D-Dimer Quantitative
| 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. D-Dimer Quantitative | |
| 2. | |
| 3. | |
| 4. | |
| 5. | |
| 6. | |
| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
QDIMR
Test Workstation :
MACH3
Specimen Type:
Blood
Tube Type:
Blue top (sodium citrate)
Collection Volume:
2.7 mL (minimum 1.8 mL) macrotainer
Must use appropriate sodium citrate tube based on volume of blood drawn (1.8 mL or 2.7 mL tube)
Minimum Volume:
1.8 mL using appropriate 1.8 mL tube
Preferred Volume:
1.8 mL using appropriate 1.8 mL tube or 2.7 mL using appropriate 2.7 mL tube
Cause for Rejection:
Sample clotted, diluted with IV fluid; contam with heparin; improperly filled; specimen stability 8 hours room temp.
Storage:
Shipping: Send Ambient; Storage: Room Temp: 8 hours
Availability:
24 Hours/day, 7 days/week
Methodology:
Particle enhanced immunoturbidometric assay
Special Instructions:
Send immediately to Laboratory.
Indicate clearly if a specimen has been drawn from an arterial line or from a line that has been rinsed with heparin.
For Outpatients, send specimen by courier STAT to the lab at Mahoning Valley Hospital.
Lab/Phone:
330-743-8416
TAT:
4 hours
Additional Info:
Reference range: < 0.5 mg/L-FEU
CPT Code:
85379
Synonyms:
Fibrin degradation products
