Laboratory Fee Schedule
Procedure #: BZZ0022A
CPT: 80061
| Synonym(s): |
Cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL) |
| Requisition Form |
G-1B, G-THSTEPS |
| Test Description |
The quantitation of lipids in human serum is used to determine the risk of coronary heart disease. |
| Pre-Approval Needed |
N/A |
| Supplemental Information Required |
N/A |
| Supplemental Form(s) |
N/A |
| Performed on Specimens from (sources) |
Human |
| Sample/Specimen Type for Testing |
- Preferred: Serum from a red top tube transferred to a transport tube
- Acceptable: Serum from a centrifuged gold top serum separator tube.
|
| Minimum Volume/Size Required |
1mL serum. |
| Storage/Preservation Prior to Shipping |
- Collect blood in red top or gold top tube.
- Gently invert the tube with the blood specimen five times immediately after collection.
- Allow to clot 30 minutes from collection.
Centrifuge gold top tube to separate serum from red blood cells.
- For red top tube: Immediately transfer serum into a transport tube.
- For gold top tube: Immediately transfer serum into a transport tube if serum will be frozen.*
- Store serum cold if testing will occur within 7 days of collection.
- Store serum frozen if testing will occur after 7 days of collection.
NOTE: * Gold top serum separator tube cannot be frozen. Serum must be transferred to a transport tube prior to freezing.
|
| Transport Medium |
N/A |
| Specimen Labeling |
- Two patient-specific identifiers required (e.g., patient full name, date of birth, Medical record number)
- Identifiers on specimen must exactly match submission form.
|
| Shipping and Specimen Handling Requirements |
- Ship all specimens overnight with enough cold packs or dry ice to maintain specimens at proper temperature until arrival at DSHS Laboratory.
- Ship according to Dangerous Good Regulations, IATA, and/or CFR 49.
- Handle as infectious agent using universal precautions.
- Ship triple-contained in accordance with federal shipping regulations for infectious agents.
- Ship Monday-Thursday; avoid weekend Friday and weekend deliveries.
- Ship cold specimens overnight on ice packs if arriving at laboratory within 7 days from collection.
- Ship frozen specimens overnight on dry ice or on ice packs.
- Specimens must be received cold/frozen by the laboratory.
- Consider freezing serum transport tubes prior to shipping during high temperature months.
|
| Method |
Quantitative enzymatic |
| Turn-around Time |
4-5 working days after receipt of specimen. |
| Interferences/Limitations |
Lipemia, turbidity, icterus, hemolysis, metamizole, N-acetyl cysteine, triglyceride value >1000 mg/dL. |
| Common Causes for Rejection |
- Two patient-specific identifiers not met.
- Specimen received at ambient temperature due to inadequate/no ice packs.
- Specimen unsuitable for testing
- Specimen was received at improper temperature.
- No specimen included with submission form.
- Submission form not included with specimen.
- Specimen tube broken/leaked in transit.
- Demographic information is missing or incorrect.
- Specimen identification is missing or incorrect.
- Whole blood was received.
- Hemolysis
- Specimen is collected in an expired blood collection tube.
- No test specified.
- Red top tubes have not had serum poured over to a transport tube.
- Frozen gold top tubes.
|
| Additional Information |
Reference Range:
Cholesterol:
- Children/adolescents (<20 years): <170 mg/dL
- Young adults (20-24 years): <190 mg/dL
- Adults: <200 mg/d
HDL
- Children/adolescents (<20 years): >45 mg/dL
- Young adults (20-24 years): >45 mg/dL
- Adults: 40 - 59 mg/dL
LDL:
- Children/adolescents (<20 years): <110 mg/dL
- Young adults (20-24 years): <120 mg/dL
- Adults: <130 mg/dL
Triglyceride:
- Children (0-9 years): <75 mg/dL
- Adolescents (10-19 years): <90 mg/dL
- Young adults (20-24 years): <115 mg/dL
- Adults: <150 mg/dL
Contact:
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