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.

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. 

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

Compliance Category

Laboratory Developed Test (LDT)

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