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)
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:  
Custom Panel: No


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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