Theophylline [878X]

Test Code

6311

CPT Codes
80198

Preferred Specimen

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

Minimum Volume

0.2 mL

Other Acceptable Specimens

Plasma collected in: Sodium heparin (green-top) tube, lithium heparin (green-top) tube, or EDTA (lavender-top) tube

Instructions

Collect as a trough just prior to next dose.

Transport Container

Plastic screw-cap vial

Transport Temperature

Room temperature

Specimen Stability

Room temperature: 6 days
Refrigerated: 7 days
Frozen: 90 days

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

Serum separator tube (SST)

Methodology
Immunoassay (IA)

Setup Schedule

Set up: Mon-Thurs p.m.; Report available: Next day

Reference Range

≤5 Months	5.0-10.0 mg/L
>5 Months	10.0-20.0 mg/L

Clinical Significance

Theophylline is used in the treatment of bronchial asthma as well as in the treatment of chronic obstructive pulmonary disease and episodes of prolonged apnea in pre-term infants. Theophylline levels are monitored to assure adequate therapeutic levels are achieved and to avoid toxicity.

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.