Comprehensive Metabolic Panel with Fibrosis-4 (FIB-4) Index

Comprehensive Metabolic Panel with Fibrosis-4 (FIB-4) Index

Test Code

10372
80053, 85049
CPT Code is subject to a Medicare Limited Coverage Policy and may require a signed ABN when ordering.
10372
80053, 85049
CPT Code is subject to a Medicare Limited Coverage Policy and may require a signed ABN when ordering.
Not offered in Quest Nichols Institute - Chantilly, VA | Quest Diagnostics Nichols Institute (IFD) – San Juan Capistrano | Quest Nichols Institute -San Juan Capistrano, CA. Please provide SERVICE AREA INFORMATION to find available tests you can order.
In-home collection may be available in your area for purchase through Quest Mobile.

Clinical Significance

Comprehensive Metabolic Panel with Fibrosis-4 (FIB-4) Index - The FIB-4 index is a simple non-invasive approach using selected laboratory measures (AST, ALT, platelet count) in combination with patient age to assess if an individual is at higher risk for advanced liver fibrosis (F3-F4).

Test Resources

Test Summary

Cardiometabolic Disease Assessment (CMDA) Panel

Test Summary

Liver Fibrosis, Fibrosis-4 (FIB-4) Index Panel

Test Details

Includes

  • Comprehensive Metabolic Panel: Albumin, Albumin/Globulin Ratio (calculated), Alkaline Phosphatase, ALT, AST, BUN/Creatinine Ratio (calculated), Calcium, Carbon Dioxide, Chloride, Creatinine with GFR Estimated, Globulin (calculated), Glucose, Potassium, Sodium, Total Bilirubin, Total Protein, Urea Nitrogen
  • Platelet Count
  • FIB 4 Index

Patient Preparation

Fasting specimen is preferred

Methodology

Electronic Cell Sizing/Counting/Cytometry/Microscopy • Spectrophotometry (SP)

Reference Range(s)

See Laboratory Report

LOINC® Codes, Performing Laboratory

Service Area must be determined
Comprehensive Metabolic Panel: Albumin, Albumin/Globulin Ratio (calculated), Alkaline Phosphatase, ALT, AST, BUN/Creatinine Ratio (calculated), Calcium, Carbon Dioxide, Chloride, Creatinine with GFR Estimated, Globulin (calculated), Glucose, Potassium, Sodium, Total Bilirubin, Total Protein, Urea Nitrogen
Platelet Count
FIB 4 Index
Fasting specimen is preferred

Methodology

Electronic Cell Sizing/Counting/Cytometry/Microscopy • Spectrophotometry (SP)

Reference Range(s)

See Laboratory Report
Service Area must be determined

Preferred Specimen(s)

1 mL serum collected in a serum separator tube (SST) and one full tube whole blood collected in an EDTA (lavender-top) tube

Minimum Volume

0.5 mL serum • 1 mL EDTA whole blood or 0.5 mL microtainer-lavender

Collection Instructions

Whole blood: Maintain specimen at room temperature. Do not refrigerate. If multiple draw, collect lavender-top tube last. Traumatic venipuncture tap can introduce thromboplastin and trap white blood cells and platelets. Refrigeration can precipitate fibrin and trap white blood cells and platelets.

Transport Container

Serum separator tube (SST) and EDTA (lavender-top) tube

Transport Temperature

Room temperature

Specimen Stability

  • Serum
  • Room temperature: 72 hours
  • Refrigerated: 72 hours
  • Frozen: Unacceptable
  •  
  • Whole blood
  • Room temperature: 48 hours

Reject Criteria

See individual tests

Setup Schedule

Service Area must be determined
1 mL serum collected in a serum separator tube (SST) and one full tube whole blood collected in an EDTA (lavender-top) tube
0.5 mL serum • 1 mL EDTA whole blood or 0.5 mL microtainer-lavender
Whole blood: Maintain specimen at room temperature. Do not refrigerate. If multiple draw, collect lavender-top tube last. Traumatic venipuncture tap can introduce thromboplastin and trap white blood cells and platelets. Refrigeration can precipitate fibrin and trap white blood cells and platelets.
Serum separator tube (SST) and EDTA (lavender-top) tube
Room temperature
Serum
Room temperature: 72 hours
Refrigerated: 72 hours
Frozen: Unacceptable

Whole blood
Room temperature: 48 hours
See individual tests
Service Area must be determined
Not offered in Quest Nichols Institute - Chantilly, VA | Quest Diagnostics Nichols Institute (IFD) – San Juan Capistrano | Quest Nichols Institute -San Juan Capistrano, CA. Please provide SERVICE AREA INFORMATION to find available tests you can order.
In-home collection may be available in your area for purchase through Quest Mobile.
Test Details

Clinical Significance

Test Resources

Reference ranges are provided as general guidance only. To interpret test results use the reference range in the laboratory report.

The CPT codes provided are based on AMA guidance and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

This material contains content from LOINC® (http://loinc.org). The LOINC Table, LOINC Table Core are copyright © 1995-2019, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license at http://loinc.org/license.

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