Spotted Fever Group Antibody, IgG and IgM, Serum
| 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. Spotted Fever Group Antibody, IgG and IgM, Serum | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
SFGP
Test Workstation :
Mayo
Specimen Type:
Blood
Tube Type:
Red Top (no anticoagulant)
Collection Volume:
1.5 mL (minimum 0.5 mL)
Cause for Rejection:
Gross Hemolysis
Gross Lipemia
Storage:
Refrigerated
Availability:
Sent to Reference Laboratory
Methodology:
Immunofluorescence
Lab/Phone:
330-543-8418
TAT:
1-3 days
Additional Info:
Reference range is available on patient report
CPT Code:
86757 X 2
Panel Includes:
Spotted Fever Group Ab, IgM
Spotted Fever Group Ab, IgG
Synonyms:
Rocky Mountain Spotted Fever
RMSF
Rickettsia
