ARUP's Laboratory Test Directory

Cortisol/Cortisone Urine Free by LC-MS/MS : 0092100

Mnemonic: CORTURATIO

Methodology: Quantitative High Performance Liquid Chromatography-Tandem Mass Spectrometry
Performed: Sun-Sat
Reported: 1-2 days
Specimen Required: Collect: 24-hour or random urine. Refrigerate 24-hour specimen during collection.

Specimen Preparation: Transport one 4 mL aliquot of urine. (Min: 1 mL) Record total volume and collection time interval on transport tube and test request form.

Storage/Transport Temperature: Refrigerated.

Unacceptable Conditions: Room temperature specimens. Acidified specimens or specimens with preservatives.

Stability (collection to initiation of testing): Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 1 month
Reference Interval:
Effective November 14, 2011
Test Name Female Male
Cortisol (µg/day) 3-8 years: Less than 18 µg/day
9-12 years: Less than 37 µg/day
13-17 years: Less than 56 µg/day
18 years and older: Less than 45 µg/day 		3-8 years: Less than 18 µg/day
9-12 years: Less than 37 µg/day
13-17 years: Less than 56 µg/day
18 years and older: Less than 60 µg/day
Cortisol/Cortisone, Ratio* 0-17 years: To be determined
18 years and older: 0.15-0.50 		0-17 years: To be determined
18 years and older: 0.15-0.50
Cortisone Value used to calculate Cortisol/Cortisone ratio
Cortisol (µg/g crt) Prepubertal: Less than 25 µg/g crt
18 years and older: Less than 24 µg/g crt
Pregnancy: Less than 59 µg/g crt 		Prepubertal: Less than 25 µg/g crt
18 years and older: Less than 32 µg/g crt

Interpretive Data: The optimal specimen for this testing is a 24-hour urine collection. Mass per day calculations are not reported for the following specimen types: a random collection, a collection with duration of less than 20 hours, a collection with duration of greater than 28 hours, or a collection with total volume less than 400 mL. Ratios to creatinine may be useful for these evaluations.

Baseline urinary free cortisol excretion less than 5 ug/d may be consistent with adrenal insufficiency.

See Compliance Statement B: www.aruplab.com/CS
Note: Reference intervals for children are based on literature from Taylor R.L. et al., Validation of a High-Throughput Liquid Chromatography-Tandem Mass Spectrometry Method for Urine Cortisol and Cortisone. Clinical Chemistry 2002; 48:1511-19.

*The ratio of the concentrations of cortisol to cortisone will not be evaluated if the cortisol concentration is less than 5 µg/L.
CPT Code(s): 82530; 83789