Catecholamines, Fractionated, Plasma [314X]

Test Code
314X

CPT Codes
82384

Includes
Dopamine, Epinephrine, Norepinephrine and Total Catecholamines (calculated)

Preferred Specimen
4 mL plasma collected in a sodium heparin (green-top) tube

Minimum Volume
2.5 mL

Other Acceptable Specimens
Lithium heparin (green-top) • Sodium heparin lead-free (tan-top)

Instructions
Patients should be relaxed in either a supine or upright position before blood is drawn. States of anxiety and stress can cause fluctuations in the catecholamine levels. Draw specimen in a pre-chilled green-top vacutainer. Plasma should be separated in a refrigerated centrifuge within 30 minutes of collection and then frozen immediately at -20° C in plastic vials. Each specimen will be invoiced separately.

Transport Container
Plastic screw-cap vial

Transport Temperature
Frozen

Specimen Stability
Room temperature: 6 hours
Refrigerated: 6 hours
Frozen: 30 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Received room temperature • Received refrigerated

Methodology
High Performance Liquid Chromatography (HPLC) with Electrochemical Detection

Limitations
Recent surgery, traumatic injury, upright posture, cold, anxiety, pain, clonidine withdrawal, and concurrent acute or chronic illness may produce elevated results.

Reference Range

Epinephrine: No reference range available
Norepinephrine: No reference range available
Dopamine: No reference range available
Catecholamines, Total:
Adult reference ranges for Catecholamines, Plasma
Epinephrine Supine: Less than 50 pg/mL
  Upright: Less than 95 pg/mL
Norepinephrine Supine: 112-658 pg/mL
  Upright: 217-1109 pg/mL
Dopamine Supine: Less than 30 pg/mL
  Upright: Less than 30 pg/mL
Total (N+E+D) Supine: 123-671 pg/mL
  Upright: 242-1125 pg/mL
Pediatric reference ranges for Catecholamines, Plasma

Due to stress, plasma catecholamine levels are generally unreliable in infants and small children. Urinary catecholamine assays are more reliable.

Epinephrine Supine: Less than or equal to 464 pg/mL
  3-15 Years Upright: Not available
Norepinephrine Supine: Less than or equal to 1251 pg/mL
  3-15 Years Upright: Not available
Dopamine Supine: Less than 60 pg/mL
  3-15 Years Upright: Not available
Pediatric data from J Chromatogr (1993) 617:304-307



Clinical Significance
The evaluation of plasma catecholamines is utilized in the differential diagnosis of pheochromocytoma. In addition, monitoring norepinephrine levels in association with clonidine suppression has been recommended as a means of distinguishing patients with pheochromocytoma from patients with essential hypertension. Measurement of plasma norepinephrine levels may aid in the differential diagnosis of orthostatic and postural hypotension.

Performed By
Quest Diagnostics Nichols Institute



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.