HRT FEMALE PRE PELLET

Index:

Order Name HRT Fem PrePel
Test Number: 5195234
Revision Date 11/16/2023

Test Name	Methodology	LOINC Code
Comprehensive Metabolic Panel	Various Methods	See Individual Assays
Vitamin D, 25-Hydroxy Total (Vit D 25-OH)	Chemiluminescence Assay	49543-2
Vitamin B12	Chemiluminescence Assay	2132-9
Estradiol, Total - Serum	Chemiluminescence Assay	2243-4
Follicle Stimulating Hormone - FSH, Serum	Chemiluminescence Assay	15067-2
Testosterone Total, LCMS	Liquid Chromatography/Tandem Mass Spectrometry	2986-8
Thyroxine (T4)	Chemiluminescence Assay	3026-2
Triiodothyronine (T3), Free	Chemiluminescence Assay	3051-0
Thyroid Stimulating Hormone (TSH)	Chemiluminescence Assay	3016-3
Thyroid Peroxidase Antibody (TPO Ab, Microsomal Ab)	Enzyme Immunoassay	8099-4
Complete Blood Count (CBC) with Automated Differential	Flow cytometry	See Indvidual Assays

SPECIMEN REQUIREMENTS

Specimen

Specimen Volume (min)

Specimen Type

Specimen Container

Transport Environment

Preferred

See Instructions

Refrigerated

Instructions

Below are the Preferred Collection Requirements for each assay. See Individual Assays for Stabilities and Alternate Specimen Types.

Assay Name	Specimen Type	Volume (min)	Temperature
Comprehensive Metabolic Panel	Lithium Heparin PST -Plasma	1mL (0.5 mL)	Refrigerated
Vitamin D, 25-Hydroxy Total	Clot Activator SST -Serum	1mL (0.3 mL)	Refrigerated
Vitamin B12	Clot Activator SST -Serum	1mL (0.5 mL)	Refrigerated
Estradiol, Total	Clot Activator SST -Serum	1mL (0.5 mL)	Refrigerated
Follicle Stimulating Hormone	Clot Activator SST -Serum	1mL (0.5 mL)	Refrigerated
Testosterone Total, LCMS	Clot Activator SST -Serum	1mL (0.5 mL)	Refrigerated
Thyroxine (T4)	Clot Activator SST -Serum	1mL (0.5 mL)	Refrigerated
Triiodothyronine (T3), Free	Clot Activator SST -Serum	1mL (0.5 mL)	Refrigerated
Thyroid Stimulating Hormone (TSH)	Clot Activator SST -Serum	2 mL (0.5 mL)	Refrigerated
Thyroid Peroxidase Antibody	Clot Activator SST -Serum	1 mL	Refrigerated
Complete Blood Count (CBC)/Auto Diff	EDTA (Lavender Top) WB	5 mL (1 mL)	Refrigerated

GENERAL INFORMATION

Expected TAT

Assay Dependant

CPT Code(s)

Order Code	Test Name	CPT Code
2028075	Comprehensive Metabolic Panel	80053
2023925	Vitamin D, 25-Hydroxy Total	82306
4500900	Vitamin B12	82607
2006475	Estradiol, Total	82670
3601200	Follicle Stimulating Hormone	83001
3602651	Testosterone Total, LCMS	84403
4502650	Thyroxine (T4)	84436
3606325	Triiodothyronine (T3), Free	84481
4501925	Thyroid Stimulating Hormone (TSH)	84443
3612430	Thyroid Peroxidase Antibody	86376
0101301	Complete Blood Count (CBC)/Auto Diff	85025

Lab Section

Assay Dependant