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CPT Code:
84443. If reflex testing is performed, concomitant CPT codes/charges will apply.
Test Type: 2 mL Serum
Stability Time:
|
Temperature |
Period |
|---|---|
|
Room temperature |
14 days |
|
Refrigerated |
14 days |
|
Frozen |
14 days |
|
Freeze/thaw cycles |
Stable x3 |
Reference Range:
TSH uIU/mL 0.45 – 4.50
T4, free ng/dL 0.82 - 1.77
Overview:
Aid clinicians in obtaining an appropriate diagnosis for common adult thyroid disorders. The cascade begins with a third-generation thyroid-stimulating hormone (TSH) test. If the TSH result is normal, a euthyroid status is assumed and testing stops. Additional testing is performed only if the initial TSH result is abnormally high or low. The cascade algorithm will select specific tests, based on the results of previously performed tests, which are necessary to arrive at the most appropriate laboratory diagnosis. The assayed value of a test, relative to the reference interval of that specific test, determines which, if any, additional tests are performed. The cascade proceeds, selecting specific tests, until the most probable diagnosis can be made.
This profile is not intended for use in pediatric patients or in monitoring patients receiving treatment for thyroid disease with either ablative or suppressive therapy. It would also not be appropriate to use this procedure to diagnose primary thyroid neoplasm.
Davey R. Thyroxine, thyrotropin, and age in a euthyroid hospital patient population. Clin Chem. 1997 Nov; 43(11):2143-2148. PubMed 9365400
Davey RX, Clarke MI, Webster AR. Thyroid function testing based on assay of thyroid stimulating hormone: Assessing an algorithm's reliability. Med J Aust. 1996 Mar 18; 164(6):329-332. PubMed 8606655
Feldkamp CS, Carey JL. An algorithmic approach to thyroid function testing in a managed care setting. 3-year experience. Am J Clin Pathol. 1996 Jan; 105(1):11-16. PubMed 8561076
Klee GG, Hay ID. Role of thyrotropin measurements in the diagnosis and management of thyroid disease. Clin Lab Med. 1993 Sep; 13(3):673-682. PubMed 8222581
Ladenson PW, Singer PA, Ain KB, et al. American Thyroid Association guidelines for detection of thyroid dysfunction. Arch Intern Med. 2000 Jun 12; 160(11):1573-1575. PubMed 10847249
Collection Details:
Collection Instructions:
Note: Special reflexing. If TSH is <0.450, it will reflex to thyroxine (T4), free, direct and depending on the thyroxine (T4), free, direct result, may reflex to a triiodothyronine (T3), free, both at an additional charge. If the TSH is >4.500, it will reflex to thyroxine (T4), free, direct and depending on the thyroxine (T4), free, direct result, may reflex to a thyroid peroxidase (TPO) antibody, both at an additional charge.
This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.
Red-top tube or gel-barrier tube.
If a red-top tube is used, transfer separated serum to a plastic transport tube.
Room temperature.