diff --git a/packages/esm-patient-common-lib/src/orders/types.ts b/packages/esm-patient-common-lib/src/orders/types.ts
index 96911d6ff2..81478cd166 100644
--- a/packages/esm-patient-common-lib/src/orders/types.ts
+++ b/packages/esm-patient-common-lib/src/orders/types.ts
@@ -39,6 +39,10 @@ export interface OrderBasketItem {
   };
   extractedOrderError?: ExtractedOrderErrorObject;
   isOrderIncomplete?: boolean;
+  /**
+   * An optional identifier from the fulfiller (e.g., lab system) for the specimen or record associated with the order.
+   */
+  accessionNumber?: string;
 }
 
 export interface OrderPost {
@@ -68,7 +72,7 @@ export interface OrderPost {
   orderReasonNonCoded?: string;
   orderReason?: string;
   instructions?: string;
-  labReferenceNumber?: string;
+  accessionNumber?: string;
 }
 
 export interface PatientOrderFetchResponse {
@@ -146,7 +150,6 @@ export interface Order {
   clinicalHistory: string;
   numberOfRepeats: string;
   type: string;
-  labReferenceNumber?: string;
 }
 
 export interface OrderTypeFetchResponse {
@@ -204,7 +207,6 @@ export interface LabOrderBasketItem extends OrderBasketItem {
     label: string;
     conceptUuid: string;
   };
-  labReferenceNumber?: string;
   urgency?: string;
   instructions?: string;
   previousOrder?: string;
diff --git a/packages/esm-patient-labs-app/src/lab-orders/add-lab-order/add-lab-order.scss b/packages/esm-patient-labs-app/src/lab-orders/add-lab-order/add-lab-order.scss
index 66ed160487..bf2fc693c8 100644
--- a/packages/esm-patient-labs-app/src/lab-orders/add-lab-order/add-lab-order.scss
+++ b/packages/esm-patient-labs-app/src/lab-orders/add-lab-order/add-lab-order.scss
@@ -28,8 +28,7 @@
 
   button {
     display: flex;
-    padding-left: 0 !important;
-    margin: 0 layout.$spacing-05;
+    margin-left: -(layout.$spacing-03);
 
     svg {
       order: 1;
diff --git a/packages/esm-patient-labs-app/src/lab-orders/add-lab-order/add-lab-order.test.tsx b/packages/esm-patient-labs-app/src/lab-orders/add-lab-order/add-lab-order.test.tsx
index b4ba8c3da6..db9e2bd2e5 100644
--- a/packages/esm-patient-labs-app/src/lab-orders/add-lab-order/add-lab-order.test.tsx
+++ b/packages/esm-patient-labs-app/src/lab-orders/add-lab-order/add-lab-order.test.tsx
@@ -139,7 +139,7 @@ describe('AddLabOrder', () => {
           display: 'CD4 COUNT',
           urgency: 'STAT',
           instructions: 'plz do it thx',
-          labReferenceNumber: 'lba-000124',
+          accessionNumber: 'lba-000124',
           testType: { label: 'CD4 COUNT', conceptUuid: 'test-lab-uuid-2' },
           orderer: mockSessionDataResponse.data.currentProvider.uuid,
         }),
diff --git a/packages/esm-patient-labs-app/src/lab-orders/add-lab-order/lab-order-form.component.tsx b/packages/esm-patient-labs-app/src/lab-orders/add-lab-order/lab-order-form.component.tsx
index 5a50965d23..a1a057c5f2 100644
--- a/packages/esm-patient-labs-app/src/lab-orders/add-lab-order/lab-order-form.component.tsx
+++ b/packages/esm-patient-labs-app/src/lab-orders/add-lab-order/lab-order-form.component.tsx
@@ -62,7 +62,7 @@ export function LabOrderForm({
         urgency: z.string().refine((value) => value !== '', {
           message: translateFrom(moduleName, 'addLabOrderPriorityRequired', 'Priority is required'),
         }),
-        labReferenceNumber: z.string().optional(),
+        accessionNumber: z.string().optional(),
         testType: z.object(
           { label: z.string(), conceptUuid: z.string() },
           {
@@ -182,7 +182,7 @@ export function LabOrderForm({
             <Column lg={16} md={8} sm={4}>
               <InputWrapper>
                 <Controller
-                  name="labReferenceNumber"
+                  name="accessionNumber"
                   control={control}
                   render={({ field: { onChange, onBlur, value } }) => (
                     <TextInput
@@ -193,8 +193,8 @@ export function LabOrderForm({
                       value={value}
                       onChange={onChange}
                       onBlur={onBlur}
-                      invalid={errors.labReferenceNumber?.message}
-                      invalidText={errors.labReferenceNumber?.message}
+                      invalid={errors.accessionNumber?.message}
+                      invalidText={errors.accessionNumber?.message}
                     />
                   )}
                 />
diff --git a/packages/esm-patient-labs-app/src/lab-orders/api.ts b/packages/esm-patient-labs-app/src/lab-orders/api.ts
index 95e3996c93..391c6d9f36 100644
--- a/packages/esm-patient-labs-app/src/lab-orders/api.ts
+++ b/packages/esm-patient-labs-app/src/lab-orders/api.ts
@@ -92,6 +92,7 @@ export function prepLabOrderPostData(
       concept: order.testType.conceptUuid,
       instructions: order.instructions,
       orderReason: order.orderReason,
+      accessionNumber: order.accessionNumber,
     };
   } else if (order.action === 'REVISE') {
     return {
@@ -105,6 +106,7 @@ export function prepLabOrderPostData(
       instructions: order.instructions,
       orderReason: order.orderReason,
       previousOrder: order.previousOrder,
+      accessionNumber: order.accessionNumber,
     };
   } else if (order.action === 'DISCONTINUE') {
     return {
@@ -117,6 +119,7 @@ export function prepLabOrderPostData(
       concept: order.testType.conceptUuid,
       orderReason: order.orderReason,
       previousOrder: order.previousOrder,
+      accessionNumber: order.accessionNumber,
     };
   } else {
     throw new Error(`Unknown order action: ${order.action}.`);
diff --git a/packages/esm-patient-orders-app/src/utils/index.ts b/packages/esm-patient-orders-app/src/utils/index.ts
index ec019258a9..1f8c556287 100644
--- a/packages/esm-patient-orders-app/src/utils/index.ts
+++ b/packages/esm-patient-orders-app/src/utils/index.ts
@@ -78,7 +78,7 @@ export function buildLabOrder(order: Order, action?: OrderAction) {
     careSetting: order.careSetting.uuid,
     instructions: order.instructions,
     urgency: order.urgency,
-    labReferenceNumber: order.labReferenceNumber,
+    accessionNumber: order.accessionNumber,
     testType: {
       label: order.concept.display,
       conceptUuid: order.concept.uuid,