Ascites Albumin Profile

Test Code

ALBA

CPT Codes
82040, 82042

Includes

Ascites Albumin, Serum Albumin and Serum:Ascites Fluid Gradient Ratio

Preferred Specimen

Serum (gold top tube) and Ascites Fluid

Minimum Volume

0.5 mL serum (gold top tube) and 1 mL ascites fluid

Other Acceptable Specimens

Lithium Heparin Plasma (green top tube) is also acceptable for the blood specimen.

Instructions

Both serum and ascites fluid specimens are required.

Serum should be collected within 24 hours of collection of ascites fluid. Blood in lab may be used if available and collected within 24 hours of ascites fluid.

This test is a panel that measures albumin in ascites and serum and calculates an albumin gradient based on these measurements. For Serum Albumin only, order ALB. For albumin measurement on body fluids other than Ascites or Peritoneal Fluid, order MISALB.

Transport Container

Serum (gold top) or Lithium Heparin (green top) tube for blood and sterile fluid collection container for ascites fluid.

Transport Temperature

Room Temperature or Refrigeration

Specimen Stability

Serum: Room Temperature - 7 days, Refrigerated - 30 days; Ascites Fluid: Room Temperature - 24 hours, Refrigerated - 3 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Quantity Not Sufficient, IV contamination (serum), high viscosity (ascites fluid)

Methodology
Colorimetric

Setup Schedule

Daily upon receipt

Report Available

Upon completion of analysis

Reference Range

Serum Albumin: 3.5 - 4.8 g/dL
Ascites Albumin: 0.31 - 1.77 g/dL
Gradient: No range established

Clinical Significance

The ascetic albumin test is the most accurate way to differentiate different causes of ascites. The albumin gradient, which is the difference between the serum albumin and the ascitic fluid albumin, is the best way to differentiate between liver causes of ascites and peritoneal causes of ascites. Generally, portal hypertension is seen in patients with liver diesase, mainly cirrhosis. These patients tend to have a high gradient, higher than 1.1 g/dL, which indicates more serum albumin than ascitic fluid albumin. A low gradient, less than 1.1 g/dL, is indicative of a tumor or inflammatory changes which are producing an exudative process. Peritoneal fluid tends to have high levels of albumin.

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.