Test Catalog

Test Id : THCX

Carboxy-Tetrahydrocannabinol (THC) Confirmation, Chain of Custody, Random, Urine

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

Detection and confirmation of drug abuse involving delta-9-tetrahydrocannabinol (marijuana) in urine specimens handled through the chain-of-custody process

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 for adulterants will be performed on all chain of custody urine samples per regulatory requirements.

Method Name
A short description of the method used to perform the test

Immunoassay/Gas Chromatography-Mass Spectrometry (GC-MS) Confirmation with Quantitation

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

Carboxy-THC Confirmation, CoC, U

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

Cannabinoids (Tetrahydrocannabinol)

J (Jane) (Tetrahydrocannabinol)

Jane (Tetrahydrocannabinol)

Marijuana (Tetrahydrocannabinol)

Mary Jane (Tetrahydrocannabinol)

Tetrahydrocannabinol (THC) Confirmation, Quantitative, Urine

TETRAHYDROCANNABINOL, QN

THC (Tetrahydrocannabinol)

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

Testing for adulterants will be performed on all chain of custody urine samples per regulatory requirements.

Specimen Type
Describes the specimen type validated for testing

Urine

Ordering Guidance

This test is for situations that require the chain-of-custody process. For testing not requiring chain of custody, order THCU / Carboxy-Tetrahydrocannabinol (THC) Confirmation, Random, 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 required.

Specimen Volume: 10 mL

Collection Instructions: Collect specimen 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

5 mL

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

Gross hemolysis 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
Urine Refrigerated (preferred) 14 days
Frozen 14 days
Ambient 72 hours

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

Detection and confirmation of drug abuse involving delta-9-tetrahydrocannabinol (marijuana) in urine specimens handled through the chain-of-custody process

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

Testing for adulterants will be performed on all chain of custody urine samples per regulatory requirements.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Delta-9-tetrahydrocannabinol is the active agent of the popularly abused street drug, marijuana.

 

After consumption, either by inhalation or ingestion, the drug is metabolized to a variety of inactive chemicals, one of them being delta-9-tetrahydrocannabinol carboxylic acid.

 

The immunoassay used to screen for tetrahydrocannabinol (THC) is designed to cross-react with THC carboxylic acid.

 

In almost all medico-legal cases and in screening of employees, or when the patient adamantly denies THC use and the immunoassay test is positive, confirmation of the result by gas chromatography-mass spectrometry is required.

 

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.

 

This includes a record of the disposition of a specimen to document the personnel 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.

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

Positives are reported with a quantitative GC-MS result.

 

Cutoff concentrations:

IMMUNOASSAY SCREEN

<50 ng/mL

 

THC CARBOXYLIC ACID BY GC-MS

<3 ng/mL

Interpretation
Provides information to assist in interpretation of the test results

The presence of tetrahydrocannabinol carboxylic acid (THC-COOH), a major metabolite of delta-9-tetrahydrocannabinol (THC), in urine at concentrations greater than 15 ng/mL is a strong indicator that the patient has used marijuana.

 

THC-COOH has a long half-life and can be detected in urine for more than 7 days after a single use. The presence of THC-COOH in urine greater than 100 ng/mL indicates relatively recent use, probably within the past 7 days. Levels greater than 500 ng/mL suggest chronic and recent use. Chronic use causes accumulation of THC and THC-COOH in adipose tissue such that it is excreted into the urine for as long as 30 to 60 days from the time chronic use is halted.

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. Moyer TP, Palmen MA, Johnson P, et al: Marijuana testing-how good is it? Mayo Clin Proc 1987;62:413-417

2. Disposition of Toxic Drugs and Chemicals in Man. 10th edition. Edited by RC Baselt. Biomedical Publications, 2014

3. Langman LJ, Bechtel LK, Meier BM, Holstege C: Chapter 41: Clinical Toxicology. In Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Edited by N Rifai, AR Horvath, CT Wittwer. Sixth edition. Elsevier, 2018, pp 832-887

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

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 Friday

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 4 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 was developed, and its performance characteristics 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.

80349

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
THCX Carboxy-THC Confirmation, CoC, U 20521-1
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.
2449 Carboxy-THC Immunoassay Screen 19415-9
36238 Carboxy-THC- by GC/MS 20521-1
36239 Carboxy-THC Interpretation 69050-3
36240 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