University of Iowa
Diagnostic Laboratories
(UIDL) Test Directory

319-384-7212 (local)
1-866-844-2522 (toll free)


Antimicrobial Susceptibility Profile MIC
Order Form: Laboratory Requisition
Specimen:
(Per Organism)
Testing
Schedule:
0700-2200, 7 days a week, including holidays.
Comments:
This test is performed on isolates according to laboratory protocol.

Please print, complete and submit the Advance Beneficiary Notice 
(ABN) along with the Laboratory Requisition before shipping the 
specimen.
Methodology:
Several methods are used; disk diffusion (Kirby-Bauer), strip diffusion 
(E-Test), manual and automated micro dilution trays.
Sample
Processing:
Label transport tube with two patient identifiers, date and time of 
collection.
Maintain sterility and forward promptly to lab.
Relevant clinical information must be submitted with specimen in order 
to provide correct interpretation of test results.
Sample
Storage:
Room temperature or refrigerate if stored overnight, weekends or 
holidays.
Transport
Instructions:
Place specimen into zip-lock type bag, seal bag.
Recommend express mail or equivalent if not on courier service.
Ship ambient or refrigerate.
Place requisition into outside pocket of bag.
Instructions:
Submit on appropriate media.
CPT Code:
87181, 87184, 87186, 87187, 87190, or 87192

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Updated: 02/15/2007