Procalcitonin

Message

Performed in Chemistry

NOTE: Procalcitonin testing includes two test codes with different reference ranges:

• PROCALS: Procalcitonin, sepsis - as a diagnostic marker of sepsis/septic shock
• PROCALR: Procalcitonin, respiratory - management of lower respiratory tract infections (LTRI)

Test Code

PROCALRS

CPT Codes
84145

Preferred Specimen

Green Top LiHep, Plasma
WyMCC - SST

NOTE: Centrifuge within 2 hours of collection.

Other Acceptable Specimens

Gold/SST or Red Top

Specimen Stability

Room Temperature 24 hours
Refrigerated 48 hours
Frozen 3 months

FDA Status
FDA Approved

Setup Schedule

Daily, Sunday through Saturday

Report Available

Less than 4 hours

Clinical Significance

PCT is the prohormone of hormone calcitonin, but PCT and calcitonin are distinct proteins. Calcitonin is exclusively produced by Ccells of the thyroid gland in response to hormonal stimuli, whereas PCT can be produced by several cell types and many organs in response to proinflammatory stimuli, in particular by bacterial products. Depending on the clinical background, PCT concentration above 0.1μg/L can indicate clinically relevant bacterial infection, requiring antibiotic treatment. PCT levels rise rapidly (within 6-12 hours) after a bacterial infectious insult with systemic consequences. At a PCT concentration >0.5μg/L, patient should be considered at risk of developing severe sepsis or septic shock. On the other hand, relief of septic infection is accompanied by a decrease in PCT concentration which returns to normal with a half-life of 24 hours, i.e., continuous decline of PCT is indicative of effective source control measures and has been implicated in safe de-escalation of antibiotic therapy. Early after multiple traumas, major surgery, severe burns, or in neonates, PCT levels can be elevated independently of an infectious process, but return to baseline is usually rapid. Viral infections, bacterial colonization, localized infections, allergic disorders, autoimmune diseases, and transplant rejection do not usually induce a significant PCT response (values <0.5 µg/L). Therefore, PCT is an important marker enabling specific differentiation between a bacterial infection and other causes of inflammatory reactions.

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.