Ordering Recommendations

Not a first-line test for Lyme disease. May be useful if strong suspicion of Lyme disease persists in spite of persistent negative serologic testing. Blood and CSF specimens have poor clinical sensitivity for detection of Borrelia burgdorferi by PCR.

Compliance Statement

For tests developed and validated by ARUP (previously referred to as Compliance Statement B, C or D). This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the U.S. Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

ARUP Test Code

0055570

Performed

Mon, Wed, Fri

Turnaround Time

Specimens are sent to reference laboratory Monday-Sunday; results reported within 5 days.

Interpretive Data

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

Specimen Type

CSF, synovial fluid or tissue.

Collection Containers

Sterile Plastic Leakproof Container

Minimum Collection Volume

1.2 mL

Specimen Preparation

CSF or Synovial Fluid: Transfer 1 mL, 0.5 mL minimum, to a sterile container.
Tissue: Transfer to a sterile container and freeze immediately.

Unacceptable Conditions

Heparinized specimens, tissues in optimal cutting temperature compound.

Storage/Transport Temperature

Frozen

Stability (from collection to initiation)

Tissue: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 1 year
All Others: Ambient: 8 hours; Refrigerated: 72 hours; Frozen: 1 year

Remarks

Specimen source required.

Containers

Sterile Tube

Sterile Plastic Leakproof Container

Reference Interval

Not detected

Interpretive Data

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

CPT Disclaimer

The Current Procedural Terminology (CPT) Codes published in the M Health Fairview Test Directory are based on American Medical Association (AMA) guidelines and are provided for informational purposes only. CPT codes are provided only as guidance to assist clients with billing. CPT coding is the responsibility of the billing party. M Health Fairview Laboratories does not assume responsibility for billing errors due to reliance on the CPT codes listed in this Test Directory. Charges may vary due to reflexing, susceptibilities, specimen source, patient age, methodology requirements, etc..

Patient Price Inquiries

Requester Contact Information
Patient and UMP/FV Care Team Fairview Consumer Line at 612-672-1048
MRL Outreach Client dept-mrl-business-assessment@fairview.org
Research research@fairview.org

Billing Information

CPTQtyHC HospitalPR ClinicNote
87476130087476018747601LYME DIS-DNA-AMP PROBE

CPT Codes

87476

Methodology

Qualitative Polymerase Chain Reaction

MRL Test Build

Test NameComponentRequiredDescriptionTypeLOINC
LAB8448  Borrelia Species by PCR Lyme Disease, Non BloodOrderable 
 SPT_1110YSpecimen type:Prompt 
 SRC_1000YSpecimen source:Prompt 
 1231000032 Borrelia Specimen SourceResult31208-2
 1231000033 Borrelia species by PCRResult4991-6

 

Data Type / Multiple Choice Response

SPT_1110
Cerebrospinal Fluid|Synovial Fluid|Tissue
SRC_1000
Text

Contact

For questions regarding the test code Interface Map, please contact DEPT-LAB-CLIENT-INTERFACE@fairview.org
Ordering

Ordering Recommendations

Not a first-line test for Lyme disease. May be useful if strong suspicion of Lyme disease persists in spite of persistent negative serologic testing. Blood and CSF specimens have poor clinical sensitivity for detection of Borrelia burgdorferi by PCR.

Compliance Statement

For tests developed and validated by ARUP (previously referred to as Compliance Statement B, C or D). This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the U.S. Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

ARUP Test Code

0055570

Performed

Mon, Wed, Fri

Turnaround Time

Specimens are sent to reference laboratory Monday-Sunday; results reported within 5 days.

Interpretive Data

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

Collection & Processing

Specimen Type

CSF, synovial fluid or tissue.

Collection Containers

Sterile Plastic Leakproof Container

Minimum Collection Volume

1.2 mL

Specimen Preparation

CSF or Synovial Fluid: Transfer 1 mL, 0.5 mL minimum, to a sterile container.
Tissue: Transfer to a sterile container and freeze immediately.

Unacceptable Conditions

Heparinized specimens, tissues in optimal cutting temperature compound.

Storage/Transport Temperature

Frozen

Stability (from collection to initiation)

Tissue: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 1 year
All Others: Ambient: 8 hours; Refrigerated: 72 hours; Frozen: 1 year

Remarks

Specimen source required.
Containers

Containers

Sterile Tube

Sterile Plastic Leakproof Container

Result Interpretation

Reference Interval

Not detected

Interpretive Data

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

Administrative

CPT Disclaimer

The Current Procedural Terminology (CPT) Codes published in the M Health Fairview Test Directory are based on American Medical Association (AMA) guidelines and are provided for informational purposes only. CPT codes are provided only as guidance to assist clients with billing. CPT coding is the responsibility of the billing party. M Health Fairview Laboratories does not assume responsibility for billing errors due to reliance on the CPT codes listed in this Test Directory. Charges may vary due to reflexing, susceptibilities, specimen source, patient age, methodology requirements, etc..

Patient Price Inquiries

Requester Contact Information
Patient and UMP/FV Care Team Fairview Consumer Line at 612-672-1048
MRL Outreach Client dept-mrl-business-assessment@fairview.org
Research research@fairview.org

Billing Information

CPTQtyHC HospitalPR ClinicNote
87476130087476018747601LYME DIS-DNA-AMP PROBE

CPT Codes

87476

Methodology

Qualitative Polymerase Chain Reaction
Interface Mapping

MRL Test Build

Test NameComponentRequiredDescriptionTypeLOINC
LAB8448  Borrelia Species by PCR Lyme Disease, Non BloodOrderable 
 SPT_1110YSpecimen type:Prompt 
 SRC_1000YSpecimen source:Prompt 
 1231000032 Borrelia Specimen SourceResult31208-2
 1231000033 Borrelia species by PCRResult4991-6

 

Data Type / Multiple Choice Response

SPT_1110
Cerebrospinal Fluid|Synovial Fluid|Tissue
SRC_1000
Text

Contact

For questions regarding the test code Interface Map, please contact DEPT-LAB-CLIENT-INTERFACE@fairview.org
Private Details