Medicare Medical Necessity Restrictions May Apply
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Patient should discontinue taking Biotin, Vitamin B7, or Vitamin H 48 hours before getting blood drawn.
Specimen Requirements:
A full Whole Blood in a Blue Top Tube - 3.2% Buffered Sodium Citrate
and
3.0 mL Plasma in a PST Mint Green Top Tube - Li Heparin
and
3.0 mL Whole Blood in a Lavender Top Tube - EDTA
Collection Instructions:
Blue Top:
Specimens must be filled appropriately see this example
Correct ratio of Blood to Citrate is critical (9:1). Specimens must be filled within +/- 10% of stated volume.
If a Blue Top Tube is collected utilizing a butterfly, a Blue Discard Tube must be drawn first to remove air from the line. If this is not done, the Blue Top Tube will not be filled properly due to the vacuum in tube and a redraw will be required
Heparinized Patient specimens must be spun within 1 hour of collection - Follow Platelet Poor Collection
Note: Collection of blood for coagulation testing through intravenous lines that have been previously flushed with heparin should be avoided, if possible.
If the blood must be drawn through an indwelling catheter, possible heparin contamination and specimen dilution should be considered.
When obtaining specimsn from indwelling lines that may contain heparin, the line should be flushed with 5mL of saline, and the first 5 mL of blood or 6-times the line volume
(dead space volume of the catheter) be drawn off and discarded before the coagulation tube is filled. For those samples collected from a normal saline lock (capped off venous port) twice the dead space volume of the catheter and extension set should be discarded.
PST Green:
Avoid Hemolysis
Centrifuge and Separate from Cells within 4 hours of collection
Lavendar:
Mix tube by inversion 5 times
Do not centrifuge
Specimens must not be clotted. Overfilling or underfilling may allow blood to clot. Specimens may be rejected due to blood changes or deterioration resulting from improper storage or age of specimen
Transport & Storage: Temperature/Stability:
Blue Top Tube: 4 hours Ambient
This tube must be transported to testing laboratory within 45 minutes from collection. If this is not a possibility follow the forllowing steps:
1. Heparinized Patient specimens must be spun wihtin 1 hour of collection, following these Platelet Poor Plasma preparation instructions
2. Send the "frozen" platelet poor plasma & primary tube to the testing laboratory
3. Contact the laboratory at 266-1500 option 1, to notify PRMC laboratory that he specimen is coming
Reference Range:
See Individual Tests
Critical Ranges:
See Individual Tests
Test Comments:
Patients taking vitamin supplements containing doses of >5 mg/day may have falsely decreased test results generated.
Methodology:
Multiple
Clinical Significance:
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Stat Eligible:
Yes
Turn Around Time:
SUPER STAT ELIGIBLE at All Locations
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 Southwest , Parkview Wabash Hospital, Parkview Warsaw , Parkview Whitley Hospital
PHL Test Code:
STRP2
EPIC Test Code:
LAB2641
Included Tests:
Activated Partial Thromboplastin Time (APTT); Alkaline Phosphatase; Aspartate Aminotransferase (AST; SGOT); Basic Metabolic Panel (Blood Urea Nitrogen (BUN); Calcium (Ca); Creatinine; Electrolytes [Carbon Dioxide (CO2); Chloride (CL); Potassium (K); Sodium (Na)] Glucose; Bilirubin, Total; Complete Blood Count with Differential (CBC Auto Differential) [Automated Differential; Hematocrit (Hct); Hemoglobin (Hgb); Mean Corpuscular Hemoglobin (MCH); Mean Corpuscular Hemoglobin Concentration (MCHC); Mean Corpuscular Volume (MCV); Platelet (PLT); Red Blood Cell Count (RBC); Red Cell Distribution Width Standard Deviation (RDWSD); Red Cell Distribution Width Coefficient Variation (RDWCV); White Blood Cell Count (WBC)]; Creatine Kinase (CK); Magnesium (Mg); Prothrombin Time (PT); Sedimentation Rate (ESR); Troponin T, 5th Generation
CPT Coding:
80048, 82247, 82550, 83735, 84075, 84450, 84484, 85025, 85610, 85652, 85730 (Reflex 85007 or 85008)