Immunodeficiency Evaluations; Adult and Pediatric

Order form:	Comprehensive Hematopathology Requisition
Supply order:	Supply Order Form
Billing:	Billing Policies
CPT code:	88184, 88185 variable - Technical 88187, 88188 or 88189 variable - Professional (varies due to the number of antibodies performed)

Specimen(s):

Peripheral Blood

Collection Medium:

Yellow top tube 8.5 mL (ACD solution A)

Minimum:

Adult: 8.5 mL whole blood in a yellow top tube (ACD solution A)
Pediatric: 2 mL whole blood in a yellow top tube (ACD solution A)
Minimum specimen requirements are cell count dependent.

For absolute quantitative results, a CBC with Automated Differential must also be ordered and a 3 mL whole blood in a lavender top tube sent refrigerated, OR the results must be sent from a CBC with Automated Differential done the day before or the day of shipment. See shipping and storage requirements for CBC with Automated Differential.

Testing Schedule:

0800-1630 Monday through Friday.

Turn Around Time:

2 days

Reference Range:

Antibodies performed vary with the patient's clinical problem; please provide history and lab findings. The pathologist will provide an interpretative report.

Adult Immunodeficiency Screening Panel:
CD3, CD4, CD8, CD14, CD19, CD25, CD45, CD56, and CD127

Autoimmune Lymphoproliferative Syndrome (ALPS):
CD2, CD3, CD4, CD8, CD19, CD45, HLA-DR, TCR alpha-beta, and TCR gamma- delta

Memory B (Switched and Unswitched): CD21, CD27, CD38, CD45, CD19, IgM, IgD

Comments:

Maintain sample at room temperature; do not incubate or refrigerate.

Test includes various T and B cell assays, as dictated by the clinical question asked. Include pertinent clinical information on the requisition. Recent corticosteroid or chemotherapy may invalidate result. Samples received for Memory B will also receive the Screening Panel.

Please print, complete and submit the Advance Beneficiary Notice (ABN) along with the Flow Cytometry Requisition before shipping the specimen. Include pertinent clinical information on the requisition.

Methodology:

Flow Cytometry-Whole Blood Lysis

Sample Processing:

Relevant clinical information must be submitted with specimen in order to provide correct interpretation of test results.
Specimen should be collected and packaged as close to shipping time as possible.

Sample Storage:

Room Temperature.

Transport Instructions:

Place labeled specimen into zip-lock type biohazard bag; seal bag.
Place completed requisition into outside pocket of bag.
Ship at room temperature.
Recommend early AM overnight shipping or equivalent if not on courier service.

CPT Code:

88184, 88185 variable - Technical
88187, 88188 or 88189 variable - Professional (varies due to the 
number of antibodies performed)