Ordering Recommendation

Useful in the assessment of overload.

New York DOH Approval Status

This test is New York state 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 nonessential over-the-counter medications (upon the advice of their physician). Collection from patients receiving iodinated or gadolinium-based contrast media must be avoided for a minimum of 72 hours postexposure. Collection from patients with impaired kidney function should be avoided for a minimum of 14 days postcontrast media exposure.


Random urine.

Specimen Preparation

Transfer an 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: 1 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.


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


Quantitative Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)




1-5 days

Reference Interval

Effective February 16, 2021

Reference Interval
Copper, Urine Less than or equal to 3.2 µg/dL
Copper Urine - ratio to CRT 10.0-45.0 µg/gCRT

Interpretive Data

Individuals with symptomatic Wilson disease usually excrete more than 100 g copper per day. Other conditions associated with elevated urine copper include cholestatic liver disease, proteinuria, some medications, and contaminated specimens.
Although random specimens may contain diagnostic information, 24-hour collection is a more consistent indicator of elevated copper.

Compliance Category

Laboratory Developed Test (LDT)


High concentrations of iodine or gadolinium may interfere with elemental testing.

Hotline History


CPT Codes



Component Test Code* Component Chart Name LOINC
0020100 Copper, Urine - per volume 5632-5
0020207 Creatinine, Urine - per volume 2161-8
0025064 Copper, Urine - ratio to CRT 13829-7
* 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.


  • 24-hour urine copper
  • Copper/Creatinine Ratio, Urine
  • Cu
  • CUU
  • Normalized Urine Copper
  • Normalized Urine Cu
Copper, Random Urine