Creatine Kinase Isoenzymes (CK Isoenzymes) with Total CK

Test Code
CKI (4451)

Quest Code
4451

CPT Codes
82550, 82552

Includes
CK-BB, CK-MB, CK-MM and Creatine Kinase (CK), Total

Preferred Specimen
2 mL serum collected in a serum separator tube (red-top)

Minimum Volume
1 mL

Instructions
If CK and CK Isoenzymes are ordered together, specimen must be submitted frozen.

Transport Temperature
Frozen

Specimen Stability
Room temperature: Unacceptable
Refrigerated: 48 hours
Frozen: 14 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Hemolysis • Received thawed

Methodology
Electrophoresis • Enzymatic

Setup Schedule
Set up: Mon-Sat; Report available: 2-3 days

Reference Range
See Laboratory Report

Clinical Significance
Evaluation of myocardial infarction and/or skeletal muscle damage. The creatine kinase isoenzyme test separates the major isoenzymes of creatine kinase (CK-MM (muscle), CK-MB (specific for cardiac muscle), and CK-BB (found in brain, prostate, gut, lung, bladder, uterus, placenta, and thyroid) by electrophoresis. The test provides the percentages of each in relationship to total creatine kinase. The test provides information on recent muscle damage (CK-MM and CK-MB), providing specific information about possible cardiac muscle damage (CK-MB) due to myocardial infarction. In all types of muscular dystrophy, and especially in the Duchenne type, serum CK activity is greatly elevated. CK-MB can arise from tissues other than the myocardium. These include inflammatory and degenerative muscle diseases, traumatic lesions including shock, intoxication, hypothyroidism, and in women immediately after obstetric delivery. Myocardial damage is usually excluded if CK-MB activity is <5 or 6% of the total CK activity. CK-BB can be elevated up to 6-fold in maternal serum with up to 10% from the uterus and and placenta. CK-BB can also be elevated in neonates, hypothermia, gastrointestinal infarction, adenocarcinoma, and lung tumors. Prostate tumors and tumors of the bladder, testes, breast, kidney, and ovary have also been associated to varying degrees with increases in CK-1. Use of a more cardiac-specific Troponin I assay test code #3393, is also recommended to evaluate patients with suspected acute myocardial infarction.

Performing Laboratory
Quest Diagnostics Nichols Institute San Juan Capistrano
33608 Ortega Hwy
San Juan Capistrano, CA 92675-2042



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.