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Test Code LAB2063 Smear to Pathology

Additional Codes

Test Name in EPIC EPIC Test Code Mnemonic
SMEAR TO PATH LAB2063 PATHSMEAR

 

Useful For/Utility

Examination of peripheral blood smear by patholoist.  Useful for detecting changes in cell morphology or altered distribution of cell types when a patients hematology parameters are determined to be significanlty abnormal or clinical symptoms suggest a particular disease state. 

Methodology

Microscopic Examination of Stained Slides

Test Algorithm

If parameters of the hemogram and differential included with the smear to pathology are within the criteria listed below, the hemogram with differential results will be reported with a comment explaining why pathology review is not indicated and the smear to pathology will be cancelled and the slides saved for 14 days to allow for additional testing if needed.

  • All parameters of the CBC and the absolute counts on the differential are normal.
  • The RDW is the only parameter out of the reference range.
  • The PLT (PLT flagged high with a result between 375 and 449) is increased and is the only parameter out of the reference range.
  • Monocytosis (Absolute Monocyte Count result between 1.0 and 1.5) present and is the only parameter out of reference range.
  • The MCV is decreased (MCV flagged low with normal HGB) and is the only parameter out of reference range.
  • The MCV is increased (MCV flagged high with a result between 99.1 and 110 with a normal HGB) and is the only parameter out of the reference range.
  • Isolated neutrophilia (WBC normal or flagged high with an absolute neutrophil count flagged high and a normal immature granulocyte count) present without a left shift.
  • Isolated microcytic or microcytic hypochromic anemia (HGB flagged low, MCV flagged low, MCHC flagged low, PLT normal or high with a value up to 449) present without erythrocytosis.
  • The order comment states, "Evaluate for blood parasites (Anaplasma, Babesia, Malaria)."　　　　　　

If the above criteria are not met, a Smear to Path will be performed.

 

 

 

Clinical Information

Do not order for evalution of anaplasmosis  refer to  CBCWD W/Reflex to Anaplasma Smear LABCBCAR                                                    

Do not order for evaluation of blood parasites, refer to   Parasite Smear. (LAB2074).                                                

Pathology report includes morphologic description and diagnosis.

Specimen Requirements

Slides and whole blood are required and to be kept together.

Slides must be made within 8 hours of draw.

Specimen Type: Whole blood

Container/Tube: Lavender top (EDTA)

Specimen Volume: 1 mL

Specimen Minimum Volume: 0.5 mL

Additional Information:

1. Fingerstick specimen is acceptable.

2. Regional and Neighborhood sites: Send remaining EDTA specimen (refrigerated), printout from hematology analyzer, and 2 unstained blood smears.

Specimen Type: Smears

Container/Tube: Slide container

Specimen Volume: 2 smears

Collection Instructions: Prepare 2 thin blood smears, using only clean, grease-free slides. Slides, with a “feathered edge,” should be no more than a single cell thick. Label slides with 2 accurate patient identifiers. 

  • Handwrite slide labels. Do not use stickers as patient identifiers/labels on slides.
  • Allow smears to thoroughy air dry.
  • Do not stain slides.

Additional Information:

1. Fingerstick specimen is acceptable.

2. Regional and Neighborhood sites: Send remaining EDTA specimen (refrigerated), printout from hematology analyzer, and 2 unstained blood smears. Allow smears to thoroughly air dry prior to packaging for shipment

3. See Ehrlichia Smears in Special Instructions for examples of properly made slides.

4. For locations that are not trained on smear preparation. Specimen must arrive at testing lab within 8 hours. Call STAT courier if necessary.

 

 

NOTE:  Add-on test requests must meet specimen acceptability criteria (slides made withing 8 hrs of collection and EDTA sample run within 8 hrs. when stored at room temperature or 24 hrs. when stored refrigerated).

Specimen Transport Temperature

Slides-Ambient/Refrigerate OK/Frozen NO

Whole Blood-Ambient 8 hours/Refrigerate 24 hours OK/Frozen NO

Day(s) Test Set Up

Monday through Sunday, reviewed Monday through Friday (day shift only)

Performing Laboratory

SMDC Clinical Lab

Fargo Hospital Lab

Test Classification and CPT Coding

85060

Reference Values

An interpretive report will be provided.

Special Instructions