Direct Antiglobulin Test
| PATIENT INFO |
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| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
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| Additional Report to: |
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| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Direct Antiglobulin Test | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
VMSO
Test Workstation :
MPROC
Specimen Type:
Blood
Tube Type:
Lavender (EDTA)tube
Collection Volume:
<4 months: 2 lavender (EDTA) microtainers; Special Care Nursery only. All other locations, please contact Mahoning Valley Laboratory for specimen requirements and information
Minimum Volume:
contact the laboratory
Preferred Volume:
contact the laboratory
Cause for Rejection:
Improperly labeled specimen, gross hemolysis
Storage:
Room temp
Availability:
Daily, 24 hours
Methodology:
Tube Testing
Special Instructions:
All Blood Bank specimens must be accompanied by a completely filled out Blood Bank Requisition to include two signatures at the time of specimen collection.
Mislabeled Blood Bank Specimens will not be processed, regardless of the situation. Specimens for Blood Bank testing with any type of mismatched or missing information must be redrawn.
Lab/Phone:
330-746-9623
Additional Info:
Sendout to St. Elizabeth's or Akron Childrens Hospital Akron Campus
CPT Code:
86880
Synonyms:
Antiglobulin Test; Direct; DAT; Direct Coombs
