Test Catalog

Test Id : HYDCU

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Hydrocodone with Metabolite Confirmation, Random, Urine

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Overview

Test Catalog

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

Detection and quantification of hydrocodone, norhydrocodone, and hydromorphone in urine

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.

Yes

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

Hydrocodone w/metabolite Conf, U

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

Hycodan (Hydrocodone)

Hydrocodone (Hycodan, Vicodin)

Opiates

Vicodin (Hydrocodone)

Dilaudid (Hydromorphone)

Hydromorphone (Dilaudid, Vicodin)

Lortab (Hydromorphone)

Norhydrocodone

Specimen Type
Describes the specimen type validated for testing

Urine

Ordering Guidance

For situations where chain of custody is required, a Chain of Custody Kit (T282) is available. For chain-of-custody testing, order OPATX / Opiates Confirmation, Chain of Custody, Random, Urine.

 

Additional drug panels and specific requests are available; call 800-533-1710.

Additional Testing Requirements

If urine creatinine is required or adulteration of the sample is suspected, order ADULT / Adulterants Survey, Random, Urine.

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: Plastic urine container

Submission Container/Tube: Plastic, 5-mL tube

Specimen Volume: 3 mL

Collection Instructions:

1. Collect a random urine specimen.

2. No preservative.

Additional Information:

1. No specimen substitutions.

2. STATS are not accepted for this test.

3. Submitting less than 1 mL will compromise our ability to perform all necessary testing.

Forms

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. The minimum volume is sufficient for one attempt at testing.

2.5 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) 28 days
Frozen 28 days
Ambient 14 days

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

Detection and quantification of hydrocodone, norhydrocodone, and hydromorphone in urine

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

Hydrocodone exhibits a complex pattern of metabolism including O-demethylation, N-demethylation, and 6-keto reduction to the 6-beta hydroxymetabolites. Hydromorphone and norhydrocodone are both metabolites of hydrocodone. Dihydrocodeine is also a minor metabolite. Trace amounts of hydrocodone can also be found in the presence of approximately 100-fold higher concentrations of oxycodone or hydromorphone since it can be a pharmaceutical impurity in these medications. The presence of hydrocodone indicates exposure within 2 to 3 days prior to specimen collection.

 

Hydromorphone is metabolized primarily in the liver and is excreted primarily as the glucuronidated conjugate, with small amounts of parent drug and minor amounts of 6-hydroxy reduction metabolites. The presence of hydromorphone indicates exposure within 2 to 3 days prior to specimen collection. Hydromorphone is also a metabolite of hydrocodone; therefore, the presence of hydromorphone could also indicate exposure to hydrocodone.

 

The detection interval for the opiates is generally 2 to 3 days after last ingestion.

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

Cutoff concentrations-liquid chromatography tandem mass spectrometry:

Hydrocodone: 25 ng/mL

Norhydrocodone: 25 ng/mL

Hydromorphone: 25 ng/mL

Interpretation
Provides information to assist in interpretation of the test results

This procedure reports the total urine concentration; this is the sum of the unconjugated and conjugated forms of the parent drug.

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

Other drugs in the opioid class, such as fentanyl, meperidine, methadone, and opiate antagonists such as naloxone, are not detected

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

1. Gutstein HB, Akil H. Opioid analgesics. In: Brunton LL, Lazo JS, Parker KL, eds. The Pharmacological Basis of Therapeutics. 11th ed. Goodman and Gilman's: McGraw-Hill Companies, Inc. 2006 Available at www.accessmedicine.com/content.aspx?aID=940653

2. Baselt RC, ed: Disposition of Toxic Drugs and Chemical in Man. 9th ed. Biomedical Publications; 2011

3. Hackett LP, Dusci LJ, Ilett KF, Chiswell GM. Optimizing the hydrolysis of codeine and morphine glucuronides in urine. Ther Drug Monit. 2002;24(5):652-657. doi:10.1097/00007691-200210000-00012

4. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham CAD, 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

Confirmation with quantification by liquid chromatography/mass spectrometry (LC-MS/MS).(Unpublished Mayo method)

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 5 days

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

14 days

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 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.

80361

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
HYDCU Hydrocodone w/metabolite Conf, U 74760-0
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.
62614 Hydrocodone-by LC-MS/MS 16252-9
35966 Hydromorphone-by LC-MS/MS 16998-7
36026 Hydrocodone Interpretation 69050-3
41999 Norhydrocodone-by LC-MS/MS 61422-2

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