Chromium and Cobalt, Whole Blood

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Turnaround Time: 3 - 7 days
CPT Code:

82495, 83018

Test Type: 4 mL Whole blood
Reference Range:

Reference interval is for patients with metal-on-metal (MoM) orthopedic implants. An algorithm intended as an aid for orthopedic surgeons in the assessment and management of patients with metal-on-metal bearings was published in 2014.1

The systematic risk stratification includes recommendations for multiple modes of failure and stratifies patient risk groups based on a thorough clinical history, a detailed physical examination, radiographic tests, and laboratory tests, including measurement of metal ions (chromium and cobalt).

The following stratification applies to chromium or cobalt as individual analytes, not to the combined total.

• Low risk group: <3.0 ng/mL

• Moderate risk group: 3.0−10.0 ng/mL

• High risk group: >10.0 ng/mL

Metal ion tests are an important adjunct to systemic clinical assessment; however, metal ion levels alone should not be relied on as the sole parameter to determine clinical recommendations for revision surgery.


Detect metal ion accumulation caused by metal-on-metal (MoM) implants.

1. Kwon YM, Lombardi AV, Jacobs JJ, Fehring TK, Lewis CG, Cabanela ME. Risk stratification algorithm for management of patients with metal-on-metal hip arthroplasty: consensus statement of the American Association of Hip and Knee Surgeons, the American Academy of Orthopaedic Surgeons, and the Hip Society. J Bone Joint Surg Am. 2014 Jan 1; 96(1):e4. PubMed 24382732

Collection Details:

Collection Instructions:

Royal blue-top (EDTA) metal-free tube.

Submission/transport (<3 days): Room temperature. For storage beyond three days, specimen should be refrigerated or frozen.