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Thyroid Stimulating Hormone (TSH) with Reflex to Free T4

Test Catalog Information

Test Catalog Synonyms
EPIC Synonyms Thyroid Stim Horm w/ FT4 reflex
TSHX
XTSH
Cerner Primary MnemonicThyroid Stim Horm w/ FT4 reflex
EPIC Display NameThyroid Stimulating Hormone (TSH) with Reflex to Free T4
Allscripts (AEHR) Order Name

Thyroid Stimulating Hormone (with FT4 reflex)

Sunrise Clinical Manager (SCM) Order Name

Thyroid Stimulating Hormone w/FT4 Reflex

EPIC Inpatient Orderable Yes
EPIC Outpatient Orderable Yes
Cerner Results TSH
Clinical Info

Test includes reflex to free T4 for TSH results outside the reference range.

Specimen Type

Blood

Container

Gold Top Tube

Collection Instructions

Container/Tube: Gold-top tube(s)
Specimen Volume: 1 mL of serum
Transport Temperature: Refrigerated
Stability: 8 Days Room Temperature
               14 Days  Refrigerated
               24 Months Frozen
 

Transport Instructions

Refrigerated

Specimen Stability

8 Days Room Temperature
               14 Days  Refrigerated
               24 Months Frozen
 

Methodology

Electrochemiluminescence Immunoassay (ECLIA)
No Biotin interference up to 1200ng/mL

Days Performed

Monday through Sunday, Continuously

Performing Laboratory

Northwell Health Laboratories

CPT

84443-TSH
84439-FT4 (if appropriate)

PDM

5300437

Desired Epic Build Thyroid Stimulating Hormone (TSH) with Reflex to Free T4

Cerner Primary Mnemonic: Thyroid Stim Horm w/ FT4 reflex
PDM 5300437
Informatics - WorkgroupChemistry
Synonyms *Thyroid Stim Horm w/ FT4 reflex
TSHX
XTSH
Display Name *Thyroid Stimulating Hormone (TSH) with Reflex to Free T4
Order Entry Specimen Sources *
Order Entry Specimen Types
Blood
Specimen Navigator Specimen Types
Specimen Navigator Specimen Sources
Specimen Navigator Short Name
Ordering info (EPIC SmartText)Test includes reflex to free T4 for TSH results outside the reference range.
IP Orderable Yes
OP Orderable Yes
AOEs *

AP AOEs
Special History No
Build Comments
Filter *
Procedure Category Change
Cerner Results

Result DescResult displayResult PDM
TSHX TSH 5300437

Actual Epic build

Procedure Id 111578
Pdm 5300437
Order Display Name Thyroid Stimulating Hormone (TSH) with Reflex to Free T4
Procedure Name TSH REFLEX FT4
Procedure Master Number LAB10537
Short Procedure Name TSH REFLEX FT4
Category Code 1.0
Category Code Record Name LAB BLOOD ORDERABLES
Synonyms
Clinically Active Yes
Orderable Yes
Performable Yes
Filter Genomics
Reference Link Url https://labs.northwell.edu/epic/test/111578
Ordering Instructions
Default Specimen Type Blood
Specimen Type Pick List Blood
Specimen Type List
Op Specimen Type List
Specimen Source Pick List Blood, Arterial Blood, Capillary Blood, Central Line Blood, Venous
Specimen Source Default - Male Blood, Venous
Specimen Source Default - Female Blood, Venous
Specimen Source List
Op Specimen Source List
Ip Lab Test Components For Report
Op Lab Test Components For Report
Order Questions ["3045300170", "3045300171", "3045300173"]
Order Questions Record Name NH IP HOME COLLECT DATE NH IP HOME COLLECT DAYS NH IP HOME COLLECT MEDICALLY NECESSARY
Inpatient Order Questions []
Inpatient Order Questions Record Name
Order Specific Question Override Yes
Inpatient Question Override
Location Restrict List Ip
Location Restrict List Ip Record Name
Location Restrict List Include Ip
Location Restrict List Op
Location Restrict List Op Record Name
Location Restrict List Includes Op
Edp Amb Order Specific Questions Record Name
Edp Ip Order Specific Questions Record Name
Edp Ip Specimen Source Blood, Venous Blood, Central Line Blood, Arterial Blood, Capillary
Edp Op Specimen Source
Edp Ip Specimen Type Blood
Edp Op Specimen Type
Derived Edp Ip Buttons S Blood, Capillary Blood, Venous Blood, Central Line Blood, Arterial
Derived Edp Ip Buttons T Blood
Derived Edp Op Buttons S
Derived Edp Op Buttons T
Ip Orderable 1
Op Orderable 1
EPIC OP AOEs

Question IDQuestion NameQuestionResponse TypeResponse ListRequire Response
3045300170 NH IP HOME COLLECT DATE Start Date Date Yes
3045300171 NH IP HOME COLLECT DAYS Days Custom List Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Yes
3045300173 NH IP HOME COLLECT MEDICALLY NECESSARY Medically Necessary? Yes/No Yes
EPIC IP AOEs

EPIC Components (results)

Component IDComponent NameBase NameCommon NameExternal NameCerner Result PDM
3047800697.0 THYROID STIMULATING HORMONE W/FT4 REFLEX TSHX TSHX 5300437