Bilirubin, Total & Direct

Message

Performing Lab: Central Lab, Hudson, Lakeview, Regions, Sartell, Westfields

Test Code

3121

Alias/See Also

Sunquest: BITD; Total Bilirubin with Direct Bilirubin

CPT Codes
82247, 82248

Includes

Total Bilirubin; Direct Bilirubin

Preferred Specimen

0.2 mL Lithium Heparin Plasma (light green-top) tube

Minimum Volume

0.1 mL

Other Acceptable Specimens

Serum (gold-top, red-top, red/gray-top), Lithium Heparin (light green-top) on ICE

Instructions

Ordering:
For patients >30 days old only. For patients 0-30 days old, order BILND
Collection:
Protect from light. Exposure to light may falsely decrease result.

Transport Temperature

Refrigerated

Specimen Stability

Room Temperature: 4 hours
Refrigerated: 7 days
Frozen: 6 months
Lakeview: Room Temperature (8 hours), Refrigerated (7 days), Frozen (6 months)

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

Gross Hemolysis

Methodology
Colorimetric

Setup Schedule

Hospital: Daily
Clinics: Monday - Friday

Report Available

Same day.

Limitations

Bilirubin is photosensitive and samples should be protected from both sunlight and fluorescent light to avoid photo-degradation.

Reference Range

Site:	Test Order:	Reference Range:	Critical:
Central Lab & Regions	Total Bilirubin	>21 days: 0.2 - 1.2 mg/dL	<31 days: >14.9 mg/dL
Hudson, Lakeview, Sartell, Westfields	Total Bilirubin	0.2 - 1.3 mg/dL	<31 days: >14.9 mg/dL
Central Lab & Regions	Direct Bilirubin	0.0 - 0.5 mg/dL
Hudson, Lakeview, Sartell, Westfields	Direct Bilirubin	0.0 - 0.3 mg/dL

Clinical Significance

Total bilirubin in serum and plasma is the sum of unconjugated bilirubin (Bu), mono- and diglucuronide conjugated bilirubin (Bc), and delta bilirubin (DELB), a bilirubin fraction covalently bound to albumin. With the exception of anicteric jaundice, total serum bilirubin is invariably increased in jaundice. Causes of jaundice are pre-hepatic, resulting from various hemolytic diseases; hepatic, resulting from hepatocellular injury or obstruction; and post-hepatic, resulting from obstruction of the hepatic or common bile ducts. Jaundice has been classified as unconjugated (indirect) and conjugated (direct) hyperbilirubinemia. Increased plasma conjugated bilirubin occurs with hepatobiliary disorders, including intrahepatic and extrahepatic biliary tree obstruction, liver cell damage, Dubin-Johnson syndrome, and Rotor syndrome.

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.