Chronic Urticaria Panel 2 (Comprehensive)

Test Code

90123

CPT Codes
83520, 84443, 86343, 86376, 86800

Includes

Histamine Release (Chronic Urticaria)
Thyroid Peroxidase Antibodies (TPO)
Thyroglobulin Antibodies
TSH
IgE Antibody (Anti-IgE IgG)

Preferred Specimen

6 mL serum collected in a red-top (no gel)

Patient Preparation
Overnight fasting is preferred. Patients taking calcineurin inhibitors should stop their medication for 72 hours prior to draw.

Specimen collection after fluorescein dye angiography should be delayed for at least 3 days. For patients on hemodialysis, specimen collection should be delayed for 2 weeks. According to the assay manufacturer Siemens: "Samples containing fluorescein can produce falsely depressed values when tested with the Advia Centaur TSH3 Ultra assay. "

Dietary supplements containing biotin may interfere in assays and may skew results to be either falsely high or falsely low. For patients receiving the recommended daily doses of biotin, draw samples at least 8 hours following the last biotin supplementation. For patients on mega-doses of biotin supplements, draw samples at least 72 hours following the last biotin supplementation.

Minimum Volume

3 mL

Instructions

Serum should be separated from the cells as soon as possible after visible clot formation (usually 15-30 minutes after collection).

Transport Temperature

Room temperature

Specimen Stability

Room temperature: 7 days
Refrigerated: 7 days
Frozen: 28 days

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

Gross hemolysis • Moderate hemolysis • Lipemia • Icteric specimen • Serum Separator Tube (SST®) • Sample other than serum • Heavy visible particulate matter

Methodology
See individual tests

FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule

See individual assays

Clinical Significance

Patients with a chronic form of urticaria who are positive with the functional Histamine Release (Chronic Urticaria) test have an autoimmune basis for their disease. A positive result does not indicate which autoantibody (anti-IgE or anti-Fc epsilon RI alpha chain) is present. A positive anti-IgE antibody does not exclude the presence of anti-Fc epsilon RI alpha chain antibody. Autoimmune thyroid disease coexists in approximately 25% of autoimmune chronic urticaria patients.

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.