Malaria Parasite Exam

Centralized Core 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. Malaria Parasite Exam
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SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

MALEX

Test Workstation :

SCOPE

Specimen Type:

Blood

Tube Type:

Purple top (EDTA) tube: Whole Blood

Collection Volume:

Purple top (EDTA) and Four fingerstick slides, 2 thick and 2 thin blood smears

Cause for Rejection:

Improperly collected blood smears (thick smear preps are too thick, blood sloughs off upon drying).

Storage:

Ambient

Availability:

Daily (slide prep: 24 hours) Slide exam: 0700-1630

Methodology:

Microscopic evaluation of Wright's stained blood film

Special Instructions:

Smears should be made prior to febrile paroxysm. If fever is unpredictable, do fingerstick at the beginning of temperature rise. If patient is symptomatic, find out if patient has visited foreign countries recently, has a headache, nausea, fever, chills or is vomiting.

Lab/Phone:

330-543-8416

TAT:

24 hours

Additional Info:

Results will be finalized after Pathologist review. Reference range: No organisms seen

CPT Code:

87207

Synonyms:

Malaria Smear; Malaria Parasites; Parasites Blood; Bloodborne Parasites Stain

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Malaria Parasite Exam

Centralized Core Laboratory - : Hematology

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