Bilirubin, Neonatal Fractionated

Last Modified: 7/1/2019 8:15:50 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 Hospital Randallia, Parkview Huntington, Parkview LaGrange, Parkview Noble, Parkview Regional Medical Center, Parkview Wabash, Parkview Warsaw , Parkview Whitley
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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