ROMI Panel

Test Code

ROMI

CPT Codes
83874; 84484

Preferred Specimen

Serum (gold top tube), collected at onset, 3 hours post onset, 6 hours post onset, and 12 hours post onset

Minimum Volume

0.5 mL per tube

Other Acceptable Specimens

Lithium Heparin Plasma (green top tubes)

Instructions

Collect 4 samples: The first specimen is considered the "Onset" specimen, followed by specimens collected 3 hours later, 6 hours later, and 12 hours later.

Transport Container

Serum (gold top) tubes or Lithium Heparin Plasma (green top) tubes

Transport Temperature

Room Temperature or Refrigeration

Specimen Stability

Room Temperature - 2 hours; Refrigerated - 7 days

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

Hemolysis, Turbidity, Quantity Not Sufficient, IV contamination

Methodology
Chemiluminescence

Setup Schedule

Daily upon receipt

Report Available

Upon completion of analysis

Limitations

Streptokinase may interfere negatively with the predicted concentration of cTnI. Care should be taken when interpreting cTnI results after administration of streptokinase.

Reference Range

Reference Range: <0.034 ng/mL

Interpretative Data:

0.034 ng/mL or less: Negative; repeat testing as clinically indicated.
0.034 - 0.12 ng/mL: Suspicious for myocardial injury. Serial measurements may be necessary to confirm or exclude the diagnosis of acute coronary syndrome.
0.12 ng/ml: Consistent with myocardial injury.

*Changes in results should be interpreted based on method.

Clinical Significance

Troponin I (TnI) is a protein normally found in muscle tissue that, in conjunction with Troponin T and Troponin C, regulates the calcium dependent interaction of actin and myosin. Three isotypes of TnI have been identified: one associated with fast-twitch skeletal muscle, one with slow-twitch skeletal muscle and one with cardiac muscle. The cardiac form has an additional 31 amino acid residues at the N terminus and is the only troponin isoform present in the myocardium. Clinical studies have demonstrated that cardiac Troponin I (cTnI) is detectable in the bloodstream 4–6 hours after an acute myocardial infarct (AMI) and remains elevated for several days thereafter. Thus, cTnI elevation covers the diagnostic windows of both creatine kinase-MB (CK-MB) and lactate dehydrogenase. Further studies have indicated that cTnI has a higher clinical specificity for myocardial injury than does CK-MB. Other conditions resulting in myocardial cell damage can contribute to elevated cTnI levels. Published studies have documented that these conditions include, but are not limited to, sepsis, congestive heart failure, hypertension with left ventricular hypertrophy, hemodynamic compromise, myocarditis, mechanical injury including cardiac surgery, defibrillation and cardiac toxins such as anthracyclines. Factors such as these should be considered when interpreting results from any cTnI test method. Because of its cardiac specificity and sensitivity, cTnI has been used as a reliable marker in evaluating patients with unstable angina and non-ST segment elevation acute coronary syndrome (ACS). Previous clinical studies of patients with ACS have shown that minor increases in cTnI values provide important prognostic information about the short and long term risk of death. Ultimately, the assessment of the prognosis can be useful in identifying patients most likely to benefit from specific therapeutic interventions.

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.