Catecholamines, Fractionated, 24-Hour Urine (without Creatinine) [318X]

Test Code
4646


CPT Codes
82384

Includes
Dopamine, Epinephrine, Norepinephrine, Total Catecholamines (calculated)

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


Preferred Specimen
10 mL of a 24-hour random urine with 25 mL 6N HCl, submitted in a plastic, 24-hour urine container


Patient Preparation
It is preferable for the patient to be off medications for 3 days before specimen 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 before collection.

Minimum Volume
5 mL


Other Acceptable Specimens
Urine aliquot from a 24-hour urine (unpreserved), with pH < or = 6, collected in a plastic, 24-hour urine container


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


Transport Temperature
Frozen


Specimen Stability
Preserved
Room temperature: 7 days
Refrigerated: 30 days
Frozen: 49 days

Unpreserved
Room temperature: Unacceptable
Refrigerated: 30 days
Frozen: 49 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 the FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule
Set up: Mon-Sat; Report available: 2-4 days


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


Reference Range
Norepinephrine
3-8 Years 5-41 mcg/24 h
9-12 Years 5-50 mcg/24 h
13-17 Years 12-88 mcg/24 h
>17 Years 15-100 mcg/24 h
Epinephrine
3-8 Years 1-7 mcg/24 h
9-12 Years ≤8 mcg/24 h
13-17 Years ≤11 mcg/24 h
>17 Years 2-24 mcg/24 h
Dopamine
3-8 Years 80-378 mcg/24 h
9-12 Years 51-474 mcg/24 h
13-17 Years 51-645 mcg/24 h
>17 Years 52-480 mcg/24 h
Total Catecholamines
3-8 Years 9-51 mcg/24 h
9-12 Years 9-71 mcg/24 h
13-17 Years 13-90 mcg/24 h
>17 Years 26-121 mcg/24 h


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.


Performing Laboratory
Quest Diagnostics Nichols Institute
14225 Newbrook Drive
Chantilly, VA 20153



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.