Last Modified:
3/25/2019 2:21:21 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
and
2.0 mL Plasma in a PST Mint Green Top Tube - Li Heparin
Collection Instructions:
Transport & Storage: Temperature/Stability:
Reference Range:
See Individual Tests
Critical Ranges:
Test Comments:
Methodology:
Multiple
Clinical Significance:
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Days Performed:
Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed:
Parkview Hospital Randallia, Parkview Huntington, Parkview LaGrange, Parkview Noble, Parkview Regional Medical Center, Parkview Wabash, Parkview Warsaw , Parkview Whitley
PHL Test Code:
EHSP
EPIC Test Code:
LAB2388
Included Tests:
CBC with Differential [Automated Differential; Hematocrit (Hct); Hemoglobin (Hgb); Mean Corpuscular Hemoglobin (MCH); Mean Corpuscular Hemoglobin Concentration (MCHC); Mean Corpuscular Volume (MCV); Platelet (PLT); Red Blood Cell Count (RBC); Red Cell Distribution Width Standard Deviation (RDWSD); Red Cell Distribution Width Coefficient Variation (RDWCV); White Blood Cell Count (WBC)], Chem 6 [Blood Urea Nitrogen (BUN); Creatinine; Electrolytes [Carbon Dioxide (CO2); Chloride (CL); Potassium (K); Sodium (Na)] ], Glucose, Liver Profile [Alanine Aminotransferase (ALT); Albumin; Alkaline Phosphatase; Aspartate Transaminase (AST); Bilirubin Direct; Bilirubin, Total; Protein, Total]
CPT Coding:
80051, 82565, 82947, 84520, 85025 (Reflex 85007, 85008)
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