Wellness PHP Package

Last Modified: 5/17/2023 5:23:58 AM


Medical Necessity Documentation:  
Client Notes:  
Patient Preparation: Fasting 10 to 12 hours
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 Wabash Hospital, Parkview Warsaw , Parkview Whitley Hospital
PHL Test Code: W2
Alternate Test Names: PHP Package
Included Tests: Comprehensive Medabolic Panel (CMP) Alanine Aminotransferase (ALT; SGPT); Alkaline Phosphatase; Aspartate Aminotransferase (AST; SGOT); Bilirubin, Total; Blood Urea Nitrogen (BUN); Calcium (Ca); Creatinine; Electrolytes [Carbon Dioxide (CO2); Chloride (CL); Potassium (K); Sodium (Na)]; Glucose; Protein Fractionation [A/G Ratio; Albumin;Globulin; Protein, Total]

Glycohemoglobin Estimated Average Glucose (eAG); Glycohemoglobin (HbA1C)

Lipid Profile Cholesterol; Cholesterol HDL; Cholesterol LDL (Calculated); Chol/HDL Ratio (Calculated); Triglycerides
CPT Coding: 80053; 83036; 80061 (Reflex 83721)

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