Reticulocyte Count, Automated

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. Reticulocyte Count, Automated
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

RTCA

Test Workstation :

AHEM1

Specimen Type:

Blood

Tube Type:

Purple top (EDTA) tube: Whole Blood

Collection Volume:

2.5 mL EDTA (minimum 0.2 mL BD microtainer)

Cause for Rejection:

Specimen more than 12 hours old; specimen hemolyzed, clotted, or diluted with IV fluid, specimens at room temperature >8 hours, or refrigerated (4C) specimens >24 hours

Storage:

Refrigerated

Availability:

Daily, 24 hours; STAT

Methodology:

Fluorescence, Forward Scatter

Lab/Phone:

330-543-8416

TAT:

8 hours

Additional Info:

Reference range:

0-180 days < 5.0%

181 days â end of life: 0.5 - 2.0%

CPT Code:

85045

Synonyms:

Retic Count

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Reticulocyte Count, Automated

Centralized Core Laboratory - : Hematology

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