Tests included in level 1 drug screen:
Amphetamines
Barbiturates
Benzodiazapines
Cocaine metabolite
Ethanol
Methadone
Opiates (including Oxycodone)
PCP
Tetrahydrocannibinol (THC)
Positive results will be confirmed through reflex ordering of confirmation test.
Ordering Recommendations
Urine screen includes Level 1 (drugs of abuse panel) and Level 2 (GC/MS analysis); Pathology resident approval is required for level 2 testing.
Used to test for drug of abuse usage in Level 1 and unknown drugs in Level 2.
Inpatient Approval Requirements
Approval is required for Level 2 screening. Comprehensive Gas Chromatography/Mass Spectrometry analysis for unknown drugs may be requested by calling the Clinical Chemistry Resident on call.
Collection Container
Collect
6 mL random urine, non-additive urine tube Do NOT send urine cup - sample must be poured off into non-additive urine tube with secure lid.
Pediatric Collection
0.5 mL for Level 1; 5 mL for Level 2
Storage/Transport Temperature
Room Temperature
Stability (from collection to initiation)
Stable at room temperature for 7 days, and refrigerated for 45 days.
Unacceptable Conditions
Specimens in preservatives
Remarks
Level 2 screening: This test was developed and its performance characteristics determined by the University of Pennsylvania Medical Center, Department of Pathology and Laboratory Medicine. It has not been cleared or approved by the US Food and Drug Administration; however, FDA clearance or approval is not currently required for clinical use.
Interpretive Data and Information
Positive results in Level 1 are screening results only and are confirmed by GC/MS or LC/MS/MS by reflex testing. Confirmation testing for positive results can include amphetamine confirmation, cocaine confirmation, methadone confirmation, opiate confirmation and PCP confirmation. Benzodiazepine and THC confirmation are performed upon request. Unconfirmed screening results must not be used for non-medical purposes (e.g., employment testing, legal testing). Unless indicated, the results of all screening tests for drugs of abuse will be confirmed by another chemical method (e.g., gas chromatography with mass spectrometry detection) and reported separately; however, the benzodiazepine drug class screening results are not routinely confirmed. Cutoff concentrations used for drugs of abuse screening:
Amphetamines including MDMA (ecstasy) 500 ng/mL
Barbiturates 200 ng/mL
Benzodiazapines 200 ng/mL
Cocaine metabolite 300 ng/mL
Ethanol 10 mg/dl
Methadone 300 ng/mL
Opiates (including Oxycodone) 300 ng/mL
PCP 25 ng/mL
Tetrahydrocannibinol (THC) 50 ng/mL
Additional Information: Screening for drugs of abuse is performed by immunoassays that detect a drug, drug metabolite or drug class. The concentration at which the screening test can detect a drug or metabolite varies within a drug class. The urine drug concentration must be greater than or equal to the cut-off concentration to be reported as positive. The ethanol screening test, an alcohol dehydrogenase enzymatic test, is selective for ethyl alcohol. For any questions regarding these screening tests or to request benzodiazepine confirmation test, please contact the Toxicology Laboratory at 215-662-3474 or the Clinical Chemistry Resident at 215-980-9770.
CPT Codes
80307; 80377
LOINC
3349-8
3377-9
3390-2
3393-6
34819-3
5644-0
3773-9
3879-4
10998-3
3936-2
3427-2
Collection & Processing
Additional Tests Included
Tests included in level 1 drug screen:
Amphetamines
Barbiturates
Benzodiazapines
Cocaine metabolite
Ethanol
Methadone
Opiates (including Oxycodone)
PCP
Tetrahydrocannibinol (THC)
Positive results will be confirmed through reflex ordering of confirmation test.
Ordering Recommendations
Urine screen includes Level 1 (drugs of abuse panel) and Level 2 (GC/MS analysis); Pathology resident approval is required for level 2 testing.
Used to test for drug of abuse usage in Level 1 and unknown drugs in Level 2.
Inpatient Approval Requirements
Approval is required for Level 2 screening. Comprehensive Gas Chromatography/Mass Spectrometry analysis for unknown drugs may be requested by calling the Clinical Chemistry Resident on call.
Collection Container
Collect
6 mL random urine, non-additive urine tube Do NOT send urine cup - sample must be poured off into non-additive urine tube with secure lid.
Pediatric Collection
0.5 mL for Level 1; 5 mL for Level 2
Storage/Transport Temperature
Room Temperature
Stability (from collection to initiation)
Stable at room temperature for 7 days, and refrigerated for 45 days.
Unacceptable Conditions
Specimens in preservatives
Remarks
Level 2 screening: This test was developed and its performance characteristics determined by the University of Pennsylvania Medical Center, Department of Pathology and Laboratory Medicine. It has not been cleared or approved by the US Food and Drug Administration; however, FDA clearance or approval is not currently required for clinical use.
CR&P Information
Result Interpretation
Interpretive Data and Information
Positive results in Level 1 are screening results only and are confirmed by GC/MS or LC/MS/MS by reflex testing. Confirmation testing for positive results can include amphetamine confirmation, cocaine confirmation, methadone confirmation, opiate confirmation and PCP confirmation. Benzodiazepine and THC confirmation are performed upon request. Unconfirmed screening results must not be used for non-medical purposes (e.g., employment testing, legal testing). Unless indicated, the results of all screening tests for drugs of abuse will be confirmed by another chemical method (e.g., gas chromatography with mass spectrometry detection) and reported separately; however, the benzodiazepine drug class screening results are not routinely confirmed. Cutoff concentrations used for drugs of abuse screening:
Amphetamines including MDMA (ecstasy) 500 ng/mL
Barbiturates 200 ng/mL
Benzodiazapines 200 ng/mL
Cocaine metabolite 300 ng/mL
Ethanol 10 mg/dl
Methadone 300 ng/mL
Opiates (including Oxycodone) 300 ng/mL
PCP 25 ng/mL
Tetrahydrocannibinol (THC) 50 ng/mL
Additional Information: Screening for drugs of abuse is performed by immunoassays that detect a drug, drug metabolite or drug class. The concentration at which the screening test can detect a drug or metabolite varies within a drug class. The urine drug concentration must be greater than or equal to the cut-off concentration to be reported as positive. The ethanol screening test, an alcohol dehydrogenase enzymatic test, is selective for ethyl alcohol. For any questions regarding these screening tests or to request benzodiazepine confirmation test, please contact the Toxicology Laboratory at 215-662-3474 or the Clinical Chemistry Resident at 215-980-9770.
Testing Updates
Billing Codes
CPT Codes
80307; 80377
LOINC
3349-8
3377-9
3390-2
3393-6
34819-3
5644-0
3773-9
3879-4
10998-3
3936-2
3427-2
Ordering Information
Cerner Orderable
UR DRUG
Penn Chart Orderable
DRUG SCREEN, URINE LEVEL 1 AND LEVEL 2 WITH REFLEX CONFIRMATIONS, C7002602
