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HelpTest Code COKEM Cocaine and Metabolites Confirmation, Meconium
Reporting Name
Cocaine and Metabolites, Confirm, MPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Detecting in utero drug 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 COKMX / Cocaine and Metabolite 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: Collect entire random meconium specimen.
Specimen Type
MeconiumSpecimen Minimum Volume
0.3 g (approximately 1/4 teaspoon)
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Meconium | Frozen (preferred) | 21 days | |
| Refrigerated | 21 days | ||
| Ambient | 72 hours |
Reject Due To
| Grossly bloody | Reject; Pink OK |
| Stool Diapers |
Reject |
Reference Values
Negative
Positives are reported with a quantitative liquid chromatography-tandem mass spectrometry (LC-MS/MS) result.
Cutoff concentrations for LC-MS/MS testing:
Cocaine: 20 ng/g
Benzoylecgonine: 20 ng/g
Cocaethylene: 20 ng/g
m-Hydroxybenzoylecgonine: 20 ng/g
Interpretation
The presence of any of the following: cocaine, benzoylecgonine, cocaethylene, or m-hydroxybenzoylecgonine, at 20 ng/g or more, is indicative of in utero drug exposure up to 5 months before birth.
Day(s) Performed
Monday through Sunday
Report Available
2 to 3 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
80353
G0480 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| COKEM | Cocaine and Metabolites, Confirm, M | 69008-1 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 31859 | Cocaine | 69009-9 |
| 31860 | Benzoylecgonine | 69010-7 |
| 31861 | Cocaethylene | 69011-5 |
| 31862 | m-Hydroxybenzoylecgonine | 69012-3 |
| 31864 | Interpretation | 69050-3 |
| 31865 | Chain of Custody | 77202-0 |
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.