| A B C D E F G H I J K L M N O P Q R S T U V W X Y Z # |
Bilirubin, Total and Direct
Test CodeBILITD - NOCO
CPT Codes
82247, 82248
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
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 LiHep – Not Protected from light | Refrigerate | 24 hours |
| Plasma LiHep – Protected from light | Refrigerate | 5 days |
| Serum – Not Protected from light | Refrigerate | 24 hours |
| Serum – Protected from light | Refrigerate | 5 days |
| Red Top – Separated – Not Protected from light* | Refrigerate | 24 hours |
| Red Top – Separated – Protected from light* | Refrigerate | 5 days |
*Centrifuge and aliquot into a plastic vial.
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
DIRECT
0 - 31 days: ≤ 0.6 mg/dL
31 days - 150 years: ≤ 0.3 mg/dL
TOTAL
0 - 31 days: 1.5 - 11.7 mg/dL
1 month - 150 years: 0.2 - 1.3 mg/dL
0 - 31 days: ≤ 0.6 mg/dL
31 days - 150 years: ≤ 0.3 mg/dL
TOTAL
0 - 31 days: 1.5 - 11.7 mg/dL
1 month - 150 years: 0.2 - 1.3 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.
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
