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HelpTest Code COS Cobalt, Serum
Additional Codes
| Mayo | COS |
| Epic ID | LAB3889 |
Special Instructions
Specimen Type
SerumOrdering Guidance
The US Food and Drug Administration recommended test for monitoring cobalt in patients with metal-on-metal implants is COWB / Cobalt, Blood.
This test should not be ordered to assess vitamin B12 activity. For that assessment see B12 / Vitamin B12 Assay, Serum or ACASM / Pernicious Anemia Cascade, Serum.
Specimen Required
Patient Preparation: High concentrations of gadolinium and iodine are known to potentially interfere with most inductively coupled plasma mass spectrometry-based metal tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.
Supplies: Metal Free Specimen Vial (T173)
Collection Container/Tube: Plain, royal blue-top Vacutainer plastic trace element blood collection tube
Submission Container/Tube: 7-mL Mayo metal-free, screw-capped, polypropylene vial
Specimen Volume: 1.6 mL Serum
Collection Instructions: See Metals Analysis Specimen Collection and Transport for complete instructions.
Collect 1.6 mL royal blue metal free serum. Serum must be separated from cells within 2 hours of draw and poured off into a metal free pour off tube.
Specimen Minimum Volume
Serum: 0.3 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 28 days | METAL FREE |
| Ambient | 28 days | METAL FREE | |
| Frozen | 28 days | METAL FREE |
Transport refrigerated in metal free pour off tube.
Reject Due To
| Gross hemolysis | OK |
| Gross lipemia | OK |
| Gross icterus | OK |
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Method Name
Triple-Quadrupole Inductively Coupled Plasma Mass Spectrometry (ICP-MS/MS)
Useful For
Detecting cobalt toxicity
Monitoring metallic prosthetic implant wear
This test is not useful for assessment of vitamin B12 activity.
Day(s) Performed
Monday through Friday
Report Available
1 to 4 daysReference Values
<1.0 ng/mL
<10.0 ng/mL (Metal-on-metal implant)
Reference values apply to all ages.
The reported unit of measurement for cobalt of ng/mL is equivalent to mcg/L.
CPT Code Information
83018