Last Modified: 12/30/2020 7:45:39 AM

Medical Necessity Documentation:  
Client Notes:  
Patient Preparation:  
Specimen Requirements:

2.0 mL Serum from a Red Top Tube in a Plastic Vial

Collection Instructions: Collect as a trough specimen or at least 12 hours after last dose
Minimum Volume: 1.5 mL Serum
Transport & Storage: Temperature/Stability: 5 days Ambient 
7 days Refrigerated
30 days Frozen
Rejection Criteria: Gross hemolysis; gel barrier; Serum Separator Tube (SST)
Reference Range:

Amitriptyline: No age/sex specific ranges for this test
Nortriptyline: No age/sex specific ranges for this test

Amitriptyline & Nortriptyline: 120 - 250 mcg/L

Low Detection Limit: 5 mcg/L

Critical Ranges: > 500 mcg/L
Test Comments: Drug Catagory: Antidepressant
Methodology: Chromatography/Mass Spectrometry
Clinical Significance:  
Custom Panel: No


Turn Around Time: 4 to 6 days
Days Performed: Monday, Tuesday, Wednesday, Thursday, Friday
Sites Performed: Quest - Chantilly
PHL Test Code: AMITR
EPIC Test Code: LAB681
Send Out Test Code: 423
Alternate Test Names: Elavil
Included Tests:  
CPT Coding: 80335

Go back to the top of the page.