Cord Blood Evaluation

Last Modified: 8/31/2023 3:29:40 PM


Medical Necessity Documentation:  
Client Notes:  
Patient Preparation:  
Specimen Requirements: 7.0 mL Cord Blood in a Large Lavender Top Tube - EDTA
or
 7.0 mL Cord Blood in a Pink Top Tube - EDTA
Collection Instructions:

1. The specimen labeling should state "CORD BLOOD" use cord blood label, code 2110
2. The mothers Chart label with full name and MRN
3. The infant Chart label with name, DOB, and MRN
4. The Date and Time of collection
5. The Collector id  (Employee id) if collected by staff; Name is sufficient if collected by physician, anesthesiologist or perfusionist.
Transport & Storage: Temperature/Stability: 72 hours Ambient
Reference Range: Not Applicable
Critical Ranges:  
Test Comments:  
Methodology: Hemagglutination
Clinical Significance:  
Documentation:  
Custom Panel: No

PRODUCTION SCHEDULE

Days Performed: Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed: Parkview Dekalb Hospital, Parkview Huntington Hospital, Parkview LaGrange Hospital, Parkview Noble Hospital, Parkview Randallia Hospital, Parkview Regional Medical Center, Parkview Wabash Hospital, Parkview Whitley Hospital
PHL Test Code: CORD1
EPIC Test Code: LAB892
Included Tests: Neonatal ABO (NABO); Neonatal Direct Coombs (NDAT); Neonatal RH (NRH)
CPT Coding: 86900, 86880, 86901

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