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 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 105007 RDW % 788-0
    004800 Iron Def Anemia Cas.+CBC/D/Plt 015172 Platelets x10E3/uL 777-3
    004800 Iron Def Anemia Cas.+CBC/D/Plt 015107 Neutrophils % 770-8
    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 115398 Immature Cells N/A
    004800 Iron Def Anemia Cas.+CBC/D/Plt 015909 Neutrophils (Absolute) x10E3/uL 751-8
    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 015108 Immature Granulocytes % 71695-1
    004800 Iron Def Anemia Cas.+CBC/D/Plt 015911 Immature Grans (Abs) x10E3/uL 53115-2
    004800 Iron Def Anemia Cas.+CBC/D/Plt 015945 NRBC % 58413-6
    004800 Iron Def Anemia Cas.+CBC/D/Plt 015180 Hematology Comments: 18314-5
    004800 Iron Def Anemia Cas.+CBC/D/Plt 004799 Iron Def Anemia Casc N/A
    Reflex Table for Immature Cells
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 115399 Immature Cells 115400 Bands % 35332-6
    Reflex Table for Immature Cells
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 115399 Immature Cells 115401 Metamyelocytes % 28541-1
    Reflex Table for Immature Cells
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 115399 Immature Cells 115403 Myelocytes % 26498-6
    Reflex Table for Immature Cells
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 115399 Immature Cells 115404 Promyelocytes % 26498-6
    Reflex Table for Immature Cells
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 115399 Immature Cells 115405 Blasts/blast like cells % 26498-6
    Reflex Table for Immature Cells
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 115399 Immature Cells 115406 Megakaryocytes % 19252-6
    Reflex Table for Immature Cells
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 115399 Immature Cells 115265 Other, Lineage Uncertain % 55433-7
    Reflex Table for Iron Def Anemia Casc
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 004801 Ferritin 004598 Ferritin ng/mL 2276-4
    Reflex 2 004811 Comment: 004811 Comment: N/A
    Reflex Table for Iron Def Anemia Casc
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 004801 Ferritin 004598 Ferritin ng/mL 2276-4
    Reflex 2 004813 Comment: 004813 Comment: N/A
    Reflex Table for Iron Def Anemia Casc
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 004801 Ferritin 004598 Ferritin ng/mL 2276-4
    Reflex 2 004821 Comment: 004821 Comment: N/A
    Reflex Table for Iron Def Anemia Casc
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 004801 Ferritin 004598 Ferritin ng/mL 2276-4
    Reflex 2 004815 Iron and TIBC 001347 Iron Bind.Cap.(TIBC) ug/dL 2500-7
    Reflex Table for Iron Def Anemia Casc
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 004801 Ferritin 004598 Ferritin ng/mL 2276-4
    Reflex 2 004815 Iron and TIBC 001348 UIBC ug/dL 2501-5
    Reflex Table for Iron Def Anemia Casc
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 004801 Ferritin 004598 Ferritin ng/mL 2276-4
    Reflex 2 004815 Iron and TIBC 001339 Iron ug/dL 2498-4
    Reflex Table for Iron Def Anemia Casc
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 004801 Ferritin 004598 Ferritin ng/mL 2276-4
    Reflex 2 004815 Iron and TIBC 011362 Iron Saturation % 2502-3
    Reflex Table for Iron Def Anemia Casc
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 004801 Ferritin 004598 Ferritin ng/mL 2276-4
    Reflex 2 004815 Iron and TIBC 004816 Reflex Information N/A
    Reflex 3 004814 Comment: 004814 Comment: N/A
    Reflex Table for Iron Def Anemia Casc
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 004801 Ferritin 004598 Ferritin ng/mL 2276-4
    Reflex 2 004815 Iron and TIBC 004816 Reflex Information N/A
    Reflex 3 004819 Comment: 004819 Comment: N/A
    Reflex Table for Iron Def Anemia Casc
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 004801 Ferritin 004598 Ferritin ng/mL 2276-4
    Reflex 2 004815 Iron and TIBC 004816 Reflex Information N/A
    Reflex 3 143308 Soluble Transferrin Receptor 143307 Soluble Transferrin Receptor nmol/L 33210-6
    Reflex 4 004803 Comment: 004803 Comment: N/A
    Reflex Table for Iron Def Anemia Casc
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 004801 Ferritin 004598 Ferritin ng/mL 2276-4
    Reflex 2 004815 Iron and TIBC 004816 Reflex Information N/A
    Reflex 3 143308 Soluble Transferrin Receptor 143307 Soluble Transferrin Receptor nmol/L 33210-6
    Reflex 4 004805 Comment: 004805 Comment: COMMENT
    Reflex Table for Iron Def Anemia Casc
    Order Code Order Name Result Code Result Name UofM Result LOINC
    Reflex 1 004809 Comment: 004809 Comment: N/A

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    The LOINC® codes are copyright © 1994-2021, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. Permission is granted in perpetuity, without payment of license fees or royalties, to use, copy, or distribute the LOINC® codes for any commercial or non-commercial purpose, subject to the terms under the license agreement found at https://loinc.org/license/. Additional information regarding LOINC® codes can be found at LOINC.org, including the LOINC Manual, which can be downloaded at LOINC.org/downloads/files/LOINCManual.pdf