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. 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 always under the control of personnel involved with testing the specimen; this control implies that the opportunity for specimen tampering would be limited.

 

This test is not intended for use in employment-related testing.

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.

Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods (gas chromatography mass spectrometry for barbiturates, cocaine and metabolites, methadone, and phencyclidine) at an additional charge. Amphetamines, benzodiazepines, opiates, and tetrahydrocannabinol metabolite that screen positive will be quantified with liquid chromatography tandem mass spectrometry 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

Immunoassay followed by Gas Chromatography Mass Spectrometry (GC-MS) or Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS) as needed

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.

Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods (gas chromatography mass spectrometry for barbiturates, cocaine and metabolites, methadone, and phencyclidine) at an additional charge. Amphetamines, benzodiazepines, opiates, and tetrahydrocannabinol metabolite that screen positive will be quantified with liquid chromatography tandem mass spectrometry 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

Supplies: Chain of Custody Kit (T282)

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

Specimen Volume: 30 mL

Collection Instructions: Collect a random specimen without preservative 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 the 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. The minimum volume is sufficient for one attempt at testing.

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. 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 always under the control of personnel involved with testing the specimen; this control implies that the opportunity for specimen tampering would be limited.

 

This test is not intended for use in employment-related testing.

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

Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods (gas chromatography mass spectrometry for barbiturates, cocaine and metabolites, methadone, and phencyclidine) at an additional charge. Amphetamines, benzodiazepines, opiates, and tetrahydrocannabinol metabolite that screen positive will be quantified with liquid chromatography tandem mass spectrometry 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

-Cocaine

-Methadone

-Phencyclidine

 

This assay was designed to test for and confirm by liquid chromatography tandem mass spectrometry (LC-MS/MS) the following:

-Opiates

-Benzodiazepines

-Carboxy-tetrahydrocannabinol

-Amphetamines

 

This test uses the simple screening technique which involves immunoassay testing for drugs by class. Oxycodone is not detected well with the opiate screening assay; therefore, confirmation testing is included to detect this drug. All positive screening results are confirmed by either 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 the individuals who collected, handled, and 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

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 one of the drugs detected by these techniques in the recent past.

 

For information about drug testing, including estimated detection times, see Drug Class Testing on MayoClinicLabs.com.

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

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

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

1. Physician's Desk Reference (PDR). 60th ed. Medical Economics Company; 2006

2. Bruntman LL. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 11th ed. McGraw-Hill Book Company; 2006

3. 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

Adulterant:

All results are measured using spectrophotometry at wavelengths specified by the reagent manufacturer. The use of a refractometer may also be used in the specific gravity measurement.(Package inserts: Specimen Validity Test Creatinine. Roche Diagnostics; V3.0, 08/2015; Specimen Validity Test Nitrite. Roche Diagnostics; V3.0, 08/2018, Specimen Validity Test Oxidant. Roche Diagnostics; V 3.0, 08/2018; Specimen Validity Test pH Roche Diagnostics; V3.0, 02/2019, Specimen Validity Test Specific Gravity. Roche Diagnostics; V4.0, 08/2022)

 

The amphetamines, barbiturates, benzodiazepines, cocaine, methadone metabolite, opiates, phencyclidine, and tetrahydrocannabinol metabolite assays are based on the kinetic interaction of microparticles in a solution 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 inserts: AMPS2. Roche Diagnostics; V 10.0, 09/2018; BARB. Roche Diagnostics; V 13.0, 09/2021; THC2. Roche Diagnostics; V 13.0, 03/2022; BNZ2. Roche Diagnostics; V 2.0, 04/2024; COC2. Roche Diagnostics; V 9.0, 03/2019; OPI2. Roche Diagnostics; V 16.0, 01/2022; PCP. Roche Diagnostics; V 13.0, 09/2021; EDDP Specific Urine Enzyme Immunoassay, Immunalysis Corp; 09/2018)

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 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 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