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3072: Thyroid Panel, Hyperthyroidism Print View
T3 Total IA  view ref range  ng/dL 
T4, Free IA  view ref range  ng/dL 
TSH IA    mIU/L 

PRIMARY
1 Serum 5 (3.5) mL   Refrigerated - 4 Day(s)/Frozen - 2 Month(s)  
ALTERNATE

Serum TSH (thyroid stimulating hormone) is low in all forms of hyperthyroidism except in rare cases in which hyperthyroidism is mediated by TSH itself. When TSH is low, free T4 concentration should be measured and will be elevated in most cases of hyperthyroidism and is sufficient for diagnosis. If TSH is low but free T4 is normal, a T3 measurement is performed, since serum T3 levels are often elevated earlier in the course of hyperthyroidism and to a greater extent than T4. Previously the most conclusive test for hyperthyroidism was TRH (thyroid releasing hormone). The TRH test is rarely needed for the diagnosis of hyperthyroidism now that sensitive TSH assays are available.

Patient Preparation:
Specimen collection after fluorescein dye angiography should be
delayed for at least 3 days. For patients on hemodialysis, specimen
collection should be delayed for 2 weeks. According to the assay
manufacturer Siemens: "Samples containing fluorescein can produce
falsely depressed values when tested with ADVIA Centaur TSH3 Ultra
assay."
Setup Schedule
Sunday-Saturday

Reported (Analytical Time)
Same day

CPT Codes
84439,84443,84480

The CPT codes provided 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 payer being billed.

Notes
Transport Temperature: Room Temperature

Reject Criteria: Plasma

According to the assay manufacturer Siemens:
"In general, the fluorescein clearance (requires) about 48 to 72 hours." For patients in "end stage renal disease on hemodialysis, the elimination will be delayed likely by several cycles of hemodialysis. Assuming the dialysis cycle serves as one half-life (and) using the rule of thumb that 5 half-lives are required to completely eliminate a compound, two weeks is conservative (if) dialysis is performed 3 times per week."






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