Test ID: COKEU
Cocaine Confirmation, Urine
NY State Approved 
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Detecting and confirming drug abuse involving cocaine
Additional Tests Lists test(s) that are always performed, at an additional charge, with the initial test(s)
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| ADULT | Adulterants Survey, U | No | Yes |
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
An evaluation to detect the presence of adulterants will be performed and reported at no additional charge.
See Adulterant Survey Algorithm in Special Instructions.
Special Instructions and Forms Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test
Method Name A short description of the method used to perform the test
COKEU/9286: Immunoassay/Gas Chromatography-Mass Spectrometry (GC-MS) Confirmation with Quantitation
ADULT/29345: Spectrophotometry (SP)
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Cocaine
Cocaine Confirmation, QN, Urine
Coke (Cocaine)
Crack (Cocaine)
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Collection Container/Tube: Plastic urine container
Submission Container/Tube: Plastic, 60-mL urine bottle
Specimen Volume: 20 mL
Collection Instructions:
1. Collect a random urine specimen.
2. Submit 20 mL in 1 plastic bottle.
3. No preservative.
Additional Information:
1. No specimen substitutions.
2. No STATS are accepted for this procedure.
3. For situations where chain-of-custody is required, a Chain-of-Custody Kit (Supply T282) is available. For chain-of-custody information, see COCH/9426 Chain-of-Custody Processing.
4. Additional drug panels and specific requests are available. Call Mayo Medical Laboratories at 800-533-1710 or 507-266-5700.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Urine | Refrigerated (preferred) | 14 days |
| Frozen | 14 days | |
| Ambient | 72 hours |
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
Positives are reported with a quantitative GC-MS result.
Cutoff concentrations:
IMMUNOASSAY SCREEN
<150 ng/mL
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
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
Not intended for use in employment-related testing.
For situations where chain-of-custody is required, a Chain-of-Custody Kit (Supply T282) is available. See COCH/9426 Chain-of-Custody-Processing.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Baselt RC, Cravey RH: Disposition of Toxic Drugs and Chemicals in Man. Third edition. Chicago, Year Book Medical Publishers, 1989
2. Langman LJ, Bechtel L, Holstege CP: Chapter 35. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Edited by CA Burtis, ER Ashwood, DE Bruns. WB Saunders Company, 2011, pp 1109-1188
Method Description Describes how the test is performed and provides a method-specific reference
Drug classes are initially screened by an immunoassay technique.
To accommodate the need to confirm specifically the presence of cocaine in urine, Mayo Medical Laboratories offers a single test to identify cocaine and its principal metabolite, benzoylecgonine, by using gas chromatography/mass spectrometry (GC-MS).
Reports will specifically indicate the presence or absence of cocaine and benzoylecgonine.(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)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Thursday, Sunday
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
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's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
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 Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
82520-Cocaine
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| 2903 | Immunoassay Screen | 3393-6 |
| 2922 | Cocaine-by GC/MS | 3398-5 |
| 2902 | Benzoylecgonine-by GC/MS | 3394-4 |
| 20671 | Interpretation | 69050-3 |
| 28080 | Chain of Custody | In Process |
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