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HelpTest Code TSHC THYROID FUNCTION CASCADE
Additional Codes
| Software | Test Code |
|---|---|
| Label Text | TSHC |
| EPIC | LAB20288 |
Performing Laboratory
NorDx Laboratories
Useful For
Screening of thyroid disease
Method Name
Electrochemiluminescent Immunoassay (ECLIA)
Reference Values
TSH:
Female
0 - < 5 years: 0.84 - 6.22 µIU/L
5 - < 10 years: 0.48 - 4.81 µIU/L
10 - < 15 years: 0.76 - 4.20 µIU/L
15 - < 20 years: 0.45 - 4.50 µIU/L
Male
0 - < 5 years: 0.84 - 6.22 µIU/L
5 - < 10 years: 1.18 - 5.33 µIU/L
10 - < 15 years: 0.76 - 4.20 µIU/L
15 - < 20 years: 0.64 - 5.37 µIU/L
All Patients ≥ 20 years: 0.270 - 4.20 µIU/mL
T4, free (if indicated): 0.9 – 1.7 ng/dL
Triiodothyronine, Total (if indicated): 80 – 200 ng/dL
TPO antibodies (if indicated): Negative (≤100 U)
Days and Times Test Performed
Monday through Sunday
TSH, FREE T4 AND T3
Tuesday through Thursday
TPO ANTIBODIES
Report Available
1 Day
5 days if reflexed to TPO antibodies
Specimen Type
Serum
Preferred Container
Serum Separator Tube (SST)
Preferred Volume
Serum: 2 mL (Serum Separator Tube (SST))
Minimum Volume
Serum: 1 mL (Serum Separator Tube (SST))
Specimen Collection and Handling
Spin specimen, separate from clot and send refrigerated. If testing will be delayed >48 hours, separate and freeze serum.
Specimen Stability Information
Specimen Type: Serum
Frozen: 30 Days
Refrigerated: 48 Hours
Room Temp: 8 Hours
Note: If testing will be delayed >48 hours, separate and freeze serum.
Add On Capable
Yes
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 |
|---|---|---|
| 84439 | Thyroxine, Free, Quantitative | if Indicated |
| 84443 | Thyroid Stimulating Hormone (TSH), Quantitative | |
| 84480 | Triidothyronine T3, Total (TT-3), Quantitative | if Indicated |
| 86376 | Microsomal Antibodies (eg: Thyroid or Liver-Kidney), Each | if Indicated |
Performing Laboratory Location
NorDx Laboratories
Clinical Significance
If thyroid stimulating hormone (TSH) is <0.270 µIU/mL, then free Thyroxine (FT4) is performed at additional charge.
If TSH is <0.100 µIU/mL and FT4 is within normal range, then total triiodothyronine (T3) is performed at an additional charge. If TSH is >4.200 µIU/mL, then FT4 and thyroperoxidase (TPO) antibodies is performed at additional charge.
Maximum Laboratory Time
5 Days
Acceptable Alternative Container(s)
Red Top Tube