Liver Fibrosis, Non-Alcoholic Fatty Liver Disease (Echosens)

Message
Labrotory/ Horizon Staff: This test requires an automated platelet count performed on the EDTA whole blood sample at the client site, if one is not ordered and resulted then testing will be CANCELLED by the reference laboratory. Platelet counts from patient's CBC, ABC or PLTCT orders can be used. If ordering provider has not requested a platelet count through one of these orders please follow up and obtain an order. 

Enter all applicable fields:
         Test Name: Liver Fibrosis, Non-Alcoholic Fatty Liver Disease (Echosens)
         Reference Lab: ARUP
         Test Code: 2012521
         Shipping Temp: FROZEN
         Specimen Type: LAVENDER (EDTA) FOR PLATELET COUNT AND 2.0 ML SERUM FROM SERUM SEPARATOR TUBE (SST)
         TAT: 2-6 DAYS
         CPT Code: 84450, 84460, 82728, 82947 (ALT CODE: 81599)
         Cost: _
         Additional Comments: SEND SERUM FROZEN, ALONG WITH PLATELET COUNT AND PATIENT’S WEIGHT
         FDA Approved Test:  YES_    NO_    LDT_
         Medical Director/Pathologist: approved by _
         Billing Completed by_    Date_   Time_


Test Code
ESOT - 2012521 - ARUP


Alias/See Also
ARUP - FIBRO NAFL - 2012521
FibroSure


CPT Codes
84450; 84460; 82728; 82947 (Alt code: 81599)

Includes
Platelet Count, FibroMeter Patient Score, Aspartate Aminotransferase, Alanine Aminotransferase, Ferritin, Glucose, Weight, EER FibroMeter NAFL Enhanced Report, FibroMeter NAFLD Interpretation, Fibrosis Metavir Classification


Preferred Specimen
Lavender (EDTA) for platelet count AND 2.0 mL serum from Serum Separator Tube (SST).


Patient Preparation
Overnight fasting specimen is required. 

Minimum Volume
1.2 mL serum


Instructions
  • Do not send the EDTA whole blood to ARUP
  • Separate from cells ASAP or within 2 hours of collection.
  • This test requires an automated platelet count performed on the EDTA whole blood sample at the client site. Include the platelet count with the patient test submission information. This test requires the patient's weight (in pounds). Include the patient's weight with the sample submission. 


Transport Temperature
Frozen


Specimen Stability
Serum: Ambient: 8 hours; Refrigerated: 48 hours; Frozen: 2 weeks


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Hemolyzed specimens. All required specimens not received. No platelet count received. No weight received.


Methodology
Quantitative Enzymatic/Quantitative Spectrophotometry/Automated Cell Count/Quantitative Chemiluminescent Immunoassay

Setup Schedule
Tue, Thu


Report Available
1-5 days


Reference Range
See report
 


Clinical Significance
Only intended for use in patients with non-alcoholic liver disease (NAFLD); results may be inaccurate in patients with other etiologies of liver disease.


Performing Laboratory
ARUP Laboratories

Additional Information
ARUP - FIBRO NAFL - 2012521


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.