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24948 Cobalt, Urine (COU)

Cobalt, Urine (COU)
Test Code: COBURSO
Synonyms/Keywords
Co (Cobalt), Cobalt (Co)
Useful For
Detecting cobalt exposure
Monitoring metallic prosthetic implant wear
This test is not useful to assess vitamin B12 activity
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Urine​ Plastic, 10-mL urine tube ​or clean, plastic aliquot container with no metal cap or glued insert.  NO Preservative 10 mL​ 0.4 mL​
Collection Processing Instructions
24-Hour volume is required
1. Collect urine for 24 hours.
2. No preservative.
3. Metal-free urine collection procedures must be followed. 
4. Refrigerate specimen within 4 hours of completion of 24-hour collection.
 
High concentrations of gadolinium and iodine are known to interfere with most metals tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.
Specimen Stability Information
Specimen Type Temperature Time
​Urine ​ ​ Refrigerated (preferred)​ 28 days​
​Ambient ​28 days
​Frozen ​28 days
Rejection Criteria

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

Interference

​Specimen collection procedures for cobalt require special specimen collection tubes, rigorous attention to ultraclean specimen collection and handling procedures, and analysis in an ultraclean facility. Unless all of these precautions are taken, elevated urine cobalt results may be an incidental and misleading finding.

Performing Laboratory Information
Performing Location Day(s) Test Performed Report Available Methodology/Instrumentation
Mayo Clinic Laboratories​​ Monday, Wednesday and Friday 1 to 3 days​
Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)
Reference Lab
Reference Range Information
Performing Location Reference Range
Mayo Clinic Laboratories​​
0 - 17 years:  not established
>/= 18 years:  0.2 - 3.5 mcg/24h
Interpretation
Concentrations > or =2.0 mcg/specimen indicate excess exposure. There are no Occupational Safety and Health Administration (OSHA) blood or urine criteria for occupational exposure to cobalt.
 
Prosthesis wear is known to result in increased circulating concentration of metal ions. In a patient with a cobalt-based implant, modest increase (2-4 mcg/specimen) in urine cobalt concentration is likely to be associated with a prosthetic device in good condition. Excessive exposure is indicated when urine cobalt concentration is >5 mcg/specimen, consistent with prosthesis wear. Urine concentrations >20 mcg/specimen in a patient with a cobalt-based implant suggest significant prosthesis wear. Increased urine trace element concentrations in the absence of corroborating clinical information do not independently predict prosthesis wear or failure.
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​83018
Synonyms/Keywords
Co (Cobalt), Cobalt (Co)
Ordering Applications
Ordering Application Description
​Centricity ​Cobalt-24hr
​Cerner ​Cobalt, Urine (80083)
​COM ​Cobalt, Urine
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Urine​ Plastic, 10-mL urine tube ​or clean, plastic aliquot container with no metal cap or glued insert.  NO Preservative 10 mL​ 0.4 mL​
Collection Processing
24-Hour volume is required
1. Collect urine for 24 hours.
2. No preservative.
3. Metal-free urine collection procedures must be followed. 
4. Refrigerate specimen within 4 hours of completion of 24-hour collection.
 
High concentrations of gadolinium and iodine are known to interfere with most metals tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.
Specimen Stability Information
Specimen Type Temperature Time
​Urine ​ ​ Refrigerated (preferred)​ 28 days​
​Ambient ​28 days
​Frozen ​28 days
Rejection Criteria

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

Interference

​Specimen collection procedures for cobalt require special specimen collection tubes, rigorous attention to ultraclean specimen collection and handling procedures, and analysis in an ultraclean facility. Unless all of these precautions are taken, elevated urine cobalt results may be an incidental and misleading finding.

Useful For
Detecting cobalt exposure
Monitoring metallic prosthetic implant wear
This test is not useful to assess vitamin B12 activity
Reference Range Information
Performing Location Reference Range
Mayo Clinic Laboratories​​
0 - 17 years:  not established
>/= 18 years:  0.2 - 3.5 mcg/24h
Interpretation
Concentrations > or =2.0 mcg/specimen indicate excess exposure. There are no Occupational Safety and Health Administration (OSHA) blood or urine criteria for occupational exposure to cobalt.
 
Prosthesis wear is known to result in increased circulating concentration of metal ions. In a patient with a cobalt-based implant, modest increase (2-4 mcg/specimen) in urine cobalt concentration is likely to be associated with a prosthetic device in good condition. Excessive exposure is indicated when urine cobalt concentration is >5 mcg/specimen, consistent with prosthesis wear. Urine concentrations >20 mcg/specimen in a patient with a cobalt-based implant suggest significant prosthesis wear. Increased urine trace element concentrations in the absence of corroborating clinical information do not independently predict prosthesis wear or failure.
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Report Available Methodology/Instrumentation
Mayo Clinic Laboratories​​ Monday, Wednesday and Friday 1 to 3 days​
Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)
Reference Lab
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​83018
For most current information refer to the Marshfield Laboratory online reference manual.