Phenylalanine/Tyrosine
Phenylalanine/Tyrosine
Laboratory Fee Schedule
Procedure #: BZZ0003A
CPT: 83789
Synonym(s): | Phenylketonuria (PKU) Dietary Monitoring |
Requisition Form | G-1B |
Test Description | Testing of phenylketonuria (PKU) dietary monitoring specimens to detect elevated concentrations of the amino acids phenylalanine and tyrosine. |
Pre-Approval Needed | N/A |
Supplemental Information Required | N/A |
Supplemental Form(s) | N/A |
Performed on Specimens from (sources) | Human |
Sample/Specimen Type for Testing | Dried whole blood on DSHS approved filter paper card. |
Minimum Volume/Size Required | Two completely filled ½ inch dried blood spots. |
Storage/Preservation Prior to Shipping |
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Transport Medium | N/A |
Specimen Labeling |
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Shipping and Specimen Handling Requirements |
Ship all specimens according to Dangerous Good Regulations, IATA, and/or CFR 49. Must include one completed G-1B form per specimen. DRIED FILTER PAPER BLOOD SPECIMENS
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Method | Tandem Mass Spectrometry |
Turn-around Time | Within 4 working days after receipt of specimen |
Interferences/Limitations | Alcohol swab with a topical pain killer such as benzocaine can interfere with the testing, |
Common Causes for Rejection |
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Additional Information |
Reference Range: Phenylalanine values less than 4.0 mg/dL are normal. Tyrosine values less than 3.0 mg/dL are normal. Additional information for specimen collection: |