AFP Screening and Prenatal Diagnosis Requisition Form
AFP Screening CPT Codes
Maternal Serum Screening and Amniotic Fluid Assays *
WHY IS AFP TESTING IMPORTANT?
This test is recommended for screening of neural tube defects and detects 95-100% of anencephaly and 80-90% of spina bifida.
WHAT IS A NEURAL TUBE DEFECT?
Defects in the development of the brain (called anencephaly) or the spinal cord (called spina bifida) are collectively described as neural tube defects (NTDs). Almost all babies with anencephaly die within hours or days of birth. Those born with spina bifida often survive, but because of damage to the spinal cord the vast majority develop handicaps varying from total paralysis from the waist down (associated with lack of bladder and bowel control) to some cases with only mild impairment of walking. Hydrocephalus (an accumulation of fluid in the brain) occurs in 80-90% of these children. Affected children with spina bifida require continuous medical and surgical care and often have a shorter life span. Mental retardation is a frequent complication.
Maternal serum must be obtained in a Red or Tiger Top tube, minimum 5cc.
In order for to accurately report results, the following information must be provided on the accompanying requisition:
- Patient Name
- Patient (or Egg Donor) DOB
- Date Specimen obtained
- Patient LMP or
- Ultrasound DATE & Gestational Age at the time of US
If you have any questions please call the Maternal Serum Coordinator at 617-492-7083.
Please note that Adobe Acrobat Reader is necessary in order to view the Requisition Form, which can be completed on-line and then printed for a signature. The latest version of the Reader may be downloaded for free by clicking on the image below.