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Test Code LAB2807- Draw only @ ACTH Stimulation

Important Note

Done only at TidalHealth Peninsula Regional Outpatient Lab between 8 am and 10 am.

Ordering office must call TidalHealth Peninsula Regional Outpatient Lab (410-543-7397) to schedule this procedure.

Lab order MUST contain the dosage and either IV or IM.

Additional Codes

CPT Code for ACTH: 82024

CPT Code for Base and 60 Min.: 82533 x 2

Performing Laboratory

TidalHealth Peninsula Regional - Core Laboratory: Chemistry

Specimen Requirements

Specimen Collection

For inpatients, order 250 µg cosyntropin (synthetic ACTH) from pharmacy at time test is scheduled.

For outpatients, intravenous ACTH Stimulation Tests must be scheduled with Outpatient Laboratory and Outpatient Surgery. This test can only be drawn at PRMC Outpatient Center between 0800 am - 1000 am.

 

For ACTH testing that is collected with BASE, draw blood in an ice-cooled, lavender-top (EDTA) tube. Spin down in a refrigerated centrifuge, immediately separate plasma from cells, and send 1 mL (minimum volume: 0.5 mL) of EDTA plasma frozen in plastic vial.

 

For BASE and 60 MIN. specimens, draw blood in a green-top (lithium heparin) tube or a gold-top serum gel tube. Spin down within 2 hours of draw and send 2 mL of lithium heparin plasma or serum as follows:

1. Draw a baseline specimen (base).

2. Administer 250 µg cosyntropin (synthetic ACTH) intramuscularly immediately after drawing baseline specimen.

3. Draw another specimen at exactly 60-minutes post ACTH.

 

Note: Label specimen appropriately (base and 60 min. and as plasma or serum).

Reference Values

A peak plasma cortisol ≥20 mcg/dL with a rise of at least 7 mcg/dL.

See Adrenocorticotropic Hormone (ACTH), Plasma (ACTH) for ACTH reference ranges.

Additional Information

This test can only be drawn at TidalHealth Peninsula Regional.  Cortrosyn should be given to a pregnant woman only if clearly needed.  Patient receiving cortisone, hydrocortisone or spirononlactone should omit their pre-test doses on the day selected for testing.