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THYROID CASCADE PROFILE
Test Code330015
CPT Codes
84443 (If reflex testing is performed, additional CPT codes, ie, 84439, 84481, 86376, and concomitant charges may apply.)
Includes
"Thyroid-stimulating hormone (TSH) with automatic reflex (as diagnostically warranted) to free thyroxine, free triiodothyronine, and/or thyroid peroxidase (TPO) antibodies. If reflex testing is performed, additional charges/CPT code(s) may apply.
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Preferred Specimen
"Serum
2 mL
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2 mL
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Minimum Volume
"1 mL (Note: This volume does not allow for repeat testing.)
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Instructions
"If a red-top tube is used, transfer separated serum to a plastic transport tube.
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Transport Container
"Red-top tube or gel-barrier tube
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Transport Temperature
"Refrigerate
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Specimen Stability
"Room temperature---14 days
Refrigerated---14 days
Frozen---14 days
Freeze/thaw cycles---Stable x3"
Refrigerated---14 days
Frozen---14 days
Freeze/thaw cycles---Stable x3"
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
"Plasma specimen
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Methodology
"Electrochemiluminescence immunoassay (ECLIA) "
Limitations
"This profile is not intended for use in pediatric patients or in monitoring patients receiving treatment for thyroid disease with either ablative or suppressive therapy. It would also not be appropriate to use this procedure to diagnose primary thyroid neoplasm.
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Clinical Significance
"Aid clinicians in obtaining an appropriate diagnosis for common adult thyroid disorders. The cascade begins with a third-generation thyroid-stimulating hormone (TSH) test. If the TSH result is normal, a euthyroid status is assumed and testing stops. Additional testing is performed only if the initial TSH result is abnormally high or low. The cascade algorithm will select specific tests, based on the results of previously performed tests, which are necessary to arrive at the most appropriate laboratory diagnosis. The assayed value of a test, relative to the reference interval of that specific test, determines which, if any, additional tests are performed. The cascade proceeds, selecting specific tests, until the most probable diagnosis can be made.
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