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Additional Codes

Software Test Code

Performing Laboratory

NorDx Laboratories

Useful For

Evaluating patients suspected of having a gastrointestinal inflammatory process.

Distinguishing inflammatory bowel disease (IBD) from irritable bowel syndrome (IBS), when used in conjunction with other diagnostic modalities, including endoscopy, histology and imaging.

Method Name

Enzyme Linked Immunosorbent Assay (ELISA)

Reference Values

27.1 – 49.9 mg/kg (Normal; No follow-up)

50.0 – 120.0 mg/kg (Borderline; Re-evaluate at 4-6 weeks)

>120.0 mg/kg (Abnormal; Repeat as clinically indicated)

Days and Times Test Performed

Saturday or Sunday

Once weekly

Report Available

1 Day

Specimen Type


Preferred Container

Stool Container

Preferred Volume

Stool: 5 g (Stool Container)

Minimum Volume

Stool: 1 g (Stool Container)

Specimen Collection and Handling

1. Collect a fresh random stool specimen, no preservatives, and store at 2-8° C during transport.

2. Separate specimens must be submitted when multiple tests are ordered. Do not add on to previously collected specimen.

3. Specimen can not be collected from a diaper.

Specimen Stability Information

Specimen Type: Stool

Frozen: >4 Days

Refrigerated: 4 Days

Add On Capable

Not Permitted

Advance Beneficiary Notice Requirements

This test, when ordered on Medicare patients, is subject to the National Coverage Determination (NCD) policies. Please verify that the diagnosis code (ICD code) you have chosen demonstrates medical necessity for the test as documented in the physician’s patient record. The CMS web site is available to assist you with this verification. A properly executed Advance Beneficiary Notice (ABN) must be submitted with the specimen if medical necessity is not demonstrated by the ICD code chosen.

CPT Code Information

CPT Code

CPT Description

CPT Disclaimer

83993 Calprotectin, Fecal, Quantitative

LOINC Code Information


Performing Laboratory Location

NorDx Laboratories