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Prometheus® IBD sgi Diagnostic

Test Code

90807

CPT Code(s)

81229, 82397 (x3), 83520 (x7), 86021, 86140, 86255 (x2)

Includes

ASCA IgA, ELISA, ASCA IgG, ELISA, Anti-OmpC IgA, ELISA, Anti-CBir1, ELISA; IBD specific pANCA Autoantibody, ELISA; Anti-A4-Fla2 IgG, ELISA, Anti-FlaX IgG, ELISA; ICAM-1, VCAM-1, VEGF, CRP; ATG16L 1 SNP (rs2241880); NKX2-3 SNP (rs10883365); EMC1 SNP (rs3737240); STAT3 SNP (rs744166); SAA; IBD Specific pANCA IFA Perinuclear Pattern; IBD Specific pANCA IFA DNAse; Sensitivity; SNP 8 (R702W), SNP 12 G908R), SNP 13 (1007fs); Anti-I2 ELISA

When ordering IBD sgi, please note that if results of IBD sgi testing are pattern consistent with Crohn’s disease, at physicians request Crohn’s Prognostic, will be added at additional charge (CPT: 83520 (x5), 88347 (x2), 83907, 83898 (x3), 83896 (x6), 83912).

Preferred Specimen(s)

Minimum 2 mL serum submitted in a red-top (no gel) tube --AND-- 2 mL whole blood collected in an EDTA (lavender-top) tube

Minimum Volume

1 mL serum • 2 mL whole blood

Collection Instructions

**Specimens will be rejected if whole blood and serum are not drawn and received together.**
2 mL whole blood and 2 mL serum (specimens must be shipped together).
Shipment within 7 days of collection and storage at or below room temperature is recommended. (Minimum specimen volume for genetic testing may vary based on WBC). Do not freeze specimen.

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Room temperature: 7 days
Refrigerated: 21 days
Frozen: Unacceptable

Reject Criteria

Improper sample type • Improper sample conditions • Improper labeling (specimens must be labeled with patient's name and date of collection; unlabeled specimens will not be accepted for testing.)

Methodology

Enzyme-Linked Immunosorbent Assay (ELISA) • Indirect Immunofluorescence Assay (IFA)

Performing Laboratory

Prometheus®
Therapeutics and Diagnostics
9410 Carroll Park Drive
San Diego, CA 92121

Setup Schedule

Set up: Mon-Fri, a.m.; Report available: 6 days

Reference Range(s)

See Laboratory Report

Clinical Significance

This test will aid healthcare providers to differentiate IBD versus Non-IBD and CD versus UC in one comprehensive blood test.

LOINC®' Code(s)

The Result and LOINC information listed below should not be used for electronic interface maintenance with Quest Diagnostics. Please contact the Quest Diagnostics Connectivity Help Desk for more information at 800-697-9302.

NOTE: The codes listed in the table below are not orderable Test Codes.

Result
Code
Result NameLOINC CodeComponent Name
ASTMRCVDResults Received19146-0Reference lab test results

Reference ranges are provided as general guidance only. To interpret test results use the reference range in the laboratory report.

The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

LOINC assignment is based on a combination of test attributes, including the method used by the performing laboratory. For tests not performed by Quest Diagnostics, codes are assigned by the performing laboratory.

* The tests listed by specialist are a select group of tests offered. For a complete list of Quest Diagnostics tests, please refer to our Directory of Services.