Epic Build / Desired Build Test Compendium
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Mycobacterium tuberculosis complex (MTB) and Rifampin Resistance, Molecular Detection, Sputum Epic Compendium  

▶ Desired Epic Build * = editable field  

Actual Epic Build 12/05/2025

PROCEDURE ID 115919
PDM 1562067
ORDER DISPLAY NAME Mycobacterium tuberculosis complex (MTB) and Rifampin Resistance, Molecular Detection, Sputum
PROCEDURE NAME PCR SPUTUM MTB & RIF
PROCEDURE MASTER NUMBER LAB11839
SHORT PROCEDURE NAME PCR Sputum MTB & RIF
CATEGORY CODE 4.0
CATEGORY CODE RECORD NAME LAB MICROBIOLOGY - GENERAL ORDERABLES
SYNONYMS MTBPCR
MTB AND RIFAMPIN PCR
TB PCR
CLINICALLY ACTIVE Yes
ORDERABLE Yes
PERFORMABLE Yes
FILTER GENOMICS
REFERENCE LINK URL https://labs.northwell.edu/epic/test/115919
ORDERING INSTRUCTIONS
DEFAULT SPECIMEN TYPE Respiratory
SPECIMEN TYPE PICK LIST Respiratory
Body Fluid
SPECIMEN TYPE LIST Respiratory
OP SPECIMEN TYPE LIST
SPECIMEN SOURCE PICK LIST Expectorated Sputum
Induced Sputum
Sputum
SPECIMEN SOURCE DEFAULT - MALE Induced Sputum
SPECIMEN SOURCE DEFAULT - FEMALE Induced Sputum
SPECIMEN SOURCE LIST Expectorated Sputum
Induced Sputum
OP SPECIMEN SOURCE LIST
IP LAB TEST COMPONENTS FOR REPORT MTBCMPLXPCR
MTBPCR
RIFAPINPCR
RIFARESINT
SRCEMTB
OP LAB TEST COMPONENTS FOR REPORT MTBCMPLXPCR
MTBPCR
RIFAPINPCR
RIFARESINT
SRCEMTB
ORDER QUESTIONS []
ORDER QUESTIONS RECORD NAME
INPATIENT ORDER QUESTIONS ["1910000003"]
INPATIENT ORDER QUESTIONS RECORD NAME NH IP RULE OUT PULMONARY TB
ORDER SPECIFIC QUESTION OVERRIDE
INPATIENT QUESTION OVERRIDE
LOCATION RESTRICT LIST IP
LOCATION RESTRICT LIST IP RECORD NAME
LOCATION RESTRICT LIST INCLUDE IP
LOCATION RESTRICT LIST OP
LOCATION RESTRICT LIST OP RECORD NAME
LOCATION RESTRICT LIST INCLUDES OP
EDP AMB ORDER SPECIFIC QUESTIONS RECORD NAME
EDP IP ORDER SPECIFIC QUESTIONS RECORD NAME
EDP IP SPECIMEN SOURCE
EDP OP SPECIMEN SOURCE
EDP IP SPECIMEN TYPE
EDP OP SPECIMEN TYPE
DERIVED EDP IP BUTTONS S
DERIVED EDP IP BUTTONS T
DERIVED EDP OP BUTTONS S
DERIVED EDP OP BUTTONS T
IP ORDERABLE 1
OP ORDERABLE 1
STANDARD LAB COMPONENTS
STANDARD LAB COMPONENTS RECORD NAME
COMPONENT DATA REQUIREMENT
EPIC OP AOEs

EPIC IP AOEs

Question IDQuestion NameQuestionResponse TypeResponse ListRequire Response
1910000003 NH IP RULE OUT PULMONARY TB Ruling out Pulmonary TB? Yes/No Yes
EPIC Components (results - crosswalked through Cerner)

Component IDComponent NameBase NameCommon NameExternal NameCerner Result PDM
3047804572.0 RIFAMPIN RESISTANCE INTERPRETATION RIFARESINT RIFAMPIN RESISTANCE INTERPRETATION Rifampin Resistance Interpretation 1562067E
3047804770.0 MYCOBACTERIUM TUBERCULOSIS COMPLEX SOURCE SRCEMTB SOURCE MTB Source MTB 1562067A
3047803623.0 MYCOBACTERIUM TUBERCULOSIS COMPLEX PCR-INTERPRETATION MTBPCR MTB PCR INTERPRETATION MTB PCR Interpretation 1562067C
3047805640.0 RIFAMPIN PCR RIFAPINPCR RIFAPINPCR, PCR Rifampin Resistance 1562067D
3047803367.0 MYCOBACTERIUM TUBERCULOSIS COMPLEX PCR MTBCMPLXPCR MTB COMPLEX M. tuberculosis complex 1562067B