Last Modified:
3/27/2019 2:42:41 PM
Medicare Medical Necessity Restrictions May Apply
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
12 hour Fasting
Smoking, drinking, gum chewing, mints, cough drops, etc… are not allowed prior to or during the duration of the test
Small amounts of water are allowed after the 1-hour specimen has been collected.
Medications may still be taken as ordered by the physician.
Specimen Requirements:
1.0 mL Plasma in a PST Mint Green Top Tube - Li Heparin (One For Each Timed Collection)
Collection Instructions:
If patient has fasting test(s) ordered, they must be collected prior to administering Glucola beverage.
If possible, medications should be noted on the order
1. Collect Fasting Specimen
2. Administer the 75 grams of Glucola beverage by having the patient consume the beverage within 5 minutes
3. Start timing the test after the patient has finished the drink.
4. Collect subsequent timed specimens will be drawn at specific time intervals, based on the test ordered
Collection hour must be included on the specimen label along with patient’s full legal name, a unique identifier (the unique identifier may be the DOB or the requisition number), date and time of collection, and the phlebotomist’s initials.
Specimens must be spun within 4 hours of collection
For Child Glucola Dosages refer to
Addendum A
Minimum Volume:
0.2 mL
Transport & Storage: Temperature/Stability:
3 days Refrigerated
4 hours Unspun
Reference Range:
Refer to report for reference ranges
Critical Ranges:
Test Comments:
Methodology:
Enzamatic
Clinical Significance:
Documentation:
For tolerance comparisons refer to the PHL Glucose Tolerance Comparison Sheet in Addendum A
Custom Panel:
No
PRODUCTION SCHEDULE
Days Performed:
Monday, Tuesday, Wednesday, Thursday, Friday
Sites Performed:
Parkview Hospital Randallia, Parkview Huntington, Parkview LaGrange, Parkview Noble, Parkview Regional Medical Center, Parkview Wabash, Parkview Warsaw , Parkview Whitley
PHL Test Code:
GTTDM
EPIC Test Code:
LAB2335
Alternate Test Names:
2 hour Glucose Tolerance Test w/out 1 hour; 2 hour GTT w/out 1 hour; Diabetes Screening
Included Tests:
2 hour Glucose; Fasting Glucose
CPT Coding:
82947, 82950
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