Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Specimen Requirements:
1.0 mL Whole Blood in a Lavender Top Tube - EDTA
Collection Instructions:
Specimen should be labeled with the patient's name, date and time of collection, [date of birth and/or social security number] and the phlebotomist's (collector's) initials
Minimum Volume:
1.0 mL Whole Blood in Pink Top Tube
Neonatal Volume:
Pediatric 1.0 mL Whole Blood in a Pink Microtainer
Transport & Storage: Temperature/Stability:
24 hours Ambient
72 hours Refrigerated
This Blood Bank test should be performed within 72 hours. If longer than 72 hours patient should be redrawn.
Rejection Criteria:
Serum Separator Tube (SST or PST)
Reference Range:
Negative
Critical Ranges:
Test Comments:
Direct Fractionated Coombs will be ordered and charged when result on patients 6 months and older is positive
HDN Antibody Screen will be ordered when the Direct Coombs Test is positive on a cord blood
Methodology:
Hemagglutination or gel hemagglutination
Clinical Significance:
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Stat Eligible:
Yes
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 Wabash Hospital, Parkview Whitley Hospital
PHL Test Code:
DAT1
EPIC Test Code:
LAB274
Alternate Test Names:
Direct Antiglobulin Test; Direct Coombs
Included Tests:
CPT Coding:
86880 (Reflexes 86880)