Test Catalog

Test Id : COKEU

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Cocaine and Metabolite Confirmation, Random, Urine

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Detecting and confirming drug abuse involving cocaine

 

This test is not intended for employment-related testing.

Method Name
A short description of the method used to perform the test

Gas Chromatography Mass Spectrometry (GC-MS) Confirmation with Quantitation

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Cocaine and metabolite Conf, U

Aliases
Lists additional common names for a test, as an aid in searching

Benzoylecgonine (Cocaine Metabolite)

Cocaine

Cocaine Confirmation, QN, Urine

Coke (Cocaine)

Crack (Cocaine)

Specimen Type
Describes the specimen type validated for testing

Urine

Ordering Guidance

1. For situations where chain of custody is required, a Chain-of-Custody Kit (T282) is available. For chain-of-custody testing, order COKEX / Cocaine and Metabolite Confirmation, Chain of Custody, Random, Urine.

2. Additional drug panels and specific requests are available. Call 800-533-1710 or 507-266-5700.

3. If urine creatinine is required or adulteration of the sample is suspected, order ADULT / Adulterants Survey, Random, Urine.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Supplies: Urine Tubes, 10 mL (T068)

Collection Container/Tube: Plastic urine container

Submission Container/Tube: 10-mL urine tube

Specimen Volume: 10 mL

Collection Instructions:

1. Collect a random urine specimen.

2. No preservative.

Additional Information:

1. No specimen substitutions.

2. STAT requests are not accepted for this test.

Forms

If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

5 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 14 days
Frozen 14 days
Ambient 72 hours

Useful For
Suggests clinical disorders or settings where the test may be helpful

Detecting and confirming drug abuse involving cocaine

 

This test is not intended for employment-related testing.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Cocaine is a drug of current health concern because of its proliferation among recreational drug abusers.

 

Freebase and crack increase the potential for major cocaine toxicity. Cocaine use is declining across the nation according to the National Institute of Drug Abuse.

 

Increasingly, laboratory results are disputed or there are medical/legal overtones. Therefore, physicians are finding an increased need to confirm positive results before informing or confronting the patients.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Negative

Positive results are reported with a quantitative gas chromatography mass spectrometry (GC-MS) result.

Cutoff concentrations:

COCAINE BY GC-MS

<50 ng/mL

 

BENZOYLECGONINE BY GC-MS

<50 ng/mL

Interpretation
Provides information to assist in interpretation of the test results

Reports will specifically indicate the presence or absence of cocaine and benzoylecgonine.

 

The presence of cocaine, or its major metabolite, benzoylecgonine, indicates use within the past 4 days.

 

Cocaine has a 6-hour half-life, so it will be present in urine for 1 day after last use.

 

Benzoylecgonine has a half-life of 12 hours, so it will be detected in urine up to 4 days after last use.

 

There is no correlation between concentration and pharmacologic or toxic effects.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

No significant cautionary statements

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Baselt RC, ed. Disposition of Toxic Drugs and Chemicals in Man. 10th ed. In: Biomedical Publications; 2014

2. Langman LJ, Bechtel LK, Holstege C. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 43

Method Description
Describes how the test is performed and provides a method-specific reference

To accommodate the need to confirm specifically the presence of cocaine in urine, Mayo Clinic Laboratories offers a single test to identify cocaine and its principal metabolite, benzoylecgonine, by using gas chromatography mass spectrometry.(Chinn DM, Crouch DJ, Peat MA, et al. Gas chromatography-chemical ionization mass spectrometry of cocaine and its metabolites in biological fluids. J Anal Toxicol 1980;4:37-42; Rosado T, Goncalves A, Margalho C, Barroso M, Gallardo E. Rapid analysis of cocaine and metabolites in urine using microextraction in packed sorbent and GC/MS. Anal Bioanal Chem. 2017;409(8):2051-2063. doi:10.1007/s00216-016-0152-2)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday, Wednesday, Thursday, Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

2 to 5 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

80353

G0480 (if appropriate)

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
COKEU Cocaine and metabolite Conf, U 53747-2
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
2922 Cocaine-by GC/MS 20519-5
2902 Benzoylecgonine-by GC/MS 16226-3
20671 Cocaine Interpretation 69050-3
28080 Chain of Custody 77202-0

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports