Nicotine and Expanded Metabolites, LC/MS/MS, Urine

Test Code

90982

CPT Codes
80323

Includes

Nicotine, Cotinine, 3-OH-Cotinine, Nornicotine, Norcotinine, Anabasine

Preferred Specimen

1 mL urine

Minimum Volume

0.5 mL

Transport Container

Plastic screw-cap vial or Plastic urine container

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Room temperature: 72 hours
Refrigerated: 14 days
Frozen: 30 days

Methodology
Chromatography/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 the U.S. Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule

Set up: Mon-Sat evening; Report available: 3 days

Reference Range

	Non-Smoker (ng/mL)	Active Tobacco User (ng/mL)
Nicotine	<17	200-700
Cotinine	<20	300-1300
3-OH-Cotinine	<50	3000-25000
Nornicotine	<2	30-900
Norcotinine	<2	Not established
Anabasine	<2	10-500

Clinical Significance

This assay is used for the detection of nicotine and several metabolites and the related alkaloid anabasine in urine to determine the tobacco exposure status of the individual. Nicotine has a short half-life of approximately sixty minutes; Its presence may indicate recent tobacco exposure. The half-life of the various nicotine metabolites is longer and provides a larger window of detection for tobacco exposure. The presence of anabasine is indicative of tobacco exposure (smoked or smokeless) versus the use of a nicotine replacement patch product. Anabasine is a related alkaloid found only in the tobacco plant. Individuals exposed to passive tobacco smoke (environmental or second-hand) can have detectable concentrations of nicotine and its metabolites depending on the type of exposure. The ranges of concentrations related to passive exposure are not well established but normally are less than those attributed to active tobacco users.

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.