TruUTI PCR Report Generator v3.2.44 Standalone

Requisition and Results Entry

The opening fields mirror the current TruPath-Labs urine PCR requisition. Required report fields are marked by the generator when missing.

Embedded TruPath data library active. Load only a complete, approved TruPath data-library JSON export.

Provider, Patient, and Specimen

Provider / Practice Name

Provider NPI

Provider Street Address

Provider Suite / Unit

Provider Phone Number

Provider City, State, ZIP Code

Patient Last Name

Patient First Name

MRN / Patient ID

Date of Birth

Biological Sex

Patient Phone

Patient Street Address

Patient Suite / Unit

Patient City, State, ZIP Code

Specimen Type

Specimen ID / Barcode

Collection Date

Urine Collection Time

Specimen Receipt Date

Specimen Receipt Time

Report Date

Report Time

Test Facility

Accession Number

Billing and Clinical Information

Guarantor / Payment

Primary Insurance

Subscriber / Member ID

Group Number

Secondary Insurance

Secondary Member ID

Relationship to Subscriber

Guarantor Name

Clinical History

Other ICD-10-CM Code

Testing Ordered

TruPath-Labs UTI Panel With resistance gene analysis Customized panel

MOLECULAR ANTIMICROBIAL SUSCEPTIBILITY TESTING (MAST)

Molecular antimicrobial susceptibility test Molecular antimicrobial susceptibility test — reflex only if PCR is positive (if load is Moderate or High) MAST not ordered

Detected Organisms - PCR and Final MAST

Select the PCR load as High, Moderate, or Low. Enter a numerical final MAST load only for bacteria evaluated by MAST. Non-bacterial final-report loads remain categorical. Choose MAST-only for Proteus vulgaris or Providencia stuartii when detected only in final MAST data.

Up to 12 detected organisms may be entered or imported.

Resistance Genes Detected

Empiric Antimicrobial Initiated

Antimicrobial

Report Display Name

Strength

Dosing Instructions

Clinical Inputs Affecting Alternatives

Antimicrobial AllergiesSelect every applicable allergy. Leave blank for no known drug allergies.

Pregnancy

Organ Function

Kidney diseaseCreatinine ≥ 1.4 Liver diseaseElevated LFTs

Individual Pathogen MAST Results

Enter S or R only for the antimicrobials assigned to each pathogen by Evolve Antibiotic Plate Types(3). Plate membership controls testing eligibility only: it never creates, removes, or ranks treatment recommendations. The resulting S/R findings are then applied to the existing TruPath recommendation mappings and to the empiric-effectiveness assessment. Fungal targets remain visible on the report but do not participate in antibacterial MAST.

Import Susceptibility Results Import MAST Load Values

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Controlled-use note: This generator applies deterministic reporting rules but does not replace laboratory validation, CLSI breakpoint governance, access controls, audit trails, release authorization, backup, or LIS/instrument interfaces required before production deployment.