Pinworm Prep
| 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. Pinworm Prep | |
| 2. | |
| 3. | |
| 4. | |
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| 6. | |
| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
PINWM
Test Workstation :
MIC2
Specimen Type:
Pinworm collection in pinworm paddle collection container.
Clear scotch tape slide preparation of perianal region is acceptable.
Cause for Rejection:
Opaque scotch tape. Stool sent instead of pinworm prep paddle. Contaminants on paddle.
Storage:
Ambient
Availability:
Mon-Sun (0700-1600)
Methodology:
Microscopy
Special Instructions:
Specimen is best obtained a few hours after the patient has retired (2200 or 2300) or the first thing in the morning before patient has moved around.
Pinworms migrate out of the anus during periods of rest and lay their eggs around the anal opening.
This collection procedure is essential if valid results are expected.
Pinworm Paddle
Remove the cap which has an optically clear polystyrene paddle with one side coated with a nontoxic mildly adhesive material. This side is marked: sticky side.
Press the sticky surface against the perianal skin with moderate pressure.
Replace the cap with paddle into the container.
Label the specimen and deliver the container to the laboratory.
Pinworms migrate out of the anus during periods of rest and lay their eggs around the anal opening.
This collection procedure is essential if valid results are expected.
Pinworm Paddle
Remove the cap which has an optically clear polystyrene paddle with one side coated with a nontoxic mildly adhesive material. This side is marked: sticky side.
Press the sticky surface against the perianal skin with moderate pressure.
Replace the cap with paddle into the container.
Label the specimen and deliver the container to the laboratory.
Lab/Phone:
330-543-8406
TAT:
48 hours
CPT Code:
87172
Synonyms:
Scotch Tape Test; Enterobius vermicularis
