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Cortisol, A.M. : 4212
Test CodeCORTAC or 4212
CPT Codes
82533
Instructions
Collect specimen between 7-9 a.m. Indicate the collection time on the specimen container and test requisition.
Assay not recommended when patient is receiving prednisone/prednisolone therapy due to cross reactivity with the antibody used in this assay.
Assay not recommended when patient is receiving prednisone/prednisolone therapy due to cross reactivity with the antibody used in this assay.
Transport Container
Preferred Specimen
1 mL serum
Minimum Volume
0.5 mL
1 mL serum
Minimum Volume
0.5 mL
Transport Temperature
Room temperature.
Specimen Stability
Room temperature: 7 days; Refrigerated: 7 days; Frozen: 28 days
Methodology
Immunoassay
Setup Schedule
Sunday - Saturday
Report Available
1 day
Reference Range
0-3 Days (infants)
Premature (31-35 Weeks) ≤15.0 mcg/dL
Term ≤14.0 mcg/dL
4 Days-1 Month Not established
2-11 Months 8 a.m. (7-9 a.m.) specimen 3.0-23.0 mcg/dL
1-17 Years 8 a.m. (7-9 a.m.) specimen 3.0-25.0 mcg/dL
>17 Years 8 a.m. (7-9 a.m.) specimen 4.0-22.0 mcg/dL
Premature (31-35 Weeks) ≤15.0 mcg/dL
Term ≤14.0 mcg/dL
4 Days-1 Month Not established
2-11 Months 8 a.m. (7-9 a.m.) specimen 3.0-23.0 mcg/dL
1-17 Years 8 a.m. (7-9 a.m.) specimen 3.0-25.0 mcg/dL
>17 Years 8 a.m. (7-9 a.m.) specimen 4.0-22.0 mcg/dL
Clinical Significance
Cortisol is increased in Cushing's Disease and decreased in Addison's Disease (adrenal insufficiency). Emerging data has demonstrated that patients with difficult-to-treat Type II Diabetes (HbA1c >7.5% despite medication) may also have elevated cortisol levels, akin to Cushing's Disease; however, the physical manifestations are not as obvious, and prevalence is significantly higher.
1. Buse JB, Kahn SE, Aroda VR, et al. Prevalence of hypercortisolism in difficult-to-control type
2 diabetes. Diabetes Care. 2025;48(12):2012-2020 doi: 10.2337/dc24-2841 2. DeFronzo RA, Auchus RJ. Cushing Syndrome, hypercortisolism, and glucose homeostasis: a review. Diabetes. 2025;74(12):2168-2178. doi: 10.2337/db25-0120
3. Lundqvist MH, Pereira MJ, Almby K, et al. Regulation of the cortisol axis, glucagon, and growth hormone by glucose is altered in prediabetes and type 2 diabetes. J Clin Endocrinol Metab. 2024;109:e675-e688. doi: 10.1210/clinem/dgad549
4. Nieman LK, Biller BMK, Findling JW, et al. The diagnosis of Cushing's Syndrome: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2008; 93: 1526-1540. doi: 10.1210/jc.2008-0125
5. DeFronzo RA, Fonseca V, Aroda VR, et al. Inadequately controlled type 2 diabetes and hypercortisolism: improved glycemia with mifepristone treatment. Diabetes Care. 2025;48(12):2036-2044. doi: 10.2337/dc25-1055
1. Buse JB, Kahn SE, Aroda VR, et al. Prevalence of hypercortisolism in difficult-to-control type
2 diabetes. Diabetes Care. 2025;48(12):2012-2020 doi: 10.2337/dc24-2841 2. DeFronzo RA, Auchus RJ. Cushing Syndrome, hypercortisolism, and glucose homeostasis: a review. Diabetes. 2025;74(12):2168-2178. doi: 10.2337/db25-0120
3. Lundqvist MH, Pereira MJ, Almby K, et al. Regulation of the cortisol axis, glucagon, and growth hormone by glucose is altered in prediabetes and type 2 diabetes. J Clin Endocrinol Metab. 2024;109:e675-e688. doi: 10.1210/clinem/dgad549
4. Nieman LK, Biller BMK, Findling JW, et al. The diagnosis of Cushing's Syndrome: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2008; 93: 1526-1540. doi: 10.1210/jc.2008-0125
5. DeFronzo RA, Fonseca V, Aroda VR, et al. Inadequately controlled type 2 diabetes and hypercortisolism: improved glycemia with mifepristone treatment. Diabetes Care. 2025;48(12):2036-2044. doi: 10.2337/dc25-1055
Performing Laboratory
med fusion
