Sending A Specimen

Please include the following information with all anatomic pathology specimens.

Patient information

All patient information (full legal name, date of birth, insurance, etc.) is required prior to testing. You must provide complete information, even if previously given.

Client information

We are required to know the pathology lab that is sending us material, even if the request for testing originates from an outside source. Please provide us with the name and NPI number of either the referring pathologist or the ordering physician. We send results reports based on this information.

Billing classification is also required prior to testing and needs to be included with the submission.

Consultation request

Complete all relevant information and attach supporting documents if appropriate.

Specimen type

Indicate specimen type(s), number included, and date of archive removal. Label the specimen container with patient identifiers.

Tissue source

Indicate source(s), collection date, accession number, and test(s)/workup(s) desired.

Pertinent clinical history and findings

Include any available information, including any previous test results, that may be relevant to the current medical problem.

Medical necessity

List all applicable codes (use complete codes; do not truncate), not descriptions.

Consultations should be addressed to:

The University of Chicago Medicine
UChicago Medical Laboratories-Client Services
Room J-601/MC6101
5841 S. Maryland Ave.
Chicago, IL 60637
Phone: 773.702.8287
Fax: 773.702.9903

Please include pertinent clinical history and cytology/surgical pathology report(s).

To avoid test error due to additive carryover, a defined order of draw should be followed for both glass and plastic collection tubes when drawing multiple specimens for clinical laboratory testing during a single venipuncture.

All additive tubes should be filled to their stated volumes. As most tubes contain an additive or clot activator that needs to be mixed with the blood sample, tubes must be mixed immediately after drawing. Tubes with anticoagulants (i.e., EDTA) must be mixed immediately to ensure that the specimen does not clot.

Procedure

After verifying that the collection tubes have not exceeded expiration dates, the following order of draw should be used:

1. Blood culture tube/bottle
2. Coagulation tube (light-blue top)
3. Serum tube with/without clot activator, with/without gel separator (red top, SST gold top, royal blue top with red-striped tube label)
4. Heparin tube with/without gel plasma separator (green top)
5. EDTA tube with/without gel separator (lavender top, pearl top, royal blue top with purple-striped tube label)
6. Oxalate/fluoride tube (gray top)
7. Any remaining additive tube (ACD tubes, SPS tubes, etc.)

Note: Waste tubes are required to be collected and discarded before any coagulation test (other than PTI/PTTB) can be collected. The discard tube must be non-additive or another coagulation tube (plastic red tops cannot be used as waste tubes).

When using a winged blood collection set for any coagulation test, the discard tube must be used to prime the tubing of the collection set to assure maintenance of the proper anticoagulant-to-blood ratio in the tube to be drawn for coagulation testing.

If the tube contains an additive, clot activator, or anticoagulant, mix it immediately after it is drawn by gently inverting it 8 to 10 times (holding the tube upright, gently invert it 180 degrees and back to complete one inversion), and then collect the next tube if drawing multiple specimens.

We offer cytogenomic array as a postnatal first-tier test appropriate for individuals with multiple anomalies that are not specific to well-defined genetic syndromes, apparently non-syndromic developmental delay and/or intellectual disability, or autism spectrum disorders as recommended by the American College of Medical Genetics. 

Cytogenomic array is also appropriate for follow-up testing for individuals with the phenotypes listed above with a previously normal chromosome analysis result; clarification of size, precise breakpoints, or gene content of abnormalities detected by routine chromosome analysis or FISH studies; or to rule out cryptic copy number changes (imbalances) at the breakpoints of apparently balanced chromosome rearrangements and for the identification of long, contiguous stretches of homozygosity.

Specimen Requirements

For proper analysis, we require:

• SNP microarray (shipped at room temperature, avoiding extreme temperatures)
  
• 3 mL of blood (NaHep) and 3 mL of blood (EDTA)

Please call our Cytogenetics Laboratory at 773-702-6203 when a specimen has been taken so we can prepare for its delivery and analysis.

No specimens are rejected, but physicians are notified upon receipt of inadequate specimen.

Delivery Instructions

Ship specimens to the Cytogenetics Laboratory as soon as possible after excising them from the patient. Specimens should be delivered to:

Carrie Fitzpatrick, PhD, FACMG
Cytogenetics Laboratory
Room G-712
5841 S. Maryland Ave.
Chicago, IL 60637          

Contact information:
Phone: 773.702.6203
Fax: 773.834.8557
Email: cfitzpat@bsd.uchicago.edu

Delivery information should be on the outside of the package.

Test Methods

Cytogenomic SNP array uses the Affymetrix CytoScan HD platform. This array includes 2.67 million markers for copy number (CN) analysis, including approximately 750,000 SNP probes and 1.9 million non-polymorphic probes for whole genome coverage. This array provides an average intergenic probe density of one probe per 880 bases and an overall (gene and non-gene backbone) probe density of one probe every 1,148 bases.

Test Analysis

We analyze results using the Affymetrix Chromosome Analysis Suite 3.0 software. The analysis of the data is based on the most recent human genome build (hg19). All reported base pair coordinates are estimated. Deletions larger than 200 kb and duplications larger than 400 kb will generally be reported.

We report smaller copy number (CN) changes if they are considered clinically significant based on genomic information available at the time the report is issued. Benign CN variants will not be reported but will be kept on file in the laboratory. We report CN changes resulting in carrier status for autosomal recessive disorders if a concern for a specific disorder is communicated to the laboratory. 

We confirm CN changes using fluorescence in situ hybridization (FISH) or other appropriate methodologies concurrently when parental analysis is recommended. Long, continuous stretches of homology (LCSH), which can result from uniparental disomy (UPD) or common descent, can also be detected using the CytoScan HD array. Reported regions of LCSH will not be confirmed, but recommendations for further molecular testing may be made to confirm UPD or to identify recessive alleles possibly associated with the patient’s condition.

Limitations

This test does not detect balanced chromosome rearrangements such as Robertsonian or other reciprocal translocations, inversions, or balanced insertions. It will not detect imbalances of regions not represented on the array, or all types and instances of uniparental disomy. This test is not designed to detect mosaicism at low levels.

Normal findings do not rule out the diagnosis of any disorder, since some genetic abnormalities may be undetectable with this assay. Specifically, this test does not detect point mutations, small deletions, or insertions below the resolution of this assay or other types of mutations, such as epigenetic changes.

Reporting Results

The results of this test may be of unclear clinical significance. In such cases, additional family studies may be necessary to interpret the results. Copy number variations (CNVs) detected by this platform may not be investigated or reported if they are devoid of relevant gene content, reported as common findings in the general population based on available database searches, or are gains smaller than 400 kb or losses smaller than 200 kb. It is appropriate to refer individuals and families to a clinical geneticist or counselor to discuss results of this test.

Diagnostic hematopathology has become an increasingly complex subspecialty, particularly with neoplastic disorders of the blood and bone marrow. While morphologic assessment of blood smears, bone marrow smears, and tissue sections remains the cornerstone of lymphoma and leukemia diagnosis and classification, immunophenotyping is a very valuable and important complementary tool. Immunophenotyping hematopoietic specimens can help resolve many differential diagnostic problems posed by clinical or morphological features.

Process

For University of Chicago Medicine bone marrow collections please refer to Bone Marrow Scheduling Policy for detailed instructions. This procedure refers to flow cytometry immunophenotyping of bone marrow and peripheral blood specimens collected outside University of Chicago Medicine. 

Specimen 

Flow cytometry bone marrow analysis requires a bone marrow aspirate with a minimum volume of 2 mL of blood collected in lavender top EDTA tube. Flow cytometry peripheral blood analysis requires a peripheral blood specimen with a minimum volume of 2 mL of blood collected in lavender top EDTA tube. Analysis of a specimen takes one day, with a maximum of four days of laboratory time. Specimens are retained for 14 days after receipt. 

If cytogenetic or molecular tests are also desired an additional specimen should be submitted. It is important that the specimen is obtained, processed, and transported according to instructions for the other required test.

The CPT codes for the services we provide include:

• 88184—Flow cytometry; first cell surface, cytoplasmic, or nuclear marker x 1
• 88185—Flow cytometry; additional cell surface, cytoplasmic, or nuclear marker (each)
  
• 88187—Flow cytometry interpretation, two to eight markers (if appropriate)

Delivery Instructions

We process and report specimens Monday through Friday. Specimens should be delivered to the Hematology Laboratory within 24 hours of collection. We do not accept deliveries on Saturday or Sunday. Delivery information should be on the outside of the package. 

Specimens should be shipped at room temperature. Extreme temperature changes should be avoided. 

Packages should be delivered to:

Hematopathology Laboratory
Room TW-051/MC0008
5841 S. Maryland Ave.
Chicago, IL 60637

Contact information:
Phone: 773.702.1314
Fax: 773.702.1200

Next-generation sequencing is a rapidly evolving and complex methodology that can examine multiple regions of genomic tumor DNA in a single assay. Many hematologic neoplasms are characterized by morphologic or phenotypic similarities but can have characteristic somatic mutations in many genes. In addition, many myeloid neoplasms lack a clonal cytogenetic finding at diagnosis (normal karyotype) but can be diagnosed and classified according to gene mutation profiles. The presence and pattern of gene mutations can provide critical diagnostic, prognostic, and sometimes therapeutic information for the managing physician(s).

Specimen Collections

To obtain optimal service, we request that you provide a complete and accurate patient history on the submission form, including relevant clinical and radiologic images.

Results are generally available within 10 to 15 days of the specimen’s arrival. No specimens are rejected, but physicians are notified upon receipt of inadequate specimens.

Specimen Types

Submit only one specimen type.

Hematology Specimens
Oncoscreen or Oncoplus

Specimen type: peripheral blood
Preferred: lavender top (EDTA)
Specimen volume: 200µL-5 mL
Specimen stability: ambient

Collection instructions:

• Invert several times to mix blood.
  
• Label specimen as blood.
  
• Send specimen in original tube.

OR

Specimen type: bone marrow aspirate
Preferred: lavender top (EDTA)
Specimen volume: 200µL-5 mL
Specimen stability: ambient

Collection instructions:

• Invert several times to mix bone marrow.
  
• Label specimen as bone marrow.
  
• Send specimen in original tube.

Solid Tumors
OncoScreen

Specimen type: FFPE (formalin-fixed, paraffin-embedded) tissue
Acceptable: paraffin block
Specimen volume: tumor area on slides = 0.1 cm2 total
Specimen stability: ambient


Collection instructions:

• Include top and bottom H&E guide slides.
  
• Label specimen as FFPE with source of specimen. 
  

OR

Specimen type: cytology smear (fine needle aspirate and fluid smears), alcohol fixed or air dried
Acceptable: cell block
Specimen volume: 3,000+ cells minimum proportion of tumor cell 20 percent
Specimen stability: ambient


Collection instructions:

• Stain with DiffQuick® or rapid Pap stain.
  
• Do not use a cover slip.
  
• Label specimen as cytology smear with source of specimen.
  

OR

Specimen type: extracted DNA
Container/tube: 1.5 or 2 mL tube with indication of volume and concentration of DNA
Specimen volume: entire specimen
Specimen stability: frozen/refrigerated/ambient


Collection instructions:

• Label specimen as extracted DNA and include source of specimen.

Oncoplus

Specimen type: FFPE (formalin-fixed, paraffin-embedded) tissue
Acceptable: paraffin block
Specimen volume: tumor area on slides = 2 cm2 total
Specimen stability: ambient


Collection instructions:

• Include top and bottom H&E guide slides.
  
• Label specimen as FFPE with source of specimen. 
  

OR

Specimen type: cytology smear (fine needle aspirate and fluid smears), alcohol fixed or air dried
Acceptable: cell block
Specimen volume: 10,000+ cells, minimum proportion of tumor cell 20 percent
Specimen stability: ambient

Collection instructions:

• Stain with DiffQuick® or rapid Pap stain.
  
• Do not use a cover slip.
  
• Label specimen as cytology smear with source of specimen.

OR

Specimen type: extracted DNA
Container/tube: 1.5 or 2 mL tube with indication of volume and concentration of DNA
Specimen volume: entire specimen
Specimen stability: frozen/refrigerated/ambient


Collection instructions:

• Label specimen as extracted DNA and include source of specimen.

Delivery Instructions

Specimens should be delivered to the Molecular Pathology Laboratory within 48 hours of collection.The driver should deliver to:

UChicago Medical Laboratories
Molecular Pathology Laboratory
Room J-601
5812 South Ellis St.
Chicago, IL 60637
Phone: 773.702.3611

The delivery information should be on the outside of the package. Include a printed submission form so that the sample can be identified and there is no delay in processing it once it arrives.

Call Client Services at 773702-8287 when a biopsy is scheduled so we can begin preparing for the specimen.

Muscle biopsy

Muscle biopsies are usually reported back the next working day for routine inflammatory myopathies and denervation. Myopathies requiring additional histochemistry or electron microscopy may require an additional week.

Patient information 

Attach any pertinent information, such as the suspected clinical diagnosis, serum creatine kinase level, results for collagen vascular disease enzymes, electromyographic (EMG) studies, and specific neurologic findings.Include the address(es) and fax number where results should be sent as well as the name of the ordering pathologist.We do not reject any specimens, but physicians are notified upon receipt of inadequate specimens.

Collection requirements and precautions

Obtain a biopsy from a muscle that is definitely affected but not so severely affected that much of it is replaced by fatty or fibrous connective tissue.

• The involved muscle should not have been previously traumatized by injections or by EMG studies.
  
• Typically, the triceps, biceps, or vastus lateralis is chosen.
  

The biopsy should be approximately 1.5 cm x 0.5 cm and dissected with minimal trauma along the long axis of the muscle fibers. If extra studies are needed, then another piece of similar size should be obtained.

• Do not use electrocautery or a muscle clamp in removing the specimen.
  
• If a muscle biopsy is received in a clamp or other apparatus, remove the specimen from it immediately.
  

Fresh muscle and nerve biopsies should be delivered to Anatomic Pathology as soon as possible after they are excised from the patient. All attempts should be made to have the biopsy reach the lab within two hours after removal.

Freezing Method Requirements and Precautions

When freezing, use one of the two approved methods listed below and:

• Freeze the specimen so all fibers are oriented in the same direction.
  
• The specimen should be blotted with an absorbent towel to extract excess moisture before flash freezing.
  
• Do not use a mounting medium such as optimal cutting temperature (OCT) compound when freezing the specimen.
  
• Do not leave forceps impressions in the muscle.
  
• Do not use pins, needles, tongue depressors, or a muscle clamp.
  
• Do not wrap muscle in tinfoil.
  
• A well-frozen specimen should have a white, chalky color.
  
• Never place the frozen specimen in a non-chilled container, as the specimen will thaw before it freezes again.
  
• The specimen can be stored at -70°C but must not thaw between the time of initial freezing and shipment.
  

Note: If the biopsy is taken on a Friday, flash freeze using one of the approved methods and store at -70°C until the specimen can be sent the following Monday.

Method 1

Isopentane- liquid nitrogen freezing (preferred)

• Puncture the lid of a screw-cap specimen container to allow excess isopentane to evaporate.
  
• Place the plastic screw-cap specimen container in a -70°C freezer or on dry ice to pre-chill.
  
• Add 50–100 mL of isopentane (2-methylbutane) to a Nalgene or metal beaker. Suspend the beaker in a bath of liquid nitrogen and wait until the isopentane freezes to a white, chalky substance. Remove the beaker from the nitrogen bath. Carefully drop or set the muscle on the frozen isopentane while keeping the muscle fibers straight and running in the same direction.
  
• The isopentane will start to thaw as soon as it contacts the warmer muscle specimen. At this point, it is important to swirl the beaker around so that the specimen will continue to contact the colder, frozen isopentane.
  
• The total freezing period should take approximately 10 to 15 seconds.
  
• After removing the specimen from the isopentane, immediately place the tissue in the container that has been pre-chilled on dry ice. Do not wrap it in foil.
  
• Place a cover on the container.
  
• Keep the specimen frozen at -70°C or on dry ice from this point on.
  

Method 2

Slurry Method

• Puncture the lid of a screw-cap specimen container to allow excess alcohol/acetone to evaporate.
  
• Place the plastic screw-cap specimen container in a -70°C freezer or on dry ice to pre-chill.
  
• Wrap solid dry ice in a towel, pulverize it with a hammer, and then pour the powder to fill a 200 mL beaker.
  
• Slowly add 100 percent alcohol or acetone and stir the mixture. At least 80 percent of the total volume of the slurry should consist of dry ice and only 20 percent of alcohol/acetone.
  
• When the slurry nearly stops bubbling, its temperature has fallen to about -70°C and it is suitable for flash freezing. Keep adding dry ice as needed to reach this point. The final product should resemble a snow cone.
  
• Hold the biopsy specimen with forceps and plunge it into the slurry quickly. Swirl the specimen in the slurry for 10 to 15 seconds, remove it, and quickly blot it dry with an absorbent towel to remove excess alcohol/acetone.
  
• Immediately place the tissue in a specimen container that has been pre-chilled on dry ice. Do not wrap it in foil.
  
• Place a cover on the container.
  
• Keep the specimen frozen at -70°C or on dry ice from this point on.
  

Note: Avoid prolonged immersion of the specimen in the quenching mixture, as it then becomes permeated with alcohol or acetone, which inhibits enzyme studies by histochemical methods.

Packaging

Use the muscle biopsy shipping kit to deliver. Call 773-702-8287 to order a kit.

• Place the transport vial with the flash-frozen specimen in the yellow frozen tissue bag with an absorbent cloth and seal the bag.
  
• Place the completed muscle histochemistry patient information sheet and any appropriate clinical history in the pocket of the bag.
  
• Store the specimen in a -70°C freezer or liquid nitrogen until it is retrieved by a courier or it is ready to be prepared for shipping to UChicago Medical Laboratories.

Shipping

Send on a Monday, Tuesday, Wednesday, or Thursday only.

If using a courier service:

• One day before shipping, contact client services at 773.702.8287 and ask for transportation.
  
• Alert transportation that a muscle biopsy will be shipped from your institution.
  
• Transportation will notify your courier to bring extra dry ice for packaging (if sending a pre-frozen sample).
  
• Fresh samples need to be delivered to the lab within two hours of removal from the patient. 

Delivery instructions

Muscle biopsies should be delivered to Anatomic Pathology as soon as possible after they are excised from the patient. All attempts should be made to have the biopsy reach the lab within two hours after removal.


The driver should deliver to:

Peter Pytel, MD
Anatomic Pathology
Room J-601
5812 South Ellis Ave.
Chicago, IL 60637
Phone: 773.702.8287

The delivery information should be on the outside of the package. No specimen will be received after 3:30 p.m. unless previously approved by the neuropathology on-call physician (Dr. Peter Pytel at 773-795-6751).

If shipping via FedEx (must be priority overnight):

• Pack the specimen in 8 to 10 lb. of pellet or small-particle dry ice so it is surrounded by ice.
  
• Send the specimen using express overnight delivery on Mondays, Tuesdays, Wednesdays, or Thursdays only. If the specimen is collected on a Friday, hold it in a -70°C freezer or liquid nitrogen until it can be shipped the following Monday.

Shipping address:

Bright Star Logistics
Attn: UCMC Lab
7800 S. Quincy St.
Willowbrook, IL 60627 

Contact Us

For questions related to specimen preparation contact:

Department of Pathology Client Services

Phone: 773.702.8287 and mention that you are inquiring about sending a fresh or frozen muscle and/or nerve biopsy
Fax: 773.702.4633

To review clinical problems with the clinician before the biopsy is performed contact:

Peter Pytel, MD
Phone: 773.795.6751

For muscle biopsy shipping kits contact:
Phone: 773.702-8287

An ideal oral biopsy for light microscopy consists of at least one 4 mm punch biopsy. If the biopsy is to be divided, collect at least one 5 mm punch biopsy. 

Place the biopsy in a container of 10% neutral buffered formalin (provided) labeled with the patient’s full legal name and date of birth. Avoid crush artifact and desiccation. A mesh bag is very helpful for small tissue samples. To identify orientation, please tag samples with a suture and indicate designation on the registration. The specimen should ideally be fixed at a 10:1 ratio of formalin to specimen volume.

For large specimens that require more formalin than is prudent for shipping, allow the sample to fix at the 10:1 ratio for approximately 24 hours; then it can be placed in a smaller volume or wrapped in formalin-soaked paper towels for shipping. This is not recommended for specimens traveling long distances or not being shipped priority/overnight.

For patients with vesiculobullous lesions that require immunofluorescence, a biopsy should be obtained when vesicles are present and it should be taken at the junction between normal tissue and vesicle. One sample should be placed in formalin for routine processing. Another sample should be placed in Michel’s fixative for immunofluorescence.

Please contact Client Services at 773-702-8287 to request jars of formalin or Michel’s fixative. To obtain optimal service, we request that you provide a complete and accurate history on the submission form, including relevant clinical and radiologic images. Results are generally available within five to seven days of the specimen’s arrival. If decalcification is required, an additional one to three days may be required.

No specimens are rejected, but physicians are notified upon receipt of inadequate specimens.

Delivery Instructions

An oral biopsy should be delivered as soon as possible after it is excised from the patient. Please call courier services to arrange for pickup and delivery to:

Mark Lingen, MD
Department of Pathology
Room 2-470, MC 8046
5700 S. Maryland Ave.
Chicago, IL 60637
Phone: 773.834.1975 (Direct Laboratory number)

The delivery information should be on the outside of the package. Include a printed submission/requisition form so that the sample can be identified and there is no delay in processing it once it arrives at our lab. Please use the patient’s full legal name and date of birth on the form and on the specimen container. The specimen container must have patient identifiers.

Call Client Services at 773-702-8287 when a biopsy has been scheduled. We do not reject any specimens, but physicians are notified upon receipt of any inadequate specimens. You must indicate whether the biopsy is from a native or transplant kidney.

Light microscopy

An ideal renal biopsy for light microscopy consists of at least one ≥1 cm-long core of renal cortex. Place the core in a container of 10% neutral buffered formalin (provided) labeled with the patient’s full legal name.

Light microscopy results are available the same day for specimens received before 12:30 p.m. and the next day for specimens received later.

Immunofluorescence microscopy

The immunofluorescence microscopy specimen consists of one 1 cm-long core of renal cortex. Place the core in a container of ZEUS or Michel’s solution (provided) labeled with the patient’s name.

Electron microscopy

The electron microscopy specimen consists of 2–3 mm pieces of tissue cut at the end of each core specimen. Do not cut the specimen into pieces that are <1 mm.

Place the pieces in a container of glutaraldehyde (provided) labeled with the patient’s name. If glutaraldehyde is not available, formalin is the next preferred fixative, but make note of this alteration on the requisition sheet.

Place the container in a cooler or other temperature-controlled device with ice.

Electron microscopy results are generally available within three business days.

Delivery instructions

Renal biopsies should be delivered to Client Services (J-601) as soon as possible after being removed from the patient.

Inform the courier that the specimen must be delivered to us by 5 p.m. If the specimen cannot arrive by then, refrigerate the specimen overnight and deliver the next morning. Do not send specimens on Saturday and Sunday.

The driver should deliver to:

Anatomic Pathology Department
Room J-601
5812 South Ellis Ave.
Chicago, IL 60637
Phone: 773.702.8287

The delivery information should be on the outside of the package.

24-hour urine collection

The preferred time for a 24-hour urine collection is 6 a.m. to 6 a.m. the following morning. However, any 24-hour period is acceptable as long as the opening and closing times are indicated on the specimen container. Only one first morning void must be included.
24-hour urine specimens must be collected in a plastic, brown, graduated urine container. These containers can be obtained from the inpatient/outpatient unit or an outpatient pharmacy. It is preferable that the collection be refrigerated and delivered promptly. The start date and time, and end date and time must be indicated.
The container must be labeled with the patient’s name and unique identification, such as the medical record number or date of birth.
Note: While timed urine collections encompassing a 24-hour period are preferable, collections of shorter duration may be accepted in certain cases (e.g., pediatric patients).

Patient instructions

1. Void and discard urine for the starting time.
   
2. Begin saving all urine in a container from this time on for 24 hours.
   
3. Refrigerate the container during collection.
   
4. Void at the end of the 24-hour period and add it to the container.
   
5. Report any loss of urine. Urine must not be removed for other purposes, such as other testing or research testing. The Laboratory Service Center must receive the entire 24-hour sample.

Collection with acid preservative

For specimens with acid preservatives, 25 milliliters of 50 percent acetic acid must be added at the start of collection. The acid preservative bottle can be obtained from an outpatient pharmacy.

The following are examples of tests that require an acid preservative:

• 5HIAA
  
• Catecholamines
  
• DALA/ALA
  
• HVA
  
• Metanephrines
  
• VMA

Collection without acid preservative

For specimens without acid preservatives, 24-hour urine is collected in a brown bottle with no preservative. These containers can be obtained from the clinic or an outpatient pharmacy.

The following are examples of tests that can be performed on a 24-hour collection with no preservative:

• Citrate
  
• Copper
  
• Heavy metal screen
  
• Mercury
  
• Oxalate
  
• Porphobilinogen qualitative/quantitative (protect from light, use brown bottle or wrap in foil)
  
• Porphyrin screen/fractionation (protect from light, use brown bottle or wrap in foil)

Random urine collection

A random, clean-catch urine specimen should be collected in a blue-capped, BD Vacutainer urine collection cup. The container must be labeled with the patient’s name and unique identification, such as the medical record number. The instructions for clean-catch, midstream urine collection are given to the patient.

Procedure

After collection, the sealed blue-capped container is returned to the healthcare worker. Urine will be transferred to both a gray top and yellow top tube. If there are orders for a urine culture, the healthcare worker will:

• Transfer the specimen from the urine cup into a gray-top tube containing boric acid by removing the seal from the blue cap and inserting the gray-top tube through the blue cap and onto the needle.
  
• Once the fill-line has been reached, the tube is removed and mixed immediately by gently inverting it 8 to 10 times (holding the tube upright, gently invert it 180 degrees and back to complete one inversion).

If there are orders for urinalysis, the healthcare worker will transfer the specimen from the urine cup into a yellow-top tube, which is then inserted onto the needle.

If there are orders for additional urine tests, the blue cap is carefully removed from the cup and the urine is poured into a wide-mouth, tightly-sealable, screw-cap container.

All specimen tubes and containers must be labeled with the patient’s name and unique identification, such as the medical history number. The healthcare worker must not send the blue-capped urine container through the pneumatic tube system or via courier.

Timed stool collection

Timed fecal specimens must be collected in Mayo stool containers (these are available from the Laboratory Service Center 773-702-1316). Containers must be obtained before collection is started. The start date and time, and the end date and time must be indicated on a timed collection. The container must be labeled with the patient’s name and unique identification, such as the medical record number.

The following is an example of a test requiring a timed collection:

• Quantitative fecal fat

Random stool collection

Random fecal specimens must be collected in Mayo stool containers (these are available in the Laboratory Service Center 773-702-1316). Containers must be obtained before collection is started. The container must be labeled with the patient’s name and unique identification, such as the medical record number.

The following are examples of tests that can be performed on random collections:

• Alpha 1 anti-trypsin
  
• Qualitative fecal fat

For the most optimal diagnosis, it’s important to have your samples properly shipped to our laboratories. 

UChicago Medical Laboratories’ specimen transportation procedures reflect the wide variety of clinical and anatomic pathology specimens received for testing from a large geographic area. The shipping and courier services which are included in our test charges are based on a number of factors including; where the specimen is coming from, specimen type, and the stability requirements for the particular specimen.

UChicago Medical Laboratories maintains independent contractor relationships with a local courier service and global carriers. For specimens coming from facilities less than 50 miles we use our local contracted courier service. Please contact the Laboratory Outreach Manager at 312-213-5441 or our Customer Service Department at 773-702-8287.

Dental and other medical facilities outside the 50 mile radius please contact the Laboratory Outreach Manager at 312-213-5441 or our Customer Service Department at 773-702-8287 to have this setup via FedEx. UChicago Medical Laboratories has made arrangements with our contracted carriers for payment for approved transportation services when properly ordered by a client. 

Non-covered services will be billed directly to the client. The specific services we cover were chosen to provide a cost effective transport solution to the greatest number of clients in order to help maintain the integrity of the most common types of specimens we receive for testing.

Included transportation services

Specimen Pick-Up Location

Less than 50 miles from UChicago Medical Laboratories

• CP Specimens
  
  • Courier Service Pick-Up
    
  • Same Business Day
    

• AP Specimens
  •  Courier Service Pick-Up
  • Same Business Day

Greater than 50 miles from UChicago Medical Laboratories

• CP Specimens
  
  • FedEx or UPS Service
    
  • Next Business Day
    
• AP Specimens
  
  • FedEx or UPS Service
    
  • Next Business Day

Expedited or unusual transportation needs

Although UChicago Medical Laboratories’ test charges include only the specific transport services described above, a client’s expedited or unusual transport needs may also be met by UPS. Clients should contact UPS directly to arrange transport. 

Clients may also use their own courier or shipping service to transport specimens to UChicago Medical Laboratories. All specimens must be handled and maintained according to industry standards, the requirements of UChicago Medical Laboratories’ Test Catalog, and all applicable state and federal regulations and restrictions for transportation of biological and hazardous materials.

All costs associated with transportation services other than the UChicago Medical Laboratories included services described above are the sole responsibility of client. UChicago Medical Laboratories does not cover partial costs nor does it offer discounted pricing for specimens that are transported by a method other than our included services.

Courier information

Same Business Day and Next Business Day services are available for both CP and AP specimens when a client is located 50 miles or less from the University of Chicago Medicine. Client should contact UChicago Medical Laboratories to determine which service is appropriate for the type of testing requested. Many CP tests require expedited turnaround time and are therefore not suitable for either type of service. UChicago Medical Laboratories maintains an independent contractor relationship with a local courier for pick-up and delivery of this category of specimens. Requests for same business day service must be received the day before the scheduled pick-up. Expedited service may be available; however all charges (not just excess amounts) for expedited pick-up and delivery will be billed directly to the client.

Shipping information

Next Business Day service is available for CP and AP specimens when the client is located greater than 50 miles from UChicago Medical Laboratories. Client should contact UChicago Medical Laboratories to determine if this service is appropriate for the type of testing they require. Many CP tests require expedited turnaround time and are therefore not suitable for Next Business Day service. UChicago Medical Laboratories maintains an independent contractor relationship with UPS and FedEx for pick-up and delivery of this category of specimens. Expedited services may be available through UPS however all charges (not just excess amounts) for expedited pick-up and delivery will be billed directly to the client.

To schedule a Next Business Day service pick-up, call UPS at 1-800-PICK-UPS or FedEx at 1-800-GO-FEDEX. Tell the operator the following information.

1. Your UChicago Medical Laboratories Account #: (provided by your Client Service Representative)
   
2. The UChicago Medical Laboratories Zip Code: 60637
   
3. Pick-up Information including your address with a room/suite number and a contact name.
   
4. The UPS or FedEx service type you require. We cover Priority Overnight and Saturday Delivery
   
5. UChicago Medical Laboratories Delivery Address:

UChicago Medical Laboratories Department of Pathology
5812 South Ellis Avenue
Surgery Brain Research Institute
Room J601, MC-6101
Chicago, IL 60637

To discuss your specific specimen delivery requirements please contact your UChicago Medical Laboratories client service representative at 773-834-4070 or uchicago.medlabs@uchospitals.edu.