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Test Code Bone Marrow Order Set Bone Marrow Biopsy Panel 

Important Note

Bone Marrow biopsy requires scheduling with the laboratory. 

For Hyde Park scheduling, refer to Bone Marrow Scheduling Policy

Refer to Epic Tip sheet for ordering guidance UCM Tip Sheet Bone Marrow Order Set.pdf (uchicagomedicine.org)

Specimen and Container/Tube

Specimen Type: Bone marrow

Preferred Specimen: based on test order requirements, refer to specific test codes for additional details

Other Acceptable Specimens: not applicable 

Specimen Handling and Transport Instructions

UCMC Onsite Instructions: Procedure assisted collection by laboratory personnel.

UCMC Offsite and UC MedLab Outreach Instructions: Procedure assisted collection by laboratory personnel.

Rejection Criteria

  • Common specimen rejected situations include: incorrect specimen type, insufficient volume, missing or incomplete specimen identifiers, incorrect specimen transport, or specimens outside stability limits.

Reference Values

Analyte

Age

Sex

Reference Range

Blast

All

Male and female

0.1 – 1.7 %

Promyelocyte 

All

Male and female

1.9 – 4.7 %

Myelocyte

All

Male and female

8.5 – 16.9 %

Metamyelocyte

All

Male and female

7.1 – 24.7 %

Band

All

Male and female

9.4 – 15.4 %

Segmented neutrophil

All

Male and female

3.8 – 11.0 %

Eosinophilic myelocyte

All

Male and female

0.2 – 1.4 %

Eosinophil

All

Male and female

0.2 – 6.0 %

Basophil

All

Male and female

0.0 – 0.2 %

Lymphocyte

All

Male and female

8.6 – 23.8 %

Plasma cell

All

Male and female

0.0 – 3.5 %

Monocyte

All

Male and female

0.0 – 0.6 %

Mast cell

All

Male and female

0.0 – 0.2 %

Histiocyte

All

Male and female

0.0 – 0.8 %

Erythrocyte precursors

All

Male and female

14.8 – 37.3 %

Changes in Differential Counts of Bone Marrow with Age

Cell Type

Limits

Age Specific Limits (percentages)

Birth

1 Week

1 week to 1 year

1 -4 years

4 – 12 years

12 years and up

Neutrophilic series

0%

54

65

37

50

52

57

95%

31 – 77

21 - 79

22 – 52

32 - 68

35 – 69

39 – 79

Eosinophilic series

0%

3

3

6

3

3

 

95%

1 – 5

1 – 5

1 – 5

2 – 10

1 – 5

1 – 5

Lymphocytes

0%

6

13

36

22

18

17

95%

2 – 10

7 – 19

15 – 54

8 – 36

12 – 28

10 – 24

Erythrocytic series

0%

34

15

17

19

21

20

95%

18 – 50

5 – 25

7 – 27

11 – 27

11 – 31

10 – 30

ME Ratio

0%

1.6

4.3

2.2

2.6

2.5

2.6

Adapted from Wintrobe’s Clinical Hematology

Critical Values

Not applicable 

Turnaround Time

Turnaround times are relative to the time the specimen is received in the test laboratory. 

 

STAT Turnaround Time: 24 - 48 hours 

Routine Turnaround Time: 24 - 48 hours 

 

Testing Schedule: Hyde Park procedures are performed Monday - Thursday from 8:00 - 4:00 pm and Fridays from 8:00 - 1:00 pm. Procedures after 1:00 pm on Friday may experience turnaround time delays and decreased specimen viability.

Bone marrow requests outside of normal hours (8:00 am – 4:00 pm Monday through Thursday and 8:00 am to 1:00 pm on Friday) require approval from the Medical Director, Lab Manager, or Pathologist.

Add-on same-day procedures are performed on a first-come, first-serve basis, and time slots may be limited depending on staffing availability.

CPT Codes

88305, 88311, 88313, 85060, 88305, 85097, 88313

LOINC Codes

Not applicable 

Volume

Preferred Volume: not applicable

Minimum Volume: not applicable

Specimen Stability

Storage Temperature

Stability

Room temperature

(20 - 25°C)

 collected by laboratory personnel

Refrigerated

(2 - 10°C)

 collected by laboratory personnel

Frozen

(-20°C)

not acceptable

Collection Instructions

Procedure-assisted collection by laboratory personnel. Required scheduling with the laboratory.

For Hyde Park, call the Hematology laboratory at 773-702-1314. For non-Hyde Park locations, contact the onsite laboratory. 

Test Components

Hematopathology case report including bone marrow differential, bone marrow core biopsy, bone marrow aspirate smear, bone marrow touch prep and clot section, gross descriptions, synoptic report, final diagnosis, and may include special stains and flow cytometry as applicable. 

Clinical Indications

  • Screening test for various diseases
  • Useful in the diagnosis of disease states such as anemias, leukemias, allergic reactions, viral, bacterial, and parasitic infections. 

Methodology

Wright-Giemsa stain and light microscopy, iron stain, and as applicable special stains and flow cytometry 

Synonyms/Search Keywords

Bone marrow, Hemepath 

Additional Information

The Clinical Hematology Laboratory provides specimen collection assistance during bone marrow procedures. Laboratory technologist or technician will come to the patient area and assist in the collection process, making aspirate smears, and routing specimens to testing laboratories. Bone marrow procedure should be pre-scheduled with Hyde Park Hematology Laboratory or an offsite laboratory. Procedure areas including IVTH and Pediatric outpatient clinic provide an electronic schedule in advance to the Hematology Lab. Changes to this schedule including delays and cancellations should be communicated to the laboratory.

Patients must have EPIC orders placed for bone marrow procedures as well as corresponding test orders such as flow, cytogenetics, molecular, etc. prior to the procedure. Refer to Epic Tip Sheet: Orders - Bone Marrow Order Set for additional information. 

Last Reviewed Date

9/6/2024