Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Carbamazepine is an anticonvulsant and mood-stabilizing drug widely used in the management of epilepsy, trigeminal neuralgia, and bipolar disorder. Therapeutic drug monitoring (TDM) of carbamazepine is essential due to its narrow therapeutic index, variable pharmacokinetics, and risk of toxicity. Serum levels are measured to ensure efficacy while avoiding adverse effects such as dizziness, diplopia, ataxia, leukopenia, and, in severe cases, aplastic anemia or Stevens-Johnson syndrome. The typical therapeutic range is 4–12 µg/mL. Carbamazepine undergoes hepatic metabolism via CYP3A4 and induces its own metabolism (autoinduction), making frequent monitoring important during dose adjustments or polytherapy. Drug levels may also be influenced by enzyme inducers or inhibitors, liver function, and patient compliance.
References:
Patsalos, P. N., Berry, D. J., Bourgeois, B. F. D., Cloyd, J. C., Glauser, T. A., Johannessen, S. I., … & Tomson, T. (2008). Antiepileptic drugs—best practice guidelines for therapeutic drug monitoring: a position paper by the subcommission on therapeutic drug monitoring, ILAE Commission on Therapeutic Strategies. Epilepsia, 49(7), 1239–1276. https://doi.org/10.1111/j.1528-1167.2008.01561.x
Perucca, E. (2005). Clinical pharmacokinetics of new-generation antiepileptic drugs at the extremes of age. Clinical Pharmacokinetics, 44(6), 485–504. https://doi.org/10.2165/00003088-200544060-00001
Statement on Medical Necessity
All ordered tests should be medically necessary for the diagnosis or detection of disease, illness, impairment, symptom, syndrome, or disorder and the results should be used in the medical management and treatment decisions for the patient. Solaris requires ICD-10 codes with each order for lab testing and both the tests ordered and the diagnosis should be documented in the provider’s medical record for the patient. The United States Department of Health and Human Services, Office of Inspector General, takes the position that a provider who orders medically unnecessary tests may be subject to civil penalties.
Panels and Profiles
Solaris offers Providers the convenience of ordering test combinations in a group at times with the flexibility to choose appropriate test(s) for individual patients. Providers should only order those tests that he or she believes are medically necessary for each patient, and a lesser inclusive profile or individual tests should be ordered if not all tests in the test combination/profile are medically necessary. All tests offered in a test combination/profile may be ordered separately as individual tests. Solaris encourages clients to contact their Solaris representative if the testing configurations shown do not meet individual needs for any reason, or if some other combination of procedures is needed.
CPT Codes
CPT Codes listed are in accordance with Current Procedural Terminology, a publication of the American Medical Association. CPT codes are the responsibility of the billing party and are listed here for informational purposes. Correct coding may vary from one carrier to another. Solaris may bill specific carriers using codes other than what is shown.
For questions or inquiries related to testing please reach out to
customerservice@solarisdx.com or contact us by phone at (844) 550-0308.
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