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Need Help?
Operator
330-543-1000
Ask Children's
8 a.m. - 4:30 p.m. M-F
330-543-2000
Providers
EpiCare
Referrals to Akron Children's
Advanced Practice Center
Medical Missions
Continuing Professional Development
Wellness Resources
Mary A. Hower Medical Library
Nurses
Nursing Overview
Research Institute
Quicklinks
COVID-19 Updates
Find a Doctor/Provider
EpicCare Link Login
Epic Remote Access
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Need Help?
Operator
330-543-1000
Laboratory Services
Hepatic Panel
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. Hepatic Panel
2.
3.
4.
5.
6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Test ID/Workstation :
LIVER MACH1
Specimen Type:
Blood
Tube Type:
Green top ( lithium heparin ) tube
Collection Volume:
0.5mL
Cause for Rejection:
Hemolysis
Storage:
Refrigerated
Availability:
Daily, 24 hours; STAT
Methodology:
See individual tests
Special Instructions:
Protect the specimen from light exposure. Ask that the blue bilirubin lights in the NICU be turned off while collecting.
Lab/Phone:
330-746-9623
TAT:
1 hour
Additional Info:
Reference ranges available under individual tests
CPT Code:
80076
Panel Includes:
Conjugated Bilirubin, Total Bilirubin, ALT, AST, Alkaline Phosphatase, Total Protein, Albumin
Synonyms:
Liver Function Test
View and print a requisition form for this test
View and print ONLY the info for this test
Hepatic Panel
Test ID/Workstation :
LIVER MACH1
Specimen Type:
Blood
Tube Type:
Green top ( lithium heparin ) tube
Collection Volume:
0.5mL
Cause for Rejection:
Hemolysis
Storage:
Refrigerated
Availability:
Daily, 24 hours; STAT
Methodology:
See individual tests
Special Instructions:
Protect the specimen from light exposure. Ask that the blue bilirubin lights in the NICU be turned off while collecting.
Lab/Phone:
330-746-9623
TAT:
1 hour
Additional Info:
Reference ranges available under individual tests
CPT Code:
80076
Panel Includes:
Conjugated Bilirubin, Total Bilirubin, ALT, AST, Alkaline Phosphatase, Total Protein, Albumin
Synonyms:
Liver Function Test