Last Modified:
10/22/2021 8:37:45 AM
Medicare Medical Necessity Restrictions May Apply
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Specimen Requirements:
1.0 mL Plasma in a PST Mint Green Top Tube - Li Heparin (preferred)
or
1.0 mL Serum in a SST Gold Top Tube
Collection Instructions:
Avoid Hemolysis
Specimen must be spun within 4 hours of collection
Minimum Volume:
0.2 mL Plasma or Serum
Neonatal Volume:
Glucometer
Transport & Storage: Temperature/Stability:
Serum/plasma only 3 days Refrigerated
Reference Range:
70 - 99 mg/dL
Critical Ranges:
Pediatric Low: < 30 mg/dL
Pediatric High: > 300 mg/dL
Inpatient Low: < 54 mg/dL
Inpatient High: > 500 mg/dL
Outpatient Low: < 40 mg/dL
Outpatient High: > 400 mg/dL
Nursing Home Low: < 40 mg/dL
Nursing Home High: > 300 mg/dL
Test Comments:
Methodology:
Enzymatic
Clinical Significance:
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Stat Eligible:
Yes
Days Performed:
Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed:
Parkview Cancer Institute, Parkview Dekalb, Parkview Hospital Randallia, Parkview Huntington, Parkview LaGrange, Parkview Noble, Parkview Regional Medical Center, Parkview Wabash, Parkview Warsaw , Parkview Whitley
PHL Test Code:
GLU
EPIC Test Code:
LAB81
Alternate Test Names:
Blood Sugar; Fasting Blood Sugar; FBS; Random Blood Sugar; RBS
Included Tests:
CPT Coding:
82947
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