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Labcorp Oklahoma, Inc.
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Alpha-Fetoprotein (AFP), Maternal Tetra Profile

Order Name AFP Tetra
Test Number: 5194839
Revision Date 12/08/2022
Test Name Methodology LOINC Code
Alpha-Fetoprotein (AFP), Maternal Tetra Profile
Chemiluminescence Assay  
SPECIMEN REQUIREMENTS
Specimen Specimen Volume (min) Specimen Type Specimen Container Transport Environment
Preferred 5 mL (3 mL) Serum Clot Activator SST Room Temperature
Instructions Notes: 3 mL (Note: This volume Does NOT allow for repeat testing).
Specimen Type: Gel-barrier tube
Specimen Storage: Room temperature
Specimen Collection: Collect in serum separator tube with gel barrier. Allow blood to clot, avoiding hemolysis. Separate serum from cells by centrifugation. Transport spun tube to testing laboratory. Pour off is not advised. Maternal serum specimens must be drawn prior to amniocentesis to avoid contamination with fetal blood.
Special Instructions: The following information must be provided: gestational age, date on which the patient was the stated gestational age, how gestational age was determined (LMP, EDD, US), patient's weight, patient's date of birth, patient's race (white, black, other), and insulin-dependent diabetic status. Also indicate relevant patient history (eg, prior neural tube defects, Down syndrome, ultrasound anomalies, or previous maternal serum screening specimen during this pregnancy). Complete information is necessary to interpret the test. Patient information may be provided to the laboratory using The Maternal Prenatal Screening requisition form 0900. Specimens must be collected before amniocentesis.
Specimen Stability:  Ambient: 7 days, Refrigerated : 14 days, Frozen: 14 days
GENERAL INFORMATION
Expected TAT 2 - 5 days  
Clinical Use Down syndrome screening is offered for gestational ages 15.0 to 21.9 weeks. Open spina bifida screening is offered for gestational ages 15.0 to 23.9 weeks. The optimal gestational age for open spina bifida screening is 16.0 to 18.9 weeks. 
Performing Labcorp Test Code 017319 
Notes Labcorp Test Code: 017319

Prompt Information - (Please provide as many as possible for the best interpretation)
Required Prompt Code Mnemonic Long Name Result Type
Required Prompt 5194810 LC PAWLBS Weight (lbs) 5 Dig Numeric
  5195221 LC PAWOZS Weight (Ounces) 2 Dig Numeric
  5194811 LC INSDEP Insulin Dependant Y or N
Required Prompt 5194684 LC GESAWK Gest Age Weeks (##) 2 Dig Numeric
Required Prompt 5194685 LC GESADY Gest Age Days (#) 1 Numeric (0-6)
  5195222 LC GESADC Gest Age In Decimal Form 1 Numeric (0-6)
  5194686 LC GESADT Gest Age Date of Calc (YYYYMMDD) YYYYMMDD
  5194687 LC GACMTH Gest Age Calc Method LMP, US, EDD/EDC
Requsted if by LMP 5194688 LC LMDATE LMP Date (YYYYMMDD) YYYYMMDD
Requsted if by EDD/EDC 5194689 LC EDDATE EDD/EDC Date (YYYYMMDD) YYYYMMDD
  5194812 LC NFETUS Number of Fetuses 1 Dig Numeric (1-9)
Requsted if Present 5194690 LC OTHIND Other Indications (Y/N) Y or N
  5194691 LC ADINFO Additional Info 0-20 characters
  5194692 LC PRELEV Prev Elevated AFP (Y/N) Y or N
  5194693 LC DONEGG Donor Egg (Y/N) Y or N
  5194694 LC EGGDAG Age of Egg Donor 2 Dig Numeric
  5194695 LC EGGTYP Type of Egg Donor S-SELF, N-NON-SELF
  5194696 LC PDONTD Prior DS/ONTD Scr Current Preg (Y/N) Y or N
  5194697 LC PFTTST Prior 1st Trimester Testing (Y/N) Y or N
  5194698 LC PSTTST Prior 2nd Trimester Testing (Y/N) Y or N
  5194813 LC FHONTD Family Hx NTD Y or N
  5194814 LC PPRGWD Prior Pregnancy with DS Y or N
CPT Code(s) 86336, 84702, 82105, 82677
Lab Section Reference Lab