Test Overview
Test Methodology

LC-MS-MS

Test Usage

Evaluate presence of abnormal catecholamine production, may be elevated when VMA and catecholamines are within normal limits. Useful in the diagnosis of pheochromocytoma, neuroblastoma, ganglioneuroblastoma, and hypertension.

Reference Range *

Metanephrines: 0-300 mcg/24 hrs, Normetanephrines: 50-800 mcg/24 hrs

Test Details
Days Set Up
Weekly
Analytic Time

5 hours

Soft Order Code
METAN
MiChart Code
Metanephrines, 24 HR Urine
Synonyms
  • Fractionated Metanephrines, Urine
  • Fractionation, Metanephrines and Normetanephrines
  • Normetanephrines, Urine
  • METANEPHRINES/NORMETANEPHRINES
  • MET
  • NORMET
  • METANEPHRINE, URINE
Laboratory
Chemical Pathology
Section
Drug Analysis
Specimen Requirements
Collection Instructions

Collect 24 hour urine specimen. Add 25 mL of 50% glacial acetic acid (15 mL for pediatric patients) to container prior to start of collection. Following collection, mix well, measure 24 hour urine volume, aliquot 20 mL into a plastic urine container and refrigerate. Record total 24 hour urine volume and collection dates/times on request form. Specimens with no preservative are also acceptable: add 50% glacial acetic acid to container following collection, mix well and send 20 mL aliquot (preferred); alternatively a non-acidified aliquot will be accepted. Patient must be off Aldomet (alpha methyldopa) and its derivatives for a period of not less than 5 weeks. This drug will falsely elevate the metanephrines and normetanephrines. A 12 hr overnight collection will be accepted, but reference ranges have been established only for 24 hr collections.

Alternate Specimen
May be collected in plain (no preservative) container and acid added at the end of collection. It is preferred to have acid added as soon as possible at the client site, mixed, and an aliquot sent. A non-acidified aliquot may also be sent. [rev 9/08]
Contraindications
Patient must be off Aldomet (alpha methyldopa) and its derivatives for a period of not less than 5 weeks prior to testing. This drug will falsely elevate the metanephrines and normetanephrines.
Red Top Tube
Normal Volume
20 mL aliquot of 24 hour urine collection
Minimum Volume
20 mL aliquot of 24 hour urine collection
Additional Information

Coma, recent surgery, severe burns, and recent AMI will give falsely elevated values. There are no dietary restrictions BUT alcohol and nicotine in high doses and unusually high intake of coffee will acutely stimulate the adrenal medulla and may raise the metanephrines and normetanephrines to suspicious levels.

Billing
CPT Code
83835
Fee Code
36903
LOINC
51993-4
NY State Approved
No