Test Code LAB4 Alkaline Phosphatase (ALP), Plasma or Serum

Additional Codes

Test Name in EPIC	EPIC Test Code	Mnemonic
ALK PHOSPHATASE	LAB4	ALP

Useful For/Utility

Diagnosing and monitoring treatment of liver, bone, intestinal, and parathyroid diseases.

Clinical Information

Alkaline phosphatase in serum consists of 4 structural genotypes: liver-bone-kidney, intestinal, and placental types, and the variant from the germ cells. It is found in osteoblasts, hepatocytes, leukocytes, the kidneys, spleen, placenta, prostate, and the small intestine. The liver-bone-kidney type is particularly important.
A rise in the alkaline phosphatase occurs with all forms of cholestasis, particularly with obstructive jaundice. It is also elevated in diseases of the skeletal system, such as Paget disease, hyperparathyroidism, rickets, and osteomalacia, as well as with fractures and malignant tumors. A considerable rise in the alkaline phosphatase activity is sometimes seen in children and teenagers. It is caused by increased osteoblast activity following accelerated bone growth.

Methodology

Kinetic Rate (Para-nitrophenyl Phosphate)

Specimen Requirements

Submit only 1 of the following specimens:

Preferred:

Specimen Type: Plasma

Container/Tube: Light-green top (lithium heparin gel)

Specimen Volume: 1 mL

Specimen Minimum Volume: 0.5 mL

Collection Instructions:

1. Hemolyzed specimen is not acceptable.

2. Separate plasma from cells within 2 hours of draw.

3. If plunger filters are used, immediate removal of plasma is indicated unless an air gap can be created between the device and specimen.

Additional Information:

1. Avoid repeated freeze/thaw cycles.

2. Label specimen appropriately (plasma).

Alternate:

Specimen Type: Serum

Container/Tube: Serum gel

Specimen Volume: 1 mL

Specimen Minimum Volume: 0.5 mL

Collection Instructions:

1. Hemolyzed specimen is not acceptable.

2. Separate serum from cells within 2 hours of draw.

3. If plunger filters are used, immediate removal of serum is indicated unless an air gap can be created between the device and specimen.

Additional Information:

1. Avoid repeated freeze/thaw cycles.

2. Label specimen appropriately (serum).

Specimen Transport Temperature

Refrigerate 5 days/Ambient 8 hours OK/Frozen OK

Day(s) Test Set Up

Monday through Sunday

Performing Laboratory

Minnesota	North Dakota	Wisconsin
Ada Hospital	Fargo Hospital	Ashland Clinic
Deer River Hospital	Mid Dakota Bismarck 9th St Clinic	St. Mary's Hospital - Superior
Fosston Hospital	South University Clinic (Fargo)
Holy Trinity Hospital (Graceville)
Moose Lake Hospital
Northern Pines (Aurora)
Sandstone Hospital
SMDC Clinical Lab (Duluth)
St. Joseph's Medical Center (Brainerd)
St. Mary's - Detroit Lakes Hospital
Virginia Hospital

Test Classification and CPT Coding

84075

Reference Values

Males

0-14 days: 90-273 IU/L

15 days-1 year: 134-518 IU/L

1-9 years: 156-369 IU/L

10-12 years: 141-460 IU/L

13-14 years: 127-517 IU/L

15-16 years: 89-365 IU/L

17-18 years: 59-164 IU/L

Adult: 40-150 IU/L

Females