Lead, Venous Confirmation by ICP-MS

Label Mnemonic:	LEADV
Epic code:	LAB7479
Order form:	Laboratory Requisition
Supply order:	Supply Order Form
Billing:	Billing Policies
CPT code:	83655

Specimen(s):

Whole Blood

Collection Medium:

Royal Blue K2 EDTA tube

Minimum:

Preferred Minimum: 6 mL whole blood in royal blue K2 EDTA tube

Pediatric and Absolute Minimum: 0.5 mL whole blood in royal blue K2 EDTA top tube

Rejection Criteria:

Serum. Specimens collected in tubes other than Royal Blue (K2EDTA). Heparinized or clotted specimens. Capillary pediatric EDTA collection tubes, refer to Lead, Blood (Capillary).

Turn Around Time:

1-3 days upon receipt at reference laboratory

Reference Range:

0.0-4.9 μg/dL

Concentration   Comment
5-9.9 μg/dL     Adverse health effects are possible, particularly
                in children under 6 years of age and pregnant women.
                Discuss health risks associated with continued lead 
                exposure. For children and women who are or may become
                pregnant, reduce lead exposure.
                All ages

10-19.9 μg/dL   Reduced lead exposure and increased biological
                monitoring are recommended.
                All ages

20-69.9 μg/dL   Removal from lead exposure and prompt medical
                evaluation are recommended. Consider chelation therapy 
                when concentrations exceed 50 μg/dL and symptoms 
                of lead toxicity are present.
                All ages

>44.9 μg/dL     Critical.  Immediate medical evaluation is
                recommended. Consider chelation therapy when symptoms 
                of lead toxicity are present.
                Less than 19 years of age

>69.9 μg/dL     Critical.  Immediate medical evaluation is
                recommended. Consider chelation therapy when symptoms 
                of lead toxicity are present.
                Greater than 19 years of age

Interpretive Data:

Elevated results may be due to skin or collection-related contamination, including the use of a noncertified lead-free tube. If contamination concerns exist due to elevated levels of blood lead, confirmation with a second specimen collected in a certified lead-free tube is recommended.

Information sources for reference intervals and interpretive comments include the "CDC Response to the 2012 Advisory Committee on Childhood Lead Poisoning Prevention Report" and the "Recommendations for Medical Management of Adult Lead Exposure, Environmental Health Perspectives, 2007." Thresholds and time intervals for retesting, medical evaluation, and response vary by state and regulatory body. Contact your State Department of Health and/or applicable regulatory agency for specific guidance on medical management recommendations.

Comments:

For acute poisoning cases where fast turnaround time is important, order LEAD, BLOOD (BY LEADCARE) (LAB98) for analysis of capillary specimens.

Methodology:

Quantitative Inductively Coupled Plasma/Mass Spectrometry

Instructions:

Referral laboratory will no longer accept a K2EDTA Lavender Top Tube and will only accept the K2EDTA Royal Blue Top tube.

Sample Processing:

Label tube with two Full patient identifiers, date and time of collection.
Submit whole blood in original container. DO NOT CENTRIFUGE.

Sample Storage:

Room Temperature.

Transport Instructions:

Place labeled specimen into zip-lock type biohazard bag; seal bag.
Place completed laboratory requisition (or packing list) into outside pocket of bag.
Ship at room temperature.

CPT Code:

83655