Toxoplasma IgG Ab
| 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. Toxoplasma IgG Ab | |
| 2. | |
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| 6. | |
| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
TOXG
Test Workstation :
MAYO
Specimen Type:
Blood
Tube Type:
Red Top (no anticoagulant) tube
Alternate Tube Type:
SST
Collection Volume:
1.5 mL
Minimum Volume:
1.0 mL
Cause for Rejection:
Gross hemolysis, Gross lipemia, Gross icterus
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Multiplex Flow Immunoassay (MFI)
Lab/Phone:
330-543-8418
TAT:
1-3 days
Additional Info:
IgG antibodies in patients younger than 6 months of age are typically the result of passive transfer from the mother. To assess possible Toxoplasma gondii infection in patients younger than 6 months, order Toxoplasma gondii Antibody, IgM, Serum. Reference range available on patient report.
CPT Code:
86777
