Last Modified:
3/25/2019 4:20:41 PM
Medicare Medical Necessity Restrictions May Apply
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Specimen Requirements:
3.0 mL Serum in a SST Gold Top Tube
and
3.0 mL Whole Blood in a Lavender Top Tube - EDTA
Collection Instructions:
Transport & Storage: Temperature/Stability:
Reference Range:
See Individual Tests
Critical Ranges:
Test Comments:
It has been noticed that allopurinol may falsely elevate TSH level. Cotesting with Free T4 and correlation with clinical symptoms are recommended in evaluation of thyroid function in this subset of patients.
TSH -- This assay utilizes biotin technology. Patients taking vitamin supplements containing high doses of biotin (>5 mg/day) may have falsely decreased test results generated.
Methodology:
Multiple
Clinical Significance:
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Days Performed:
Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed:
Parkview Hospital Randallia, Parkview Huntington, Parkview LaGrange, Parkview Noble, Parkview Regional Medical Center, Parkview Wabash, Parkview Warsaw , Parkview Whitley
PHL Test Code:
GHP1
EPIC Test Code:
LAB2397
Included Tests:
CBC with Differential [Automated Differential; Hematocrit (Hct); Hemoglobin (Hgb); Mean Corpuscular Hemoglobin (MCH); Mean Corpuscular Hemoglobin Concentration (MCHC); Mean Corpuscular Volume (MCV); Platelet (PLT); Red Blood Cell Count (RBC); Red Cell Distribution Width Standard Deviation (RDWSD); Red Cell Distribution Width Coefficient Variation (RDWCV); White Blood Cell Count (WBC)]; Comprehensive Metabolic Profile [Alanine Aminotransferase (ALT; SGPT); Albumin; Alkaline Phosphorus; Aspartate Aminotransferase (AST; SGOT); Bilirubin, Total; Blood Urea Nitrogen (BUN); Calcium (Ca); Creatinine; Electrolytes [Carbon Dioxide (CO2); Chloride (CL); Potassium (K); Sodium (Na)]; Glucose; Protein, Total]; Thyroid Stimulating Hormone (TSH)
CPT Coding:
80053, 84443, 85025 (Reflex 85007 or 85008)
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