AMITRIPTYLINE AND NORTRIPTYLINE

General Information

HLAB/HOL Code: AMIT
UPHSM LIS Test #: 6539
Schedule: Monday-Friday
Testing Time: 2 Days
Testing Lab: Mayo Labs

Specimen Info
Only 1 specimen type required, unless otherwise specified

Volume: 1.0 mL
Temperature: Refrigerate
Tube Type: 1 Red Top tube
Collection Info:
Collection Instructions:

1. Draw specimen immediately before next scheduled dose (minimum 12 hours after last dose).

2. Serum must be separated from cells within 2 hours of draw.

Specimen Acceptability

Reject Due To

Hemolysis
Mild OK; Gross reject

Lipemia
Mild OK; Gross reject

Icterus
Mild OK; Gross reject

Other
Serum gel tube

Clinical Utilities

Useful For

Monitoring serum concentration during therapy

Evaluating potential toxicity

The test may also be useful to evaluate patient compliance

CPT Codes

G0480

* The CPT codes provided are based on AMA guidelines 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.

Component Info

Name: AMITRIPTYLINE
Method: LC/MS/MS
CPT Code: 80152
Ref Range: By Report
Comp Units: mcg/L
Name: NORTRIPTYLINE
Method: LC/MS/MS
CPT Code: 80182
Ref Range: By Report
Comp Units: mcg/L
Name: TOTAL
Method: Calculated
CPT Code:
Ref Range: 100 - 250
Comp Units: mcg/L