Last Modified:
6/17/2019 1:49:39 PM
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Specimen Requirements:
1.0 mL Plasma from a Lavender Top Tube - EDTA in a Plastic Vial
Collection Instructions:
Collect as a trough specimen just before next dose.
Transport & Storage: Temperature/Stability:
72 hours Ambient
7 days Refrigerated (transport)
30 days Frozen
24 hours on cells
Rejection Criteria:
Serum Separator Tube (SST or PST); Hemolyzed
Reference Range:
| Primidone |
5.0-12.0 mg/L |
| Phenobarbital |
15.0-40.0 mg/L |
Critical Ranges:
Test Comments:
Methodology:
Immunoassay
Clinical Significance:
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Turn Around Time:
1 to 2 days
Days Performed:
Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed:
Quest - Chantilly
PHL Test Code:
PRIM
EPIC Test Code:
LAB485
Send Out Test Code:
6381
Alternate Test Names:
Mysoline ; Primidone (Mysoline) includes Phenobarb Quantitati; Primidone (Mysoline) w/ Phenobarb Quantitative
Included Tests:
Primidone, Phenobarbital
CPT Coding:
80188, 80184
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