Turnaround Time

Varies by site.

Specimen Type

Blood

Collection Containers

Green (lithium heparin, gel)
Alternate Containers: Green (lithium heparin, no gel), Green (lithium heparin, gel) on ICE, Red (no gel), Red or gold (gel)

Collection Volume

2.5 mL

Minimum Collection Volume

0.6 mL

Specimen Preparation

Separate from cells within 2 hours of collection for optimal results. Within 6 hours is also acceptable.
Non-gel tubes: transfer serum/plasma to approved aliquot container.
Optimal testing volume:1.25 mL serum/plasma; Minimum testing volume: 0.2 mL

Unacceptable Conditions

Gross hemolysis

Storage/Transport Temperature

Refrigerated

Stability (from collection to initiation)

After separation from cells:
Room temperature: 5 days
Refrigerated: 7 days
Frozen: 30 days, freeze once

Containers

Green (Lithium Heparin, Gel)

Alternate Containers

Green (Lithium Heparin, No Gel)

Green (Lithium Heparin, Gel) on ICE

Red (No Gel)

Red or Gold (Gel)

Reference Interval

Age FT4 ng/dL
0-5 d 0.90-2.50
6 d - 2 mo 0.90-2.20
3-12 mo 0.90-2.00
1-5 y 1.00-1.80
6-10 y 1.00-1.70
11-19 y 1.00-1.60
20 y & older 0.90-1.70

Contraindications

Large doses of biotin (10 mg or more per day) may cause clinically significant interference in free T4 levels. If interference is suspected, it is strongly recommended that biotin is discontinued for at least one week prior to retesting.

CPT Disclaimer

The Current Procedural Terminology (CPT) Codes published in the M Health Fairview Test Directory are based on American Medical Association (AMA) guidelines and are provided for informational purposes only. CPT codes are provided only as guidance to assist clients with billing. CPT coding is the responsibility of the billing party. M Health Fairview Laboratories does not assume responsibility for billing errors due to reliance on the CPT codes listed in this Test Directory. Charges may vary due to reflexing, susceptibilities, specimen source, patient age, methodology requirements, etc..

Patient Price Inquiries

Requester Contact Information
Patient and UMP/FV Care Team Fairview Consumer Line at 612-672-1048
MRL Outreach Client dept-mrl-business-assessment@fairview.org
Research research@fairview.org

CPT Codes

CPTQtyHC HospitalPR ClinicNote
84439130084439028443901HC T4 FREE

Methodology

Electrochemiluminescence immunoassay (ECLIA)

MRL Test Build

Test Name Component Required Description Type LOINC
LAB127     T4 Free Orderable  
  SRC_1001 Y Blood specimen source: Prompt  
  1230001282   Thyroxine Free Result 3024-7

Data Type / Multiple Choice Response

SRC_1001
Blood specimen source:
Arm, Left|Arm, Right|Hand, Left|Hand, Right|Blood, Capillary|Other|Peripheral Blood
Default: Peripheral Blood

Contact

For questions regarding the test code Interface Map, please contact DEPT-LAB-CLIENT-INTERFACE@fairview.org
Ordering

Turnaround Time

Varies by site.
Collection & Processing

Specimen Type

Blood

Collection Containers

Green (lithium heparin, gel)
Alternate Containers: Green (lithium heparin, no gel), Green (lithium heparin, gel) on ICE, Red (no gel), Red or gold (gel)

Collection Volume

2.5 mL

Minimum Collection Volume

0.6 mL

Specimen Preparation

Separate from cells within 2 hours of collection for optimal results. Within 6 hours is also acceptable.
Non-gel tubes: transfer serum/plasma to approved aliquot container.
Optimal testing volume:1.25 mL serum/plasma; Minimum testing volume: 0.2 mL

Unacceptable Conditions

Gross hemolysis

Storage/Transport Temperature

Refrigerated

Stability (from collection to initiation)

After separation from cells:
Room temperature: 5 days
Refrigerated: 7 days
Frozen: 30 days, freeze once
Containers

Containers

Green (Lithium Heparin, Gel)

Alternate Containers

Green (Lithium Heparin, No Gel)

Green (Lithium Heparin, Gel) on ICE

Red (No Gel)

Red or Gold (Gel)

Result Interpretation

Reference Interval

Age FT4 ng/dL
0-5 d 0.90-2.50
6 d - 2 mo 0.90-2.20
3-12 mo 0.90-2.00
1-5 y 1.00-1.80
6-10 y 1.00-1.70
11-19 y 1.00-1.60
20 y & older 0.90-1.70

Contraindications

Large doses of biotin (10 mg or more per day) may cause clinically significant interference in free T4 levels. If interference is suspected, it is strongly recommended that biotin is discontinued for at least one week prior to retesting.
Administrative

CPT Disclaimer

The Current Procedural Terminology (CPT) Codes published in the M Health Fairview Test Directory are based on American Medical Association (AMA) guidelines and are provided for informational purposes only. CPT codes are provided only as guidance to assist clients with billing. CPT coding is the responsibility of the billing party. M Health Fairview Laboratories does not assume responsibility for billing errors due to reliance on the CPT codes listed in this Test Directory. Charges may vary due to reflexing, susceptibilities, specimen source, patient age, methodology requirements, etc..

Patient Price Inquiries

Requester Contact Information
Patient and UMP/FV Care Team Fairview Consumer Line at 612-672-1048
MRL Outreach Client dept-mrl-business-assessment@fairview.org
Research research@fairview.org

CPT Codes

CPTQtyHC HospitalPR ClinicNote
84439130084439028443901HC T4 FREE

Methodology

Electrochemiluminescence immunoassay (ECLIA)

Interface Mapping

MRL Test Build

Test Name Component Required Description Type LOINC
LAB127     T4 Free Orderable  
  SRC_1001 Y Blood specimen source: Prompt  
  1230001282   Thyroxine Free Result 3024-7

Data Type / Multiple Choice Response

SRC_1001
Blood specimen source:
Arm, Left|Arm, Right|Hand, Left|Hand, Right|Blood, Capillary|Other|Peripheral Blood
Default: Peripheral Blood

Contact

For questions regarding the test code Interface Map, please contact DEPT-LAB-CLIENT-INTERFACE@fairview.org
Private Details