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Test Code
CCOSV
Test Name
Cortisol and Cortisone, Saliva
CPT Codes
82530, 82542
Included Tests
  • Cortisol Free
  • Cortisone Free
  • Cortisol Free/Cortisone Free Ratio interpretation

The ratio is only reported when a strict numerical value is provided. If the result for Cortisol or Cortisone has a < or > value, a result can't be reported since the exact value is needed to perform a ratio calculation.
Expected Turnaround Time
3 - 6 days
Clinical Utility
Screening and diagnosis of Cushing syndrome/hypercortisolism.
Specimen and Container Info

Specimen Type: Saliva

Collection Container: Saliva Collection Kit

Desired Specimen Volume: 1.5 mL
Collection Instructions
  1. Provide patient with a Saliva Collection Kit (Salivette) containing the Cortisol and Cortisone - Saliva Collection Instructions and ask them to follow the instructions as written.
Processing and Submission Instructions
  1. Order should reflect the date and time that the patient collected the sample.
  2. Transport 1.5 mL of saliva in the original collection container.
  3. If multiple specimens are collected, submit each Salivette under a separate order number.
  4. Collection time is required for testing.
Patient Preparation

Do not brush teeth, eat, drink, or take any oral medication for at least 60 minutes before collecting specimen. Have patient rinse mouth thoroughly with water for 1 to 5 seconds. Wait 10 minutes before collecting the specimen to avoid contamination of the saliva by an interfering substance.
Transport Instructions
Transport to the laboratory refrigerated.
Stability Requirements

Room Temperature

14 days

Refrigerated

28 days

Frozen

60 days
Methodology
Liquid Chromatography - Tandem Mass Spectrometry (LC-MS/MS)
Reference Intervals
See patient report.
Limitations

Several factors may influence results:

  • Stress, acute illness, psychiatric conditions, alcohol use, and certain medications can elevate levels
  • Timing of collection is critical due to circadian variation
  • Irregular sleep schedules (eg, shift work) may affect interpretation
  • Topical hydrocortisone may falsely elevate salivary cortisol, whereas cortisone is less affected
Reference Lab
Mayo Clinic Laboratories
Testing Schedule
Monday-Friday
The American Medical Association (AMA) Current Procedural Terminology (CPT) codes published by HNL Lab Medicine are guidelines and are intended for informational purposes only. CPT coding is the exclusive responsibility of the billing entity. View the Terms.
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