Parkview Health Laboratory: Test Directory

Medicare Medical Necessity Restrictions May Apply

Medical Necessity Documentation:

Patient Preparation:

Specimen Requirements: 3.0 mL Whole Blood in a Lavender Top Tube - EDTA

Collection Instructions: Mix tube by inversion 5 times

Do not centrifuge

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

Minimum Volume: 1.5 mL (Microtainer: no less than .3 no more .5)

Transport & Storage: Temperature/Stability: 24 hours Ambient
72 hours Refrigerated

Reference Range:

Pediatric
0 days to 1 month: 5.0 - 21.0 TH/UL
1 month to 2 months: 5.0 - 19.0 TH/UL
2 month to 1 year: 6.0 - 17.0 TH/UL
1 year to 6 years: 6.0 -17.0 TH/UL
6 years to 14 years: 4.5 - 13.5 TH/UL

Males > 14 Yrs: 3.5 - 10.5 TH/UL

Females > 14 Yrs: 3.5 - 10.5 TH/UL

Critical Ranges:

Pediatric
(< = 15 days old) Low Critical Limits : WBC: < = 2.0 TH/UL

(< = 15 days old) High Critical Limits : WBC: > = 39.0 TH/UL

Low Critical Limits: WBC: < = 1.5 TH/UL

High Critical Limits: WBC: > = 40.0 TH/UL

Low ONC (Patients in a Parkview Health Oncology Unit): <= 1.0 T/UL

Test Comments:

Methodology: Blood Cell Analyzer

Clinical Significance:

Documentation:

Custom Panel: No

Stat Eligible: Yes

Days Performed: Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday

Sites Performed: Parkview Cancer Institute, 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: WBC

EPIC Test Code: LAB299

Alternate Test Names: Leukocyte Count; WBC; White Blood Count

Included Tests:

CPT Coding: 85048

Parkview Laboratory: Test Directory

White Blood Cell Count

PRODUCTION SCHEDULE