Test Id : OPATS
Opiate Panel, Free (Unconjugated), Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
Monitoring therapeutic efficacy, compliance, misuse and/or abuse in serum specimens of patients who have been prescribed any of the following: codeine, hydrocodone, oxycodone, morphine, hydromorphone, oxymorphone, and dihydrocodeine,
Detection and quantification of codeine, hydrocodone, oxycodone, morphine, hydromorphone, oxymorphone, noroxycodone, noroxymorphone, norhydrocodone, dihydrocodeine, and 6-monoacetylmorphine
Method Name
A short description of the method used to perform the test
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
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
Codeine
DHC Plus (Dihydrocodeine)
Dihydrocodeine (DHC Plus, Panlor DC, Synalgos DC)
Dilaudid (Hydromorphone)
Heroin (as Morphine)
Hycodan (Hydrocodone)
Hydrocodone (Hycodan, Vicodin)
Hydromorphone (Dilaudid, Exalgo ER, Lortab)
Exalgo ER (Hydromorphone)
Lortab (Hydromorphone)
Morphine
Morphine (Arymo ER, MorphaBond ER, Duramorp, MS Contin)
Arymo ER (Morphine)
MorphaBond ER (Morphine)
Duramorp (Morphine)
MS Contin (Morphine)
Noroxycodone
Noroxymorphone
Opiates
Oxymorphone (Opana)
Opana (Oxymorphone)
Oxycodone (Oxycontin, Percodan)
Oxycontin (Oxycodone)
Panlor DC (Dihydrocodeine)
Percodan (Oxycodone)
Synalgos DC (Dihydrocodeine)
Vicodin (Hydrocodone)
Specimen Type
Describes the specimen type validated for testing
Serum Red
Ordering Guidance
This test should only be ordered by healthcare professionals to monitor patients who have been prescribed any of the following opiates/opiates antagonists: codeine, oxycodone, noroxycodone, oxymorphone, hydrocodone, norhydrocodone, dihydrocodeine, morphine, 6-monoacetylmorphine, hydromorphone, and noroxymorphone.
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube: Red top (Serum gel/SST are not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL serum
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Special Instructions
Library of PDFs including pertinent information and forms related to the test
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.
Serum: 0.5 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | OK |
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 |
|---|---|---|---|
| Serum Red | Refrigerated (preferred) | 14 days | |
| Ambient | 24 hours | ||
| Frozen | 28 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Monitoring therapeutic efficacy, compliance, misuse and/or abuse in serum specimens of patients who have been prescribed any of the following: codeine, hydrocodone, oxycodone, morphine, hydromorphone, oxymorphone, and dihydrocodeine,
Detection and quantification of codeine, hydrocodone, oxycodone, morphine, hydromorphone, oxymorphone, noroxycodone, noroxymorphone, norhydrocodone, dihydrocodeine, and 6-monoacetylmorphine
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. They are used primarily for relief of pain and often produce physical and psychological dependence. This test is for use by healthcare professionals to determine if patients prescribed any of the following opiates/opioids are receiving the right dose for therapeutic efficacy and/or are compliant: codeine, oxycodone, noroxycodone, oxymorphone, hydrocodone, norhydrocodone, dihydrocodeine, morphine, 6-monoacetylmorphine, hydromorphone, and noroxymorphone.
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.
Therapeutic range/Metabolite information (as applicable):
6-monoacetylmorphine: Metabolite of heroin
Codeine: 10-100 ng/mL
Morphine: 10-80 ng/mL when used as sole therapy; Minor metabolite of codeine
Hydromorphone: 1.0-30 ng/mL when used as sole therapy; Metabolite of hydrocodone and minor metabolite of morphine
Hydrocodone: 10-100 ng/mL
Dihydrocodeine: 72-150 ng/mL when used as sole therapy; Minor metabolite of hydrocodone
Norhydrocodone: Metabolite of hydrocodone
Oxycodone: 10-100 ng/mL
Noroxycodone: Metabolite of oxycodone
Oxymorphone: 1.0-8.0 ng/mL when used as sole therapy; Metabolite of oxycodone
Noroxymorphone: Metabolite of oxymorphone
Cutoff concentrations:
6-Monoacetylmorphine: 1.0 ng/mL
Codeine: 1.0 ng/mL
Morphine: 1.0 ng/mL
Hydromorphone: 1.0 ng/mL
Hydrocodone: 1.0 ng/mL
Dihydrocodeine: 1.0 ng/mL
Norhydrocodone: 1.0 ng/mL
Oxycodone: 1.0 ng/mL
Noroxycodone: 1.0 ng/mL
Oxymorphone: 1.0 ng/mL
Noroxymorphone: 1.0 ng/mL
Interpretation
Provides information to assist in interpretation of the test results
Clinically, the presence of oxycodone, noroxycodone, oxymorphone, noroxymorphone, morphine, hydrocodone, norhydrocodone, hydromorphone, dihydrocodeine, codeine, and/or 6-monoacetylmorphine in serum can be
used to verify adherence or compliance to prescribed opioids, and discourage drug misuse, abuse, and diversion.
The following adult therapeutic ranges are suggested by literature but must be interpreted alongside other clinical features/test results, symptoms, collection time since last dosage was taken, and signs of abuse/misuse.
6-monoacetylmorphine: Not established, it is a metabolite of heroin
Codeine: 10-100 ng/mL
Morphine: 10-80 ng/mL when used as sole therapy; it is also a minor metabolite of codeine
Hydromorphone: 1.0-30 ng/mL when used as sole therapy; it is also a metabolite of hydrocodone and minor metabolite of morphine.
Hydrocodone: 10-100 ng/mL
Dihydrocodeine: 72-150 ng/mL when used as sole therapy; it is also a minor metabolite of hydrocodone.
Norhydrocodone: Not established; it is a metabolite of hydrocodone.
Oxycodone: 10-100 ng/mL
Noroxycodone: Not established; it is a metabolite of oxycodone.
Oxymorphone: 1.0-8.0 ng/mL when used as sole therapy; it is a metabolite of oxycodone.
Noroxymorphone: Not established; it is a metabolite of oxymorphone.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Any aberrant result should be discussed with the patient and could be confirmed by re-testing or using an alternative matrix (eg, urine).
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Jannetto PJ, Bratanow NC, Clark WA, et al. 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. doi:10.1373/jalm.2017.023341
2. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham C-AD, 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 opiates are extracted from serum using a solvent to precipitate proteins. The supernatant is removed and analyzed by liquid chromatography tandem mass spectrometry.(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.
Wednesday
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.
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- 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.
G0480
80361 (if appropriate for select payers)
80365 (if appropriate for select payers)
80356 (if appropriate for select payers)
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 |
|---|---|---|
| OPATS | Opiate Panel, Free (Unconjugated),S | In Process |
| 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.
|
|---|---|---|
| 623436 | 6-monoacetylmorphine - Free | 49749-5 |
| 623437 | Codeine - Free | 12784-5 |
| 623438 | Morphine - Free | 11244-1 |
| 623439 | Hydromorphone - Free | 12787-8 |
| 623440 | Hydrocodone - Free | 12786-0 |
| 623441 | Dihydrocodeine - Free | 12785-2 |
| 623442 | Norhydrocodone - Free | In Process |
| 623443 | Oxycodone - Free | 12789-4 |
| 623444 | Noroxycodone - Free | In Process |
| 623445 | Oxymorphone - Free | 46974-2 |
| 623446 | Noroxymorphone - Free | In Process |