Procalcitonin

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. Procalcitonin
2.
3.
4.
5.
6.

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