Liver Fibrosis, Hepatic Function Panel with Fibrosis-4 (FIB-4) Index

Liver Fibrosis, Hepatic Function Panel with Fibrosis-4 (FIB-4) Index

Test Code

30710
80076, 85049
CPT Code is subject to a Medicare Limited Coverage Policy and may require a signed ABN when ordering.
30710
80076, 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. 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

Liver Fibrosis, Hepatic Function 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

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

Test Details

Includes

  • Hepatic Function Panel: Total Protein, Albumin, Globulin, Albumin/Globulin Ratio, Total Bilirubin, Direct Bilirubin, Indirect Bilirubin, Alkaline Phosphatase, Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT)
  • Platelet Count
  • FIB 4 Index

Methodology

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

Reference Range(s)

See Laboratory Report

Alternative Name(s)

FIB4, NASH, NAFLD, Nonalcoholic, Fatty, Steatosis, Steatohepatitis, LFT

LOINC® Codes, Performing Laboratory

Service Area must be determined
Hepatic Function Panel: Total Protein, Albumin, Globulin, Albumin/Globulin Ratio, Total Bilirubin, Direct Bilirubin, Indirect Bilirubin, Alkaline Phosphatase, Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT)
Platelet Count
FIB 4 Index

Methodology

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

Reference Range(s)

See Laboratory Report

Alternative Name(s)

FIB4, NASH, NAFLD, Nonalcoholic, Fatty, Steatosis, Steatohepatitis, LFT
Service Area must be determined

Preferred Specimen(s)

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

Alternative Specimen(s)

Whole blood from a full EDTA (tan-top) tube

Minimum Volume

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

Collection Instructions

Note: If drawn with lead testing, EDTA (tan-top) is required

Transport Container

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

Transport Temperature

Serum: Refrigerated (cold packs)
Whole blood: Room temperature

Specimen Stability

  • Serum
  • Room temperature: 24 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 whole blood full EDTA (lavender-top) tube
Whole blood from a full EDTA (tan-top) tube
0.5 mL serum • 0.5 mL microtainer-lavender or 1 mL EDTA whole blood
Note: If drawn with lead testing, EDTA (tan-top) is required
Serum separator tube (SST) and EDTA (lavender-top) tube
Serum: Refrigerated (cold packs)
Whole blood: Room temperature
Serum
Room temperature: 24 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. 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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