Last Modified:
10/1/2020 1:30:05 PM
Medicare Medical Necessity Restrictions May Apply
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Specimen Requirements:
3.0 mL Whole Blood in a Lavender Top Tube - EDTA
Collection Instructions:
Must be submitted within 24 hours of collection
Minimum Volume:
1.5 mL Whole Blood
Neonatal Volume:
0.3 mL Whole Blood
Transport & Storage: Temperature/Stability:
72 hours Refrigerated
Reference Range:
< 15 days: 42% - 66%
Critical Ranges:
NICU at PRMC & PVH Low Critical Limits:
HCT: >15 days old <=30% and >=70%
NICU at PRMC & PVH High Critical Limits:
HCT: >15 days old <=25% and >=70%
< 15 days: > 70.0%
Test Comments:
This test is for newborns < 15 days only
Methodology:
Spun Microhematocrit
Clinical Significance:
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Days Performed:
Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed:
Parkview Regional Medical Center, Parkview Warsaw
PHL Test Code:
MHCT
EPIC Test Code:
LAB2465
Alternate Test Names:
Hematocrit Micro
Included Tests:
CPT Coding:
85013
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