Protein S Antigen, Plasma
| PATIENT INFO |
| Patient Name: |
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| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
| Address: |
| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
| Ph: ( ) - Fax: ( ) - |
| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Protein S Antigen, Plasma | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
PSTF
Test Workstation :
MAYO
Specimen Type:
Blood
Tube Type:
Blue top (sodium citrate) tube
Collection Volume:
2.7 mL (minimum 1.8mL) - properly filled tube. Must use appropriate sodium citrate tube based on volume of blood drawn(1.8mL or 2.7mL)
Cause for Rejection:
Gross hemolysis, Gross lipemia, Grossly icteric
Storage:
Frozen
Availability:
Sent to reference lab
Methodology:
Latex Immunoassay (LIA)
Special Instructions:
- Days Performed: Mon Fri
- Centrifuge, remove plasma, centrifuge plasma again
Please send 1 mL frozen citrated plasma.
Lab/Phone:
330-543-8418
TAT:
1-3 days
Additional Info:
Reference Range:
- TOTAL
- Males: 80-160%
- Females:
- <50 years: 70-160%
- > or =50 years: 80-160%
- FREE
- Males: 65-160%
- Females:
- <50 years: 50-160%,/ul>
- > or =50 years: 65-160%
CPT Code:
85305, 85306
Panel Includes:
Total Protein S; Free Protein S
