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Test Code TSHFT4 Thyroid-Stimulating Hormone- Sensitive (s-TSH) with T4 (Thyroxine),Free Reflex if indicated, Serum or Plasma

Additional Codes

Testing Algorithm

 

Age TSH (u[IU]/mL Reflexed FT4
0-1 month <0.72 Performed
0-1 month >13.10 Performed
2 months - 4 years <0.46 Performed
2 months - 4 years >8.10 Performed
5 years - 17 years <0.36 Performed
5 years - 17 years >5.80 Performed
18 years and older <0.27 Performed
18 years and older >4.20 Performed

 

Methodology

Electrochemiluminescence Immunoassay (ECLIA)

Specimen Requirements

Container/Tube:

Preferred: Lithium heparin (light green-top)

Acceptable: Serum Gel

 Draw blood, spin down and send 1 mL (pediatric:  0.2 mL) of plasma or serum.

Specimen Stability Information

 

Specimen Type

Temperature

Time

Plasma,lithium heparin / Serum

RT, spun

8 days
  Refrigerated, spun 14 days

 

Reference Values

See individual components. TSH and FT4

Reject Due To

 

Hemolysis

Mild:

ok

Gross:

ok

Lipemia

Mild:

ok

Gross:

ok

Icterus

Mild:

ok

Gross:

Reject

 

Day(s) Test Set Up

Monday through Sunday

CPT Coding

84443- TSH

84439- T4, free (if appropriate)

Secondary ID

HHA253

Performing Laboratory

Huntsville Hospital Laboratory/Madison Hospital Laboratory

LOINC Coding

Test Name LOINC Code

Thyroid-Stimulating Hormone - Sensitive (s-TSH), Serum or Plasma

 3016-3
T4 (Thyroxine), Free, Serum or Plasma 3024-*7