Ordering Recommendation

Use to detect and monitor nicotine and cotinine in serum or plasma. Serum or plasma testing may be useful when a valid urine specimen cannot be obtained (eg, due to anuria or dialysis).


Quantitative Liquid Chromatography-Tandem Mass Spectrometry




1-4 days

New York DOH Approval Status

This test is New York DOH approved.

Specimen Required

Patient Preparation

Plain red, green (sodium heparin), lavender (EDTA), or pink (K2EDTA).

Specimen Preparation

Separate serum or plasma from cells ASAP or within 2 hours of collection. Transfer 4 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 1 mL)

Storage/Transport Temperature


Unacceptable Conditions

Plasma or whole blood collected in lt. blue (sodium citrate) or SST. Specimens exposed to repeated freeze/thaw cycles. Hemolyzed specimens.


After separation from cells: Ambient: 1 week; Refrigerated: 2 weeks; Frozen: 3 years

Reference Interval

Effective August 15, 2022

Drugs Covered Cutoff Concentrations
Nicotine 5 ng/mL
Cotinine (metabolite) 5 ng/mL

Interpretive Data

Methodology: Quantitative Liquid Chromatography-Tandem Mass Spectrometry

Positive cutoff: 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 10 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, or limitations of testing. This test cannot distinguish between use of tobacco and purified nicotine products. The concentration value must be greater than or equal to the cutoff to be reported as positive.

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)


Hotline History


CPT Codes

80323 (Alt code: G0480)


Component Test Code* Component Chart Name LOINC
0092362 Nicotine, S/P, Quant 3853-9
0092363 Cotinine, S/P, Quant 10365-5
* 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.


  • Cotinine
  • Nicotine
  • Nicotine and Cotinine, LC/MS/MS, Serum/Plasma
  • Pain Management
Nicotine and Metabolites, Serum or Plasma, Quantitative