We are experiencing exceptionally high volumes in our emergency rooms.
Every patient is important to us, and we are doing all we can to provide care quickly and efficiently.

Carbon Dioxide

Laboratory : Chemistry

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. Carbon Dioxide
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

TCO2 MACH3

Specimen Type:

Blood

Tube Type:

Green top (lithium heparin) tube

Collection Volume:

1.5 mL

Storage:

Shipping: Send Refrigerated; Storage: Room Temp: 40 hours; Refrigerated: 7 days

Availability:

24 Hours/day, 7 days/week

Methodology:

Roche- PEPC

Lab/Phone:

330-746-9623

TAT:

1 hour

Additional Info:

Reference range available on patient report

CPT Code:

82374

Profile Includes:

Remove Special Instructions

Synonyms:

CO2; Total CO2; Bicarbonate

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