Prenatal Profile

Last Modified: 5/20/2019 4:06:52 PM


  Medicare Medical Necessity Restrictions May Apply
Medical Necessity Documentation:  
Client Notes:  
Patient Preparation:  
Specimen Requirements:
6.0 mL Whole Blood in a Pink Top Tube – EDTA
and
3.0 mL Whole Blood in a Lavender Top Tube EDTA
and 
3.0 mL Serum in a SST Gold Top Tube
Collection Instructions: Red Top and Pink Top Specimens 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

Lavender
Mix tube by inversion 5 times

Do not centrifuge

If submitting a specimen that is greater than 24 hours, please also submit a slide for the differential
Specimens must not be clotted. Overfilling or underfilling may allow blood to clot. Specimens may be rejected due to blood changes or deterioration resulting from improper storage or age of specimen

For slide preparation see Addendum D
Transport & Storage: Temperature/Stability:  
Reference Range:

See Individual Tests
Critical Ranges:  
Test Comments: HBSAG -- This assay utilizes biotin technology. Patients taking vitamin supplements containing high doses of biotin (>5 mg/day) may have falsely decreased test results generated.
Methodology: Multiple
Clinical Significance:  
Documentation:  
Custom Panel: No

PRODUCTION SCHEDULE

Days Performed: Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Departments:
Sites Performed: Parkview Huntington Hospital, Parkview LaGrange Hospital, Parkview Noble Hospital, Parkview Randallia Hospital, Parkview Regional Medical Center, Parkview Wabash Hospital, Parkview Warsaw , Parkview Whitley Hospital
PHL Test Code: PNN
EPIC Test Code: LAB2355
Alternate Test Names: AMA Prenatal Profile; Obstetric Panel; Prenatal Profile (American Medical Association)
Included Tests:
ABO, Rh Type; Antibody Screen; CBC with Auto Diff [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)]; Hepatitis B Surface Antigen (HBsAg); Rapid Plasma Reagin (RPR); Rubella IgG (Screen/Titer)
CPT Coding: Panel Code 80055

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