Fibro Panel

Overview

  • EPIC Code:
  • LAB2303
  • Soft Test Code:
  • FIBRO
Alternate Names
  • Fibro Panel w/ Urines
Included Tests

Antinuclear Antibody Screen (ANA); Anti Streptolysin-O (ASO); Calcium (Ca); Chem 6 [Blood Urea Nitrogen (BUN); Creatinine; Electrolytes [Carbon Dioxide (CO2); Chloride (CL); Potassium (K); Sodium (Na)]; Complete Blood Count [Automated Differential; Hematocrit (Hct); Hemoglobin (Hgb); Mean Corpuscular Hemoglobin (MCH); Mean Corpuscular Hemoglobin Concentration (MCHC); Mean Corpuscular Volume (MCV); Platelet (PLT);  Red Blood Cell Count (RBC); Red Cell Distribution Width Standard Deviation (RDWSD);  Red Cell Distribution Width Coefficient Variation (RDWCV); White Blood Cell Count (WBC)]; Cortisol, Free 24-hr Urine; C-Reactive Protein (CRP); Creatine Kinase (CK); Epstein-Barr Virus Basic Panel [Epstein-Barr Virus Antibody IgG; Epstein-Barr Virus Antibody IgM]; Estrogen, Total; Glucose Random; HLA-B27 Antigen; Insulin - Like Growth Factor 1 (IGF-1 / Somatomedin C); Magnesium (Mg); Parathyroid Hormones Intact (PTH Intact); Progesterone; Protein Electrophoresis; Protein Electrophoresis 24-hr Urine; Rheumatoid Factor (RF); Sedimentation Rate (ESR); Testosterone, Total; Thyroid Profile with TSH [Free Thyroxine Index (FTI); T3 Uptake; Thyroid Stimulated Hormone (TSH); Thyroxine Total (T4)]; Uric Acid


Specimen Collection & Preparation

Required Forms & Information

Order and specimens must include the patient's age.


Patient Preparation

Patient should discontinue taking Biotin, Vitamin B7, or Vitamin H 48 hours before getting blood drawn.


Specimen Overview

Do not collect on Friday's, Saturday's Sunday's, the day before or of a holiday. The HLA-B27 must be sent to the laboratory the same day as collected, and all specimens should be collected together. 

Specimen Requirements:

-AND-

5.0 mL Serum from a Red Top Tube in a Plastic Vial
Collection Instructions:

 Avoid Hemolysis


Processing Instructions:

Centrifuge and separate from cells within 1 hour of collection


-AND-

3.0 mL Plasma in a PST Mint Green Top Tube - Li Heparin
Collection Instructions:

Avoid Hemolysis


Processing Instructions:

Centrifuge and separate from cells within 1 hour of collection


-AND-

5.0 mL Whole Blood in a Green Top - Na Heparin
Rejection Criteria:

Specimen Hemolized

Green Top Tube - Li Heparin

Specimen Clotted 

Received frozen


Transport and Storage:
  • Ambient (18-24°C): 7 days

    Transport 

  • Refrigerated (2-8°C): 5 days
  • Frozen (-20° C or colder): Unacceptable

-AND-

3.0 mL Whole Blood in a Lavender Top Tube - EDTA
Specimen Information:

Must be tested within 4 hours of collection


Collection Instructions:

Mix tube by inversion 5 times; Do not centrifuge; Specimens must not be clotted and cannot contain microclots. Overfilling or underfilling may allow blood to clot.


Processing Instructions:

Do not centrifuge

Specimens must not be clotted and cannot contain microclots. Overfilling or underfilling may allow blood to clot.


Rejection Criteria:

Do not Freeze


Transport and Storage:
  • Ambient (18-24°C):

    Must be tested within 4 hours of collection 

  • Refrigerated (2-8°C):

    Must be tested within 4 hours of collection, if testing delayed longer than this Refrigerate

  • Frozen (-20° C or colder): Unacceptable

-AND-

3.0 mL Plasma from a Lavender Top Tube - EDTA in a Plastic Vial
Processing Instructions:

Centrifuge and separate from cells immediately


-AND-

20.0 mL aliquot from a well mixed 24 hour Urine Collection in a Plastic Container
Collection Instructions:

  1. When starting the 24-hour period, urinate and discard (throw-away) this specimen.
  2. NOTE THE TIME
    1. From that time on, collect all urine by urinating into a clean container and transfer into the provided container.
    2. DO NOT URINATE DIRECTLY INTO CONTAINER.
    3. Try to pass the last urine just prior to the end of the 24 hour period. Add this urine into the container.
  3. Urine Specimen should be kept refrigerated during and after collection

Printable Patient Collection Instructions

English 24 Hour Urine Collection

Spanish 24 Hour Urine Collection 

Burmese 24 Hour Urine Collection

Arabic 24 Hour Urine Collection 


Processing Instructions:

Record Total Volume and Total Hours of Collection on the submitted specimen and requisition

Mix 24 hour urine well, pour off 20.0 mL (No Additive) for Protein Electrophoresis and then proceed to next 24 hour urine test processing instructions 


-AND-

10.0 mL aliquot from a well mixed 24 hour Urine Collection in a Plastic Container 
Collection Instructions:

  1. When starting the 24-hour period, urinate and discard (throw-away) this specimen.
  2. NOTE THE TIME
    1. From that time on, collect all urine by urinating into a clean container and transfer into the provided container.
    2. DO NOT URINATE DIRECTLY INTO CONTAINER.
    3. Try to pass the last urine just prior to the end of the 24 hour period. Add this urine into the container.
  3. Urine Specimen should be kept refrigerated during and after collection

Printable Patient Collection Instructions

English 24 Hour Urine Collection

Spanish 24 Hour Urine Collection 

Burmese 24 Hour Urine Collection

Arabic 24 Hour Urine Collection 


Processing Instructions:

Once the 20.0 mL urine specimen is removed from the well mixed 24 hour urine, pour an additional 10.0 mL into a separate container and add the 50% acetic acid  


Clinical Interpretation

Reference Range:

Refer to Individual Tests


Test Comments:

It has been noticed that allopurinol may falsely elevate TSH level. Cotesting with Free T4 and correlation with clinical symptoms are recommended in evaluation of thyroid function in this subset of patients.

Patients taking vitamin supplements containing high doses of biotin (> 5 mg/day) may have falsely increased  or decreased test results generated.


Methodology:
  • Multiple - Based on Individual Components

Production Schedule

Sites Performed
  • Parkview DeKalb Hospital
  • Parkview Huntington Hospital
  • Parkview Kosciusko Hospital
  • Parkview LaGrange Hospital
  • Parkview Noble Hospital
  • Parkview Randallia Hospital
  • Parkview Regional Medical Center
  • Parkview Southwest
  • Parkview Wabash Hospital
  • Parkview Whitley Hospital
  • Quest - Chantilly
Days Performed
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Departments
  • Chemistry
  • Hematology
  • Immunology
  • Sendouts - Clinical
  • Special Chemistry

Coding & Compliance

CPT Coding

80051, 82310, 82530, 82550, 82565, 82672, 82947, 83735, 83970, 84144, 84165 x 2, 84305, 84403, 84436 x 2, 84479, 84520, 84550, 85025, 85652, 86038, 86063, 86140, 86430, 86665 x 2, 86812 (Reflex 85007, 85008, 86039, 86060, 86431)


Medical Necessity May Apply