Differential

Message

Performing Lab: All Sites

Test Code

3115

Alias/See Also

Sunquest: HEDF

CPT Codes
85004

Includes

Neutrophil % and Absolute, Lymphocyte % and Absolute, Monocyte % and Absolute, Eosinophil % and Absolute, Basophil % and Absolute, Immature Granulocyte % and Absolute Reflexes to when present: Metamyelocyte % and Absolute, Myelocyte % and Absolute, Promyelocyte % and Absolute, Blast % and Absolute, Plasma Cell % and Absolute

Preferred Specimen

4.0 mL EDTA Whole Blood (lavender-top) tube

Minimum Volume

1.0 mL - tube
250uL- microtainer

Other Acceptable Specimens

EDTA (pink-top), EDTA microtainer

Instructions

Ordering: Requires WBC to be ordered (Sunquest order code HEWBC)

Transport Temperature

Refrigerated

Specimen Stability

Refrigerated: 48 hours
HP Clinics: 24 hours

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

Clotted, Hemolyzed

Methodology
Automated

Setup Schedule

Hospital: Daily
Clinics: Monday - Friday

Report Available

Same Day

Limitations

HP Clinics: CG, HI, NK, & NSFPLL NSFPRV perform Hemoglobin and White Blood Count only

Reference Range

Differential
Absolute Neutrophils (PMN)	Age	Reference Range
	21 Years	1.8 - 7.7 k/µl
	16 Years	1.8 - 8.0 k/µl
	6 Years	1.5 - 8.0 k/µl
	1 Year	1.5 - 8.5 k/µl
	6 Months	1.0 - 8.5 k/µl
	7 Days	1.5 - 10.0 k/µl
	Newborn	6.0 - 26.0 k/µl
Absolute Lymphocytes	Age	Reference Range
	21 Years	1.0 - 4.8 k/µl
	16 Years	1.2 - 5.2 k/µl
	6 Years	1.5 - 7.0 k/µl
	4 Years	2.0 - 8.0 k/µl
	1 Year	4.0 - 10.5 k/µl
	1 Month	2.5 - 16.5 k/µl
	7 Days	2.0 - 17.0 k/µl
	Newborn	2.0 - 11.0 k/µl
Absolute Monocytes	Age	Reference Range
	18 Years	0.1 - 0.7 k/µl
	<18 Years	0.0 - 1.0 k/µl
Absolute Eosinophils	Age	Reference Range
Absolute Eosinophils	All ages	0.0 - 0.5 k/µl
Absolute Basophils	Age	Reference Range
Absolute Basophils	All ages	0.0 - 0.2 k/µl
Absolute Immature Granulocytes	Age	Reference Range
Absolute Immature Granulocytes	All ages	0.0 X 10³/μL
Absolute Reticulocyte	Age	Reference Range
	18 Years	0.03 - 0.06 M/µl
	4 Days	Reference interval not established for this age group
	Newborn	0.15 - 0.22 M/µl

Clinical Significance

Evaluate and monitor hematologic disorders and drug, radiation, bone marrow transplant therapy; with WBC count, calculate absolute numbers of leukocyte types; help distinguish bacterial and viral infections

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.