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General Laboratory
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Standard Laboratory Practice, Reflex and Confirmatory Testing
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Initial Test
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Reflex Criteria
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Reflex test
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Charge Information
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BC CBC
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Abnormal results: Pathologist-determined criteria
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Pathologist peripheral smear review
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Additional professional charge
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CBC (85025) automated differential
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Abnormal results: Pathologist-determined criteria
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CBC (85023) manual differential
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CBC with manual differential charged, credit issued for CBC with automated differential
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D-Dimer DIC
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Positive
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Titer performed
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Additional technical charge
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HCV ( Hepatitis C Antibody)
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Positive screen
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Confirmation testing - reference lab
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Additional technical charge
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HbsAg (Hepatitis B surface antigen) *
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Positive screen
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Hep BS Confirmatory test
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Additional technical charge
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HIV
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Positive screen
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Western Blot - State mandated
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No additional charge
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Lupus Anticoagulant: DRVVT Lupus Anticoagulant: PT Lupus Anticoagulant:PTT
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Abnormal results
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DRVVT Mix - Reference laboratory PT Mix - Reference laboratory PTT Mix - Reference laboratory
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Additional technical charge - DRVVT Mix only. PT/PTT Mix - No charge as of 11/2001
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Malaria smear *
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Positive
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Pathologist review Possible referral to determine species.
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Additional professional charge Potential additional technical charges for species determination
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RPR *
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Reactive or Weakly reactive
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FTA-Abs - reference laboratory confirmation
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Additional technical charge
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Streptozyme screen *
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Positive
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Titer performed
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Additional technical charge
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UA
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Abnormal results: Pathologist-determined criteria
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Microscopic exam
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Additional technical charge
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UA, culture if indicated
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Test is ordered and WBC >5, or 2+ bacteria
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Urine bacterial culture
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Additional technical charge for culture. Potential additional charges for ID and susceptibility
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Von Willebrand Panel #
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Positive result
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Von Willebrand factor multimers
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Additional technical charges
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*May be ordered without reflex test for known positive patients Note: Hepatitis Acute Panel includes automatic confirmation of positive Hep C Antibody
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