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Test Code LAB9554 Controlled Substance Monitoring Panel, Random, Urine

Additional Codes

SQ: CSMPM

MAYO: CSMPU


Ordering Guidance


The 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

610271

Useful For

Detecting drug use involving stimulants, barbiturates, benzodiazepines, cocaine, opioids, and tetrahydrocannabinol

 

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

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

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 immunoassay screen is positive, confirmation is performed. Confirmation with quantification of positive results for barbiturates, cocaine and metabolites, and tetrahydrocannabinol metabolite will be performed at an additional charge.

Method Name

ADULT: Spectrophotometry

PNRCH: Immunoassay followed by Gas Chromatography Mass Spectrometry (GC-MS) as needed

TOPSU, TABSU, TSTIM: Liquid Chromatography Tandem Mass Spectrometry, High-Resolution Accurate Mass (LC-MS/MS HRAM)

Reporting Name

Controlled Substance Monitoring, U

Specimen Type

Urine

Specimen 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

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 Immunoassay 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)

Performing 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

80364

80347

80307

80326

G0482 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CSMPU Controlled Substance Monitoring, 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
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

Day(s) Performed

Monday through Saturday

Report Available

3 to 4 days

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-General Request (T239)

-Therapeutics Test Request (T831)