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9064 MML Test Setup(2)

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Page 1: 9064 MML Test Setup(2)

Test Definition: FRAGOsmotic Fragility, Erythrocytes

Reporting Title: Osmotic Fragility, RBCPerforming Location: Rochester

Specimen Requirements:See Recommendations for Collection of Control Specimens for FRAG, HSEP, and HAEVP in Special Instructions. Specimens must arrive in the testing laboratory within 96 hours of draw. A whole blood EDTA specimen and a control specimen are required. Patient:Container/Tube: Lavender top (EDTA)Specimen Volume: 4 mLCollection Instructions:1. Immediately refrigerate specimen after draw.2. Do not transfer blood to other containers.3. Rubber band patient specimen and control vial together.Additional Information: Patient's age and sex are required.Forms: If not ordering electronically, please submit a Hematopathology/Molecular Oncology Request Form (SupplyT241) with the specimen. Normal Control:Specimen Type: Whole bloodContainer/Tube: Lavender top (EDTA)Specimen Volume: 4 mLCollection Instructions:1. Draw a control specimen at the same time from a normal, unrelated, non-smoking individual.2. Clearly write normal control on outermost label and also indicate sex of control on same label.3. Immediately refrigerate specimen after draw.4. Do not transfer blood to other containers.5. Rubber band patient specimen and control vial together.

Specimen Type Temperature Time

Control Refrigerated 4 days

Whole Blood EDTA Refrigerated 4 days

Ask at Order Entry (AOE) Questions:

Test ID Question ID Description Type Reportable

Document generated May 11, 2014 at 9:56pm CDT Page 1 of 3

Page 2: 9064 MML Test Setup(2)

Test Definition: FRAGOsmotic Fragility, Erythrocytes

Test ID Question ID Description Type Reportable

SCTRL SCTRL Sex of Control Vial:• Male• Female

Answer List Yes

Result Codes:

Result ID Reporting Name Type Unit LOINC®

9064 Osmotic Fragility, RBC Numeric 34964-7

3306 Osmotic Fragility, 0.50 g/dL NaCl Numeric %hemol 23915-2

3307 Osmotic Fragility, 0.60 g/dL NaCl Numeric %hemol 23917-8

3308 Osmotic Fragility, 0.65 g/dL NaCl Numeric %hemol 23919-4

3309 Osmotic Fragility, 0.75 g/dL NaCl Numeric %hemol 30543-3

3310 Osmotic Fragility Comment Alphanumeric In Process

SCTRL Sex of Control Vial Alphanumeric N/A

Components:

Test ID Reporting Name CPT Units CPT Code AlwaysPerformed

OrderableSeparately

FRAGO Osmotic Fragility Yes No

SCTRL Sex of Control Vial Yes No

CPT Code Information:

85557

Reference Values:

0.50 g/dL NaCl (unincubated) Males: 0.0-47.8% hemolysis Females: 0.0-31.1% hemolysis   0.60 g/dL NaCl (incubated) Males: 18.7-67.4% hemolysis Females: 10.9-65.5% hemolysis   0.65 g/dL NaCl (incubated)

Document generated May 11, 2014 at 9:56pm CDT Page 2 of 3

Page 3: 9064 MML Test Setup(2)

Test Definition: FRAGOsmotic Fragility, Erythrocytes

Males: 4.4-36.6% hemolysis Females: 0.2-39.3% hemolysis   0.75 g/dL NaCl (incubated) Males: 0.8-9.1% hemolysis Females: 0.0-10.9% hemolysis

Document generated May 11, 2014 at 9:56pm CDT Page 3 of 3