PLATELET MAPPING BY TEG

Message

If testing is not ordered in Epic a TEG Requisition Form MUST accompany the specimen. Call Hematology Lab 7-4230 before sending sample. Priority samples include those from OR, ED, and
ECMO/PICU.

Test Code

LAB1231235

Includes

Percent Inhibitor to ADP,arachidonic acid and clot strength.

Preferred Specimen

One 2.7 mL adult dark green top tube(no Gel). An Epic order or TEG Requisition Form must accompanyspecimens.

Instructions

Call Hematology Lab 7-4230 before collecting samples
Collect samples using 21 gauge needle or larger. NO BUTTERFLIES, if possible must be 21 gauge
Draw 1 Blue Top waste tube and DISCARD before collecting sample
Completely fill 1 Dark Green Tube (no gel, 5 or 7 mL), Mix well, label, and record collection time on tube
If samples are collected from a line first collect 5 mL waste prior to samples for testing.
Samples CANNOT be used for other testing
Outpatient collection must be done in the Physician Office Lab

Hand delivery of samples is preferred. Pneumatic tube delivery is acceptable. Emergent/Trauma cases should be hand delivered to the lab to expedite testing.

Not available for outreach clients.

Specimen Stability

Stable 2 hours, hand deliver to the lab immediately.

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

Samples greater than 2 hours old, clotted samples, under-filled samples. Tubes other than Becton Dickinson (BD)

Methodology
Thromboelastography on Haemonetics instruments

Setup Schedule

Sunday- Saturday

Reference Range

HKH: 53-68 mm
Act F 2-19 mm
ADP-MA: 45-69 mm
ADP % inhibitor: 0-17 %
AA-MA: 51-71mm
AA % inhibitor: 0-11%

Performing Laboratory
West Virginia University Hospital, Inc.
Berkeley Medical Center

Additional Information
TEG Requisition

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.