Test Code H72 Neonatal Metabolic Screen
Additional Codes
ALAB: NMS
PowerChart: State Newborn Screen (Lab)
Test Method
17-Hydroxyprogesterone: Fluorometric
TSH: Fluorometric
Gal-1-Phosphate Uridyl Transferase: Fluorometric
Biotinidase: Wolfe Method
Amino Acids & Acylcarnitines: Tandem Mass Spectometry
Hemoglobin Phenotype: Isoelectric Focusing & HPLC
Immunoreactive Trypsinogen: Tandem Mass Spectrometry (MS/MS)
Severe Combined Immunodeficiency (SCID): DNA-Based PCR
Specimen Requirement
Whole blood - blood spot
Additional Specimen Collection Information
Specimen is collected via capillary puncture to the infant's heel. Drops of blood are allowed to soak into the filter paper circles on the request form provided by the State Hygienic Laboratory. All 5 circles must be filled and the blood must penetrate the filter paper completely to the opposite side of collection. Specimen must be dry before mailing.
SHL requisition form must have the following information completed on the form before delivery to laboratory: infant's last name and first name, sex, first or repeat specimen, physician name, date and time of birth, feeding method (bottle/breast/npo/parenteral nutrition), mother's first and last name, mother's date of birth, date and time of collection, weight at time of collection, gestational age in weeks, transfusion within the last eight weeks and date of transfusion.
Performance
Allow 3-6 days turn around time.
Reference Values
17-Hydroxyprogesterone: Within Normal Limits
Thyroid Stimulating Hormone (TSH): Within Normal Limits
Gal-1-Phosphate Uridyl Transferase: Within Normal Limits
Biotinidase: Within Normal Limits
Amino Acids & Acylcarnitines: Within Normal Limits
Hemoglobin Phenotype: (FA or AF) Normal
Immuoreactive Trysinogen (Cystic Fibrosis): Within Normal Limits
Severe Combined Immunodeficiency (SCID): Within Normal Limits
This is a screening test. The possibility of a false negative or
a false positive result must always be considered especially when
screening newborns for metabolic disorders. Additional information
about the disorders can be found in the INMSP Practitioners’
Manual at www.idph.state.ia.us/genetics.
To order more request/sample collection forms call the State
Hygienic Laboratory, Ankeny: (515) 725-1630.
CPT Code Information
82261 Chemistry: Biotinidase
82776 Chemistry: Galactose-1-phosphate uridyl transferase; screen
83020 Chemistry: Hemoglobin fractionation and quantitation; electrophoresis
83498 Chemistry: Hydroxyprogesterone
83789 Chemistry: MS/MS analyte not elsewhere specified; quantitative, each specimen
84443 Chemistry: Thyroid Stimulating hormone (TSH)
81479 Molecular Pathology Tier 2 Procedures: Unlisted molecular pathology procedure
Useful For
Iowa neonatal screening program protocol detects congenital adrenal hyperplasia, primary hypothyroidism, biotinidase deficiency, galactosemia, hemoglobinopathies, cystic fibrosis, expanded screening disorders, and SCID.
LOINC Code Information
46738-1 Genetic.Disorders Newborn Screen Interpretation