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HelpTest Code MAMMX 6-Monoacetylmorphine (6-MAM) Confirmation, Chain of Custody, Meconium
Reporting Name
6-MAM Confirmation, CoC, MPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Detecting in utero heroin exposure up to 5 months before birth
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 it was always under the control of personnel involved with testing the specimen; this control implies that the opportunity for specimen tampering would be limited. Since the evidence of illicit drug use during pregnancy can be cause for separating the baby from the mother, a complete chain of custody ensures that the test results are appropriate for legal proceedings.
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Shipping Instructions
The laboratory recommends sending chain-of-custody specimens by overnight shipment.
Specimen Required
Supplies: Chain of Custody Meconium Kit (T653) includes the specimen containers, seals, and documentation required.
Specimen Volume: 1 g (approximately 1 teaspoon)
Collection Instructions:
1. Collect entire random meconium specimen.
2. Send specimen frozen. When refrigerated, a significant percentage of 6-monoacetylmorphine will convert to morphine in less than 24 hours.
Additional Information: Specimen that arrives with a broken seal does not meet the chain-of-custody requirements.
Specimen Type
MeconiumSpecimen Minimum Volume
0.3 g (approximately 1/4 teaspoon)
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Meconium | Frozen | 14 days |
Reject Due To
| Grossly bloody | Reject; Pink OK |
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.
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
80356
G0480 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| MAMMX | 6-MAM Confirmation, CoC, M | 29345-6 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 36202 | 6-Monoacetylmorphine | 29345-6 |
| 36203 | Interpretation | 69050-3 |
| 36204 | 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 |