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23279 Amnisure Rupture of Membranes (ROM), Amniotic Fluid

Amnisure Rupture of Membranes (ROM), Amniotic Fluid
Test Code: ASURE
Synonyms/Keywords
​PROM, rupture
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​See Collection Processing Instructions ​ ​ ​ ​ ​ ​
Collection Processing Instructions

​Test is only available at Marshfield Main Campus, Rice Lake Center/LMC, Minocqua and Good Samaritan Health Center.

 Kit supplied swab of vaginal vault.

Specimen Stability Information
​Performed by the provider at point of care.
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Marshfield Main Campus, Eau Claire,
Diagnostic & Treatment Center,
Rice Lake Center/LMC,
Minocqua and
Good Samaritan Health Center.		 24 hours daily only at Marshfield Main Campus, DTC, Rice Lake Center/LMC, Minocqua and Good Samaritan Health Center-performed by the provider at point of care.​ Same day​ ​Amnisure ROM
Reference Range Information

Positive - indicates ruptured membrane.
Negative - indicates no ruptured membrane.

Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​84112 ​ ​ ​ ​
Synonyms/Keywords
​PROM, rupture
Ordering Applications
Ordering Application Description
​Centricity ​Amnisure ROM-Mfld Only
​Cerner ​Amnisure ROM (COMMON)
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​See Collection Processing Instructions ​ ​ ​ ​ ​ ​
Collection Processing

​Test is only available at Marshfield Main Campus, Rice Lake Center/LMC, Minocqua and Good Samaritan Health Center.

 Kit supplied swab of vaginal vault.

Specimen Stability Information
​Performed by the provider at point of care.
Reference Range Information

Positive - indicates ruptured membrane.
Negative - indicates no ruptured membrane.

For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Marshfield Main Campus, Eau Claire,
Diagnostic & Treatment Center,
Rice Lake Center/LMC,
Minocqua and
Good Samaritan Health Center.		 24 hours daily only at Marshfield Main Campus, DTC, Rice Lake Center/LMC, Minocqua and Good Samaritan Health Center-performed by the provider at point of care.​ Same day​ ​Amnisure ROM
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​84112 ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.