CBC without Diff

Additional Codes

LAB294

Performing Laboratory

MBMC Main Laboratory

Methodology

Quantitative Automated Hematology Analyzer

Testing Algorithm

If platelet count is < 50 x10³ /uL, the Immature Platelet Fraction (IPF) will reflex with an additional charge.

Specimen Requirements

Specimen Type: Whole blood

Container/Tube: Lavender top (EDTA)

Specimen Volume: Full tube

Specimen Minimum Volume: 1 mL

Collection Instructions: 500 microliters of blood in a lavender EDTA Microtainer is also acceptable.

Specimen Transport Temperature

Ambient

Day(s) Test Set Up

Monday through Sunday

Turnaround Time:
STAT: 1 hour after receipt in laboratory
Routine: within 4 hours

Reference Values

See Reference Ranges in Special Instructions.

Hematology Criticals	Rule
Platelets
Inpatient Adult ≥18 yrs	Less than 20 or Greater than 1000; Call every 72 hours
Inpatient Pediatric < 18 yrs	Less than 25 or Greater than 1000; Call every 72 hours
ED All ages	Less than 50 or Greater than 1000; Call every 72 hours
Outpatient All ages	Less than 50 or Greater than 1000; Call every time
MBMC Labor and Delivery Adult ≥18 years	Less than 50 or Greater than 1000; Call every 72 hours
MBMC Cancer Center Adult ≥18 years	Less than 20 or Greater than 1000; Call every time
Hemoglobin
Outpatient Age 0 -11 yrs	Less than 7.0; Call every time
Outpatient Age 12- 17 yrs	Less than 6.0; Call every time
Outpatient Adult ≥ 18 yrs	Less than 6.5 or Greater than or equal to 20; Call every time
Inpatient/ED Age 0-11 yrs	Less than 7.0; Call every 72 hours
Inpatient/ED Age 12-17 yrs	Less than 6.0; Call every 72 hours
Inpatient/ED Adult ≥ 18 yrs	Less than 6.5 or Greater than or equal to 20; Call every 72 hours
WBC
Outpatient ≥ 3 days	Less than 1.0 or Greater than 50.0; Call every time
Inpatient/ED ≥3 days	Less than 1.0 or Greater than 50.0; Call every 72 hours
Inpatient and Outpatient/ED 0-2 days	Less than 2.0 or Greater than 50.0; Call every time
Differential
Outpatient All ages	Blasts >0% Call every time
Inpatient/ED ≤18 years	Blasts >0% Call every 72 hours
Inpatient/ED >18 years	Blasts >0% Call every 30 days
Inpatient/ED all ages	NEUTAB <0.50; Call every 72 hours
Outpatient all ages	NEUTAB <0.50; Call every time
Inpatients/ED all ages	ANC <0.50; Call every 72 hours
Outpatients all ages	ANC <0.50; Call every time

Test Classification and CPT Coding

Test Classification:This test has been cleared or approved by the U.S. Food and Drug Administration and is used per manufacturer’s instructions.
CPT Code:

85027

85055 - Immature platelet function, if indicated

Stability

24 hours

Profile Information

Includes WBC, RBC, HGB, HCT, MCV, MCH, MCHC, RDW, and platelet count.

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