Parkview Health Laboratory: Test Directory

Medicare Medical Necessity Restrictions May Apply

Medical Necessity Documentation:

Patient Preparation:

Specimen Requirements:

3.0 mL Serum in a SST Gold Top Tube

Collection Instructions:

Minimum Volume: 1.5 mL Serum

Transport & Storage: Temperature/Stability: 7 days Ambient
14 days Refrigerated
30 days Frozen

Reference Range:

Specific                                                 Level of Allergen
IgE Class               kU/L                       Specific IGE Antibody
---------                    ------------                ---------------------

0 <0.10 Absent/Undetectable

0/1 0.10 - 0.34 Very Low Level

1 0.35 - 0.69 Low Level

2 0.70 - 3.49 Moderate Level

3 3.50 - 17.4 High Level

4 17.5 - 49.9 Very High Level

5 50 – 100 Very High Level

6 >100 Very High Level

The clinical relevance of allergen results of 0.10 - 0.34 kU/L are undetermined and intended for specialist use. Allergens denoted with a ** include results using one or more analyte specific reagents. In those cases, the test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes

Critical Ranges:

Test Comments:

Methodology: Immucap

Clinical Significance:

Documentation:

Custom Panel: No

Turn Around Time: 3 to 5 days

Sites Performed: Quest - Chantilly

PHL Test Code: MSOT

EPIC Test Code:

Alternate Test Names: E.N.T Pediatric Panel; Ears, Nose & Throat Pediatric Panel; Pediatric Allergen Panel; Pediatric Allergen Panel - ENT

Included Tests:

CPT Coding: 86003 x 15, 82785

Parkview Laboratory: Test Directory

Pediatric Immucap Panel

PRODUCTION SCHEDULE