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Macro/microscopic examination of fluid (manual cell count and differential)

Published: August 9, 2026Updated: August 16, 2026

This test involves a visual and manual count of cells in a fluid sample, such as blood, urine, or cerebrospinal fluid, to identify and assess the types and numbers of cells present.

Quick summary

["Helps diagnose infections, inflammation, or other conditions by examining cell types in bodily fluids."]

Medically reviewed by WellAlly Editorial TeamLast reviewed August 16, 2026Editorial policy

Key facts at a glance

LOINC
21394-2
Short code
Monos+Macros NFr Fld Manual
Synonyms
Monos+Macros NFr Fld Manual
Category
chemistry
Sample
serum
Container
Red-top tube (SST)
Units
N/A
Fasting
false
Population
adult
Sex
all
Age range
18–65 years
Method
manual-count
CPT
86430
Specimen volume
5 mL
Stability
Room temperature: 4h, Refrigerated: 24h, Frozen: 7d
Hemolysis max
500
Lipemia max
1000
Icterus max
500
TAT
4–24 hours
Order
routine

What Is This Test Used For?

This test is primarily used to detect abnormal cell counts or types in fluids like blood, urine, or spinal fluid. It helps identify conditions such as infections (e.g., bacterial or viral), blood disorders (e.g., leukemia), kidney issues, or neurological problems (e.g., meningitis).

How Is the Sample Collected?

A small amount of fluid is collected via a needle or catheter, depending on the type of fluid being tested. For example, blood is drawn from a vein, while urine or spinal fluid may be collected through a catheter or needle inserted into the body. The sample is then sent to the lab for microscopic and manual cell counting.

What Does the Test Involve?

The lab technician examines the fluid under a microscope to count and identify different cell types, such as red blood cells, white blood cells, and sometimes specialized cells like macrophages or neutrophils. Manual cell differentiation ensures accuracy for conditions requiring detailed cell analysis.

How Are Results Interpreted?

Results are reported as counts of specific cell types (e.g., total white blood cell count, percentage of neutrophils or lymphocytes). Abnormal counts or cell types may signal underlying health issues that require further medical evaluation.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings1

Short name

None

Frequently asked questions

Why might my doctor order this test?
Your doctor may order this test to investigate symptoms like fever, unexplained weight loss, frequent infections, unusual fatigue, or neurological symptoms. It can also help monitor conditions like chronic infections, cancers, or inflammatory diseases by closely examining cell populations in fluids.
How long does it take to get results?
Results are typically available within a few hours to a couple of days, depending on the lab’s processing time and whether additional tests are needed for confirmation.
What are common reasons for abnormal results?
Abnormal results may indicate infections (e.g., high white blood cell count), blood disorders (e.g., low red blood cells), kidney disease (e.g., abnormal urine cells), or other inflammatory or neoplastic conditions. Follow-up testing or medical evaluation will determine next steps.
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medical Disclaimer

This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.

If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.

Medically reviewed by WellAlly Editorial Team Last reviewed August 16, 2026. · Read our editorial policy