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 Field Name  Data Description
CPT Code  Suggested Medicare billing: replace CPT code 80100x2 with procedure code G0431x1; replace CPT code 80101x15 with procedure code G0434x1
Last Modified  4/22/2014
Test Name  
Patient Preparation  
Spec. Requirements  Tissue, not in formalin
Tube  Screw Top Container
Collection Volume  50 gm
Storage  Refrigerated or frozen
Routine TAT  2 weeks
Days Test Performed  
Performed by BHS  None
See Availability  
Reference Lab  N/A
Reference Lab Code  Tissue Drug Screen 330; Drug Screen, Tissue;
Clinical Use  
Reference Range  
Critical Value  
Testing Sample Type  Tissue, not in formalin
Min Lab Testing Volume  50 gm
Special Handling  List of drugs screened for in tissue: acetaminophen, acetone, acetylmorphine, alprazolam, amitriptyline, amobarbital, amoxapine and metabolite, amphetamine, barbital, barbiturates, benzodiazepines, benztropine, brompheniramine, bupropion and metabolites, butabarbital, butalbital, caffeine, carbamazepine and metabolite, carisoprodol, chlordiazepoxide and metabolites, chlorpheniramine and metabolite, chlorpromazine, chlorzoxazone, clomipramine and desmethylclomipramine, clonazepam, cocaine and metabolite, codeine, cyclobenzaprine, desalkylflurazepam, desipramine, desmethyldiazepam, dextromethorphan (as methorphan), diazepam and metabolites, diltiazem, diphenhydramine and metabolite, doxepin and desmethyldoxepin, doxylamine, ephedrine (and/or pseudoephedrine), ethosuximide, ethyl alcohol, flurazepam and metabolite, fluoxetine and norfluoxetine, fluvoxamine, glutethimide, guaifenesin, halazepam, heroin (as acetylmorphine and morphine), hydrocodone, hydromorphone, hydroxyzine and metabolite, ibuprofen andmetabolite, imipramine, isopropyl alcohol, ketoprofen, lidocaine and metabolite, lorazepam, loxapine and metabolite, mefenamic acid, meperidine and normeperidine, marijuana (as metabolite), mephobarbital, mepivacaine, meprobamate, mesoridazine, methadone and metabolite, methamphetamine, methapyrilene, methaqualone, methocarbamol, methorphan, methyl alcohol, methylphenidate, metoprolol, midazolam, morphine, naproxen and metabolite, nifedipine, nortriptyline, opiates, orphenadrine, oxaprozin, oxazepam, oxycodone, pentazocine, pentobarbital, phenacetin, phencyclidine, phenmetrazine, phenobarbital, phentermine, phenylpropanolamine, phenytoin, prazepam (as desmethyldiazepam), primidone, procainamide, procaine, promazine, promethazine, propoxyphene and metabolites, propranolol, protriptyline, pseudoephedrine (and/or ephedrine), pyrilamine, quazepam (as desalkylflurazepam), salicylate, secobarbital, sertraline and metabolite, temazepam, terfenadine metabolite, THC (marijuana) metabolite, theophylline, thiopental, thioridazine, tolmetin, tramadol and metabolites, triazolam, tricyclic antidepressants, trihexyphenidyl, trimipramine, tripelennamine, valproic acid, venlafaxine and metabolite, and verapamil and metabolite
Lab Notes  Send to Medtox SPECIMEN
Methodology  Immunoassay (IA); Gas Chromatography/Mass Spectrometry (GC/MS); Confirmation: Various

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