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Test Code 8073 Hemogram without Differential

Important Note

Test subject to Medicare National Coverage Determination (NCD) 190.15 Blood Count TESTING

See Medical Necessity on Sidebar

Includes: RBC Count, WBC Count, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet Count, and MPV

Note: If an automated differential is desired, order Complete Blood Count (CBC) with Automated Differential.

Purpose

Screening tool to confirm a hematologic disorder, to establish or rule out a diagnosis, to detect an unsuspected hematologic disorder, or to monitor effects of radiation or chemotherapy.

 

Performing Laboratory

Copley Hospital

 

Methodology

Automated Cell Counter

 

Specimen Requirements

Specimen Type: Whole Blood

Container/Tube: Lavender Top

Specimen Volume: Full Tube

Specimen Minimum Volume: 2 mL

 

Collection Instructions:

1. Invert tube 8 times immediately after collection.

2. Label specimen with patient’s full name, date of birth,

    date & time of collection, and person collecting.

3. Refrigerate specimen during transport.

 

Reference Values

Critical:        WBC: > 20.0        Hematocrit: < 25 %        Platelets: < 30 / µL         ANC: < 0.5

 

Normal Values

Male

Female

WBC                    5 - 10 (x 103 / uL)                  

WBC                    5 - 10 (x 103 / uL)                  

 RBC               4.30 - 6.20 (x 106 / uL) 

 RBC               3.90 - 5.40 (x 106 / uL) 

HGB                   13 - 17 g / dL 

HGB                   12 - 16 g / dL 

HCT                   45 - 52 % 

HCT                   37 - 47 % 

MCV                  82 - 92 fL 

MCV                  82 - 92 fL 

RDW                 0.0 - 14.9 % 

RDW                 0.0 - 14.9 % 

PLT                  150 - 450 (x 103 / uL) 

PLT                  150 - 450 (x 103 / uL) 

 

Stability

Refrigerated: 24 Hours

 

Day(s) Performed

Daily

Available STAT

Analytical Time: 1 Day

 

Aliases

Hemogram without Differential

Hemogram

 

Test Classification and CPT Coding

85027