIO-<strong>TEST</strong> LABS<br />
168 Charlotte St., Ottawa, ON., K1N 8K6<br />
Last printed 28/11/2011 1:52 PM<br />
BIO-<strong>TEST</strong> LABORATORY<br />
Tel: (613) 789-4242<br />
Fax: (613) 789-7033<br />
NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red ‘MASTER COPY’ are not controlled and should<br />
be checked against the original document titled as above in the electronic/hard copy version prior to use.
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