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HelpTest Code CMMPP Cobalamin, Methionine, and Methylmalonic Acid Pathways, Plasma
Reporting Name
CMMP, PPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Screening and monitoring patients suspected of or confirmed with an inherited disorder of methionine, cobalamin, or propionate metabolism using plasma specimens
Evaluating individuals with suspected deficiency of vitamin B12
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Necessary Information
Patient's age and sex are required.
Specimen Required
Collection Container/Tube:
Preferred: Lavender top (EDTA)
Acceptable: Green top (sodium or lithium heparin)
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Immediately place specimen on ice.
2. Centrifuge and aliquot plasma into plastic vial within 4 hours of collection.
3. If blood cannot be placed on wet ice immediately, centrifuge and aliquot plasma into plastic vial within 1 hour of collection.
4. A refrigerated centrifuge is not required if the above time restrictions are met.
Specimen Type
PlasmaSpecimen Minimum Volume
0.3 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Plasma | Refrigerated (preferred) | 28 days | |
| Frozen | 309 days | ||
| Ambient | 28 days |
Reject Due To
| Gross hemolysis | OK |
| Gross lipemia | OK |
| Gross icterus | OK |
Reference Values
|
Age |
Total homocysteine |
Methylmalonic acid (nmol/mL) |
2-Methylcitric |
Total cysteine |
Methionine (nmol/mL) |
Cystathionine |
|
|||
|
Female |
Male |
Female |
Male |
|||||||
|
0-11 months |
3.1-8.3 |
3.2-9.7 |
0.08-0.32 |
0.02-0.35 |
142.8-258.8 |
14.7-43.1 |
14.5-42.3 |
0.07-0.38 |
||
|
12-23 months |
3.2-8.3 |
3.3-9.6 |
0.08-0.31 |
0.02-0.35 |
143.7-258.7 |
14.7-43.1 |
14.5-42.2 |
0.07-0.38 |
||
|
24-35 months |
3.2-8.2 |
3.3-9.6 |
0.08-0.31 |
0.02-0.35 |
144.8-258.6 |
14.7-43.0 |
14.5-42.1 |
0.07-0.38 |
||
|
3 years |
3.2-8.2 |
3.3-9.6 |
0.08-0.31 |
0.02-0.35 |
146.0-258.5 |
14.7-43.0 |
14.5-42.0 |
0.07-0.38 |
||
|
4 years |
3.3-8.2 |
3.4-9.5 |
0.08-0.30 |
0.02-0.35 |
148.2-258.4 |
14.7-42.8 |
14.5-41.8 |
0.07-0.38 |
||
|
5 years |
3.4-8.1 |
3.5-9.4 |
0.08-0.30 |
0.02-0.35 |
150.6-258.3 |
14.8-42.7 |
14.5-41.6 |
0.07-0.38 |
||
|
6 years |
3.5-8.1 |
3.6-9.4 |
0.08-0.29 |
0.02-0.35 |
153.2-258.3 |
14.8-42.5 |
14.5-41.4 |
0.07-0.38 |
||
|
7 years |
3.5-8.1 |
3.7-9.4 |
0.08-0.29 |
0.02-0.35 |
155.8-258.4 |
14.8-42.2 |
14.5-41.1 |
0.07-0.38 |
||
|
8 years |
3.6-8.2 |
3.8-9.3 |
0.08-0.28 |
0.02-0.35 |
158.5-258.7 |
14.9-42.0 |
14.6-40.9 |
0.07-0.37 |
||
|
9 years |
3.7-8.2 |
3.9-9.4 |
0.09-0.28 |
0.02-0.35 |
161.0-259.1 |
14.9-41.7 |
14.6-40.7 |
0.07-0.37 |
||
|
10 years |
3.8-8.3 |
4.1-9.4 |
0.09-0.28 |
0.02-0.35 |
163.5-259.7 |
15.0-41.4 |
14.7-40.6 |
0.07-0.37 |
||
|
11 years |
3.9-8.4 |
4.3-9.4 |
0.09-0.28 |
0.02-0.35 |
165.9-260.5 |
15.1-41.0 |
14.8-40.4 |
0.07-0.37 |
||
|
12 years |
3.9-8.6 |
4.4-9.5 |
0.09-0.27 |
0.02-0.35 |
168.4-261.4 |
15.1-40.7 |
14.9-40.3 |
0.07-0.37 |
||
|
13 years |
4.0-8.7 |
4.6-9.6 |
0.09-0.27 |
0.02-0.35 |
170.9-262.4 |
15.2-40.3 |
15.1-40.1 |
0.07-0.36 |
||
|
14 years |
4.1-8.8 |
4.8-9.7 |
0.09-0.27 |
0.02-0.35 |
173.6-263.6 |
15.3-39.9 |
15.3-40.0 |
0.07-0.36 |
||
|
15 years |
4.2-8.9 |
5.0-9.8 |
0.09-0.27 |
0.02-0.35 |
176.4-264.7 |
15.4-39.5 |
15.5-39.9 |
0.07-0.36 |
||
|
16 years |
4.2-9.1 |
5.2-9.9 |
0.09-0.27 |
0.02-0.35 |
179.3-265.9 |
15.5-39.1 |
15.8-39.7 |
0.07-0.35 |
||
|
17 years |
4.3-9.2 |
5.4-10.0 |
0.09-0.27 |
0.02-0.35 |
182.2-267.1 |
15.6-38.7 |
16.1-39.6 |
0.07-0.35 |
||
|
18 years |
4.3-9.3 |
5.6-10.1 |
0.08-0.27 |
0.02-0.35 |
184.9-268.3 |
15.7-38.2 |
16.4-39.4 |
0.07-0.35 |
||
|
19 years |
4.4-9.5 |
5.7-10.3 |
0.08-0.26 |
0.02-0.35 |
187.4-269.4 |
15.7-37.8 |
16.7-39.3 |
0.07-0.34 |
||
|
20 years |
4.4-9.6 |
5.9-10.5 |
0.08-0.26 |
0.02-0.35 |
189.5-270.5 |
15.8-37.3 |
17.0-39.1 |
0.07-0.34 |
||
|
21 years |
4.4-9.8 |
6.0-10.6 |
0.08-0.26 |
0.02-0.35 |
191.2-271.7 |
15.9-36.8 |
17.3-38.9 |
0.07-0.33 |
||
|
22 years |
4.4-9.9 |
6.1-10.8 |
0.08-0.27 |
0.02-0.35 |
192.5-272.8 |
15.9-36.3 |
17.6-38.7 |
0.07-0.33 |
||
|
23 years |
4.4-10.1 |
6.2-11.0 |
0.08-0.27 |
0.02-0.35 |
193.5-274.1 |
15.9-35.8 |
17.9-38.5 |
0.07-0.33 |
||
|
24 years |
4.4-10.3 |
6.2-11.1 |
0.08-0.27 |
0.02-0.35 |
194.2-275.4 |
15.9-35.3 |
18.1-38.3 |
0.07-0.32 |
||
|
25 years |
4.4-10.4 |
6.3-11.3 |
0.08-0.28 |
0.02-0.35 |
194.8-277.0 |
15.9-34.8 |
18.2-38.1 |
0.07-0.32 |
||
|
26 years |
4.4-10.6 |
6.3-11.4 |
0.08-0.28 |
0.02-0.35 |
195.3-278.6 |
15.9-34.3 |
18.4-37.9 |
0.07-0.32 |
||
|
27 years |
4.3-10.8 |
6.4-11.6 |
0.08-0.28 |
0.02-0.35 |
196.0-280.5 |
16.0-33.8 |
18.5-37.7 |
0.07-0.31 |
||
|
28 years |
4.3-11.0 |
6.4-11.7 |
0.08-0.29 |
0.02-0.35 |
196.7-282.4 |
16.0-33.4 |
18.7-37.5 |
0.07-0.31 |
||
|
29 years |
4.3-11.2 |
6.4-11.8 |
0.08-0.29 |
0.02-0.35 |
197.7-284.3 |
16.0-33.0 |
18.8-37.3 |
0.07-0.31 |
||
|
30 years |
4.3-11.4 |
6.4-11.9 |
0.08-0.30 |
0.02-0.35 |
198.8-286.3 |
16.1- 32.6 |
18.9-37.1 |
0.07-0.30 |
||
|
31 years |
4.4-11.6 |
6.4-12.1 |
0.08-0.30 |
0.02-0.35 |
200.2-288.2 |
16.1-32.2 |
19.0-36.9 |
0.07-0.30 |
||
|
32 years |
4.4-11.8 |
6.4-12.2 |
0.08-0.31 |
0.02-0.35 |
201.7-290.0 |
16.1-31.8 |
19.1-36.7 |
0.07-0.30 |
||
|
33 years |
4.4-11.9 |
6.4-12.3 |
0.08-0.31 |
0.02-0.35 |
203.4-291.5 |
16.1-31.5 |
19.2-36.5 |
0.07-0.29 |
||
|
34 years |
4.5-12.1 |
6.4-12.4 |
0.08-0.31 |
0.02-0.35 |
205.2-292.9 |
16.1-31.2 |
19.3-36.3 |
0.07-0.29 |
||
|
35 years |
4.5-12.2 |
6.4-12.6 |
0.08-0.32 |
0.02-0.35 |
207.2-294.1 |
16.1-30.8 |
19.4-36.1 |
0.07-0.28 |
||
|
36 years |
4.6-12.4 |
6.4-12.8 |
0.08-0.32 |
0.02-0.35 |
209.3-295.1 |
16.1-30.5 |
19.5-35.9 |
0.07-0.28 |
||
|
37 years |
4.6-12.5 |
6.4-12.9 |
0.08-0.33 |
0.02-0.35 |
211.5-296.0 |
16.1-30.2 |
19.6-35.6 |
0.07-0.27 |
||
|
38 years |
4.7-12.7 |
6.4-13.1 |
0.08-0.33 |
0.02-0.35 |
213.8-296.9 |
16.1-29.9 |
19.7-35.4 |
0.07-0.27 |
||
|
39 years |
4.7-12.8 |
6.4-13.2 |
0.08-0.34 |
0.02-0.35 |
216.3-297.7 |
16.1-29.7 |
19.8-35.2 |
0.07-0.27 |
||
|
40 years |
4.8-13.0 |
6.5-13.4 |
0.08-0.34 |
0.02-0.35 |
218.9-298.7 |
16.1-29.4 |
19.9-35.0 |
0.07-0.27 |
||
|
41 years |
4.8-13.2 |
6.5-13.5 |
0.08-0.35 |
0.02-0.35 |
221.6-299.7 |
16.1-29.2 |
20.0-34.8 |
0.07-0.27 |
||
|
42 years |
4.8-13.4 |
6.5-13.7 |
0.08-0.36 |
0.02-0.35 |
224.3-300.8 |
16.2-29.0 |
20.1-34.6 |
0.07-0.26 |
||
|
43 years |
4.9-13.5 |
6.6-13.9 |
0.08-0.36 |
0.02-0.35 |
227.0-302.0 |
16.2-28.8 |
20.2-34.4 |
0.07-0.26 |
||
|
44 years |
4.9-13.7 |
6.6-14.0 |
0.08-0.37 |
0.02-0.35 |
229.8-303.5 |
16.3-28.6 |
20.3-34.2 |
0.07-0.26 |
||
|
45 years |
4.9-13.9 |
6.6-14.2 |
0.08-0.38 |
0.02-0.35 |
232.6-305.2 |
16.3-28.5 |
20.3-34.0 |
0.07-0.26 |
||
|
46 years |
4.9-14.0 |
6.7-14.4 |
0.08-0.38 |
0.02-0.35 |
235.3-307.3 |
16.4-28.4 |
20.4-33.8 |
0.07-0.26 |
||
|
47 years |
4.9-14.2 |
6.7-14.5 |
0.08-0.39 |
0.02-0.35 |
238.0-309.7 |
16.4-28.2 |
20.4-33.6 |
0.07-0.26 |
||
|
48 years |
5.0-14.3 |
6.8-14.7 |
0.08-0.39 |
0.02-0.35 |
240.8-312.6 |
16.5-28.1 |
20.5-33.3 |
0.07-0.26 |
||
|
49 years |
5.0-14.4 |
6.8-14.9 |
0.08-0.40 |
0.02-0.35 |
243.5-315.9 |
16.5-28.0 |
20.5-33.1 |
0.07-0.26 |
||
|
50 years |
5.0-14.5 |
6.8-15.0 |
0.08-0.40 |
0.02-0.35 |
246.2-319.7 |
16.5-27.9 |
20.6-32.8 |
0.07-0.26 |
||
|
51 years |
5.1-14.6 |
6.8-15.2 |
0.08-0.41 |
0.02-0.35 |
248.9-323.8 |
16.5-27.8 |
20.6-32.5 |
0.07-0.26 |
||
|
52 years |
5.1-14.7 |
6.9-15.4 |
0.08-0.41 |
0.02-0.35 |
251.5-328.1 |
16.5-27.6 |
20.7-32.3 |
0.07-0.26 |
||
|
53 years |
5.1-14.8 |
6.9-15.5 |
0.08-0.42 |
0.02-0.35 |
254.0-332.4 |
16.5-27.5 |
20.8-32.1 |
0.07-0.26 |
||
|
54 years |
5.2-14.9 |
6.9-15.6 |
0.08-0.42 |
0.02-0.35 |
256.4-336.5 |
16.5-27.4 |
21.0-31.9 |
0.07-0.25 |
||
|
55 years |
5.2-15.0 |
6.9-15.7 |
0.08-0.43 |
0.02-0.35 |
258.6-340.2 |
16.5-27.3 |
21.1-31.7 |
0.07-0.25 |
||
|
56 years |
5.3-15.0 |
6.9-15.8 |
0.08-0.43 |
0.02-0.35 |
260.6-343.6 |
16.6-27.2 |
21.2-31.5 |
0.07-0.25 |
||
|
57 years |
5.3-15.1 |
6.9-15.9 |
0.08-0.44 |
0.02-0.35 |
262.5-346.5 |
16.6-27.1 |
21.2-31.3 |
0.07-0.25 |
||
|
58 years |
5.3-15.2 |
6.9-16.0 |
0.08-0.44 |
0.02-0.35 |
264.3-349.0 |
16.6-27.1 |
21.3-31.0 |
0.07-0.25 |
||
|
59 years |
5.4-15.2 |
6.9-16.0 |
0.08-0.44 |
0.02-0.35 |
266.2-351.1 |
16.7-27.1 |
21.3-30.8 |
0.07-0.25 |
||
|
60 years |
5.4-15.3 |
6.9-16.1 |
0.08-0.45 |
0.02-0.35 |
268.3-353.1 |
16.8-27.1 |
21.3-30.6 |
0.07-0.25 |
||
|
61 years |
5.4-15.4 |
7.0-16.2 |
0.09-0.45 |
0.02-0.35 |
270.8-355.1 |
16.9-27.2 |
21.3-30.3 |
0.07-0.25 |
||
|
62 years |
5.5-15.4 |
7.0-16.2 |
0.09-0.46 |
0.02-0.35 |
273.8-357.3 |
17.0-27.2 |
21.2-30.0 |
0.08-0.25 |
||
|
63 years |
5.5-15.5 |
7.0-16.3 |
0.09-0.46 |
0.02-0.35 |
277.5-359.7 |
17.1-27.3 |
21.2-29.8 |
0.08-0.25 |
||
|
64 years |
5.6-15.5 |
7.1-16.3 |
0.09-0.46 |
0.02-0.35 |
281.9-362.3 |
17.2-27.4 |
21.1-29.5 |
0.08-0.25 |
||
|
65 years |
5.6-15.6 |
7.1-16.3 |
0.09-0.47 |
0.02-0.35 |
286.9-365.2 |
17.3-27.6 |
21.1-29.2 |
0.08-0.25 |
||
|
66 years |
5.7-15.6 |
7.1-16.3 |
0.09-0.47 |
0.02-0.35 |
292.4-368.3 |
17.4-27.7 |
21.1-29.0 |
0.08-0.25 |
||
|
67 years |
5.7-15.7 |
7.2-16.3 |
0.09-0.47 |
0.02-0.35 |
298.1-371.6 |
17.5-27.8 |
21.0-28.7 |
0.09-0.25 |
||
|
68 years |
5.8-15.7 |
7.2-16.3 |
0.09-0.47 |
0.02-0.35 |
303.6-374.8 |
17.7-27.9 |
21.0-28.5 |
0.09-0.25 |
||
|
69 years |
5.9-15.7 |
7.2-16.3 |
0.09-0.47 |
0.02-0.35 |
308.7-377.8 |
17.8-28.0 |
21.0-28.4 |
0.09-0.25 |
||
|
70 years |
6.0-15.8 |
7.3-16.3 |
0.09-0.48 |
0.02-0.35 |
313.1-380.7 |
18.0-28.1 |
21.0-28.3 |
0.09-0.25 |
||
|
71 years |
6.1-15.8 |
7.3-16.3 |
0.09-0.48 |
0.02-0.35 |
316.5-383.2 |
18.1-28.2 |
20.9-28.2 |
0.09-0.25 |
||
|
72 years |
6.2-15.8 |
7.3-16.3 |
0.09-0.48 |
0.02-0.35 |
318.9-385.3 |
18.3-28.3 |
20.9-28.0 |
0.09-0.25 |
||
|
73 years |
6.3-15.9 |
7.3-16.3 |
0.09-0.48 |
0.02-0.35 |
320.1-387.0 |
18.5-28.4 |
20.8-27.9 |
0.10-0.26 |
||
|
74 years |
6.4-15.9 |
7.3-16.3 |
0.09-0.48 |
0.02-0.35 |
320.6-388.3 |
18.8-28.5 |
20.8-27.8 |
0.10-0.26 |
||
|
75 years |
6.5-15.9 |
7.3-16.3 |
0.09-0.48 |
0.02-0.35 |
320.3-389.3 |
19.1-28.5 |
20.8-27.7 |
0.10-0.26 |
||
|
76 years |
6.6-15.9 |
7.3-16.3 |
0.09-0.48 |
0.02-0.35 |
319.6-389.9 |
19.3-28.6 |
20.8-27.5 |
0.10-0.26 |
||
|
77 years |
6.7-16.0 |
7.4-16.3 |
0.10-0.48 |
0.02-0.35 |
319.1-390.2 |
19.6-28.6 |
20.9-27.4 |
0.10-0.26 |
||
|
78 years |
6.8-16.0 |
7.4-16.3 |
0.10-0.48 |
0.02-0.35 |
318.5-390.5 |
20.0-28.7 |
20.9-27.2 |
0.11-0.26 |
||
|
79 years |
6.9-16.0 |
7.5-16.3 |
0.10-0.48 |
0.02-0.35 |
317.9-390.6 |
20.3-28.7 |
21.0-27.1 |
0.11-0.26 |
||
|
80 years |
7.0-16.0 |
7.5-16.3 |
0.10-0.48 |
0.02-0.35 |
317.9-390.6 |
20.3-28.7 |
21.0-27.1 |
0.11-0.26 |
||
|
81 years |
7.1-16.0 |
7.7-16.2 |
0.10-0.48 |
0.02-0.35 |
317.9-390.6 |
20.3-28.7 |
21.0-27.1 |
0.11-0.26 |
||
|
82 years |
7.2-16.0 |
7.8-16.2 |
0.10-0.48 |
0.02-0.35 |
317.9-390.6 |
20.3-28.7 |
21.0-27.1 |
0.11-0.26 |
||
|
83 years |
7.2-16.0 |
7.9-16.2 |
0.10-0.48 |
0.02-0.35 |
317.9-390.6 |
20.3-28.7 |
21.0-27.1 |
0.11-0.26 |
||
|
84 years |
7.3-16.0 |
8.0-16.2 |
0.10-0.48 |
0.02-0.35 |
317.9-390.6 |
20.3-28.7 |
21.0-27.1 |
0.11-0.26 |
||
|
85 years |
7.3-16.0 |
8.2-16.2 |
0.10-0.48 |
0.02-0.35 |
317.9-390.6 |
20.3-28.7 |
21.0-27.1 |
0.11-0.26 |
||
|
>85 years |
7.4-16.0 |
8.3-16.2 |
0.10-0.48 |
0.02-0.35 |
317.9-390.6 |
20.3-28.7 |
21.0-27.1 |
0.11-0.26 |
||
Interpretation
An interpretive report will be provided.
When abnormal results are detected, a detailed interpretation is given, including an overview of the results and of their significance, a correlation to available clinical information, elements of differential diagnosis, recommendations for additional biochemical testing, and in vitro confirmatory studies (complementation studies, molecular analysis), and a phone number to reach one of the laboratory directors in case the referring physician has additional questions.
Abnormal results are not sufficient to conclusively establish a diagnosis of a particular disease. To verify a preliminary diagnosis based on the analysis, independent biochemical (eg, complementation studies) or molecular genetic analyses are required.
Day(s) Performed
Monday through FridayReport Available
3 to 5 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
83090
83918
82136
82542 (if appropriate for government payers)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CMMPP | CMMP, P | 104535-0 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 606110 | Interpretation | 59462-2 |
| 606104 | Total Homocysteine | 13965-9 |
| 606105 | Methylmalonic acid | 13964-2 |
| 606119 | 2-Methylcitric acid | 26904-3 |
| 606106 | Methionine | 20651-6 |
| 606107 | Total Cysteine | 20641-7 |
| 606108 | Cystathionine | 26607-2 |
| 606109 | Reviewed By | 18771-6 |
Forms
1. Biochemical Genetics Patient Information (T602)
2. If not ordering electronically, complete, print, and send a Biochemical Genetics Test Request (T798) with the specimen.