South Bend Medical Foundation - Your Community Laboratory

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Test Name:
Drug Screen 9, with Confirmation/Quantitation if Indicated, Serum or Plasma

• SBMF No:
  44646
• Performance Lab Name:
  ARUP Laboratories
• Test Mnemonic:
  DRUG SCRSP
• ABN:
  May be required – Medical Necessity
• CPT Code:
  80101x9
  If positive, add appropriate CPT for drug confirmed: 82145 Amphetamines; 82205 Barbiturates; 80154 Benzodiazpeines; 82520 Cocaine; 82542 Marijuana; 83840 Methadone; 83925 Opiates; 83992 Phencyclidine; 83925 Propoxyphene
  

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  Medicare: G0434
  If positive, add appropriate CPT for drug confirmed: 82145 Amphetamines; 82205 Barbiturates; 80154 Benzodiazpeines; 82520 Cocaine; 82542 Marijuana; 83840 Methadone; 83925 Opiates; 83992 Phencyclidine; 83925 Propoxyphene
• LOINC Code:
  19146-0; 19146-0; 19146-0; 19146-0; 19146-0; 19146-0; 19146-0; 19146-0; 19146-0; 19146-0
• Ref Lab Test No:
  0092420
• Test Includes:
  Amphetamines
  Barbiturates
  Benzodiazepines
  Cocaine
  Marijuana
  Methadone
  Opiates
  Phencyclidine
  Propoxyphene
• Spec Type:
  Plasma
• Spec Container:
  Two (2) Gray top (fluoride/oxalate), Green top (sodium heparin), or Lavender top (EDTA) tubes
• Alt Spec Type:
  Serum
• Alt Spec Container:
  Two (2) Red top (serum) tubes
• Pref Vol:
  4.0 mL
• Min Vol:
  3.0 mL
• Fasting:
  No
• Spec Collect:
  Do not use gel-barrier tubes for specimen collection
  Routine venipuncture
• Spec Process:
  Serum sample tubes, clot 30 minutes
  Promptly centrifuge 15 minutes
  Immediately transfer serum or plasma to separate plastic tube
• Spec Store Transport:
  Refrigerated
• Spec Stability:
  After separation from cells:
  1 week room temperature (20-30°C)
  2 weeks refrigerated (2-8°C)
  3 years frozen (-20°C) – Do not use frost-free units that undergo repeated freeze/thaw cycles
• Spec Reject:
  Sample collected in gel barrier (SST, PST, or PPT) tube or lt. blue top (sodium citrate) tube
  Sample exposed to repeated freeze/thaw cycles
• Spec Remarks:
  Remove plasma or serum from cells ASAP or within 2 hours of collection
  Cocaine and coaethylene are more stable in fluoride-preserved plasma than serum
• Methodology:
  Qualitative Enzyme-Linked Immusorbent Assay (ELISA) [Moderate Complexity]
  Quantitative Gas Chromatography-Mass Spectrometry (GC/MS)
  Quantitative Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
• Clinical Significance:
  Refer to:
  
• Reference Range:
  
  Drugs Covered and Cutoff Concentrations

  Drugs/Drug Classes	Screen	Confirmation
  Marijuana Cocaine Opiates Phencyclidine Amphetamines Barbiturates Methadone and metabolite Benzodiazepines Propoxyphene and metabolite	30 ng/mL 30 ng/mL 30 ng/mL 15 ng/mL 30 ng/mL 75 ng/mL 40 ng/mL 75 ng/mL 75 ng/mL	5 ng/mL 20 ng/mL 2 ng/mL 10 ng/mL 20 ng/mL 50 ng/mL 10 ng/mL 20 ng/mL 10 ng/mL

  Interpretive Data:
  The absence of expected drug(s) and/or drug metabolite(s) may indicate non-compliance, inappropriate timing of specimen collection relative to drug administration, poor drug absorption, or limitations of testing. The concentration at which the screening test can detect a drug or metabolite varies within a drug class. Specimens for which drugs or drug classes are detected by the screen are reflexed to a second, more specific technology (GC/MS and/or LC-MS/MS). The concentration value must be greater than or equal to the cutoff to be reported as positive. Interpretive questions should be directed to the laboratory.

  For medical purposes only; not valid for forensic use.

  Note:
  Screen-positive specimens are automatically confirmed by GC/MS and/or LC-MS/MS; additional charges may apply.

• Day Run:
  Sun-Sat (daily)
• Time Reported:
  2-5 days
• Test Type:
  TOX-TDM