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Test Code LAB000 - Enter Specimen type, Source, and Test Name Cobalt, Serum

Important Note

PRMC OutReach Serum Collection Instructions
1. Prepare the patient for phlebotomy, following your normal protocol, using alcohol to disinfect the collection site. Do not use iodine-containing products.
2. Draw blood in a plain (no additive, red on label) royal blue Vacutainer (Supply T184) tube
3. Allow the specimen to clot for at least 30 mins but serum must be separated from cells within 2 hrs.
4. Centrifuge the specimen to separate serum from cellular fraction.
5. Attach a specimen identification label to a Mayo Metal-Free Specimen Vial (Supply T173).
6. Remove the collection tube stopper. Carefully pour the serum into the vial, avoiding transfer of the cellular components of blood.
***Do not insert a pipette into the serum to accomplish transfer.
***Do not ream the specimen with a wooden stick to assist with serum transfer.
***Blood from a dialysis patient on heparin may produce an uncoagulated serum that forms a fibrin clot after centrifugation. Pour off serum as soon as possible, and repeat centrifugation step if more serum is needed.
7. If there are cells in the poured off specimen, centrifuge the tube and pour off serum into a second Mayo Metal-Free Specimen Vial (Supply T173).
8. Place the cap on the vial tightly and send the specimen to the laboratory at the temperature indicated in the test’s transport instructions.

Additional Codes

Mayo Test ID
COS

Reporting Name

Cobalt, S

Useful For

Detecting cobalt toxicity

 

Monitoring metallic prosthetic implant wear

 

This test is not useful for assessment of vitamin B12 activity.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum


Ordering Guidance


The US Food and Drug Administration recommended test for monitoring cobalt in patients with metal-on-metal implants is COWB / Cobalt, Blood.

 

This test should not be ordered to assess vitamin B12 activity. For that assessment see B12 / Vitamin B12 Assay, Serum or ACASM / Pernicious Anemia Cascade, Serum.



Specimen Required


Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metal tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.

Supplies: Metal Free Specimen Vial (T173)

Collection Container/Tube: Plain, royal blue-top Vacutainer plastic trace element blood collection tube

Submission Container/Tube: 7-mL Mayo metal-free, screw-capped, polypropylene vial

Specimen Volume: 0.5 mL

Collection Instructions:

1. Allow the specimen to clot for 30 minutes; then centrifuge the specimen to separate serum from the cellular fraction.

2. Remove the stopper. Carefully pour specimen into a Mayo metal-free, polypropylene vial, avoiding transfer of the cellular components of blood. Do not insert a pipet into the serum to accomplish transfer, and do not ream the specimen with a wooden stick to assist with serum transfer.

3. See Metals Analysis Specimen Collection and Transport for complete instructions.


Specimen Minimum Volume

0.3 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 28 days METAL FREE
  Ambient  28 days METAL FREE
  Frozen  28 days METAL FREE

Reference Values

<1.0 ng/mL

<10.0 ng/mL (Metal-on-metal implant)

Reference values apply to all ages.

 

The reported unit of measurement for cobalt of ng/mL is equivalent to mcg/L.

Day(s) Performed

Tuesday, Wednesday, Friday

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

83018

LOINC Code Information

Test ID Test Order Name Order LOINC Value
COS Cobalt, S 5627-5

 

Result ID Test Result Name Result LOINC Value
80084 Cobalt, S 5627-5

Report Available

1 to 4 days

Reject Due To

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Method Name

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)