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Orderable Name PMHPU Pain Management Hybrid Profile, 22 Drug Classes, High-Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine


Ordering Guidance


This 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.


Useful For

Detecting drug use involving stimulants, barbiturate, benzodiazepines, cocaine, opioids, tetrahydrocannabinol, gabapentinoids, and alcohol.

 

Clinical monitoring or management of patients

 

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
LDPU Limited Drug Panel, 3, IA, U No Yes
TOPU Targeted Opioid MS Screen, U Yes, (Order TOSU) Yes
TABSU Targeted Benzodiazepine Screen, U Yes, (Order TBSU) Yes
TSIM Gabapentinoid/Stim MS Screen, U Yes, (Order TGSU) Yes
ETGSR Ethyl Glucuronide Scrn w/Reflex, U No Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
ETGC Ethyl Glucuronide 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.

 

Positive results can be confirmed and quantitated by definitive methods: gas chromatography mass spectrometry for barbiturates, cocaine and metabolites and liquid chromatography tandem mass spectrometry for tetrahydrocannabinol metabolites. Ethyl glucuronide/ethyl sulfate confirmation will be performed at an additional charge.

Method Name

ADULT: Spectrophotometry (SP)

ETGSR, LDPU: Immunoassay

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

Specimen Type

Urine

Specimen Minimum Volume

20 mL

Specimen Stability Information

Specimen Type Temperature Time
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

 

LIMITED DRUG PROFILE, 3 DRUG CLASSES, IMMUNOASSAY PANEL:

Negative

Screening cutoff concentrations:

Barbiturates: 200 ng/mL

Cocaine (benzoylecgonine-cocaine metabolite): 150 ng/mL

Tetrahydrocannabinol carboxylic acid: 50 ng/mL

 

TARGETED OPIOID MASS SPECTROMETRY SCREEN:

Not detected (Positive results are reported with qualitative "Present" results)

 

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

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 MASS SPECTROMETRY SCREEN:

Not detected (Positive results are reported with qualitative "Present" results)

 

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 GABAPENTINOID AND STIMULANT MASS SPECTROMETRY SCREEN:

Not detected (Positive results are reported with qualitative "Present" results)

 

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

Gabapentin: 500 ng/mL

Pregabalin: 500 ng/mL

 

ETHYL GLUCURONIDE SCREEN:

Negative

Screening cutoff concentrations:

Ethyl glucuronide: 500 ng/mL

Day(s) Performed

Monday through Saturday

Report Available

3 to 4 days

CPT Code Information

G0482

80307

80364 (if appropriate for select payers)

80347 (if appropriate for select payers)

80326 (if appropriate for select payers)

80321 (if appropriate for select payers)

Clinical Toxicology CPT Code Client Guidance