Direct bilirubin (conjugated bilirubin) is a water-soluble form of bilirubin that the liver has processed. It is then eliminated from the body. Whereas total bilirubin contains both direct and indirect bilirubin (also known as unconjugated bilirubin). Indirect bilirubin is a type of bilirubin created when RBCs break down, and this bilirubin is not water-soluble. This indirect bilirubin must first be converted into direct bilirubin by the liver to get eliminated from the body.