Parkview Health Laboratory: Test Directory

Medicare Medical Necessity Restrictions May Apply

Medical Necessity Documentation:

Patient Preparation:

Specimen Requirements: 3.0 mL Whole Blood in a Lavender Top Tube - EDTA

Collection Instructions: Mix tube by inversion 5 times
Do not centrifuge
If submitting a specimen that is greater than 24 hours, please also submit a slide for the differential
Specimens must not be clotted. Overfilling or underfilling may allow blood to clot.

Minimum Volume: 1.5 mL

Transport & Storage: Temperature/Stability: 72 hour Refrigerated

Specimens may be rejected due to blood changes or deterioration

Reference Range:

Pediatric
0 days to 15 days: 15.4 - 22.0 g/dL
16 days to 1 month: 13.4 - 18.0 g/dL
1 month to 2 months: 10.5 - 17.0 g/dL
2 months to 4 months: 9.4 - 13.0 g/dL
4 months to 6 months: 10.0 - 14.0 g/dL
6 months to 1 year: 10.5 - 14.0 g/dL
1 year to 6 years: 11.0 - 14.0 g/dL
6 years to 14 years: 12.0 - 15.5 g/dL

Males > 14 Yrs: 13.5 - 17.2 g/dL

Females > 14 Yrs: 12.0 - 15.5 g/dL

Critical Ranges:

Pediatric (< = 15 days old) Low Critical Limits

Hgb: < = 10.0 G/DL

Pediatric (< = 15 days old) High Critical Limits

Hgb: > = 24.0 G/DL

Low Critical Limit: Hgb: < = 6.0 G/DL

High Critical Limit: Hgb: > = 19.0 G/DL

Oncology Wards at PRMC Low Critical Limit: <= 5.0 G/dL

OHP Low Critical Limit: <= 7.0 G/dL

Test Comments:

Methodology: Blood Cell Analyzer

Clinical Significance:

Documentation:

Custom Panel: No

Stat Eligible: Yes

Days Performed: Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday

Sites Performed: Parkview Cancer Institute, Parkview Hospital Randallia, Parkview Huntington, Parkview LaGrange, Parkview Noble, Parkview Regional Medical Center, Parkview Wabash, Parkview Warsaw , Parkview Whitley

PHL Test Code: HGB

EPIC Test Code: LAB291

Alternate Test Names: HGB

Included Tests:

CPT Coding: 85018

Parkview Laboratory: Test Directory

Hemoglobin

PRODUCTION SCHEDULE