Test ID: PANOX Pain Clinic Survey 10, Chain of Custody, Random, Urine
Useful For
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
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
PN10X | Pain Clinic Survey 10, CoC | No | Yes |
OXYSX | Oxycodone Screen, CoC, U | Yes | Yes |
Additional Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
COCH | Chain of Custody Processing | No | Yes |
ADLTX | Adulterants Survey, CoC, U | Yes | Yes |
Reflex 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 |
Testing Algorithm
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.
Reporting Name
Pain Clinic Survey 10, CoC, USpecimen Type
UrineSpecimen Required
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.
Specimen Minimum Volume
20 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Urine | Refrigerated (preferred) | 7 days | |
Frozen | 14 days |
Clinical Information
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
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
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.
Clinical Reference
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
Day(s) Performed
Monday through Saturday
Report Available
2 to 3 daysCPT Code Information
80307
LOINC Code Information
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 |
---|---|---|
36253 | Amphetamines | 43983-6 |
61727 | Oxycodone | 19642-8 |
36027 | Chain of Custody | 77202-0 |
36258 | Barbiturates | 70155-7 |
36259 | Benzodiazepines | 14316-4 |
36254 | Cocaine | 43984-4 |
36260 | Methadone metabolite | 41858-2 |
36255 | Opiates | 70151-6 |
36256 | Phencyclidine | 14310-7 |
36257 | Tetrahydrocannabinol | 14312-3 |
36261 | Chain of Custody | 77202-0 |
Method Name
Immunoassay followed by Gas Chromatography Mass Spectrometry (GC-MS) or Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS) as needed
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.
Test Classification
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.mml-custody, mml-antiarrhythmics, mml-substancemonitoring, mml-drugmonitoring |