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Epic Test Code LAB1748 Heme Profile with Automated Differential (CBCA)

Important Note

This test can be added on to a previously run GHGB if specimen meets the CBCA criteria. 
This test can NOT be added on to a previously run BNP. 

Performing Location(s)

BMC,CRH,LFH,HRK,OCH,FTT,FOX,FCC

Synonyms

Complete blood count with automated differential

Specimen Type

Whole Blood

Preferred Container

Lavender top tube

Alternate Container

Filled Purple top microtainer

Blood Tube Draw Volume

Min 50% draw volume  

Minimum Volume to Submit for Testing

3.0 mL Whole blood

  • Multiple test can be performed from this volume. For question please contact the lab at 547-3975

Transportation Needs

Deliver to the laboratory within 12 hours at room temperature

Storage Requirements

Refrigerate up to 24 hours DO NOT FREEZE

Causes for Rejection

Mislabeled or unlabeled specimens
Less than 50% draw for Vacutainer tubes
Clotted
Macroscopic clot detected with wooden sticks
Fibrin strands with platelet involvement on peripheral smear
Less than 50% draw for Vacutainer® tubes
Less than 250µL of sample for Microtainer® tubes
Collection in 6.0 mL pink or purple top Vacutainer®
Collection in any anticoagulant other that K2EDTA
> 24 hours refrigerated for CBC and/or differential
> 12 hours at room temp or > 24 hours refrigerated for reticulocytes
Grossly hemolyzed
Samples drawn above an IV line
Contaminated line draws

Limitations

A manual differential will not be performed on inpatients with WBC counts < 1,000/ul. Only a CBC will be performed and billed. Call Laboratory if a Manual Differential is necessary

Reference Values

 

Parameter

Population

Reference Range

High Critical

Low Critical

WBC

Newborn - 1 month

9.0 - 30.0 x 10³cells /uL

> 30.0 x 10³cells /uL

< 2.0 x 10³cells /uL

1 month - 5 month

5.0 - 19.5 x 10³cells /uL

> 25 x 10³cells /uL

< 1.0 x 10³cells /uL

5 month - 2 years

6.0 - 17.5 x 10³cells /uL

2 years - 6 years

5.0 - 15.5 x 10³cells /uL

6 years - 12 years

4.5 - 13.5 x 10³cells /uL

Greater than 12 years

3.7 - 10.6 x 10³cells /uL
 

RBC

Female (< 12 years)

4.10 - 5.10X106 cells/uL

    

Female (> 12 years)

3.70 - 5.10X106 cells/uL

Male (< 12 years)

4.50 - 5.90X106 cells/uL

Male (> 12 years)

3.70 - 5.90X106 cells/uL
 

HGB

<1 month

13.0 - 19.0 g/dL

  

< 7.0 g/dL

1 month - 5 month

11.0 - 17.0 g/dL

5 month - 2 years

11.0 - 14.0 g/dL

2 years - 6 years

11.0 - 13.0 g/dL

6 years - 12 years

11.0 - 15.0 g/dL

Female > 12 years

11.5 - 15.5 g/dL

Male > 12 years

11.5 - 18.0 g/dL
 

HCT

<1 month

42.0 - 60.0%

> 60%

< 35%

1 month - 5 month

33.0 - 55.0%

<21%

5 month - 2 years

31.0 - 41.0%

2 years - 6 years

34.0 - 40.0%

6 years - 12 years

35.0 - 45.0%

Female > 12 years

34.0 - 46.0%

Male > 12 years

35.0 - 50.0% 
 

MCV

<1 month

98.0 - 118.0 fL

    

1 month - 5 month

91.0 - 111.0 fL

5 month - 2 years

68.0 - 84.0 fL

2 years - 6 years

75.0 - 87.0 fL

6 years - 12 years

77.0 - 95.0 fL

> 12 years

81.0 - 99.0 fL
 

MCH

< 1 month

27.0 - 33.0 pg

    

> 1 month

27.0 - 33.5 pg
 

MCHC

< 1 month

32.0 - 35.0 g/dL

    

> 1 month

31.5 - 35.5 g/dL
 

RDW

All Populations

37.3 - 49.0 fL

    
 

PLT

< 12 years

140 - 350 x 10³ cells/uL

> 1,000,000

< 20,000

> 12 years

140 - 425 x 10³ cells/uL
 

MPV

All Populations

8.0 - 12.0 fL

    

IPF %

All Populations

1.2-8.6 %

 

 

IPF #

All Populations

3.6-20 x 10³ cells/uL

 

 
         

 

 

 

Parameter

Test

Code

 Population % Count Absolute Count

Neutrophils:

Segmented

 SEG < 1 month 32.0-62.0 1600 - 6115 cells/uL
1 month - 5 months 15.0 - 35.0 750 - 3452 cells/uL
5 months - 2 years 13.0 - 33.0 650 - 3255 cells/uL
2 years - 6 years 15.0 - 35.0 750 - 3452 cells/uL
6 years - 12 years 32.0 - 54.0 1600 - 5326 cells/uL
> 12 years 40.0 - 70.0 1500 - 7400 cells/uL
 

Neutrophils:

Band

 BAND < 1 month 10.0 - 18.0  
1 month - 5 months 7.0 - 13.0
5 months - 2 years 6.0 - 12.0
2 years - 12 years 5.0 - 11.0
> 12 years 0.0 - 8.0

 
Lymphs: Normal LYMP <1 month 26.0 - 36.0 1235 - 2864 cells/uL
1 month - 5 months 41.0 - 71.0 1948 - 5648 cells/uL
5 months - 2 years 46.0 - 76.0 2185 - 6045 cells/uL
2 years - 6 years 44.0 - 74.0 2090 - 5886 cells/uL
6 years - 12 years 27.0 - 57.0 1283 - 4534 cells/uL
> 12 years 12.0 - 50.0 950 - 3500 cells/uL
 
Lymphs: Reactive LYMR All Populations 0.0-6.0  
 
Monocytes MONO < 1 month 1.0 - 11.0 75 - 862 cells/uL
1 month - 5 months 2.0 - 12.0 150 - 940 cells/uL
5 months - 12 years 0.0 - 10.0 0 - 783 cells/uL
> 12 years 2.0 - 14.0 150 - 940 cells/uL
 
Eosinophils EOS < 12 years 0.0 - 7.0 0 - 642 cells/uL
>12 years 0 .0- 6.0 0 - 550 cells/uL
 
Basophils BASO All Populations 0.0-3.0 0 - 175 cells/uL
 
Immature Granulocytes IG All Populations 0.0 - 3.0 0 - 150 cells/uL
 
Blasts BLAS All Populations 0.0 0
 
Nucleated RBC's NRBC All Populations 0.0 0

 

 

Reflex Testing

The Heme Profile, Automated WBC Differential and RBC Morphology (CBCA) are reported directly from the analyzer and CPT 85025 is billed whenever a CBCA is ordered and the results received are within established limits (see criteria delineated below).
The Heme Profile and a manually performed WBC Differential (CBCM) is reported and billed (CPT 85027 and 85007) when the ordered.

 

Criteria used to determine whether a manual differential or slide review is performed
Note: Criteria is based on the International Society for Laboratory Hematology (ISLH) consensus rules for reflexing automated differentials to a manual differential.
Condition Noted Action
Abnormal Cell Count (except as noted below) No Smear Review or manual differential performed
All Neonates Lab will perform and report a manual WBC differential
WBC >30,000 cells/uL Lab will perform and report a manual WBC differential
Abnormal  WBC flags 
(includes left shift, blast and/or atypical/variant lymphocytes)		 Lab will perform and report a manual WBC differential
Automated Differential shows:
       > 5% Basophils (or)  >20% Eosinophils (or) >20% Monocytes (or)
       > 5% IG		 Lab will perform and report a manual WBC differential
The first time any of following conditions is noted:
   * Platelet Count <100 or >1 million 
   * MCV <65 or >110 fl
   * RDW-SD >65 fl		 Lab will perform a smear review and note any abnormalities observed
Abnormal RBC Flags (includes NRBC flag) Lab will perform a smear review and note any abnormalities observed
Abnormal Platelet Flags Lab will perform a smear review and note any abnormalities observed

 

Days of Analysis

All

Available STAT

Yes

Includes

WBC, RBC, HGB, HCT, MCV, MCH, MCHC, RDW, and Platelet Count; differential (cell enumeration in percent and absolute number) by flow cytometry and, if necessary (see Limitations), a manual differential

Methodology

Automated; flow cytometry

CPT Code

85025

Last Updated

13-Apr-23 BHD