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16167: Serum Integrated Screen, Part 2 Print View
Interpretation      
Risk for ONTD      
Age Risk Down Syndrome      
MSS Down Syndrome Risk      
MSS Trisomy 18 Risk      
Calc'd Gestational Age CALC     
AFP, Serum     ng/mL 
AFP Mom   < 2.50   
hCG, Serum     IU/mL 
hCG Mom      
Estriol, Free     ng/mL 
Estriol Mom      
Inhibin A, Dimeric     pg/mL 
Inhibin A Mom      
PAPP-A     ng/mL 
PAPP-A MoM      
Referring Physician Name      
Referring Physician Phone      
Referring Physician NPI      
Specimen # from Part 1      
Date of Birth      
Collection Date      
Maternal Weight     lbs 
Est'd Date of Delivery      
Mother's Ethnic Origin      
Insulin Depend Diabetic      
Repeat Specimen      
Number of Fetuses      
Hx of Neural Tube Defects      

PRIMARY
1 Serum 3 (1) mL   Room Temperature - 7 Day(s)/Refrigerated - 7 Day(s)/Frozen - 28 Day(s)  
ALTERNATE

To assess maternal risk for carrying a fetus with Down Syndrome (Trisomy 21), Trisomy 18, or a neural tube defect. These types of tests are standard-of-care in obstetrics. The maternal serum biochemical quad screen is used for prenatal screening of Down syndrome (DS) (Trisomy 21), Edward's syndrome (Trisomy 18), and open neural tube defects (ONTD) and ventral abdominal wall defects. This profile includes alpha-fetoprotein

Collect between 14.0 weeks to 22 6/7 weeks.
Maternal date of birth (mm/dd/yy), Estimated Date of Delivery by
US/LMP/PE, weight, race, insulin-dependent diabetes status,
repeat sample (Y/N), number of fetuses, and neural tube defect
history must be provided for interpretation of results.
Must complete patient demographic information using the "Maternal
Serum Screen Requisition".
Setup Schedule
Monday-Saturday

Reported (Analytical Time)
Next day

CPT Codes
82105,84702,82677,86336,84163

The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Notes
Not for California Clients or New York patient testing. Reject Criteria: Gross hemolysis; Gross lipemia METHODOLOGY: Immunoassay, Chemiluminescence






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