Bilirubin, Total with Reflex to Direct Bilirubin

Message

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

Test Code

4562

Alias/See Also

Sunquest: BILTR; Total Bilirubin with Reflex to Direct Bilirubin

CPT Codes
82247

Includes

If Total Bilirubin is >1.2 - Direct Bilirubin will be automatically ordered.

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

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

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

	Reference Range	Critical Value
	0.2-1.2	<31 Days >14.9

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.