Catecholamines, Fractionated and VMA, 24-Hour Urine with Creatinine

Test Code

39626

CPT Codes
82384, 82570, 84585

Includes

Catecholamines, Fractionated, 24-Hour Urine with Creatinine
VMA (Vanillylmandelic Acid), 24-Hour Urine with Creatinine

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

Preferred Specimen

20 mL aliquot from a 24-hour urine that has been preserved with 25 mL 6N HCl, collected in a plastic 24-hour urine container

Patient Preparation
It is preferable for the patient to be off medications for three days prior to collection. However, common antihypertensives (diuretics, ACE inhibitors, calcium channel blockers, alpha and beta blockers) cause minimal or no interference. Patient should avoid alcohol, coffee, tea, tobacco (including use of nicotine patch), bananas, citrus fruits and strenuous exercise prior to collection.

Minimum Volume

10 mL

Other Acceptable Specimens

Aliquot from a 24-hour urine, unpreserved with a pH ≤6, collected in a plastic 24-hour urine container

Instructions

Collect 24-hour urine with 25 mL of 6N HCl to maintain a pH ≤3. If no preservative is used, specimen must be stored refrigerated during collection but shipped frozen and pH must be ≤6.
Record 24-hour urine volume and patient's age on test request form and on urine container.

Transport Temperature

Frozen

Specimen Stability

Preserved urine
Room temperature: 7 days
Refrigerated: 14 days
Frozen: 49 days

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

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

Preserved urine received refrigerated with pH > 3 • Unpreserved urine received frozen with pH > 6

Methodology

High Performance Liquid Chromatography (HPLC)

Setup Schedule

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

Limitations

Recent surgery, traumatic injury, upright posture, cold, anxiety, pain, clonidine withdrawal, and concurrent acute or chronic illness may produce elevated results.

Reference Range

See Laboratory Report

Clinical Significance

Catecholamines include the hormones epinephrine, norepinephrine, and dopamine. Catecholamines, along with VMA, are produced in chromaffin cell tumors, pheochromocytoma, ganglioneuroma, and neuroblastoma. Symptoms of pheochromocytomas include episodic hypertension, headaches, sweating, heart palpitations, and anxiety.

Performing Laboratory
Quest Diagnostics Nichols Institute
14225 Newbrook Drive
Chantilly, VA 20153

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.