Metabolic Syndrome and Glucose Control Including Insulin

Test Code

91398

CPT Codes
82947, 83525, 82465, 84478, 83718

Includes

Glucose
Insulin, Intact, LC/MS/MS
Cholesterol, Total
Triglycerides
HDL and Calculated Components

Preferred Specimen

3 mL serum collected in a Serum Separator Tube (SST®) and
0.4 mL serum collected in a red-top tube (no gel)

Patient Preparation
Patient should fast 9-12 hours prior to collection. The assay manufacturer Beckman Coulter advises: "N-Acetyl Cysteine (NAC), when administered in therapeutic concentrations (for the treatment of acetaminophen overdose), has been...determined to interfere with assays for... Cholesterol, Uric Acid" where "NAC interference may lead to falsely low results." According to Beckman Coulter, the NAC interference should be insignificant by 12 hours after completion of the initial loading dose of an IV infusion treatment regimen consisting of an initial loading dose of 150 mg/kg administered over 1 hr, a second dose of 50 mg/kg administered over 4 hrs and a third dose of 100 mg/kg administered over 16 hrs.

Minimum Volume

1.5 mL serum collected in an SST® and
0.2 mL serum collected in a red-top tube (no gel)

Instructions

See individual assays

Transport Temperature

Frozen

Specimen Stability

Serum: Serum Separator Tube (SST®)
Room temperature: 48 hours
Refrigerated: 7 days
Frozen: 15 days

Serum: Red-top tube (no gel)
Room temperature: 24 hours
Refrigerated: 24 hours
Frozen: 28 days

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

Unspun serum or plasma separator tube (SST® or PST) • red-top or green-top tube (serum or; heparinized plasma not
separated from cells) • anticoagulants other than lithium heparin; sodium heparin or fluoride/oxalate • gross hemolysis • gross to moderately icteric

Methodology
Chromatography/Mass Spectrometry • Spectrophotometry (SP)

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

Night Sets up 3 days a week.

Report Available

Reports in 2 days.

Clinical Significance

Identifying patients who have metabolic syndrome and who are thus at higher risk of diabetes, coronary heart disease or stroke. Identifying patients who are insulin resistant (fasting insulin at or above the 75th percentile) and who are thus at higher risk of diabetes, coronary heart disease, stroke, or liver disease. Monitoring of risk factors and insulin levels after life style change, medication use, or both.

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.