VMA (Vanillylmandelic Acid), 24-Hour Urine : 1016580

Test Code
UVMA24 or 1016580

Alias/See Also
3-methoxy-4-hydroxy-mandelic acid, VMA, Urine

CPT Codes
84585

Instructions
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.

24-hour urine. Refrigerate 24-hour specimens during collection.

Transport Container
Transfer 10 mL aliquot from a well-mixed 24-hour collection to a transport container. (Min: 5 mL) Record total volume on the transport container. Specimen may be sent without preservatives if sending within 24 hours of the completion of collection. If longer than 24 hours, adjust the pH of the Urine with 6 N HCl to pH <3 OR send unpreserved urine frozen.

Transport Temperature
Refrigerated or Frozen.

Specimen Stability
After preservation: Ambient: 10 days; Refrigerated: 14 days; Frozen: 1 year

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
pH greater than 3.0 and unfrozen.

Methodology
High Performance Liquid Chromatography (HPLC)

Setup Schedule
Sunday - Friday

Report Available
2-6 days (From receipt at performing laboratory)

Limitations
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.

Reference Range
3-8 Years less than or equal to 2.3 mg/24 h
9-12 Years less than or equal to 3.4 mg/24 h
13-17 Years less than or equal to 3.9 mg/24 h
greater than 17 Years less than or equal to 6.0 mg/24 h

Clinical Significance
Vanillylmandelic acid (VMA) is the major urinary product resulting from the metabolic degradation of catecholamine, norepinephrine and epinephrine. Elevated concentrations of VMA are commonly found in cases of catecholamine secreting tumors such as pheochromocytoma, neuroblastoma, and ganglioneuroma.
Drugs which can interfere with testing due to physiologic response: clonidine, L-dopa, methocarbamol, monoamine oxidase inhibitors, reserpine, salicylates.

Performing Laboratory
Quest Diagnostics



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.