Choose to Know

Hormone Testing for Men and Women

Laboratory testing to measure levels of the steroid hormones testosterone and estradiol can help discover, diagnose and monitor treatment of a number of serious conditions and chronic diseases.

Conditions and diseases include:

  • Polycystic ovarian syndrome
  • Androgen deficiency in men, a possible precursor to diabetes or cardiovascular disease
  • Breast disease and breast cancer
  • Testicular cancer
  • Prostate cancer
  • Erectile dysfunction
  • Infertility
  • Osteoporosis
  • Hypothalamus and pituitary disorders

Expert Clinical Consultations DLO’s Medical Director is available for consultation during regular business hours, in addition to the more than 900 MDs, PhDs and genetic counselors accessible through Quest Diagnostics.

Hormone Testing Codes

Cardiovascular Disease in Oklahoma

Heart Disease and Stroke Statistics for 2016

Heart Disease (including Coronary Heart Disease, Hypertension, and Stroke) remains to be the No. 1 cause of death in the US. Stroke ranks No. 5.1

Heart Disease and its risk factors in Oklahoma

Cardiovascular disease, listed as the underlying cause of death, accounts for nearly 801,000 deaths in the US. That’s about 1 of every 3 deaths in the US.1

  • Coronary heart disease accounts for 1 in 7 deaths in the US, killing over 360,000 people a year.1
  • In Oklahoma, heart disease was the leading cause of death, accounting for 1 in 4 deaths, killing almost 10,000 people a year.2
  • Stroke accounts for 1 of every 20 deaths in the US, killing nearly 133,000 people a year.1
  • In Oklahoma, stroke is the 5th leading cause of death, accounting for more than 1 in 20 deaths and killing more than 1,800 a year.2

In 2014, heart disease death rates were highest among Oklahoma non-Hispanic Blacks and American Indians. These rates were twice as high as the rate among Hispanics.2

Determining Cardiovascular Disease Risk with Cardio IQ

C-reactive protein (CRP) is made by the liver in response to tissue injury, infection, and inflammation. High levels indicate inflammation due to infection or tissue injury. Moderately elevated levels may be associated with increased heart disease risk.5 Certain medications and food may anti-inflammatory benefits.
Cardio IQ hs-CRP                                         Test Code: 91737              CPT Code: 86141

Lp-PLA2 is an enzymatic, specific marker for vascular inflammation and is believed to contribute to plaque development.6,7 High levels of Lp-PLA2 may predict risk of a heart attack or stroke. Certain medications can reduce levels of Lp-PLA2
Cardio IQ Lp-PLA2 Activity                           Test Code: 94218             CPT Code: 83698

Cardio IQ Lipid Panel is a panel of blood tests that serves as an initial broad medical assessment tool for abnormalities in Total Cholesterol, HDL Cholesterol, Triglycerides, LDL-Cholesterol (calculated), Cholesterol/ HDL Ratio (calculated). A Lipid Panel is used to identify hyperlipidemia which may indicate an increased risk for cardiovascular disease. If the Triglyceride level is greater than 400 mg/dL, a measure of Direct LDL is done. The LDL direct test, unlike what is reported in the chemistry profile, is not a calculation but rather a direct test for the best evaluation and monitoring of this risk factor.
Cardio IQ Lipid Panel w/ Direct LDL Reflex   Test Code: 92061            CPT Code: 80061
Cardio IQ Lipid Panel                                      Test Code: 91716            CPT Code: 80061

Ion Mobility Lipoprotein Fractionation is a technology that uses gas-phase (laminar flow) electrophoresis to separate unmodified lipoproteins on the basis of size. Following the separation, each lipoprotein particle is directly detected and counted as it exits the separation chamber. Proprietary test. 
Cardio IQ Ion Mobility                                   Test Code: 91604             CPT Code: 83704

QuestDirect’s Heart Health tests are available to patients without a health care provider's order.

The cholesterol panel, also known as a lipid panel, is made up of a group of tests to detect the risk of coronary artery disease, heart attack or stroke. It is also used to monitor treatment for someone already diagnosed with cardiac issues. It measures total cholesterol, HDL, LDL, and triglycerides.

A total cholesterol test is used to screen for the risk of developing heart disease. Because high blood cholesterol has been associated with the hardening of arteries, called atherosclerosis, and an increased risk of death from heart attacks, cholesterol testing is considered a routine part of preventative health care.

An inflammation marker test, also known as a high-sensitivity CRP is a blood test that is used to evaluate the risk of cardiovascular disease, heart attacks and strokes. The test measures low levels of CRP in the blood to identify low levels of inflammation that can lead to heart disease.

Important: Patients are always incouraged to discuss QuestDirect testing results with a healthcare provider.

CVD Treatment Cost

Heart Disease Death Rates by Gender, Race and Ethnicity in the United States from 2012-2014About 92.1 million American adults are living with some form of cardiovascular disease or the after-effects of stroke. Direct and indirect costs of cardiovascular diseases and stroke are estimated to total more than $316 billion, which includes both health expenditures and lost productivity.1

Heart attacks ($11.5 billion) and Coronary Heart Disease ($10.4 billion) were 2 of the 10 most expensive hospital principal discharge diagnoses.3

Between 2013 and 2030, medical costs of Coronary Heart Disease are projected to increase by about 100%.3

References

  1. Retreived from http://professional.heart.org/professional/ScienceNews/UCM_491264_Heart-Disease-and-Stroke-Statistics---2017-Update.jsp
  2. Retreived from https://www.ok.gov/health/Wellness/Chronic_Disease_Service/Heart_Disease_&_Stroke/
  3. Retreived from https://nccd.cdc.gov/DHDSPAtlas/Reports.aspx
  4. Prevalence data are from the Behavioral Risk Factor Surveillance System (BRFSS). *2013 data
  5. Greenland P, Alpert JS, Beller GA, et al. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2010;56:e50-103.
  6. Davidson MH, Corson MA, Alberts MJ, et al. Consensus panel recommendation for incorporating lipoprotein-associated phospholipase A2 testing into cardiovascular disease risk assessment guidelines. Am J Cardiol. 2008;101(suppl):51F-57F.
  7. Gonçalves I, Edsfeldt A, Ko NY, et al. Evidence supporting a key role of Lp-PLA2-generated lysophosphatidylcholine in human atherosclerotic plaque inflammation. Arterioscler Thromb Vasc Biol. 2012;32:1505-1512.

Diagnostic Laboratory of Oklahoma (DLO) strives to empower patients to take a more active role in their healthcare decisions through providing education on disease states and available diagnostic testing, as well as resources for additional information from medical organizations.

DLO News

DLO Team Exceeds Holiday Meal Goal: A Testament to Community Spirit

As the holidays approached, Diagnostic Laboratory of Oklahoma (DLO) set an ambitious target to provide over 4,000 meals to those in need throughout the state.  Partnering with the Regional Food Bank of Oklahoma, the DLO team mobilized to tackle food insecurity during this vital season of giving.

Testing to reduce Prescription Drug Abuse

OSBI 2016 drug graphPrescription drug misuse is Oklahoma’s fastest growing civic problem and impacts our state in multiple ways. Oklahoma workers who abuse prescription drugs contribute to poor work performance, injuries, absenteeism and lack of economic productivity. Teens in a recent national study reported that nearly one in five of their classmates drink, use drugs and smoke during the school day, and more than a third said it is fairly easy to do so without getting caught.1 Of the more than 4,200 impaired driving cases submitted to Oklahoma State Bureau for Investigation (OSBI) in 2016, more than 36% of those drivers tested positive for at least one prescription drug without having been prescribed that medication by a health care provider.2
 

Oklahoma is one of the leading states in prescription painkiller sales per capita with 128 painkiller prescriptions dispensed per 100 people in 2012.3 The misuse of prescription medication has become an overwhelming nationwide problem, killing one American every 19 minutes.4 It’s more prevalent in Oklahoma than most residences are aware of. Prescription opioids were responsible for more than half of Oklahoma’s drug over dose deaths in 2015.5 In 2014, Oklahoma had the 10th highest drug overdose death rate in the nation.5 This epidemic has been spreading across the US, and within Oklahoma, for years. Of the more than 5,800 unintentional poisoning deaths in Oklahoma from 2010-2015, 74% involved at least one prescription drug.4 The most common drugs involved in unintentional overdose deaths are hydrocodone, oxycodone, and alprazolam.

 

Oklahoma Morbidity Due to Overdose

There are also more Mental Health Consumers per capita in Oklahoma than the national average.5 These consumers can experience improved function with prescription medication used correctly5, but the risk for abuse is always present. DLO’s comprehensive, reliable, and effective behavioral health testing solutions can help monitor your patient’s psychotropic medications as well as detect commonly misused prescription or illicit drugs.

DLO’s comprehensive, reliable, and effective prescription drug testing solutions can help monitor your patient’s medications as well as detect commonly misused prescription or illicit drugs. Make the right choice for your patients.

Services to support your practice

medMATCH®: optional report feature indicates if the patient’s results are consistent with the prescribed medication.

Easily accessible reports through Quanum™ Labs & Meds, with the option of online ordering which reduces the risk of transcription errors- no need to deal with faxes or paper trails.

Access to direct toxicologist consultation available to address questions or concerns. Call our toxicology hotline: 1-877-40-RXTOX (1-877-407-9869).

Oral Fluid Drug Testing is available for those situations when urine collection isn't practical.

Testing information

Frequently used PDM profiles and test codes
PDM Reference Guide
ICD-10 PDM CPT Codes
Quest Diagnostics Precription Drug Monitoring Program
2016 PDM Health Trends Report

QuestDirect's Drug Screen test is available to patients without a health care provider's order.

Urine drug testing through QuestDirect that detects the presence of certain illegal drugs and prescription medications is available at DLO Patient Service Centers. Urine drug screening detects recent drug use in the previous 24 to 72 hours, but detection times can vary depending on the type of drug that was used.

The urine screen tests for the following drugs:

  • Amphetamines
  • Benzodiazepines
  • Marijuana metabolite
  • Cocaine metabolite
  • Opiates
  • Oxycodone

QuestDirect™ offers direct access to laboratory testing for informational purposes only. A QuestDirect lab test result is not a medical diagnosis and is not intended as medical advice. Only a healthcare provider can interpret lab results and diagnose a medical condition or disease.

Because tests have not been ordered by a healthcare provider, third party entities, including Medicare and Medicaid, will not reimburse for these tests.


  1. Fitzgerald, Eileen., More teens using drugs at school, study shows.” News Times. August 23, 2012. Retreived from http://www.newstimes.com/local/article/More-teens-using-drugs-at-school…
  2. Oklahoma State Bureau of Investigation, Impaired Driver Statistics for 2016, February 2017
  3. Eastes, Laura. “The fight against opioids continues”. Oklahoma Gazette. Oct. 19, 2016. Retreived from http://okgazette.com/2016/10/19/the-fight-against-opioids-continues/
  4. Vieth, Warren. “Prescription Drug Deaths Subside; Meth, Heroin Overdoses Soar.” Oklahoma Watch, Retrieved from http://oklahomawatch.org/2016/07/28/prescription-drug-deaths-subside-me…. July 28, 2016.
  5. Substance Abuse and Mental Health Services Administration. Behavioral Health Barometer: Oklahoma, 2015. HHS Publication No. SMA–16–Baro–2015–OK. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015.
  6. Oklahoma Department of Mental Health and Substance Abuse Services . Reducing Prescription Drug Abuse In Oklahoma 2016. Norman, OK. October, 2016. Retreived from https://www.ok.gov/health2/documents/UP_Rx_Abuse_Prevention_State_Plan_…

Sexually Transmitted Infections

Encourage your patients to be proactive about their health by sharing information about sexually transmitted infections

Oklahoma Chlamydia Diagnosis, men and women according to age, 2015Chlamydia can cause serious, permanent damage to a woman’s reproductive system, making it difficult or impossible for her to get pregnant later on. It can also cause a potentially fatal ectopic pregnancy (a pregnancy that occurs outside the womb).5

How is chlamydia spread?

Chlamydia is contracted by having anal, vaginal, or oral sex with someone who has chlamydia.1,3,5

If a patient has had chlamydia and was treated in the past, re-infection can occur through unprotected sex with someone who has chlamydia.1,3,5

If she is pregnant, the baby can become infected during childbirth.1,5

Gonorrhea can cause infections in the genitals, rectum, and throat. It is a very common infection, especially among young people ages 15-24 years.1,3,5

How is gonorrhea spread?

Oklahoma Gonorrhea Diagnosis, men and women according to age, 2015Patients can get gonorrhea by having anal, vaginal, or oral sex with someone who has gonorrhea.

A pregnant woman with gonorrhea can give the infection to her baby during childbirth.1,3,5

Trichomonas vaginalis or “Trich” is an infection with a protozoan parasite that is easily spread from one person to another, usually through sexual contact and infects both women and men.1 This is a common and curable infection. Without treatment, the infection can last for months or even years.1

How is trich spread?

The parasite is passed from an infected person to an uninfected person during sex.1,5 In women, the most commonly infected part of the body is the lower genital tract (vulva, vagina, cervix, or urethra), and in men, the most commonly infected body part is the inside of the penis (urethra). 1,3,5

Infected people without symptoms can still pass the infection on to others.1,3,5

Diagnosis can be quick and easy with multiple specimen options

Have an honest and open talk with patients and ask whether they should be tested for chlamydia, gonorrhea, trichomonas, or other sexually transmitted infections.

Chlamydia, gonorrhea and trich can be detected with a single swab, a urine sample or out of the Pap vial. 

Patients can be tested for certain sexually transmitted infections (STIs) without a provider order through Quest Health’s Sexually Transmitted Disease testing. A simple urine sample collected at any DLO Patient Service Center can be used to detect chlamydia and gonorrhea.

Chlamydia, gonorrhea and trich are easily treated and cured with common and affordable antibiotics. Unfortunately many cases go undiagnosed since most are without symptoms.1,3,5

Why should you test your patients for sexually transmitted infections?

  • High risk for an sexually transmitted infection. The highest rates of infection are in sexually active young women under 25 years of age, any woman with new or multiple partners, or a woman whose partner who has been diagnosed with an STI.1
  • Chlamydia was the most commonly reported STI in Oklahoma during 2015, with gonorrhea second.2
  • Most chlamydia and gonorrhea infections have no symptoms. An infection can go unnoticed, which can cause consequences later on.1
  • Almost 2 million new cases of chlamydia and gonorrhea were reported to the CDC in 2015. For a second year in a row, increases were seen in these nationally reported STI’s. Chlamydia increased by 6%, while gonorrhea increased 13%.1
  • Trichomonas infects an estimated 3.7 million people in the United States each year. Approximately 30% of those infected develop symptoms, resulting in the majority of cases going untreated.1
  • Young people (ages 15-24) account for half of all new STIs reported to the CDC in 2015, yet they represent just 25% of the sexually active population.1

STI Diagnosis Trends and Case Volumes 2011-2015

The American Academy of Pediatrics (AAP) recommends annual testing for chlamydia and gonorrhea. The AAP calls out testing as part of routine screening for sexually active female adolescents and young adults younger than 25 years.3

Testing as a teen helps to establish a lifetime of healthy habits and protects future reproductive health. Testing helps ensure that you can have children—when you’re ready.3

In adolescence, the female cervix is still not fully developed, which makes it more vulnerable to infections.3

Condoms do not provide absolute protection from sexually transmitted infections (STIs) as they are hard to use consistently and correctly.1

Regular checkups are an important part of reproductive health

Multiple health organizations recommend screening for chlamydia and gonorrhea, including the American Academy of Family Physicians, U.S. Preventative Services Task Force, and Centers for Disease Control and Prevention.

The American Congress of Obstetrics and Gynecology (ACOG) and The American Academy of Pediatrics (AAP) recommend regular screening for chlamydia and gonorrhea for all women who are sexually active, beginning in early adolescence.3,5

These routine tests can be added to the other screenings which are usually done as part of a woman’s annual physical.

Routine screening for sexually transmitted infections (STIs) can help protect reproductive health in a number of ways:1,3,5,6

  • Screening can catch an infection early, even if there are no symptoms
  • If you have an infection, screening ensures appropriate treatment
  • Effective treatment can help avoid complications like Pelvic Inflammatory Disease (PID), which is a leading cause of infertility6

Good habits that start when you’re young can help keep you healthy—today and in the future.

Resources

  1. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2015. Atlanta: U.S. Department of Health and Human Services; 2016.
  2. Retrieved from https://www.ok.gov/health/Disease,_Prevention,_Preparedness/HIV_STD_Service/
    Fact_Sheets_-_OK_Data/
  3. Reuters Health Information STI Screening Advocated for Pediatric EDs. Marilynn Larkin. March 22, 2016. Retrieved from http://www.medscape.com/viewarticle/860595;
  4. Sexually Transmitted Diseases Diagnosed in Oklahoma, by County of Residence. 2015 Retrieved from https://www.ok.gov/health2/documents/Table%20-%20STDS%20by%20County%202015.pdf
  5. Chlamydia, Gonorrhea, and Syphilis, Frequently asked questions; Gynecological problems; FAQ071, December 2016. Retrieved from http://www.acog.org/Patients/FAQs/Chlamydia-Gonorrhea-and-Syphilis
  6. Pelvic Inflammatory Disease (PID), Frequently asked questions; Gynecological problems; FAQ077, September 2015. Retrieved from http://www.acog.org/Patients/FAQs/Pelvic-Inflammatory-Disease-PID

Diagnostic Laboratory of Oklahoma (DLO) strives to empower patients to take a more active role in their healthcare decisions through providing education on disease states and available diagnostic testing, as well as resources for additional information from medical organizations.