Test Catalog

Test Id : PANOX

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Pain Clinic Survey 10, Chain of Custody, Random, Urine

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

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.

Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.

Test Id Reporting Name Available Separately Always Performed
PN10X Pain Clinic Survey 10, CoC No Yes
OXYSX Oxycodone Screen, CoC, U Yes Yes

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
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

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.

If immunoassay screen is positive, then gas chromatography-mass spectrometry (GC-MS) confirmation is performed. GC-MS confirmation with quantification of positives for amphetamines, barbiturates, benzodiazepines, cocaine and metabolites, methadone, phencyclidine, and tetrahydrocannabinol metabolite 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

Screened by Immunoassay and Confirmed by Gas Chromatography-Mass Spectrometry (GC-MS)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Pain Clinic Survey 10, CoC, U

Aliases
Lists additional common names for a test, as an aid in searching

"J" (Jane) Tetrahydrocannabinol)

7-Amino Flunitrazepam (Metabolite of Flunitrazepam (Rohypnol)

Alprazolam (Xanax)

Amobarbital (Amytal)

Amphetamines

Amytal (Amobarbital)

Ativan (Lorazepam)

Barbita (Phenobarbital)

Barbiturates

Benzodiazepines

Benzoylecgonine (Cocaine Metabolite)

Butabarbital (Butisol)

Butalbital (Fiorinal)

Butisol (Butabarbital)

Cannabinoids (Tetrahydrocannabinol)

Chlordiazepoxide (Librium)

Clorazepate (Tranxene)

Cocaine

Codeine

Coke (Cocaine)

Crack (Cocaine)

Dalmane (Flurazepam)

Date Rape Drug (Rohypnol [Flunitrazepam])

Desalkyl Flurazepam (Metabolite)

Desoxyn (Methamphetamines)

Diazepam (Valium)

Dilaudid (Hydromorphone)

Dolophine (Methadone)

Drugs of Abuse

Ecstasy

Fiorinal (Butalbital)

Flunitrazepam (Rohypnol)

Flurazepam (Dalmane)

Halcion (Triazolam)

Heroin

Hycodan (Hydrocodone)

Hydrocodone (Hycodan, Vicodin)

Hydromorphone (Dilaudid, Vicodin)

Hydroxy-Ethyl Flurazepam (Metabolite of Flurazepam) (Dalmane)

Killer Weed (Phencyclidine)

Librium (Chlordiazepoxide)

Lorazepam (Ativan)

Lortab (Hydromorphone)

Luminal (Phenobarbital)

Marijuana (Tetrahydrocannabinol)

MDA (Methylenedioxyamphetamine) Metabolite for Methylenedioxyethylamphetamine (MDEA) and Methylenedioxymethamphetamine (MDMA)

MDMA (Methylenedioxymethamphetamine)

Mebaral (Mephobarbital)

Mephobarbital (Mebaral)

Methadone (Dolophine)

Methamphetamines (Desoxyn)

Methylenedioxyamphetamine (MDA) Metabolite for Methylenedioxyethylamphetamine (MDEA) and Methylenedioxymethamphetamine (MDMA)

Methylenedioxymethamphetamine (MDMA)

Nembutal (Pentobarbital)

Nordiazepam (Tranxene)

Norpropoxyphene (Metabolite of Propoxyphene) (Darvon)

Opiates

Oxazepam (Serax)

Oxycodone (Oxycontin, Percodan)

Oxycontin (Oxycodone)

PCP (Phencyclidine)

Pentobarbital (Nembutal)

Pentothal (Thiopental)

Percodan (Oxycodone)

Phencyclidine (PCP)

Phenobarbital

Restoril (Temazepam)

Rocket Fuel (Phencyclidine)

Rohypnol (Flunitrazepam)

Secobarbital (Seconal)

Seconal (Secobarbital)

Serax (Oxazepam)

Solfoton (Phenobarbital)

Speed (Amphetamines)

TCP (Phencyclidine)

Temazepam (Restoril)

Tetrahydrocannabinol (THC)

THC (Tetrahydrocannabinol)

Thiopental (Pentothal)

Toxicology Screen, Drugs

Tranxene (Clorazepate)

Triazolam (Halcion)

Tuinal (Amobarbital and Secobarbital)

Valium (Diazepam)

Vicodin (Hydrocodone)

Xanax (Alprazolam)

EDDP

Methadone metabolite

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

If immunoassay screen is positive, then gas chromatography-mass spectrometry (GC-MS) confirmation is performed. GC-MS confirmation with quantification of positives for amphetamines, barbiturates, benzodiazepines, cocaine and metabolites, methadone, phencyclidine, and tetrahydrocannabinol metabolite 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

Container/Tube: Chain-of-Custody Kit (T282) containing the specimen containers, seals, and documentation required.

Specimen Volume: 30 mL

Collection Instructions: Collect a random specimen 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 our ability to perform all necessary 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

20 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

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) 7 days
Frozen 14 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

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.

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

If immunoassay screen is positive, then gas chromatography-mass spectrometry (GC-MS) confirmation is performed. GC-MS confirmation with quantification of positives for amphetamines, barbiturates, benzodiazepines, cocaine and metabolites, methadone, phencyclidine, and tetrahydrocannabinol metabolite 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

This assay was designed to test for and confirm by gas chromatography-mass spectrometry (GC-MS) the following:

-Barbiturates

-Benzodiazepines

-Cocaine

-Methadone

-Phencyclidine

-Tetrahydrocannabinol

 

Confirmation by liquid chromatograph-tandem mass spectrometry (LC-MS/MS) is completed for all opiates and amphetamines.

 

This test uses the simple screening technique which involves immunologic testing for drugs by class. Oxycodone is not detected well with the opiate screening assay; therefore, OPATX / Opiate Confirmation, Chain of Custody, Urine is included to detect this drug. All positive screening results are confirmed by GC-MS or LC-MS/MS, and quantitated, before a positive result is reported.

 

Chain of custody is a record of the disposition of a specimen to document who collected it, who handled it, and who 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. 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 under the control of personnel involved with testing the specimen at all times; this control implies that the opportunity for specimen tampering would be limited.

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 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.

Interpretation
Provides information to assist in interpretation of the test results

A positive result derived by this testing indicates that the patient has used 1 of the drugs detected by these techniques in the recent past. See individual tests (eg, AMPHU / Amphetamines Confirmation, Urine) for more information.

 

For information about drug testing, including estimated detection times, see Drugs of Abuse Testing.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Not intended for use in employment-related testing.

 

The test does not screen for drug classes other than those listed above. More comprehensive screening is available using the serum or urine drug screens (DSSX / Drug Screen, Prescription/OTC, Chain of Custody, Serum or PDSUX / Drug Screen, Prescription/OTC, Chain of Custody, Urine).

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Physician’s Desk Reference (PDR). 60th edition. Montvale, NJ, Medical Economics Company, 2006

2. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 11th edition. Edited by LL Bruntman. New York, McGraw-Hill Book Company, 2006

3. Langman LJ, Bechtel L, Holstege CP: Chapter 35. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Edited by CA Burtis, ER Ashwood, DE Bruns. WB Saunders Company, 2011, pp 1109-1188

Method Description
Describes how the test is performed and provides a method-specific reference

The amphetamines, barbiturates, benzodiazepines, cocaine, methadone metabolite, opiates, phencyclidine, and tetrahydrocannabinol metabolite assays are based on the kinetic interaction of microparticles in a solution (KIMS) 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 insert: Roche Amphetamines, Barbiturates, Cannabinoids, Benzodiazepines, Cocaine, Opiates, Oxycodone, Phencyclidine, reagents, Roche Diagnostic Corp, Indianapolis, IN; Package insert: EDDP Specific Urine Enzyme Immunoassay, Immunalysis Corp, Pomona, CA)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

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.

2 to 3 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

2 weeks

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

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 Regional Manager. 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 modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test 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.

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
PANOX Pain Clinic Survey 10, CoC, U 69739-1
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.
36253 Amphetamines 43983-6
36254 Cocaine 43984-4
36255 Opiates 70151-6
36256 Phencyclidine 14310-7
36257 Tetrahydrocannabinol 14312-3
36261 Chain of Custody 77202-0
36258 Barbiturates 70155-7
36259 Benzodiazepines 14316-4
36260 Methadone metabolite 41858-2
61727 Oxycodone 19642-8
36027 Chain of Custody 77202-0

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports

Test Update Resources

Change Type Effective Date
File Definition - Result ID 2022-12-13