Lead
Label Mnemonic: BLPB
Epic Lab Code: LAB98
Downtime Form: A-1a Miscellaneous Request
Chemistry
6240 RCP
356-3527
Specimen(s):
Whole Blood, by LeadCare II
Collection Medium:
Lavender top tube 3 mL (EDTA)
Alternate Collection Media:
Call laboratory for additional acceptable specimen collection containers.
Minimum:
3 mL lavender top tube (EDTA), green top tube (Heparin), or special trace metals tube or ONE lavender top (EDTA) microtube for pediatric patients. It is recommended that patients at high risk for having elevated lead concentrations have a venous (as opposed to capillary) sample drawn to facilitate confirmatory testing if blood lead concentration exceeds 15 μg/dL.
Testing Schedule:
24 hrs/day, 7 days a week, including holidays.
Turn Around Time:
5 hours (upon receipt in laboratory)
Reference Range:
Children: <10 ug/dL Adults: <10 ug/dL
Comments:
Methodology of blood lead testing changed on 4/20/2011 from atomic absorption (AA) to the LeadCare II instrument. This allows for 24/7 availability of lead concentrations compared to the previous schedule of routine testing performed only one day/week.

By state of Iowa requirements, all lead concentrations of 15 μg/dL or greater by the LeadCare II instrument must be confirmed with a venous sample analyzed by a reference method such as atomic absorption or inductively-coupled plasma mass spectrometry (ICP-MS). This requirement is fulfilled by having the test "LEAD, VENOUS CONFIRMATION BY ICP-MS" (Epic LAB7479) available. For the confirmatory test, only a venous specimen is acceptable (i.e., no capillary sample allowable).

If the lead concentration is 15 μg/dL or greater by LeadCare II test and sufficient venous specimen is available for confirmatory testing, the Clinical Chemistry laboratory will reflexively send out the confirmatory testing and the following comment will be appended to the LeadCare II result:

"This venous specimen has a blood lead concentration of 15 μg/dL by the LeadCare II instrument and has been sent-out for confirmation by a reference method. This is in accord with state of Iowa requirements. Contact Medical Director at 384-9380 with questions."

If the lead concentration is 15 μg/dL or greater by LeadCare II but insufficient specimen is available for confirmatory testing (which includes all capillary samples), the ordering clinician will be contacted and informed of the state of Iowa requirement for obtaining a venous confirmatory specimen at a future visit. The following comment will be appended to the LeadCare II results.

"This venous specimen has a blood lead concentration of 15 μg/dL by the LeadCare II instrument but does not have sufficient specimen for confirmatory testing. By state of Iowa requirements, the patient must have a follow-up venous sample analyzed by a reference method (orderable as "LEAD, VENOUS CONFIRMATION BY ICP-MS" in Epic). Contact Medical Director at 384-9380 with questions."

Venous lead concentrations are currently measured by confirmatory method (ICP-MS). Expected turn-around time is 2-4 days. Please contact the Pathology Resident on-call (pager 3724) if more rapid testing is required for management of lead toxicity.
Methodology:
Electrochemical
CPT Code:
83655
 
See also:
Lead, Confirmation by ICP-MS, Blood (Venous)