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HelpTest Code Billings Clinic: 0140 Physician Ordered Path Review
Performing Laboratory
Billings Clinic Laboratory: Hematology
Useful For
Detecting disease states or syndromes of the white blood cells, red blood cells, or platelet cell lines of a patient's peripheral blood.
Methodology
Under normal conditions, the morphology and proportion of each blood cell type is fairly consistent in corresponding age groups. The morphology and proportion of each blood cell type may change in various hematologic diseases. Differential leukocyte count and special smear evaluation is helpful in revealing the changes in morphology or proportion of each cell type in the peripheral blood.
Specimen Requirements
Specimen Type: Peripheral blood slides and with complete blood count (CBC) results
Container/Tube: Transport in plastic slide holders.
Preferred: 2 Slides made from whole blood in EDTA, made within 4 hours of collection; include analyzer CBC results
Collection Instructions:
- Prepare 2 good quality blood smears from EDTA whole blood within 4 hours of collection.
- Stain one slide stained and one unstained with 2 patient identifiers.
- Forward slides, CBC result, and diagnosis code and/or reason for pathology review to Billings Clinic.
Clinical Indication and if there is a concern for MAHA must be provided.
Storage/Stability
2-8 C for up to 24 hours.
Reject Due To
Specimens will be cancelled if the following criteria is not met:
|
Parameter |
Frequency |
|
Clinical concern for microangiopathic hemolytic anemia |
Always |
|
Clinical concern for blood born parasites (order a “malaria smear” |
Always, order a “malaria smear” |
|
Myelocytes reported as >5% |
Initial and every 60 days |
|
Promyelocytes reported as >2% |
Initial and every 60 days |
|
Pancytopenia (HMG <13g/dL males, <12 g/dL females, and absolute neutrophils count (< 1.8 x 10 (3)/uL), and platelets < 150 x 10 (3)/uL) |
Initial and every 30 days |
|
Blasts reported in peripheral blood |
Initial and every 14 days |
|
Basophils>0.5 x 10 (3)/UL |
Initial and Every 30 days |
|
Lymphocytes >5 x 10 (3)/uL |
Initial Every 6 months |
|
WBC < 3.0 x 10 (3)/uL or >30 x 10 (3)/uL |
Initial and every 30 days |
|
Hgb < 7.0 or >16.0 g/dL |
Initial and, every 60 days |
|
MCV >105 fL |
Initial and every 60 days |
|
Monocytes >10% and > 0.5 x 10(3)/uL |
Initial and every 30 days |
|
ANC <1.8 x 10 (3)/uL |
Initial and every 30 days |
|
PLT <50 x 10 (3) or >500 x 10 (3)/uL |
Initial every 90 days |
|
Eosinophils (>2 x 10(3)/uL) |
Initial and every 30 days |
Reference Values
An interpretive report will be provided.
LOINC Code Information
LOINC-Code 78251-6
Reporting Name- Hematology Consult note
Test Classification and CPT Coding
CPT Code: 88325-Consultation, comprehensive, with review of records and specimens, with report on referred material.