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HelpTest Code 6MAMX 6-Monoacetylmorphine, Chain of Custody, Random, Urine
Reporting Name
6-MAM Confirmation, CoC, UPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Determination of heroin use in urine specimens handled through the chain-of-custody process
Chain of custody is required whenever the results of testing could be used in a court of law. Its purpose is to protect the rights of the individual contributing the specimen by demonstrating that, at all times, it was under the control of personnel involved with testing the specimen; this control implies that the opportunity for specimen tampering would be limited.
Method Name
Gas Chromatography Mass Spectrometry (GC-MS)
Ordering Guidance
This test is for situations that require the chain-of-custody process. For testing not requiring chain of custody, order 6MAMU / 6-Monoacetylmorphine Confirmation, Random, Urine.
Specimen Required
Supplies: Chain of Custody Kit (T282)
Container/Tube: Chain-of-Custody Kit containing the specimen containers, seals, and documentation required.
Specimen Volume: 10 mL
Collection Instructions: Collect specimen in the container provided, seal, and submit with the associated documentation to satisfy the legal requirements for chain-of-custody testing.
Specimen Type
UrineSpecimen Minimum Volume
2.1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 14 days | |
| Frozen | 14 days | ||
| Ambient | 72 hours |
Reject Due To
| Gross hemolysis | OK |
| Gross icterus | OK |
Reference Values
Negative
6-MAM cutoff concentration: <5 ng/mL
Interpretation
The presence of 6-monoacetylmorphine (6-MAM) in urine is definitive for recent heroin use. However, the absence of 6-MAM does not rule out heroin use because of its short half-life. 6-MAM is typically only detectable within 24 hours of heroin use. 6-MAM is further metabolized into morphine, which may be detected 1 to 2 days after 6-MAM is no longer measurable. Morphine will typically be found in a specimen containing 6-MAM.(2,3)
Day(s) Performed
Tuesday, Wednesday
Report Available
3 to 7 daysTest 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
80356
G0480 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| 6MAMX | 6-MAM Confirmation, CoC, U | 19593-3 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 36118 | 6-Monoacetylmorphine by GC/MS | 19593-3 |
| 36119 | 6-MAM Interpretation | 69050-3 |
| 36120 | Chain of Custody | 77202-0 |
Forms
1. Chain of Custody Request is included in the Chain-of-Custody Kit (T282).
2. If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.
Additional Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| COCH | Chain of Custody Processing | No | Yes |
| ADLTX | Adulterants Survey, CoC, U | Yes | Yes |
Testing Algorithm
Testing for adulterants will be performed on all chain of custody urine samples per regulatory requirements.