Lithium

CPT: 80178

Expected Turnaround Time

24 Hours

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.

Specimen Requirements

Specimen

Serum, Plasma

Volume

5 ml

Minimum Volume

13 ul

Container

SST (Serum), Red Top (Separate Serum), EDTA (Plasma), Sodium Heparin (Plasma)

Storage Instructions

Room Temp., Refrigerated (2-8 C)

Stability Requirements

Room temp. 7 days, Refrigerated 7 days

Causes for Rejection

Mislabeled specimen, grossly hemolyzed specimen, sample collected expired tubes, clotted specimen.

Test Details

Use

Lithium measurements are used as an aid in the monitoring of lithium therapy.

Methodology

Colorimetric

Reference Interval

1.00–1.20 mmol/L

Additional Information

Lithium is a mood-stabilizing agent primarily used in the long-term management of bipolar disorder, particularly effective in treating acute manic episodes and preventing mood relapses. Though its exact mechanism is not fully understood, lithium is believed to modulate neurotransmission by influencing sodium transport in nerve and muscle cells, inhibiting inositol monophosphatase, and reducing excitatory neurotransmitters like dopamine and glutamate. It has also been associated with neuroprotective effects and reduced suicide risk in bipolar patients.

Therapeutically, lithium has a narrow therapeutic window, requiring routine blood level monitoring to avoid toxicity. Target serum levels typically range from 1.0 to 1.2 mmol/L, depending on whether the goal is maintenance or acute intervention. Toxicity may present with tremors, confusion, ataxia, gastrointestinal symptoms, or, in severe cases, seizures and renal failure. Monitoring is especially critical in patients with renal impairment, dehydration, or those on interacting medications such as NSAIDs, ACE inhibitors, or diuretics. Regular assessment of renal and thyroid function is also recommended during therapy.

Reference:
Malhi, G. S., Tanious, M., Das, P., Coulston, C. M., & Berk, M. (2012). The science and practice of lithium therapy. Australian & New Zealand Journal of Psychiatry, 46(3), 192–211. https://doi.org/10.1177/0004867412437346

Footnotes

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.

Questions?

For questions or inquiries related to testing please reach out to
customerservice@solarisdx.com or contact us by phone at (844) 550-0308.