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Test Code CINP Cortisol, Mass Spectrometry, Serum

Reporting Name

Cortisol, S, LC-MS/MS

Useful For

Second-order testing when cortisol measurement by immunoassay (eg, CORT / Cortisol, Serum) gives results that are not consistent with clinical symptoms, or if patients are known to, or suspected of, taking exogenous synthetic steroids (order SGSS / Synthetic Glucocorticoid Screen, Serum to confirm the presence of synthetic steroids)

 

An adjunct in the differential diagnosis of primary and secondary adrenal insufficiency

 

An adjunct in the differential diagnosis of Cushing syndrome

 

This test is not recommended for evaluating response to metyrapone; DOCS / 11- Deoxycorticosterone, Serum is more reliable.

Testing Algorithm

For more information see Steroid Pathways.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum Red


Ordering Guidance


The preferred screening test for Cushing syndrome is the 24-hour urinary free cortisol excretion, order CORTU / Cortisol, Free, 24 Hour, Urine.

 

When patients are not taking, or are not suspected to be taking, exogenous glucocorticoids, order CORT / Cortisol, Serum.



Specimen Required


Collection Container/Tube: Red top (serum gel/SST are not acceptable)

Specimen Volume: 0.6 mL

Submission Container/Tube: Plastic vial

Collection Instructions:

1. Morning (8 a.m.) and afternoon (4 p.m.) specimens are preferred.

2. Include time of collection.

3. Centrifuge and aliquot serum into a plastic vial.

Additional Information: If multiple specimens are collected, send a separate order for each specimen.


Specimen Minimum Volume

0.25 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Red Refrigerated (preferred) 28 days
  Ambient  28 days
  Frozen  28 days

Special Instructions

Reference Values

5-25 mcg/dL (a.m.)

2-14 mcg/dL (p.m.)

Pediatric reference ranges are the same as adults, as confirmed by peer-reviewed literature.

 

Petersen KE. ACTH in normal children and children with pituitary and adrenal diseases. I. Measurement in plasma by radioimmunoassay-basal values. Acta Paediatr Scand. 1981;70:341-345

Day(s) Performed

Monday through Friday

Test Classification

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

82533

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CINP Cortisol, S, LC-MS/MS 87429-7

 

Result ID Test Result Name Result LOINC Value
84279 Cortisol, S, LC-MS/MS 2143-6
23606 AM Cortisol 9813-7
23607 PM Cortisol 9812-9

Report Available

2 to 5 days

Reject Due To

Gross hemolysis OK
Gross lipemia Reject
Gross icterus OK

NY State Approved

Yes

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)