3 full 6 mL pink K2 EDTA top tube 1 full 6 mL red top tube 0.5 mL of clean catch urine if testing is needed for chlamydia/or gonorrhea is preferred (Male or Female)

Antibody to Trypanosoma cruzi (Anti-T.cruzi)-Red top tube Negative Chlamydia trachomatis (Chlamydia)-Urine preferred or swab Negative 1) CMV Antibody (No reflective testing occurs)-Pink EDTA tube Negative (Positive result suggest current or past infection with Cytomegalovirus (CMV). The presence of Anti-CMV does not assure immunity to the disease.) 2) CMV Total Antibody with Reflex to IgG & IgM-Pink EDTA tube Negative Positive Antibodies screens will be determined by confirmation. CMVTG-CMV IGG CMVTM-CMV IGM This particular version of CMV testing is for gestational carriers determined by the IVF OBG Department and protocol. Antibody to Hepatitis B Core Antigen, Total (detects IgG and IgM)-Pink EDTA tube Negative Hepatitis B Surface Antigen-Pink EDTA tube Non-reactive Hepatitis C Antibody-Pink EDTA tube Non-reactive HIV 1/2 Antibody plus O-Pink EDTA tube Non-reactive HTLV I/II Antibody Screen-Pink EDTA tube Non-reactive MPX (HIV/HCV/HBV PCR-NAT)-Pink EDTA tube These 3 tests are done together, they cannot be separated out. Non-reactive *If the MPX results is negative then the associated comments will state that there is no evidence of exposure to HIV-1, M, O, HIV-2, HBV, HCV. *If the MPX test is positive, the results will indicate a positive. Further discriminary testing will subsequently be performed for HIV-1, HCV and HBV to identify the positive marker. Neisseria Gonorrhoeae (Gonorrhea)-Urine preferred or swab Negative Syphilis TP (TPPA)-Pink EDTA tube Non-reactive West Nile Virus (WNV NAT)-Pink EDTA tube Negative

CMV testing is determined by protocol. Two version exist: 1) Screen with no reflex. 2) Screen with reflex to IgG and IgM. If you require Antibody to Trypanosoma cruzi (Anti-T.cruzi) testing (TCRUZIMN) this must be ordered on the requisition along with the ORGTMN. If you require West Nile Virus nucleic acid testing (WNVNAT) this must be ordered on the requisition along with the ORGTMN. These tests may be ordered only if the patient is part of the donor network, sperm, egg or embryo donor, autologous blood donor or stem cell donor. Chlamydia/Gonorrhoeae: clean catch urine is preferred: (Male or Female)

1) CMV antibody with no reflex: Immucor Capture-CMV-solid phase- automated. 2) CMV antibody with reflex to IgG and IgM: Capture-CMV-solid phase- automated. Reflex CMV IgG: Chemiluminescence; ELISA II Reflex CMV IgM: Captia Enzyme Immunoassay; ELISA II Antibody to Hepatitis B Core Antigen, Hepatitis B Surface Antigen, Hepatitis C Antibody, HIV 1/2 Antibody plus O, CMV-Immucor and HTLV I/II Antibody Screen use Abbott Prism HTLV-1/HTLV-2 methodology for testing. HIV 1/2 plus O series Antibody Immunoblot will be confirmed on any reactive specimen. Confirmatory scheme includes the following testing: Anti HIV-1 Western Blot (Bio-Rad Western blot), HIV-2 EIA (if Western blot negative) (Bio-Rad), and HIV-2 Immunoblot (if HIV-2 EIA positive) (Viromed). MPX series (HIV/HCV/HBV PCR-NAT) and West Nile Virus (NAT) use Nucleic Acid Testing (NAT) Roche Molecular method. Syphilis Treponema Pallidum uses microhemagglutination on the Olympus PK system. Trypanosoma cruzi (T. cruzi) uses Ortho EIA screening. Confirmatory Testing: Hepatitis B Surface Antigen Confirmation: Neutralization confirmation performed by BioRad - EIA. Hepatitis C Antibody Confirmation: Recombinant Immunoblot Assay (HCV RIBA: Chiron-SIA-v.3.0) HIV-1 Group O or HIV-2. These results should be evaluated in the context of the individual's risk factors and other clinical findings. MPX: (Roche Multiplex PCR) HBV-PCR: (Roche HBV-PCR) Discriminatory testing performed at Lifesource Testing Laboratory HCV-PCR: (Roche HCV-PCR) Discriminatory testing performed at Lifesource Testing Laboratory HIV-1PCR: (Roche HIV-1-PCR) Discriminatory testing performed at Lifesource Testing Laboratory Syphilis Treponema Pallidum (Syphilis TP) confirmatory testing: Fluorescent Treponemal Antibody (FTA-ABS) sent to Viromed Laboratory. Chlamydia trachomatis (Chlamydia): uses the Gen-Probe Amptima Combo 2 kit; transferred by Mailouts to this kit for submission to reference laboratory Neisseria Gonorrhoeae (Gonorrhea): uses the Gen-Probe Amptima Combo 2 kit; transferred by Mailouts to this kit for submission to reference laboratory. Trypanosoma cruzi (T. cruzi) uses: RIPA (radioimmunoprecipitationassay) at a reference laboratory if reactive, results in 12 days, set-up on Mondays and Thursdays.

Antibody to Trypanosoma cruzi (Anti-T.cruzi) EIA screen: CPT = 86753 Confirmation testing RIPA confirmed CPT = 86753 Chlamydia trachomatis CPT = 87491 CMV Antibody CPT = 86644 (screen) Reflex CMV IgG CPT = 86644 Reflex CMV IgM CPT = 86645 Hepatitis B Core Antigen CPT = 86704 Hepatitis B Surface Antigen CPT = 87340 (Hepatitis B Surface Antigen Confirmatory testing done automatically if positive. CPT code = 87340) Hepatitis C Antibody CPT = 86803 (Hepatitis C Antibody Confirmatory testing done automatically if positive. CPT code = 86804) HIV 1/2 Antibody plus O CPT = 86703 (HIV 1/2 Antibody Immunoblot will be confirmed on any reactive specimen; CPT code = 86689. Confirmatory scheme includes the following testing: Anti HIV-1 Western Blot (Bio-Rad), HIV-2 EIA (if Western blot negative--Bio-Rad), and HIV-2 Immunoblot (if HIV-2 EIA positive--Viromed). MPX (HIV/HCV/HBV PCR-NAT) - Combination Test as a screen has the following CPT's: HIV = 87535 HCV = 87521 HBV = 87516 Confirmatory testing will be performed on all positive samples using the following CPT's: HIV = 87535 HCV = 87521 HBV = 87516 Additional charges apply to confirmatory testing. HTLV I/II Antibody: HTLV I CPT code = 86687; HTLV II CPT code = 86688 (screen only test, no confirmation will be performed). Neisseria Gonorrhoeae CPT = 87491 Syphilis TP CPT code = 86592 If positive, confirmatory test is performed FTA-ABS = 86781 at Viromed. West Nile Virus (WNV NAT) CPT code = 87798