Thyroid Function Panel

Test Code
TSHRFLX - NOCO


Alias/See Also
TSH W/Reflex Free T4


CPT Codes
84443

Includes


Preferred Specimen
In-patient: 1 mL plasma from Green top (Lithium Heparin)
Out-patient: 1 mL serum from SST


Minimum Volume
0.5 mL

Note: For neonate requirements see Neonate Minimum Blood Volume


Other Acceptable Specimens
1 mL serum from SST or Red Top


Specimen Stability
Temperature Time
Ambient 5 days
Refrigerated 5 days


Setup Schedule
Monday through Sunday; Continuously


Report Available
Same day


Reference Range
TSH
0 - 4 days: 3.20 - 35.00 mIU/L
4 days - 1 month: 1.70 - 9.10 mIU/L
1 month - 1 years: 0.80 - 8.20 mIU/L
1 - 6 years: 0.60 7.40 mIU/L
6 - 11 years: 0.50 - 5.40 mIU/L
11 - 20 years: 0.30 - 4.00 mIU/L
20 - 150 years: 0.45 - 4.50 mIU/L

FT4
0 - 31 days: 0.8 - 2.2 ng/mL
31 days - 7 months: 0.8 - 1.8 ng/mL
7 months - 1 year: 0.8 1.6 ng/mL
1 - 7 years: 0.9 - 1.4 ng/mL
7 - 12 years: 0.9 - 1.6 ng/mL


Clinical Significance
TSH is formed in specific basophil cells of the anterior pituitary and is subject to a circadian secretion sequence. The hypophyseal release of TSH (thyrotropic hormone) is the central regulating mechanism for the biological action of thyroid hormones. TSH has a stimulating action in all stages of thyroid hormone formation and secretion; it also has a proliferative effect. The germination of TSH serves as the initial test in thyroid diagnostics. Even very slight changes in the concentrations of the free thyroid hormones bring about much greater opposite changes in the TSH level. Accordingly, TSH is a very sensitive and specific parameter for assessing thyroid function and is particularly suitable for early detection or exclusion of disorders in the central regulating circuit between the hypothalamus, pituitary and thyroid. Thyroxine (T4) is the main thyroid hormone secreted into the bloodstream by the thyroid gland. Together with triiodothyronine (T3) it plays a vital role in regulating the body’s metabolic rate, influences the cardiovascular system, growth and bone metabolism, and is important for normal development of gonadal functions and nervous system. T4 circulates in the bloodstream as an equilibrium mixture of free and serum bound hormone. Free T4 (fT4) is the unbound and biologically active form, which represents only 0.03% of the total T4. The remaining T4 is inactive and bound to serum proteins such as thyroxine binding globulin (75%), pre-albumin (15%), and albumin (10%). The determination of free T4 has the advantage of being independent of changes in the concentrations and binding properties of the binding proteins; additional determination of a binder parameter (T-uptake, TBG) is therefore unnecessary. Therefore, free T4 is a useful tool in clinical routine diagnostics for the assessment of the thyroid status. It should be measured together with TSH if thyroid disorders are suspected and is also suitable for monitoring thyrosuppressive therapy.


Performing Laboratory
McKee Medical Center
Banner Fort Collins Medical Center
North Colorado Medical Center

 



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.