South Bend Medical Foundation - Your Community Laboratory

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Test Name:
Drug Screen 8, with Confirmation/Quantitation if Indicated, Urine

• SBMF No:
  31213
• Performance Lab Name:
  Toxicology
• Test Mnemonic:
  U DAS8/C-
• ABN:
  May be required – Medical Necessity
• CPT Code:
  80101x8; 82570; 83986; 84311
  If positive, add appropriate CPT for drug confirmed: 82145 Amphetamines; 82205 Barbiturates; 80154 Benzodiazepines; 82520 Cocaine; 82542 Marijuana; 83925 Opiates; 83992 Phencyclidine; 83925 Propoxyphene
  

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  Medicare: G0434; 82570; 83986; 84311
  If positive, add appropriate CPT for drug confirmed: 82145 Amphetamines; 82205 Barbiturates; 80154 Benzodiazepines; 82520 Cocaine; 82542 Marijuana; 83925 Opiates; 83992 Phencyclidine; 83925 Propoxyphene
• LOINC Code:
  19343-3; 19554-5; 19359-9; 19411-8; 19597-4; 19659-2; 21556-6; 19270-8; 14316-4; 19429-0; 58400-3; 2161-8; 48767-8; 48767-8
• Test Includes:
  Amphetamines (Amphetamine, Methamphetamine)
  Barbiturates
  Benzodiazepines
  Cocaine
  Marijuana (THC metabolite)
  Opiates (Codeine, Morphine)
  Phencyclidine
  Propoxyphene
  Oxidant Screen
  pH
  Creatinine
  Confirmation of positive screens
• Spec Type:
  Urine, random
• Spec Container:
  Plastic container with tightly fitting lid (No preservative)
• Pref Vol:
  20.0 mL
• Min Vol:
  10.0 mL
• Spec Collect:
  Routine random urine collection
• Spec Process:
  Keep container tightly sealed
  Refrigerate promptly after collection
• Spec Store Transport:
  Refrigerated
• Spec Stability:
  5 days room temperature (20-30°C)
  1 week refrigerated (2-8°C)
• Spec Reject:
  Specimens other than urine
• Methodology:
  Enzyme Immunoassay (EIA) [Moderate Complexity]
  Gas Chromatography/Mass Spectrometry (GC/MS)
• Use:
  Detect drug use
• Reference Range:
  

  DRUG SCREEN
  URINE:		RESULT	EIA CUTOFF
  	Amphetamine Methamphetamine Cocaine Metab. Codeine Morphine Phencyclidine THC Metabolite Barbiturates Benzodiazepines Propoxyphene	NEGATIVE NEGATIVE NEGATIVE NEGATIVE NEGATIVE NEGATIVE NEGATIVE NEGATIVE NEGATIVE NEGATIVE	1000 ng/mL 1000 ng/mL 300 ng/mL 300 ng/mL 300 ng/mL 25 ng/mL 20 ng/mL 200 ng/mL 200 ng/mL 300 ng/mL
  Note: Forensic procedures not followed.
  	Oxidant Screen pH Screen Creatinine	NEGATIVE 4.5-8.9 > 20.0 mg/dL

• Additional Test Info:
  Screen-positive specimens are automatically confirmed by GC/MS. Additional charges may apply.
• Day Run:
  Mon-Fri
• Time Run:
  9:00 pm
• Time Reported:
  24 hours
• Test Type:
  TOX-TDM