Coombs, Direct Fractionation

Last Modified: 2/20/2019 4:26:18 PM

Medical Necessity Documentation:  
Client Notes:  
Patient Preparation:  
Specimen Requirements: 3.0 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: Peds: 1.0 mL Whole blood from 2 Lav Microtainers
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: This test is ordered and charged when a Direct Coombs test is positive on any 6 months or older
Methodology: Hemagglutination
Clinical Significance:  
Custom Panel: No


Days Performed: Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed: Parkview Hospital Randallia, Parkview Regional Medical Center
PHL Test Code: DATF
EPIC Test Code: LAB2214
Alternate Test Names: Direct Coombs Fractionated
Included Tests:  
CPT Coding: 86880 x 2

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