Generally, the specimen requirements are written in a format that specifies the requested volume, storage temperature, and any special handling notes. The requested volume is an amount sufficient to allow at least two performances of the assay either singly or in duplicate. The minimum volume allows one single analysis including instrument dead volume. Storage temperature is specified as room temperature (15 - 30°C), refrigerated (2 to 10°C) or frozen (-20°C or colder). When temperature is not indicated, the sample may be stored and shipped in the most convenient manner for the client.
For panels or multiple assay requests, the sample should be submitted with the physician’s priority of determination on the Test Request Form. Tests will be performed in the order of that priority. If the volume is insufficient to run all the tests requested, our Client Services department will contact the physician.
Specific specimen requirements for each test are listed in the Test Directory. Specimen requirements include information such as specimen volume, collection and transport containers as well as transport temperature. If additional information is needed for the interpretation of the test results or there are specific instructions for patient preparation, they are listed along with specimen requirements. It is critical that an adequate specimen volume is submitted for analysis. The volume requested in this directory is enough for initial analysis as well as for any confirmatory tests that must be performed. If an inadequate specimen is submitted, we may not be able to perform the initial test or required confirmatory procedures.
If repeat or confirmatory tests cannot be performed, the report will indicate that the specimen quantity submitted was “QNS” (Quantity Not Sufficient) for additional testing. When serum or plasma is to be submitted for analysis, it is good practice to collect a volume of blood that is 2 to 2.5 times the volume of serum or plasma needed for the test. As an example, if 4 mL of serum or plasma is needed for a test, collect 8 to 10 mL of blood. When an inappropriate specimen or unclear test request has been submitted, you will receive notification with instructions for resolving the problem.
We generally request 1 tube per test to avoid delays in processing and to expedite turnaround time. To minimize specimen volume requirements for small children, however, only one tube is required even when multiple tests are ordered.
For pediatric specimen tubes, wrap the label around the tube just below the screw cap so the ends of the label adhere to each other and the information stipulated above can be read.
Bright orange, self-adhesive “Pediatric Sample” labels are provided. Please place one of these labels in a blank area of the Test Request Form. The Test Request Form, properly filled out and labeled, should be folded and inserted in the pediatric specimen bag.
Some tests require the patient to ingest a substance. The most common are the Glucose Tolerance Tests where the patient drinks a solution containing glucose, and blood specimens are obtained before and at various times after the drink, to measure the concentration of glucose in plasma or serum. In the standard Glucose Tolerance Tests, adults ingest 75 g (10 ounces) of a glucose solution (Glucola™). Children ingest an amount of glucose proportional to their body weight (1.75 grams of glucose per kilogram of body weight, up to 75 g of glucose).
All specimens should be labeled at the time of collection with at least two patient identifiers.
- The patient’s name (full last name, then full first name or initial) or a unique ID code is always required.
- The second patient identifier may be one of the following:
- Date of birth (month/date/year)
- Other unique patient identifier that is also on the test requisition, e.g. hospital or office ID code or file number
- Quest Diagnostic’s requisition number or specimen barcode label
- Other barcode labels can be used if barcode matches the unique identifiers on the printed requisition (the barcode does not need to be human readable)
NOTE: Location-based identifiers are NOT acceptable, e.g. hospital room number or street address
Each specimen must have a securely affixed label with the following information:
- the patient’s name written exactly as it appears on the test requisition (e.g., Doe, Jane)
- a second patient identifier as noted above
- your account number
- date of collection
If the label is hand-written, use a ballpoint pen–do not use a felt tip pen. If glass slides are submitted, use a pencil for labeling the frosted end–two identifiers are preferred although patient’s name alone is acceptable.
When using an electronically generated Quest Diagnostics test requisition, place the label lengthwise on the tube. When submitting a specimen in a container other than the tube used to draw the sample (e.g., transfer vials), also indicate specimen type on the label (e.g., serum, plasma, urine, etc.). When submitting specimens for microbiological testing (e.g., cultures, bacterial antigen, microscopic examination), the nature and anatomic source of the sample and the specific organism(s) to be detected, if any, should be specified.
Specimens must be accompanied by a paper requisition, prepared either by hand or printed from an electronic ordering system. The requisition, at a minimum should contain the following information:
- Adequate patient identification information (e.g., name, address, telephone number, medical record number
- Patient gender
- Patient date of birth, or age
- Name and address of physician ordering the test
- Test(s) requested
- Date of specimen collection, when appropriate
- Source and type of specimen and time of collection, when appropriate
- Clinical information, when appropriate
Complete the “Patient Information” and “Insurance Information” sections on the requisition. Select the tests to be performed. Legibly print patient information and indicate with a check mark which party will be responsible for payment in the “Bill To” section of the requisition. Enter the ICD diagnosis code that reflects the patient’s symptoms, condition, or diagnosis and provide medical justification for the tests ordered. Complete billing information.
When ordering tests in a series (e.g., growth-hormone stimulation, glucose tolerance, etc.):
- Use one test requisition.
- Label each specimen with the patient’s name, date and time of collection, or site (if applicable).
- Write the number of specimens on the test requisition.
- Submit all specimens within a series together in one specimen bag.
Improperly labeled specimens will be rejected.PACKAGING
- Ensure that all specimen container caps and lids are properly tightened to prevent leakage.
- Properly complete the requisition.
- Collect the specimen(s) and transfer to a proper transport container, if needed. Double check the specimen container to ensure that the device is not beyond its stated expiration date.
- If using a manual test requisition, remove a -self--stick label from the bottom of the pre-printed paper test requisition and affix this label to the specimen transport container. Place on the container so that the label does not cover the handwritten patient name.
- Fold the top copy (original) of the test requisition in half widthwise (top to bottom) with the patient’s name and bar code facing out. Retain the second copy for your files.
- The specimen transport bag has two pouches. Place the specimen container(s) in the front pocket. Insert the requisition into the rear pocket with the bar code visible in the bottom corner of the bag.
- Frozen specimens should be transported in plastic -screw--cap containers only. Frozen specimens must be placed in a separate specimen bag along with a separate test requisition. Frozen specimens cannot be split for other tests. If more than one test is ordered on a single frozen sample, we will call you to authorize which of the tests ordered you want performed before testing can proceed.
- Remove the protective strip and seal the specimen bag. The protective strip must not obstruct the bar code. This will protect the test requisition from leakage and help ensure that the patient information can be entered directly into the laboratory computer by scanning of the bar code.
- If the specimen has been classified as an “infectious substance,” transport in a box designed to withstand 95kPa of pressure to meet the ICAO/IATA and DOT requirements. These boxes are available from the local laboratory (See the Transporting Specimens to Quest Diagnostics section). Please inform Quest Diagnostics prior to, or at the time of our Logistics Representative -pick--up, so that proper transport arrangements can be made.
- Any updates to these guidelines (or to the specimen transport supplies) will be communicated through your local Quest Diagnostics sales representative or Logistics Representative.
PROPER SPECIMEN PACKING HELPS TO EXPEDITE YOUR ORDER.
Air carrier: Follow any additional packaging and documentation requirements according to carrier’s instructions and/or those issued by the IATA, including Packing Instruction.
U.S. Postal Service: Label, package and document according to U.S.Postal Service instructions (note that the U.S. Postal Service may not accept certain types of specimens).
Because different parts of the U.S. Department of Transportation (DOT) regulations apply based upon the mode of transport, check with your carrier or transportation expert about application of the DOT rules prior to submitting.
Packages originating outside of the United States must meet any applicable legal requirements of the country of origin and the U.S. Customs and/or CDC requirements for entry into the United States.
Quest Diagnostics and its affiliates will not be responsible for any liability attributable to the shipper’s improper actions or failure to comply with any applicable legal requirements. The outline of transportation requirements herein is only a summary of current law. It is provided with the understanding that you seek competent expert or legal advice about regulatory compliance, when applicable. In some cases, these requirements include employee training on these regulations. Quest Diagnostics cannot be responsible for this training. Quest Diagnostics reserves the right to refuse to accept any shipments that fail to meet legal requirements and those that pose a safety hazard to its employees.