Test Overview
Test Methodology

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

Test Usage

Evaluate catecholamine production, useful in the diagnosis of pheochromocytoma and neuroblastoma and in confirmation of elevated catecholamine levels.

Reference Range *

24 Hour Urine - VMA:
0-1 years: 0 - 1.5 mg/24 hours
1-3 years: 0 - 1.5 mg/24 hours
3-5 years: 0 - 4.0 mg/24 hours
5-10 years: 0 - 4.0 mg/24 hours
10-127 years: 0 - 10.0 mg/24 hours

Random Urine - VMA / Creatinine Ratio:
0-1 years: < 18 mg/gm creatinine
1-3 years: < 12 mg/gm creatinine
3-5 years: < 12 mg/gm creatinine
5-10 years: < 9 mg/gm creatinine
10-127 years: < 8 mg/gm creatinine

* Reference ranges may change over time. Please refer to the original patient report when evaluating results.

Test Limitations

False elevations may occur if patients do not follow the VMA preparation instructions.

Test Details
Days Set Up
Monday, Thursday
Analytic Time

8 hours

Soft Order Code
VMA/VMAR
MiChart Code
VMA, 24HR Urine
Synonyms
    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 10 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 10 mL aliquot (preferred); alternatively a non-acidified aliquot will be accepted. Patient should avoid medications, chocolate, fruit, bananas and any vanilla containing substances for 48 hrs prior to beginning collection. Random samples will be accepted on children less than 10 years old, in which case the VMAR test code must be ordered instead of the VMA test code.

    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] Random samples will be accepted on children less than 10 years old, in which case the VMAR test code must be ordered instead of the VMA test code.
    MLABS: Random specimen has been approved for all ages for clients. [4/98]
    Contraindications
    Patient should avoid medications, chocolate, fruit, bananas and any vanilla containing substances for 48 hrs prior to and during collection.
    Normal Volume
    10 mL aliquot of 24 hour urine collection, 6 mL of a random collection.
    Minimum Volume
    4 mL aliquot of 24 hour urine collection, 4 mL of a random collection.
    Additional Information

    Tested using a laboratory developed assay performed on a Waters liquid chromatography tandem mass spectrometry (LC-MS/MS) system. Results determined from different manufacturers and/or methods may not be comparable.

    Billing
    CPT Code
    84585
    Fee Code
    36902
    LOINC
    3122-9
    NY State Approved
    No