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Specimen Collection Manual and Test Catalog

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CBC WITH WBC DIFFERENTIAL

Geisinger Epic Procedure Code:  LAB1963    Geisinger Epic ID:  14855

SPECIMEN COLLECTION
Specimen type: 

Whole blood


Preferred collection container: 
Alternate collection container: 
Lavender-top (K2 EDTA) microcollection tube
Specimen required: 

3 mL lavender-top (K2 EDTA) tube MUST be properly filled to at least 1.5 mL (half the fill volume of the tube). 
Lavender-top (K2 EDTA) microcollection tube MUST be properly filled to at least 250 uL (half the fill volume of the tube).



SPECIMEN PROCESSING
Processing instructions: 

Do NOT centrifuge.


Transport temperature: 

Refrigerated (preferred) or room temperature.


Specimen stability: 

CBC: Refrigerated: 72 hours. Room temperature: 24 hours. 
DIFF: Refrigerated: 72 hours. Room temperature: 24 hours.


Rejection criteria: 

Clotted, frozen, underfilled, overfilled, hemolyzed, or centrifuged specimens. Specimens beyond stability limits.



TEST DETAILS
Reference interval: 
 AgeMalesFemales
WBC   
 16 y/Adult4.00 -10.80 K/uL4.00-10.80 K/uL
 6 y4.00-13.50 K/uL4.00-13.50 K/uL
 2 y5.00-15.50K/uL5.00-15.50 K/uL
 1 month5.00-17.50 K/uL5.00-17.50 K/uL
 3 days5.00-21.00 K/uL5.00-21.00 K/uL
 Newborn9.00-30.00 K/uL9.00-30.00 K/uL
    
 
RBC18 y/Adult4.28-5.64 M/uL3.85-5.15 M/uL
 12 y4.50-5.30 M/uL3.85-5.15 M/uL
 6 y4.00-5.20 M/uL3.85-5.15 M/uL
 2 y3.90-5.30 M/uL3.90-5.30 M/uL
 6 months3.70-5.30 M/uL3.70-5.30 M/uL
 3 months3.10-4.50 M/uL3.10-4.50 M/uL
 2 months2.70-4.90 M/uL2.70-4.90 M/uL
 1 month3.00-5.40 M/uL3.00-5.40 M/uL
 14 days3.60-6.20 M/uL3.60-6.20 M/uL
 7 days3.90-6.30 M/uL3.90-6.30 M/uL
 Newborn4.10-6.10 M/uL4.10-6.10 M/uL
 
Hemoglobin   
 18y/Adult13.0-16.9 gm/dL12.0-15.3 gm/dL
 1213.0-16.0 gm/dL12.0-16.0 gm/dL
 611.5-15.5 gm/dL11.5-15.5 gm/dL
 211.5-13.5 gm/dL11.5-13.5 gm/dL
 6 months10.5-13.5 gm/dL10.5-13.5 gm/dL
 3 months9.5-13.5 gm/dL9.5-13.5 gm/dL
 2 months9.0-13.0 gm/dL9.0-13.0 gm/dL
 1 month10.0-18.0 gm/dL10.0-18.0 gm/dL
 14 days12.5-20.5 gm/dL12.5-20.5 gm/dL
 7 days13.5-21.5 gm/dL13.5-21.5 gm/dL
 Newborn14.5-22.5 gm/dL14.5-22.5 gm/dL
 
Hematocrit   
 18y/Adult39.1-49.5%36.0-45.2%
 12 y37.0-49.0%36.0-46.0%
 6 y35.0-45.0%35.0-45.0%
 2 y34.0-40.0%34.0-40.0%
 6 months33.0-39.0%33.0-39.0%
 3 months29.0-41.0%29.0-41.0%
 2 months28.0-42.0%28.0-42.0%
 1 month31.0-55.0%31.0-55.0%
 14 days39.0-63.0%39.0-63.0%
 7 days42.0-66.0%42.0-66.0%
 Newborn45.0-67.0%45.0-67.0%
    
 
MCV18 y.Adult82.0-99.5 fL81.5-97.5 fL
 12 y78.0-98.0 fL78.0-98.0 fL
 6 y77.0-95.0 fL77.0-95.0 fL
 2 y75.0-87.0 fL75.0-87.0 fL
 6 months70.0-86.0 fL70.0-86.0 fL
 3 months74.0-108.0 fL74.0-108.0 fL
 2 months77.0-115.0 fL77.0-115.0 fL
 1 month85.0-123.0 fL85.0-123.0 fL
 Newborn88.0-126.0 fL88.0-126.0 fL
    
 
MCH18 y/Adult27.0-34.0 pg27.0-34.0 pg
 12 y25.0-35.0 pg25.0-35.0 pg
 6 y25.0-33.0 pg25.0-33.0 pg
 2 y24.0-30.0 pg24.0-30.0 pg
 6 months23.0-31.0 pg23.0-31.0 pg
 3 months25.0-35.0 pg25.0-35.0 pg
 2 months26.0-34.0 pg26.0-34.0 pg
 1 month26.0-34.0 pg26.0-34.0 pg
 7 days28.0-40.0 pg28.0-40.0 pg
 Newborn31.0-37.0 pg31.0-37.0 pg
 
MCHCAll ages32.0-36.0 gm/dL32.0-36.0 gm/dL
RDWAll ages11.5-15.5%11.5-15.5%
PLTAll ages140-400 K/uL140-400 K/uL
MPVAll ages6.6-11.1 fL6.6-11.1 fL
DifferentialAgePercentageAbsolute
Neutrophils21 y/Adult40-75%1.8-7.7
 20 y40-75%1.8-8.0
 14 y35-65%1.8-8.0
 10 y30-60%1.8-8.0
 6 y30-60%1.5-8.0
 4 y30-60%1.5-8.5
 1 y27-51%1.5-8.5
 6 months27-51%1.0-8.5
 30 days27-51%1.0-9.0
 14 days27-51%1.0-9.5
 7 days27-51%1.5-10.0
 5 days27-51%5.0-21.0
 3 days37-67%5.0-21.0
 Newborn37-67%6.0-26.0
    
 
Lymphocytes21 y/Adult18-42%1.0-4.8
 20 y18-42%1.2-5.4
 16 y23-53%1.2-5.4
 12 y23-53%1.5-7.0
 6 y29-65%1.5-7.0
 4 y29-65%2.0-8.0
 2 y16-46%3.0-9.5
 1 y16-46%4.0-10.5
 6 months16-46%4.0-13.5
 1 month16-46%2.5-16.5
 7 days16-46%2.0-17.0
 4 days16-46%2.0-11.5
 Newborn18-38%2.0-11.5
    
 
Monocytes18 y/Adult1-11%0.0 - 1.1
 12 y1-11%0.0 - 1.2
 4 y1-11%0.0 - 1.4
 2 y1-11%0.0 - 1.6
 1 y1-11%0.0 - 1.7
 1 month1-11%0.0 - 1.8
 Newborn (0 days)1-11%0.0 - 2.0
    
 
Eosinophils12 y/Adult0-6%0.0 - 0.7
 4 y0-6%0.0 - 0.8
 2 y0-6%0.0 - 0.9
 1 y0-6%0.0 - 1.0
 1 month0-6%0.0 - 1.1
 Newborn (0 days)0-6%0.0 - 1.2
    
 
Basophils12 y/Adult0-2%0.0 - 0.2
 1 y0-2%0.0 - 0.3
 Newborn (0 days)0-2%0.0 - 0.4
    
 
Immature Granulocytes16 y/Adult0-2%0.0 - 0.2
 6 y0-2%0.0 - 0.3
 2 y0-2%0.0 - 0.3
 1 month0-2%0.0 - 0.4
 3 days0-2%0.0 - 0.4
 Newborn (0 days)0-2%0.0 - 0.6

Adult ranges established by normal study performed at GMC and GWV Sysmex validation in 2010. Pediatric ranges from Nathan and Oski's "Hematology of Infancy and Childhood, 7th edition."


Critical values/courtesy alerts: 
See individual member listings
Additional information: 

Patient with clumped platelets will result an estimate only (decreased, adequate, increased). For EDTA platelet clumping, order platelet count for patients with platelet clumping (LAB2859), an additional blue-top (sodium citrate) tube is required.

Potential related available add on testing includes: CBC with WBC differential (LAB1963); reticulocyte panel (LAB3006); immature platelet fraction (LAB2524) can only be added if sample is collected at testing laboratory. 

See individual test requirements.


CPT code(s):  Varies with differential methodology
Note: The billing party has sole responsibility for CPT coding.  Any questions regarding coding should be directed to the payer being billed.
The CPT codes provided by GML are based on AMA guidelines and are for informational purposes only.

Test includes: 

WBC, RBC, HGB, HCT, MCV, MCH, MCHC, RDW, PLT, MPV and WBC differential with absolute values and percentages. The CBC analyzer will flag certain abnormalities for manual review. A technologist performed WBC differential and/or morphology scan may be automatically performed. Technologist may identify abnormalities that require additional pathologist review.


Methodology: 
Electronic resistance detection enhanced by hydrodynamic focusing and flow cytometry
Microscopic Examination
Synonyms: 

CBCD, CBC/Diff, Blood Cell Count with Diff


Clinical significance: 

Complete blood count plus white blood cell differential which looks at the types of white blood cells present to aid physician in diagnosing infection, viral condition or other disease affecting the white blood cells, such as leukemias. The white blood cell differential assesses the body's ability to respond to and eliminate infection. It also detects the severity of allergic and drug reactions, plus the response to viral, parasitic, and other types of infection. It is essential in identifying various stages of leukemia and monitoring response to chemotherapy.


Doctoral Director(s): 
Mary Dhesi MD
Review Date:  05/23/2025

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