Metanephrines, Fractionated, LC/MS/MS, 24-Hour Urine

Test Code

14962

CPT Codes
83835

Includes

Metanephrine, Normetanephrine, Total Metanephrines

CPT code 81050 may be added at an additional charge for volume measurement

Preferred Specimen

5 mL of a 24-hour urine with 25 mL 6N HCl collected in a 24-hour urine container

Patient Preparation
It is preferable for the patient to be off medications for three days prior to collection. Patient should avoid tobacco, tea, coffee, for three days prior to specimen collection. Common antihypertensives (diuretics, ACE inhibitors, calcium channel blockers, alpha and beta blockers) cause minimal or no interference. Medications which are alpha agonists (Aldomet), alpha blockers (Dibenzyline) should be avoided 18-24 hours prior to specimen collection.

Minimum Volume

1.5 mL

Other Acceptable Specimens

Unpreserved 24-hour urine

Instructions

After urine collection, add 25 mL of 6N HCl to maintain a pH below 3. Urine without preservative is acceptable if pH is below 6 and the sample is shipped frozen. Record 24-hour urine volume on test request form and urine vial. Record patients age on test request form and urine vial.

Transport Temperature

Preserved urine: Room temperature
Unpreserved urine: Frozen

Specimen Stability

Preserved urine
Room temperature: 10 days
Refrigerated: 14 days
Frozen: 90 days

Unpreserved urine
Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 30 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Urine collected with boric acid

Methodology
Chromatography/Tandem Mass Spectrometry

FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule

Set up: Mon-Sat; Report available: 2-4 days

Reference Range

Metanephrines, 24-Hour Urine
Age	Reference Range	UOM
3 months-4 years	25-117	mcg/24 h
5-9 years	11-139	mcg/24 h
10-13 years	51-275	mcg/24 h
14-17 years	40-189	mcg/24 h
18-29 years	25-222	mcg/24 h
30-39 years	36-190	mcg/24 h
40-49 years	58-203	mcg/24 h
≥50 years	90-315	mcg/24 h

Normetanephrines, 24-Hour Urine
3 months-4 years	54-249	mcg/24 h
5-9 years	31-398	mcg/24 h
10-13 years	67-503	mcg/24 h
14-17 years	69-531	mcg/24 h
18-29 years	40-412	mcg/24 h
30-39 years	35-482	mcg/24 h
40-49 years	88-649	mcg/24 h
≥50 years	122-676	mcg/24 h

Metanephrines, Total 24-Hour Urine
3 months-4 years	79-345	mcg/24 h
5-9 years	49-408	mcg/24 h
10-13 years	110-714	mcg/24 h
14-17 years	107-741	mcg/24 h
18-29 years	94-604	mcg/24 h
30-39 years	115-695	mcg/24 h
40-49 years	182-739	mcg/24 h
≥50 years	224-832	mcg/24 h

Clinical Significance

Test is useful in the evaluation of pheochromocytoma.

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.