Ordering Recommendation

Useful in confirming hepatic iron overload, particularly in individuals with hemochromatosis and no common HFE mutations. Initial approach to diagnosis for hemochromatosis should include Iron and Iron Binding Capacity (0020420) (NOTE: test includes serum transferrin saturation) and Ferritin (0070065).


Quantitative Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)




3-10 days

New York DOH Approval Status

This test is New York DOH approved.

Specimen Required

Patient Preparation

Liver tissue obtained with an 18 gauge needle.

Specimen Preparation

Transport at least a 1 cm long specimen. Tissue can be fresh, paraffin-embedded, or dried. Also acceptable: Formalin-fixed. Specimens should be stored and transported in a metal-free container such as a royal blue (no additive).

Storage/Transport Temperature


Unacceptable Conditions

Specimens less than 0.25 mg (dry weight). Specimens stored or shipped in saline.


Age is required on test request form in order to calculate iron index.


Paraffin block, preserved (formalin), or dried: Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Indefinitely
Fresh tissue: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: Indefinitely

Reference Interval

Hepatic Iron Concentration by Weight (HIC) 200-2,000 µg/g of tissue 200-1,600 µg/g of tissue
Hepatic Iron Index (HII) Less than 1.0 Less than 1.0

Interpretive Data

A Hepatic Iron Index (HII) is not calculated for patients less than 14 years.  An HII less than 1.0 is consistent with normal iron accumulation.  An HII 1.0 through 1.9 is consistent with mild iron accumulation such as in heterozygous hemochromatosis or alcoholic liver disease.  An HII greater than 1.9 is consistent with iron overload such as in homozygous hemochromatosis, porphyria cutanea tarda, and cirrhotic liver disease.  The HII will decrease with chelation, chronic blood loss, or phlebotomy.

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

Compliance Category

Laboratory Developed Test (LDT)


Hotline History


CPT Codes



Component Test Code* Component Chart Name LOINC
0020815 Tissue Weight 29638-4
0020816 Hepatic Iron Concentration by Weight 15357-7
0020817 Hepatic Iron Index 49061-5
2004961 EER Iron, Liver 11526-1
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.


  • Fe
  • Hepatic Iron Concentration
  • Hepatic Iron Index
  • Iron Tissue
  • Iron, Tissue Liver
  • Metals, Tissue
  • Quantitative Iron
  • Total Iron, Liver Tissue
Iron, Liver