Last Modified:
12/28/2023 5:27:17 AM
Medicare Medical Necessity Restrictions May Apply
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Specimen Requirements:
1.0 mL Serum in a SST Gold Top Tube
Collection Instructions:
Minimum Volume:
0.25 mL Serum
Transport & Storage: Temperature/Stability:
7 Days Refrigerated
24 hours unspun
Reference Range:
0.8 - 1.8 ng/dl
Critical Ranges:
Test Comments:
This assay utilizes biotin technology. Patients taking vitamin supplements containing high doses of biotin (>5 mg/day) may have falsely increased test results generated.
Methodology:
Chemiluminescence
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 Randallia Hospital, Parkview Regional Medical Center, Parkview Wabash Hospital, Parkview Whitley Hospital
PHL Test Code:
T4FRE
EPIC Test Code:
LAB127
Alternate Test Names:
Free T4; FT4; T4 Free; T4, Free
Included Tests:
CPT Coding:
84439
Go back to the top of the page.