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Bilirubin, Total

Item Value
Clinical Questions Is my patient actively hemolyzing his/her own or transfused RBCs?
Approval req'd? No
Available Stat? Yes
Test code BILT
Test group Bilirubin
Performed by Parnassus & Mt. Zion Chemistry
In House Availability Test available 24 hours per day 7 days per week
Method Spectophotometric (diazo)
Collection Instructions Protect from light.
Container type Gold top or Light Green top
Amount to Collect 1 mL blood Click here for Microdetermination info
Sample type Serum or plasma
Preferred volume 0.5 mL serum or plasma
Min. Volume 0.2 mL serum or plasma Click here for Microdetermination info
Processing notes Protect from light.
Units mg/dL
Normal range 0.2-1.3 mg/dL

Normal range was determined by testing 268 male and female healthy adult blood donors at UCSF.
Critical value Only applicable for infants < 30 days old:

Age in days Critical value
0 > 6 mg/dL
1 > 9 mg/dL
2 > 12 mg/dL
3 > 15 mg/dL
4 > 18 mg/dL
5-30 > 21 mg/dL


Note: Criticals are not called to MIN, West, East, North 15ICN per prior agreement. Repeat critical values within 30 days of an initial critical report will not be called.

See 'Additional Information'
Synonyms T bili; TBIL; Conjugated and unconjugated bilirubin; Bile
Turn around times STAT 1 hour, Routine 4 hours
Additional information To convert mg/dL to µmol/L (SI units) multiply by 17.1. Hemolysis may artifactually increase the result; lipemia may decrease the result.

The clinical laboratory will call physicians for total bilirubin results that exceed the above age-based cutoffs in newborns outside of the intensive care nursery. Only the first critical value will be called in any given patient; subsequent critical values will not be called.

These cutoffs were recommended by Dr. Tom Newman in the Department of Pediatrics based in part on the nomogram of Bhutani et al for well newborns (gestational age of 36 weeks or more with birth weight of at least 2000 g, or a gestational age of 35 weeks or more with birth weight of at least 2500 g). Reference: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation, Pediatrics 114:297-316, 2004. Based on the recommendation of Dr. Yao Sun in the intensive care nursery (ICN), bilirubin results will not be called for infants in the ICN as different cutoffs and monitoring approaches are used in the ICN with sicker/premature infants.

The cutoffs take into consideration uncertainty about the exact age of the infant as reported by the hospital computer. (The dating of age by the hospital computer system is not entirely accurate and cannot provide patient age in hours. Age "day 0" is date of birth where infant could be anywhere between 0+ hrs to 23+ hours old depending on when sample is drawn. Age "day 1" is next day after birth and the infant could be anywhere between 1 to 47 hours old depending on when sample is drawn in relation to time of birth (e.g., baby could be listed as age day 1 in the computer but be only 1 hour old when the sample is drawn if, for example, the baby was born day 0 at 23:30 hrs and the sample was collected at 00:30 on day 1. A different baby could be listed as age day 1 in the computer and be 47 hrs old if it was born at 00:30 and the sample was collected at 23:30 on day 1 . Similarly, age "day 2" could range from ~ 25 hours to 71 hours old, etc.)
CPT coding 82247
LOINC code 34543-9
Last Updated 1/24/2012 11:13:24 AM
Entry Number 119
Lab Procedure Link Click here for Procedure
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