Last Modified:
2/13/2019 2:35:49 PM
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Specimen Requirements:
2 full capillary tubes
Collection Instructions:
Due to smearing of print while on ice, please label specimen following procedure and a second label in the pocket of transport bag with requisition
Mix immediately with flea
Transport & Storage: Temperature/Stability:
2 hours on ice
Reference Range:
Base Excess: -2.0 - 2.0
HCO3: 21 - 28
O2 Sat: 95 -100
pCO2: 35 - 46
pH: 7.35 - 7.45
pO2: 80 - 100
TCO2: 22 - 29
Critical Ranges:
Low Limits: High Limits
pCO2: < 20 pCO2: > 70
pH: < 7.10 pH: > 7.60
TCO2: < 10 TCO2: > 45
Test Comments:
Methodology:
ISE / Co-oximetry
Clinical Significance:
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Stat Eligible:
Yes
Days Performed:
Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed:
Parkview Hospital Randallia, Parkview Regional Medical Center
PHL Test Code:
CABG
EPIC Test Code:
LAB78
Alternate Test Names:
Capillary Blood Gases
Included Tests:
Base Excess; HCO3; O2 Sat; pCO2; pH; pO2; TCO2
CPT Coding:
82805
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