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HelpTest Code LAB168 Bilirubin, Total and Direct
Performing Laboratory
St. Louis Children's Hospital Laboratory - Chemistry
Specimen Requirements
Patient Preparation: None
Collection Container/Tube:
Preferred: Mint green-top lithium heparin (MNTGRN LiHep) tube
Acceptable: Green samplette/microtainer, plain red-top tube, or Gold SST gel tube
Submission Container/Tube: If specimen is coming from outside facility and collected in a microtainer or plain red-top tube aliquot processed sample into an amber (light protecting) plastic vial for transport (labeling with specimen type).
Specimen Collection Volume: 1.0 mL (minimum 0.6 mL)
Special Instructions: Protect specimen from light and send to lab promptly.
Sample Rejection
Specimens that are received >4 hours old that have not been protected from light.
Cord Blood specimens
Mislabled or unlabeled specimens
Logistics
Test Availability: Monday-Sunday
Cut-off time: None, performed as received
Turnaround Time: Same Day; 2 hours from receipt in performing lab
Reference Values
Reference Interval:
| BILI TOTAL | |
| 0-24 Hours: | ≤ 5.0 mg/dL |
| 24-48 Hours: | ≤ 8.0 mg/dL |
| 48-120 Hours: | ≤ 12.0 mg/dL |
| 5 days-2 weeks: | ≤ 8.0 mg/dL |
| 2 weeks-1 month: | ≤ 5.0 mg/dL |
| ≥ 1 month: | 0.1-1.2 mg/dL |
| BILI DIRECT | |
| < 30 days: | ≤ 0.4 mg/dL |
| ≥ 30 days: | 0.1-0.3 mg/dL |
| BILI DIRECT/TOTAL RATIO | |
| < 6 months | ≤ 0.2 |
| NOTE: no ratio will be reported on patients ≥ 6 months of age | |
Critical Value: ≥ 15.0 mg/dL (all ages)
Critical test results will be called initially and every 24 hours thereafter.
Methodology
Colorimeteric (Diazo method)
Limitations
- In very rare cases gammopathy, in particular type IgM (Waldenstrom's macroglobulinemia) may cause unreliable results.
- Cyanokit (Hydroxocobalamin) may cause false low results
Additional Information
FOR SLCH CORE LABORATORY USE ONLY
Lab Processing Instructions: Centrifuge to separate within 1 hour of collection. If specimen is collected in microtainer or plain red-top tube aliquot sample into a Roche false-bottom tube for testing (labeling aliquot with specimen type).
Processed Volume: 0.3 mL plasma/serum
Specimen Stability Information:
| Specimen Type | Temperature | Time |
|---|---|---|
| Whole Blood (unprocessed) | Ambient | 4 hours (exposed to light) |
| Plasma/Serum (processed) | Refrigerated (preferred) | 4 hours (exposed to light) |
| 24 hours protected from light | ||
| Ambient | 4 hours (exposed to light) | |
| 24 hours protected from light | ||
| Frozen | 6 months protected from light | |
Test Classification and CPT Code
Bili Total: 82247
Bili Direct: 82248
LOINC
Bili Total: 1975-2
Bili Direct: 1968-7
Last Reviewed
06/2025