Arsenic, Random Urine with Reflex to Fractionated
Label Mnemonic: ARSUR
Epic Lab Code: LAB8527
Downtime Form: A-1a Miscellaneous Request
Commercial Mail-out Laboratory
5231 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. Abstinence from iodine- containing medications or contrast agents for at least 1 month prior to collecting specimens for elemental testing is recommended.
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:
Urine collected within 48 hours after administration of a gadolinium (Gd) containing contrast media (may occur with MRI studies). Acid preserved urine.
Turn Around Time:
1-5 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 a total arsenic concentration of 35 to 2000 μg/L, fractionation is automatically performed to determine the proportions of inorganic, methylated and organic species. It may be appropriate to request fractionation for specimens with total arsenic greater than 30 μg/gCRT despite a total arsenic concentration less than 35 μg/L. If low-level chronic poisoning is suspected, the μg/gCRT ratio may be a more sensitive indicator of arsenic exposure than the total arsenic concentration.

Note: If total arsenic concentration is between 35-2000 μg/L, 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