URIC ACID TEST FOR RASBURICASE PATIENTS

Message

This test is only ordered for patients receiving rasburicase therapy. These samples must be collected in a light green top tube and
transported to the clinical laboratory immediately ON ICE.

Test Code

LAB1234151

CPT Codes
84550

Preferred Specimen

Adult: One 4.5 mL light green top tube on ice
Pediatric: One light green microtainer on ice

Instructions

Patients receiving the recombinant uricolytic agent Elitek© (rasburicase) must have their blood samples collected on ice for uric acid testing to prevent falsely decreased results.

Sample must be collected and immedicately put onto ice. 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. Sample must be collected and immediately put onto ice. 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

Methodology
Colorimetric/Uricase

Setup Schedule

Sunday-Saturday

Reference Range

Age (years)	Male Normal Ranges (mg/dL)	Female Normal Ranges (mg/dL)
0	1.2-6.7	1.3-6.2
1	1.7-5.0	1.7-5.0
4	2.2-4.7	2.2-4.7
7	1.9-5.0	1.9-5.0
10	2.3-5.4	3.0-4.7
12	2.7-6.8	3.0-5.8
14	2.4-7.9	3.0-5.8
16	4.0-8.7	3.0-5.8
>=20	3.5-7.5	2.9-6.3

Performing Laboratory
West Virginia University Hospital, Inc.
Berkeley Medical Center
Jefferson Medical Center

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.