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HelpOrder Code PANOX Pain Clinic Survey 10, Chain of Custody, Random, Urine
Useful For
Detecting drug use involving amphetamines, barbiturates, benzodiazepines, cocaine, methadone, opiates, phencyclidine, and tetrahydrocannabinol
This chain-of-custody test is intended to be used in a setting where the test results can be used to make a definitive diagnosis. Chain of custody is required whenever the results of testing could be used in a court of law. Its purpose is to protect the rights of the individual contributing the specimen by demonstrating that it was always under the control of personnel involved with testing the specimen; this control implies that the opportunity for specimen tampering would be limited.
This test is not intended for use in employment-related testing.
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| PN10X | Pain Clinic Survey 10, CoC | No | Yes |
| OXYSX | Oxycodone Screen, CoC, U | Yes | Yes |
Additional Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| COCH | Chain of Custody Processing | No | Yes |
| ADLTX | Adulterants Survey, CoC, U | Yes | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| AMPHX | Amphetamines Confirmation, CoC, U | Yes | No |
| COKEX | Cocaine and metabolite Conf, CoC, U | Yes | No |
| BARBX | Barbiturates Confirmation, CoC, U | Yes | No |
| MTDNX | Methadone Confirmation, CoC, U | Yes | No |
| PCPX | Phencyclidine Confirmation, CoC, U | Yes | No |
| THCX | Carboxy-THC Confirmation, CoC, U | Yes | No |
| OPATX | Opiate Confirmation, CoC, U | Yes | No |
| OXYCX | Oxycodone w/metabolite Conf, CoC, U | Yes | No |
| BNZX | Benzodiazepines Conf, CoC, U | Yes | No |
Testing Algorithm
Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods (gas chromatography mass spectrometry for barbiturates, cocaine and metabolites, methadone, and phencyclidine) at an additional charge. Amphetamines, benzodiazepines, opiates, and tetrahydrocannabinol metabolite that screen positive will be quantified with liquid chromatography tandem mass spectrometry at an additional charge.
Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
Reporting Name
Pain Clinic Survey 10, CoC, USpecimen Type
UrineSpecimen Required
Supplies: Chain of Custody Kit (T282)
Container/Tube: Chain-of-Custody Kit containing the specimen containers, seals, and documentation is required.
Specimen Volume: 30 mL
Collection Instructions: Collect a random specimen without preservative in the container provided, seal, and submit with the associated documentation to satisfy the legal requirements for chain-of-custody testing.
Additional Information: Submitting less than 30 mL will compromise the ability to perform all necessary testing.
Specimen Minimum Volume
20 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 7 days | |
| Frozen | 14 days |
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Reference Values
Negative
Screening cutoff concentrations
Amphetamines: 500 ng/mL
Barbiturates: 200 ng/mL
Benzodiazepines: 100 ng/mL
Cocaine (benzoylecgonine-cocaine metabolite): 150 ng/mL
Methadone metabolite: 300 ng/mL
Opiates: 300 ng/mL
Phencyclidine: 25 ng/mL
Tetrahydrocannabinol carboxylic acid: 50 ng/mL
This report is intended for use in clinical monitoring or management of patients. It is not intended for use in employment-related testing.
Method Description
Adulterant:
All results are measured using spectrophotometry at wavelengths specified by the reagent manufacturer. The use of a refractometer may also be used in the specific gravity measurement.(Package inserts: Specimen Validity Test Creatinine. Roche Diagnostics; V3.0, 08/2015; Specimen Validity Test Nitrite. Roche Diagnostics; V3.0, 08/2018, Specimen Validity Test Oxidant. Roche Diagnostics; V 3.0, 08/2018; Specimen Validity Test pH Roche Diagnostics; V3.0, 02/2019, Specimen Validity Test Specific Gravity. Roche Diagnostics; V4.0, 08/2022)
The amphetamines, barbiturates, benzodiazepines, cocaine, methadone metabolite, opiates, phencyclidine, and tetrahydrocannabinol metabolite assays are based on the kinetic interaction of microparticles in a solution as measured by changes in light transmission. In the absence of sample drug, soluble drug conjugates bind to antibody-bound microparticles causing the formation of particle aggregates. As the aggregation reaction proceeds in the absence of sample drug, the absorbance increases. When a urine sample contains the drug in question, this drug competes with the drug derivative conjugate for microparticle-bound antibody. Antibody bound to sample drug is no longer available to promote particle aggregation, and subsequent particle lattice formation is inhibited. The presence of sample drug diminishes the increasing absorbance in proportion to the concentration of drug in the sample. Sample drug content is determined relative to the value obtained for a known cutoff concentration of drug.(Package inserts: AMPS2. Roche Diagnostics; V 10.0, 09/2018; BARB. Roche Diagnostics; V 13.0, 09/2021; THC2. Roche Diagnostics; V 13.0, 03/2022; BNZ2. Roche Diagnostics; V 2.0, 04/2024; COC2. Roche Diagnostics; V 9.0, 03/2019; OPI2. Roche Diagnostics; V 16.0, 01/2022; PCP. Roche Diagnostics; V 13.0, 09/2021; EDDP Specific Urine Enzyme Immunoassay, Immunalysis Corp; 09/2018)
Day(s) Performed
Monday through Saturday
Performing Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
80307
Method Name
Immunoassay followed by Gas Chromatography Mass Spectrometry (GC-MS) or Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS) as needed
Forms
1. Chain of Custody Request is included in the Chain-of-Custody Kit (T282).
2. If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.