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16457: Drug Monitoring, Base Panel, with Confirmation, Urine Print View
Creatinine S  > 19.9  mg/dL 
Specific Gravity REFRACT  > 1.002   
pH S/METER  4.5 - 9   
Oxidant S  < 200  mcg/mL 
Abnormal Specimen Validity Test:      
Benzodiazepines IA  < 100  ng/mL 
Alphahydroxyalprazolam MASS SPEC  < 25  ng/mL 
Alphahydroxymidazolam MASS SPEC  < 50  ng/mL 
Alphahydroxytriazolam MASS SPEC  < 50  ng/mL 
Aminoclonazepam MASS SPEC  < 25  ng/mL 
Hydroxyethylflurazepam MASS SPEC  < 50  ng/mL 
Lorazepam MASS SPEC  < 50  ng/mL 
Nordiazepam MASS SPEC  < 50  ng/mL 
Oxazepam MASS SPEC  < 50  ng/mL 
Temazepam MASS SPEC  < 50  ng/mL 
Cocaine Metabolite IA  < 150  ng/mL 
Benzoylecgonine MASS SPEC  < 100  ng/mL 
Opiates IA  < 100  ng/mL 
Codeine MASS SPEC  < 50  ng/mL 
Hydrocodone MASS SPEC  < 50  ng/mL 
Hydromorphone MASS SPEC  < 50  ng/mL 
Morphine MASS SPEC  < 50  ng/mL 
Norhydrocodone MASS SPEC  < 50  ng/mL 
Oxycodone IA  < 100  ng/mL 
Noroxycodone MASS SPEC  < 50  ng/mL 
Oxycodone MASS SPEC  < 50  ng/mL 
Oxymorphone MASS SPEC  < 50  ng/mL 
Confirmation Testing Performed at:      

PRIMARY
1 Urine 30 (7) mL   Frozen - 30 Day(s)/Refrigerated - 7 Day(s)/Room Temperature - 5 Day(s)  
ALTERNATE

This panel can be used to monitor patients currently prescribed pain medication for compliance to their drug therapy and to evaluate the possibility of illicit drug use.

Preferred Specimen: 30 mL (7 mL minimum) urine collected in clinical
drug transport vial

Acceptable: Urine collected in urine collection container.

Reject Criteria: Preserved samples
Setup Schedule
Monday-Saturday

Reported (Analytical Time)
Next day

CPT Code
80307

The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Notes
Transport Temperature: Room temperature
Methodology:
Screen: Immunoassay
Confirm: Mass Spectrometry
Additional information: Quantitative confirmation of positives will be performed at an additional charge (CPT code(S):
dependent upon the confirmed drug class)






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