Catecholamines, Fractionated, 24-Hour Urine (without Creatinine) [318X]

Test Code
4646


CPT Codes
82384

Includes
Epinephrine, Norepinephrine, Total Catecholamines (Nor + Epi), Dopamine

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


Preferred Specimen
1 mL preserved 24-hour urine 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 a minimum of 18-24 hours prior to collection. However, common antihypertensives (diuretics, ACE inhibitors, calcium channel blockers, alpha and beta blockers) may cause minimal or no interference.
Patient should avoid tobacco, tea, coffee, and strenuous exercise for 8-12 hours prior to collection.

Minimum Volume
0.7 mL


Other Acceptable Specimens
Unpreserved 24-hour urine with pH ≤ 6


Instructions
Collect 24-hour urine with 25 mL 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: Unacceptable
Refrigerated: 30 days
Frozen: 60 days

Unpreserved urine
Room temperature: Unacceptable
Refrigerated: 7 days
Frozen: 60 days



Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Preserved urine received refrigerated with pH >3 • Unpreserved urine received frozen with pH >6


Methodology
Liquid Chromatography/Mass Spectrometry (LC/MS)

Setup Schedule
Set up: Mon-Sat; Report available: 3-5 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
Epinephrine, 24 hr Urine
PediatricNot Established
Adults≤24 mcg/24 h

Norepinephrine, 24 hr Urine
PediatricNot established
Adults≤100 mcg/24 h

Total Catecholamines (U) (NOR+EPI)
PediatricNot Established
Adults26-121 mcg/24 h

Dopamine, 24 hr Urine
PediatricNot Established
Adults52-480 mcg/24 h


Clinical Significance
The three catecholamines (norepinephrine, epinephrine and dopamine) are the principal secretory products of neural tissue. Clinically, the measurement of circulating catecholamines is valuable in the diagnosis of catecholamine secreting tumors associated chiefly with hypertension (pheochromocytomas, neuroblastomas and gangliomas) and with the evaluation of orthostatic hypotension.


Performing Laboratory
Quest Diagnostics Nichols Institute-San Juan Capistrano, CA
33608 Ortega Highway
San Juan Capistrano, CA 92675-2042




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.