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DRUG FACIL SEXUAL ASSAULT PNL RFLX

Test Code
DFSA
 
This test may reflex to additional tests depending upon the results of this test. An additional fee will be added if the reflex test is necessary.
This test is a lab developed test. For further information, see the Compliance Remarks section below.
SPECIMEN REQUIREMENTS
Container TypeRandom urine
Supply Item Numberpicture1387
Specimen TypeRandom urine
Preferred Volume50 mL
Emergency Minimum Volume10 mL
Collection ProcedureCollect a random urine in a leakproof plastic urine container.
Specimen ProcessingTwo aliquots required for testing. Transfer a minimum 0.5 mL into a plastic aliquot tube for Separation Science. Send remaining sample in urine specimen cup to Toxicology.
Store and TransportRefrigerated
StabilityRoom Temp 10 days  Refrigerated 1 month  
CPT Codes80337, 80339, 80343, 80333, 80369, 80361, 80377, 80325, 80338, 80360, 80357, 80356, 80365, 80347, 80368, 80307, 80362, (HCPCS G0482)
Interface Order Code80100.Z197
Billing CodeDFSAP
Test ScheduleMon-Fri
Turnaround Time1-4 days
MethodEnzyme Immunoassay/Liquid Chromatography Tandem Mass Spectrometry/Gas Chromatography Mass Spectrometry
Reference Ranges
TitleDescriptorRangesUnits
Urine CreatinineNormal> 19mg/dL
Urine pHNormal4.5-9.0
GlucoseNegative< 20mg/dL
Urine Specific GravityNormal1.003-1.020
Phencyclidine (PCP) ScreenNegative< 25ng/mL
Ecstasy ScreenNegative< 500ng/mL
Tramadol ScreenNegative< 200ng/mL
Fentanyl ScreenNegative< 2ng/mL
Barbiturates ScreenNegative< 200ng/mL
Propoxyphene ScreenNegative< 300ng/mL
Cannabinoid ScreenNegative< 50ng/mL
AcetaminophenNegative< 2.5ug/mL
Meperidine ScreenNegative< 200ng/mL
Ethanol ScreenNegative< 20mg/dL
Methadone (EDDP) ScreenNegative< 300ng/mL
CotinineNegative< 250ng/mL
Carisoprodol ScreenNegative< .1ug/mL
Buprenorphine ScreenNegative< 25ng/mL
Cocaine (BEG) ScreenNegative< 150ng/mL
AmitriptylineNot Detected< 350ng/mL
CarbamazepineNot Detected< 350ng/mL
ChlorpromazineNot Detected< 350ng/mL
CimetidineNot Detected< 350ng/mL
CitalopramNot Detected< 350ng/mL
ClomipramineNot Detected< 350ng/mL
CyclobenzaprineNot Detected< 350ng/mL
DesipramineNot Detected< 350ng/mL
DextromethorphanNot Detected< 350ng/mL
DiphenhydramineNot Detected< 350ng/mL
DoxepinNot Detected< 350ng/mL
DoxylamineNot Detected< 350ng/mL
Ephedrine/PsedoephedrineNot Detected< 350ng/mL
FluphenazineNot Detected< 350ng/mL
HydroxybupropionNot Detected< 350ng/mL
ImipramineNot Detected< 350ng/mL
LidocaineNot Detected< 350ng/mL
MethocarbamolNot Detected< 350ng/mL
MethylphenidateNot Detected< 350ng/mL
MetoprololNot Detected< 350ng/mL
MirtazapineNot Detected< 350ng/mL
NorfluoxetineNot Detected< 350ng/mL
NortriptylineNot Detected< 350ng/mL
NorvenlafaxineNot Detected< 350ng/mL
OlanzepineNot Detected< 350ng/mL
OxcarbazepineNot Detected< 350ng/mL
ParoxetineNot Detected< 350ng/mL
PentazocineNot Detected< 350ng/mL
PhentermineNot Detected< 350ng/mL
PhenylpropanolamineNot Detected< 350ng/mL
PhenytoinNot Detected< 650ng/mL
PropranololNot Detected< 350ng/mL
QuetiapineNot Detected< 350ng/mL
Quinine/QuinidineNot Detected< 350ng/mL
RanitidineNot Detected< 350ng/mL
Ritalinic AcidNot Detected< 350ng/mL
SertralineNot Detected< 350ng/mL
StrychnineNot Detected< 350ng/mL
ThioridazineNot Detected< 350ng/mL
Trazodone/NefazodoneNot Detected< 350ng/mL
TriamterineNot Detected< 350ng/mL
TrihexyphenidylNot Detected< 350ng/mL
VerapamilNot Detected< 350ng/mL
KetamineNegative< 7ng/mL
GHBNegative< 10ng/mL
Compliance RemarksThis test was developed and its performance characteristics determined by PAML. The U.S. Food and Drug Administration (FDA) has not approved or cleared this test. However, FDA approval or clearance is currently not required for clinical use of this test. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions. PAML is authorized under Clinical Laboratory Improvement Amendments (CLIA) to perform high-complexity testing.
NotesThe Drug Facilitated Sexual Assault Panel offers a qualitative screen and quantitative confirmation of a broad spectrum of licit and illicit drugs.
Reflex Testing
Reflex ConditionReflex Test NameReflex CPT codesReflex Billing codes
TGLUC Positive & Ethanol PositiveTYEAST81015
Ethanol PositiveTGLUC81003
Phencyclidine (PCP) Screen PositiveMSPCP83992BMSPCP
Ecstasy (MDMA) Screen PositiveMSAPX80324, 80359BMSAPX
Tramadol Screen PositiveMSTRAM80373BMSTRA
Fentanyl Screen PositiveFENTU80354BFENTU
Barbiturates Screen PositiveMSBAR80345BMSBAR
Propoxyphene Screen PositiveMSPRO80367BMSPRO
Cannabinoid Screen PositiveMSTHC80349BMSTHC
Meperidine Screen PositiveMSMEP80362BMSMEP
Ethanol Screen PositiveGCALC80320BALC
Methadone Screen PositiveMSMET80358BMSMET
Carisoprodol Screen PositiveMSCARI80369BMSCAR
Amphetamines Screen PositiveMSAPX80324, 80359BMSAPX
Buprenorphine Screen PositiveMSBUP80348BMSBUP
Cocaine Screen PositiveMSCOC80353BMSCOC

Interface Codes
typeorder codetest descriptionresult coderesult descriptionunitsdecimal placesloinc code
o80100.Z197Drug Facil Sexual Assault Pnl
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z121Carbamazepineng/mL 16548-0
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z122Citalopramng/mL 73584-5
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z123Cyclobenzaprine, Urineng/mL 14061-6
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z124Desipramineng/mL 3534-5
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z125Dextromethorphanng/mL 21240-7
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z126Diphenhydramineng/mL 3572-5
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z127Doxylamineng/mL 16792-4
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z128Doxepinng/mL 3581-6
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z129Norfluoxetineng/mL 12439-6
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z131Lidocaineng/mL 17075-3
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z132Methocarbamolng/mL 3791-1
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z133Mirtazapineng/mL 49690-1
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z134Metoprololng/mL 3817-4
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z136Olanzapineng/mL 77888-6
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z137Paroxetineng/mL 39591-3
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z138Phenytoinng/mL 17444-1
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z139Phenylpropanolamineng/mL 17443-3
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z140Propranololng/mL 3994-1
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z142Phentermineng/mL 3958-6
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z143Pentazocineng/mL 3918-0
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z144Quetiapineng/mL 59174-3
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z145Quinine/Quinidineng/mL 17507-5
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z146Ranitidineng/mL 14902-1
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z147Sertralineng/mL 74662-8
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z148Strychnineng/mL 5740-6
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z152Trihexyphenidylng/mL 10345-7
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z153Triamterineng/mL 4066-7
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z154Norvenlafaxineng/mL 18467-1
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z155Verapamilng/mL 17767-5
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z157Imipramineng/mL 3692-1
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z158Clomipramineng/mL 3492-6
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z162Ecstasy (MDMA,MDEA,MDA) Screenng/mL 73971-4
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z163MDEA (GCMS)ng/mL 27085-0
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z164Fentanyl Screenng/mL 58379-9
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z165Acetaminophenug/mL 13622-6
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z166Cotinineng/mL 12293-7
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z167Carisoprodolug/mL 10979-3
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z168Noroxycodone (LCMSMS)ng/mL 61423-0
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z169Norhydrocodone (LCMSMS)ng/mL 61420-6
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z170Chlorpromazineng/mL 
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z171Cimetidineng/mL 
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z172Ephedrine/Pseudophedrineng/mL 
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z173Fluphenazineng/mL 
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z174Hydroxybupropionng/mL 
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z175Methylphenidateng/mL 
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z176Oxcarbazepineng/mL 
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z177Ritalinic Acidng/mL 
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z178Thioridazineng/mL 
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z179Toxicology Glucosemg/dL 
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z180Yeast  
r80100.Z197Drug Facil Sexual Assault Pnl80100.Z204Trazodone/Nefazodoneng/mL 
r80100.Z197Drug Facil Sexual Assault Pnl80101.Z17Methadone Rflxng/mL 70149-0
r80100.Z197Drug Facil Sexual Assault Pnl80101.Z179Meperidine Screen Rflxng/mL 19532-1
r80100.Z197Drug Facil Sexual Assault Pnl80101.Z182Tramadol Screenng/mL 19710-3
r80100.Z197Drug Facil Sexual Assault Pnl80101.Z21Phencyclidine Screenng/mL 3937-0
r80100.Z197Drug Facil Sexual Assault Pnl80101.Z24Ethanol, Urinemg/dL 42242-8
r80100.Z197Drug Facil Sexual Assault Pnl80101.Z246Buprenorphineng/mL 58359-1
r80100.Z197Drug Facil Sexual Assault Pnl80101.Z29Propoxyphene Rflxng/mL 19429-0
r80100.Z197Drug Facil Sexual Assault Pnl80101.Z31Amphet/Methamphet Screenng/mL 43983-6
r80100.Z197Drug Facil Sexual Assault Pnl80101.Z37Barbiturates Screenng/mL 70155-7
r80100.Z197Drug Facil Sexual Assault Pnl80101.Z55MDMA (GCMS)ng/mL018358-2
r80100.Z197Drug Facil Sexual Assault Pnl80101.Z56MDA (GCMS)ng/mL 20545-0
r80100.Z197Drug Facil Sexual Assault Pnl80101.Z6Cannabinoid Screenng/mL 70145-8
r80100.Z197Drug Facil Sexual Assault Pnl80101.Z8Cocaine Screenng/mL 43984-4
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z1096 MAM (Heroin Metabolite) (LCMSMS)ng/mL 19593-3
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z11Amphetamine (GCMS)ng/mL 20410-7
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z12Methamphetamine (GCMS)ng/mL 16235-4
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z14Amobarbital (GCMS)ng/mL 16239-6
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z15Butalbital (GCMS)ng/mL 16237-0
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z155Buprenorphine by GC/MSng/mL 49752-9
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z156Norbuprenorphine by GC/MSng/mL 49751-1
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z16Pentobarbital (GCMS)ng/mL 16240-4
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z1647-Aminoflunitrazepam (LCMSMS)ng/mL 51777-1
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z17Phenobarbital (GCMS)ng/mL 16241-2
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z18Secobarbital (GCMS)ng/mL 16238-8
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z26Cocaine Metab (GCMS)ng/mL 53743-1
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z29Methadone Metab. by GC/MSng/mL 58429-2
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z33Phencyclidine (GCMS)ng/mL 16254-5
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z36Norpropoxyphene by GC/MSng/mL 17377-3
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z38Carboxy-THC (GCMS)ng/mL 20521-1
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z60Urine Alcohol (GC)mg/dL 5645-7
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z75Gamma-Hydroxybutyric Acid Scr GC/MSmcg/mL143197-3
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z76Clonazepam (LCMSMS)ng/mL 16229-7
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z77Confirm Ketamine (GCMS)ng/mL120537-7
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z78Flunitrazepam (LCMSMS)ng/mL120528-6
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z81Morphine (LCMSMS)ng/ml 16251-1
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z82Oxymorphone (LCMSMS)ng/ml 17395-5
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z83Hydromorphone (LCMSMS)ng/ml 16998-7
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z84Codeine (LCMSMS)ng/ml 16250-3
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z85Oxycodone (LCMSMS)ng/ml 16249-5
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z86Hydrocodone (LCMSMS)ng/ml 16252-9
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z91Meperidineng/mL016253-7
r80100.Z197Drug Facil Sexual Assault Pnl80102.Z92Normeperidineng/mL058389-8
r80100.Z197Drug Facil Sexual Assault Pnl80154.Z34Diazepam (LCMSMS)ng/mL 16227-1
r80100.Z197Drug Facil Sexual Assault Pnl80154.Z35Nordiazepam (LCMSMS)ng/mL 16228-9
r80100.Z197Drug Facil Sexual Assault Pnl80154.Z37Alprazolam (LCMSMS)ng/mL 59615-5
r80100.Z197Drug Facil Sexual Assault Pnl80154.Z39Midazolam (LCMSMS)ng/mL 16233-9
r80100.Z197Drug Facil Sexual Assault Pnl80154.Z42Temazepam (LCMSMS)ng/mL 20559-1
r80100.Z197Drug Facil Sexual Assault Pnl80154.Z43Oxazepam (LCMSMS)ng/mL 16201-6
r80100.Z197Drug Facil Sexual Assault Pnl80154.Z44Lorazepam (LCMSMS)ng/mL 17088-6
r80100.Z197Drug Facil Sexual Assault Pnl80154.Z45Alpha-OH Alprazolam (LCMSMS)ng/mL 16348-5
r80100.Z197Drug Facil Sexual Assault Pnl80154.Z46Flurazepam (LCMSMS)ng/mL 16231-3
r80100.Z197Drug Facil Sexual Assault Pnl80154.Z47Alpha-OH-Triazolam (LCMSMS)ng/mL 49876-6
r80100.Z197Drug Facil Sexual Assault Pnl80335.Z1Amitriptylineng/mL 20515-3
r80100.Z197Drug Facil Sexual Assault Pnl80335.Z2Nortriptylineng/mL 61428-9
r80100.Z197Drug Facil Sexual Assault Pnl81000.Z15Toxicology Specific Gravity 35811-5
r80100.Z197Drug Facil Sexual Assault Pnl82491.Z108Carisoprodol, Urineng/mL010979-3
r80100.Z197Drug Facil Sexual Assault Pnl82541.Z11Tramadol (GCMS)ng/mL020561-7
r80100.Z197Drug Facil Sexual Assault Pnl82542.Z257 amino-Clonazepam (LCMSMS)ng/mL 51776-3
r80100.Z197Drug Facil Sexual Assault Pnl82570.Z15Tox Creatininemg/dL02161-8
r80100.Z197Drug Facil Sexual Assault Pnl83805.Z3Meprobamate, Urineug/mL03755-6
r80100.Z197Drug Facil Sexual Assault Pnl83925.Z24Fentanylng/mL13637-6
r80100.Z197Drug Facil Sexual Assault Pnl83925.Z25Norfentanylng/mL158383-1
r80100.Z197Drug Facil Sexual Assault Pnl83986.Z9Toxicology pH  2756-5

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