Bile Acids, Fractionated and Total, Pregnancy

Message

Consider Bile Acid, Total, Enzymatic (BILAC) for screening pregnant patients for obstetric cholestasis.

Test Code

BILEP

Alias/See Also

19546

CPT Codes
82542

Includes

Cholic Acid
Deoxycholic Acid
Chenodeoxycholic Acid
Total Bile Acids

Preferred Specimen

1 mL serum

Patient Preparation
Overnight fasting is preferred

Minimum Volume

0.5 mL

Instructions

Collect blood in a red-top (no gel), or a serum separator tube (SST®). After clot formation centrifuge sample and pour off serum into a transport tube. Store sample refrigerated or frozen.

Transport Container

Transport tube

Transport Temperature

Room temperature

Specimen Stability

Room temperature: 14 days
Refrigerated: 21 days
Frozen: 30 days

Methodology
Chromatography/Mass Spectrometry

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

Set up: Sun-Fri; Report available: 4-6 days

Report Available

Set up: Sun-Fri
Report available: 7-9 days after receipt at the performing laboratory.
Add two (2) days for transport.

Reference Range

Cholic Acid	≤2.8 umol/L
Deoxycholic Acid	≤2.3 umol/L
Chenodeoxycholic Acid	≤3.9 umol/L
Total Bile Acids	≤8.3 umol/L

Clinical Significance

Intrahepatic cholestasis of pregnancy (ICP) is a rare disorder that typically occurs in the third trimester of pregnancy and is associated with itching, jaundice and disturbances in liver enzymes. While it poses little risk for the mother it may cause problems for the fetus, including preterm delivery, perinatal mortality and other disorders. Measurement of maternal serum bile acids can help in the diagnosis of ICP as the serum total bile acids are increased significantly (6-fold) with large increases primarily in cholic acid (12-fold).

Performing Laboratory

Quest Diagnostics Nichols Institute-San Juan Capistrano, CA

33608 Ortega Highway

San Juan Capistrano, CA 92675-2042

Last Updated: September 20, 2024

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.