Bilirubin, Total, Serum

Test Code
BILIT - NOCO


CPT Codes
82247

Includes


Preferred Specimen
1 mL plasma from Green top (Lithium Heparin)


Minimum Volume
0.5 mL
Note: For neonate requirements see Neonate Minimum Blood Volumes


Other Acceptable Specimens
1 mL serum from SST or Red Top


Instructions
Protect from light


Specimen Stability
Specimen Type
Temperature  
Time
Plasma Li Hep Ambient 24 hours
  Refrigerated 5 days
  Frozen 6 months
Serum SST Ambient 24 hours
  Refrigerated 5 days
  Frozen 6 months
Red Top - (Separated) Ambient 24 hours
  Refrigerated 5 days
  Frozen 6 months


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


Methodology
Diazotization Bichromatic Endpoint

Setup Schedule
Monday through Sunday; Continuously


Report Available
Same day


Reference Range
Summit View
0-31 days: 0.1-11.0 mg/dL


≥31 days: 0.2-1.0 mg/dL

Critical value (automatic call-back) 0 - 31 days old: >15.0 mg/dL 

Critical value (automatic call-back) Labor & Delivery only: >3.0 mg/dL

MMC, BFCMC & NCMC
0 - 31 days: 1.5 - 11.7 mg/dL
1 month - 150 years: 0.2 - 1.3 mg/dL
Critical value (automatic call-back) 0 - 31 days old: >15.0 mg/dL 

Courtesy Call (automatic call-back) Labor & Delivery only: >3.0 mg/dL


Clinical Significance
Measurement of the levels of bilirubin, an organic compound formed during the
normal and abnormal destruction of red blood cells, is used in the diagnosis and
treatment of liver, hemolytic, hematological, and metabolic disorders, including
hepatitis and gall bladder blockage.
Bilirubin is formed in the reticuloendothelial system during the degradation of
aged erythrocytes. The heme portion from hemoglobin and form other hemecontaining proteins is removed, metabolized to bilirubin, and transported as a
complex with serum albumin to the liver. In the liver, bilirubin is conjugated with
glucuronic acid for solubilization and subsequent transport through the bile duct
and elimination via the digestive tract.
Diseases or conditions which, through hemolytic processes, produce bilirubin
faster than the liver can metabolize it, cause the levels of unconjugated (indirect)
bilirubin to increase in the circulation. Liver immaturity and several other diseases
in which the bilirubin conjugation mechanism is impaired cause similar elevations
of circulating unconjugated bilirubin. Bile duct obstruction or damage to
hepatocellular structure causes increases in the level of both conjugated (direct)
and unconjugated (indirect) bilirubin in the circulation.


Performing Laboratory
Banner Fort Collins Medical Center Laboratory
Mckee Medical Center Laboratory
North Colorado Medical Center Laboratory
Summit View Laboratory



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.