The Clinical Chemistry laboratory currently offers two panels for drug of abuse-urine (DAU) screening that use immunoassays:

"DRUG OF ABUSE – URINE"	[EPIC # LAB500]
"DRUG OF ABUSE – URINE + CONFIRM"	[EPIC # LAB1032]

Effective Monday, April 12, 2010, the following changes will occur to the DAU immunoassay panels:

1. THC will no longer be part of the routine DAU panels. For those who wish to screen for THC, individual tests for THC will instead be available for ordering within Epic:

a. THC-URINE SCREEN	[EPIC # LAB5203]
b. THC-URINE SCREEN + REFLEX CONFIRMATION*	[EPIC # LAB7388]
*Reflexes to confirmatory mail-out test if immunoassay screen is positive

2. A screening test for oxycodone/oxymorphone will be added to the routine panel. Oxycodone and its metabolite oxymorphone are not detected by the opiates screen. The oxycodone screen has a cutoff of 300 ng/mL and does not cross-react with opiates other than oxycodone or oxymorphone. The "new" DAU panel will thus consist of the following six tests:

Amphetamines

Barbiturates

Benzodiazepines

Cocaine

Opiates

Oxycodone/oxymorphone

3. The individual components of the DAU panel will now also be available as individually orderable tests, allowing for ordering of a more limited set of drug of abuse screens instead of the full DAU panel, if desired.

a. AMPHETAMINES-URINE SCREEN	[EPIC # LAB7381]
b. BARBITURATES-URINE SCREEN	[EPIC # LAB7382]
c. BENZODIAZEPINES-URINE SCREEN	[EPIC # LAB7383]
d. COCAINE-URINE SCREEN	[EPIC # LAB7384]
e. OPIATES-URINE SCREEN	[EPIC # LAB7385]
f. OXYCODONE-URINE SCREEN	[EPIC # LAB7386]

Each drug of abuse screening test has the same CPT code (80101) associated with it and thus billing charges are determined by the total number of individual drug of abuse screening tests performed, not by a single charge associated with a panel. This means that the removal of the THC screen from the routine DAU panel and addition of the oxycodone/oxymorphone screen results in no net change in charges, as there are still six drugs of abuse assays in the panel.

The attached pdf document ("Extra_DAU_testing_information") includes additional detailed information on drug of abuse screening issues such as cross-reactivity, false negatives, false positives, send-out confirmatory testing, and frequently asked questions (e.g., “can passive inhalation of marijuana smoke cause a positive THC screen?”).

For questions regarding these changes, contact Matthew Krasowski, MD, PhD, Medical Director of Clinical Chemistry (ext. 4-9380 or pager 1171).