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Test Code PR595 Pediatric Food Allergen Panel

Important Note

NAH Outreach Interface Order

Specimen Type

Serum

Result Information

Result
Code

Result

EGG

Egg White IgE

YOLK

Yolk IgE

MILK

Milk IgE

SOY

Soybean IgE

WHT

Wheat IgE

Specimen Required

Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Specimen Volume: 1.5 mL

Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 14 days
  Frozen  90 days

Reject Due To

Hemolysis

Mild OK; Gross OK

Lipemia

Mild OK; Gross OK

Icterus

NA

Other

NA

Reference Values

Class

IgE kU/L

Interpretation

0

<0.10

Negative

0/1

0.10-0.34

Borderline / Equivocal

1

0.35-0.69

Equivocal

2

0.70-3.49

Positive

3

3.50-17.4

Positive

4

17.5-49.9

Strongly positive

5

50.0-99.9

Strongly positive

6

≥100

Strongly positive

Reference values apply to all ages.

Performing Laboratory

Mayo Clinic Laboratories in Rochester    

 

Test Classification

This test has been cleared or approved by the U.S. Food and Drug
Administration and is used per manufacturer’s instructions.
Performance characteristics were verified by Mayo Clinic in a
manner consistent with CLIA requirements.

CPT Code Information

86003 (x5)