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HelpTest Code LAB2411 Controlled Substance Monitoring Enhanced Profile with Reflex, 21 Drug Classes, High Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine
Additional Codes
SQ: CSMEUM
MAYO: CSMEU
Ordering Guidance
This test does not screen for drug classes other than those listed in Reference Values.
Specimen Required
Supplies: Urine Container, 60 mL (T313)
Collection Container/Tube: Plastic urine container
Submission Container/Tube: Plastic, 60 mL urine container
Specimen Volume: 30 mL
Collection Instructions:
1. Collect a random urine specimen.
2. Submit 30 mL in 1 plastic bottle.
3. No preservative.
Additional Information:
1. No specimen substitutions.
2. Submitting less than 30 mL may compromise the ability to perform all necessary testing.
3. STAT requests are not accepted for this test.
Secondary ID
615907Useful For
Detecting drug use involving stimulants, barbiturate, benzodiazepines, cocaine, opioids, tetrahydrocannabinol, and alcohol
This test is not intended for use in employment-related testing.
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| LPCM | List Patient's Current Medications | No | Yes |
| ADULT | Adulterants Survey, U | Yes | Yes |
| PNRCH | Drug Immunoassay Panel, U | No | Yes |
| TOPSU | Targeted Opioid Screen, U | Yes, (Order TOSU) | Yes |
| TABSU | Targeted Benzodiazepine Screen, U | Yes, (Order TBSU) | Yes |
| TSTIM | Targeted Stimulant Screen, U | Yes, (Order TSPU) | Yes |
| ETGSR | Ethyl Glucuronide Scrn w/Reflex, U | No | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| COKEU | Cocaine and metabolite Conf, U | Yes | No |
| BARBU | Barbiturates Confirmation, U | Yes | No |
| THCU | Carboxy-THC Confirmation, U | Yes | No |
| ETGC | Ethyl Glucuronide Confirmation, U | Yes | No |
Testing Algorithm
Testing begins with an adulterant survey. If the sample is found to be adulterated, testing will end, and the remaining tests will be canceled.
If the specimen is normal or only diluted, remaining testing will continue.
If the immunoassay screen is positive, confirmation testing can be ordered separately. Confirmation with quantification of positive results for barbiturates, cocaine and metabolites, tetrahydrocannabinol metabolite, and ethyl glucuronide/ethyl sulfate will be performed at an additional charge.
Method Name
ADULT: Spectrophotometry
PNRCH: Immunoassay followed by Gas Chromatography Mass Spectrometry (GC-MS) or Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS) as needed
TOPSU, TABSU, TSTIM: Liquid Chromatography Tandem Mass Spectrometry, High-Resolution Accurate Mass (LC-MS/MS HRAM)
ETGSR: Immunoassay followed by Liquid Chromatography Tandem Mass Spectrometry as needed
Reporting Name
CSM Enhanced Profile,21, HRMS/IA, USpecimen Type
UrineSpecimen Minimum Volume
20 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 14 days | |
| Frozen | 14 days |
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Reference Values
ADULTERANT SURVEY:
Cutoff concentrations
Oxidants: 200 mg/L
Nitrites: 500 mg/L
DRUG IMMUNOASSAY PANEL:
Negative
Screening cutoff concentrations:
Barbiturates: 200 ng/mL
Cocaine (benzoylecgonine-cocaine metabolite): 150 ng/mL
Tetrahydrocannabinol carboxylic acid: 50 ng/mL
This report is intended for use in clinical monitoring or management of patients. It is not intended for use in employment-related testing.
TARGETED OPIOID SCREEN:
Not detected
Cutoff concentrations:
Codeine: 25 ng/mL
Codeine-6-beta-glucuronide: 100 ng/mL
Morphine: 25 ng/mL
Morphine-6-beta-glucuronide: 100 ng/mL
6-Monoacetylmorphine: 25 ng/mL
Hydrocodone: 25 ng/mL
Norhydrocodone: 25 ng/mL
Dihydrocodeine: 25 ng/mL
Hydromorphone: 25 ng/mL
Hydromorphone-3-beta-glucuronide: 100 ng/mL
Oxycodone: 25 ng/mL
Noroxycodone: 25 ng/mL
Oxymorphone: 25 ng/mL
Oxymorphone-3-beta-glucuronide: 100 ng/mL
Noroxymorphone: 25 ng/mL
Fentanyl: 2 ng/mL
Norfentanyl: 2 ng/mL
Meperidine: 25 ng/mL
Normeperidine: 25 ng/mL
Naloxone: 25 ng/mL
Naloxone-3-beta-glucuronide: 100 ng/mL
Methadone: 25 ng/mL
2-Ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP): 25 ng/mL
Propoxyphene: 25 ng/mL
Norpropoxyphene: 25 ng/mL
Tramadol: 25 ng/mL
O-desmethyltramadol: 25 ng/mL
Tapentadol: 25 ng/mL
N-desmethyltapentadol: 50 ng/mL
Tapentadol-beta-glucuronide: 100 ng/mL
Buprenorphine: 5 ng/mL
Norbuprenorphine: 5 ng/mL
Norbuprenorphine glucuronide: 20 ng/mL
TARGETED BENZODIAZEPINE SCREEN:
Not detected
Cutoff concentrations:
Alprazolam: 10 ng/mL
Alpha-hydroxyalprazolam: 10 ng/mL
Alpha-hydroxyalprazolam glucuronide: 50 ng/mL
Chlordiazepoxide: 10 ng/mL
Clobazam: 10 ng/mL
N-desmethylclobazam: 200 ng/mL
Clonazepam: 10 ng/mL
7-Aminoclonazepam: 10 ng/mL
Diazepam: 10 ng/mL
Nordiazepam: 10 ng/mL
Flunitrazepam: 10 ng/mL
7-Aminoflunitrazepam: 10 ng/mL
Flurazepam: 10 ng/mL
2-Hydroxy ethyl flurazepam: 10 ng/mL
Lorazepam: 10 ng/mL
Lorazepam glucuronide: 50 ng/mL
Midazolam: 10 ng/mL
Alpha-hydroxymidazolam: 10 ng/mL
Oxazepam: 10 ng/mL
Oxazepam glucuronide: 50 ng/mL
Prazepam: 10 ng/mL
Temazepam: 10 ng/mL
Temazepam glucuronide: 50 ng/mL
Triazolam: 10 ng/mL
Alpha-hydroxytriazolam: 10 ng/mL
Zolpidem: 10 ng/mL
Zolpidem phenyl-4-carboxylic acid: 10 ng/mL
TARGETED STIMULANT SCREEN:
Not detected
Cutoff concentrations:
Methamphetamine: 100 ng/mL
Amphetamine: 100 ng/mL
3,4-Methylenedioxymethamphetamine (MDMA): 100 ng/mL
3,4-Methylenedioxy-N-ethylamphetamine (MDEA): 100 ng/mL
3,4-Methylenedioxyamphetamine (MDA): 100 ng/mL
Ephedrine: 100 ng/mL
Pseudoephedrine: 100 ng/mL
Phentermine: 100 ng/mL
Phencyclidine (PCP): 20 ng/mL
Methylphenidate: 20 ng/mL
Ritalinic acid: 100 ng/mL
ETHYL GLUCURONIDE SCREEN:
Negative
Screening cutoff concentrations:
Ethyl glucuronide: 500 ng/mL
Method Description
Adulterant:
All results are measured using spectrophotometry at wavelengths specified by the reagent manufacturer. The use of a refractometer may also be used in the specific gravity measurement.(Package inserts: Specimen Validity Test Creatinine. Roche Diagnostics; V3.0, 08/2015; Specimen Validity Test Nitrite. Roche Diagnostics; V3.0, 08/2018, Specimen Validity Test Oxidant. Roche Diagnostics; V 3.0, 08/2018; Specimen Validity Test pH Roche Diagnostics; V3.0, 02/2019, Specimen Validity Test Specific Gravity. Roche Diagnostics; V4.0, 08/2022)
Drug Panel:
The barbiturate, cocaine metabolite, and tetrahydrocannabinol metabolite assays are based on the kinetic interaction of microparticles in a solution as measured by changes in light transmission. In the absence of sample drug, soluble drug conjugates bind to antibody-bound microparticles, causing the formation of particle aggregates. As the aggregation reaction proceeds in the absence of sample drug, the absorbance increases. When a urine sample contains the drug in question, this drug competes with the drug derivative conjugate for microparticle-bound antibody. Antibody bound to sample drug is no longer available to promote particle aggregation, and subsequent particle lattice formation is inhibited. The presence of sample drug diminishes the increasing absorbance in proportion to the concentration of drug in the sample. Sample drug content is determined relative to the value obtained for a known cutoff concentration of drug.(Package inserts: BARB. Roche Diagnostics; V 13.0, 09/2021; THC2. Roche Diagnostics; V 13.0, 03/2022; COC2. Roche Diagnostics; V 9.0, 03/2019)
Targeted Screening Panels for opioids, benzodiazepines, and stimulants:
The urine sample is diluted with internal standard and clinical laboratory reagent water and then analyzed by liquid chromatography tandem mass spectrometry using a high-resolution accurate mass orbitrap detector.(Unpublished Mayo method)
Ethyl Glucuronide Screen:
This assay is a homogeneous enzyme-linked immunosorbent assay technique. The assay will be performed semiquantitatively. The assay is based on competition between free drug in the urine sample, and a drug labeled with the enzyme glucose-6-phosphate dehydrogenase for a fixed amount of specific antibody binding sites. Active enzyme converts nicotinamide adenine dinucleotide (NAD+) to NADH, which results in an absorbance change that can be measured spectrophotometrically at 340 nm.(Package insert: DRI Ethyl Glucuronide Assay. Microgenics Corporation; 09/2015)
Day(s) Performed
Monday through Saturday
Report Available
3 to 4 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
80307
80347
80364
80326
G0482 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CSMEU | CSM Enhanced Profile,21, HRMS/IA, U | 69739-1 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| LPCM | List Patient's Current Medications | 66423-5 |
| 610273 | Methamphetamine | 19554-5 |
| 20606 | Creatinine, U | 2161-8 |
| 2574 | Barbiturates | 70155-7 |
| 616033 | Ethyl Glucuronide Screen, U | 58375-7 |
| 604871 | Alprazolam | 94116-1 |
| 42323 | Codeine | 19411-8 |
| 42324 | Codeine-6-beta-glucuronide | 89310-7 |
| 604867 | Alpha-Hydroxyalprazolam | 19325-0 |
| 21652 | Cocaine | 19359-9 |
| 22312 | Specific Gravity | 5810-7 |
| 610274 | Amphetamine | 19343-3 |
| 610275 | 3,4-methylenedioxymethamphetamine (MDMA) | 19568-5 |
| 23509 | pH | 2756-5 |
| 2664 | Tetrahydrocannabinol | 19415-9 |
| 604891 | Alpha-Hydroxyalprazolam Glucuronide | 94115-3 |
| 42325 | Morphine | 19597-4 |
| 42326 | Morphine-6-beta-glucuronide | 89308-1 |
| 604872 | Chlordiazepoxide | 19385-4 |
| 23511 | Oxidants | 58714-7 |
| 610276 | 3,4-methylenedioxy-N-ethylamphetamine (MDEA) | 59844-1 |
| 610277 | 3,4-methylenedioxyamphetamine (MDA) | 19565-1 |
| 23510 | Nitrites | 32710-6 |
| 604889 | Clobazam | 94114-6 |
| 42327 | 6-monoacetylmorphine | 19321-9 |
| 42328 | Hydrocodone | 19482-9 |
| 604890 | N-Desmethylclobazam | 94113-8 |
| 30914 | Comment | 48767-8 |
| 610278 | Ephedrine | 99108-3 |
| 610279 | Pseudoephedrine | 99109-1 |
| 604873 | Clonazepam | 19399-5 |
| 42329 | Norhydrocodone | 89304-0 |
| 42330 | Dihydrocodeine | 19446-4 |
| 604267 | 7-aminoclonazepam | 94112-0 |
| 610280 | Phentermine | 19674-1 |
| 610281 | Phencyclidine (PCP) | 19659-2 |
| 604874 | Diazepam | 19443-1 |
| 42331 | Hydromorphone | 19486-0 |
| 42332 | Hydromorphone-3-beta-glucuronide | 89309-9 |
| 604880 | Nordiazepam | 19624-6 |
| 610282 | Methylphenidate | 19577-6 |
| 610283 | Ritalinic acid | 99110-9 |
| 604875 | Flunitrazepam | 19466-2 |
| 42333 | Oxycodone | 19642-8 |
| 42334 | Noroxycodone | 89303-2 |
| 604866 | 7-aminoflunitrazepam | 94111-2 |
| 610284 | Stimulant Interpretation | 54247-2 |
| 604876 | Flurazepam | 19474-6 |
| 42335 | Oxymorphone | 19646-9 |
| 42336 | Oxymorphone-3-beta-glucuronide | 89301-6 |
| 604868 | 2-Hydroxy Ethyl Flurazepam | 94110-4 |
| 604877 | Lorazepam | 19520-6 |
| 42337 | Noroxymorphone | 89302-4 |
| 42338 | Fentanyl | 59673-4 |
| 604878 | Lorazepam Glucuronide | 94109-6 |
| 604879 | Midazolam | 19585-9 |
| 42339 | Norfentanyl | 43199-9 |
| 42340 | Meperidine | 19532-1 |
| 604869 | Alpha-Hydroxy Midazolam | 94108-8 |
| 604881 | Oxazepam | 19638-6 |
| 42341 | Normeperidine | 27920-8 |
| 42342 | Naloxone | 42618-9 |
| 604882 | Oxazepam Glucuronide | 94107-0 |
| 604883 | Prazepam | 19678-2 |
| 42343 | Naloxone-3-beta-glucuronide | 89307-3 |
| 42344 | Methadone | 19550-3 |
| 604884 | Temazepam | 19698-0 |
| 604885 | Temazepam Glucuronide | 94106-2 |
| 42345 | EDDP | 93495-0 |
| 42346 | Propoxyphene | 19429-0 |
| 604886 | Triazolam | 19714-5 |
| 604870 | Alpha-Hydroxy Triazolam | 94105-4 |
| 42347 | Norpropoxyphene | 19632-9 |
| 42348 | Tramadol | 19710-3 |
| 604887 | Zolpidem | 94104-7 |
| 604888 | Zolpidem Phenyl-4-Carboxylic acid | 94103-9 |
| 42349 | O-desmethyltramadol | 86453-8 |
| 42350 | Tapentadol | 72485-6 |
| 604949 | Benzodiazepine Interpretation | 69050-3 |
| 42351 | N-desmethyltapentadol | 89306-5 |
| 42352 | Tapentadol-beta-glucuronide | 89300-8 |
| 42353 | Buprenorphine | 93494-3 |
| 42354 | Norbuprenorphine | 82371-6 |
| 42355 | Norbuprenorphine glucuronide | 89305-7 |
| 65059 | Opioid Interpretation | 69050-3 |
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-Renal Diagnostics Test Request (T830)
-Therapeutics Test Request (T831)