Last Modified: 5/17/2019 2:28:46 PM

  Medicare Medical Necessity Restrictions May Apply
Medical Necessity Documentation:  
Client Notes:  
Patient Preparation:  
Specimen Requirements: 1.0 mL Plasma from a PST Mint Green Top Tube - Lithium Heparin (preferred)
1.0 mL Serum in a SST Gold Top Tube
Collection Instructions: Avoid Hemolysis 
Minimum Volume: 0.2 mL
Transport & Storage: Temperature/Stability: 5 days Refrigerated

48 hours on cells
Reference Range: 1.8 - 2.5 mg/dL
Critical Ranges: NICU (Infants in a Parkview Health Neonatal Intensive Care Unit): 
Low: <1.4 meq/L
High: >5.0 meq/L

Low: <1.0 meq/L
High: >5.0 meq/L
Test Comments:  
Methodology: Colorimetric
Clinical Significance:  
Custom Panel: No


Stat Eligible: Yes
Days Performed: Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed: Parkview Hospital Randallia, Parkview Huntington, Parkview LaGrange, Parkview Noble, Parkview Regional Medical Center, Parkview Wabash, Parkview Warsaw , Parkview Whitley
PHL Test Code: MG
EPIC Test Code: LAB103
Alternate Test Names: Mg
Included Tests:  
CPT Coding: 83735

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