Blood Culture
| 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. Blood Culture | |
| 2. | |
| 3. | |
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| 6. | |
| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
BLOOD
Test Workstation :
MMIC3
Specimen Type:
Blood
Tube Type:
Blood Culture Bottle
Collection Volume:
Click on "Blood culture" under the Specimen Collection Procedures (below) for Table: Blood Culture Recommended Volume Based on Patient Weight
Storage:
Ambient
Availability:
Daily
Methodology:
Automated Detection Instrumentation
Special Instructions:
Blood cultures should be drawn prior to initiation of antimicrobial therapy. If more than one culture is drawn, the specimens should be drawn from different sites. The minimum amount of blood is only to be used in cases where there is a difficult draw. Do not overfill the bottles (>10mL in adult aerobic and anaerobic bottles), as this can lead to false positives. NOTE: Be sure to cleanse top of blood culture bottle with chlorhexidine before inoculating with patient specimen.
Lab/Phone:
330-746-9623
TAT:
5 days
Additional Info:
Preliminary report available after 24 hours
CPT Code:
87040
