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Laboratory Testing Procedures Keep these helpful hints in mind when having laboratory testing: • • • • • • It is important to follow any directions your physician has indicated on the lab order form to ensure the accuracy of the test. You must bring the physician'fs lab order or requisition with you. All requests for laboratory tests must include a diagnosis and all tests for which Medicare will be billed must be medically necessary for the patient. Some tests ordered by your physician may not be medically necessary by Medicare's policy definitions. In those cases, you will be asked to sign an Advanced Beneficiary Notice (ABN) and be financially responsible. Questions regarding the benefits of having these tests performed should be discussed with your physician. Please remember to check your laboratory orders for diagnosis before leaving your physician's office or delays may occur, as our laboratory cannot perform your procedures without a diagnosis on the requisition. Tests Requiring Appointments Bone Marrow Biopsy Cortrosyn Stimulation Fine Needle Aspiration Glucose Tolerance Test Platelet Aggregation TRH Stimulation Tests Requiring Fasting: (12-14 hours before the test) Cardiac Risk Panel C-Peptide Glucose Tolerance Test Glucose, Fasting Insulin Lipid Panel Lipoprotein Phenotype Testosterone, Free and Weakly Bound Triglycerides Urine Specimen Collection To ensure accurate test results, 24-hour urine collections must be collected accurately. The specimen should be refrigerated until delivery to the laboratory and received by the laboratory within six hours of completion of the collection. 1. The laboratory or your physician will provide you with a 24-hour urine container with the correct preservative. Some of these preservatives may burn if touched, so be careful. You may also be provided with dietary instructions to follow before and during the 2. 3. 4. 5. 6. collection period. You may also be instructed to abstain from taking certain medications before and during the collection period. Label the 24-hour urine container with your first and last name, and your height and weight. Empty your bladder into the toilet. This first specimen is NOT to be included in the 24hour collection. Write the date and time on the container. The collection container should be stored in a refrigerator during the 24-hour collection. Collect all subsequent urine specimens and add them to the container for the next 24 hours. The last sample added to the collection should be collected the second day at the same time as the first day's first void that was discarded. Write the collection finish time and date on the container and deliver the collection container to the laboratory within six hours of the collection finish time. Fecal (Stool) Occult Blood Test Instructions Diet Do not consume the following drugs, vitamins and foods seven (7) days before and during the test period: • • • • • aspirin Bufferin Excedrin nonsteroidal anti-inflammatory drugs (e.g., Advil, Ibuprofen, Motrin, and Aleve) any preparation that contains the following medications: butazolidin, indocin, reserpine and corticosteroids. Three (3) days before and during the test period, please avoid the following: • • • rare meat (beef or lamb), processed meats and liver (small amounts of well-cooked chicken or tuna are permissible) melons, radishes, turnips and horseradish. vitamin C in excess of 250 mg. per day from all sources (note: some iron supplements may contain vitamin C) You may include the following in your diet: • • • • plenty of vegetables both raw and cooked especially lettuce, spinach and corn fruit - especially prunes, grapes, plums and apples moderate amounts of peanuts, popcorn or bran cereal each day Acetaminophen, if needed. NOTE: If any of the above are known to cause you discomfort from past experience, you are instructed to inform your physician. IF YOU HAVE ANY QUESTIONS REGARDING THE COLLECTION OF THE STOOL SPECIMEN, PLEASE CALL (559) 450-3683. Collection You will be given a test card by your physician or laboratory technician. It is important to collect each stool specimen in a clean container. Do not contaminate it with urine or water from the toilet. NOTE: Place the stool specimen on the side of the test card that has the flaps with lines for the patient's name, address and date of collection. Store at room temperature (59°to 86° F). Lift up the flap on the test cards, revealing box "A" and box "B", where you will place the stool sample. Using only the applicator stick provided, place a thin smear of the stool sample inside box "A" on the test card. Reuse the same applicator stick to obtain a stool sample from a different part of the same stool specimen. Apply a thin smear of the stool sample inside box B on the same test card. Close the flap and discard the applicator stick and any remaining stool specimen. NOTE: Do not send stool specimen(s) on toilet paper or used applicator sticks. Place all stool specimen(s) on the test cards provided. Store at room temperature (59°to 86° F). Write your name and the date of specimen collection on the test card flap. Do not leave the test card in direct sunlight. If your physician wants you to collect more than one stool specimen (usually three), use a separate section of the test card for each specimen collected. Tests should be done from consecutive bowel movements. You will need to repeat steps 1-4 for each stool specimen collected. Mailing Instructions (after stool specimen collection is completed) Test cards should be kept at room temperature (59° to 86° F) and mailed to the laboratory as soon as possible and within seven days of the first collection date. • • • Place test card inside the mailing pouch that is provided. Remember to enclose your physician's order for testing and/or the laboratory requisition that your physician completed. Seal the mailing pouch, provide your return address, apply postage and mail. If you have any questions, please call the Outpatient Lab at (559) 450-3683.