Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Patient should avoid food high in indoles: Avocado, banana, tomato, plum, walnut, pineapple, and eggplant. Patient should also avoid tobacco, tea and coffee three days prior to specimen collection.
Specimen Requirements:
10.0 mL aliquot from a well mixed 24 hour Urine Collection in (2) Plastic Vials
Collection Instructions:
pH must be < = or 6.
1. When starting the 24-hour period, urinate and discard (throw-away) this specimen. NOTE THE TIME
2. From that time on, collect all urine by urinating into a clean container and transfer into the provided container.
DO NOT URINATE DIRECTLY INTO CONTAINER.
3. Try to pass the last urine just prior to the end of the 24 hour period. Add this urine into the container.
4. Urine Specimen MUST be kept refrigerated during and after collection.
For patient collection instruction sheet see Addendum D
For Spanish patient collection instruction sheet see Addendum D
For Burmese patient collection instruction sheet see Addendum D
For Arabic patient collection instruction sheet see Addendum D
Minimum Volume:
5.0 mL Urine
Transport & Storage: Temperature/Stability:
Unpreserved
Unacceptable Ambient
30 days Refrigerated
49 days Frozen (Transport)
Rejection Criteria:
Unpreserved urine received frozen with pH >6
Reference Range:
Norepinephrine
| 3-8 Years |
5-41 mcg/24 h |
| 9-12 Years |
5-50 mcg/24 h |
| 13-17 Years |
12-88 mcg/24 h |
| >17 Years |
15-100 mcg/24 h |
Epinephrine
| 3-8 Years |
1-7 mcg/24 h |
| 9-12 Years |
≤8 mcg/24 h |
| 13-17 Years |
≤11 mcg/24 h |
| >17 Years |
2-24 mcg/24 h |
Dopamine
| 3-8 Years |
80-378 mcg/24 h |
| 9-12 Years |
51-474 mcg/24 h |
| 13-17 Years |
51-645 mcg/24 h |
| >17 Years |
52-480 mcg/24 h |
Total Catecholamines
| 3-8 Years |
9-51 mcg/24 h |
| 9-12 Years |
9-71 mcg/24 h |
| 13-17 Years |
13-90 mcg/24 h |
| >17 Years |
26-121 mcg/24 h |
Critical Ranges:
Test Comments:
Methodology:
Ultra Performance Liquid chromatography, Electrochemical Detection, Kinetic Alkaline Picrate
Clinical Significance:
Catecholamines, Fractionated, 24-Hour Urine (without Creatinine) [318X] - The three catecholamines (norepinephrine, epinephrine and dopamine) are the principal secretory products of neural tissue. Clinically, the measurement of circulating catecholamines is valuable in the diagnosis of catecholamine secreting tumors associated chiefly with hypertension (pheochromocytomas, neuroblastomas and gangliomas) and with the evaluation of orthostatic hypotension
Documentation:
Adrenaline,Noradrenaline,Catecholamines, Free
Custom Panel:
No
PRODUCTION SCHEDULE
Turn Around Time:
2 to 4 days
Days Performed:
Monday, Tuesday, Wednesday, Thursday, Friday
Sites Performed:
Quest - Chantilly
PHL Test Code:
CATFU
EPIC Test Code:
LAB373
Send Out Test Code:
4646 | 318X
Alternate Test Names:
Catecholamine Fractionated Urine; Catecholamine Fractionation, Urinary, Free; Catecholamines Fractionated, Free (w/out Creatinin
Included Tests:
Dopamine, Epinephrine, Norepinephrine, Total Catecholamines (calculated)
CPT Coding:
82384 CPT code 81050 may be added at an additional charge for volume measurement