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3074: Thyroid Panel, Hypothyroidism Print View
T4, Free ICMA  < 1 years: Call Client Services
< 10 years: 0.9 - 1.6
< 19 years: 0.9 - 1.4
>= 19 years: 0.8 - 1.8 
ng/dL 
TSH IA    mIU/L 

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

Primary hypothyroidism results when the thyroid gland is damaged and unable to produce adequate amounts of T3 and T4 and in inherited conditions in which thyroid hormone synthesis is insufficient, or after removal of thyroid tissue or treatment with radioactive iodine. This decrease in T3 and T4 leads to an increase in TSH levels. Secondary hypothyroidism results from pituitary or hypothalamic diseases that produce a deficiency of TSH, TRH (thyroid releasing hormone) or both. When T4 and TSH levels are both low, a TRH test is helpful. In patients with destructive lesions of the pituitary gland that result in TSH deficiency, no response of TSH to TRH is expected. In patients with hypothalamic abnormalities that affect TRH and TSH release, the peak TSH response to TRH may be normal but is generally delayed until 45 to 60 minutes after the TRH administration (rather than the normal time of 20 to 30 mins).

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

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
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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