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Test Code 6MAMM 6-Monoacetylmorphine (6-MAM), Confirmation, Meconium

Reporting Name

6-MAM Confirmation, M

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Detection of in utero heroin exposure up to 5 months before birth

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)


Ordering Guidance


For chain-of-custody testing, order MAMMX / 6-Monoacetylmorphine (6-MAM) Confirmation, Chain of Custody, Meconium.



Specimen Required


Supplies: Stool container, Small (Random), 4 oz (T288)

Container/Tube: Stool container

Specimen Volume: 1 g (approximately 1 teaspoon)

Collection Instructions:

1. Collect entire random meconium (newborn's first bowel movements) specimen.

2. Send specimen frozen.

Additional Information: When refrigerated, a significant percentage of 6-monoacetylmorphine (MAM) will convert to morphine in less than 24 hours.


Specimen Type

Meconium

Specimen Minimum Volume

0.3 g (approximately 1/4 teaspoon)

Specimen Stability Information

Specimen Type Temperature Time
Meconium Frozen 14 days

Reject Due To

Grossly bloody Reject; Pink OK
Stool; diapers Reject

Reference Values

Negative

Positive results are reported with a quantitative liquid chromatography tandem mass spectrometry result.

Cutoff concentration: 5 ng/g

Interpretation

The presence of 6-monoacetylmorphine (6-MAM) in meconium is definitive for heroin use by the mother. However, the absence of 6-MAM does not rule-out heroin use because of its short half-life and stability.

Day(s) Performed

Monday through Sunday

Report Available

2 days

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

G0480

80356 (if appropriate for select payers)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
6MAMM 6-MAM Confirmation, M 29345-6

 

Result ID Test Result Name Result LOINC Value
31874 6-Monoacetylmorphine 29345-6
31875 Interpretation 69050-3

Forms

If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.