Parkview Health Laboratory: Test Directory

Medicare Medical Necessity Restrictions May Apply

Medical Necessity Documentation: APTT ABN Form: For acceptable narrative descriptions and ICD-9 information see Addendum C
PT ABN Form: For acceptable narrative descriptions and ICD-9 information see Addendum C
Blood Count ABN Form: For Non-acceptable narrative descriptions and ICD-9 information see Addendum C

Specimen Requirements: 3 full Whole Blood Blue Top Tube - 3.2% Na Citrate
and
3.0 mL Whole Blood in a Lavender Top Tube - EDTA
and
1.0 mL Plasma from a Blue Top Tube - 3.2% Na Citrate in a Plastic Vial

Collection Instructions: Instructions for platelet-poor plasma collection:
1. Draw a plain red top tube to remove tissue fluid contamination. Discard this tube.
2. Draw blood into a buffered citrate collection tube (light blue top) filled to proper level. Do not overfill.
3. The blood-to-anticoagulant ratio should be 9:1; inadequate filling of the collection device will decrease this ratio and
may lead to inaccurate results.
4. Invert gently 6 times to mix. Process immediately.
5. Centrifuge for 15 min at 2500 x g.
6. Using a plastic pipette transfer plasma into a new tube
7. Repeat centrifugation at 2500 x g for 15 minutes to assure complete platelet removal.
8. Dispense the plasma into 2 or more plastic tubes using a plastic transfer pipette. Label tubes appropriately.
9. Freeze immediately
10. Specimen must remain frozen at all times.

Temperature & Stability:

Whole Blood Blue Top Tube:
2 hours Ambient or Refrigerated if patient heparinized
24 hours Ambient or Refrigerated if patient non-heparinized

Lavendar Top Tube: 72 hours Refrigerated

Platelet Poor Plasma
72 hours Frozen

Reference Range: Refer to Individual Tests

Methodology: Multiple

Custom Panel: No

Days Performed: Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday

Sites Performed: Parkview Hospital, Parkview Huntington, Parkview LaGrange, Parkview Noble, Parkview North, Parkview Whitley

PHL Test Code: ABP

Included Tests:

Activated Partial Thromboplastin Time (APTT); Bleeding Time; D-Dimer Quantitative; Fibrinogen; Platelet Count (PLT); Prothrombin Time (PT)

CPT Coding: 85002, 85049, 85610, 85730, 85384, 85379

Parkview Laboratory: Test Directory

Abnormal Bleeding Time

PRODUCTION SCHEDULE