Theophylline, Plasma or Serum

Test Code
THEO


CPT Codes
80198

Preferred Specimen
Submit only 1 of the following specimens: Plasma
Draw blood in a green-top (heparin) tube. Spin specimen down and send 0.5 mL of plasma.
Note: 1. Indicate plasma.
2. Label specimen appropriately (plasma).
Serum
Draw blood in a plain, red-top tube. Spin specimen down and send 0.5 mL of serum.
Note: 1. Indicate serum.
2. Label specimen appropriately (serum).


Transport Temperature
Refrigerate


Methodology
Reflection Density
Note: Refer to Therapeutic Drug Monitoring (TDM) Recommended Collection Times for Peak/Trough Levels located in General Information.

Setup Schedule
Monday through Sunday


Reference Range
10-20 µg/mL

Critical value: >20 µg/mL



Performed By
North Mississippi Medical Center Pathology Department

Performing Laboratory
NMMC Pathology Department



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.