Hydroxychloroquine, Serum/Plasma

Test Code

30095

CPT Codes
80220

Preferred Specimen

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

Minimum Volume

0.4 mL

Other Acceptable Specimens

Plasma collected in: EDTA (lavender-top), or EDTA (pink-top) tube

Instructions

Promptly centrifuge and separate serum or plasma into a plastic (preservative-free) screw-capped vial.

Transport Container

Plastic screw-capped vial, preservative-free

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Room temperature: 30 days
Refrigerated: 30 days
Frozen: 12 months

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

Polymer gel separation tube (SST or PST)

Methodology
Liquid Chromatography/Tandem Mass Spectrometry (LC/MS/MS)

FDA Status
This test was developed and its performance characteristics determined by NMS Labs. It has not been cleared or approved by the US Food and Drug Administration.

Setup Schedule

Set up: Varies; Report available: 7 days

Reference Range

10 ng/mL

The reported value may vary based on dilution or weight of the specimen.

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.