Reference Laboratory

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Reference Laboratory
Tests

51940

Nafcillin Level, BA

Specimens collected just before or within 15 minutes of the next dose represent the TROUGH levels. Specimens obtained within 15-30 minutes after the end of I.V. infusion or 45-60 minutes after an IM injection or 90 minutes after oral intake represent the PEAK level.

This test is available for New York patient testing.

Methodology		Bioassay
Reference Range		By report
Preferred Specimen		1 mL serum (minimum 0.5 mL)
Transport Temperature		FROZEN
Results Available		3 to 4 days
CPT Code		80299

-160

Naegleria Culture (See Acanthamoeba/Naegleria Culture)

-261

Natalizumab Antibodies (See Tysabri Antibodies)

Tysabri® Antibodies, ELISA

-162

Native DNA (See dsDNA)

dsDNA Antibody, IFA

20590

Natural Killer Cell Enumeration, FC


This unit code has been inactivated. Please see unit code 2590.

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-169

Neuropathy Antibody Testing

The following Neuropathy-Related Assays are available. See individual panels or assays for complete description.

Code # Test Description Specimen Requirements CPT Code

20500 Acetylcholine Receptor Antibody, Binding, RIA 1 mL serum 83519

20504 Acetylcholine Receptor Antibody, Blocking, RIA 1 mL serum 83519

20503 Acetylcholine Receptor Antibody, Modulating, RIA 1 mL serum 83519

21006 Anti-Neuronal Nuclear (Hu/Ri) Antibodies (ANNA), IFA (Serum) 1 mL serum 86255

61006 Anti-Neuronal Nuclear (Hu/Ri) Antibodies (ANNA), IFA (CSF) 1 mL CSF 86255

21001 AsialoGM1 Antibody, ELISA (Serum) 1 mL serum 83520 x 2

61002 AsialoGM1 Antibody, ELISA (CSF) 1 mL CSF 83520 x 2

21019 GD1a Antibody Panel, ELISA (Serum) 1 mL serum 83520 x 2

61019 GD1a Antibody Panel, ELISA (CSF) 1 mL CSF 83520 x 2

21002 GD1b Antibody, ELISA (Serum) 1 mL serum 83520 x 2

61001 GD1b Antibody, ELISA (CSF) 1 mL CSF 83520 x 2

21000 GM1 Antibody, ELISA (Serum) 1 mL serum 83520 x 2

21050 GM1 IgG, IgM and IgA Antibody, ELISA (Serum) 1 mL serum 83520 x 3

61050 GM1 IgG, IgM and IgA Antibody, ELISA (CSF) 1 mL CSF 83520 x 3

27000 GQ1b IgG Antibody (Serum) 1 mL serum 83520

67000 GQ1b IgG Antibody (CSF) 1 mL CSF 83520

20358 Interferon Beta IgG, ELISA (reflex to neutralization) 1.5 mL serum 83520

20468 Interferon Beta (INFB) Neutralization Assay 1 mL serum 86382;87253

21004 MAG Antibody, Dual ELISA (Serum) 1 mL serum 83520 x 2

21008 MAG Antibody, Western Blot 1 mL serum 84181

20444 Myelin Basic Protein, ELISA 1 mL CSF 83873

20290 Oligoclonal IgG Bands, IEF 2 mL CSF AND 1 mL serum 83916

21007 Purkinje Cell Cytoplasmic (YO) Antibodies (PCCA), IFA (Serum) 1 mL serum 86255

61007 Purkinje Cell Cytoplasmic (YO) Antibodies (PCCA), IFA (CSF) 1 mL CSF 86255

20443 Tysabri Antibodies, ELISA 1 mL serum 83516

2453 Acetylcholine Recepter Antibody Panel, RIA

Acetylcholine Receptor Antibody, Binding, RIA
Acetylcholine Receptor Antibody, Blocking, RIA Acetylcholine Receptor Antibody, Modulating, RIA

1 mL serum 83519 x 3

2501 Ganglioside Antibody Panel (Serum)

AsialoGM1 Antibody, ELISA
GD1a Antibody, ELISA GD1b Antibody, ELISA
GM1 Antibody, ELISA

3 mL serum 83520 x 8

6501 Ganglioside Antibody Panel (CSF)

GM1 Antibody, ELISA (CSF)
AsialoGM1 Antibody, ELISA (CSF) GD1a Antibody Panel, ELISA (CSF)
GD1b Antibody, ELISA (CSF)

3 mL CSF 83520 x 8

3500 Motor and Sensory Neuropathy Evaluation

GM1 Antibody, ELISA
AsialoGM1 Antibody, ELISA
GD1a Antibody, ELISA GD1b Antibody, ELISA
MAG Antibody, Dual ELISA
Anti-Neuronal Nuclear (Hu/Ri) Antibodies (ANNA), IFA

3 mL serum 83520 x 10

2260 Motor and Sensory Neuropathy Evaluation with GQ1b Antibody and IFE

GM1 Antibody, ELISA GQ1b IgG Antibody (Serum)
AsialoGM1 Antibody, ELISA
GD1a Antibody, ELISA
GD1b Antibody, ELISA MAG Antibody, Dual ELISA
Anti-Neuronal Nuclear (Hu/Ri) Antibodies (ANNA), IFA
Immunfixation Electrophoresis (IFE)

4 mL serum 83520 x 11;
86255;
86334

2503 Motor Neuropathy Antibody Panel

AsialoGM1 Antibody, ELISA
GD1a Antibody, ELISA GM1 Antibody, ELISA GD1b Antibody, ELISA
MAG Antibody, Dual ELISA

3 mL serum 83520 x 10

2585 Motor Neuropathy panel with GQ1b Antibody and IFE

GM1 Antibody, ELISA
AsialoGM1 Antibody, ELISA
GD1a Antibody, ELISA
GD1b Antibody, ELISA MAG Antibody, Dual ELISA
GQ1b IgG Antibody, ELISA
Immunofixation Electrophoresis (IFE)

4 mL serum 83520 x 11;
86334

2215 Myasthenia Gravis Panel

Acetylcholine Receptor Antibody, Binding, RIA Striational Muscle Antibody, IFA

3 mL serum 83519;
86255

2555 Myasthenia Gravis Panel Complete

Acetylcholine Receptor Antibody, Binding, RIA
Acetylcholine Receptor Antibody, Blocking, RIA Acetylcholine Receptor Antibody, Modulating, RIA
Striational Muscle Antibody, IFA

1 mL serum 83519 x 3; 86255

2502 Neuropathy Antibody Panel

Anti-Neuronal Nuclear (Hu/Ri) Antibodies (ANNA), IFA (Serum)
GD1b Antibody, ELISA
GM1 Antibody, ELISA Purkinje Cell Cytoplasmic (YO) Antibodies (PCCA), IFA (Serum)
MAG Antibody, Dual ELISA

3 mL serum 83520 x 6; 86255 x 2

2508 Neuropathy Antibody Panel with AsialoGM1 and GD1a Antibodies

Anti-Neuronal Nuclear (Hu/Ri) Antibodies (ANNA), IFA (Serum)
GD1b Antibody, ELISA
GM1 Antibody, ELISA MAG Antibody, Dual ELISA Purkinje Cell Cytoplasmic (YO) Antibodies (PCCA), IFA (Serum)
AsialoGM1 Antibody, ELISA
GD1a Antibody, ELISA

3 mL serum 83520 x 10; 86255 x 2

2500 Sensory Neuropathy Antibody Panel

MAG Antibody, Dual ELISA
Anti-Neuronal Nuclear (Hu/Ri) Antibodies (ANNA), IFA
Purkinje Cell Cytoplasmic (YO) Antibodies (PCCA), IFA (Serum)

3 mL serum 83520 x 2;
86255 x 2

2105 Paraneoplastic Syndrome Antibody Panel (Serum):

Anti-Neuronal Nuclear (Hu/Ri) Antibodies (ANNA), IFA (Serum)
Purkinje Cell Cytoplasmic (YO) Antibodies (PCCA), IFA (Serum)

3 mL serum 86255 x 2

6105 Paraneoplastic Syndrome Antibody Panel (CSF):

Anti-Neuronal Nuclear (Hu/Ri) Antibodies (ANNA), IFA (CSF)
Purkinje Cell Cytoplasmic (YO) Antibodies (PCCA), IFA (CSF)

3 mL CSF 86255 x 2

2599 Sensory Neuropathy Antibody Panel with IFE

Anti-Neuronal Nuclear (Hu/Ri) Antibodies (ANNA), IFA (Serum)
Purkinje Cell Cytoplasmic (YO) Antibodies (PCCA), IFA (Serum)
Immunofixation Electrophoresis(IFE)
MAG Antibody, Dual ELISA

2 mL serum 83520 x 2;
86255 x 2;
86334

20595

Natural Killer Cell Functional Assay, FC

Natural Killer (NK) cells, a component of the cell-mediated arm of the immune system, mediate destruction of some types of tumor cells and virus-infected cells. Decreased NK cytotoxicity is associated with impaired immune surveillance, and may explain a predisposition to malignancy and viral infections. Increased NK cytotoxicity has been observed in women with a history of spontaneous abortions.

This test is available for New York patient testing.

Methodology		Flow Cytometry
Reference Range		8-170 LU30
Preferred Specimen		20 mL Heparinized or ACD blood (minimum 10 mL) Specimens should be received by Focus <=24 hours post collection. Specimens accepted Monday through Saturday noon. Store at room temperature.
Transport Temperature		Room temperature. DO NOT REFRIGERATE OR FREEZE.
Results Available		1 to 3 days
CPT Code		88184; 88185 x 2

20556

Neutrophil Antibody, Flow Cytometry

Neutrophil antibody has been implicated in causing neutropenia of various autoimmune disorders including Felty's syndrome, SLE and drug-induced neutropenia. In addition, isoimmune neutrophil destruction may be caused by antibodies to neutrophil-specific antigens and HLA antigens in febrile transfusion reactions as well as isoimmune neonatal neutropenia.

†This test was developed and its performance characteristics determined by Focus 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. Performance characteristics refer to the analytical performance of the test.

Test performed at Quest Diagnostics Nichols Institute.

Methodology		Flow Cytometry
Reference Range		None detected
Preferred Specimen		1 mL serum or plasma (minimum 0.1 mL)
Transport Temperature		2-8° C
Results Available		2 to 7 days
CPT Code		86021†

2196

Natural Killer Cell Functional and Enumeration Panel, FC


This unit code has been inactivated. Please see unit code 2590.

2930

Neutrophil Function Panel

See individual assay for description.

Panel Includes:

Neutrophil Function, Oxidative Burst
Phagocytic Index, FC

Methodology		Flow Cytometry
Reference Range		By report
Preferred Specimen		10 mL heparinized whole blood. Specimens accepted 72 hours post collection, Monday through Friday.
Transport Temperature		Room temperature
Results Available		1 to 4 days
CPT Code		82657; 86344

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2590

Natural Killer Cells, Flow Cytometry

CD16/56, human natural killer cell antigens, are expressed on a subpopulation of peripheral blood large granular lymphocytes. The CD16/56 positive cells are present as two sub-populations: those without CD3 (T cell antigen) and those with CD3. The CD16/56+/CD3- cell population contains the entire pool of spontaneous natural killer cell activity. The CD16/56 and the CD3 populations are both enumerated.

†This test was developed and its performance characteristics determined by Focus 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. Performance characteristics refer to the analytical performance of the test.

Test performed at Quest Diagnostics Nichols Institute.

Methodology		Flow Cytometry
Reference Range		By report
Preferred Specimen		5 mL whole blood (EDTA only) (minimum 0.5 mL)
Transport Temperature		Room temperature - DO NOT REFRIGERATE OR FREEZE
Results Available		2 to 4 days
CPT Code		86357 x 2†

-163

Neisseria gonorrhoeae Culture (See Bacterial Culture, Aerobic, Special)

Bacterial Culture, Aerobic, Special

20474

Neutrophil Function, Oxidative Burst

This assay measures the capability of neutrophils to undergo oxidative metabolism to produce superoxide anion and hydrogen peroxide, as detected by oxidation of dihydrorhodamine (DHR). Patients with chronic granulomatous disease (CGD) are unable to oxidize DHR due to defects in oxidative metabolism.

Note: A transport control (heparinized blood from a healthy donor) should accompany each specimen, and will be tested at no charge.

This test is approved for New York patient testing.

Methodology		Flow Cytometry
Reference Range		By report
Preferred Specimen		7 mL sodium heparin (green-top) whole blood Specimens accepted <=72 hours post collection, Monday through Friday noon.
Transport Temperature		Room temperature
Results Available		1 to 4 days
CPT Code		82657

40200

Neisseria gonorrhoeae Antibody, CF (Serum)

Titers >=1:8 suggest either gonococcal infection or asymptomatic colonization. Antibodies recognizing Neisseria gonorrhoeae are apparently unprotective, since reinfection frequently occurs.

This test is approved for New York patient testing.

Methodology		CF (Complement Fixation)
Reference Range		<1:8
Preferred Specimen		1 mL serum (minimum 0.5 mL)
Transport Temperature		2-8° C
Results Available		2 to 5 days
CPT Code		86609

51173

Nocardia Smear, Modified Acid-Fast Stain

Nocardia species, because of unusual long-chain fatty acids in their cell walls, can retain carbolfuchsin stain during mild acid decolorization. The modified Kinyoun acid-fast stain is useful for detecting in clinical material partially acid-fast branching delicate filaments and rod- and cocci-like fragments suggestive of Nocardia.

This test is approved for New York patient testing.

Methodology		Light Microscopy
Reference Range		No partially acid-fast bacteria suggestive of Nocardia seen.
Preferred Specimen		Clinical specimen properly collected or an air-dried heat-fixed smear on a glass slide (minimum 0.5 mL or 1 slide)
Transport Temperature		2-28° C
Results Available		1 to 3 days
CPT Code		87206

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60200

Neisseria gonorrhoeae Antibody, CF (CSF)


This unit code has been inactivated. Please see unit code 40200.

81106

Norovirus, EIA (Stool)

Norovirus, also called Norwalk-like virus, is a major cause of viral gastroenteritis and has been associated with many close-contact outbreaks including in hospitals, schools, cruise ships, and residential homes. Detection of Norovirus antigen is important for patient and public health management and helps to provide diagnosis of the gastroenteritis. A positive EIA result indicates the presence of Norovirus antigen, but does not differentiate genotype 1 and 2.

This test is approved for New York patient testing.

Methodology		EIA (Enzyme Immunoassay)
Reference Range		Negative
Preferred Specimen		2 grams stool, unpreserved, in sterile container (minimum 1 gram)
Transport Temperature		FROZEN
Results Available		1 to 4 days
CPT Code		87449

40175

Neisseria meningitidis Antigen Detection (Groups A/Y and C/W135), LA

Specific soluble bacterial capsular polysaccharide antigens accumulate in CSF, serum, or urine. This is a presumptive latex agglutination test for the direct qualitative detection of bacterial antigen. Visible agglutination occurs when a sample containing a bacterial antigen reacts with specific polyclonal antibody-coated latex particles. This test is not intended as a substitute for a properly performed Gram stain and bacterial culture. Confirmatory diagnosis of bacterial meningitis is only possible with appropriate culture procedures. Samples with extremely low levels of antigen may yield negative results. Nonspecific reactions are known to occur, especially with urine samples. Cross-reactions and interference by rheumatoid factor and other substances have also been reported.

This test is approved for New York patient testing.

Methodology		Latex Agglutination
Reference Range		Not detected
Preferred Specimen		1 mL serum, CSF or urine (minimum 0.25 mL)
Transport Temperature		FROZEN
Results Available		1 to 2 days
CPT Code		86403 x 2
Sample Report(s)		Positive Negative

44340

Norovirus RNA, RT-PCR

Noroviruses are a major cause of viral gastroenteritis in children and adults, with large outbreaks reported in hospitals, cruise ships, schools and residential homes. This assay detects norovirus RNA using reverse transcription of specific conserved norovirus genomic RNA sequences followed by real-time PCR amplification.

This test is not approved for New York patient testing.

Methodology		Real-Time RT-PCR
Reference Range		Not detected
Preferred Specimen		1 gram stool (minimum 0.5 grams)
Transport Temperature		FROZEN
Results Available		1 to 3 days
CPT Code		87798

40177

Neisseria meningitidis Antigen Detection (Group B and E. coli K1), LA

This test is approved for New York patient testing.

Methodology		Latex Agglutination
Reference Range		Not detected
Preferred Specimen		1 mL serum, CSF or urine (minimum 0.25 mL)
Transport Temperature		FROZEN
Results Available		1 to 2 days
CPT Code		86403
Sample Report(s)		Positive Negative

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-172

Norwalk-like Virus (NLV) (See Norovirus)

42560

Neisseria meningitidis IgG Vaccine Response, MAID

This assay measures serum IgG antibodies recognizing polysaccharide antigens from the four Neisseria meningitidis serogroups included in the licensed meningococcal vaccine. The meningococcal vaccine response is best evaluated by testing pre-vaccination and post-vaccination samples in parallel. A two-fold or greater increase for at least two serogroups is expected when comparing post-vaccination to pre-vaccination results. N. meningitidis IgG levels peak approximately one month post-vaccination, but decline markedly by two years.

This test is approved for New York patient testing.

Please see the following technical sheet for more information:

Vaccine Response Testing

Methodology		MAID (Multi-Analyte Immunodetection)
Reference Range		Serogroup A: < 4.0 mcg/mL Serogroup C: < 5.0 mcg/mL Serogroup Y: < 4.0 mcg/mL Serogroup W-135: < 3.0 mcg/mL
Preferred Specimen		0.5 mL serum (minimum 0.3 mL)
Transport Temperature		2-8° C
Results Available		1 to 8 days
CPT Code		86741 x 4

52025

Neisseria meningitidis Serotyping, SA

Neisseria meningitidis can be separated into serological groups based on capsular antigens. Although there are currently 13 meningococcal capsular polysaccharide serogroups recognized, most serious infections are caused by organisms belonging to serogroups A, B, C, Y and W135. Focus also detects additional serotypes D, X, and Z. In this slide agglutination test, agglutination occurs when a suspension of the isolate reacts with serogroup-specific antisera.

This test is approved for New York patient testing.

Methodology		Slide Agglutination
Reference Range		By report
Preferred Specimen		Pure culture on chocolate agar plate or slant, safely contained.
Transport Temperature		Room temperature
Results Available		1 to 4 days
CPT Code		87147 x 8

52140

Neomycin Level, BA

This test is available for New York patient testing.

Methodology		Bioassay
Reference Range		By report
Preferred Specimen		1 mL serum (minimum 0.5 mL)
Transport Temperature		FROZEN
Results Available		3 to 4 days
CPT Code		80299

20256

Neopterin Level, RIA

Increased neopterin levels have been associated with inflammatory infectious diseases, including HIV-1 infection. Neopterin levels are also elevated in patients with kidney graft rejection and malignancies including acute leukemia/lymphoma involving the central nervous system. In HIV-1 infected individuals, neopterin measurement has been used as a sensitive marker for activation of cellular immunity. Serum concentrations of neopterin have been correlated with progression of HIV-1 infection. Elevated levels of neopterin during the early asymptomatic antibody positive stage are an indication of poor prognosis. This test is re-referred by Focus to another laboratory. Prices are subject to change without notice.

Test performed at Quest Diagnostics Nichols Institute.

Please see the following technical sheet for more information:
Antimicrobial Testing

Methodology		Radioimmunoassay
Reference Range		2.0-10 nmol/L
Preferred Specimen		2 mL serum in dark amber container (minimum 0.2 mL)
Transport Temperature		FROZEN Protect from light.
Results Available		2 to 14 days
CPT Code		83519

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-168

Neuronal Nuclear Antibody (See Anti-Neuronal Nuclear Antibody)

Anti-Neuronal Nuclear (Hu/Ri) Antibodies (ANNA), IFA (Serum) with Reflex To Titer and Western Blot

First FDA Clearance of a 2009 H1N1 Test Given to Focus Diagnostics

FDA Issues Another Emergency Use Authorization for Commercial H1N1 Flu Test to Quest Diagnostics� Focus Diagnostics

Focus Diagnostics provides the first commercial test for detecting the 2009 H1N1 influenza virus that the FDA has authorized for emergency use.

Focus Diagnostics receives NYSDOH exemption for Diagnostic Immunology and Serology testing services

Focus Diagnostics Launches Laboratory Test for Chikungunya Virus

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