90480:NEONATAL THROMBOCYTOPENIA

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90480:NEONATAL THROMBOCYTOPENIA
Alias Names: PLT Ab / PLT Ag / PLA-1
Methodology: Flow Assay
Edit Date: 4/14/2009
Performed: Tuesday-Friday
Released: 7 days after setup at PeaceHealth Laboratories’ reference lab.
CPT Code: 83890-904Z / 83892-904Z x6 / 83894-904Z x6 / 83898-904Z x6 / 83912-904Z / 86021-90 / 86022-90 / 86023-90 / 86807-90
Specimen Collection Details
Collection: FROM MOTHER: Eight 4.0 mL lavender top tubes, three 4.5 mL light blue top tubes (sodium citrate), AND two 5.0 mL red top tubes.
FROM FATHER: Eight 4.0 mL lavender top tubes.
Draw specimens only Monday-Wednesday.
Handling: Keep as whole blood. Keep ambient.
Send specimens to PeaceHealth Laboratories STAT. Specimens must reach the reference lab within 24 hours of collection.
Standard Volume: MOTHER: 30mL EDTA whole blood, 10 mL sodium citrate whole blood, AND 10 mL whole blood from red top tube.
FATHER: 30 mL EDTA whole blood.
Minimum Volume: Volumes above are required.
Transport: STAT at ambient temperature.
Comments: This test should be requested for evaluation of a neonate with unexplained thrombocytopenia. Direct and indirect tests will be performed on the samples from the infant and parents to determine if the mother is sensitized to her infant’s platelet antigens.
This test may require insurance company prior authorization before ordering.
Please check the prior authorization list
.
Failure to gain preauthorization may result in denial of coverage.

PeaceHealth Laboratories