Last Modified:
8/30/2023 1:01:30 PM
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
10 to 12 hours Fasting
Specimen Requirements:
4.0 mL Serum in a SST Gold Top Tube
and
3.0 mL Whole Blood in a Lavender Top Tube - EDTA
Collection Instructions:
Avoid Hemolysis
Transport & Storage: Temperature/Stability:
7 days Refrigerated
48 hours on cells
Reference Range:
Refer to Interpretive Results
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:
DAW3
EPIC Test Code:
LAB3282
Alternate Test Names:
Wellness Green Package (Direct Access Testing)
Included Tests:
Glycohemoglobin Estimated Average Glucose (eAG); Glycohemoglobin (HbA1C)
Lipid Profile Cholesterol; Cholesterol HDL; Cholesterol LDL (Calculated); Chol/HDL Ratio (Calculated); Triglycerides
CPT Coding:
80061; 83036
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