Prothrombin Time & Activated PTT
| 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. Prothrombin Time & Activated PTT | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
PTPTT
Test Workstation :
ACOAG
Specimen Type:
Blood
Tube Type:
Blue top (sodium citrate) tube
Collection Volume:
2.7 mL (minimum 1.8 mL)
Must use appropriate sodium citrate tube based on volume of blood drawn (1.8 mL or 2.7 mL tube)
Cause for Rejection:
Samples hemolyzed, clotted, diluted with IV fluid; contaminated with heparin; improperly filled; received >4 hours after drawn
Storage:
Ambient
Availability:
Daily, 24 hours; STAT
Methodology:
Photometric/turbidometric
Special Instructions:
Indicate clearly if a specimen has been drawn from an arterial line or from a line that has been rinsed with heparin. This information is absolutely essential to the CCL personnel for proper handling of the specimen and the reporting of results. Please indicate if the patient is currently receiving anticoagulant therapy. If collected at an offsite location, send Whole Blood by a STAT Courier to Akron Children's lab. Must be received within 4 hours
Lab/Phone:
330-543-8416
TAT:
4 hours
Additional Info:
Reference ranges: PT 8.5-14.0 secs; APTT < 40 secs
CPT Code:
85610
Synonyms:
PT & PTT; Protime & APTT
