Occult Blood, Qual
| 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. Occult Blood, Qual | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
OCBLD
Test Workstation :
MCHM
Specimen Type:
Stool
Tube Type:
Stool container
Collection Volume:
1 gram stool specimen
Storage:
Ambient
Availability:
Daily, 24 hours; STAT
Methodology:
GUAIAC
Special Instructions:
Patient should follow a diet free of red meats, vitamin C, ascorbic acid, turnips, horseradish, melons, aspirin, and antiinflammatory drugs for 7 days prior to testing and for the duration of testing.
Lab/Phone:
330-543-8418
TAT:
1 hour
Additional Info:
Reference range: Normal = Negative
CPT Code:
82270
Synonyms:
Hemoccult
