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Test Code THYROID Thyroid-Stimulating Hormone (TSH), Plasma or Serum

Specimen Requirements

Submit only 1 of the following specimens:

 

Plasma

Container/Tube: Green-top (heparin) gel tube

Specimen Volume: 0.5 mL of heparinized plasma
Transport Temperature: Refrigerate
Collection Instructions: Separate plasma from cells within 24 hours. If specimen will not be analyzed within 24 hours, send plasma frozen in plastic vial. 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

Specimen Volume: 0.5 mL of serum
Transport Temperature: Refrigerate
Collection Instructions: Separate plasma from cells within 24 hours. If specimen will not be analyzed within 24 hours, send plasma frozen in plastic vial. 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).

Performing Laboratory

Munson Medical Center Laboratories

Methodology

Chemiluminescence Immunoassay

Reference Values

30 days through Adult:  0.30 - 5.00 µIU/mL

Less than 30 days: No reference range established by this laboratory; suggest analysis at Mayo Clinic Laboratories if result with validated reference range is needed.

Day(s) Test Set Up

Monday through Sunday

Test Classification and CPT Coding

84443