Catecholamines, Fractionated, 24-Hour Urine with Creatinine (39627X)

Test Code

4168N

CPT Codes
82384, 82570

Includes

Creatinine, Norepinephrine, Epinephrine, Dopamine, and Total Catecholamines (calculated)

CPT code 81050 may be added at an additional charge for volume measurement

Preferred Specimen

10 mL 24-hour urine preserved with 25 mL 6N HCl collected in a 24-hour urine container

Patient Preparation
It is preferable for the patient to be off medications for three days prior to collection. However, common antihypertensives (diuretics, ACE inhibitors, calcium channel blockers, alpha and beta blockers) cause minimal or no interference. Patient should avoid alcohol, coffee, tea, tobacco and strenuous exercise prior to collection.

Minimum Volume

5 mL

Instructions

Collect 24-hour urine with 25 mL of 6N HCl to maintain a pH < or = 3. If no preservative is used, specimen must be stored refrigerated during collection but shipped frozen. Record 24-hour urine volume and patient's age on test request form and on urine container.

Transport Temperature

Preserved urine: Room temperature
Unpreserved urine: Frozen

Specimen Stability

Preserved urine:
Room temperature: 7 days
Refrigerated: 30 days
Frozen: 49 days

Unpreserved urine:
Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 30 days

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

Preserved urine received refrigerated with pH >3 • Unpreserved urine received frozen with pH >6

Methodology
High Performance Liquid Chromatography (HPLC)

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 5 days a week

Limitations

Recent surgery, traumatic injury, upright posture, cold, anxiety, pain, clonidine withdrawal, and concurrent acute or chronic illness may produce elevated results..

Clinical Significance

The three catecholamines (norepinephrine, epinephrine and dopamine) are the principal secretory products of neural tissue. Clinically, the measurement of circulating catecholamines is valuable in the diagnosis of catecholamine secreting tumors associated chiefly with hypertension (pheochromocytomas, neuroblastomas and gangliomas) and with the evaluation of orthostatic hypotension.

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.