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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