Acid Fast Bacilli Isolate Identification by High Performance Liquid Chromatography (HPLC)
Laboratory Fee Schedule
Procedure: MAC0052A
CPT: 87143
| Synonym(s): | HPLC Identification of clinical isolates |
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| Requisition Form | G-MYCO |
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| Test Description | Mycolic acid analysis identification of mycobacterial isolates cultured from clinical specimens in DSHS Laboratory |
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| Pre-Approval Needed | N/A |
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| Supplemental Information Required | N/A |
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| Supplemental Form(s) | N/A |
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| Performed on Specimens from (sources) | Pure isolate from human sources |
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| Sample/Specimen Type for Testing | Mycobacterium species recovered by DSHS laboratory in liquid or on solid culture medium. |
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| Minimum Volume/Size Required | - Liquid culture- 2.0 mL
- Solid culture- Single mature colony
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| Storage/Preservation Prior to Shipping | N/A |
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| Transport Medium | N/A |
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| Specimen Labeling | - At least two patient identifiers required on specimen (e.g., patient full name, date of birth, medical record number).
- Three patient identifiers are preferred.
- Patient identifiers on specimen label must exactly match identifiers on submission form. (e.g., abbreviated name on label and full name on form is not acceptable.)
- Additional DSHS Laboratory specimen labeling guidelines available online here.
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| Shipping and Specimen Handling Requirements | - Ship according to Dangerous Goods Regulations, IATA, and/or CFR 49.
- Category B Biological Substance, UN3373 shipping requirements apply.
- Submitters are responsible for packaging and shipping specimens according to regulatory requirements.
- Additional DSHS Laboratory specimen shipping guidelines online here.
- Ship overnight on cold packs if specimens are refrigerated.
- Ship specimens overnight Monday–Thursday to avoid weekend deliveries.
- Do not ship specimens for holiday or weekend delivery.
- Ensure media used to isolate specimens is not expired.
- Additional DSHS Laboratory submission guidelines available online here.
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| Method | High performance liquid chromatography (HPLC) |
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| Turn-around Time | 1 day |
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| Interferences/Limitations | - Direct HPLC may detect only the predominant organism in a mixed population.
- Direct HPLC is not highly sensitive and will not be conclusive on specimens that have negative or weakly AFB positive smears.
- Direct HPLC cannot determine the viability of organisms detected.
- Direct HPLC results that are negative for M. tuberculosis complex do not conclusively rule out the presence of viable M. tuberculosis complex in the specimen.
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| Common Causes for Rejection | Insufficient volume for testing. |
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| Additional Information | Processed specimen sediments may be accepted for testing following pre-approval but AFB smear and culture must be performed concurrently in the submitting laboratory. |
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