Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Specimen Requirements:
20 mL urine submitted in a Clinical Drug Test transport vial
Collection Instructions:
Minimum Volume:
5.0 mL Urine
Transport & Storage: Temperature/Stability:
14 days Ambient
14 days Refrigerated
30 days Frozen
Rejection Criteria:
preserved samples
Reference Range:
| Alphahydroxyalprazolam |
<25 ng/mL |
| Alphahydroxymidazolam |
<50 ng/mL |
| Alphahydroxytriazolam |
<50 ng/mL |
| Aminoclonazepam |
<25 ng/mL |
| Hydroxyethylflurazepam |
<50 ng/mL |
| Lorazepam |
<50 ng/mL |
| Nordiazepam |
<50 ng/mL |
| Oxazepam |
<50 ng/mL |
| Temazepam |
<50 ng/mL |
Critical Ranges:
Test Comments:
Methodology:
Mass Spectrometry (MS)
Clinical Significance:
Drug Monitoring, Benzodiazepines, Quantitative, Urine - This test measures levels of benzodiazepine metabolites in urine. Benzodiazepine metabolites are biomarkers for monitoring possible use or non-use of benzodiazepine drugs. The test is a definitive drug assay using the liquid chromatography/mass spectrometry (LC/MS-MS) method of analysis.
Benzodiazepines are GABAergic drugs used as anxiolytics, anticonvulsants, and sedatives to treat alcohol dependence, seizures, anxiety, and panic disorders. Metabolites include alphahydroxyalprazolam, alphahydroxymidazolam, alphahydroxytriazolam, aminoclonazepam, hydroxyethylflurazepam, lorazepam, nordiazepam, oxazepam, and temazepam. Benzodiazepines are extensively metabolized and excreted as conjugated [1-9].
According to the American Association for Clinical Chemistry (AACC), testing drugs/drug metabolites is recommended and effective for detecting the use of relevant over-the-counter, prescribed, and nonprescribed drugs, as well as illicit substances in pain-management patients [10].
Laboratory testing is more effective than other physician tools for the detection of these substances in pain-management patients and is useful for routine monitoring of adherence. Instances where unchanged drug is detected, but metabolite(s) is not, may be indicative of drug added to the specimen after collection (eg, pill shaving, drug spiking) [10].
Note: No single monitoring approach provides adequate information about the pattern or dose of patient drug use. Safest prescribing habits should include a combination of tools and laboratory test results to correctly detect drug use patterns.
Urine drug test results equal to or greater than cutoff are reported as quantitative values and results less than cutoff are reported as negative. Quantitative values cannot be used to assess the drug dose, because the drug is extensively metabolized and excreted in the urine.
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Turn Around Time:
3 to 4 days
Days Performed:
Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed:
Quest - Chantilly
PHL Test Code:
MSOT
Send Out Test Code:
16914
Alternate Test Names:
Drug Monitoring, Benzodiazepines, Quantitative, Ur
Included Tests:
Alphahydroxyalprazolam; Alphahydroxymidazolam; Alphahydroxytriazolam; Aminoclonazepam; Hydroxyethylflurazepam; Lorazepam; Nordiazepam; Oxazepam; Temazepam
CPT Coding:
80346 (HCPCS: G0480)