Test Id : SPSM
Morphology Evaluation (Special Smear), Blood
    
        Useful For
            
                
                
                    
                    Suggests clinical disorders or settings where the test may be helpful
                
            
    
    Detecting disease states or syndromes of the white blood cells, 
    
        Profile Information
            
                
                
                    
                    A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.
                
            
    
    | Test Id | Reporting Name | Available Separately | Always Performed | 
|---|---|---|---|
| DIFFS | Morphology Eval (Special Smear) | No | Yes | 
| SPSM_ | Special Smear | No | Yes | 
    
        Reflex Tests
            
                
                
                    
                    Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.
                
            
    
    | Test Id | Reporting Name | Available Separately | Always Performed | 
|---|---|---|---|
| DIFFR | Morphology Eval (special Smear) | No | No | 
| PINTP | Peripheral Smear Interpretation | No | No | 
| CBCN | CBC without Differential | Yes | No | 
| LCMSB | Leukemia/Lymphoma Phenotype | Yes | No | 
    
        Additional Tests
            
                
                
                    
                    Lists tests that are always performed, at an additional charge, with the initial tests.
                
            
    
    | Test Id | Reporting Name | Available Separately | Always Performed | 
|---|---|---|---|
| PBPC | Peripheral Blood | No, (Bill Only) | Yes | 
    
        Testing Algorithm
            
                
                
                    
                    Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
                
            
    
    If clinically abnormal results are identified by microscopic examination, a peripheral blood smear review is performed by a Hematopathologist at an additional charge.
 
If patient has not had a complete blood cell count in the last 3 days, one will be performed at an additional charge.
 
    
        Method Name
            
                
                
                    
                    A short description of the method used to perform the test
                
            
    
    Manual-Microscopic Examination of Cells
    
        NY State Available
            
                
                
                    
                    Indicates the status of NY State approval and if the test is orderable for NY State clients.
                
            
    
    
    
        Reporting Name
            
                
                
                    
                    Lists a shorter or abbreviated version of the Published Name for a test
                
            
    
    
    
        Aliases
            
                
                
                    
                    Lists additional common names for a test, as an aid in searching
                
            
    
    SPSM
Peripheral Blood morphology evaluation
    
        Testing Algorithm
            
                
                
                    
                    Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
                
            
    
    If clinically abnormal results are identified by microscopic examination, a peripheral blood smear review is performed by a Hematopathologist at an additional charge.
 
If patient has not had a complete blood cell count in the last 3 days, one will be performed at an additional charge.
 
    
        Specimen Type
            
                
                
                    
                    Describes the specimen type validated for testing
                
            
    
        Whole blood
    
        Necessary Information
    
    Clinician should provide indication for performing test.
    
        Specimen Required
            
                
                
                    
                    Defines the optimal specimen required to perform the test and the preferred volume to complete testing
                
            
    
    Collection Container/Tube: 2 slides
Specimen Volume: 2 unstained, well prepared peripheral blood smears
Collection Instructions: Smears made from blood obtained by either a lavender top (EDTA) tube or finger stick specimen
    
        Special Instructions
            
                
                
                    
                    Library of PDFs including pertinent information and forms related to the test
                
            
    
    
            
            
            
    
        Specimen Minimum Volume
            
                
                
                    
                    Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
                
            
    
    See Specimen Required
    
        Reject Due To
            
                
                
                    
                    Identifies specimen types and conditions that may cause the specimen to be rejected
                
            
    
    | Gross hemolysis | Reject | 
| Clotted blood | Reject | 
    
        Specimen Stability Information
            
                
                
                    
                    Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
                
            
    
    | Specimen Type | Temperature | Time | Special Container | 
|---|---|---|---|
| Whole blood | Ambient (preferred) | CARTRIDGE | |
| Refrigerated | CARTRIDGE | ||
    
        Useful For
            
                
                
                    
                    Suggests clinical disorders or settings where the test may be helpful
                
            
    
    Detecting disease states or syndromes of the white blood cells, 
    
        Testing Algorithm
            
                
                
                    
                    Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
                
            
    
    If clinically abnormal results are identified by microscopic examination, a peripheral blood smear review is performed by a Hematopathologist at an additional charge.
 
If patient has not had a complete blood cell count in the last 3 days, one will be performed at an additional charge.
 
    
        Clinical Information
            
                
                
                    
                    Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
                
            
    
    Under normal conditions, the morphology and proportion of each blood cell type is fairly consistent in corresponding age groups. The morphology and proportion of each blood cell type may change in various hematologic diseases. Differential leukocyte count and special smear evaluation is helpful in revealing the changes in morphology or proportion of each cell type in the peripheral blood.
    
        Reference Values
            
                
                
                    
                    Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
                
            
    
    1-3 years
Neutrophils/bands: 22-51%
Lymphocytes: 37-73%
Monocytes: 2-11%
Eosinophils: 1-4%
Basophils: 0-2%
Metamyelocytes: 0%
Myelocytes: 0%
4-7 years
Neutrophils/bands: 30-65%
Lymphocytes: 29-65%
Monocytes: 2-11%
Eosinophils: 1-4%
Basophils: 0-2%
Metamyelocytes: 0%
Myelocytes: 0%
8-13 years
Neutrophils/bands: 35-70%
Lymphocytes: 23-53%
Monocytes: 2-11%
Eosinophils: 1-4%
Basophils: 0-2%
Metamyelocytes: 0%
Myelocytes: 0%
Adults
Neutrophils/bands: 50-75%
Lymphocytes: 18-42%
Monocytes: 2-11%
Eosinophils: 1-3%
Basophils: 0-2%
Metamyelocytes: <1%
Myelocytes: <0.5%
An interpretive report will be provided.
    
        Interpretation
            
                
                
                    
                    Provides information to assist in interpretation of the test results
                
            
    
    The laboratory will provide an interpretive report of percentage of 
    
        Cautions
            
                
                
                    
                    Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
                
            
    
    A poorly prepared peripheral smear may result in less than optimal interpretation.
    
        Clinical Reference
            
                
                
                    
                    Recommendations for in-depth reading of a clinical nature
                
            
    
    1. Kjeldsberg CR, eds. Practical Diagnosis of Hematologic Disorders. 5th ed. American Society of Clinical Pathologists; 2010
2. Pozdnyakova O, Connell NT, Battinelli EM, Connors JM, Fell G, Kim AS. Clinical significance of CBC and WBC morphology in the diagnosis and clinical course of COVID-19 infection. Am J Clin Pathol.. 2021 Feb 11;155(3):364-375. doi: 10.1093/ajcp/aqaa231
    
        Method Description
            
                
                
                    
                    Describes how the test is performed and provides a method-specific reference
                
            
    
    Microscopic examination of a Wright-Giemsa stained smear.(Unpublished Mayo method)
    
        PDF Report
            
                
                
                    
                    Indicates whether the report includes an additional document with charts, images or other enriched information
                
            
    
    
    
        Day(s) Performed
            
                
                
                    
                    Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
                
            
    
    Sunday through Saturday
    
        Report Available
            
                
                
                    
                    The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
                
            
    
    
    
        Specimen Retention Time
            
                
                
                    
                    Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
                
            
    
    
    
        Performing Laboratory Location
            
                
                
                    
                    Indicates the location of the laboratory that performs the test
                
            
    
    
    
        Fees :
            
                
                
                    
                    Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
                
            
    
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        Test Classification
            
                
                
                    
                    Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
                
            
    
    This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
    
        CPT Code Information
            
                
                
                    
                    Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
                
            
    
    CPT codes are provided by the performing laboratory.
85007
85060-(if appropriate)
85027-(if appropriate)
88184-(If appropriate)
88185-(If appropriate)
88187-(if appropriate)
88188-(if appropriate)
88189-(if appropriate)
    
        LOINC® Information
            
                
                
                    
                    Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
                
            
    
    | Test Id | Test Order Name | Order LOINC Value | 
|---|---|---|
| SPSM | Morphology Eval (special smear) | 14869-2 | 
| Result Id | Test Result Name | Result LOINC Value 
                                        
                                        Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
                                     | 
|---|---|---|
| LYMPH | Lymphocytes | 26478-8 | 
| MONOC | Monocytes | 26485-3 | 
| EOS | Eosinophils | 714-6 | 
| BASO | Basophils | 707-0 | 
| META | Metamyelocytes | 740-1 | 
| MYEL | Myelocytes | 749-2 | 
| PROMY | Promyelocytes | 783-1 | 
| UBLS | Blasts | 709-6 | 
| PLSM | Plasma Cells | 79426-3 | 
| M_KR | Megakaryocytes | 19252-6 | 
| NUCL | Nucleated RBC | 19048-8 | 
| FRAGC | Fragile Cells | In Process | 
| BL_PR | Blasts and Promonocytes | In Process | 
| MANC | Manual Absolute Neutrophil Count | 753-4 | 
| INT01 | Interpretation | 59466-3 | 
| REV96 | Reviewed by: | 18771-6 | 
| SEGBA | Neutrophilic Segs and Bands | 23761-0 |