Respiratory Culture
| 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. Respiratory Culture | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
RESP
Test Workstation :
MIC2
Specimen Type:
1.0 mL bronchoalveolar lavage (BAL) or sputum collected in sterile container.
Eswab from throat, nasopharyngeal, nose, or sinus is acceptable.
Minimum Volume:
BAL and sputum minimum volume is 0.5 mL.
Cause for Rejection:
Quantity not sufficient, improper specimen type, improper storage/transport, improper swab, dry swab, swab not present, multiple swabs per vial, mislabeled, or unlabeled.
Storage:
Transport refrigerated required from off campus location. Upon arrival in laboratory, store refrigerated.
Availability:
Mon-Sun (0700-1600)
Methodology:
Culture
Special Instructions:
Cystic fibrosis patients must be designated as such on the requisition or audit trail accompanying the specimen. This clinical test includes a gram stain for nonCystic fibrosis patients. Throat cultures for Group A Strep only are not ordered under this test. SEE STREP CULTURE.
Lab/Phone:
330-543-8406
TAT:
2 days (non-Cystic fibrosis patients), 5 days (Cystic fibrosis patients)
CPT Code:
87070
Synonyms:
Throat Culture; NPH Culture; Sinus Culture
