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).

Mnemonic
HYMET 6
Methodology

Quantitative Inductively Coupled Plasma-Mass Spectrometry

Performed

Sun-Sat

Reported

1-5 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, 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.

Collect

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.

Remarks

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.

Stability

Ambient: 1 week; Refrigerated: 2 weeks; Frozen: 1 year

Reference Interval

Effective May 18, 2015

Test Number
Components
Reference Interval
0025000 Arsenic, Urine with Reflex to Fractionated Effective November 13, 2017
Test Number
Components
Reference Interval
Arsenic, Urine - per volume 0-34.9 µg/L (based on Biological Exposure Index)
Arsenic, Urine - per 24h 0-49.9 µg/d
Arsenic, Urine-Ratio to CRT 0.0-29.9 µg/gCRT
0020734 Arsenic, Fractionated, Urine Refer to report
  Creatinine, Urine - per 24h Refer to report

0025040 Cadmium, Urine Effective November 13, 2017
Test Number
Components
Reference Interval
Cadmium, Urine - per volume 0.0-1.0 µg/L
Cadmium, Urine - per 24h 0.0-3.2 µg/d
Cadmium, Urine - ratio to CRT 0.0-3.2 µg/g crt
  Creatinine, Urine - per 24h Refer to report

0020461 Copper, Urine Effective November 13,2017
Test Number
Components
Reference Interval
Copper, Urine-per volume 0.3-3.2 µg/dL
Copper, Urine-per 24h 3.0-45.0 µg/d
  Creatinine, Urine - per 24h Refer to report
Copper, Urine-ratio to CRT 10.0-45.0 µg/gCRT

0025060 Lead, Urine Effective November 12,2018
Test Number
Components
Reference Interval
Lead, Urine - per 24h 0.0-8.1 µg/d
Lead, Urine - per volume 0.0-5.0 µg/L
Lead Urine-ratio to CRT 0.0-5.0 ug/gCRT
  Creatinine, Urine - per 24h Refer to report

0025050 Mercury, Urine Effective November 12,2018
Test Number
Components
Reference Interval
Mercury, Urine - per 24h 0.0-20.0 µg/d
Mercury, Urine - per volume 0.0-5.0 µg/L
Mercury, Urine - ratio to CRT 0.0-20.0 µg/gCRT
  Creatinine, Urine - per 24h Refer to report

0020462 Zinc, Urine Effective November 13,2017
Test Number
Components
Reference Interval
Zinc, Urine 15.0-120.0 µg/dL
Zinc, Urine-per 24h 150.0-1200.0 µg/d
Zinc, Urine-ratio to CRT 110.0-750.0 µg/gCRT
  Creatinine, Urine - per 24h Refer to report

Interpretive Data

Refer to report

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

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
N/A
CPT Codes

82175; 82300; 82525; 83655; 83825; 84630; if reflexed, add 82175

Components
Component Test Code* Component Chart Name LOINC
0020100 Copper, Urine - per volume 5632-5
0020101 Copper, Urine - per 24h 5633-3
0020102 Zinc, Urine - per volume 21610-1
0020103 Zinc, Urine - per 24h 5765-3
0020207 Creatinine, Urine - per volume 2161-8
0020208 Creatinine, Urine - per 24h 2162-6
0025001 Arsenic Urine - per volume 5586-3
0025002 Arsenic Urine - per 24h 5587-1
0025038 Cadmium, Urine - ratio to CRT 13828-9
0025041 Cadmium, Urine - per 24h 5612-7
0025042 Cadmium, Urine - per volume 5611-9
0025051 Mercury, Urine - per 24h 6693-6
0025052 Mercury, Urine - per volume 5689-5
0025054 Mercury, Urine - ratio to CRT 13465-0
0025058 Arsenic, Urine - ratio to CRT 13463-5
0025061 Lead, Urine - per 24h 5677-0
0025062 Lead, Urine - per volume 5676-2
0025063 Zinc, Urine - ratio to CRT 27201-3
0025064 Copper, Urine - ratio to CRT 13829-7
0025065 Lead, Urine - ratio to CRT 13466-8
0097110 Total Volume 19153-6
0097111 Hours Collected 30211-7
* 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 click the sidebar link to access the Interface Map.
Aliases
  • Arsenic
  • As fractionation
  • Cadmium
  • Cd
  • Copper
  • Cu
  • heavy metals urine screen
  • Hg
  • Inorganic As
  • Lead
  • Mercury
  • methylated As
  • Organic As
  • Pb
  • Zinc
  • Zn
Heavy Metals Panel 6, Urine with Reflex to Arsenic Fractionated