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Test Code ACTHSTIM ACTH Stimulation Test

Important Note

1. Optimum time for this test is Morning, preferable starting at 8:00 am.  The patient should have an appointment with the St Joseph Hospital Infusion Center.

2. The patient must have a prescription for cosyntropin (Cortrosyn 250 ug) and pick up the drug from the Pharmacy prior to beginning the test.  Personnel from the Infusion Center will inject the drug following collection of the baseline blood specimen.

3.  Order three Cortisol tests as indicated below (Baseline, 30 min post injection, 60 min post injection)

Additional Codes

Baseline Cortisol:   EPIC:  LAB30112    SUNQUEST:  CORB

30 min post:           EPIC:  LAB5481      SUNQUEST:  COR30

60 min post:           EPIC:  LAB5482     SUNQUEST:   COR60

Methodology

Chemiluminescent Immunoassay

Performing Laboratory

St. Joseph Hospital

Specimen Requirements

Collect 3 (three) blood specimens:  baseline, 30 minutes post-injection, and 60 minutes post-injection.  Collect the baseline cortisol specimen and collect any other tests ordered at the same time.  Send the patient to the Infusion Center for injection of the cosyntropin.. This may be done I.M. or I.V. depending on the provider's order.  Collect blood samples for cortisol at exactly 30 and 60 minutes after the drug is injected.  

Serum:  Draw blood in an SST or red-top tubes.  Centrifuge to separate serum from cells and send 1 mL of serum refrigerated.

Note: Clearly label specimens as "baseline", "30 min", and "60 min"

Reference Values

Physician interpretation

Day(s) Test Set Up

By appointment only, Monday - Friday, excluding holidays

Test Classification and CPT Coding

80400

Clinical Information

The ACTH stimulation test measures the functional integrity of the adrenal glands and their sensitivity to ACTH stimulation.  Individuals with adrenal insufficiency fail to produce enough cortisol following ACTH stimulation.  The test is useful to determine the cause of abnormal cortisol production.  A synthetic analog of ACTH (Cosyntropin) is injected following baseline blood levels and cortisol production is measured at timed intervals of 30 and 60 minutes.