Pathologist Consult for Hematology

Overview

  • EPIC Code:
  • LAB2475
  • Soft Test Code:
Alternate Names
  • PATH
  • Path Consult
  • Path Review
  • Pathologist Smear Review
  • Pathology Consult
Included Tests

Pathologist review of the quantities and morphology of white blood cells, red blood cells, and platelets on a peripheral blood smear with interpretative comments.


Specimen Collection & Preparation

Client Notes

Peripheral smear reviews are performed by trained laboratory scientists when certain criteria are met based on the CBC with Differential results and instrument flagging. If criteria and review of the slide also meets Pathologist Review criteria, established by the Medical Director of the Laboratory, the lab will communicate that to the ordering provider and request that the Pathologist Smear Review be added on to the sample. 


Required Forms & Information

Must include CBC with Differential results and clinical indication to be sent to the pathologist for review.


Specimen Requirements:

-OR-

Peripheral Blood Smears- 1 Unstained and 1 Wright stained slide prepared from EDTA Lavendar Top Tube whole blood
Specimen Information:

Prepare two well made peripheral blood smear from well mixed whole blood (EDTA) on a notched corner glass slide (Sysmex brand slides preferred). Send one unstained slide and one Wright stained slide.

Slide must be properly labeled with:

  • Two patient identifiers (last name, first name AND date of birth OR medical record number).
  • Sample ID for specimen tracking.
  • Date of preparation if different than collection date.


Collection Instructions:

For slide preparation see Addendum D


Processing Instructions:

Allow the blood smears to dry completely before placing in the slide carrier for transport.

Print the instrument printout from the hematology analyzer as well as the pathology review coversheet (printed from the hematology analyzer or use attachment on policy.)


Transport and Storage:
  • Ambient (18-24°C): up to 24 hours

    If testing/transport of the specimen will exceed 24 hours then the specimen (and slide) should be transported refrigerated.

  • Refrigerated (2-8°C): 48 hours

Once completely dry, place the smears in a slide holder for transport. Place the slide holder and EDTA tube in transport bag. Instrument printouts and coversheet should be placed in the outside pocket of the transport bag. 

-AND-

Whole Blood in a 3.0 ml K2 EDTA Lavender Top Tube
Minimum Volume:
1.0 ml whole blood*

* This volume does not allow for repeat testing

Specimen Information:

A CBC with Differential must be performed to order the Pathologist Review. Add-on testing is acceptable if the CBC with Differential has been completed within the last 48 hours.

Include Clinical Indication for Review


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 blood changes or deterioration resulting from improper storage or age of specimen

For slide preparation see Addendum D


Rejection Criteria:

Clotted specimens

Frozen samples

Wrong anticoagulant tube

Samples >48 hours old


Transport and Storage:
  • Ambient (18-24°C): 24 Hours

    If testing/transport of the specimen will exceed 24 hours then the specimen (and slide) should be transported refrigerated.

  • Refrigerated (2-8°C): 48 Hours

Clinical Interpretation

Reference Range:

Pathologist Interpretive comment.


Test Comments:

Pathologist Review will reflex when indicated based on established criteria. Pathologist has the discretion to cancel the test if not indicated.

This test may be ordered by laboratory staff when established criteria is met based on complete blood count results.


Methodology:
  • Wright Stained Smear

Production Schedule

Sites Performed
  • Parkview Bryan Hospital
  • 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
Monday
Tuesday
Wednesday
Thursday
Friday
Departments
  • Hematology
Turn Around Time

72 hrs


Coding & Compliance

CDM

01439002


CPT Coding

.