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25146 6-Monoacetylmorphine (Heroin Metabolite), Urine

6-Monoacetylmorphine (Heroin Metabolite), Urine
Test Code: HEROIN
Synonyms/Keywords
6-MAM, 6-AM, Heroin​
Useful For
Detecting heroin abuse.​
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
No​ Urine​ Sage urine collection container​ Sterile plastic container with no preservatives​ 10 mL​ 7 mL​ 4 mL​
Specimen Stability Information
Specimen Type Temperature Time
Urine​ ​ Ambient​ 72 hours​
Refrigerate (Preferred)​ 30 days​
Frozen​ 30 days​
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​ 2-4 days​ Gas chromatography-mass spectrometry (GCMS) using selected ion monitoring​
Test Information
This test was developed and its performance characteristics determined by Marshfield Labs. This laboratory is certified under the Clinical Laboratory Improvement Amendments (CLIA) to perform high complexity testing.

6-monoacetylmorphine (6-MAM) is a metabolite of heroin (3,6-diacetylmorphine).  When a person uses heroin, the drug is rapidly deacetylated to form 6-MAM.  6-MAM is then deactylated at a slower rate for form morphine.  6-monoacetylmorphine (6-MAM) arises only from metabolism of heroin. It is not found in poppy seeds and is not a metabolic product of morphine, codeine, or any other opiate. Therefore, the presence of 6-MAM in urine is firm evidence of heroin use. Although 6-MAM is present in urine of a majority of heroin users, failure to detect 6-MAM does not rule out heroin, because 6-MAM is only present in low concentrations and for a relatively short time after use of the drug. ​
Reference Range Information
Performing Location Reference Range
Marshfield​

Negative.  Positives are reported with a quantitative GCMS result.

Interpretation

Presence of the heroin metabolite 6-MAM is definitive evidence of recent heroin use.  However, the failure to detect heroin does not rule out heroin use due to its short half-life.  6-MAM is generally only present in urine up to 24 hours after heroin use.  6-MAM metabolizes to morphine, which can be detected up to a maximum of 3 days after heroin use.​

Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
80356 ​ 1​ 6-Monoacetylmorphine (Heroin Metabolite) Confirmation ​
G0480​ ​ 1​ 6-Monoacetylmorphine (Heroin Metabolite) Confirmation For Medicare/Medicaid​
Classification
This test was developed and its performance characteristics determined by Marshfield Labs. This laboratory is certified under the Clinical Laboratory Improvement Amendments (CLIA) to perform high complexity testing.​
Synonyms/Keywords
6-MAM, 6-AM, Heroin​
Ordering Applications
Ordering Application Description
​Centricity ​6-MAM (Heroin Metab), Urine
​Cerner None​
​COM ​6-MAM (Heroin Metab), Urine
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
No​ Urine​ Sage urine collection container​ Sterile plastic container with no preservatives​ 10 mL​ 7 mL​ 4 mL​
Specimen Stability Information
Specimen Type Temperature Time
Urine​ ​ Ambient​ 72 hours​
Refrigerate (Preferred)​ 30 days​
Frozen​ 30 days​
Useful For
Detecting heroin abuse.​
Reference Range Information
Performing Location Reference Range
Marshfield​

Negative.  Positives are reported with a quantitative GCMS result.

Interpretation

Presence of the heroin metabolite 6-MAM is definitive evidence of recent heroin use.  However, the failure to detect heroin does not rule out heroin use due to its short half-life.  6-MAM is generally only present in urine up to 24 hours after heroin use.  6-MAM metabolizes to morphine, which can be detected up to a maximum of 3 days after heroin use.​

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Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​ 2-4 days​ Gas chromatography-mass spectrometry (GCMS) using selected ion monitoring​
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
80356 ​ 1​ 6-Monoacetylmorphine (Heroin Metabolite) Confirmation ​
G0480​ ​ 1​ 6-Monoacetylmorphine (Heroin Metabolite) Confirmation For Medicare/Medicaid​
Classification
This test was developed and its performance characteristics determined by Marshfield Labs. This laboratory is certified under the Clinical Laboratory Improvement Amendments (CLIA) to perform high complexity testing.​
For most current information refer to the Marshfield Laboratory online reference manual.