Last Modified:
2/2/2022 7:34:53 AM
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Specimen Requirements:
1.0 mL Serum from a Red Top Tube in a Plastic Vial
Collection Instructions:
Specimen should be drawn at 24 hours after oral dose; 3 to 7 hours after Theodur dose; or Immediatately before next dose. Order should reflect time from medication to draw.
Do not collect in a Serum Separator Tube (SST or PST)
Transport & Storage: Temperature/Stability:
7 days Refrigerated
24 hours unspun
Reference Range:
10 - 20 ug/mL
Critical Ranges:
> 20 ug/mL
Test Comments:
Methodology:
Immnoassay
Clinical Significance:
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Days Performed:
Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed:
Parkview Regional Medical Center
PHL Test Code:
THEO
EPIC Test Code:
LAB35
Alternate Test Names:
Aminophyllin; Aminophylline; Theo; Theodur; Theo-Dur; Theolair; Theophylline Level; Theospan
Included Tests:
CPT Coding:
80198
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