Print Preview

Amitriptyline-929

Test info

Test name:

Amitriptyline

Test number:

929

Excellian order number:

LAB929

Abbreviation:

AMT

Alternate names:

Elavil

Tests included:

Nortriptyline

Useful for:

Therapeutic drug management

Specimen

Specimen type:

Serum

Collection container:

Red serum vial/tube, 5 mL

Volume:

2.0 mL

Minimum volume:

0.5 mL

Processing instructions:

Allow sample to clot
Spin within two (2) hours of sample collection
Transfer serum to a Serum/plasma transfer vial/tube (MedTox), labelled as serum

Transport container:

Serum/plasma transfer vial/tube (MedTox)

Alternate specimen type:

Heparin plasma

Alternate collection container:

Dk green heparin (Li or Na), no gel

Alternate collection instructions:

Immediately following collection, mix sample by inverting 5 - 10 times to prevent clotting.

Alternate processing instructions:

Spin within two (2) hours of sample collection
Transfer plasma to a Serum/plasma transfer vial/tube (MedTox), labelled as Li or Na heparin plasma

Transport and stability:

Refrigerated (preferred)

Ambient - 3 days

Frozen (OK)

Reason for rejection:

Gel-barrier tubes are not recommended

Performance

Performing lab:

MedTox Laboratories (11): R-MX

Days set up:

We, Sa

TAT:

3 - 4 days

Method:

Liquid Chromatography/Tandem Mass Spectrometry (LC/MS/MS)

Clinical and Interpretive info

Reference ranges:

Nortriptyline: 50 - 150 ng/mL

Amitriptyline & Nortriptyline (combined total): 80 - 200 ng/mL

Results that require action (critical):

>1,000 ng/mL

Billing

CPT codes:

G0480

Subject to medical necessity (Y/N):

Yes

LCD/NCD:

Medical necessity

Tracking

Date created:

11/30/2001

Revised date:

01/04/2024

Review date:

01/04/2024