Heavy Metal Screen
Label Mnemonic: HMSB
Epic code: LAB3272
Downtime form: A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery
Commercial Mail-out Laboratory
5231 RCP
Specimen Instructions:
Patient Prep: Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, non-essential over-the-counter medications (upon the advice of their physician), and avoid shellfish and seafood for 48 to 72 hours.
Collection Medium:
Royal Blue K2 EDTA tube
Preferred Minimum: 7 mL whole blood collected in full Royal Blue top tube
Absolute Minimum: 0.5 mL whole blood

Royal Blue Trace Metal tubes are available from Specimen Control, 6240 RCP.
Rejection Criteria:
Specimens collected in tubes other than Royal Blue (EDTA). Specimens transported in containers other than Royal Blue (EDTA) tube or Trace Element-Free Transport Tube. Heparin anticoagulant. Clotted specimens.
Turn Around Time:
1-4 days upon receipt at reference laboratory
Reference Range:
Components             Reference Interval
Arsenic, Blood         0.0-12.0 μg/L
Mercury, Whole Blood   0.0-10.0 μg/L
Lead, Blood (Venous)   0.0-4.9 μg/dL

Note: Mercury is volatile; concentration may decrease 
over time. If the specimen is drawn and stored in the appropriate 
container, the arsenic and lead values do not change with time
Includes Arsenic, Lead and Mercury.
Quantitative Inductively Coupled Plasma-Mass Spectrometry
CPT Code:
82175 Arsenic, 83655 Lead, 83825 Mercury