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Cortisol, plasma

Centralized Core Laboratory : Chemistry

PATIENT INFO

Patient Name:

Medical Record #:

BD: / / Sex: F M

PHYSICIAN INFO

Physician Name :

Address:

Ph: ( ) - Fax: ( ) -

Additional Report to:

Ph: ( ) - Fax: ( ) -

TESTS REQUESTED
Test Name:	ICD9 Code: (required)
1. Cortisol, plasma
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Test ID/Workstation :

CORT SUMMA

Specimen Type:

Blood

Tube Type:

Green top (lithium heparin)tube

Collection Volume:

3.0 mL (minimum 1.5 mL)

Cause for Rejection:

Hemolysis, lipemia

Storage:

Refrigerated

Availability:

Sent to reference lab

Methodology:

Chemiluminescence Immunoassay

Special Instructions:

Do not administer isotopes 24 hours prior to collection.

Lab/Phone:

330-543-8418

TAT:

4 days

Additional Info:

Reference range: AM = 6.0-22.0 mcg/dL; PM = less than or equal to 10

CPT Code:

82533

Synonyms:

Hydrocortisone, serum

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Cortisol, plasma

Centralized Core Laboratory : Chemistry

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