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Test Code LAB126 T4, TOTAL

Important Note

Test subject to Medicare National Coverage Determination (NCD) 190.22 - Thyroid Testing.

Additional Codes

Orderable Codes:

Epic Code Atlas Code Mayo Access ID Order LOINC
LAB126 TT4 FAH5787 3026-2

Result Component(s):

Reporting Name Epic Code Atlas Code Mayo Access ID Result LOINC
T4, Total 12301002182 TT4 FAH5787 3026-2

 

Specimen Information

Container Specimen Temperature Collect Vol Submit Vol Min Vol Stability
SST  Serum Refrigerate 4 mL 0.5 mL 0.2 mL 5 days
Lithium Heparin (Green Top) Plasma Refrigerate 4 mL 0.5 mL 0.2 mL 5 days

*While a green microtainer is an optional tube type in rare circumstances, it is not recommended.

Test Schedule / Analytical Time / Test Priority

Daily / Same day / Available STAT

Method

Chemiluminescence Immunoassay

CPT(s)

Description CPT Code
T4 84436

 

Instrumentation

Ortho Vitros 5600

Reference Range

Age Sex Low High Units
0 - 14 days All 3.2 24.7 ug/dL
14 days - 4 years All 6.9 18.7 ug/dL
4 years - 15 years All 6.2 10.8 ug/dL
15 years - 18 years Male 5.7 9.3 ug/dL
15 years - 18 years Female 6.0 15.5 ug/dL
≥18 years All 5.5 11.0 ug/dL

 

Section

Chemistry-1

Performing Location

University of Vermont Medical Center

Is the UVMMC lab NY State Certified to perform this testing?  Yes/No

Yes