IMMUNODEFICIENCY PANEL BY FLOW CYTOMETRY, BLOOD

Additional Codes

Software	Test Code
Label Text	IMDE1
EPIC	LAB10089

Performing Laboratory

NorDx Laboratories

Useful For

Evaluating T, B, and NK-cell lymphocyte subsets which is of diagnostic utility in suspected immunodeficiency.

Method Name

Flow Cytometry

This assay is a lab developed test established by the NorDx Flow Cytometry Laboratory. This laboratory is certified under the Clinical Laboratory Improvement Amendments (CLIA) as qualified to perform high complexity clinical laboratory testing. This test is used for clinical purposes. It should not be regarded as investigational or for research.

Reference Values

Percentage and absolute counts of T, B, and NK-cell markers reported with age-specific normal ranges.

Days and Times Test Performed

Monday through Friday

Specimens drawn on Friday MUST ARRIVE in Scarborough lab before midnight Friday to ensure processing within 48 hours of collection.

Report Available

3 Days

Profile Information

Individual Test Description
ABSOLUTE COUNT
CD16+ ABSOLUTE
CD16+ PERCENT
CD19+ (B CELLS) PERCENT
CD19+ ABSOLUTE
CD2+ (T CELLS) PERCENT
CD20+ (B CELLS) PERCENT
CD20+ ABSOLUTE
CD3+ (T CELLS) PERCENT
CD3+ ABSOLUTE
CD4 / CD8 RATIO
CD4+ (T CELLS) PERCENT
CD4+ ABSOLUTE
CD5+ (T CELLS) PERCENT
CD56+ (NK CELLS) PERCENT
CD56+ ABSOLUTE
CD7+ (T CELLS) PERCENT
CD8+ (T CELLS) PERCENT
CD8+ ABSOLUTE
LYMPHOCYTES, TOTAL, PERCENT
PATHOLOGY REVIEW

Specimen Type

Whole Blood

Preferred Container

Lavender Top Tube (EDTA)

Preferred Volume

Whole Blood: 4.0 mL (Lavender Top Tube (EDTA))

Minimum Volume

Collecting minimum volumes can result in a need for sample recollection, and/or a delay in results. Minimum volumes are subjective and cannot account for all aspects of specimen and testing needs. Refer to the Preferred Volume section for optimal volumes for laboratory specimens.

Whole Blood: 2.0 mL Lavender Top Tube (EDTA))

Specimen Collection and Handling

Send at ambient temparture.

Specimen must be received at the NorDx Scarborough facility by midnight Friday to guarantee processing within 48 hours of collection

Do not collect specimen on Friday afternoon for Saturday arrival at the Scarborough location or before a holiday weekend.

Date of collection and clinical information are required on the request form for processing.

Specimen Stability Information

Specimen Type: Whole Blood

Room Temp: 48 hours

Add On Capable

Yes.

Advance Beneficiary Notice Requirements

This test, when ordered on Medicare patients, is subject to the National Coverage Determination (NCD) policies. Please verify that the diagnosis code (ICD code) you have chosen demonstrates medical necessity for the test as documented in the physician’s patient record. The CMS web site is available to assist you with this verification. A properly executed Advance Beneficiary Notice (ABN) must be submitted with the specimen if medical necessity is not demonstrated by the ICD code chosen.

CPT Code Information

CPT Code	CPT Description	CPT Disclaimer
86355	B Cells, Total Count
86357	Natural Killer (NK) Cells, Total Count
86359	T cells, Total Count
86360	T cells, Absolute CD4 and CD8 count, Including Ratio
88184	Flow Cytometry, Cell Surface, Cytoplasmic, or Nuclear Marker, Technical Component Only, First Marker
88185 x4	Flow Cytometry, Cell Surface, Cytoplasmic, or Nuclear Marker, Technical Component Only, Each Additional Marker (List Separately in Addition to Code for First Marker)

Performing Laboratory Location