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Test Code FT4M T4 (Thyroxine), Free, Med-Check, 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