Glucose by Meter
| PATIENT INFO |
| Patient Name: |
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| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
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| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
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| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Glucose by Meter | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
GLUM
Test Workstation :
MCHM
Specimen Type:
Fresh Whole Peripheral Blood
Tube Type:
None
Collection Volume:
1 drop by capillary puncture at patient's bedside
Storage:
None
Availability:
Daily, 24 hours; STAT
Methodology:
Electrochemical principle of Biamperometry
Special Instructions:
Heparinized whole blood can also be sent to lab if capillary puncture is not possible (ex: burned extremities or patient has a line to avoid repeated punctures). Glucose by meter levels that are <45 mg/dL or >450 mg/dL (>300 mg/dL for NICU patients) will be confirmed via a whole blood specimen analyzed on the Blood Gas Analyzer.
Lab/Phone:
330-543-8418
TAT:
20 minutes
Additional Info:
Reference range:
0-1 day = 50-80 mg/dL
2-28 days = 40-60 mg/dL
29 days to end of life 70-99 mg/dL
Criteria for Diagnosis of Diabetes(Effective 6/6/11): Fasting specimen (no caloric intake for at least 8 hours).<100 mg/dl Normal100-125 mg/dl Increased Risk for Diabetes>125 mg/dl Diagnostic for Diabetes Random Glucose (any time of day without regard to last meal).>=200 mg/dl plus Classic Symptoms of Diabetes
CPT Code:
82948
