Ammonia
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
| Address: |
| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
| Ph: ( ) - Fax: ( ) - |
| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Ammonia | |
| 2. | |
| 3. | |
| 4. | |
| 5. | |
| 6. | |
| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
AMON
Test Workstation :
ACHM5
Specimen Type:
Blood
Tube Type:
Purple top (EDTA) tube
Minimum Volume:
500 uL (microtainer)1 mL (macrotainer)
Preferred Volume:
1.5 mL
Cause for Rejection:
Collected in tube other than EDTA; sample clotted; >30 minutes not on ice; capillary collection.
Storage:
Collect and ship on ice
Availability:
24 hours/day, 7 days/week
Methodology:
Roche-Enzymatic-UV
Special Instructions:
No finger or heel stick collections. Place specimen on ice and deliver to lab immediately. Specimen cannot be shared for any other lab test. Keep tube tightly stoppered at all times. Place immediately on ice and centrifuge. Perform analysis within 60 minutes of venipuncture. If testing cannot be completed within 60 minutes freeze plasma.
For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly).
Lab/Phone:
330-543-8418
TAT:
1 hour
Additional Info:
Reference range is on patient report
CPT Code:
82140
Synonyms:
NH3
