Aldosterone/Cortisol Ratio, Adrenal Vein Sampling, 5 Sites

Test Code

18825

CPT Codes
82088 (x5), 82533 (x5)

Includes

Aldosterone; Cortisol, Total; Aldosterone/Cortisol Ratio

Preferred Specimen

2 mL serum collected in each of five red-top tubes (no gel)

Minimum Volume

0.5 mL (x5)

Other Acceptable Specimens

Plasma collected in each of five EDTA (lavender-top) tubes

Instructions

For each timed specimen submitted, each tube must be clearly marked with time drawn and the exact location of the sample collection. Submit all tubes with one test request form.
Ship frozen, do not thaw.

Transport Container

Plastic screw-cap vial(s)

Transport Temperature

Frozen

Specimen Stability

Room temperature: 48 hours
Refrigerated: 7 days
Frozen: 28 days

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

Serum separator tubes (SST) • Moderate to gross hemolysis

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

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 FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule

Set up: Mon-Fri; Report available: 2-6 days

Reference Range

See Laboratory Report

Clinical Significance

Measurements of aldosterone/cortisol ratios in samples of adrenal venous blood, obtained by an experienced radiologist, is the "gold standard" test to distinguish between an adenoma or unilateral hyperplasia and bilateral hyperplasia. Unilateral disease is associated with a marked (usually greater than four-fold) increase in Aldosterone/Cortisol on the side of the tumor, whereas there is little difference between the two sides in patients with bilateral hyperplasia. AVS with Aldosterone/Cortisol measurement is indicated if imaging studies fail to unequivocally identify an adenoma or if the identified adenoma is <1 cm in size.

Performing Laboratory

Quest Diagnostics Nichols Institute-San Juan Capistrano, CA

33608 Ortega Highway

San Juan Capistrano, CA 92675-2042

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.