Glucose Phosphate Isomerase, B
| 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. Glucose Phosphate Isomerase, B | |
| 2. | |
| 3. | |
| 4. | |
| 5. | |
| 6. | |
| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
GPIB
Test Workstation :
MAYO
Specimen Type:
Whole Blood
Tube Type:
Yellow top (ACD Solution B) tube: Whole Blood
Alternate Tube Type:
Lavender Top- EDTA
Collection Volume:
6.0 mL (minimum 1.0 mL)
Cause for Rejection:
Specimen that has been frozen. Gross Hemolysis.
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Kinetic Spectrophotometry
Lab/Phone:
330-543-8418
TAT:
1-6 days
Additional Info:
The evaluation of individuals with Coombs-negative chronic hemolysis.
Reference range:
> or = 12 months: 40.0-58.0 U/g hemoglobin
(Reference values have not been established for patients who are <12 months of age).
CPT Code:
84087
Synonyms:
Glucose Phosphate Isomerase (RBC)
