Test Id : TABSU
Targeted Benzodiazepine Screen, Random, Urine
    
        Useful For
            
                
                
                    
                    Suggests clinical disorders or settings where the test may be helpful
                
            
    
    Qualitatively (present vs not detected) identifying 27 benzodiazepine compounds (parent drug and metabolites) in urine to help determine compliance or identify illicit benzodiazepine drug use
 
This test is not intended for employment-related testing.
    
        Method Name
            
                
                
                    
                    A short description of the method used to perform the test
                
            
    
    Only orderable as part of profile. For more information see:
-CSMPU / Controlled Substance Monitoring Panel, Random, Urine
-ADMPU / Addiction Medicine Profile with Reflex, 22 Drug Classes, High Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine
-CSMEU / Controlled Substance Monitoring Enhanced Profile with Reflex, 21 Drug Classes, High Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine
-CSMTU / Controlled Substance Monitoring Targeted Profile, 17 Drug Classes, Mass Spectrometry, Random, Urine
-TBSU / Targeted Benzodiazepine Screen, Random, Urine
Liquid Chromatography Tandem Mass Spectrometry, High-Resolution Accurate Mass (LC-MS/MS HRAM)
    
        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
                
            
    
    
    
        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
                
            
    
    Only orderable as part of profile. For more information see:
-CSMPU / Controlled Substance Monitoring Panel, Random, Urine
-ADMPU / Addiction Medicine Profile with Reflex, 22 Drug Classes, High Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine
-CSMEU / Controlled Substance Monitoring Enhanced Profile with Reflex, 21 Drug Classes, High Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine
-CSMTU / Controlled Substance Monitoring Targeted Profile, 17 Drug Classes, Mass Spectrometry, Random, Urine
-TBSU / Targeted Benzodiazepine Screen, Random, Urine
Supplies: Sarstedt Aliquot Tube 5 mL (T914)
Collection Container/Tube: Plastic urine container
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative
    
        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.
                
            
    
    0.5 mL
    
        Reject Due To
            
                
                
                    
                    Identifies specimen types and conditions that may cause the specimen to be rejected
                
            
    
    | Gross hemolysis | Reject | 
| Gross icterus | Reject | 
    
        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 | 28 days | 
    
        Useful For
            
                
                
                    
                    Suggests clinical disorders or settings where the test may be helpful
                
            
    
    Qualitatively (present vs not detected) identifying 27 benzodiazepine compounds (parent drug and metabolites) in urine to help determine compliance or identify illicit benzodiazepine drug use
 
This test is not intended for employment-related testing.
    
        Clinical Information
            
                
                
                    
                    Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
                
            
    
    Benzodiazepines represent a large family of medications used to treat a wide range of disorders from anxiety to seizures, and they are also used in pain management. With a high risk for abuse/diversion, professional practice guidelines recommend compliance monitoring for these medications using urine drug tests. However, traditional benzodiazepine immunoassays suffer from a lack of cross-reactivity with all the benzodiazepines, so many compliant patients taking either clonazepam (Klonopin) or lorazepam (Ativan) may screen negative by immunoassay but are positive when confirmatory testing is done. The new targeted benzodiazepine screening test provides a more sensitive and specific test to check for compliance to all the commonly prescribed benzodiazepines and looks for both the parent drug and its metabolites in the urine.
    
        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.
                
            
    
    Only orderable as part of profile. For more information see:
-CSMPU / Controlled Substance Monitoring Panel, Random, Urine
-ADMPU / Addiction Medicine Profile with Reflex, 22 Drug Classes, High Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine
-CSMEU / Controlled Substance Monitoring Enhanced Profile with Reflex, 21 Drug Classes, High Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine
-CSMTU / Controlled Substance Monitoring Targeted Profile, 17 Drug Classes, Mass Spectrometry, Random, Urine
-TBSU / Targeted Benzodiazepine Screen, Random, Urine
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-hydroxy midazolam: 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-hydroxy triazolam: 10 ng/mL
Zolpidem: 10 ng/mL
Zolpidem phenyl-4-carboxylic acid: 10 ng/mL
    
        Interpretation
            
                
                
                    
                    Provides information to assist in interpretation of the test results
                
            
    
    If a benzodiazepine or its corresponding metabolites is identified (present), it indicates that the patient has used the respective benzodiazepine in the recent past. The absence of expected benzodiazepines or their metabolites may indicate noncompliance, inappropriate timing of specimen collection relative to drug administration, poor drug absorption, diluted or adulterated urine, or limitations of testing. The concentration of the drug must be greater than or equal to the cutoff to be reported as present. If a specific drug concentration is required, the laboratory must be contacted within 2 weeks of specimen collection/testing to request quantification by a second analytical technique at an additional charge.
    
        Cautions
            
                
                
                    
                    Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
                
            
    
    No significant cautionary statements
    
        Clinical Reference
            
                
                
                    
                    Recommendations for in-depth reading of a clinical nature
                
            
    
    1. Jannetto PJ, Bratanow NC, Clark WA, et al. Executive summary: American Association of Clinical Chemistry Laboratory Medicine Practice Guideline-Using clinical laboratory tests to monitor drug therapy in pain management patients. J Appl Lab Med. 2018;2(4):489-526
2. 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
                
            
    
    The urine sample is diluted with internal standard and then analyzed by liquid chromatography tandem mass spectrometry using a high-resolution accurate mass orbitrap detector.(Unpublished Mayo method)
    
        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 Sunday
    
        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 was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
    
        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.
80347
G0480 (if appropriate)
    
        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 | 
|---|---|---|
| TABSU | Targeted Benzodiazepine Screen, U | 94117-9 | 
| 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.
                                     | 
|---|---|---|
| 604871 | Alprazolam | 94116-1 | 
| 604867 | Alpha-Hydroxyalprazolam | 19325-0 | 
| 604891 | Alpha-Hydroxyalprazolam Glucuronide | 94115-3 | 
| 604872 | Chlordiazepoxide | 19385-4 | 
| 604889 | Clobazam | 94114-6 | 
| 604890 | N-Desmethylclobazam | 94113-8 | 
| 604873 | Clonazepam | 19399-5 | 
| 604267 | 7-aminoclonazepam | 94112-0 | 
| 604874 | Diazepam | 19443-1 | 
| 604880 | Nordiazepam | 19624-6 | 
| 604875 | Flunitrazepam | 19466-2 | 
| 604866 | 7-aminoflunitrazepam | 94111-2 | 
| 604876 | Flurazepam | 19474-6 | 
| 604868 | 2-Hydroxy Ethyl Flurazepam | 94110-4 | 
| 604877 | Lorazepam | 19520-6 | 
| 604878 | Lorazepam Glucuronide | 94109-6 | 
| 604879 | Midazolam | 19585-9 | 
| 604869 | Alpha-Hydroxy Midazolam | 94108-8 | 
| 604881 | Oxazepam | 19638-6 | 
| 604882 | Oxazepam Glucuronide | 94107-0 | 
| 604883 | Prazepam | 19678-2 | 
| 604884 | Temazepam | 19698-0 | 
| 604885 | Temazepam Glucuronide | 94106-2 | 
| 604886 | Triazolam | 19714-5 | 
| 604870 | Alpha-Hydroxy Triazolam | 94105-4 | 
| 604887 | Zolpidem | 94104-7 | 
| 604888 | Zolpidem Phenyl-4-Carboxylic acid | 94103-9 | 
| 604949 | Benzodiazepine Interpretation | 69050-3 |