Ordering Recommendation

Use to detect and monitor nicotine, cotinine, and trans-3'-hydroxycotinine in serum or plasma. Serum or plasma testing may be useful when a valid urine specimen cannot be obtained (anuretic or dialysis).

Mnemonic
NICOTINESP
Methodology

Quantitative Liquid Chromatography-Tandem Mass Spectrometry

Performed

Sun-Sat

Reported

1-4 days

New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
Collect

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

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

Refrigerated.

Unacceptable Conditions

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

Remarks
Stability

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

Reference Interval

Effective August 17, 2015

Drugs Covered Cutoff Concentrations
Nicotine 2 ng/mL
Cotinine (metabolite) 2 ng/mL
3-OH-Cotinine (metabolite) 2 ng/mL

Interpretive Data

Methodology: Quantitative Liquid Chromatography-Tandem Mass Spectrometry

Positive cutoff: 2 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.

Compliance Category

Laboratory Developed Test (LDT)

Note
Hotline History
N/A
CPT Codes

80323 (Alt code: G0480)

Components
Component Test Code* Component Chart Name LOINC
0092362 Nicotine, S/P, Quant 3853-9
0092363 Cotinine, S/P, Quant 10365-5
0092364 3-OH-Cotinine, S/P, Quant 35140-3
* 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
  • 3-Hydroxycotinine
  • Cotinine
  • Nicotine
  • Nicotine and Cotinine, LC/MS/MS, Serum/Plasma
  • Pain Management
Nicotine and Metabolites, Serum or Plasma, Quantitative