A slide will be sent for pathologist review if any of the following abnormalities are present and have not been reported in the past week (there are some exceptions for Primary Children's Hospital):
1.) Blasts - Chemo/growth factor exception: Few nonneoplastic blasts are expected in patients recovering from recent chemotherapy or receiving growth factors (GCSF, GMCSF, Neulasta, Neupogen). If patient has recently (<1 month) received chemotherapy or growth factors as documented in the medical record or confirmed by provider (and are < 20% and lack Auer rods), append to the differential comment code in WAM or GUI keyboards (DCOM) the following: “Patient with recent chemotherapy or growth factors. Pathologist review upon request." If suspected acute leukemia blasts are >=20%, or blasts have Auer rods, or there are cytopenia(s) [absolute neutrophils <1.8 K/uL, Hgb <10 g/dL, platelets <100 K/uL)] which are unexplained by recent chemotherapy or growth factors, contact the on-call pathologist STAT.
2.) Lymphoma cells/neoplastic lymphocyte - CLL exception: If the patient has a history of CLL AND morphology is consistent with CLL, append to the differential comment code in WAM or GUI keyboards (DCOM) the following: “Patient with reported history of CLL. Pathologist review upon clinician request."
3.) Plasma cells >1%
4.) Bacteria, yeast or parasites. Contact the on-call pathologist, STAT.
5.) >= 2+ schistocytes, or, >= 1+ schistocytes and platelets <150 K/uL; exception for neonates <28 days, and PCH smears. If suspected microangiopathic hemolysis (schistocytes are predominant RBC abnormality, and platelets <35 K/uL), contact the on-call pathologist STAT.
6.) Sickle cells in patient without history of sickle cell disease.
7.) Any smear containing other features that are not readily classified by the screening technologist(s). If possible, include pictures of cells involved.
Lab Department
Hematology
Testing Location
Intermountain
Synonyms
CBC
Complete Blood Count
Diff
Manual diff
Man diff
PIH,Pre-eclampsia
smear review
Peripheral blood smear
Peripheral smear
CPT Codes
85007, 85027
Updated
02 11 21
Interface Order Code (OBR)
CBCMD
Interface Result Code (OBX)
CBC,DMAN
Collecting
Collect
1 Lavender (K2 EDTA)
Collect, Minimum Volume
1 mL blood
Pediatric Collection
1 Lavender (K2 EDTA) microtainer filled between the lines
Storage/Transport Temperature
Whole blood, room temperature or refrigerated
If specimen cannot be analyzed immediately after collection, store refrigerated at 2-8°C
Stability (from collection to initiation)
Room temperature: Vacutainer (2,3, or 4 mL) 24 hrs Microtainer MAP (Microtube for Automated Process) / RBT (Raised Bottom Tube) 12 hrs Microtainer 4 hrs Refrigerated: Vacutainer (2,3, or 4 mL) 24 hrs Microtainer MAP (Microtube for Automated Process) / RBT (Raised Bottom Tube) 12 hrs Microtainer 4 hrs Frozen: DO NOT FREEZE
Unacceptable Conditions
Frozen
Remarks
For a pre-eclampsia (PIH) panel, order CBC and CMP
A slide will be sent for pathologist review if any of the following abnormalities are present and have not been reported in the past week (there are some exceptions for Primary Children's Hospital):
1.) Blasts - Chemo/growth factor exception: Few nonneoplastic blasts are expected in patients recovering from recent chemotherapy or receiving growth factors (GCSF, GMCSF, Neulasta, Neupogen). If patient has recently (<1 month) received chemotherapy or growth factors as documented in the medical record or confirmed by provider (and are < 20% and lack Auer rods), append to the differential comment code in WAM or GUI keyboards (DCOM) the following: “Patient with recent chemotherapy or growth factors. Pathologist review upon request." If suspected acute leukemia blasts are >=20%, or blasts have Auer rods, or there are cytopenia(s) [absolute neutrophils <1.8 K/uL, Hgb <10 g/dL, platelets <100 K/uL)] which are unexplained by recent chemotherapy or growth factors, contact the on-call pathologist STAT.
2.) Lymphoma cells/neoplastic lymphocyte - CLL exception: If the patient has a history of CLL AND morphology is consistent with CLL, append to the differential comment code in WAM or GUI keyboards (DCOM) the following: “Patient with reported history of CLL. Pathologist review upon clinician request."
3.) Plasma cells >1%
4.) Bacteria, yeast or parasites. Contact the on-call pathologist, STAT.
5.) >= 2+ schistocytes, or, >= 1+ schistocytes and platelets <150 K/uL; exception for neonates <28 days, and PCH smears. If suspected microangiopathic hemolysis (schistocytes are predominant RBC abnormality, and platelets <35 K/uL), contact the on-call pathologist STAT.
6.) Sickle cells in patient without history of sickle cell disease.
7.) Any smear containing other features that are not readily classified by the screening technologist(s). If possible, include pictures of cells involved.
