Parkview Health Laboratory: Test Directory

Medicare Medical Necessity Restrictions May Apply

Medical Necessity Documentation:

Patient Preparation:

Specimen Requirements: 2.0 mL Plasma in a PST Mint Green Top Tube - Li Heparin (preferred)
or
2.0 mL Serum in a SST Gold Top Tube

Collection Instructions:

Do not collect by Capllary Draw

Avoid Hemolysis

Minimum Volume: 1.0 mL

Transport & Storage: Temperature/Stability: 5 days Refrigerated

6 hours on cells

Reference Range:

A/G Ratio: 0.8 - 1.6 g/dL

Albumin:
Pediatric:
1 day to 1 year: 2.1 - 3.6 g/dL
1 year to 4 years: 2.9 - 4.2 g/dL
4 years to 7 years: 3.0 - 5.2 g/dL
7 years to 20 years: 3.2 - 5.6 g/dL

Adult:
>20 years: 3.4 - 5.0 g/dL

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

ALT (SGPT):
10 days to <1 month: 10-50 U/L
1 month to Adult: 10-40 U/L

AST (SGOT):
1 day to 1 month: 23 - 56 uL
1 month to 1 year: 19 - 46 uL
1 year to Adult: 15 - 37 uL

Bilirubin, Direct: 0.0 - 0.3 mg/dL

Bilirubin, Indirect: 0.0 - 0.7 mg/dL

Bilirubin, Total: 0.0 - 1.0 mg/dL

Globulin: 2.2 - 4.2 g/dL

Protein, Total:
< 1 year: 5.4 - 7.0 g/dL
1 year to 4 years: 5.9 - 7.0 g/dL
4 years to 7 years: 5.9 - 7.8 g/dL
7 years to 10 years: 6.2 - 8.1 g/dL
10 years to 20 years: 6.3 - 8.6 g/dL
> 20 years: 6.3 - 8.2 g/dL

Critical Ranges:

Test Comments:

Methodology: Enzymatic

Clinical Significance:

Documentation:

Custom Panel: No

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: LIVER

EPIC Test Code: LAB20

Alternate Test Names: Hepatic Profile; LFT

Included Tests:

A/G Ratio; Alanine Aminotransferase (ALT); Albumin; Alkaline Phosphatase; Aspartate Transaminase (AST); Bilirubin Direct; Bilirubin Indirect: Bilirubin, Total; Globulin; Protein, Total

CPT Coding: 80076

Parkview Laboratory: Test Directory

Liver Profile

PRODUCTION SCHEDULE