Ordering Recommendation

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

Mnemonic
COBALT S
Methodology

Quantitative Inductively Coupled Plasma-Mass Spectrometry

Performed

Sun-Sat

Reported

1-3 days

New York DOH Approval Status
This test is New York DOH 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 non-essential over-the-counter medications (upon the advice of their physician).

Collect

Royal Blue (No Additive) or Royal Blue (K2 EDTA), or Royal Blue (Na2 EDTA).

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)

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

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.

Whole blood is the preferred specimen type for evaluating metal ion release from metal-on-metal joint arthroplasty. 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.

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.

Note
Hotline History
N/A
CPT Codes

83018

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