CBC WITH DIFFERENTIAL

Message

Hematology

Test Code

LAB293

Alias/See Also

Complete Blood Count with Differential
CBC Auto Diff
CBC DIFF

CPT Codes
85025

Includes

WBC, RBC, HGB, HCT, MCV, MCH, MCHC, RDW-CV, RDW-SD, PLT, MPV, NRBC%

Neut Abs, Neut %, Lymph Abs, Lymph %, Mono Abs, Mono %, Eos Abs, Eos %, Baso Abs, Baso %, IG Abs, IG %

May reflex the following:
Reticulocyte Battery (Retic Abs, Retic %, IRF%, Ret-He)
Immature Platelet Fraction
Smear Review
Manual Differential
Pathology Review

Preferred Specimen

2.5 mL whole blood (lavender top tube, EDTA)

Minimum Volume

1.0mL

Other Acceptable Specimens

Microtainer fingerstick/heelstick (neonates)

Instructions

**Testing must be completed within 24 hours of collection.

Transport Temperature

Never place whole blood on ice or transport frozen.

Specimen Stability

Room Temp 24 hours
Refrigerated 48 hours
Allow refrigerated samples to come to room temperature and mix well before analysis.

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Hemolyzed
Contaminated
Clotted
QNS

Methodology
The analyzer performs hematology analysis according to the hydrodynamic focusing (DC Detection), flow cytometry method (semiconductor laser), and SLS-hemoglobin method.

The device counts and sizes red blood cells (RBC) and platelets (PLT) using electronic resistance detection. Hematocrit (HCT) is measured as a ratio of the total RBC volume to whole blood using cumulative pulse height detection. Hemoglobin (HGB) is converted to SLS-hemoglobin and read photometrically.

The white blood cell (WBC) count, differential (DIFF), reticulocytes (RET), nucleated red blood cells (NRBC) and fluorescent platelets (PLT-F) are all evaluated using flow cytometry with a semiconductor laser exploiting the differences in cell size, complexity, and RNA / DNA content. Forward scattered light provides information on blood cell size and lateral scattered light provides information on the cell interior such as the size of the nucleus. Lateral fluorescent light intensity increases as the concentration of the stain becomes higher. By measuring the intensity of the fluorescence emitted, information is obtained on the degree of blood cell staining. Fluorescent light is emitted in all directions. The Sysmex XN detects the fluorescent light that is emitted sideways.

Setup Schedule

Same day. Available STAT.

Report Available

Same day

Limitations

Severely hemolyzed samples (in vitro) falsely decrease RBC and hematocrit. Recollect hemolyzed specimens.
Severely icteric samples may falsely elevate the HGB value and related indices.
Extremely elevated WBC counts may cause turbidity and falsely increase the hemoglobin, RBC and HCT values.
Platelet clumping and/or "platelet satellitism" may occur in specimens collected in EDTA. Methods for handling samples with platelet clumping or "platelet satellitism" include: vortexing the original sample and reanalyzing or redrawing the patient sample in a blue top and testing within 30 min of draw.

Reference Range

Refer to CBC report for individual Reference Ranges

Clinical Significance

The Sysmex XN Hematology module is a quantitative automated hematology analyzer for in vitro diagnostic use in determining 31 whole blood diagnostic parameters and seven body fluid diagnostic parameters. Examination of the numerical and/or morphological findings of the complete blood count by the physician are useful in the diagnosis of disease states such as anemias, leukemias, allergic reactions, viral, bacterial, and parasitic infections.

Performing Laboratory
HHN/HHI

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.