Homocysteine, Total Plasma
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
| Address: |
| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
| Ph: ( ) - Fax: ( ) - |
| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Homocysteine, Total Plasma | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
HOM
Test Workstation :
MAYO
Specimen Type:
Blood - Plasma
Tube Type:
Purple top (EDTA) tube - Plasma
Collection Volume:
2.5 mL
Minimum Volume:
0.8mL
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) Stable Isotope Dilution Analysis
Special Instructions:
Fasting (12 hours preferred but not required). Immediately place specimen on wet ice.
For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly)
Lab/Phone:
330-543-8418
TAT:
3-5 days
Additional Info:
Reference range is available on patient report
CPT Code:
83090
