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Path Consult, Hematology

Pathologist Consult

Test Codes

EPIC Users: O139820 or O137869, Non-EPIC Users: LAB8502 and LAB6724

Department

Hematology

Instructions

• Includes CBC with Differential, Reticulocyte Count, and Pathologist Consultation.
• Orders for Hematopathologist Consult for morphology review MUST contain an established diagnosis or signs/symptoms. All Path Consult requests must have the applicable diagnosis code entered into EPIC/Laboratory Information System (LIS) upon order entry. While Rule Out (R/O) is often a useful way to communicate your suspicion to the consulting hematopathologist, it is NOT sufficient. 
• It is also essential when ordering Hematopathologist Consults to avoid using the word "Hemogram". A hemogram is a simple CBC w/o platelet count or differential and is not synonymous with a consult. If a Hematopathologist Consult is required, please so indicate.

Specimen Collection Criteria

Collect (preferred specimen): One 4.0 mL Lavender-top K₂EDTA tube. (Minimum: 2.0 mL)
Also acceptable: One Lavender-top K₂EDTA Microtainer^®. (Minimum: 300 mcL)
See Minimum Pediatric Specimen Requirements for Microtainer^® collection.

A copy of the requisition must be sent with the specimen.

Physician Office/Draw Specimen Preparation

Maintain specimens refrigerated (2-8°C or 36-46°F) prior to transport. Room temperature (20-26°C or 68-78.8°F) is acceptable for a maximum of 8 hours.

Preparation for Courier Transport

Transport: Whole blood or capillary blood, refrigerated (2-8°C or 36-46°F). (Minimum: 2.0 mL whole blood or 300 mcL capillary blood)

Rejection Criteria

• Specimens containing clots.
• Insufficient volume.
• Frozen specimens.
• Centrifuged specimens.
• A slide review to the pathologist must be ordered as a Pathology Consult.
• In order to ensure compliance with Medicare and other federal regulatory agencies, the Hematology Laboratory has instituted the written policy of not accepting requests for pathologist consultation to review normal CBC/Differential results.
• Due to the deterioration of morphology on aged specimens, it is not appropriate to add a Path Consult to an EDTA specimen that was collected more than 24 hours prior. All requests for an add-on Path Consult should be re-directed at obtaining a fresh specimen.
• Duplicate orders for a Path Consult within a 7 day time frame will not be accepted.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 8 hours
Refrigerated (2-8°C or 36-46°F): 24 hours
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days

Laboratory

Dearborn Hematology Laboratory
Farmington Hills Hematology Laboratory
Grosse Pointe Hematology Laboratory
Royal Oak Hematology Laboratory
Taylor Hematology Laboratory
Trenton Hematology Laboratory
Troy Hematology Laboratory
Wayne Blood Bank

Performed

Monday – Friday, 7:00 am – 3:30 pm.
Reports available within 24 hours.
Specimens received Friday afternoon through Sunday will have results available the following Monday.

Reference Range

See specific analytes for reference range: CBC with Differential and Reticulocyte Count.

Test Methodology

SYSMEX XN Series or XE Series.

Interpretation

By pathologist report.

Clinical Utility

Path Consults are helpful when a hematological abnormality is present and the clinician wants an in-depth interpretation of hematology results by a pathologist before further action is taken. Based upon interpretive findings, a further workup of the patient may be indicated.

CPT Codes

Based on complexity of case and time spent on the case: 80503, 80504, 80505, or 80506. 

Contacts

Last Updated

8/16/2023