Lithium
| 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. Lithium | |
| 2. | |
| 3. | |
| 4. | |
| 5. | |
| 6. | |
| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
LI
Test Workstation :
ACHM5
Specimen Type:
Blood
Tube Type:
Red top (no anticoagulant) tube
Minimum Volume:
500 uL
Preferred Volume:
1.5 mL
Storage:
Shipping- Send Refrigerated; Storage-Room Temp: 1 day; Refrigerated:7 days; Frozen: 6 months if specimen is not exposed to light
Availability:
24 hours/day, 7 days/week
Methodology:
Roche-Colorimetric
Special Instructions:
Collect samples for lithium determination at least 12 hours after the last dose. Separate from cells if analysis is not performed within 4 hours.
Lab/Phone:
330-543-8418
TAT:
1 hour
Additional Info:
Reference Range:
Therapeutic range: 0.5-1.2 mEq/L.
Toxic: > 2.0 mEq/L.
Critical Limit: >1.5 mEq/L.
CPT Code:
80178
