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Collagen Cross-Linked N-Telopeptide (NTx), Urine

Test Code


CPT Code(s)

82523, 82570



Preferred Specimen(s)

2 mL unpreserved urine from second morning void

Minimum Volume

1 mL

Alternative Specimen(s)

Unpreserved random urine, unpreserved catheterized, or unpreserved first morning void clean catch

Collection Instructions

Do not use preservatives. Acidified specimen is not acceptable. Second morning void urine: Discard the first morning void. Collect the second morning void. Mix well.

Specimen Container

Urine container, leak-proof

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Room temperature: 72 hours
Refrigerated: 5 days
Frozen: 30 days

Reject Criteria

Acidified specimen • Preserved specimen


Enhanced Chemiluminescence

Performing Laboratory

Quest Diagnostics Nichols Institute
14225 Newbrook Drive
Chantilly, VA 20153

Setup Schedule

Set up: Mon-Sat evenings; Report available: Next day

Reference Range(s)

Collagen Cross-Linked N-Telopeptide (NTx), Random Urine

  18-29 Years 12-99 nmol BCE/mmol creat
  30-59 Years 9-60 nmol BCE/mmol creat
  Premenopausal 4-64 nmol BCE/mmol creat
Results are primarily used for monitoring the response to therapy. A value within the premenopausal reference range does not rule out osteoporosis nor the need for therapy.
Creatinine, Random Urine
≤6 Months 2-28 mg/dL
7-11 Months 2-31 mg/dL
1-2 Years 2-110 mg/dL
3-8 Years 2-130 mg/dL
9-12 Years 2-160 mg/dL
>12 Years Male 20-320 mg/dL
>12 Years Female 20-275 mg/dL

Clinical Significance

NTx is useful to assess bone resorption in patients with metabolic bone disease. The test is also useful in monitoring therapy to slow or halt osteoporotic bone loss. A decline of 30% or more of NTx over a six-month period suggests effective therapy.

Alternative Name(s)

Collagen Cross-Linked N-Telopeptide, N-Telopeptide or NTx

LOINC®' Code(s)

The Result and LOINC information listed below should not be used for electronic interface maintenance with Quest Diagnostics. Please contact the Quest Diagnostics Connectivity Help Desk for more information at 800-697-9302.

NOTE: The codes listed in the table below are not orderable Test Codes.

Result NameLOINC CodeComponent Name
14440Creatinine, Random Urine2161-8Creatinine
14466AN-Telopeptide (NTx)14115-0Collagen crosslinked N-telopeptide/Creatinine

Reference ranges are provided as general guidance only. To interpret test results use the reference range in the laboratory report.

The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

LOINC assignment is based on a combination of test attributes, including the method used by the performing laboratory. For tests not performed by Quest Diagnostics, codes are assigned by the performing laboratory.

* The tests listed by specialist are a select group of tests offered. For a complete list of Quest Diagnostics tests, please refer to our Directory of Services.