“See note” on a test result means the lab added a written comment to explain something about that specific result. It’s not a diagnosis, and it doesn’t automatically mean something is wrong. It simply tells you to look for additional text, usually found below the result or in a separate comments section of your report, where a lab scientist or pathologist has provided context that a simple number or “normal/abnormal” label can’t capture.
Why Labs Add Notes Instead of Just Numbers
Most lab results are straightforward: a number, a reference range, and a flag like “high” or “low” if the value falls outside that range. But some results need more explanation than a single number can provide. When that happens, the lab attaches a comment and flags the result with “see note,” “see comment,” or a similar phrase so you (and your doctor) don’t miss the extra information.
The note itself can say many different things depending on the situation. It might clarify why a result looks unusual, explain that a follow-up test was automatically run, or point out that something about the sample could have affected accuracy. The key thing to understand is that “see note” is a pointer, not a verdict. The actual information is in the note.
Common Reasons You’ll See This Flag
Several specific situations trigger a lab note:
- Sample quality issues. If your blood sample was hemolyzed (red blood cells broke open during collection), clotted, too small in volume, or visibly fatty or yellow-tinted, the lab will note this because it can skew certain results. The note may say something like “specimen hemolyzed; potassium may be falsely elevated.”
- A result that needs interpretation, not just a number. Some tests produce qualitative results rather than a simple value. A pathologist reviewing a tissue biopsy, for example, may write a comment describing unusual features of the sample. One real-world example from a breast biopsy report reads: “The foci of ductal carcinoma in situ have focal necrosis and marked nuclear pleomorphism. Hormonal receptors will be performed.” That level of detail can’t be reduced to a single line.
- Borderline or mildly abnormal values. Labs increasingly attach brief clinical context to results that fall in gray zones. A slightly low hemoglobin or a fasting glucose between 110 and 125 might come with a note like “discuss with your doctor at the next visit,” while a more concerning value could say “contact your doctor at your earliest convenience.”
- Reflex testing was triggered. Some lab orders are set up so that if the first test comes back positive, a second confirmatory test runs automatically on the same sample. Hepatitis C screening works this way: if your antibody test is positive, the lab reflexes to a viral RNA test without needing a new blood draw. The note explains that both results are being reported and what they mean together.
- Interference from medications or substances. Certain drugs, supplements, or even high levels of a natural substance in your blood (like bilirubin) can interfere with specific assays. The note flags this so your doctor knows to interpret the number with caution or reorder the test.
- A change in reference ranges. Labs occasionally update what they consider the “normal” range for a test. When this happens, a note may explain that the reference range has changed, which is why a previously normal result now appears flagged, or vice versa.
- Tests that can’t distinguish between related substances. Some panels detect a group of similar compounds but can’t tell them apart. The note will specify this, saying something like “this test does not differentiate between analyte A and analyte B.”
Where to Find the Actual Note
On most patient portals, the note appears directly below the flagged result or at the bottom of the report in a section labeled “Comments” or “Notes.” Some portals collapse this section by default, so you may need to click or scroll to see it. If you’re looking at a printed report, check the bottom of the page or the back side.
In some cases, the note is brief and technical. Lab comments were originally written for doctors, not patients, so you may encounter terms that aren’t immediately clear. If the note references something like “specimen lipemic” or “platelet clumping observed,” those are descriptions of sample characteristics, not conditions you have. Your doctor can translate the clinical shorthand into plain language.
Drug Screens and “See Note”
Drug tests are one of the most common places you’ll encounter notes, because these results are rarely as simple as positive or negative. Most urine drug screens are qualitative, meaning they detect whether a substance is present above a certain threshold but don’t measure how much is there. Notes often explain the detection window for a substance, flag a potential false positive, or indicate that confirmatory testing is needed. In workplace or legal settings, confirmatory testing using a more precise method is standard before any action is taken based on a positive screen.
Blood Count Results With Notes
Complete blood count (CBC) results frequently carry notes, especially when the automated counting machine flags something that needs a human eye. A lab technician may examine your blood under a microscope and note what they see: cells that vary in size or shape, cells that look immature, or clumps that could make a count inaccurate. For instance, if the machine reports a low platelet count, a technician might note that platelets were clumping together in the sample, which means your actual platelet count is likely higher than what was measured. That context changes how your doctor reads the result entirely.
Pathology and Biopsy Reports
In pathology reports from biopsies or surgeries, “see comment” plays a particularly important role. The pathologist uses the comment section to describe special features of the tissue, note whether the abnormal area extends to the edges of the removed sample, or explain that additional testing (like hormone receptor analysis) has been ordered. These notes are part of the diagnosis itself, not an afterthought. If you’ve had a biopsy and the report says “see comment,” the comment section contains critical details your doctor will use to plan next steps.
What to Do When You See It
First, find the note and read it. In many cases, the note is reassuring, explaining a minor technical issue or confirming that a borderline value isn’t immediately concerning. If the language is confusing or the note flags something that sounds serious, bring it up with your doctor rather than trying to decode it yourself. Lab notes are meant to add nuance to a result, and nuance is best interpreted by someone who knows your full medical picture.
If you can’t find the note on your patient portal, call the lab or your doctor’s office and ask them to read it to you. Occasionally, comment fields don’t transfer cleanly between electronic systems, and the note may be visible on the lab’s end but not yours.