Ammonia
| 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. Ammonia | |
| 2. | |
| 3. | |
| 4. | |
| 5. | |
| 6. | |
| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
AMON
Test Workstation :
MACH3
Specimen Type:
Blood
Tube Type:
Purple top (EDTA) tube
Collection Volume:
1.5 mL macrotainer
Minimum Volume:
500 uL macrotainer
Preferred Volume:
1.5 mL macrotainer
Cause for Rejection:
Collected in microtainer or in tube other than EDTA; Sample clotted; >30 minutes not on ice.
Storage:
See Special Instructions for shipping; Storage: Room Temp: 30 minutes; Refrigerated: 2 hours; Frozen: 3 days
Availability:
Daily, 24 hours; STAT
Methodology:
Roche- Enzymatic- UV
Special Instructions:
No finger or heel stick collections. Place specimen on ice and deliver to lab immediately. Specimen cannot be shared for any other lab test. Keep tube tightly stoppered at all times. Place immediately on ice and centrifuge. Perform analysis within 60 minutes of venipuncture or freeze separated plasma immediately. For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Mahoning Valley).
Lab/Phone:
330-746-9623
TAT:
1 hour
Additional Info:
Reference range is on patient report
CPT Code:
82140
Synonyms:
NH3
