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HelpTest Code BILI3 Bilirubin, Serum
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| BILIT | Bilirubin Total, S | Yes | Yes |
| BILID | Bilirubin, Direct | Yes | Yes |
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumShipping Instructions
Ship specimen in amber vial to protect from light.
Necessary Information
Patient's age and sex are required.
Specimen Required
Supplies: Amber Frosted Tube, 5 mL (T915)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Amber vial
Specimen Volume: 1 mL
Collection Instructions:
1. Serum gel tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged, and the serum aliquoted into an amber vial within 2 hours of collection.
Specimen Minimum Volume
0.25 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 24 hours | LIGHT PROTECTED |
| Frozen | 30 days | LIGHT PROTECTED | |
| Ambient | 6 hours | LIGHT PROTECTED |
Reference Values
Direct Bilirubin
≥12 months: 0.0-0.3 mg/dL
Reference values have not been established for patients who are younger than 12 months of age.
Total Bilirubin
0-6 days: Refer to www.bilitool.org for information on age-specific (postnatal hour of life) serum bilirubin values.
7-14 days: 0.0-14.9 mg/dL
15 days to 17 years: 0.0-1.0 mg/dL
≥18 years 0.0-1.2 mg/dL
Day(s) Performed
Monday through Sunday
CPT Code Information
82247-Bilirubin, total
82248-Bilirubin, direct
Clinical Information
Bilirubin is one of the most frequently used tests to assess liver function. Approximately 85% of the total bilirubin produced is derived from the heme moiety of hemoglobin, while the remaining 15% is produced from red blood cell precursors destroyed in the bone marrow and from the catabolism of other heme-containing proteins. After production in peripheral tissues, bilirubin is rapidly taken up by hepatocytes where it is conjugated with glucuronic acid to produce bilirubin mono- and diglucuronide, which are then excreted in the bile.
A number of inherited and acquired diseases affect 1 or more of the steps involved in the production, uptake, storage, metabolism, and excretion of bilirubin. Bilirubinemia is frequently a direct result of these disturbances.
The most commonly occurring form of unconjugated hyperbilirubinemia is that seen in newborns and referred to as physiological jaundice.
The increased production of bilirubin, that accompanies the premature breakdown of erythrocytes and ineffective erythropoiesis, results in hyperbilirubinemia in the absence of any liver abnormality.
The rare genetic disorders, Crigler-Najjar syndromes type I and type II, are caused by a low or absent activity of bilirubin uridine 5'-diphospho--glucuronosyltransferase. In type I, the enzyme activity is totally absent, the excretion rate of bilirubin is greatly reduced, and the serum concentration of unconjugated bilirubin is greatly increased. Patients with this disease may die in infancy owing to the development of kernicterus.
In hepatobiliary diseases of various causes, bilirubin uptake, storage, and excretion are impaired to varying degrees. Thus, both conjugated and unconjugated bilirubin are retained and a wide range of abnormal serum concentrations of each form of bilirubin may be observed. Both conjugated and unconjugated bilirubins are increased in hepatitis, space-occupying lesions of the liver, and obstructive lesions such as carcinoma of the head of the pancreas, common bile duct, or ampulla of Vater.
Report Available
Same day/1 to 2 daysReject Due To
| Gross hemolysis | Reject |
Method Name
Total Bilirubin: Photometric, Diazonium Salt
Direct Bilirubin: Colorimetric Diazo Method