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Alkali Denaturation Test (APT and Downey)

Test Summary

The Alkali Denaturation Test (APT) is useful in distinguishing between newborn swallowing mother's blood and fetal gastrointestinal bleeding (Melena neonatorum).

The APT test is used to determine whether blood in the diaper, vomitus, or feces of a neonate contains predominantly the baby's or the mother's blood. It is a crude, qualitative method based on resistance of hemoglobin F to alkali denaturation.

Aliases

  • N/A

Specimen Collection

Special Instructions

N/A

Preferred Specimen

2 mL of a random, bloody stool submitted in a plastic leak-proof container

Minimum Volume

1 mL

Instructions

Note: The specimen requirement for this test is a grossly bloody (red) non-tarry stool (or bloody vomitus, bloody mucus or blood-stained diaper from newborn within 1 day of birth). If the specimen submitted was not bloody and we were unable to elute any red color from it, the test cannot be performed and will be cancelled

Patient Preparation

N/A

Storage

N/A

Transport Temperature

Room temperature

Specimen Stability

  • Room temperature: 7 days
  • Refrigerated: 7 days
  • Frozen: Unacceptable

Limitations

N/A

Other Acceptable Specimens

2 mL bloody vomitus or bloody mucus, submitted in a plastic leak-proof container or bloody diaper submitted in a plastic leak-proof container

Unacceptable Specimens

Received frozen

Order Code

APT

EPIC (Premier) Code

LAB1993

Includes

N/A

CPT Code

  • 85460

Billing Code

  • 700000

CPT Statement

Methodology

Colorimetric (C)

FDA Status

FDA Approved

Physician Attestation of Informed Consent

N/A

Testing Laboratory

Quest Diagnostics Nichols Institute
14225 Newbrook Drive
Chantilly VA, 20153

Reference Range

Negative for fetal blood

Setup Schedule / Expected Turnaround Time

Daily; Report available: 1 day

Specimen Collection

Special Instructions

N/A

Preferred Specimen

2 mL of a random, bloody stool submitted in a plastic leak-proof container

Minimum Volume

1 mL

Instructions

Note: The specimen requirement for this test is a grossly bloody (red) non-tarry stool (or bloody vomitus, bloody mucus or blood-stained diaper from newborn within 1 day of birth). If the specimen submitted was not bloody and we were unable to elute any red color from it, the test cannot be performed and will be cancelled

Patient Preparation

N/A

Storage

N/A

Transport Temperature

Room temperature

Specimen Stability

  • Room temperature: 7 days
  • Refrigerated: 7 days
  • Frozen: Unacceptable

Limitations

N/A

Other Acceptable Specimens

2 mL bloody vomitus or bloody mucus, submitted in a plastic leak-proof container or bloody diaper submitted in a plastic leak-proof container

Unacceptable Specimens

Received frozen

Billing

CPT Code

  • 85460

Billing Code

  • 700000

CPT Statement

Result Information

Methodology

Colorimetric (C)

Testing Laboratory

N/A

Reference Range

Negative for fetal blood

Setup Schedule / Expected Turnaround Time

Daily; Report available: 1 day