T4 (THYROXINE), TOTAL ONLY

Test Code

LAB126

CPT Codes
84436

Preferred Specimen

One 4.5 mL light green top tube
Pediatric: One light green top microtainer

Other Acceptable Specimens

Dark green top tube
Red top tube
Gold top tube

Instructions

Sample must be centrifuged within two hours of collection. Serum/plasma must be removed from the red cells and put into aliquot tubes following centrifugation.

Transport Temperature

Refrigerated

Specimen Stability

Centrifuge within 2 hours after collection.
Ambient: 24 hours
Refrigerated: 6 days
Frozen: 6 days

Methodology
Chemiluminescent Immunoassay

Setup Schedule

Sunday-Saturday

Reference Range

Age	Female Ref Range	Male Ref Range
0D-6D	5.0-18.0 ug/dL	5.0-18.0 ug/dL
7D-12M	5.9-13.7 ug/dL	5.9-13.7 ug/dL
1Y-8Y	6.2-10.3 ug/dL	6.2-10.3 ug/dL
9Y-11Y	5.5-9.3 ug/dL	5.5-9.3 ug/dL
12Y-13Y	5.1-8.3 ug/dL	5.0-8.3 ug/dL
14Y-18Y	5.5-13.0 ug/dL	4.7-8.6 ug/dL
>=19Y	4.8-11.7 ug/dL	4.8-11.7 ug/dL

Performing Laboratory
West Virginia University Hospital, Inc.
Camden Clark Medical Center
Garrett Regional Medical Center
Princeton Community Hospital
Potomac Valley Hospital
United Hospital Center
Uniontown Hospital
Wheeling Hospital

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.