Expanded Urine Toxicology Panel (Pain Management Drug Testing Panel)

Label Mnemonic:	EXTOXU
Epic code:	LAB8951
Downtime form:	A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery

Commercial Mailout Laboratory
6240-8 RCP
356-8593

Specimen(s):

Urine

Collection Medium:

	and
Yellow top round bottom tube (no additive)	and	Yellow top round bottom tube (no additive)

Minimum:

Preferred Minimum: 4 mL each into TWO (2) Yellow top tubes with no additives or preservatives

Absolute Minimum: 2 mL each into TWO (2) Yellow top tubes with no additives or preservatives

Rejection Criteria:

Specimens exposed to repeated freeze/thaw cycles.

Turn Around Time:

1-3 days upon receipt at reference laboratory

Reference Range:

Effective February 16, 2021

Drugs covered and range of cutoff concentrations. Note: some 
drugs are identified based on the presence of unique drug metabolites 
not listed below.

Drugs/Drug Classes                                     Range of Cutoff
                                                       Concentrations

Barbiturates                                           200 ng/mL

Benzodiazepine-like: alprazolam, clonazepam,           20-60 ng/mL
  diazepam, lorazepam, midazolam, nordiazepam,
  oxazepam, temazepam, zolpidem

Cannabinoids (11-nor-9-carboxy-THC)                    20 ng/mL

Ethyl Glucuronide                                      500 ng/mL

Muscle Relaxant(s): carisoprodol, meprobamate          100 ng/mL

Opiates/Opioids: buprenorphine, codeine, fentanyl,     2-300 ng/mL
  heroin, hydrocodone, hydromorphone, meperidine, 
  methadone, morphine, naloxone, oxycodone, 
  oxymorphone, tapentadol, tramadol

GABA analogues:                                        100 ng/mL
  Gabapentin, pregabalin

Phencyclidine (PCP)                                    25 ng/mL

Stimulants: amphetamine, cocaine, methamphetamine,     50-400 ng/mL
  methylphenidate, MDMA (Ecstasy), MDEA (Eve), MDA,
  phentermine

Interpretive Data:

The absence of expected drug(s) and/or drug metabolite(s) may indicate noncompliance, inappropriate timing of specimen collection relative to drug administration, poor drug absorption, diluted/adulterated urine, or limitations of testing. The concentration must be greater than or equal to the cutoff concentration to be reported as present. If specific drug concentrations are required, contact the laboratory within two weeks of specimen collection to request confirmation and quantification by a second analytical technique. Interpretive questions should be directed to the laboratory.

Results based on immunoassay detection that do not match clinical expectations should be interpreted with caution. Confirmatory testing by mass spectrometry for immunoassay-based results is available, if ordered within two weeks of specimen collection. Additional charges apply.

For medical purposes only; not valid for forensic use.

Comments:

This test is known as Pain Management Drug Testing Panel (LAB8349) in specific order sets in Epic.

Note: Creatinine concentration is also provided. The carisoprodol immunoassay has cross-reactivity to carisoprodol and meprobamate.

Methodology:

Qualitative Liquid Chromatography-Tandem Mass Spectrometry/Enzyme Immunoassay/Quantitative Spectrophotometry

CPT Code:

80307x5

See Additional Information:
Urine Tests Requiring no Preservatives