Medicare Medical Necessity Restrictions May Apply
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Specimen Requirements:
10.0 mL Serum in a SST Gold Top Tube
and
3.0 mL Whole Blood in a Lavender Top Tube - EDTA
Collection Instructions:
Lavender Top:
Collection requirements for ESR are by venipuncture or line draw. Capillary samples are NOT acceptable.
Mix by inversion
Do not centrifuge
Transport & Storage: Temperature/Stability:
Serum:
7 days Refrigerated
ESR Whole Blood Lavendar:
Must be tested within 4 hours of collection, if testing delayed longer than this Refrigerate
Do not Freeze
Reference Range:
See Indvidual 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 Dekalb Hospital, Parkview Huntington Hospital, Parkview LaGrange Hospital, Parkview Noble Hospital, Parkview Randallia Hospital, Parkview Regional Medical Center, Parkview Southwest , Parkview Wabash Hospital, Parkview Warsaw , Parkview Whitley Hospital
PHL Test Code:
ARTPC
EPIC Test Code:
IMO19
Included Tests:
Alkaline Phosphatase, Total; Antinuclear Antibodies (ANA); Anti Streptolysin-O (ASO); Blood Urea Nitrogen (BUN); C-Reactive Protein (CRP); Calcium (Ca); Cyclic Citrullinated Peptide (CCP); Phosphorus, Inorganic; Rheumatoid Factor (RF); Sedimentation Rate (ESR); Uric Acid
CPT Coding:
82310, 84075, 84100, 84520, 84550, 85652, 86038, 86063, 86140, 86200, 86431 (Reflex 86060, 86039)