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22729 Executive Panel with Differential

Executive Panel with Differential
Test Code: EPD
Test Components
Albumin, Alkaline Phosphatase, Alanine Amino Transferase, Aspartate Amino Transferase, Bicarbonate, Urea Nitrogen, Calcium, Chloride, Creatinine, Glucose, Potassium, Sodium, Total Bilirubin, Direct Bilirubin, Indirect Bilirubin, Gamma Glutamyl Transferase, Lactate Dehydrogenase, Total Protein, Anion Gap, Uric Acid, Phosphorus, Cholesterol, Triglycerides, LDL Cholesterol, A/G ratio, BUN/Creat Ratio, TSH, White Blood Cell count, Red Blood Cell count, Hemoglobin, Hematocrit, Mean Corpuscular Volume, Mean Corpuscular Hemoglobin, Mean Corpuscular Hemoglobin Concentration, Red Cell Distribution Width, Platelet, Mean Platelet Volume, Percent/Absolute Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils, any abnormal nucleated cells present (including blasts and NRBC's), and RBC and Platelet morphology​
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​No Serum and EDTA Whole Blood​ Red Top Tube (RTT) and EDTA Lavendar Top Tube (LTT)​ ​ 3.0 mL (RTT) and 5.0 mL (LTT)​ 1.0 mL (RTT) and 2.0 mL (LTT)​ ​
Collection Processing Instructions
Centrifuge and remove serum from cells within one hour.
 
Test panel includes bilirubin which is light sensitive, minimize light exposure during storage/transport.
 
Prepare 2 blood smears as soon as possible, preferably within two hours of collection, up to 24 hours, label with computer generated label or use pencil to label with patients full name and date. Store slides at room temperature.​
Specimen Stability Information
Specimen Type Temperature Time
Serum, Whole Blood​ Refrigerate​ <48 hours​
Whole Blood​ Ambient​ <24 hours​
Whole Blood​ Refrigerate​ >48 hours may be reported with additional comments​
Blood slides (smears)​ Ambient​ <30 days​
Rejection Criteria
Grossly hemolyzed samples
Clotted whole blood​
Frozen whole blood​
Serum specimens not separated from cells <2 hours​
Whole blood diluted with IV or tissue fluid​
Interference
Hemolyzed samples will falsely increase K and AST
Exposure to light will falsely decrease TBIL​
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Sunday​ 2-4 hours​ See individual tests for methodology/Beckman DXC, DxI and DxH800, Light Microscopy ​
Test Information
Medicare patients must sign a waiver before specimen is collected since Medicare considers this a non-covered screening panel.  Individual tests ordered for diagnostic purposes are covered.​
Reference Range Information
Performing Location Reference Range
Marshfield ​ See individual test listings for reference ranges​
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
80053 ​ ​ ​ Metabolic Panel, Comprehensive​ ​
84443 ​ ​ ​TSH ​
85025 ​ ​ ​Hemogram and plt count, automated ​
82465 ​ ​ ​Cholesterol ​
82977​ ​ ​ ​GGT ​
83615​ ​ ​ ​LDH ​
84100​ ​ ​ ​Phosphorus ​
84550 ​ ​ ​Uric Acid ​
​84478 ​ ​ ​Triglyceride ​
Test Components
Albumin, Alkaline Phosphatase, Alanine Amino Transferase, Aspartate Amino Transferase, Bicarbonate, Urea Nitrogen, Calcium, Chloride, Creatinine, Glucose, Potassium, Sodium, Total Bilirubin, Direct Bilirubin, Indirect Bilirubin, Gamma Glutamyl Transferase, Lactate Dehydrogenase, Total Protein, Anion Gap, Uric Acid, Phosphorus, Cholesterol, Triglycerides, LDL Cholesterol, A/G ratio, BUN/Creat Ratio, TSH, White Blood Cell count, Red Blood Cell count, Hemoglobin, Hematocrit, Mean Corpuscular Volume, Mean Corpuscular Hemoglobin, Mean Corpuscular Hemoglobin Concentration, Red Cell Distribution Width, Platelet, Mean Platelet Volume, Percent/Absolute Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils, any abnormal nucleated cells present (including blasts and NRBC's), and RBC and Platelet morphology​
Ordering Applications
Ordering Application Description
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​No Serum and EDTA Whole Blood​ Red Top Tube (RTT) and EDTA Lavendar Top Tube (LTT)​ ​ 3.0 mL (RTT) and 5.0 mL (LTT)​ 1.0 mL (RTT) and 2.0 mL (LTT)​ ​
Collection Processing
Centrifuge and remove serum from cells within one hour.
 
Test panel includes bilirubin which is light sensitive, minimize light exposure during storage/transport.
 
Prepare 2 blood smears as soon as possible, preferably within two hours of collection, up to 24 hours, label with computer generated label or use pencil to label with patients full name and date. Store slides at room temperature.​
Specimen Stability Information
Specimen Type Temperature Time
Serum, Whole Blood​ Refrigerate​ <48 hours​
Whole Blood​ Ambient​ <24 hours​
Whole Blood​ Refrigerate​ >48 hours may be reported with additional comments​
Blood slides (smears)​ Ambient​ <30 days​
Rejection Criteria
Grossly hemolyzed samples
Clotted whole blood​
Frozen whole blood​
Serum specimens not separated from cells <2 hours​
Whole blood diluted with IV or tissue fluid​
Interference
Hemolyzed samples will falsely increase K and AST
Exposure to light will falsely decrease TBIL​
Test Components
Albumin, Alkaline Phosphatase, Alanine Amino Transferase, Aspartate Amino Transferase, Bicarbonate, Urea Nitrogen, Calcium, Chloride, Creatinine, Glucose, Potassium, Sodium, Total Bilirubin, Direct Bilirubin, Indirect Bilirubin, Gamma Glutamyl Transferase, Lactate Dehydrogenase, Total Protein, Anion Gap, Uric Acid, Phosphorus, Cholesterol, Triglycerides, LDL Cholesterol, A/G ratio, BUN/Creat Ratio, TSH, White Blood Cell count, Red Blood Cell count, Hemoglobin, Hematocrit, Mean Corpuscular Volume, Mean Corpuscular Hemoglobin, Mean Corpuscular Hemoglobin Concentration, Red Cell Distribution Width, Platelet, Mean Platelet Volume, Percent/Absolute Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils, any abnormal nucleated cells present (including blasts and NRBC's), and RBC and Platelet morphology​
Reference Range Information
Performing Location Reference Range
Marshfield ​ See individual test listings for reference ranges​
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Sunday​ 2-4 hours​ See individual tests for methodology/Beckman DXC, DxI and DxH800, Light Microscopy ​
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
80053 ​ ​ ​ Metabolic Panel, Comprehensive​ ​
84443 ​ ​ ​TSH ​
85025 ​ ​ ​Hemogram and plt count, automated ​
82465 ​ ​ ​Cholesterol ​
82977​ ​ ​ ​GGT ​
83615​ ​ ​ ​LDH ​
84100​ ​ ​ ​Phosphorus ​
84550 ​ ​ ​Uric Acid ​
​84478 ​ ​ ​Triglyceride ​
For most current information refer to the Marshfield Laboratory online reference manual.