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Test Code LAB3382 Drug of Abuse Screen, Pain Clinic, Urine

Test Name Alias

UDS | DrugScrAb Pain Clinic | Pain Management Panel | DOA | 4009

Panel Information

Document: Panels available at Spectrum Health

Collection Instructions

Specimen Collection: Urine, Random

 

Container(s):  Sterile Urine Cup or Pale Yellow Top Urine Tube-no preservative

Preferred Volume to Collect: 10.0 mL

Minimum Volume to Collect: 1.0 mL

 

Collection Instructions:

  • Include Chain of Custody form when appropriate
  • Keep container upright at all times and check that lid is fastened evenly and securely.
  • Do not send container home with patient, must be collected on site.
  • Do not open container after collection.

Processing Instructions (Laboratory, Outpatient or Off-site collection)

Transport Temperature: Refrigerate

Specimen Stability

Ambient: 72 hours

Refrigerate: 14 days

Frozen: 14 days

Laboratory Retention: 10 days

Test Frequency

Available Monday through Friday, day shift. TAT 2 – 3 days

Reference Range

Screen Cutoff Limits:

 

Amphetamines 500 ng/mL

Barbiturates 200 ng/mL

Benzodiazepines 300 ng/mL

Cannabinoids 50 ng/mL

Cocaine/Metab. 150 ng/mL

Ethanol 20 mg/dL

Methadone 300 ng/mL

 

SCREENING PROCEDURE ONLY. Positives are not confirmed except where established by Laboratory policy. For other specimens, confirmation testing must be ordered by the physician. The Laboratory recommends that no legal action be taken on a positive screen result without Mass Spectrometry confirmation.

Screening procedures generally target only one or a few specific drugs of a given class. Other drugs of the class may or may not cross react. Comprehensive Drug Screen may detect drugs not detected by this screening procedure.

pH and SG testing are performed to evaluate specimen integrity. Results outside the indicated ranges may or may not indicate an attempt by the patient to adulterate or otherwise compromise the specimen. Repeat testing on a new collection may be indicated if there is a question as to specimen integrity.

All urine drug screen specimens are stored for 14 days. Contact the Toxicology laboratory at 267-2780 for questions about confirmation testing, cross reactivity, Comprehensive Drug Screen, or specimen integrity testing.

 

Also includes these opiate confirmations:

 

Urine Codeine by LC/MS. (cutoff level 300 ng/mL)

Urine Morphine by LC/MS. (cutoff level 300 ng/mL)

Urine Heroin Metabolite (6-MAM) by LC/MS. (cutoff level 10 ng/mL)

Urine Hydrocodone by LC/MS (cutoff level 100 ng/mL)

Urine Hydromorphone by LC/MS (cutoff level 100 ng/mL)

Urine Oxycodone by LC/MS (cutoff level 100 ng/mL)

Urine Oxymorphone by LC/MS (cutoff level 100 ng/mL)

 

 

pH Screen UR
4.0 – 8.50

SG Screen UR
1.003 – 1.030

Creatinine Screen UR

20 – 400 mg/dL

 

Clinical Information

 

Mandatory Reflex information

  • All positive screens will be confirmed by GC/MS or LC/MS

Performing Department

TOXICOLOGY

Performing Department Laboratory Location

Spectrum Health Regional Laboratory, Grand Rapids, MI

Methodology

Kinetic Interaction of Micro particles in a Solution (KIMS) / Enzyme Immunoassay (EIA)

Liquid Chromatography-Mass Spectrometry

CPT

80307-LAB-DRUG SCREEN CLASS A
Amphetamine scree, urine; Barbiturate screen,urine; Benzodiazepine screen, urine; Cannabinoids screen, urine;Cocaine screen, urine; Ethanol screen, urine; Methadone screen,urine
80361-LABLCMS OPIATESEXPANDEDCodeine, Morphine, Hydrocodone,Hydromorphone, Oxymorphone
80356-LABLCMS 6MAM Heroin
80365-LABLCMS OXYCODONE

HCPCS: G0480

 

CDM Code

4024018, 4028242, 4028246, 4028885

Epic Test ID

1230100634

Interface Order Alias

11686

Interface Information

Order alias: 11686

Result alias:

24035 - 6-MA-Morphine Ur

20480 – Amphetamine scrn UR

20470 – Barbiturates scrn UR

20471 – Benzodiazepines scrn UR

20472 – Cannabinoids scrn UR

20481 – Cocaine scrn UR

24033 - Codeine Ur

21461 – Creat Scr Ur

22572 – Ethanol scrn UR

24036 - Hydrocodone Ur

24037 - Hydromorphone Ur

20473 – Methadone scrn UR

24034 - Morphine Ur

24038 - Oxycodone Ur

24039 - Oxymorphone Ur

20476 – pH scrn UR

20517 – SG scrn UR

Questions

Is GCMS confirmation of positive screen results requested? (There will be an additional cost per drug confirmed) [DROPDOWN – YES/NO]

Is GCMs confirmation of unexpected results requested? (If yes, this will require a complete list of expected drugs) [DROPDOWN – YES/NO]

Complete list of drugs expected: (include time and date of last dose) [TEXT]

Specimen Integrity: Bluing agent in bowl? [DROPDOWN – YES/NO]

Specimen Integrity: Dry toilet used? [DROPDOWN – YES/NO]

Specimen Integrity: Hand washing prior to collection? [DROPDOWN – YES/NO]

Specimen Integrity: Urine temperature in range? (32.5C-37.7C/90.5F-99.8F) [DROPDOWN – YES/NO]

Specimen Integrity: Temperature taken within 4 minutes of collection? [DROPDOWN – YES/NO]

Mayo Access Code

SHO4009

Reviewed Date

6/14/2018