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Test Name:
Drug Screen 6, Serum

• SBMF No:
  29062
• Performance Lab Name:
  Automated Lab
• Test Mnemonic:
  S DS
• ABN:
  May be required – Medical Necessity
• CPT Code:
  80101x6
  

  ---

  Medicare: G0434
• LOINC Code:
  3298-7; 4024-6; 5643-2; 20421-4; 3389-4; 4073-3
• Test Includes:
  Acetaminophen
  Barbiturates
  Benzodiazepine
  Ethanol
  Salicylate
  Tricylic Antidepressants
• Also Known As:
  Serum Drug Screen
• Spec Type:
  Serum
• Spec Container:
  Red top (serum) tube
• Pref Vol:
  1.0 mL
• Min Vol:
  0.5 mL
• Spec Collect:
  Do not use gel-barrier tubes for specimen collection
  Prep venipuncture site with non-alcohol containing prepping agent
  Routine venipuncture
  Fill collection tube to vacuum capacity to minimize evaporation of volatiles
  Note anatomical draw site on specimen label and test request form
• Spec Process:
  Do not centrifuge
  Do not remove tube stopper (tube must remain tightly stoppered)
  Do not remove serum or plasma from cells
• Spec Store Transport:
  Refrigerated
• Spec Stability:
  1 week refrigerated (2-8°C)
• Methodology:
  Enzyme Immunoassay (EIA) [Moderate Complexity]
  Colorimetric Reaction [Moderate Complexity]
  Ferric Nitrate Reaction [Moderate Complexity]
  Photometric Reaction [Moderate Complexity]
• Use:
  Detect drug use
  Evaluate toxicity
• Clinical Significance:
  This drug screen primarily detects common over-the-counter (OTC) analgesics, as well as anticonvulsants, sedative-hypnotics, and common volatile compounds. It does not readily detect common drugs of abuse.
• Reference Range:
  

  Ethanol
  None Detected

  20-100 mg/dL 100-200 mg/dL 200-300 mg/dL 250-400 mg/dL 350-500 mg/dL

  - May exhibit slight alcoholic influence - Incoordination; decreased response to stimuli - Staggering gait; slurred speech; delirium - Severe incoordination; unconsciousness - May be comatose

  Salicylate
  None Detected

  Antipyretic/Analgesic:    Anti-inflammatory: Toxic Concentrations:

  2-10 mg/dL 10-25 mg/dL >30 mg/dL

  Acetaminophen
  None Detected

  Analysis of acetaminophen should be made at least 4 hours after ingestion to assure that peak concentration has been achieved. Minimal liver damage when < 150 ug/mL at 4 hours or < 36 ug/mL at 12 hours after ingestion. (Single determination.)

  A second determination should be made within 4-6 hours when an overdose is suspected.

  SERUM:	RESULT	CUTOFF
  Barbiturates	NEGATIVE	3000 ng/mL
  Benzodiazepines	NEGATIVE	300 ng/mL
  TCA	NEGATIVE	300 ng/mL

  Note:
  All positives are presumptive and have not been confirmed by an alternate method.

• Day Run:
  Sun-Sat (daily)
• Time Run:
  As received
• Time Reported:
  4 hours
• Test Type:
  TOX-TDM