Total Bilirubin is a bile pigment. When bilirubin levels are high, a condition called jaundice occurs, and further testing is needed to determine the cause. Too much bilirubin may mean that too much is being produced, usually due to increased destruction of red blood cells (hemolysis). It may also mean that the liver is incapable of adequately removing bilirubin in a timely manner due to blockage of bile ducts, liver diseases (such as cirrhosis, acute hepatitis), or inherited problems with bilirubin handling.