Test Summary Sheet for:

Purpose
Exclusion Screen
Method(s)
Gas Chromatography (GC)
Suggested CPT Code(s)
80307
New York State Approval Status

Approved

Known Interference(s)
Protriptyline [GC]: Desmethylsertraline (Sertraline metabolite); Norcyclobenzaprine (Cyclobenzaprine metabolite)
Turnaround Time

5 days (If Positive: 12 days)

Test Includes
1 Protriptyline Vivactil® Gas Chromatography (GC) ng/mL 10 Antidepressant Desmethylsertraline (Sertraline metabolite); Norcyclobenzaprine (Cyclobenzaprine metabolite)

Test Also Known As
Triptil®
Reflex Tests
Test Code Test Name
5566SP Protriptyline Confirmation, Serum/Plasma
Specimen Type
Serum or Plasma
Requested Volume
5 mL
Minimum Volume
2.4 mL
Special Handling
Promptly centrifuge and separate Serum or Plasma into a plastic screw capped vial using approved guidelines.
Specimen Container
NMS Labs has no experimental or literature-based data regarding the choice of specific specimen collection containers for this test.

Additional Collection Instructions

Transport Temperature
Refrigerated
Light Protection
Not Required
Rejection Criteria
Polymer gel separation tube (SST or PST).

Rejection criteria pertain to clinical specimen submissions only.

Stability
Room Temperature: 14 day(s)
Refrigerated: 14 day(s)
Frozen (-20 °C): 12 month(s)
1 Protriptyline Vivactil® Gas Chromatography (GC) ng/mL 10 Antidepressant Desmethylsertraline (Sertraline metabolite); Norcyclobenzaprine (Cyclobenzaprine metabolite)

Interface Map

LOINC® Information

The CPT Codes provided in this document are based on AMA Guidelines and are for informational purposes only. NMS Labs Does not assume responsibility for billing errors due to Reliance on the CPT Codes listed in this document.

*The information contained in this document represents database configurations, as they will appear on the effective date listed above.