Gestational 3HR Challenge
| PATIENT INFO |
| Patient Name: |
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| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
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| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
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| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Gestational 3HR Challenge | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
MG3HR
Test Workstation :
MACH3
Specimen Type:
Blood
Tube Type:
Green top ( lithium heparin) tube
Collection Volume:
500 uL microtainer; 1.5 mL macrotainer
Minimum Volume:
500 uL microtainer; 1.5 mL macrotainer
Preferred Volume:
500 uL microtainer; 1.5 mL macrotainer
Storage:
Shipping: Send Refrigerated; Storage: Room Temp: 8 hours; Refrigerated: 72 hours.
Availability:
Mon-Fri, call for appointment
Methodology:
Roche- UV test
Special Instructions:
Separate plasma from cells ASAP.
Prior to drawing patient, see Specimen Collection Procedure Glucose Tolerance Testing.
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/draw
Additional Info:
Criteria for Diagnosis of Gestational Diabetes Mellitus(GDM)
100g, 3HR Glucose Challenge
The Diagnosis of GDM is made when two or more of the
following plasma glucose values are exceeded:
Fasting >=95 mg/dl
1HR Glucose >=180 mg/dl
2HR Glucose >=155 mg/dl
3HR Glucose >=140 mg/dl
CPT Code:
82951, 82952
