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25058 IBD sgi Diagnostic, Prometheus (1800)

IBD sgi Diagnostic, Prometheus (1800)
Test Code: IBDSGSO
Useful For
​This test is a serologic, genetic and inflammation panel of antibodies optimized to detect inflammatory bowel disease (IBD). It includes a proprietary Smart Diagnostic Algorithm to provide added IBD diagnostic clarity.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Pediatric Minimum Volume
(no repeat)
​Serum AND Whole Blood ​Red Top Tube (RTT) AND EDTA Lavender Top Tube (LTT) ​Serum Separator Tube (SST) ​2 mL serum AND 2 mL EDTA whole blood ​
Collection Processing Instructions
​Must submit both serum AND EDTA whole blood.
Specimen Stability Information
Specimen Type Temperature Time
​Serum and Whole Blood ​ Ambient ​7 days
​Refrigerated ​21 days
Rejection Criteria
Not submitting both serum AND whole blood.
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Prometheus Labs​ ​Monday through Friday ​4 days ​ELISA, PCR, Immunoflurescent
Reference Lab
Prometheus Biosciences
Reference Range Information
Performing Location Reference Range
​Prometheus Labs ​Interpretive Report
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
83520​ ​ ​6 ​ASCA IgA & IgG, Anti-OmpC IgA, Anti-CBir1, ANCA ​
​82397 ​ ​4 ​Chemiluminescent assay ​
​86140 ​ ​1 ​CRP ​
​81479 ​ ​1 ​ATG16 L1 Gene ​
​81479 ​ ​1 ​EMC1 Gene ​
​81479 ​ ​1 ​NKX 2-3 Gene ​
​81479 ​ ​1 ​STAT3 Gene ​
86255 ​ ​2 PANCA and DNAase ​
Ordering Applications
Ordering Application Description
​COM ​IBD sgi Diagnostic, Prometheus
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Pediatric Minimum Volume
(no repeat)
​Serum AND Whole Blood ​Red Top Tube (RTT) AND EDTA Lavender Top Tube (LTT) ​Serum Separator Tube (SST) ​2 mL serum AND 2 mL EDTA whole blood ​
Collection Processing
​Must submit both serum AND EDTA whole blood.
Specimen Stability Information
Specimen Type Temperature Time
​Serum and Whole Blood ​ Ambient ​7 days
​Refrigerated ​21 days
Rejection Criteria
Not submitting both serum AND whole blood.
Useful For
​This test is a serologic, genetic and inflammation panel of antibodies optimized to detect inflammatory bowel disease (IBD). It includes a proprietary Smart Diagnostic Algorithm to provide added IBD diagnostic clarity.
Reference Range Information
Performing Location Reference Range
​Prometheus Labs ​Interpretive Report
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Prometheus Labs​ ​Monday through Friday ​4 days ​ELISA, PCR, Immunoflurescent
Reference Lab
Prometheus Biosciences
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
83520​ ​ ​6 ​ASCA IgA & IgG, Anti-OmpC IgA, Anti-CBir1, ANCA ​
​82397 ​ ​4 ​Chemiluminescent assay ​
​86140 ​ ​1 ​CRP ​
​81479 ​ ​1 ​ATG16 L1 Gene ​
​81479 ​ ​1 ​EMC1 Gene ​
​81479 ​ ​1 ​NKX 2-3 Gene ​
​81479 ​ ​1 ​STAT3 Gene ​
86255 ​ ​2 PANCA and DNAase ​
For most current information refer to the Marshfield Laboratory online reference manual.