General Information

UPHSM LIS Test #: 352
Schedule: Monday-Friday
Testing Time: 1 day
Testing Lab: UP Health System-Marquette

Specimen Info
Only 1 specimen type required, unless otherwise specified

Volume: 1 ml
Temperature: Refrigerate
Tube Type: semen
Collection Info:
1. A vasectomy is regarded as one of the safest and most effective methods of birth control.  A qualitative sperm count is performed to
        confirm a successful vasectomy.
2. Two samples should be submitted 2-4 weeks apart.  The first one 16 weeks post surgery.
3. A minimum of 24 ejaculations should be accomplished before the first sample is submitted.
4. Sample needs to arrive at the laboratory 30 minutes post collection and kept at 20-37*C.
5. Samples should be collected after a minimum of 2 days and a maximum of 7 days of sexual abstinence.
6. Make sure your name, date of birth, date and time of collection are written on the cup.
7. A brief questionnaire needs to be filled out at the laboratory, or can be printed off the website and accompany the sample.
8. You will also need a copy of the Dr.’s orders.

Clinical Utilities

Determining the presence (few, mod, many) or absence of sperm motility post-vasectomy.

CPT Codes


* The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding
is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Reference Range

None seen