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triple screen (prenatal)
Synonyms: Prenatal Screen Testing 
Computer Code: (TRIPS)
Specimen Collection: 5 mL blood (red or gold top tube). 
Minimum Volume: 2 mL 
Handling Instructions for Offsite Areas: Centrifuge, remove serum, store at room temperature. Refrigerate if transport is delayed >24 hours. Requisition must be signed by patient and physician, and all fields must be completed. 
Reference Values: See report. Includes: Maternal Serum AFP, Total Beta HCG, Unconjugated Estriol.  
Lab Code: CC 
Requisition: REPRO See Test Requisition 12
Test Frequency: 2/week 
Routine TAT: 4 days 
Stat TAT: NA 
CPT Code(s): 82105, 84702, 82677 
LCD or NCD:  
Methodology Used: 77
See Addendum XVII

Albany Medical Center
43 New Scotland Avenue
Albany, NY, 12208
Date: 05/03/2016
Time: 06:38:07 (24hr)