Arsenic, Random Urine with Reflex to Fractionated

Label Mnemonic:	ARSUR
Epic code:	LAB8527
Downtime form:	Doctor/Provider Orders - Pathology Core and Specialty Care Nursery

Commercial Mailout Laboratory
6240-8 RCP
356-8593

Specimen(s):

Random Urine

Specimen Instructions:

Patient Prep: Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, nonessential over-the-counter medications (upon the advice of their physician), and avoid shellfish and seafood for 48 to 72 hours. High concentrations of iodine may interfere with elemental testing. Collection of urine specimens from patients receiving iodinated or gadolinium-based contrast media should be avoided for a minimum of 72 hours post-exposure. Collection from patients with impaired kidney function should be avoided for a minimum of 14 days post contrast media exposure.

Collection Medium:

Urine (Random)-BD Vacutainer^®, no additive yellow top

Minimum:

Preferred Minimum: 8 mL random urine
Absolute Minimum: 2 mL random urine

Rejection Criteria:

Acid preserved urine. Specimens collected within 72 hours after administration of iodinated or gadolinium-based contrast media.

Turn Around Time:

1-10 days upon receipt at reference laboratory

Reference Range:

Arsenic, Urine - per volume
   0.0-34.9 μg/L (based on Biological Exposure Index)

Arsenic, Urine-ratio to CRT
   0.0-29.9 μg/gCRT

Arsenic, Fractionated, Urine
   As Organic               Refer to report
   Arsenic Total Inorganic  Refer to report
   Arsenic, Methylated      Refer to report

Interpretive Data:

The ACGIH Biological Exposure Index (BEI) for arsenic in urine is 35 μg/L. The ACGIH BEI is based on the sum of inorganic and methylated species. For specimens with elevated total arsenic results, fractionation is automatically performed to determine the proportions of inorganic, methylated and organic species.

Note: If total arsenic concentration is found to be elevated based on reference intervals, then Arsenic, Fractionated, will be added to determine the proportion of organic, inorganic, and methylated forms. Additional charges apply.

Methodology:

Quantitative High Performance Liquid Chromatography/Quantitative Inductively Coupled Plasma-Mass Spectrometry

CPT Code:

82175; if reflexed, add 82175