Test Id : OXYSX
Oxycodone Screen, Chain of Custody, Random, Urine
Useful For
Suggests clinical disorders or settings where the test may be helpful
Detection of oxycodone and oxymorphone in urine following chain-of-custody procedures
This chain-of-custody test is intended to be used in a setting where the test results can be used definitively to make a 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.
Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| OXYCX | Oxycodone w/metabolite Conf, CoC, U | Yes | No |
Additional Tests
Lists tests that are always performed, at an additional charge, with the initial tests.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| COCH | Chain of Custody Processing | No | Yes |
| ADLTX | Adulterants Survey, CoC, U | Yes | Yes |
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Testing begins with screening assay. If oxycodone screen is positive, then the liquid chromatography tandem mass spectrometry confirmation with quantification will be performed at an additional charge.
Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
Method Name
A short description of the method used to perform the test
Immunoassay
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Oxycodone (Oxycontin, Percodan)
Oxycontin (Oxycodone)
Oxymorphone
Percodan (Oxycodone)
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Testing begins with screening assay. If oxycodone screen is positive, then the liquid chromatography tandem mass spectrometry confirmation with quantification will be performed at an additional charge.
Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
Specimen Type
Describes the specimen type validated for testing
Urine
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Supplies: Chain of Custody Kit (T282)
Container/Tube: Chain-of-Custody Kit containing the specimen containers, seals, and documentation is required.
Specimen Volume: 20 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.
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.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
2.5 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 14 days | |
| Ambient | 72 hours | ||
| Frozen | 14 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Detection of oxycodone and oxymorphone in urine following chain-of-custody procedures
This chain-of-custody test is intended to be used in a setting where the test results can be used definitively to make a 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.
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Testing begins with screening assay. If oxycodone screen is positive, then the liquid chromatography tandem mass spectrometry confirmation with quantification will be performed at an additional charge.
Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Opiates are the natural or synthetic drugs that have a morphine-like pharmacological action. Medically, opiates are used primarily for relief of pain. Opiates include morphine and drugs structurally similar to morphine (eg, codeine, hydrocodone, hydromorphone, oxycodone, oxymorphone).
Oxycodone is metabolized to noroxycodone, oxymorphone, and their glucuronides and is excreted primarily via the kidney. The presence of oxycodone greater than 100 ng/mL indicates exposure to oxycodone within 2 to 3 days prior to specimen collection.
Oxymorphone is metabolized in the liver and excreted via the kidney primarily as the glucuronide conjugates. Oxymorphone is also a metabolite of oxycodone and therefore the presence of oxymorphone could also indicate exposure to oxycodone.
Chain of custody is a record of the disposition of a specimen to document the individuals who collected, handled, and performed the analysis. When a specimen is submitted in this manner, analysis will be performed in such a way that it will withstand regular court scrutiny.
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Negative
Screening cutoff concentration:
Interpretation
Provides information to assist in interpretation of the test results
A positive result indicates that the patient has used the drugs detected in the recent past.
For information about drug testing, including estimated detection times, see Drug Class Testing on MayoClinicLabs.com.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Other drugs in the opioid class, such as fentanyl, meperidine, methadone, and opiate antagonists such as naloxone, are not detected.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Anderson DT, Fritz KL, Muto JJ. Oxycontin: the concept of a "ghost pill" and the postmortem tissue distribution of oxycodone in 36 cases. J Anal Toxicol. 2002;26(7):448-459
2. Jannetto PJ, Gock SG. Oxycodone: Recognition and Pharmacogenomics. Clinical and Forensic Toxicology News 2003 March
3. Cone EJ, Fant RV, Rohay JM, et al. Oxycodone involvement in drug abuse deaths: a DAWN-based classification scheme applied to an oxycodone postmortem database containing over 1000 cases. J Anal Toxicol. 2003;27(2):57-67. doi:10.1093/jat/27.2.57
4. Baselt RC, Cravey RH. Oxycodone. In: Disposition of Toxic Drugs and Chemicals in Man. 4th ed. Chemical Toxicology Institute. 1995;572-574
5. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 43
Method Description
Describes how the test is performed and provides a method-specific reference
Oxycodone and its metabolite, oxymorphone, are analyzed via immunoassay. The assay uses specific antibodies that can detect oxycodone and oxymorphone without any significant cross-reactivity to other opiate compounds. The assay is based on the competition between a drug labeled with glucose-6-phosphate dehydrogenase (G6PD) and free drug from the urine sample for a fixed amount of specific antibody binding sites. In the absence of free drug from the sample, the specific antibody binds the drug labeled with G6PD and causes a decrease in enzyme activity. This phenomenon creates a direct relationship between the drug concentration in urine and enzyme activity. The enzyme activity is determined spectrophotometrically at 340 nm by measuring the conversion of nicotinamide adenine dinucleotide (NAD) to NADH.(Package insert: OXY. Roche Diagnostics; V3.0, 08/2023)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Saturday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
80307
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| OXYSX | Oxycodone Screen, CoC, U | 19642-8 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| 61727 | Oxycodone | 19642-8 |
| 36027 | Chain of Custody | 77202-0 |