Iron Deficiency Anemia Cascade With Complete Blood Count (CBC) With Differential

TEST: 004800
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CPT: 85025
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Special Instructions

Note special reflexing: If Hemoglobin (Hb) [005041] is low, test will reflex to Ferritin [004598]. If Ferritin is normal, test will reflex to Iron and Total Iron-binding Capacity (TIBC) [001321]. Depending on results of Iron and TIBC, test may reflex to Soluble Transferrin Receptor [143305], all at an additional charge or CPT code.

Expected Turnaround Time

Within 5 days

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

Related Documents

For more information, please view the literature below.

Iron Deficiency Anemia Cascade White Paper

Specimen Requirements

Specimen

Serum and whole blood

Volume

4 mL serum and 4 mL whole blood (fill tube to capacity)

Minimum Volume

Serum: 2 mL

Whole blood: 0.5 mL or 500 µL for pediatric microtainer capillary tubes; venous tube collection: fill tube to capacity

Container

Gel-barrier tube and lavender-top (EDTA) tube

Collection

Serum: Separate serum from cells within 45 minutes of collection.

Lavender-top: Invert tube 8 to 10 times immediately after tube is filled at the time of collection.

Storage Instructions

Maintain one serum and lavender-top tube at room temperature. Refrigerate one serum transport tube.

Stability Requirements

Temperature

Period

Room temperature

Serum: 14 days

Whole blood: 1 day

Refrigerated

Serum: 14 days

Whole blood: 3 days

Frozen

Serum: 14 days

Whole blood: Unstable

Causes for Rejection

Serum: Hemolysis; specimen clotted; improper labeling; EDTA, yellow-top tube, citrate or oxalate plasma specimen

Whole blood: Hemolysis; clotted specimen; specimen drawn in any anticoagulant other than EDTA; specimen diluted or contaminated with IV fluid; tube not filled with minimum volume; improper labeling; transfer tubes with whole blood; specimen received with plasma removed (plasma is used for other testing)

Test Details

Use

This test is used to determine iron deficiency anemia.

Methodology

See individual test components.

References

Baillie FJ, Morrison AE, Fergus I. Soluble transferrin receptor: a discriminating assay for iron deficiency. Clin Lab Haematol. 2003 Dec;25(6):353-357.14641138
Camaschella C. Iron deficiency: new insights into diagnosis and treatment. Hematology Am Soc Hematol Educ Program. 2015;2015:8-13.26637694
Cappellini MD, Musallam KM, Taher AT. Iron deficiency anaemia revisited. J Intern Med. 2020 Feb;287(2):153-170.31665543
Daru J, Allotey J, Pea-Rosas JP, Khan KS. Serum ferritin thresholds for the diagnosis of iron deficiency in pregnancy: a systematic review. Transfus Med. 2017 Jun;27(3):167-174.28425182
Farrington DK, Sang Y, Grams ME, et al. Anemia Prevalence, Type, and Associated Risks in a Cohort of 5.0 Million Insured Patients in the United States by Level of Kidney Function. Am J Kidney Dis. 2023 Feb;81(2):201-209.e1. Epub 22 Sep 28.36181996
Kumar A, Sharma E, Marley A, Samaan MA, Brookes MJ. Iron deficiency anaemia: pathophysiology, assessment practical management. BMJ Open Gastroenterol. 2022 Jan;9(1):e000759.34996762

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
004800 Iron Def Anemia Cas.+CBC/D/Plt 000000
004800 Iron Def Anemia Cas.+CBC/D/Plt 004799 Iron Def Anemia Casc N/A
004800 Iron Def Anemia Cas.+CBC/D/Plt 005025 WBC x10E3/uL 6690-2
004800 Iron Def Anemia Cas.+CBC/D/Plt 005033 RBC x10E6/uL 789-8
004800 Iron Def Anemia Cas.+CBC/D/Plt 005041 Hemoglobin g/dL 718-7
004800 Iron Def Anemia Cas.+CBC/D/Plt 005058 Hematocrit % 4544-3
004800 Iron Def Anemia Cas.+CBC/D/Plt 015065 MCV fL 787-2
004800 Iron Def Anemia Cas.+CBC/D/Plt 015073 MCH pg 785-6
004800 Iron Def Anemia Cas.+CBC/D/Plt 015081 MCHC g/dL 786-4
004800 Iron Def Anemia Cas.+CBC/D/Plt 015107 Neutrophils % 770-8
004800 Iron Def Anemia Cas.+CBC/D/Plt 015108 Immature Granulocytes % 71695-1
004800 Iron Def Anemia Cas.+CBC/D/Plt 015123 Lymphs % 736-9
004800 Iron Def Anemia Cas.+CBC/D/Plt 015131 Monocytes % 5905-5
004800 Iron Def Anemia Cas.+CBC/D/Plt 015149 Eos % 713-8
004800 Iron Def Anemia Cas.+CBC/D/Plt 015156 Basos % 706-2
004800 Iron Def Anemia Cas.+CBC/D/Plt 015172 Platelets x10E3/uL 777-3
004800 Iron Def Anemia Cas.+CBC/D/Plt 015180 Hematology Comments: 18314-5
004800 Iron Def Anemia Cas.+CBC/D/Plt 015909 Neutrophils (Absolute) x10E3/uL 751-8
004800 Iron Def Anemia Cas.+CBC/D/Plt 015911 Immature Grans (Abs) x10E3/uL 53115-2
004800 Iron Def Anemia Cas.+CBC/D/Plt 015917 Lymphs (Absolute) x10E3/uL 731-0
004800 Iron Def Anemia Cas.+CBC/D/Plt 015925 Monocytes(Absolute) x10E3/uL 742-7
004800 Iron Def Anemia Cas.+CBC/D/Plt 015933 Eos (Absolute) x10E3/uL 711-2
004800 Iron Def Anemia Cas.+CBC/D/Plt 015941 Baso (Absolute) x10E3/uL 704-7
004800 Iron Def Anemia Cas.+CBC/D/Plt 015945 NRBC % 58413-6
004800 Iron Def Anemia Cas.+CBC/D/Plt 105007 RDW % 788-0
004800 Iron Def Anemia Cas.+CBC/D/Plt 115398 Immature Cells N/A

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