Last Modified:
8/30/2023 11:53:44 AM
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
This test is for infants 6 months and younger
Specimen Requirements:
0.4 mL Plasma from a Green Top Microtainer - Li Heparin in a Plastic Vial
Collection Instructions:
Avoid Hemolysis
If potiential prolonged exposure to sunlight specimen should be protected from the light by placing in an Opaque bag
Minimum Volume:
0.2 mL
Transport & Storage: Temperature/Stability:
5 days Refrigerated
6 hours unspun
Reference Range:
Direct: 0 - 0.2 mg/dL
Indirect: 0.0 - 6.7
Total: 0 - 7.0 mg/dL
Critical Ranges:
Neonatal (Total) Bilirubin
0 to 1 day: >=7.0 mg/dL
2 days: >=12.0 mg/dL
3 days to 6 months: >15.0 mg/dL
Test Comments:
Methodology:
Colorimetric
Clinical Significance:
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
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:
BILFN
EPIC Test Code:
LAB2375
Included Tests:
Bilirubin Direct ; Bilirubin Indirect ; Bilirubin Neonatal (Total)
CPT Coding:
82247, 82248
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