CLINICIAN INFORMATION

Pathology Tests Order of Draw Collection Chart Swabs Chart Polymerase Chain Reaction Medicare Requirements

Pathology Tests

Austech Medical Laboratories offers a complete range of diagnostic pathology services in all major pathology disciplines, including chemical pathology, toxicology, microbiology, cytopathology, histology, immunopathology, haematology, endocrinology, reproductive medicine and biochemistry.

A list of tests performed by our laboratories are listed in the table below. Please contact the laboratory if you have any queries related to our range of tests.

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#	Test Name	Tube	Vol (ml)	Instructions	Comp. Time (days)
1	AB	Plain		Please label tubes with patient
2	Acetylcholine Receptor Abs	Serum		Sep & Freeze, this test takes 3 weeks	28
3	Acid Phosphatase			Do PSA	1
4	ACTH	EDTA	2 tubes	Sep & Freeze	7
5	Activated Protein C	CIT	1 tube	Sep & Freeze
6	Adenovirus Serology	Serum	5.0		7
7	AFB	Sputum/	3 spec.	To be collected on 3 consecutive days. Keep refrigerated.	42
8	AFP	Serum	0.5		1
9	AIDS SCREEN	Serum	1.0		2
10	Alanine Transaminase	Serum	0.5		1
11	ALB	Serum	0.5		1
12	Albumin	Serum	0.5		1
13	Alcohol level	Flox plasma	0.5	Gel accepted
14	Aldolase (Non MBS) $162.40	Whole EDTA		Room temp
15	Aldosterone	EDTA		Separate & Freeze	28
16	Alkaline Phosphatase	Serum	0.5		1
17	ALP	Serum	0.5		1
18	ALP Isoenzymes	Serum	0.5ml		1
19	Alpha fetoprotein	Serum	0.5
20	Alpha-1-1Antitrypsin	Serum	1.0
21	ALT	Serum	0.5
22	AMA	Serum	0.5
23	AMH (Anti Mullerian Hormone) (non MBS) $70.50	Serum		Gel tube	1
24	Amino Acid -plasma	Lithium Hep
25	Amiodarone	Serum	0.5	This test takes up to 2 weeks	14
26	Ammonia	EDTA/Lit Hep	10ml	Separate & Freeze - Lithium Hep Tube. EDTA acceptable. Smoking avoided prior to test.	7
27	Amoebic serology	Serum			7
28	Amylase	Serum	0.5		1
29	Amyloid A (NON MBS)$33.00	Serum	0.5
30	ANA/ANF	Serum	0.5		3
31	ANCA	Serum	0.5		7
32	Androgens	Serum	0.5		7
33	Androstenedione	Serum	1.0		7
34	Angiotensin Converting Enzyme	Serum	1.0		7
35	Anion Gap	Serum	0.5
36	Antenatal Serology (ANS)	Serum, EDTA	3.0
37	Anti - DNase B	Serum	1.0		5
38	Anti - Gliadin IgA	Serum	1.0		7
39	Anti acetylcholine esterase receptor antibodies	Serum		Sep & Freeze	7
40	Anti Basement Membrane Ab (Non MBS)	Serum	0.5		14
41	Anti Cardiolipin (ACL) Antiphospholipid antibody	Serum	0.5
42	Anti DNA	Serum	0.5
43	Anti ds DNA	Serum	0.5		5
44	Anti Endomysial Ab (EMA)	Serum	0.5
45	Anti Filaggrin Ab (AFA)	Serum	0.5
46	Anti LKM Ab (ALKMA)	Serum	0.5
47	Anti mitochondrial Antibodies	Serum	0.5
48	Anti Mullerian ABS(AMH) NON MBS $70.50	Serum	0.5
49	Anti myelin antibodies	Serum	0.5
50	Anti Parietal Cell Antibody	Serum	0.5		7
51	Anti Phospholipid Ab/Anticardiolipin	Serum	0.5
52	Anti reticulin Ab (ARA)	Serum	0.5	Sep & Freeze
53	Anti Saccharomyces cerevisiae abs	Serum	0.5		7
54	Anti Smooth Muscle Ab (ASMA)	Serum	0.5		14
55	Anti Sperm Antibody (ASAB)	Serum	1.0	Sep & Freeze
56	Anti Streptolysin-O Titer	Serum	1.0		14
57	Anti Thrombin III	CIT	1 tube	Sep & Freeze
58	Anti Thyroid Antibodies	Serum	1.0		1
59	Anti Transglutaminase Ab (ATGA)	Serum	0.5
60	Anti TSH Receptor	Serum	2.0	Sep & Freeze	14
61	Antibody ID	Serum	10.0	10ml Serum, 1 EDTA and form	7
62	Antibody Screening	Plain			2
63	APC Resistance	Citrate	3 tubes	Sep & Freeze
64	APCA	Serum	0.5
65	APTT	CIT	1 tube	Collect blood to the exact vol.	1
66	Arsenic	EDTA		Whole blood. DO NOT spin
67	ASMA	Serum	0.5
68	ASOT	Serum	0.5		14
69	Aspartate Transaminase	Serum	0.5
70	Aspergillus serology	Serum	1.0		7
71	AST	Serum	0.5		1
72	AST (Aspartate Transaminase)	Serum	0.5		1
73	Auto antibodies	Serum	1.0	Includes both tests.
74	Auto Antibody Screen	Serum	10.0	10 ml Serum + EDTA and Form
75	Avian Precipitins	Serum	1.0

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Order of Draw

Type	Volume	Common Determinations
Blood Cultures	8-10 ml	Blood Cultures - Aerobic and Anaerobic (OXOID - Signal Blood Culture System)
Sodium Citrates (Light Blue)	2.7 ml	APTT, INR, Coag Screen, DIC Screen, Platelet Aggregation, PFA, ATIII Protein C+S, Factor Assays, TT, Fib, APC, DD. ELT, Lupus, Von Willebrand, Factor Inhibitors
ACD (Yellow)	6 ml	T Cells, T&B Cell Counts, Lymphocyte Markers, Peripheral Blood Flow Cytometry. Phenotyping, Tissue Typing
Plain	9 ml	Amiodarone, Serotonin, Vitamin C, Cold Agglutinins, Red Cell Antibody Titres
SST/Gel (Gold)	8.5 ml	UEC, LFT, Troponin, Chol, Trig, HDL, LDL, Ca, Mg, PO4, Uric Acid, Iron Studies, TFT, lonised Calcium, Lithium, EPG, B12, Folate, Tumour Markers, Hormone Assays, Auto-Immune Serology, Viral Titres, Hepatitis Antibodies, HIV, Syphilis
Sodium Heparin (Dark Green)	6 ml	Chromosome Studies, Karyotype, Blood Cytogenetics, STAT Troponin
Trace Element (Navy)	6 ml	Aluminium, Chromium, Copper, Lead, Manganese, Mercury. Selenium, Zinc
EDTA (Small Purple)	4 ml	FBC, ESR, Hb, WCC, PLT Count, Retics, Drug Assays (not Warfarin or Lithium), HbA1c, Red Cell Folate, PCR for FVL, Prothrombin gene, Malaria, DAT
EDTA (Large Purple)	9 ml	Blood Banking: Cross Match, Group and Hold, Blood Group & Antibody Screens Molecular Diagnostic Testing: Hep B PCR, Hep C PCR, CMV PCR, HIV Viral Load
Flouride Oxalate (Grey)	4 ml	Glucose, Lactate, Blood Alcohol
Quantiferon Gold Kit	1 ml	TB Gold, Quantiferon

Collection Chart.

Tube Description	Common Use	Special Instructions
Coag tube 3.2% Sodium Citrate	Coagulation Studies: PT, PI, INR, APTT, Coagulation studies, D- Dimer Other: Lupus Anti-coagulant (please collect 4 tubes for these tests) Factor Assays Protein C and S, Factor V Leiden	Mix well gently. 2ml only please. The vacuum is set to deliver 2ml only; this is the correct ratio of blood/sodium citrate solution NOTE: When using a winged blood collection set for venepuncture, a separate sodium citrate tube is drawn and DISCARDED to allow for elimination of dead space within tube. MIX SAMPLE GENTLY 8-10 TIMES
Serum gel SST	Clinical Chemistry Routine Biochemistry Analysis (LFT, EUC, TFT, Chol & Trigs, HDL, Cardiac Enzymes, Amylase, CRP, Iron Studies, etc.) Serology/Immunology/Endocrino logy: (ENA/DNA, TGA etc), Hormones, Anticardiolipin Antibodies	MIX SAMPLE GENTLY 8-10 TIMES Then allow to stand for 15 minutes before centrifuging
EDTA Tube	Haematology: FBC, ESR, WCC, Diff, Platelets, Malarial Parasites, HbEPG, Reticulocyte count, Blood Group, Rh antibodies (2 tubes) Clinical Chemistry: HbA1C (Glycosylated Haemoglobin). Heavy metals (requires 2 tubes) Red Cell Folate, HLAB2 (Mon-Thu) Haemochromatosis Gene Analysis Molecular: HBV-DNA, Hep C RNA (2x EDTA)	MIX SAMPLE GENTLY 8- 10 TIMES
Glucose tube Sodium fluoride	Clinical Chemistry: Glucose testing, GTT, Glucose load tests	Mix well gently. Please specify on the request form if patient is fasting or non-fasting and any glucose load given to patient. MIX SAMPLE GENTLY 8-10 TIMES
Heparin tube Lithium Heparin	Cytogenetics (Chromosomes) R.T. Fragile X Vitamins A E C & K	NOTE: Sydney Genetics ONLY. Collect 2x EDTAs (for chromosomes) Mon-Thu Only. Tubes for vitamins should be shielded from the light, wrapping in aluminium foil is recommended. MIX SAMPLE GENTLY 8-10 TIMES
ACD tube	T Cells DLAQ Gene	Mon-Thu Only. MIX SAMPLE GENTLY 8-10 TIMES
Navy Blue Trace Metal	Trace Elements Zinc	MIX SAMPLE GENTLY 8- 10 TIMES

Regulatory rules require that all specimens have at least two forms of identification. We recommend FULL NAME and DATE OF BIRTH as the two forms of identification.
For specimen requirements of unusual tests, please contact the laboratory on: (02) 9724 2255

Swabs Chart.

Code	Stopper Colour	Determinations	Instructions
108CIS	Blue Top Clear Amies, Plastic applicator	Used for routine bacterial culture, e.g. pus, wound/skin, ear, nose, throat and eye swabs	Not suitable for viral culture
155CIS	White Top Pastic Swab Rayon Applicator	Dry swab suitable for PCR (Herpes, Chlamydia, Gonorrhoea, Varicella Zoster and Pertussis)	Not suitable for viral or bacterial culture
147CV	Green Top Viral Swab	Use for any viral PCR. Suitable for HSV, VZV, EBV, Measles, HPV and Respiratory viruses PCR. Also suitable for viral culture.	Not suitable for bacterial culture
160CIS	Orange Top Pastic Swab Aluminium applicator	Use for naso-pharyngeal specimen (Pertussis PCR). If used for urethral cultures (e.g. N. gonorrhoeae), must be placed into Transport Medium	Suitable for PCR (if culture required, transfer the swab to a tube with Transport Medium).
	Thin Prep Vial	Thin prep vial solution in addition to being used for Cytology related procedures are also required for HPV-DNA testing. Chlamydia and Gonorrhoea PCR can be performed	Follow same collection instructions for either of the tests listed.

Polymerase Chain Reaction (PCR).

Clinical	Pathogen
STI	Chlamydia trachomatis * & Neisseria gonorrhoeae
STI	Mycoplasma genitalium ** & Ureaplasma urealyticum
STI	Trichomonas vaginalis **
STI	Treponema pallidum (syphilis)
STI/Skin or affected body site	Human Herpes Virus I & II
Skin	Varicella Zoster Virus
STI	Human Papilloma Virus (HPV)
Respiratory	Bordetella pertussis
Respiratory	Influenza A (incl. swine flu), Influenza B and Respiratory Syncytial Virus (RSV).
Respiratory	Mycoplasma pneumoniae
Respiratory	Chlamydia pneumoniae
Gastroenteritis	Salmonella spp. Shigella spp. Yersinia spp. Campylobacter jejuni, Clostridium difficile toxin, Aeromonas, Giardia lamblia, Blastocystis hominis, Dientamoeba fragilis, Entamoeba histolytica, Cryptosporidium spp. Rotavirus, Human Adenovirus and Norovirus
Skin Rash/URTI/Lymphadenopathy	Epstein Barr Virus (EBV)
Skin Rash	Parvovirus
Skin Rash	Measles virus
Conjunctivitis	Adenovirus

HIC/Medicare Requirements for Certain Tests

The Health Insurance Commission (HIC) has established a set of rules and conditions that apply to specific tests and eligibility for Medicare billing, which are subject to change from time to time.

PLEASE NOTE: Information is subject to change without notice. For the latest and most up-to-date information, always refer to your current MBS documents, or online at MBS Online - MBS Online

At the time of publication, the following rules apply:

MBS Item	Test Name	MBS Rules and Comments
65175	Activated Protein C (APC) Resistance	Patient has a history of venous thromboembolism
65175	Anti-thrombin	Patient has a history of venous thromboembolism
66819	Copper, Zinc, Manganese, Selenium	3x patient episodes in 6 month period
73300	Factor V Leiden Gene Mutation PCR	Proven venous thrombosis or pulmonary embolism
69345 69336 69339	Faeces for culture and Ova, Cysts and Parasites (OCP) Examination	Culture
66719	Free T4 (FT4); Free T3 (FT3)	At least one of the following conditions is satisfied: The patient has an abnormal level of TSH; or The tests are performed: For the purpose of monitoring thyroid disease in the patient; or To investigate the sick euthyroid syndrome if that patient is an admitted patient; or To investigate dementia or psychiatric illness of the patient; or To investigate amenorrhoea of the patient; The medical practitioner who requested the tests suspects the patient has a pituitary dysfunction; The patient is on drugs that interfere with thyroid hormone metabolism or function.
66557	Fructosamine	Maximum of 4x tests in a 12 month period for established diabetes.
66554	HbA1C (in pregnancy)	Maximum of 6x tests in a 12 month period for established diabetes in pregnancy.
69418	Human Papilloma Virus (HPV)	A test for high risk human papilloma viruses that can be bulkbilled in a patient who: Has received excisional or ablative treatment for high grade squamous intraepithelial lesions (HSIL) of the cervix within the last two (2) years; Or who within the last two (2) years has had a positive HPV test after excisional; Or ablative treatment for the HSIL of the cervix; Or is already undergoing annual cytological review for the follow-up of a previously treated HSIL. To a maximum of 2 of this item in a 24 month period. (Item is subject to rule 25).

66900	Urea Breath Test	This test will attract a Medicare benefit payment in the following situations: Conformation of H. pylori colonisation. Where suitable biopsy material for diagnosis cannon be obtained at endoscopy in patients with peptic ulcer disease, or where diagnosis of peptic ulcer has been made on barium meal or in patients with past history of duodenal ulcer, gastric ulcer or gastric neoplasia, where endoscopy is not indicated. Monitoring of success of eradication of H. pylori in patients with PUD. Please ensure indication(s) for the test are clearly written on the request form.
69491	Hepatitis C virus (HCV) genotype	The patient is HCV RNA Positive and is being evaluated for antiviral therapy of chronic HCV hepatitis; and The request for the test is made by, or on the advice of, the specialist or consultant physician managing the treatment of the patient. Maximum of1 test in a 12 month period.
71075	Immunoglobulin E (IgE)	2 patient episodes in a 12 month period
71057	Protein EPG	1 specimen type collected within a 28 day period.
66655	Prostate Specific Antigen (PSA)	1 patient episodes in a 12 month period.
66660	PSA (Total & Free)	Result between age related reference limit and 10 ug/ml. 4 patient episodes in a 12 month period
71079	Specific IgE antibodies to single or multiple allergens (RAST)	4 patient episodes in a 12 month period
66626	Urine Drug Screen (UDS)	36 patient episodes in a 12 month period
66599	Vitamin B12, Serum Folate	3 patient episodes (any test combination) in a 12 month period
66833	Vitamin D	As per Medicare Benefits Schedule, the quantification of Vitamin D in serum is for the investigation of a patient who: Has signs or symptoms of osteoporosis or osteomalacia; or Has increased alkaline phosphate and otherwise normal liver function tests; or Has hyperparathyroidism, hypo- or hypercalcaemia, or hypophosphataemia; or Is suffering from malabsorption (for example, because the patient has cystic fibrosis, short bowel syndrome, inflammatory bowel disease or untreated coeliac disease or has had bariatric surgery); or Has deeply pigmented skin, or chronic and severe lack of sun exposure for cultural, medical, occupational, or residential reasons; or Is taking medication known to decrease 250H-D levels (for example, anti- convulsants); or Has chronic renal failure or is a renal transplant recipient; or Is less than 16 years of age and has signs or symptoms of rickets; or Is an infant whose mother has established vitamin D deficiency; or Is an exclusively breastfed baby and has at least one other risk factor mentioned in a paragraph in this item; or Has a sibling who is less than 16 years of age and has vitamin D deficiency. Kindly ensure the clinical indication(s) for this test are clearly marked on the pathology request form

Please note: information is subject to change without prior notice. For the latest and most up-to-date information, always refer to your current MBS documents, or online at: Medicare Benefits Schedule MBS-1