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HelpTest Code LAB90343 Thyroid-Stimulating Hormone (TSH) with Reflex Free T4, Plasma or Serum
Reporting Title
TSH with Reflex Free T4 with an Additional Charge
Methodology
Testing Algorithm:
If TSH is <0.27 microIU/mL or >4.2 µIU/mL, then LAB127 “T4 (Thyroxine), Free, Plasma or Serum” is performed at an additional charge.
Method Name:
Roche Diagnostics, Electrochemiluminescence Immunoassay at RMH, GMC, DMH, DH, GMH. WECC, PMC, GCMH, OBH, MGH, MH, HMH, SH
General Information:
Used as a primary test for differential diagnosis of thyroid disease.
Performing Laboratory
OhioHealth Laboratory Services- RMH, GMC, DH ,DMH, MGH, GMH, HMH, OBH, MH, SH, WECC, PMH, GCMH Core Laboratories
Specimen Requirements
Collection Instructions:
1. Serum and Plasma gel tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
Submit only 1 of the following specimens:
Preferred:
Serum
Draw blood in a gold-top gel tube(s). Spin down and send 1 mL of serum refrigerated.
Note:
1. A speckled-top serum gel tube(s) or plain red-top is also acceptable. .
2. Heterophile antibodies may interfere with this assay.
3. Indicate serum on request form.
4. Label specimen appropriately (serum).
Alternate:
Plasma
Draw blood in a mint green-top (heparin) gel tube(s). Spin down and send 1 mL of heparinized plasma refrigerated.
Note: 1. Heterophile antibodies may interfere with this assay.
2. Indicate plasma on request form.
3. Label specimen appropriately (plasma).
Specimen Transport Temperature
Refrigerate/Frozen/Ambient -All OK
Reference Values
TSH-3rd GENERATION
0-5 d: 0.7-15.2 microIU/mL
6d-2 mo: 0.7-11.0
3-11 mo: 0.7-8.4
1-5 y: 0.7-6.0
6-10 y: 0.6-4.8
11-18 y: 0.5-4.3
> 19 y:
0.27- 4.2 microIU/mL (euthyroid)
<0.1 microIU/mL (hyperthyroid)
>7.1 microIU/mL (hypothyroid)
FREE T4
0.7-1.7 ng/dL
Day(s) Test Set Up
Monday through Sunday; Continuously
Test Classification and CPT Coding
84443 - TSH
84439 - free T4 (if appropriate)