Posted Date
Effective Date
Update Type New Tests
Order Code SCOR



Cortisol, Salivary

Order Code:                  SCOR

Fee Code:                     KA055 (CPT 82533)


MLabs Toxicology Laboratory will begin offering Salivary Cortisol testing by liquid chromatography mass spectrometry (LC-MS/MS) effective February 28, 2023.  This test replaces Mayo Clinic Laboratories test ID SALCT. 


Measurement of midnight/late-night salivary cortisol (LNSC) is used for screening of adrenal hyperfunction (Cushing syndrome). Although other cortisol tests may be ordered for the initial workup, LNSC has a superior sensitivity to plasma and 24-hour urinary free cortisol measurements. A positive LNSC result (≥ 100 ng/dL) should be followed by a second test for cortisol which may include LNSC, 24-hour urinary cortisol or dexamethasone suppression testing.  Two positive LNSC may be used to confirm Cushing Syndrome.


The order code SCOR will reflex to one of the following dependent on the time of collection:


Collection Time

Reference Range



0700 – 0800

100-750 ng/dL



1500 – 1700

<401 ng/dL



2300 – 2400

<100 ng/dL 



any time outside of the time frames above




Collection Instructions: The preferred time of collection is between 2300 – 2400. Collect saliva specimen using Starstedt Salivette Cortisol Saliva Collection Device. Because of the onset of bacterial growth in saliva after a few hours at room temperature, it is recommended to either centrifuge the firmly closed Salivette® Cortisol within 4 hours after specimen collection at 1,000 x g for 2 minutes. Alternatively store and transport refrigerated (unspun).


Patient Collection Instructions:

The saliva sample should be taken at least 60 minutes after a meal (liquid/solid food intake), brushing teeth or taking oral medication, in order to avoid the saliva being contaminated with interfering substances. Up to 10 minutes before taking the sample, rinse mouth with water for 1-5 seconds. Immediately before collecting the saliva, wash and dry hands. With two fingers, remove the absorbent roll at the far end from the opened Salivette® Cortisol and place it in the mouth.   The absorbent roll should be kept in the mouth (e.g., in the cheek) for 2 minutes without chewing. With two fingers, take the absorbent roll out of the mouth by the far end and place it immediately in the Salivette® Cortisol and seal with the blue cap. Store refrigerated.