Additional Tests Included

Drugs tested for includes:
Benzoylecgonine Oxazepam
Amphetamine Temazepam
MDA Buprenorphine
MDMA Norbuprenorphine
Methamphetamine Fentanyl
Phentermine Norfentanyl
Phencyclidine Codeine
6-MAM Hydrocodone
Methadone Dihydrocodeine
EDDP Hydromorphone
7-Aminoclonazepam Morphone
Alprazolam Naxalone
alpha-Hydroxyalprazolam Naltrexone
Chlordiazepoxide Oxycodone
Clobazam Oxymorphone
Diazepam Tapentadol
Nordiazepam N-Desmethyltapentadol
Estazolam Tramadol
Desalkylflurazepam N-desmethyltramadol
2-Hydroxyethylflurazepam alpha-Hydroxytriazolamalpha-Hydroxytriazolamalpha-Hydroxytriazolam
Lorazepam Midazolam
alpha-Hydroxymidazolam  

Collection Container

Collect

5 mL urine, non-additive clear top tube or container
Minimum volume: 1 mL

Storage/Transport Temperature

Room temperature

Stability (from collection to initiation)

Room temperature: 1 Week

Unacceptable Conditions

QNS; Container with preservatives or additives

Remarks

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.

Processing - HUP

Deliver directly to Toxicology laboratory.

Reference Interval

Not detected

Interpretive Data

      Cutoff Concentration
Drugs of Abuse (DOA) 1 Benzoylecgonine 100
2 Amphetamine 100100
3 MDA 100
4 MDMA 100
5 Methamphetamine 100
6 Phentermine 100
7 Phencyclidine 15
8 6-MAM 20
9 Methadone 100
10 EDDP 100
Benzodiazepines 11 7-Aminoclonazepam 100
12 Alprazolam 100
13 alpha-Hydroxyalprazolam 100
14 Chlordiazepoxide 100
15 Clobazam 100
16 Diazepam 100
17 Nordiazepam 100
18 Estazolam 100
19 Desalkylflurazepam 100
20 2-Hydroxyethylflurazepam 100
21 alpha-Hydroxytriazolam 100
22 Lorazepam 100
23 Midazolam 100
24 alpha-Hydroxymidazolam 100
25 Oxazepam 100
26 Temazepam 100
Opiates 27 Buprenorphine 25
28 Norbuprenorphine 25
29 Fentanyl 2
30 Norfentanyl 10
31 Codeine 100
32 Hydrocodone 100
33 Dihydrocodeine 100
34 Hydromorphone 100
35 Morphone 100
36 Naxalone 100
37 Naltrexone 100
38 Oxycodone 100
39 Oxymorphone 100
40 Tapentadol 100
41 N-Desmethyltapentadol 100
42 Tramadol 100
43 N-desmethyltramadol 100

Clinical Significance

Used to monitor compliance or drug abuse in pain management population.

News and Updates

To: Members of UPHS Clinical Staff
 
From: Leslie M Shaw, PhD and Michael C Milone, MD, PhD
 
Date: October 22, 2018
 
Re: New Pain Management Drug Analysis test procedure

_______________________________________________________________________________________
 
New Pain Management Drug Analysis procedure effective October 22, 2018
 
The Toxicology laboratory has validated and implemented a new Pain Management Drug Analysis test procedure using liquid chromatography-tandem mass spectrometry (LC-MSMS) that will detect the presence of 44 drugs and metabolites in urine including 11 drugs of abuse, 17 opioids and 16 benzodiazepines (see table below).
 
This testing procedure replaces and expands upon the current Pain Management tests that includes a combination of urine drug testing using 10 immunoassays(DA10), the Opiate confirmatory testing by LC-MSMS and additional confirmation testing by GC-MS.  The new Pain Management Drug Analysis procedure has a high degree of specificity and sensitivity, for all of the 44 drugs and metabolites and uses a single LC-MSMS test methodology.
 
Result reporting includes the cutoff concentration values for each of the 44 analytes.  The 11 drugs of abuse are reported as qualitative results similar to the current immunoassay-based screening approach.  Opioids and benzodiazepines will be reported with quantitative concentration results which should aid in result interpretation.  Ethanol testing is done as in the past using a specific alcohol dehydrogenase enzyme assay and the report will include ethanol presence or absence as well as its cutoff value.  For many of the analytes, standardized interpretative comments will also be provided.
 
The enhanced sensitivity of the LC-MSMS methodology provides for lowered cutoff concentrations for most of the 44 analytes as compared to the immunoassay-based cutoffs.  These lower detection thresholds may result in changes to typical urine drug screening results for some patients undergoing monitoring when compared with the immunoassay-based screening approach.
_______________________________________________________________________________________
 
EPIC Ordering information:
 
TEST CODE is DAPM; TEST NAME is DRUG ANALYSIS, PAIN MANAGEMENT
 
Please feel free to contact us regarding the new Pain Management Drug Analysis testing procedure.
 
Contact information:
 
Clinical Chemistry resident:215-980-9770
Leslie M Shaw
Email: Les.Shaw@uphs.upenn.edu
Cell phone: 267-251-8901
 
Michael C Milone
Email: Michael.Milone@uphs.upenn.edu
Cell phone: 215-900-4954
 
 The Table below includes the tests for 11 Drugs of Abuse, 17 Opioids & metabolites and 16 Benzodiazepines & metabolites included in the new Pain Management Drug Analysis procedure.
 
DOA OPIOIDS BENZODIAZEPINES
Benzoylecognine Buprenorphine Naloxone Alprazolam Desalkylflurazepam
Amphetamine nor-Buprenorphine Naltrexone α-hydroxyalprazolam 2-Hydroxyethylflurazepam
Methamphetamine Codeine Oxycodone 7-aminoclonazepam α-Hydroxytriazolam
MDMA Dihydrocodeine Oxymorphone Chlordiazepoxide Lorazepam
MDA Fentanyl Tapentadol Clobazam Midazolam
6-MAM nor-Fentanyl N-desmethyltapentadol Diazepam α-hydroxymidazolam
Phentermine Hydrocodone cis-tramadol nor-Diazepam Oxazepam
PCP Morphine N-desmethyltramadol Estazolam Temazepam
THC Hydromorphone      
Methadone        
EDDP        

CPT Codes

G0483

LOINC

  • 5644-0 x2
  • 18282-4 x2
  • 14315-6
  • 19344-1
  • 19566-9
  • 19569-3
  • 19555-2
  • 16222-2
  • 18392-1
  • 51776-3
  • 59615-5
  • 16348-5
  • 59635-3
  • 16227-1
  • 16228-9 x2
  • 59668-4
  • 19619-6
  • 19495-1
  • 49876-6
  • 17088-6
  • 16233-9
  • 20522-9
  • 16201-6
  • 20559-1
  • 19593-3
  • 49752-9
  • 49751-1
  • 3637-6
  • 11075-9
  • 3508-9
  • 3681-4
  • 19448-0
  • 9835-0
  • 3831-5
  • 19553-7
  • 58429-2
  • 77207-9
  • 19610-5
  • 11246-6
  • 17395-5
  • 77879-5
  • 81754-4
  • 19713-7
  • 18339-2
Collection & Processing

Additional Tests Included

Drugs tested for includes:
Benzoylecgonine Oxazepam
Amphetamine Temazepam
MDA Buprenorphine
MDMA Norbuprenorphine
Methamphetamine Fentanyl
Phentermine Norfentanyl
Phencyclidine Codeine
6-MAM Hydrocodone
Methadone Dihydrocodeine
EDDP Hydromorphone
7-Aminoclonazepam Morphone
Alprazolam Naxalone
alpha-Hydroxyalprazolam Naltrexone
Chlordiazepoxide Oxycodone
Clobazam Oxymorphone
Diazepam Tapentadol
Nordiazepam N-Desmethyltapentadol
Estazolam Tramadol
Desalkylflurazepam N-desmethyltramadol
2-Hydroxyethylflurazepam alpha-Hydroxytriazolamalpha-Hydroxytriazolamalpha-Hydroxytriazolam
Lorazepam Midazolam
alpha-Hydroxymidazolam  

Collection Container

Collect

5 mL urine, non-additive clear top tube or container
Minimum volume: 1 mL

Storage/Transport Temperature

Room temperature

Stability (from collection to initiation)

Room temperature: 1 Week

Unacceptable Conditions

QNS; Container with preservatives or additives

Remarks

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

Processing - HUP

Deliver directly to Toxicology laboratory.
Result Interpretation

Reference Interval

Not detected

Interpretive Data

      Cutoff Concentration
Drugs of Abuse (DOA) 1 Benzoylecgonine 100
2 Amphetamine 100100
3 MDA 100
4 MDMA 100
5 Methamphetamine 100
6 Phentermine 100
7 Phencyclidine 15
8 6-MAM 20
9 Methadone 100
10 EDDP 100
Benzodiazepines 11 7-Aminoclonazepam 100
12 Alprazolam 100
13 alpha-Hydroxyalprazolam 100
14 Chlordiazepoxide 100
15 Clobazam 100
16 Diazepam 100
17 Nordiazepam 100
18 Estazolam 100
19 Desalkylflurazepam 100
20 2-Hydroxyethylflurazepam 100
21 alpha-Hydroxytriazolam 100
22 Lorazepam 100
23 Midazolam 100
24 alpha-Hydroxymidazolam 100
25 Oxazepam 100
26 Temazepam 100
Opiates 27 Buprenorphine 25
28 Norbuprenorphine 25
29 Fentanyl 2
30 Norfentanyl 10
31 Codeine 100
32 Hydrocodone 100
33 Dihydrocodeine 100
34 Hydromorphone 100
35 Morphone 100
36 Naxalone 100
37 Naltrexone 100
38 Oxycodone 100
39 Oxymorphone 100
40 Tapentadol 100
41 N-Desmethyltapentadol 100
42 Tramadol 100
43 N-desmethyltramadol 100

Clinical Significance

Used to monitor compliance or drug abuse in pain management population.
Testing Updates

News and Updates

To: Members of UPHS Clinical Staff
 
From: Leslie M Shaw, PhD and Michael C Milone, MD, PhD
 
Date: October 22, 2018
 
Re: New Pain Management Drug Analysis test procedure

_______________________________________________________________________________________
 
New Pain Management Drug Analysis procedure effective October 22, 2018
 
The Toxicology laboratory has validated and implemented a new Pain Management Drug Analysis test procedure using liquid chromatography-tandem mass spectrometry (LC-MSMS) that will detect the presence of 44 drugs and metabolites in urine including 11 drugs of abuse, 17 opioids and 16 benzodiazepines (see table below).
 
This testing procedure replaces and expands upon the current Pain Management tests that includes a combination of urine drug testing using 10 immunoassays(DA10), the Opiate confirmatory testing by LC-MSMS and additional confirmation testing by GC-MS.  The new Pain Management Drug Analysis procedure has a high degree of specificity and sensitivity, for all of the 44 drugs and metabolites and uses a single LC-MSMS test methodology.
 
Result reporting includes the cutoff concentration values for each of the 44 analytes.  The 11 drugs of abuse are reported as qualitative results similar to the current immunoassay-based screening approach.  Opioids and benzodiazepines will be reported with quantitative concentration results which should aid in result interpretation.  Ethanol testing is done as in the past using a specific alcohol dehydrogenase enzyme assay and the report will include ethanol presence or absence as well as its cutoff value.  For many of the analytes, standardized interpretative comments will also be provided.
 
The enhanced sensitivity of the LC-MSMS methodology provides for lowered cutoff concentrations for most of the 44 analytes as compared to the immunoassay-based cutoffs.  These lower detection thresholds may result in changes to typical urine drug screening results for some patients undergoing monitoring when compared with the immunoassay-based screening approach.
_______________________________________________________________________________________
 
EPIC Ordering information:
 
TEST CODE is DAPM; TEST NAME is DRUG ANALYSIS, PAIN MANAGEMENT
 
Please feel free to contact us regarding the new Pain Management Drug Analysis testing procedure.
 
Contact information:
 
Clinical Chemistry resident:215-980-9770
Leslie M Shaw
Email: Les.Shaw@uphs.upenn.edu
Cell phone: 267-251-8901
 
Michael C Milone
Email: Michael.Milone@uphs.upenn.edu
Cell phone: 215-900-4954
 
 The Table below includes the tests for 11 Drugs of Abuse, 17 Opioids & metabolites and 16 Benzodiazepines & metabolites included in the new Pain Management Drug Analysis procedure.
 
DOA OPIOIDS BENZODIAZEPINES
Benzoylecognine Buprenorphine Naloxone Alprazolam Desalkylflurazepam
Amphetamine nor-Buprenorphine Naltrexone α-hydroxyalprazolam 2-Hydroxyethylflurazepam
Methamphetamine Codeine Oxycodone 7-aminoclonazepam α-Hydroxytriazolam
MDMA Dihydrocodeine Oxymorphone Chlordiazepoxide Lorazepam
MDA Fentanyl Tapentadol Clobazam Midazolam
6-MAM nor-Fentanyl N-desmethyltapentadol Diazepam α-hydroxymidazolam
Phentermine Hydrocodone cis-tramadol nor-Diazepam Oxazepam
PCP Morphine N-desmethyltramadol Estazolam Temazepam
THC Hydromorphone      
Methadone        
EDDP        
Billing Codes

CPT Codes

G0483

LOINC

  • 5644-0 x2
  • 18282-4 x2
  • 14315-6
  • 19344-1
  • 19566-9
  • 19569-3
  • 19555-2
  • 16222-2
  • 18392-1
  • 51776-3
  • 59615-5
  • 16348-5
  • 59635-3
  • 16227-1
  • 16228-9 x2
  • 59668-4
  • 19619-6
  • 19495-1
  • 49876-6
  • 17088-6
  • 16233-9
  • 20522-9
  • 16201-6
  • 20559-1
  • 19593-3
  • 49752-9
  • 49751-1
  • 3637-6
  • 11075-9
  • 3508-9
  • 3681-4
  • 19448-0
  • 9835-0
  • 3831-5
  • 19553-7
  • 58429-2
  • 77207-9
  • 19610-5
  • 11246-6
  • 17395-5
  • 77879-5
  • 81754-4
  • 19713-7
  • 18339-2

Ordering Information

Cerner Orderable
DAPM
Penn Chart Orderable
Drug Analysis, Pain Management; DAPM
Performing Lab
Toxicology
Performed
Monday - Friday
Reported
3 Days
Methodology
LC/MS/MS, Immunoassay
Synonyms
  • DAPM

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