0025037
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Cobalt, Serum or Plasma

COBALT S
Example Reports
High
Normal

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Specimen Collection and Handling

Ordering Recommendation

May be used in the assessment of occupational exposure or toxic ingestion.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation

Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, and nonessential over-the-counter medications (upon the advice of their physician).

Collect

Royal blue (no additive), royal blue (K2EDTA), or royal blue (NaHep).

Specimen Preparation

Separate from cells ASAP or within 2 hours of collection. Transfer 2 mL serum or plasma to an ARUP Trace Element-Free Transport Tube (ARUP supply #43116) available online through eSupply using ARUP Connect™ or contact ARUP Client Services at 800-522-2787 (Min: 0.5 mL). Do not use utensils (i.e., syringes, needles) during the transfer of the sample. Carefully pour directly into the transport tube avoiding transfer of the cellular components of blood.

Storage/Transport Temperature

Room temperature. Also acceptable: Refrigerated or frozen.

Unacceptable Conditions

Specimens collected in containers other than specified. Specimens transported in containers other than specified.

Remarks
Stability

Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Indefinitely

Methodology

Quantitative Inductively Coupled Plasma-Mass Spectrometry

Performed

Sun-Sat

Reported

1-3 days

Reference Interval

Less than or equal to 1.0 µg/L

Interpretive Data

Elevated results may be due to skin or collection-related contamination, including the use of a noncertified metal-free collection/transport tube. If contamination concerns exist due to elevated levels of serum/plasma cobalt, confirmation with a second specimen collected in a certified metal-free tube is recommended.

Serum cobalt levels can be used in the assessment of occupational exposure or toxic ingestion. Symptoms associated with cobalt toxicity vary based on route of exposure, and may include cardiomyopathy, allergic dermatitis, pulmonary fibrosis, cough, and dyspnea.

Serum cobalt levels can be significantly higher in patients with metal-on-metal total hip replacement implants than in control patients without metal implants. Serum cobalt levels may be increased in asymptomatic patients with metal-on-metal prosthetics and should be considered in the context of the overall clinical scenario. Whole blood is the specimen type recommended by the U.S. Food and Drug Administration for assessing the risks of metal-on-metal hip implants in symptomatic patients.

Compliance Category

Laboratory Developed Test (LDT)

Note

Hotline History

View Hotline History

 

Hotline History

Date of Change
Test Name Change
Methodology
Performance/Reported Schedule
Specimen Requirements
Reference Interval
Interpretive Data
Note
CPT Code
Component Change
Other Interface Change
New Test
Inactive
07/21/2025
X
X
N/A

CPT Codes

83018

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Components

Component Test Code* Component Chart Name LOINC
0025037 Cobalt, Serum or Plasma 5627-5
* 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.

Aliases

  • COS
  • Co
  • Plasma cobalt level
Cobalt, Serum or Plasma