Nicotine and Expanded Metabolites, LC/MS/MS [90983]

Message

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Test Code

NICOT

Alias/See Also

90983

CPT Codes
80323

Includes

Nicotine, Cotinine, 3-OH-Cotinine

Preferred Specimen

1 mL serum collected in a red-top tube (no-gel)

Minimum Volume

0.5 mL

Other Acceptable Specimens

Plasma or whole blood collected in: EDTA (royal blue-top) tube or EDTA (lavender-top) tube

Instructions

Spin and transfer serum or plasma into a plastic, screw-capped vial.

Transport Container

Plastic screw-cap vial

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Serum and plasma
Room temperature: 72 hours
Refrigerated: 21 days
Frozen: 30 days
Whole blood
Room temperature: 72 hours
Refrigerated: 21 days
Frozen: Unacceptable

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

Gross hemolysis • Serum separator tube (SST) • Frozen whole blood

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	<4	2-10
Cotinine	<8	16-145
3-OH-Cotinine	<2	100-500

Clinical Significance

This assay is used for the detection of nicotine and two primary metabolites, 3-OH cotinine and cotinine in serum and plasma to determine the tobacco exposure status of an individual. Nicotine has a short half-life of approximately sixty minutes; Its presence may indicate recent tobacco exposure. The half-life of the primary metabolites is longer and provides a larger window of detection for tobacco exposure. 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.

Performing Laboratory

Quest Diagnostics Nichols Institute

14225 Newbrook Drive

Chantilly, VA 20153

Last Updated: November 30, 2021

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.