Laboratory Fee Schedule
Procedure: MAM0089A
CPT: 86790
| Synonym(s): | Arbovirus, Flavivirus |
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| Requisition Form | G-2V |
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| Test Description | Qualitative Immunochromatographic Assay (ICA) for the presumptive detection of IgM antibodies to Zika virus using Chembio DPP Assay system. |
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| Pre-Approval Needed | Yes. Contact your local or state epidemiologist if Zika virus is suspected. Contact information can be found at the following link: http://www.dshs.texas.gov/idcu/investigation/conditions/contacts/ |
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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) | Human |
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| Sample/Specimen Type for Testing | Serum collected in Serum Separator tubes (SST) or red top tubes |
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| Minimum Volume/Size Required | 1.0 mL |
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| Storage/Preservation Prior to Shipping | - Store serum cold at 2°C to 8°C for up to 48 hours after collection.
- Store frozen at-20°C or colder if being stored longer than 48 hours after collection.
- Never freeze serum in separator tubes.
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| Transport Medium | N/A |
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| Specimen Labeling | - At least two patient-specific identifiers required on specimen (e.g. patient full name, date of birth, medical record number).
- Three unique patient identifiers are preferred.
- Patient identifiers on specimen label must exactly match identifiers on G-2V 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.
- If specimen will arrive at the Lab within 48 hours of collection, refrigerate at 2°C –8°C and ship overnight on cold packs.
- If specimen will arrive at the lab more than 48 hours after time of collection, freeze at -20°C or colder, and ship overnight on dry ice.
- Additional DSHS Laboratory specimen shipping guidelines online here.
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| Method | Immunochromatographic Assay (ICA), Lateral Flow Test |
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| Turn-around Time | 7 working days |
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| Interferences/Limitations | - The most common cause of false positive results is cross-reactivity with IgM specific for other flaviviruses.
- Negative results do not preclude infection with Zika and should not be the sole basis of a patient treatment/management or public health decision.
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| 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, illegible, or missing submission form
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| Additional Information | - Reactive samples will be forwarded to CDC for confirmatory testing by Plaque Reduction Neutralization Test (PRNT).
- Minimum volume for CDC confirmation testing 0.5 mL.
- Please visit www.texaszika.org/labs/htm for more information.
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