Heavy Metals Panel 6, Urine with Reflex to Arsenic Fractionated
Ordering Recommendation

Useful in the assessment of acute and chronic exposure to arsenic, cadmium, copper, mercury, lead, and zinc. The preferred test for the assessment of lead exposure is Lead, Blood (Venous) (0020098). For occupational exposure, consider Lead, Industrial Exposure Panel, Adults (0025016) and/or Cadmium Exposure Panel - OSHA (0025013).

Quantitative Inductively Coupled Plasma-Mass Spectrometry
1-5 days
New York DOH Approval Status
This test is New York DOH approved.
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, non-essential over-the-counter medications (upon the advice of their physician), and avoid shellfish and seafood for 48 to 72 hours. Collection from patients receiving iodinated or gadolinium-based contrast media must be avoided for a minimum of 72 hours post-exposure. Collection from patients with impaired kidney function should be avoided for a minimum of 14 days post-contrast media exposure. 
24 Hour Urine. Refrigerate during collection. Specimen must be collected in a plastic container. Also acceptable: Random Urine. 
Specimen Preparation
Transfer 8 mL aliquot from a well-mixed collection to ARUP Trace Element-Free Transport Tubes (ARUP supply #43116). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 2 mL) 
Storage/Transport Temperature
Refrigerated. Also acceptable: Room temperature or frozen. 
Unacceptable Conditions
Specimens collected within 72 hours after administration of iodinated or gadolinium-based contrast media. Acid preserved urine. Specimens transported in containers other than specified. Specimens contaminated with blood or fecal material. 
Trace Elements requisition form may be required (ARUP form #32990-Barcode; #32991-No Barcode). Record total volume and collection time interval on transport tube and on test request form. 
Ambient: 1 week; Refrigerated: 2 weeks; Frozen: 1 year 
Reference Interval
Effective May 18, 2015
Test Number
Reference Interval
0025000Arsenic, Urine with Reflex to FractionatedEffective November 13, 2017
Test Number
Reference Interval
Arsenic, Urine - per volume0-34.9 µg/L (based on Biological Exposure Index)
Arsenic, Urine - per 24h0-49.9 µg/d
Arsenic, Urine-Ratio to CRT0.0-29.9 µg/gCRT
0020734Arsenic, Fractionated, UrineRefer to report
 Creatinine, Urine - per 24hRefer to report

0025040Cadmium, UrineEffective November 13, 2017
Test Number
Reference Interval
Cadmium, Urine - per volume0.0-1.0 µg/L
Cadmium, Urine - per 24h0.0-3.2 µg/d
Cadmium, Urine - ratio to CRT0.0-3.2 µg/g crt
 Creatinine, Urine - per 24hRefer to report

0020461Copper, UrineEffective November 13,2017
Test Number
Reference Interval
Copper, Urine-per volume0.3-3.2 µg/dL
Copper, Urine-per 24h3.0-45.0 µg/d
 Creatinine, Urine - per 24hRefer to report
Copper, Urine-ratio to CRT10.0-45.0 µg/gCRT

0025060Lead, UrineEffective November 12,2018
Test Number
Reference Interval
Lead, Urine - per 24h0.0-8.1 µg/d
Lead, Urine - per volume0.0-5.0 µg/L
Lead Urine-ratio to CRT0.0-5.0 ug/gCRT
 Creatinine, Urine - per 24hRefer to report

0025050Mercury, UrineEffective November 12,2018
Test Number
Reference Interval
Mercury, Urine - per 24h0.0-20.0 µg/d
Mercury, Urine - per volume0.0-5.0 µg/L
Mercury, Urine - ratio to CRT0.0-20.0 µg/gCRT
 Creatinine, Urine - per 24hRefer to report

0020462Zinc, UrineEffective November 13,2017
Test Number
Reference Interval
Zinc, Urine15.0-120.0 µg/dL
Zinc, Urine-per 24h150.0-1200.0 µg/d
Zinc, Urine-ratio to CRT110.0-750.0 µg/gCRT
 Creatinine, Urine - per 24hRefer to report

Interpretive Data
Refer to report

Statement B: Compliance Statement B: For laboratory developed tests not using a RUO kit, and for FDA approved, cleared or 510(k) exempt assays with alterations. This test was developed and its performance characteristics determined by ARUP Laboratories. The U. S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

High concentrations of iodine or gadolinium may interfere with elemental testing. If total arsenic concentration is between 35-2000 ug/L, then Arsenic, Fractionated, will be added to determine the proportion of organic, inorganic, and methylated forms. Additional charges apply.
Hotline History
View Hotline History
CPT Code(s)
82175; 82300; 82525; 83655; 83825; 84630; if reflexed, add 82175
Component Test Code*Component Chart NameLOINC
0020100Copper, Urine - per volume5632-5
0020101Copper, Urine - per 24h5633-3
0020102Zinc, Urine - per volume21610-1
0020103Zinc, Urine - per 24h5765-3
0020207Creatinine, Urine - per volume2161-8
0020208Creatinine, Urine - per 24h2162-6
0025001Arsenic Urine - per volume5586-3
0025002Arsenic Urine - per 24h5587-1
0025038Cadmium, Urine - ratio to CRT13828-9
0025041Cadmium, Urine - per 24h5612-7
0025042Cadmium, Urine - per volume5611-9
0025051Mercury, Urine - per 24h6693-6
0025052Mercury, Urine - per volume5689-5
0025054Mercury, Urine - ratio to CRT13465-0
0025058Arsenic, Urine - ratio to CRT13463-5
0025061Lead, Urine - per 24h5677-0
0025062Lead, Urine - per volume5676-2
0025063Zinc, Urine - ratio to CRT27201-3
0025064Copper, Urine - ratio to CRT13829-7
0025065Lead, Urine - ratio to CRT13466-8
0097110Total Volume19153-6
0097111Hours Collected30211-7
* 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 view this test within the Laboratory Test Directory found at www.aruplab.com
  • Arsenic
  • As fractionation
  • Cadmium
  • Cd
  • Copper
  • Cu
  • heavy metals urine screen
  • Hg
  • Inorganic As
  • Lead
  • Mercury
  • methylated As
  • Organic As
  • Pb
  • Zinc
  • Zn