Last Modified:
8/30/2023 12:58:05 PM
Medical Necessity Documentation:
Client Notes:
When sending to Parkview Dekalb: 1.0 mL Serum in a SST Gold Top Tube is the recommend specimen
Patient Preparation:
Specimen Requirements:
1.0 mL Plasma in a PST Mint Green Top Tube - Li Heparin (preferred)
or
1.0 mL Serum in a SST Gold Top Tube
Collection Instructions:
Minimum Volume:
0.5 mL Plasma
Transport & Storage: Temperature/Stability:
7 days Refrigerated
24 hours unspun
Reference Range:
0.25 - 4.5 uIU/ml
Free T4: 0.80 - 1.80 ng/dL
Critical Ranges:
Test Comments:
Methodology:
ECLIA
Clinical Significance:
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Days Performed:
Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed:
Parkview Dekalb Hospital, Parkview Huntington Hospital, Parkview LaGrange Hospital, Parkview Noble Hospital, Parkview Randallia Hospital, Parkview Regional Medical Center, Parkview Southwest , Parkview Wabash Hospital, Parkview Warsaw , Parkview Whitley Hospital
PHL Test Code:
DATHY
EPIC Test Code:
LAB3279
Alternate Test Names:
Thyroid Pro Direct Access; Thyroid Profile Direct Access; TSH and T4 Free
Included Tests:
Thyroid Stimulating Hormone (TSH); Thyroxine (Free T4)
CPT Coding:
84443 & 84439
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