Texas Department of State Health Services - Microbiology Lab Tests

Microbiology
Hepatitis A (Serological – Enzyme Immunoassay for HAVAb-total and HAV IgM)
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Microbiology - Hepatitis A (Serological – Enzyme Immunoassay for HAVAb-total and HAV IgM)
Test Includes: Enzyme Immunoassay for Hepatitis A antibodies
Reporting
Results Available:	Contact #s:
Reference
Method: EIA
Turnaround Time: 5-7 days	Reference Range: <1.00 (Nonreactive)
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system.	Interpretation: Nonreactive indicates that the patient does not have detectable antibody to the infectious agent. Reactive indicates that the patient has detectable antibody to the infectious agent, and depending on the clinical picture, may have a current or past infection.
Specimen Requirements
Specimen Collection: Venipuncture	Sample Type: Serum
Volume/Amount Required: 2 mL Serum	Preferred Specimen: Single Serum
Collection/Preservation: Red top or tiger top tube	Storage Instructions: Separated serum may be held at 2-8°C
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing	Sample Container: Red top or tiger top tube
Sample Test Kit:	Availability: Test run once per week
Diagnostic Information: Tests are available only to Department’s epidemiologists to investigate outbreaks. Test is performed once per week.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Use Universal Precautions
Transport Temperature: Cold (2-8º C) on ice packs if received within 48 hours from time of collection. Frozen (≤-20°) on dry ice if received more than 48 hours from time of collection.	Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8°C), or frozen (-20°C) and mailed on dry ice.
Billing
CPT Code: 86708 - Total, 86709 - IgM	Fees:

Microbiology
Hepatitis B (Serological – Enzyme Immunoassay for HbsAg,and Anti-HBsAg, Total antibody or HBcAb-Total of IgM)
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Microbiology - Hepatitis B (Serological – Enzyme Immunoassay for HbsAg,and Anti-HBsAg, Total antibody or HBcAb-Total of IgM)
Test Includes:
Reporting
Results Available:	Contact #s:
Reference
Method: EIA
Turnaround Time: 1-2 days for HbsAg, 3-4 days for Anti-HbsAg and 5-7 days for HbcAb-Total	Reference Range: <1.00 (Nonreactive)
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system.	Interpretation: Nonreactive indicates that the patient does not have detectable antibody to the infectious agent. Reactive indicates that the patient has detectable antibody to the infectious agent, and depending on the clinical picture, may have a current or past infection.
Specimen Requirements
Specimen Collection: Venipuncture	Sample Type: Serum
Volume/Amount Required: 2 mL Serum	Preferred Specimen: Single Serum
Collection/Preservation: Red top or tiger top tube	Storage Instructions: Separated serum may be held at 2-8°C
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing	Sample Container: Red top or tiger top tube
Sample Test Kit:	Availability: Tests run daily
Diagnostic Information:
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Use Universal Precautions
Transport Temperature: Cold (2-8º C) on ice packs if received within 48 hours from time of collection. Frozen (≤-20°) on dry ice if received more than 48 hours from time of collection.	Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8°C), or frozen (-20°C) and mailed on dry ice.
Billing
CPT Code: 86704 - Core, 86706 - sAb, 87340 - sAg	Fees:

Microbiology
Hepatitis C (Serological – Enzyme Immunoassay)
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Microbiology - Hepatitis C (Serological – Enzyme Immunoassay)
Test Includes:
Reporting
Results Available:	Contact #s:
Reference
Method: EIA
Turnaround Time: 3-4 days	Reference Range: <0.620
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system.	Interpretation:
Specimen Requirements
Specimen Collection: Venipuncture	Sample Type: Serum
Volume/Amount Required: 5 mL Serum	Preferred Specimen: Single Serum
Collection/Preservation: Red top or tiger top tube	Storage Instructions: Separated serum may be held at 2-8°C
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing	Sample Container: Red top or tiger top tube
Sample Test Kit:	Availability: test run 3 times weekly
Diagnostic Information: Hepatitis C virus (HCV) causes 50-75% of cases described as non-A non-B hepatitis. The virus is spread primarily via blood and blood products. Known high-risk groups for HCV hepatitis include transfusion recipients, intravenous drug users, individuals with “street” tattoos and health care workers with frequent body fluid contact. Test is performed 3 times per week.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Use Universal Precautions
Transport Temperature: Separated serum or SST tubes at 2-8°C (refrigerated) or serum -20°C (frozen).	Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8°C), or frozen (-20°C) and mailed on dry ice.
Billing
CPT Code: 86803, 86804 (RIBA)	Fees:

Microbiology
Herpes Simplex (Culture - Isolate)
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Microbiology - Herpes Simplex (Culture - Isolate)
Test Includes: Cell culture
Reporting
Results Available: 1-12 days	Contact #s: 512-458-7594
Reference
Method: Cell culture
Turnaround Time: 1-12 days	Reference Range: Herpes simples not isolated
Limitations:	Interpretation: A result of “Herpes simplex virus not isolated” does not necessarily mean absence of disease. The success of virus isolation depends a great deal on the submissions of the proper specimen, collected at the right time, adequately maintained, and shipped with the least possible delay.
Specimen Requirements
Specimen Collection: Specimens should be collected at an appropriate anatomic site and at the proper time after infection because viruses are generally shed for only a short period of time. Refer to Specimen Collection by Type table for additional instructions.	Sample Type: See preferred specimen
Volume/Amount Required: Swab in 2-4 mL of viral transport media, or tissue in enough viral transport media to prevent drying	Preferred Specimen: Vesicular fluid/swab; Tissue
Collection/Preservation: Viral transport media.	Storage Instructions: Arriving < 48 hours after collection, store and send at 2-8° C. Arriving > 48 hours after collection, store and send at -70° C (dry ice).
Causes for Rejection: Specimens submitted on a preservative such as formalin.	Sample Container: Sterile container
Sample Test Kit:	Availability: Monday - Friday
Diagnostic Information: Isolation services are limited to designated public health programs. A variety of cell monolayers which support the growth of herpes simplex are inoculated and observed for 10 days. If characteristic CPE is observed, confirmation of identification will be performed.
Specimen Submission
Required Request Form: G-2V	Specimen Handling:
Transport Temperature: Arriving <48 hours: 2-8° C Arriving >48 hours: send on dry ice	Shipping Requirements: Ship specimens in compliance with governmental regulations.
Billing
CPT Code: 87252	Fees:

Microbiology
Herpes Simplex (Culture - Identification)
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Microbiology - Herpes Simplex (Culture - Identification)
Test Includes: Immunofluorescence
Reporting
Results Available: 1-12 days	Contact #s: 512-458-7594
Reference
Method: Immunofluorescence
Turnaround Time: 1-12 days	Reference Range: By report
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type:
Volume/Amount Required: If transporting on dry ice, send 1-2 mL.	Preferred Specimen: Cell culture isolate with CPE.
Collection/Preservation:	Storage Instructions: If shipment of isolate will be delayed, store at -70° C.
Causes for Rejection:	Sample Container: Sterile cryovial.
Sample Test Kit:	Availability: Monday - Friday
Diagnostic Information: Isolation services are limited to designated public health programs.Identification is based on immunofluorescence test using monoclonal antibodies.
Specimen Submission
Required Request Form: G-2V	Specimen Handling:
Transport Temperature: Frozen isolate: on dry ice	Shipping Requirements: Ship specimens in compliance with governmental regulations.
Billing
CPT Code: 87273, 87274	Fees:

Microbiology
Histoplasmosis (Culture - Isolation)
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Microbiology - Histoplasmosis (Culture - Isolation)
Test Includes: Isolation of fungus and identification by Gen-Probe Accuprobe Test
Reporting
Results Available: 21-28 days	Contact #s: 512-458-7455 for prior approval Technical questions: 512-458-7586
Reference
Method: Accuprobe culture confirmation test; hybridization of ribosomal RNA to probe detected by chemiluminesence
Turnaround Time: 21-28 days	Reference Range: Negative
Limitations: Delay in transport of specimen could compromise isolation of organism.	Interpretation: Positive by DNA Probe Test means that the probe detected ribosomal RNA of Histoplasma capsulatum from the isolate.
Specimen Requirements
Specimen Collection:	Sample Type: Clinical specimen.
Volume/Amount Required: 3 mL to 15 mL	Preferred Specimen: Sputum; Tissue; Exudate; Blood; Bone marrow
Collection/Preservation: No preservative.	Storage Instructions: Transport specimen as soon as possible. If transport is delayed over one hour, refrigerate specimen, unless blood.
Causes for Rejection: Specimens received frozen, in formalin, or in culture medium will be rejected. Swabs are discouraged unless the only specimen available; submit swabs in 5 mL sterile saline. Blood specimens less than 5 mL are unacceptable. Refrigerated blood specimens will be rejected.	Sample Container: Triple-contained. Sterile, leak-proof, 50 mL conical tube preferred for primary container. Add up to 10 mL of sterile saline to tissue if needed to maintain moisture during transport. If blood, prefer yellow-top with ACD; may also contain SPS. Green-top is acceptable with lithium or heparin.
Sample Test Kit:	Availability: Testing available upon approval by Dr. Penfield.
Diagnostic Information: Approval for this testing must be obtained prior to shipping by telephoning Dr. Susan Penfield at 512-458-7455.
Specimen Submission
Required Request Form: G-2B	Specimen Handling:
Transport Temperature: Ambient acceptable but 2-8º C preferred for non-sterile specimens.	Shipping Requirements: Triple-contained and packaged to meet requirements of DOT, USPS, PHS, and IATA for shipping of clinical specimens.
Billing
CPT Code: 87102	Fees:

Microbiology
Histoplasmosis (Culture – Genetic Probe Confirmation)
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Microbiology - Histoplasmosis (Culture – Genetic Probe Confirmation)
Test Includes: Identification of isolate by Gen-Probe Accuprobe Test
Reporting
Results Available: 7-10 days	Contact #s: 512-458-7318, ext. 2687
Reference
Method: Accuprobe culture confirmation test; hybridization of ribosomal RNA to probe detected by chemiluminesence
Turnaround Time: 7-10 days	Reference Range: By Report
Limitations: Positive Probe Test does not mean isolate is still viable.	Interpretation: Positive by DNA Probe Test means that the probe detected ribosomal RNA of Histoplasma capsulatum from the isolate.
Specimen Requirements
Specimen Collection:	Sample Type:
Volume/Amount Required:	Preferred Specimen: Pure Culture
Collection/Preservation: No preservative	Storage Instructions:
Causes for Rejection: Culture infested with mties.	Sample Container: Triple-contained
Sample Test Kit:	Availability: Accuprobe test is run once weekly.
Diagnostic Information: Fungal isolates (pure culture) submitted to this Laboratory for definitive identification. Drug susceptibility testing on these organisms not available at TDSHS laboratory.
Specimen Submission
Required Request Form: G-2B	Specimen Handling:
Transport Temperature: Room temperature	Shipping Requirements: Triple-contained and packaged to meet rigorous performance tests as outlined in the DOT, USPS, PHS, and IATA regulations for shipping of infectious substances.
Billing
CPT Code:	Fees:

Microbiology
HIV-1, Screen (Serological – Enzyme Immunoassay)
Related Agents: Acquired Immunodeficiency Virus
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Microbiology - HIV-1, Screen (Serological – Enzyme Immunoassay)
Test Includes: Enzyme Assay (EIA)
Reporting
Results Available: 1 day	Contact #s:
Reference
Method: EIA
Turnaround Time: 1-2 days	Reference Range: Nonreactive
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system.	Interpretation: Nonreactive indicates that the patient does not have detectable antibody to the infectious agent. Reactive indicates that the patient has detectable antibody to the infectious agent, and depending on the clinical picture, may have a current or past infection.
Specimen Requirements
Specimen Collection: Venipuncture	Sample Type:
Volume/Amount Required: 5 mL Serum, or filter paper with 3 circles completely filled.	Preferred Specimen: Serum, plasma; Oral Fluid; Filter Paper Blood Spot
Collection/Preservation: Red top or tiger top tube	Storage Instructions: Separated serum may be held at 2-8°C
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing	Sample Container: Red top or tiger top tube
Sample Test Kit:	Availability: Test performed daily
Diagnostic Information: The EIA procedure for the detection of antibodies to HIV is a screening procedure. All positive or borderline results require validation by the Western Blot Confirmatory procedure. The western blot will automatically be performed and charged on all specimens with positive or borderline results. Specimens with Nonreactive EIA results will not be tested by western blot unless specifically requested.
Specimen Submission
Required Request Form: G-2A, G-THSTEPS for THSteps Medicaid	Specimen Handling: Use Universal Precautions
Transport Temperature: Separated serum or SST tubes at 2-8°C (refrigerated) or serum -20°C (frozen). Dried blood spots ambient up to 7 days.	Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8°C), or frozen (-20°C) and mailed on dry ice.
Billing
CPT Code: 86701	Fees:

Microbiology
HIV-1, Confirmation (Serological – Western Blot)
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Microbiology - HIV-1, Confirmation (Serological – Western Blot)
Test Includes: Western Blot for antibodies to HIV-1
Reporting
Results Available: 1-2 days	Contact #s:
Reference
Method: Western Blot
Turnaround Time: 1-2 days	Reference Range: Nonreactive
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system.	Interpretation: Nonreactive indicates that the patient does not have detectable antibody to the infectious agent. Reactive indicates that the patient has detectable antibody to the infectious agent, and depending on the clinical picture, may have a current or past infection.
Specimen Requirements
Specimen Collection: Venipuncture	Sample Type:
Volume/Amount Required: 5 mL Serum	Preferred Specimen: Serum, plasma; Oral Fluid; Filter Paper Blood Spot
Collection/Preservation: Red top or tiger top tube	Storage Instructions: Separated serum may be held at 2-8°C
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing	Sample Container: Red top or tiger top tube
Sample Test Kit:	Availability: Test performed daily
Diagnostic Information Available on repeatedly reactive EIA specimens. The major bands of diagnostic significance on a reactive HIV-1 western blot are the glycoproteins gp41, gp120 and gp160 encoded by the envelope (ENV) gene; p17, p24, p55 encoded by the group-specific antigen gene (GAG); and p31, p55 and p66 encoded by the polymerase (POL) gene. The interpretative criteria employed are those proposed by APHL and the CDC, whereby serum reactivity with two or more of the following antigens defines a positive result: p24, gp41, gp120/160. Sera reactive with less than two of these antigens and sera reactive with other antigens are reported as indeterminate and a follow-up specimen is requested. Western blot tests for oral fluid and filter paper blood spots are now FDA approved for diagnostic purposes and no longer require a follow-up serum specimen.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Use Universal Precautions
Transport Temperature: Separated serum or SST tubes at 2-8°C (refrigerated) or serum -20°C (frozen). Dried Blood Spots ambient up to 7 days. Oral fluid ambient up to 21 days.	Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8°C), or frozen (-20°C) and mailed on dry ice.
Billing
CPT Code: 86689	Fees:

Microbiology
HIV-2, Screen (Serological – Forwarded by TDSHS to CDC for testing.)
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Microbiology - HIV-2, Screen (Serological – Forwarded by TDSHS to CDC for testing.)
Test Includes:
Reporting
Results Available:	Contact #s:
Reference
Method:
Turnaround Time: 3 weeks	Reference Range: Nonreactive
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system.	Interpretation: Nonreactive indicates that the patient does not have detectable antibody to the infectious agent. Reactive indicates that the patient has detectable antibody to the infectious agent, and depending on the clinical picture, may have a current or past infection.
Specimen Requirements
Specimen Collection: Venipuncture	Sample Type: serum, plasma
Volume/Amount Required: 10 mL whole blood	Preferred Specimen: Serum, plasma
Collection/Preservation: Red top or tiger top tube	Storage Instructions: Do not freeze or refrigerate whole blood. Separated serum may be held at 2-8°C
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing	Sample Container: Red top or tiger top tube
Sample Test Kit:	Availability:
Diagnostic Information: Prior notification is requested (512) 458-7760. A detailed patient history is required. Serum forwarded to the CDC from patients with reactive HIV-2 if HIV1/HIV2 combo EIA screen reactive or appropriate risk factors. Patient history required. HIV-2 is cross-reactive with HIV-1 and has been detected with the whole viral lysate EIA used by TDSHS.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Use Universal Precautions
Transport Temperature: Ambient temperature for specimens on the blood clot, separated serum at 2-8°C (refrigerated) or -20°C (frozen).	Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8°C), or frozen (-20°C) and mailed on dry ice.
Billing
CPT Code: 86702	Fees:

Microbiology
HTLV-I-II (Serological – Forwarded by TDSHS to CDC for testing.)
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Microbiology - HTLV-I-II (Serological – Forwarded by TDSHS to CDC for testing.)
Test Includes:
Reporting
Results Available:	Contact #s:
Reference
Method:
Turnaround Time: 3 weeks	Reference Range: Nonreactive
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system.	Interpretation: Nonreactive indicates that the patient does not have detectable antibody to the infectious agent. Reactive indicates that the patient has detectable antibody to the infectious agent, and depending on the clinical picture, may have a current or past infection.
Specimen Requirements
Specimen Collection: Venipuncture	Sample Type: Serum, Plasma
Volume/Amount Required: 10 mL whole blood	Preferred Specimen: Serum, plasma
Collection/Preservation: Red top or tiger top tube	Storage Instructions: Do not freeze or refrigerate whole blood. Separated serum may be held at 2-8°C
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing	Sample Container: Red top or tiger top tube
Sample Test Kit:	Availability:
Diagnostic Information: Prior notification is requested (512) 458-7760. A detailed patient history is required. Serum or plasma will be forwarded to the CDC for testing.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Use Universal Precautions
Transport Temperature: Ambient temperature for specimens on the blood clot, separated serum at 2-8°C (refrigerated) or -20°C (frozen).	Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8°C), or frozen (-20°C) and mailed on dry ice.
Billing
CPT Code: 86687,86688	Fees:

Microbiology
Hookworm (Microscopic – Direct Wet Smears Concentration)
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Microbiology - Hookworm (Microscopic – Direct Wet Smears Concentration)
Test Includes: Microscopic examination
Reporting
Results Available: 3 days	Contact #s: (512) 458-7560
Reference
Method: Microscopic examination
Turnaround Time: 3 days	Reference Range: No parasites found
Limitations:	Interpretation: No parasite found indicates that there were no visible parasites in the specimen submitted.
Specimen Requirements
Specimen Collection: feces	Sample Type: Feces, unpreserved (less than 5 hours), formalin preserved
Volume/Amount Required: 15 mL liquid stool, 15 g stool	Preferred Specimen: Formalin preserved feces
Collection/Preservation: Collect liquid stool or stool and immediately place into formalin preservative. Hold at ambient temperature.	Storage Instructions: Ambient temperature
Causes for Rejection: Unpreserved stool > 5 hours.	Sample Container: Formalin transport for parasites
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: Demonstration of eggs in formalin preserved stool samples. If stool is unpreserved for over 24 hours, the eggs may continue to develop and the larvae may hatch for identification.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Handle body fluids using universal precautions. Formalin is considered a poison.
Transport Temperature:	Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.
Billing
CPT Code:87177	Fees:

Microbiology Laboratory Tests: Hepatitis to Hookworm