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Test Code LAB711 ACTH Stimulation Panel

Additional Codes

Synonym: Cortisol Stimulation Test

Useful For

  • An aid in the diagnosis of primary and secondary adrenal insufficiency and Cushing Syndrome. 

  • Elevated serum levels can be found in stress responses, psychiatric diseases, obesity, diabetes, alcoholism and pregnancy.

  • Low levels of cortisol are seen in patients with rare adrenal enzyme defects and after long-lasting stress.

Methodology

Electrochemiluminescence Immunoassay (ECLIA)

Performing Laboratory

Bozeman Health Laboratory Services

Specimen Requirements

 

Test Code Test Name Time Drawn
LAB2321 Cortisol - Baseline Prior to cosyntropin injection
LAB2322

Cortisol- 30 minutes Post Dose

30 min after cosyntropin injection
LAB2323 Cortisol - 60 minutes Post Dose 60 min after cosyntropin injection

 

 

Specimen Type: Plasma or Serum
Container/Tube: Light-green top (lithium heparin gel), red top, or gold top
Specimen Volume: 1 mL

Specimen Minimum Volume: 0.5 mL

Collection Instructions:  

Important Note: Time and date must be accurately documented on each tube

  1. Draw a baseline specimen no more than 30 minutes prior to administration of cosyntropin.  Indicate time of draw on tube.

  2. Cosyntropin is administered according to instructions and the time of injection/administration is noted.

  3. Draw an additional specimen 30-minutes post cosyntropin administration. Indicate time of draw on tube.

  4. Draw an additional specimen 60-minutes post cosyntropin administration. Indicate time of draw on tube.

Specimen Rejection:

  1. Hemolyzed samples may be rejected.
  2. Samples should not be taken from patients receiving therapy with high biotin doses (i.e. > 5 mg/day) until at least 8 hours following the last biotin administration.

 

Additional Information

  • Patients do not need to be fasting.  Caffeine intake is also allowed.

Special Instructions

Cortisol Stimulation Form

Specimen Transport Temperature

Ambient <24 hours/Refrigerated >24 hours

Specimen Stability

Specimen Type Temperature Time
Plasma or Serum Ambient 24 hours
  Refrigerated 4 days
  Frozen 1 year

Reference Values

A normal patient responds with an increase of serum cortisol of >7 mg/dL with a peak cortisol level of >18 mg/dL. Failure to respond is characteristic of adrenal insufficiency. Patients with adrenal insufficiency due to pituitary disease may require more intensive stimulation with cosyntropin to develop an appropriate increment serum cortisol.

Day(s) Test Set Up

Monday through Sunday

Test Classification and CPT Coding

82533 x 3