Complete Blood Count with Differential (CBC WITH DIFF)
Laboratory - :
Hematology
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. Complete Blood Count with Differential (CBC WITH DIFF)
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SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
CBC
Test Workstation :
MAHM1
Specimen Type:
Blood
Tube Type:
Purple top (EDTA) tube: Whole Blood
Collection Volume:
300 ul microtainer, 2.0 ml macrotainer
Minimum Volume:
300 ul microtainer; 1.0 ml mactrotainer
Preferred Volume:
300 ul microtainer, 2.0 macrotainer
Cause for Rejection:
Specimens hemolyzed, clotted diluted with IV fluid, drawn with heparin or contaminated with heparin; tubes improperly filled; specimens at RT for more than 8 hours or 4C for more than 24 hours
Storage:
Refrigerated
Availability:
Daily, 24 hours; STAT
Methodology:
Impedance measurement with Optical Flow light scatter and fluorescent measurements and microscopic evaluation of a Wright's stained blood film
Special Instructions:
Indicate clearly if the specimen has been drawn from an arterial line or from a line that has been rinsed with heparin.
Lab/Phone:
330-746-9623
TAT:
8 hours
Additional Info:
Reference ranges available on patient report
CPT Code:
85025
Profile Includes:
WBC
Nucleated RBC
RBC
Hemoglobin
Hematocrit
MCV
MCH
MCHC
RDW
Platelets
MPV
% Immature Granulocyte
Absolute Neutrophil Number
Band Neutrophils
Segmented Neutrophils
Lymphocytes
Monocytes
Promyelocytes
Metamyelocytes
Myelocytes
Cell Morphology
Synonyms:
Complete Blood Count; Hemogram & Smear Review; CBC with Diff
Complete Blood Count with Differential (CBC WITH DIFF)
Test ID/Workstation :
CBC
Specimen Type:
Blood
Tube Type:
Purple top (EDTA) tube: Whole Blood
Collection Volume:
300 ul microtainer, 2.0 ml macrotainer
Cause for Rejection:
Specimens hemolyzed, clotted diluted with IV fluid, drawn with heparin or contaminated with heparin; tubes improperly filled; specimens at RT for more than 8 hours or 4C for more than 24 hours
Storage:
Refrigerated
Availability:
Daily, 24 hours; STAT
Methodology:
Impedance measurement with Optical Flow light scatter and fluorescent measurements and microscopic evaluation of a Wright's stained blood film
Special Instructions:
Indicate clearly if the specimen has been drawn from an arterial line or from a line that has been rinsed with heparin.
Lab/Phone:
330-746-9623
TAT:
8 hours
Additional Info:
Reference ranges available on patient report
CPT Code:
85025
Profile Includes:
WBC
Nucleated RBC
RBC
Hemoglobin
Hematocrit
MCV
MCH
MCHC
RDW
Platelets
MPV
% Immature Granulocyte
Absolute Neutrophil Number
Band Neutrophils
Segmented Neutrophils
Lymphocytes
Monocytes
Promyelocytes
Metamyelocytes
Myelocytes
Cell Morphology
Synonyms:
Complete Blood Count; Hemogram & Smear Review; CBC with Diff
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