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3091: Alpha-Fetoprotein Triple Marker Screen, 2.5 MoM Print View
AFP IA  By Report  ng/mL 
AFP MoM CALC  < 2.50  MoM 
uE3 (unconjugated Estriol) ICMA  By Report  ng/mL 
uE3 (unconjugated Estriol) MoM CALC  By Report  MoM 
hCG IA  By Report  IU/mL 
hCG MoM CALC  By Report  MoM 
Down Syndrome Risk   > 269   
DOWN SYNDROME SCREEN   Negative   
Down Syndrome Interpretation   By Report   
Open Spina Bifida Risk   By Report   
OPEN SPINA BIFIDA SCREEN   Negative   
Open Spina Bifida Interpretation   By Report   
TRISOMY 18 SCREEN   Negative   
Comments   By Report   
Method of Estimation   By Report   
Number of Fetuses   By Report   
Weeks Gestation   By Report   
Race   By Report   
Weight   By Report   
Insulin Dependant Diabetes   By Report   
Date of Ultrasound   By Report   
Date of LMP   By Report   
Date of Birth   By Report   

PRIMARY
1 Serum 3 (1.5) mL   Room Temperature - 14 Day(s)/Refrigerated - 14 Day(s)/Frozen - 45 Day(s) See COLLECTION INSTRUCTIONS./// 
ALTERNATE

Screening for indication of fetal anomalities including Down syndrome (DS) and Neural Tube Defects (NTD).

Collect specimen between 14-22 weeks gestation. Icteric or
Grossly lipemic specimens are not acceptable.
Split serum into two tubes and ship on cold pack. If not shipped
immediately, samples should be frozen.
SPECIAL INSTRUCTIONS: Must include: Gestational age, LMP, Weight,
Race, Insulin dependent, number of fetuses, and initial or
repeat screen.
Setup Schedule
Sunday, Tuesday-Saturday

Reported (Analytical Time)
Same day

CPT Codes
82105,82677,84702

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
Reject criteria: Grossly lipemic The performance of this test varies with maternal age and other clinical parameters. Ongoing research suggests that approximately 60% of Down syndrome (DS) pregnancies and 60% of trisomy 18 pregnancies can be detected. This use is considered to be investigational. Follow-up testing is recommended for patients when the calculated second trimester risk of Down syndrome risk is 1 in 270 or greater. Normal serum AFP levels for neural tube defects (NTD) are less than 2.5 multiples of the median (MoM). Normal values exclude approximately 95% of cases of anencephaly, 80% of cases of spina bifida, and 85% of ventral wall defects. Closed dysraphic states and small defects generally constitute the group in which total exclusion is not possible.COMMENT: TMS fails to detect about 30% of DS cases in women 35 years old and 10% in those 40 years old, as well as approximately 30% of trisomy 18 and 50% of other chromosomal abnormalities. CVS or amniocentesis chromosome analysis is the test recommended by the American College of Medical Genetics for women over 35 years old.






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