Test Details
Mnemonic
COBS
Ordering Code
3689080
CPT-4 Code(s)
83018
Specimen Information
Patient Preparation
Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals and non-essential over-the-counter medications.
Collect
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
Stability
Room temperature: Indefinitely
Refrigerated: Indefinitely
Frozen: Indefinitely
Refrigerated: Indefinitely
Frozen: Indefinitely
Methodology
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.
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
Yes