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Comprehensive Drug Analysis (Immunoassay Screening and GC/MS Analysis)

Drug Screen, Urine Drug Screen, GCMS

Test Codes

EPIC: LAB1230988, CMPD2
Emergency Center and Inpatient Orders ONLY

Department

Toxicology

Instructions

This panel includes urine immunoassay screening for:
Amphetamine/Methamphetamines, Barbiturates, Benzodiazepines, Cannabinoid, Cocaine, Fentanyl, Methadone, Opiates, Oxycodone, Phencyclidine (PCP), and a GC/MS analysis for common illicit drugs and other prescription and over-the-counter medications (e.g., non-narcotic analgesics, anti-epileptics, antidepressants, anti-psychotics).  Drugs not present in the mass spectral library will not be detected.  This GC/MS analysis does not replace confirmation testing. Mass spectrometry confirmation assays for specific drug classes must be ordered separately or added on to the original sample within 7 days of sample collection.

This order does not include acetaminophen or salicylate screening.

Specimen Collection Criteria

Collect: Urine: 50 mL random urine in a screw-capped container (preferred) or other sterile collection cup. (Minimum: 30 mL for adults, 20 mL for pediatrics)

Refrigerate the urine specimen immediately after collection.
Record the exact time of specimen collection on the container or in the computer system.

Preparation for Courier Transport

Transport: 50 mL urine, refrigerated (2-8°C or 36-46°F). (Minimum: 30 mL)

Rejection Criteria

Urine Vacutainer^® tubes. Urine received in a glass or plastic tube with a rubber stopper may contain insufficient sample volume, preclude later confirmatory testing, and give rise to contaminants and artifacts. 

In-Lab Processing

Deliver immediately to the appropriate testing station. Analyze immediately upon receipt in the Laboratory. Send original samples (not aliquots) to Royal Oak Toxicology for GC/MS analysis.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 72 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): 3 months

Specimen Storage in Department Prior to Disposal:

Frozen (-20°C/-4°F or below): 1 month

Laboratory

Dearborn Chemistry Laboratory
Royal Oak Automated Chemistry Laboratory

NOTE: All samples will be sent to Royal Oak for GC/MS analysis.

Performed

Sunday – Saturday, 24 hours a day.
STAT immunoassay screen results available within 1 hour of receipt in the Laboratory.
GC/MS analysis results available within 4 hours of receipt in the Royal Oak Toxicology Laboratory.

Reference Range

No drugs detected.

Test Methodology

Immunoassay, Gas Chromatography/Mass Spectrometry (GC/MS).

This test was developed and its performance characteristics determined by Beaumont Health. It has not been cleared or approved by the FDA. The Laboratory is regulated under CLIA as qualified to perform high-complexity testing. This test is used for clinical purposes and should not be regarded as investigational or for research.

Interpretation

Drugs detected by the immunoassay screening procedures represent tentative findings and will be reported as "Unconfirmed positive." Effective 6 December 2022, the laboratory will no longer automatically perform confirmation testing on positive immunoassay screening results. Drugs identified by GC/MS analysis will be reported as "Confirmed positive."  

NOTE: GC/MS analysis cannot confirm all positive drug screens. Drug class-specific mass spectrometry confirmation tests must be ordered separately to confirm amphetamines, barbiturates, cannabinoids, and low/therapeutic doses of benzodiazepines, fentanyl, and other opioids.

Clinical Utility

Drugs detected by the immunoassay screening procedures represent tentative findings and should be considered presumptive. The GC/MS analysis portion of this order is a broad based chromatographic screen for common illicit, over-the-counter, and prescription drugs. Drugs that cannot be volatilized or that are not present in the GCMS library will not be detected.

CPT Codes

80307x8, 80345, 80347, 80349, 80353, 80358, 80364, 80375, 83992 (alternate: G0480, G0482).

Contacts

Last Updated

7/21/2024