Medical Necessity Documentation:
Client Notes:
Provider must supply patient with the Fresh Test Beverage
Patient Preparation:
Smoking, drinking, gum chewing, mints, cough drops, etc… are not allowed during the duration of the test
Medications may still be taken as ordered by the physician.
Specimen Requirements:
1.0 mL Plasma in a PST Mint Green Top Tube - Li Heparin
Collection Instructions:
1. Have patient consume Fresh Test beverage within 5 minutes
2. Start timing the test after the patient finished the beverage.
Centrifuge within 4 hours of collection
Minimum Volume:
0.2 mL Serum
Transport & Storage: Temperature/Stability:
3 days Refrigerated
4 hours unspun
Rejection Criteria:
Presentation with Fresh test powder insted of the fresh test glucose beverage. Presentation of non-pregnant individuals.
Reference Range:
Critical Ranges:
Test Comments:
Methodology:
Enzymatic
Clinical Significance:
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Days Performed:
Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed:
Parkview Dekalb Hospital, Parkview Huntington Hospital, Parkview LaGrange Hospital, Parkview Physician Group Montpelier, Parkview Randallia Hospital, Parkview Regional Medical Center, Parkview Southwest , Parkview Wabash Hospital, Parkview Warsaw , Parkview Whitley Hospital
PHL Test Code:
MCHEM
Alternate Test Names:
Glucose Prenatal Fresh Test
Included Tests:
CPT Coding:
82947