Procalcitonin
| 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. Procalcitonin | |
| 2. | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
PCAL
Test Workstation :
MACH5
Specimen Type:
Blood
Tube Type:
Green top (lithium heparin) tube
Collection Volume:
500 uL microtainer; 1.5 mL macrotainer
Minimum Volume:
500 uL microtainer; 1.5 mL macrotainer
Preferred Volume:
500 uL microtainer; 1.5 mL macrotainer
Storage:
Storage- Room Temp: 24 hours; Refrigerated: 48 hours; Frozen: 3 months
Availability:
24 hours/day, 7 days/week
Methodology:
Roche-ECLIA sandwich principle
Lab/Phone:
330-543-8418
TAT:
2 hours
Additional Info:
- TAT: 2 hours
- Reference range: <.10 ng/mL
- < 0.50 ng/mL = low risk of severe sepsis and/or septic shock (do not exclude infection, as infections or systemic infections in early stages (<6hrs) can be associated with low concentrations.)
- 0.50 -2.00 ng/mL = interpret in the clinical context of the patient, as a variety of conditions such as burns, trauma, surgery and severe cardiogenic shock can cause procalcitonin elevations.
- >2.00 ng/mL = elevated risk of sever sepsis and/or septic shock.
CPT Code:
84145
