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 Plasma or Serum

Neonatal Volume: 0.5 mL Whole Blood

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: The drug Eltrombopag (Promacta) has been identified as causing a false positive bias in total protein measurement on the Ortho Vitros instrumentation which is utilized for total protein analysis at Parkview Dekalb Hospital. If your patient is on eltrombopag and being directed to Parkview Dekalb Hospital for testing, please contact the lab at 920-2605 so that testing can be performed using an alternate instrument

Methodology: Enzymatic

Clinical Significance:

Documentation:

Custom Panel: No

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: LIVER

EPIC Test Code: LAB20

Alternate Test Names: Hepatic Panel; 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