Vanillylmandelic Acid (VMA), 24-Hour Urine

CPT: 84585
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  • 3-Methoxy-4-Hydroxymandelic Acid, 24-Hour Urine
  • VMA, 24-Hour Urine

Special Instructions

Record total 24-hour urine volume on the request form.

Expected Turnaround Time

3 - 4 days

Related Documents

For more information, please view the literature below.

Q & A: Laboratory Screening for Pheochromocytomas

Specimen Requirements


Urine (24-hour)


4 mL aliquot

Minimum Volume

1 mL aliquot (Note: This volume does not allow for repeat testing.)


Plastic urine container, no preservative (preferred), or acidic preservative


Instruct the patient to void at 8 AM and discard the specimen. Then collect all urine, including the final specimen voided at the end of the 24-hour collection period (ie, 8 AM the next morning). Measure and record total urine volume. Mix well; send aliquot. Label container with patient's name, date and time collection started, and date and time collection completed.

Storage Instructions

Vanillylmandelic acid is stable at room temperature unpreserved for seven days.

Stability Requirements



Room temperature

7 days


14 days


14 days

Freeze/thaw cycles

Stable x3

Patient Preparation

Patient should avoid salicylates, caffeine, phenothiazine, and antihypertension agents. Also coffee, tea, chocolate, fruit (especially bananas and any vanilla containing substances for 72 hours prior to collection).

Test Details


Diagnose pheochromocytoma, VMA is of value for evaluation of hypertension, diagnose and follow up neuroblastoma, ganglioneuroma, and ganglioneuroblastoma. Most neuroblastoma patients excrete excess HVA in 24-hour collections. If VMA and HVA are both used in work-up, up to 80% of all cases will be detected.


This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration.


Liquid chromatography/tandem mass spectrometry (LC/MS-MS)

Reference Interval

0.0−7.5 mg/24 hours

Additional Information

Some neuroblastoma patients are positive for urinary homovanillic acid abnormality but do not excrete increased VMA. Twenty percent to 32% of patients with neuroblastoma do not have elevation of VMA. Many will have other laboratory abnormalities such as increased metanephrines, homovanillic acid (HVA), or dopamine.


Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
004143 Vanillylmandelic Acid, 24-Hr U 3122-9 004144 VMA, Urine mg/L 9624-8
004143 Vanillylmandelic Acid, 24-Hr U 3122-9 004145 VMA, Urine, 24hr mg/24 hr 3122-9

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