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microsomal antibody
Synonyms: TPO Antibodies Thyroid Peroxidase AB 
Computer Code: MSOM
Specimen Collection: 1 mL blood (red or gold top tube). 
Minimum Volume: 1 mL 
Handling Instructions for Offsite Areas: Allow to clot, centrifuge for 20 minutes, refrigerate. Serum must be removed from red top tube. 
Reference Values: Negative: <9 IU/mL  
Lab Code: SI 
Requisition: SEROL
Test Frequency: 2/week 
Routine TAT: 3-5 days 
Stat TAT: NA 
CPT Code(s): 86376 
LCD or NCD:  
Methodology Used: 77
See Addendum XVII

Albany Medical Center
43 New Scotland Avenue
Albany, NY, 12208
Date: 10/30/2014
Time: 14:22:01 (24hr)