Cortisol, Total, LC/MS

Test Code

11281

CPT Codes
82533

Preferred Specimen

1 mL serum collected in a red-top tube (no gel)

Minimum Volume

0.2 mL

Other Acceptable Specimens

Plasma collected in: EDTA (lavender-top) tube

Instructions

Specify time of day specimen was collected

Transport Temperature

Room temperature

Specimen Stability

Room temperature: 14 days
Refrigerated: 21 days
Frozen: 1 year

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

Gross hemolysis • Serum separator tube (SST)

Methodology
Chromatography/Mass Spectrometry

FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule

Set up: Mon-Fri; Report available: 3-7 days

Reference Range

Adult
8:00 - 10:00 AM	4.6-20.6 mcg/dL
4:00 - 6:00 PM	1.8-13.6 mcg/dL

Cortisol Response to ACTH
Peak	>20.0 mcg/dL
Peak	>16.0 mcg/dL after IM injection

Pediatric

Age	mcg/dL
Infants
Premature (31-35 weeks)**	≤15.0
Term, 3 days old**	≤14.0
<30 days	Not established
1-11 months	1.4-24.0
1 year	1.7-25.4
2 years	1.8-26.4
3 years	2.0-27.0
4 years	2.0-27.2
5 years	2.0-27.3
6 years	2.0-27.2
7 years	2.0-27.1
8 years	2.0-27.0
9 years	1.9-26.8
10 years	1.9-26.4
11 years	1.8-26.1
12 years	1.8-26.0
13 years	1.8-26.1
14 years	1.9-26.6
15 years	2.1-27.5
16 years	2.3-28.6
17 years	2.6-29.8

Pediatric lower reference values are reflective of both AM and early PM sampling
⁠⁠⁠⁠⁠⁠⁠

ACTH Stimulation**	Baseline (mcg/dL)	60 Minutes (mcg/dL)
1-12 Months	3.0-23.0	32.0-60.0
1-5 Years	6.0-25.0	22.0-40.0
6-12 Years	3.0-15.0	17.0-28.0

**Pediatric data from J Clin Endocrinol Metab
(1991) 73:674-686 and J Clin Endocrinol Metab
(1989) 69:1133-1136.

Clinical Significance

Total cortisol concentrations are decreased in Addison's Disease and increased in Cushing's Disease and in other conditions of glucocorticoid excess.

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.