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Epic Code LAB2111025 Cell Count, Differential if Indicated, Cerebrospinal Fluid (CSF)

Important Note

Specimen must be received in lab within one hour of collection.

Do not send specimen through pneumatic tube system.

Xanthochromia is assessed by visual inspection. If the appropriate history and symptoms are present, CSF xanthochromia is suggestive of subarachnoid blood, either as part of an inflammatory reaction such as meningitis, or after subarachnoid hemorrhage (SAH). Xanthochromia must be viewed within the appropriate clinical context.

Spectrum Health Kelsey Laboratory does not perform this test.  If testing is urgently required by the ED, ensure that a stat courier is on sight prior to collection to ensure transportation is available for this time sensitive testing.


CSF Priorities on QNS Specimens:

When a Cerebrospinal fluid (CSF) specimen arrives into the laboratory and is deemed Quantity Not Sufficient (QNS) for ordered testing, the ordering provider is contacted to identify testing priorities. Occasionally, the laboratory is unable to secure these priorities.

If the lab is unable to secure priorities from the ordering provider within an hour of collection, the following will occur:

1. We will move forward with the Cell count with differential, Culture, and Protein/Glucose

2. The rest of the ordered testing will hold until we can clarify the priorities

Test Name Alias

Cell Count w/ Differential if indicated CSF | Cell Count with Differential if indicated CSF | Cerebrospinal fluid | Cell CNT | Cerebrospinal fluid analysis | WBC CSF| 10

Interface Order Alias


Quick Collect


Collection Instructions

Specimen Collection: Cerebral Spinal Fluid (CSF)


Container(s): 1 or more sterile plastic tubes

Preferred Volume to Collect: 2.0 mL

Minimum Volume to Collect: 1.0 mL

Neonate Volume to Collect: 1.0 mL


Collection Instructions:

  • IMPORTANT: Label container with
    • number containers/tube in order of collection
    • patient information
    • specimen source
    • date of collection
  • Specimen must be received within one hour of collection.
  • Hand deliver to laboratory, do not send through pneumatic tube system.

Processing Instructions (Laboratory, Outpatient or Off-site collection)

Processed Specimen: CSF

Centrifuge/Spin: No

Aliquot: No

Processing Instructions:

  • Lab Testing is performed using the following tube designation, regardless of label on tube:

    • Tube 1 = Chemistry 

    • Tube 2 = Microbiology

    • Tube 3 = Hematology

    • Tube 4 = Extra

Transport Temperature: Room Temperature

Lab Staff Instructions

Lab Central Staff: All CSF specimens to Hematology first.

Rejection Criteria

Frozen specimens will be rejected

Specimen Stability

Laboratory Retention: 30 days (United Laboratory: 14 days)

Ambient: 1 hour

Refrigerated: 1 hour

Frozen: Not acceptable

Reflex Information

Link: Mandatory Reflex approved by ME

Test Frequency

Available daily, usual TAT 1 hour for Cell Count, 24 Hours for Differential

Reference Range

CSF: appearance should be colorless and clear

WBC ≤5 cells/uL

RBC≤0 cells/uL

The reference range data is summarized/complied from published literature

Performing Department


Performing Department Laboratory Location

Corewell Health Reference Laboratory, Grand Rapids, MI
Corewell Health Big Rapids Laboratory, Big Rapids, MI
Corewell Health Blodgett Laboratory, Grand Rapids, MI
Corewell Health Gerber Laboratory, Fremont, MI
Corewell Health Ludington Laboratory, Ludington, MI
Corewell Health Pennock Laboratory, Hastings, MI
Corewell Health Reed City Laboratory, Reed City, MI
Corewell Health Greenville Laboratory, Greenville, MI
Corewell Health Zeeland Laboratory, Zeeland, MI


Manual or automated. Manual: Hemocytometer (Microscopy) 

Clarity and Color, including Xanthochromia: assessed by visual inspection

Cell counts and differential: Manual hemocytometer cell counts and manual differential on cytospin preparations

Gerber performs on the IRIS


89050 (Cell Count Only)
89051 (Differential+ Cell Count)
89050 (Reflex: Count tube 1)

CDM Code


Epic Test ID



Volume CSF: 17607-3

Tube Num CSF: 19157-7

CSF Color: 10335-8

CSF Clarity: 49736-2

CSF Xantho: 13532-7

CSF WBC Count: 806-0

CSF RBC Count: 792-2

Tube 2 Color: 10335-8

Tube 2 Clarity: 49736-2

Tube 2 Xan: 13532-7

Man Diff Y/N: N/A

Basos CSF: 55771-0

Blasts CSF: 56470-8

Eos CSF: 55778-5

Immature Cells CSF: 55794-2

Lymphs CSF: 55787-6

Lymphoma cells Man CSF: 55794-2

Macrophage CSF: 55794-2

NRBC CSF: 55780-1

Segs CSF: 55791-8

Cells in Diff: 19075-1


Plasma Cells CSF:

Lymphoma Cells CSF: 55794-2

Other Cells CSF:


Reviewed Date