Test Code FT4 T4 (Thyroxine), Free, Plasma or Serum
Methodology
Chemiluminescence Immunoassay
Performing Laboratory
Munson Medical Center Laboratories
Specimen Requirements
Submit only 1 of the following specimens:
Plasma
Container/Tube: Green-top (heparin) gel tube.
Microcontainer with heparin and plasma gel separator is also acceptable.
Specimen Volume: 0.5 mL of heparinized
plasma
Transport Temperature: Refrigerate
Collection Instructions: Forward promptly.
Note: 1. Medicare frequency limitations exist for this test in addition to diagnosis requirements. Click on link for list of medically necessary diagnoses: http://www.munsonhealthcare.org/medical-necessity. See Advance Beneficiary Notice of Noncoverage (ABN) form in Special Instructions.
2. Indicate plasma.
3. Label specimen appropriately (plasma).
Serum
Container/Tube: Gold-top serum gel tube.
Microcontainer with serum gel separator is also acceptable.
Specimen Volume: 0.5 mL of serum
Transport Temperature: Refrigerate
Collection Instructions: Forward promptly.
Note: 1. Medicare frequency limitations exist for this test in addition to diagnosis requirements. Click on link for list of medically necessary diagnoses: http://www.munsonhealthcare.org/medical-necessity. See Advance Beneficiary Notice of Noncoverage (ABN) form in Special Instructions.
2. Indicate serum.
3. Label specimen appropriately (serum).
Reference Values
0.7-2.0 ng/dL
Day(s) Test Set Up
Monday through Sunday
Test Classification and CPT Coding
84439