Wellness Diamond Package with PSA

Last Modified: 5/17/2023 5:16:35 AM


Medical Necessity Documentation:  
Client Notes:  
Patient Preparation:  
Specimen Requirements: 4.0 mL Serum in a SST Gold Top Tube

and

3.0 mL Whole Blood in a Lavender Top Tube - EDTA
Collection Instructions:  
Transport & Storage: Temperature/Stability:  
Reference Range:

Refer to Interpretive Results
Critical Ranges:  
Test Comments:  
Methodology: Mutiple
Clinical Significance:  
Documentation:  
Custom Panel: No

PRODUCTION SCHEDULE

Days Performed: Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed: Parkview Dekalb Hospital, Parkview Huntington Hospital, Parkview LaGrange Hospital, Parkview Noble Hospital, Parkview Randallia Hospital, Parkview Regional Medical Center, Parkview Wabash Hospital, Parkview Warsaw , Parkview Whitley Hospital
PHL Test Code: W1
Alternate Test Names: Diamond Package; Diamond Package Male; Wellness Diamond Package w/ PSA; Wellness Diamond Package with PSA
Included Tests:
CPT Coding: 80053; 80061 (Reflex 83721), 83036, 84443, 85027

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