Complete Blood Count with Differential

Overview

  • EPIC Code:
  • LAB293
  • Soft Test Code:
Alternate Names
  • CBC Auto Differential
  • CBC w/Diff
  • CBC with Auto Differential, reflex Manual Differential if indicated
  • CBC with Diff
  • CBC with manual differential
  • CBC with peripheral smear
  • CBCWD
  • Hemogram with Differential
  • Manual Differential
  • Peripheral Smear
Included Tests

White Blood Cell Count (WBC); Red Blood Cell Count (RBC); Hemoglobin (HGB); Hematocrit (HCT); Mean Corpuscular Volume (MCV); Mean Corpuscular Hemoglobin (MCH); Mean Corpuscular Hemoglobin Concentration (MCHC); Red Cell Distribution Width Standard Deviation (RDWSD); Red Cell Distribution Width Coefficient Variation (RDWCV); Platelet (PLT); Mean Platelet Volume (MPV); Automated Differential with Reflex to Manual Differential if indicated.
Smear review reflex is based on review criteria established by the Medical Director of the Laboratory.


Specimen Collection & Preparation

Client Notes

Manual differential or peripheral smear review for morphology will reflex when indicated based on established criteria.


Specimen Requirements:

-OR-

Whole Blood in K2 EDTA 3.0 mL Lavender Top Tube
Minimum Volume:
1.0 ml whole blood*
Neonatal Volume:
0.5 ml (500ul) in Microtainer collection tube*

* This volume does not allow for repeat testing

Collection Instructions:

Mix tube by inversion 5 times

Do not centrifuge

Specimens must not be clotted. Overfilling or underfilling may allow blood to clot. Specimens may be rejected due to improper storage or age of specimen.

 


Rejection Criteria:

Clotted specimens


Transport and Storage:
  • Ambient (18-24°C): 24 Hours
  • Refrigerated (2-8°C): 48 Hours

Clinical Interpretation

Reference Range:

For Pediatric Reference Ranges refer to Addendum B

Adults > 14 Years
WBC: 3.4 - 10.5 x10^3/uL
RBC: 4.30 - 5.70 x10^6/uL (Male)
 4.00-5.20 x10^6/uL (Female)
 4.00-5.70 x10^6/uL (Unknown*)
HGB: 13.5 - 17.2 g/dl (Male) 
 12.0-15.5 g/dl (Female)
 12.0-17.2 g/dl (Unknown*)
HCT:  40.0 - 54.0% (Male)
 35.0-48.0% (Female)
 35.0-54.0% (Unknown)
MCV: 82.0 - 98.0 fl
MCH: 27.0 - 33.0 pg
MCHC: 32.0 - 36.0 g/dl
RDWSD: 36.4 - 54.5 fl
RDWCV: 11.5 - 14.5%
Platelet: 150 - 450 x10^3/uL
MPV: 8.6 - 12.6 fl
Neut% (automated): 45 - 75%
Segmented Neutrophils (manual): 40-70%
Band Neutrophils (manual): 0-9%
Lymph%: 17 - 43%
Monos%: 0 - 12%
Eos%: 0 - 4%
Basos%: 0 - 2%
IG% automated (Includes metamyelocytes, myelocytes, and promyelocytes): 0 - 1%
Absolute Neut: 1.60-6.50 x10^3/uL
Absolute Lymph: 0.90-3.00 x10^3/uL
Absolute Mono: 0.00-1.00 x10^3/uL
Absolute Eos: 0.00-0.50 x10^3/uL
Aboslute Baso: 0.00-0.20 x10^3/uL
Absolute IG: 0.00-0.10 x10^3/uL
IPF: 0.9 - 7.2% (Reportable only at PRMC, PFCI, PDH, PVH, PKH, and PBRY)
*Unknown reference range is used when sex is not known, undisclosed, or there is a mismatch between birth sex and gender in LIS. Becuase the reference range for these parameters is sex-specific the range may not apply to these patients so a broader range that includes typical ranges for both male and female patients is used. 


Critical Ranges:

Pediatric (<= 15 days old) Low Critical Limits:
WBC: <= 2.0 x10^3/uL
HGB: <= 10.0 g/dl
Platelet: <= 30 x10^3/uL

Pediatric (<= 15 days old) High Critical Limits:
WBC: >= 39.0 x10^3/uL
HGB: >= 24.0 g/dl
HCT: >= 70.0%
Platelet: >= 850 x10^3/uL
 
Low Critical Limits: 
WBC: <= 1.5 x10^3/uL
Abs Neut: <= 0.50 x10^3/uL
HGB: <= 6.0 g/dl
HCT: <=18%
Platelet: <= 30 x10^3/uL

 
For PFCI: Critical low WBC & ANC will not be called to the physician per physician request.
High Critical Limits: 
WBC: >= 40.0 x10^3/uL
HGB: >= 19.0 g/dl
HCT: >= 56%
Platelet: >= 850 x10^3/uL

NICU <= 15 days old Critical Limits: 
HCT: <=30% and >=70%
Platelet: <= 100.0 x10^3/uL and >= 600 x10^3/uL

NICU >15 days old Critical Limits: 
HCT:  <=25% and >=70%
Platelet: <= 100.0 x10^3/uL and >= 600 x10^3/uL

Inpatient Oncology Low Critical Limits: 
WBC: <= 1.0 x10^3/uL                      
HGB: <= 5.0 g/dl 
Platelet: <=20 x10^3/uL
For Inpatient Oncology: Criticals may be seen repeatedly over several days. In these cases, it is only necessary to call the critical value on the first occurrence of the current admission.
Inpatient Oncology High Critical Limits: 
WBC: >=40 x10^3/uL                   
HGB: >=19 g/dl 
Platelet: >= 850 x10^3/uL
For Inpatient Oncology: Criticals may be seen repeatedly over several days. In these cases, it is only necessary to call the critical value on the first occurrence of the current admission.

Ortho Hosptial Patients Low Critical Limits: 
HGB: <= 7.5 g/dl
Platelet: <= 50 x10^3/uL
Ortho Hosptial Patients High Critical Limits: 
HGB: >=19 g/dl
Platelet: >= 850 x10^3/uL

Differential Critical Results:
Blasts, bacteria, fungi, malarial or blood parasites


Test Comments:

IPF (Immature Platelet Fraction) is a measurement of thrombopoietic activity that helps determine the cause of thrombocytopenia (platelet production vs. platelet destruction). Available only at PRMC, PFCI, PDH, PVH, PKH, and PBRY:

If PLT is <50,000, it will automatically reflex the PLT-F to run with the IPF value and the IPF value will be reported.


Methodology:
  • Blood Cell Analyzer

Production Schedule

Sites Performed
  • Parkview Bryan Hospital
  • Parkview Cancer Institute
  • Parkview DeKalb Hospital
  • Parkview Huntington Hospital
  • Parkview Kosciusko Hospital
  • Parkview LaGrange Hospital
  • Parkview Montpelier Hospital
  • Parkview Noble Hospital
  • Parkview Randallia Hospital
  • Parkview Regional Medical Center
  • Parkview Southwest
  • Parkview Wabash Hospital
  • Parkview Whitley Hospital
Days Performed
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Departments
  • Hematology
Turn Around Time

Same Day/1 to 2 days


Stat Eligible

Coding & Compliance

CDM

01430747


CPT Coding

85025 (Reflex 85007, 85008) | PRMC/PVH/PCI <50,000 PLT reflex 85055


Medical Necessity May Apply