Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3)
CPT4 code
Name of the Procedure:
Calcitonin Stimulation Panel (e.g., Calcium, Pentagastrin Stimulation Test)
Summary
The Calcitonin Stimulation Panel is a test that measures the levels of calcitonin in the blood after stimulating its release with substances like calcium or pentagastrin. Calcitonin is a hormone produced by the thyroid gland and is involved in regulating blood calcium levels.
Purpose
This procedure is primarily used to detect medullary thyroid carcinoma (MTC) and to monitor patients with a known history of the condition. It helps to identify abnormal calcitonin levels, which can be a marker of MTC or other related disorders.
Indications
- Suspected medullary thyroid carcinoma
- Follow-up in patients with a history of medullary thyroid carcinoma
- Evaluation of multiple endocrine neoplasia type 2 (MEN2)
Preparation
- Fasting for 8 hours prior to the test
- Avoidance of specific medications as per the physician’s instructions
- Basic blood tests to assess baseline health conditions
Procedure Description
- Pre-Test Blood Sample: A baseline blood sample is drawn to measure initial calcitonin levels.
- Stimulation Agent Administration: Administer the stimulation agent (calcium or pentagastrin) intravenously.
- Post-Stimulation Blood Samples: Three subsequent blood samples are drawn at specific intervals to measure calcitonin levels. This is denoted as Calcitonin (82308 x 3).
- Monitoring: The patient is observed for any immediate adverse reactions.
Duration
The entire procedure, including monitoring, typically takes about 1 to 2 hours.
Setting
The test is usually performed in a hospital, outpatient clinic, or an endocrinology specialty center.
Personnel
- Endocrinologist or specialized physician
- Nurse or phlebotomist for blood draws
- Medical assistant for patient monitoring
Risks and Complications
- Common: Mild nausea, flushing, and a warm sensation from the stimulation agent
- Rare: Allergic reactions, low blood pressure, dizziness Management involves close monitoring and immediate medical intervention if necessary.
Benefits
- Early detection of medullary thyroid carcinoma
- Accurate monitoring of calcitonin levels in previously diagnosed patients
- Better management and treatment planning for at-risk patients
Recovery
- Patients can typically resume normal activities shortly after the procedure.
- Follow-up instructions may include hydration and monitoring for delayed reactions.
- Results are usually discussed in a follow-up appointment with the physician.
Alternatives
- Ultrasound and Fine-Needle Aspiration (FNA): For thyroid nodules
- Genetic Testing: For familial conditions like MEN2
- Pros: Less invasive options available
- Cons: Might not be as specific or sensitive for early detection of MTC
Patient Experience
During the procedure, patients might feel slight discomfort or stinging at the IV site and possible mild flushing or nausea from the stimulation agent. Post-procedure, there could be minor bruising or soreness at the blood draw sites. Pain management is generally minimal or not required, as the procedure is relatively straightforward.