PT by Monitor

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. PT by Monitor
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

PTMON MNCOG

Specimen Type:

Fresh Whole Peripheral Blood

Tube Type:

None

Collection Volume:

0.05 mL Whole Blood

Cause for Rejection:

Specimen diluted with IV fluid or heparin; containing anticoagulants; collected in glass tubes or syringes

Storage:

None

Availability:

Daily, 24 hours; STAT

Methodology:

Electronic Optical Detection Clotting Assay; cartridge-based

Special Instructions:

Testing is done on unanticoagulated blood at the bedside. Plasma or serum can't be used. Prepare capillary puncture site by warming fingertips or heel with warm water and/or warm washcloth. Testing can be drawn at Akron Campus only. For Outpatients, test should only be drawn in outpatient locations within the Hospital on the Akron campus.

Lab/Phone:

330-543-8416

TAT:

30 minutes

Additional Info:

Reference range: PT = 12-14 secs Only INR will be reported. This testing can ONLY be used for patients on stable oral anticoagulant therapy. There is no significant contribution to the diagnosis or treatment of patients whose Prothrombin Time is prolonged for other reasons.

CPT Code:

85610

Synonyms: