Last Modified:
2/25/2020 12:22:01 PM
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Specimen Requirements:
1.0 mL Plasma from a PST Mint Green Top Tube - Li Heparin (preferred)
or
1.0 mL Serum in a SST Gold Top Tube
Minimum Volume:
0.8 mL
Transport & Storage: Temperature/Stability:
2 days Refrigerated
4 hours on cells
Rejection Criteria:
Hemolysis
Reference Range:
Carbon Dioxide
0 days to 1 year: 14 - 23 mmol/L
1 year to Adult: 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
Anion Gap 9-16 mmoL
Critical Ranges:
Carbon Dioxide
Low: < 10 mmol/L
High: > 45 mmol/L
Potassium
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
Test Comments:
Test can be reported with disclaimer if on cells for 4-6 hours
Methodology:
Ion Selective Electrode
Clinical Significance:
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Stat Eligible:
Yes
Days Performed:
Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed:
Parkview Dekalb, Parkview Hospital Randallia, Parkview Huntington, Parkview LaGrange, Parkview Noble, Parkview Regional Medical Center, Parkview Wabash, Parkview Warsaw , Parkview Whitley
PHL Test Code:
LYTES
EPIC Test Code:
LAB16
Alternate Test Names:
Lytes
Included Tests:
Carbon Dioxide (CO2); Chloride (CL); Potassium (K); Sodium (Na)
CPT Coding:
80051
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