Test Code HGB Hemoglobin Level
Specimen Type
Blood
Container/Tube
Lavender top, EDTA
Turnaround Time
4 hour
STAT Days and Times Performed
24/7
Days and Times Performed
24/7
Method Name
Sysmex XN automated hematology analzyer
Fee Code
53228
Preferred Volume
4 mL
Critical Results
HGB: <6.0 or > 20.0 (g/dL)
Test Limitations
Transportation temperature: specimen cannot be frozen or heated.
Refrigerate sample if transportation is delayed
Rejection criteria: clotted or short specimen volume; microclot
formation; improper tube
Coverage Information
CMS has established a national coverage policy (NCD) for
Medicare for this test as of November 25, 2002. Please document
medical necessity.
Specimen Minimum Volume
- 2 mL blood in 4 mL tube
- 1.5 mL blood in 3 mL tube.
- If a microvette is collected, the minimum volume is 250 µL
CPT
85018
Reference Values
Parameter |
Age | Male & Female |
Male | Female | Units |
HGB | 0 days | 13.2 – 19.1 | g/dL | ||
1 day | 14.2 – 22.1 | g/dL | |||
7 days | 13.2 – 21.1 | g/dL | |||
14 days | 12.3 – 20.1 | g/dL | |||
1 month | 9.8 – 17.6 | g/dL | |||
2 months | 8.8 – 13.7 | g/dL | |||
3 months | 9.3 – 13.2 | g/dL | |||
6 months | 10.3 – 13.2 | g/dL | |||
2 years | 11.3 – 13.2 | g/dL | |||
6 years | 11.3 – 15.2 | g/dL | |||
12 years & up | 13.5 – 17.5 | 11.5 – 15.5 | g/dL |
STAT Turnaround Time
1 hour