Heavy Metal Creatinine Ratio, Urine, Random with Reflex, Urine
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
| Address: |
| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
| Ph: ( ) - Fax: ( ) - |
| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Heavy Metal Creatinine Ratio, Urine, Random with Reflex, Urine | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
HMCRU
Test Workstation :
MAYO
Specimen Type:
Urine
Tube Type:
Clean plastic urine collection container
Collection Volume:
6.0 mL(minimum 3.0 mL)
Cause for Rejection:
urine container with a metal cap or glued insert
Storage:
Refrigerated
Availability:
Sent to Reference Laboratory
Methodology:
Inductively Coupled Plasma-Mass Spectrometry(ICP-MS) and Enzymatic Colorimetric Assay
Special Instructions:
Patient should not eat seafood for a 48 hour periods prior to start of collection. High concentrations of gadolinium and iodine are known to interfere with most metals tests. If either gadolinium or iodine containing contrast media has been administered, a specimen should not be collected for 96 hours.
Lab/Phone:
330-543-8418
TAT:
2-4 days
Additional Info:
Reference range available on patient report
CPT Code:
82570,82175,82300,83825,83655, Reflex 82715
Panel Includes:
Creatinine Concentration
Arsenic/Creatinine Ratio, U
Cadmium/Creatinine Ratio, U
Mercury/Creatinine Ratio, U
Lead/Creatinine Ratio, U
Reflex Test: Arsenic Fractionation, Random, U which includes Inorganic Arsenic(Toxic), Organic Arsenic(Non-Toxic) and Total Arsenic.
