Comprehensive Metabolic Panel

Last Modified: 8/30/2023 12:13:05 PM


Medical Necessity Documentation:  
Client Notes:  
Patient Preparation:  
Specimen Requirements: 1.0 mL Plasma in a PST Mint Green Top Tube - Li Heparin (Preferred)
or
1.0 mL Serum in a SST Gold Top Tube
Collection Instructions: Avoid Hemolysis
Minimum Volume: 0.5 mL Plasma or Serum
Neonatal Volume: 0.7 mL Whole Blood Green Microtainer
Transport & Storage: Temperature/Stability:  
Reference Range: Alanine Aminotransferase (ALT; SGPT): 
1 day to 1 month: 10-50 U/L
1 month to Adult: 10-40 U/L
 
Alkaline Phosphatase:
Pediatric
1 day to 7 days: 80 - 218 Units/L
7 days to 1 month: 140 - 381 Units/L
1 month to 5 years: 100 - 272 Units/L

Male
5 years to 16 years: 120 - 326 Units/L
>16 years: 40 - 110 Units/L

Female
5 years to 16 years: 80 -218 Units/L
>16 years: 40 - 110 Units/L

Aspartate Aminotransferase (AST; SGOT)
1 day to 1 month: 23 - 56 U/L
1 month to 1 year: 19 - 46 U/L
1 year to Adult: 15 - 37 U/L

Bilirubin, Total
0.0 - 1.0 mg/dL

Blood Urea Nitrogen (BUN)
Pediatric
1 day to 5 days: 5 - 17 mg/dL
5 days to 14 years: 7 - 17 mg/dL
14 years to 20 years: 7 - 21 mg/dL

Male > 20 years: 9 -21 mg/dL
Female > 20 years: 7 - 18 mg/dl 

Calcium: 
Pediatric
< 1 year: 8.7 - 10.5 mg/dL
1 year to 4 years: 8.5 - 10.6 mg/dL
4 years to 20 years: 8.9 - 10.4 mg/dL
 
Adult: 
> 20 years: 8.9 - 10.4 mg/dL

Creatinine:
Male:
< 1 year: 0.3 - 1.0 mg/dl
1 year to 4 years: 0.1 - 0.4 mg/dl
5 years to 11 years: 0.2 - 0.7 mg/dl
12 years to 15 years: 0.4 - 0.9 mg/dl
> = 16 years: 0.8 - 1.4 mg/dl

Females
< 1 year: 0.3 - 1.0 mg/dl
1 year to 5 years: 0.1 - 0.5 mg/dl
6 years to 15 years: 0.3 - 0.7 mg/dl
> = 16 years: 0.6 - 1.1 mg/dl

Electrolytes:
Carbon Dioxide 
< 1 year: 14 - 23 mmol/L
> 1 year: 21 - 29 mmol/L

Chloride
98 - 107 mmol/L

Potassium
1 day to 1 month: 4.0 - 6.0 mmol/L
1 month to 2 years: 3.8 - 5.6 mmol/L
> 2 years: 3.6 - 5.1 mmol/L

Sodium
1 day to 1 month: 133 - 150 mmol/L
1 month to Adult: 134 - 146 mmol/L

Glucose: 
70 - 99 mg/dL

Protein Fractionation: 
Albumin: 3.4 - 5.0 g/dL
A/G Ratio: 1.0 - 2.5 g/dL
Globulin: 1.9 - 3.7 g/dL
Total Protein: 6.3 - 8.2 g/dL
Critical Ranges:

Blood Urea Nitrogen (BUN)
NICU (Infants in a Parkview Health Neonatal Intensive Care Unit): 
>50 mg/dL

Pediatric to Adult
>100 mg/dL

Calcium:
NICU (Infants in a Parkview Health Neonatal Intensive Care Unit): 
Low: < 6.0 mg/dL 
High: > 11.5 mg/dL
 
Low: < 7.0 mg/dL 
High: > 13.0 mg/dL

Creatinine:
> 10.0 mg/dL

Electrolytes:
Carbon Dioxide 
Low: < 10 mmol/L
High: > 45 mmol/L

Potassium
NICU (Infants in a Parkview Health Neonatal Intensive Care Unit): 
Low: <3.5 mmol/L
High: >6.9 mmol/L

Low: < 2.5 mmol/L
High: > 6.0 mmol/L

Sodium
NICU (Infants in a Parkview Health Neonatal Intensive Care Unit): 
<125 mmol/L
>= 155 mmol/L

1 day to Adult:
Low: < 120 mmol/L
High: > 160 mmol/L

Glucose:
Pediatric Low: < 30 mg/dL
Pediatric High: > 300 mg/dL
Inpatient Low: < 54 mg/dL
Inpatient High: > 500 mg/dL
Outpatient Low: < 40 mg/dL
Outpatient High: > 400 mg/dL
Test Comments: Test can be reported with disclaimer if on cells for 4-6 hours
Methodology: Multiple
Clinical Significance:  
Documentation:  
Custom Panel: No

PRODUCTION SCHEDULE

Stat Eligible: Yes
Days Performed: Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed: Parkview Cancer Institute, Parkview Dekalb Hospital, Parkview Huntington Hospital, Parkview LaGrange Hospital, Parkview Noble Hospital, Parkview Randallia Hospital, Parkview Regional Medical Center, Parkview Southwest , Parkview Wabash Hospital, Parkview Warsaw , Parkview Whitley Hospital
PHL Test Code: CMP
EPIC Test Code: LAB17
Alternate Test Names: Chem 14; Chemistry Panel 14; CMP
Included Tests: Alanine Aminotransferase (ALT; SGPT);  Alkaline Phosphatase; Aspartate Aminotransferase (AST; SGOT); Bilirubin, Total; Blood Urea Nitrogen (BUN); Calcium (Ca); Creatinine; Electrolytes [Carbon Dioxide (CO2); Chloride (CL); Potassium (K); Sodium (Na)]; Glucose; Protein Fractionation [A/G Ratio; Albumin;Globulin; Protein, Total]
CPT Coding: 80053

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