Ordering Recommendation
Recommended for determination of active or passive nicotine use or for differentiation between nicotine replacement and tobacco use. For a screening test to determine active exposure to nicotine and compliance with smoking-cessation programs, Cotinine Screen, Urine (2007081) is preferred.
Mnemonic
Methodology
Quantitative Liquid Chromatography-Tandem Mass Spectrometry
Performed
Sun-Sat
Reported
1-4 days
New York DOH Approval Status
Specimen Required
Random urine.
Transfer 4 mL with no additives or preservatives urine to an ARUP Standard Transport Tube. (Min: 1 mL)
Room temperature.
Specimens exposed to repeated freeze/thaw cycles.
Ambient: 10 days; Refrigerated: 10 days; Frozen: 8 months
Reference Interval
Effective August 17, 2015
Drugs Covered | Cutoff Concentrations |
Nicotine | 15 ng/mL |
Cotinine (metabolite) | 15 ng/mL |
3-OH-Cotinine (metabolite) | 50 ng/mL |
Anabasine (tobacco biomarker) | 5 ng/mL |
Interpretive Data
Methodology: Quantitative Liquid Chromatography-Tandem Mass Spectrometry
Positive cutoff:
Nicotine 15 ng/mL
Cotinine 15 ng/mL
3-OH-Cotinine 50 ng/mL
Anabasine 5 ng/mL
For medical purposes only; not valid for forensic use.
This test is designed to evaluate recent use of nicotine-containing products. Passive and active exposure cannot be discriminated definitively, although a cutoff of 100 ng/mL cotinine is frequently used for surgery qualification purposes. For smoking cessation programs or compliance testing, the absence of expected drug(s) and/or drug metabolite(s) may indicate non-compliance, inappropriate timing of specimen collection relative to drug administration, poor drug absorption, diluted/adulterated urine, or limitations of testing. The concentration value must be greater than or equal to the cutoff to be reported as positive. Anabasine is included as a biomarker of tobacco use, versus nicotine replacement. Interpretive questions should be directed to the laboratory.
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.
Laboratory Developed Test (LDT)
Note
Hotline History
Hotline History
CPT Codes
80323 (Alt code: G0480)
Components
Component Test Code* | Component Chart Name | LOINC |
---|---|---|
0092357 | Nicotine, Urn, Quant | 3854-7 |
0092358 | Cotinine, Urn, Quant | 10366-3 |
0092359 | 3-OH-Cotinine, Urn, Quant | 33916-8 |
0092365 | Anabasine, Urn, Quant | 33915-0 |
Aliases
- 3-Hydroxycotinine
- Anabasine
- Cotinine
- Nicotine and Cotinine, LC/MS/MS, Urine
- Pain Management