Test Details



Ordering Code


CPT-4 Code(s)


Specimen Information

Patient Preparation

Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals and non-essential over-the-counter medications.


Dark blue trace element no additive

Specimen Preparation

Centrifuge and separate serum from cells within 2 hours of collection. Send 2.0 mL serum room temperature in a blue capped ARUP metal-free screw capped plastic vial. Please contact laboratory for metal-free screw capped plastic vials. Specimens in other containers will be rejected.

Alternate Specimen

Plasma: Dark blue trace element EDTA

Minimum Volume

0.5 mL

Transport Temperature

Room temperature

Rejection Criteria

SST, clotted specimens, serum from a red-top


Room temperature: Indefinitely
Refrigerated: Indefinitely
Frozen: Indefinitely


Quantitative Inductively Coupled Plasma - Mass Spectrometry

Reference Range

≤1.0 µg/L
Interpretive Data: Elevated results may be due to skin or collection-related contamination, including the use of a noncertified metal-free collection/transport tube. If contamination concerns exist due to elevated levels of serum/plasma cobalt, confirmation with a second specimen collected in a certified metal-free tube is recommended.
Serum cobalt levels can be used in the assessment of occupational exposure or toxic ingestion. Symptoms associated with cobalt toxicity vary based on route of exposure, and may include cardiomyopathy, allergic dermatitis, pulmonary fibrosis, cough and dyspnea. Whole blood is the preferred specimen type for evaluating metal ion release from metal-on metal joint arthroplasty. Serum cobalt levels may be increased in asymptomatic patients with metal-on-metal prostetics and should be considered in the context of the overall clinical scenario.

Performing Laboratory

ARUP Reference Laboratory

New York DOH Approval Status