Geisinger Medical Laboratories/Geisinger Proven Diagnostics Test Catalog

Test Name: Sunquest Test Code Epic Procedure Code Or ID CPT Code:  

C. DIFFICILE/EPI, PCR

ORDERING INFORMATION:
Sunquest Test Code:
CDIFP      Geisinger Epic Procedure Code: CDIFP         Geisinger Epic ID: 41929

SPECIMEN COLLECTION
Specimen type:
Fresh undiluted, non-formed stool. Refer to Bristol stool chart 5, 6 and 7 for acceptable stool consistency. Formed stool may be accepted from a stool transplant donor.
Preferred collection container:
Specimen required:
1-2 mL of non-formed stool (or formed stool from stool transplant donor only).
Special notes:
See stool test selection algorithm for appropriate test selection. See Microbiology Collection Appendix for collection instructions. Stool aspirate specimens (i.e., stool aspirate, colon contents, colon aspirate) are acceptable as long as it is verified that the patient did not have a gastrointestinal preparation. Please contact laboratory prior to the collection of stool aspirates for instructions.

SPECIMEN PROCESSING
Transport temperature:
Transport specimens to laboratory at 2-8°C (2-25°C also acceptable). Protect specimen against freezing or exposure to excessive heat.
Specimen stability:
Stable at 2-8°C for 5 days. Stable at room temperature (15-25°C) = 24 hours.
Rejection criteria:
Specimens collected on swabs or in diapers. Specimens collected in formalin, PVA, MF, SAF or ETM. Specimens contaminated with barium. Formed stools, lumen contents, and duodenal aspirates/washes/biopsies are also not acceptable. Improperly labeled/identified specimens. Frozen specimens. Specimens which exceed stability limits. Improper specimen type. Specimen collected in non-sterile container. Diluted samples.

TEST DETAILS
Reference interval:
Negative. No C. difficile toxin B gene DNA detected by PCR (Amplified Probe)
Critical values/courtesy alerts:
Positive for C. difficile toxin B gene DNA detected by PCR (Amplified Probe). Presumptive negative for C. diffiicle 027-NAP1-B1 strain by PCR (Amplified Probe) OR Positive for C. difficile Toxin B gene DNA by PCR (Amplified Probe). Presumptive positive for C. difficile 027-NAP1-B1 strain by PCR (Amplified Probe).
Additional information:
See C. diffile FAQ Sheet
CPT code(s):
87493
Note: The billing party has sole responsibility for CPT coding.  Any questions regarding coding should be directed to the payer being billed.  The CPT codes provided by GML are based on AMA guidelines and are for informational purposes only.
Test includes:
Detection of C. difficile toxin B gene DNA. Presumptive detection of genetic targets associated with hypervirulent (NAP1/027/B2) strain.
Methodology:
Real-time Polymerase Chain Reaction (PCR)
Synonyms:
C. difficile assay, Toxin A Assay, Toxin B Assay, Toxin A/B Assay, C. difficile, PCR nucleic acid amplification, Clostridium difficile
Clinical significance:
C. difficile is a causative agent of a spectrum of diseases ranging from antibiotic-associated diarrhea to toxic megacolon. Overgrowth of the C. difficile bacteria and subsequent toxin production has been associated primarily with antibiotic usage; however, hypervirulent strains may cause disease in people with out predisposition.
Doctoral Director(s:)
Donna Wolk PhD, D(ABMM), Raquel Martinez, PhD, D(ABMM)    
Review Date: 05/06/2019

Performing Locations

Geisinger Medical Center

Performing laboratory: Microbiology
Technical Lead: Barbara Heiter
Frequency: Daily, all shifts
Performed stat? No

Geisinger Wyoming Valley Medical Center

Performing laboratory: Microbiology
Technical Lead: Theresa Serafin    
Frequency: Daily, all shifts    
Performed stat? No

Geisinger Shamokin Area Community Hospital

Performing laboratory: Microbiology
Technical Lead: Kelly Alleman    
Frequency: Daily, all shifts    
Performed stat? No

Geisinger Bloomsburg Hospital

Performing laboratory: Microbiology
Technical Lead: Christon Henderson  
Frequency: Daily, all shifts    
Performed stat? No

Geisinger Community Medical Center

Performing laboratory: Microbiology
Technical Lead: Kaitlyn Clarke  
Frequency: Daily, all shifts    
Performed stat? No

Geisinger Lewistown Hospital

Performing laboratory: Microbiology
Technical Lead: Kris Robb  
Frequency: Daily, all shifts    
Performed stat?

Geisinger Holy Spirit Hospital

Performing laboratory: ATL+
Technical specialist: Beth Houser, PhD    
Frequency: Daily, all shifts    
Performed stat? No

Geisinger Jersey Shore Hospital

Performing laboratory: Microbiology
Technical specialist: Kenneth Starr    
Frequency: Daily, all shifts    
Performed stat? No
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*GMC - Geisinger Medical Center; GWV - Geisinger Wyoming Valley Medical Center; GSACH - Geisinger Shamokin Area Community Hospital; GBH - Geisinger Bloomsburg Hospital;
GCMC - Geisinger Community Medical Center (Scranton); GLH - Geisinger Lewistown Hospital; GHS - Geisinger Holy Spirit; GJSH - Geisinger Jersey Shore Hospital,
GSWB - Geisinger South Wilkes-Barre