Laboratory Fee Schedule
Procedure: BTA0201
CPT: 83789
	| Synonym(s): | 
	Clostridium botulinum toxin, Botulism | 
	| Requisition Form | 
	G-27A | 
	| Test Description | 
	Detection of Clostridium botulinum toxin | 
	| Pre-Approval Needed | 
	
	
	- DSHS Epidemiology consultation with physician required
 
	- Must notify BioThreat Team prior to sample submission: (512) 689-5537
 
	 
	 | 
	| Supplemental Information Required | 
	Patient history | 
	| Supplemental Form(s) | 
	N/A | 
	| Performed on Specimens from (sources) | 
	
	
	- Human
 
	- Environmental
 
	- Food (associated with a positive clinical sample)
 
	 
	 | 
	| Sample/Specimen Type for Testing | 
	
	
	- Anaerobic isolate
 
	- Stool
 
	- Gastric
 
	- Water enema
 
	- Serum (no serum on infants)
 
	- Wound swab
 
	- Tissue
 
	- Food (associated with a positive clinical sample)
 
	 
	 | 
	| Minimum Volume/Size Required | 
	
	 Feces 
	
	- Infant 10 g or 5 mL enema
 
	- Adult 50 g or 5 ml enema
 
	 
	Vomitus or gastric aspirate  
	
	Serum (no serum on infants) 
	
	Food 
	
	Wound swab 
	
	Tissue 
	
	 | 
	| Storage/Preservation Prior to Shipping | 
	
	 Wound swab, anaerobic culture or tissue 
	
	- Maintain at ambient temperature
 
	 
	Serum 
	
	- Maintain at 2° to 8°C (refrigerated) unless >48 hours, ship at -20°C (frozen)
 
	 
	All others 
	
	- Maintain at 2° to 8°C (refrigerated)
 
	 
	Food 
	
	- At existing storage temperature, collected by sanitarian only
 
	 
	 | 
	| Transport Medium | 
	Isolates sent in anaerobic transport media | 
	| Specimen Labeling | 
	
	 Human 
	
	- Two patient-specific identifiers required (e.g., patient full name, date of birth, Medical record number)
 
	- Identifiers on specimen must exactly match submission form.
 
	 
	Environmental or Food 
	
	- Sample identification must match submission form.
 
	 
	 | 
	| Shipping and Specimen Handling Requirements | 
	
	
	- Ship according to Dangerous Good Regulations, IATA, and/or CFR 49.
 
	- Handled as infectious agent using universal precautions. 
 
	- Triple contained in accordance with federal shipping regulations for infectious agents. 
 
	- See also Emergency Preparedness resources online.
 
	- Notify BioThreat Team prior to sample submission: (512) 689-5537
 
	 
	 | 
	| Method | 
	Mass spectrometry | 
	| Turn-around Time | 
	7-14 days | 
	| Interferences/Limitations | 
	
	 Improper storage or shipping temperatures may affect toxin detection. 
	 | 
	| Common Causes for Rejection | 
	
	
	- Insufficient quantity
 
	- Unacceptable specimen type or source
 
	- Improper shipping conditions
 
	- Expired media or collection container
 
	- Discrepancies between specimen label and submission form
 
	- Incomplete or missing submission form
 
	 
	 | 
	| Additional Information | 
	May be paired with Culture:  Botulinum (human) and/or PCR – Botulinum toxin genes |