PAML

DRUG FACIL SEXUAL ASSAULT PNL RFLX

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Test Code
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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 Type

Random urine

Supply Item Number

1387

Specimen Type

Random urine

Preferred Volume

50 mL

Emergency Minimum Volume

10 mL

Collection Procedure

Collect a random urine in a leakproof plastic urine container.

Specimen Processing

Two 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 Transport

Refrigerated

Stability

Room Temp 10 days Refrigerated 1 month

Reference Laboratory

PAML

Reference Lab Test Code

LCA code 911048

CPT Codes

80337, 80339, 80343, 80333, 80369, 80361, 80377, 80325, 80338, 80360, 80357, 80356, 80365, 80347, 80368, 80307, 80362, (HCPCS G0482)

Interface Order Code

80100.Z197

Billing Code

DFSAP

Test Schedule

Mon-Fri

Turnaround Time

1-4 days

Method

Enzyme Immunoassay/Liquid Chromatography Tandem Mass Spectrometry/Gas Chromatography Mass Spectrometry

Reference Ranges

Title	Descriptor	Ranges	Units
Urine Creatinine	Normal	> 19	mg/dL
Urine pH	Normal	4.5-9.0
Glucose	Negative	< 20	mg/dL
Urine Specific Gravity	Normal	1.003-1.020
Phencyclidine (PCP) Screen	Negative	< 25	ng/mL
Ecstasy Screen	Negative	< 500	ng/mL
Tramadol Screen	Negative	< 200	ng/mL
Fentanyl Screen	Negative	< 2	ng/mL
Barbiturates Screen	Negative	< 200	ng/mL
Propoxyphene Screen	Negative	< 300	ng/mL
Cannabinoid Screen	Negative	< 50	ng/mL
Acetaminophen	Negative	< 2.5	ug/mL
Meperidine Screen	Negative	< 200	ng/mL
Ethanol Screen	Negative	< 20	mg/dL
Methadone (EDDP) Screen	Negative	< 300	ng/mL
Cotinine	Negative	< 250	ng/mL
Carisoprodol Screen	Negative	< .1	ug/mL
Buprenorphine Screen	Negative	< 25	ng/mL
Cocaine (BEG) Screen	Negative	< 150	ng/mL
Amitriptyline	Not Detected	< 350	ng/mL
Carbamazepine	Not Detected	< 350	ng/mL
Chlorpromazine	Not Detected	< 350	ng/mL
Cimetidine	Not Detected	< 350	ng/mL
Citalopram	Not Detected	< 350	ng/mL
Clomipramine	Not Detected	< 350	ng/mL
Cyclobenzaprine	Not Detected	< 350	ng/mL
Desipramine	Not Detected	< 350	ng/mL
Dextromethorphan	Not Detected	< 350	ng/mL
Diphenhydramine	Not Detected	< 350	ng/mL
Doxepin	Not Detected	< 350	ng/mL
Doxylamine	Not Detected	< 350	ng/mL
Ephedrine/Psedoephedrine	Not Detected	< 350	ng/mL
Fluphenazine	Not Detected	< 350	ng/mL
Hydroxybupropion	Not Detected	< 350	ng/mL
Imipramine	Not Detected	< 350	ng/mL
Lidocaine	Not Detected	< 350	ng/mL
Methocarbamol	Not Detected	< 350	ng/mL
Methylphenidate	Not Detected	< 350	ng/mL
Metoprolol	Not Detected	< 350	ng/mL
Mirtazapine	Not Detected	< 350	ng/mL
Norfluoxetine	Not Detected	< 350	ng/mL
Nortriptyline	Not Detected	< 350	ng/mL
Norvenlafaxine	Not Detected	< 350	ng/mL
Olanzepine	Not Detected	< 350	ng/mL
Oxcarbazepine	Not Detected	< 350	ng/mL
Paroxetine	Not Detected	< 350	ng/mL
Pentazocine	Not Detected	< 350	ng/mL
Phentermine	Not Detected	< 350	ng/mL
Phenylpropanolamine	Not Detected	< 350	ng/mL
Phenytoin	Not Detected	< 650	ng/mL
Propranolol	Not Detected	< 350	ng/mL
Quetiapine	Not Detected	< 350	ng/mL
Quinine/Quinidine	Not Detected	< 350	ng/mL
Ranitidine	Not Detected	< 350	ng/mL
Ritalinic Acid	Not Detected	< 350	ng/mL
Sertraline	Not Detected	< 350	ng/mL
Strychnine	Not Detected	< 350	ng/mL
Thioridazine	Not Detected	< 350	ng/mL
Trazodone/Nefazodone	Not Detected	< 350	ng/mL
Triamterine	Not Detected	< 350	ng/mL
Trihexyphenidyl	Not Detected	< 350	ng/mL
Verapamil	Not Detected	< 350	ng/mL
Ketamine	Negative	< 7	ng/mL
GHB	Negative	< 10	ng/mL

Compliance Remarks

This 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.

Notes

The Drug Facilitated Sexual Assault Panel offers a qualitative screen and quantitative confirmation of a broad spectrum of licit and illicit drugs.

Reflex Testing

Reflex Condition	Reflex Test Name	Reflex CPT codes	Reflex Billing codes
TGLUC Positive & Ethanol Positive	TYEAST	81015
Ethanol Positive	TGLUC	81003
Phencyclidine (PCP) Screen Positive	MSPCP	83992	BMSPCP
Ecstasy (MDMA) Screen Positive	MSAPX	80324, 80359	BMSAPX
Tramadol Screen Positive	MSTRAM	80373	BMSTRA
Fentanyl Screen Positive	FENTU	80354	BFENTU
Barbiturates Screen Positive	MSBAR	80345	BMSBAR
Propoxyphene Screen Positive	MSPRO	80367	BMSPRO
Cannabinoid Screen Positive	MSTHC	80349	BMSTHC
Meperidine Screen Positive	MSMEP	80362	BMSMEP
Ethanol Screen Positive	GCALC	80320	BALC
Methadone Screen Positive	MSMET	80358	BMSMET
Carisoprodol Screen Positive	MSCARI	80369	BMSCAR
Amphetamines Screen Positive	MSAPX	80324, 80359	BMSAPX
Buprenorphine Screen Positive	MSBUP	80348	BMSBUP
Cocaine Screen Positive	MSCOC	80353	BMSCOC

Interface Codes

type	order code	test description	result code	result description	units	decimal places	loinc code
o	80100.Z197	Drug Facil Sexual Assault Pnl
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z121	Carbamazepine	ng/mL		16548-0
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z122	Citalopram	ng/mL		73584-5
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z123	Cyclobenzaprine, Urine	ng/mL		14061-6
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z124	Desipramine	ng/mL		3534-5
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z125	Dextromethorphan	ng/mL		21240-7
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z126	Diphenhydramine	ng/mL		3572-5
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z127	Doxylamine	ng/mL		16792-4
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z128	Doxepin	ng/mL		3581-6
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z129	Norfluoxetine	ng/mL		12439-6
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z131	Lidocaine	ng/mL		17075-3
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z132	Methocarbamol	ng/mL		3791-1
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z133	Mirtazapine	ng/mL		49690-1
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z134	Metoprolol	ng/mL		3817-4
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z136	Olanzapine	ng/mL		77888-6
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z137	Paroxetine	ng/mL		39591-3
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z138	Phenytoin	ng/mL		17444-1
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z139	Phenylpropanolamine	ng/mL		17443-3
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z140	Propranolol	ng/mL		3994-1
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z142	Phentermine	ng/mL		3958-6
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z143	Pentazocine	ng/mL		3918-0
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z144	Quetiapine	ng/mL		59174-3
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z145	Quinine/Quinidine	ng/mL		17507-5
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z146	Ranitidine	ng/mL		14902-1
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z147	Sertraline	ng/mL		74662-8
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z148	Strychnine	ng/mL		5740-6
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z152	Trihexyphenidyl	ng/mL		10345-7
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z153	Triamterine	ng/mL		4066-7
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z154	Norvenlafaxine	ng/mL		18467-1
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z155	Verapamil	ng/mL		17767-5
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z157	Imipramine	ng/mL		3692-1
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z158	Clomipramine	ng/mL		3492-6
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z162	Ecstasy (MDMA,MDEA,MDA) Screen	ng/mL		73971-4
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z163	MDEA (GCMS)	ng/mL		27085-0
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z164	Fentanyl Screen	ng/mL		58379-9
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z165	Acetaminophen	ug/mL		13622-6
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z166	Cotinine	ng/mL		12293-7
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z167	Carisoprodol	ug/mL		10979-3
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z168	Noroxycodone (LCMSMS)	ng/mL		61423-0
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z169	Norhydrocodone (LCMSMS)	ng/mL		61420-6
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z170	Chlorpromazine	ng/mL
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z171	Cimetidine	ng/mL
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z172	Ephedrine/Pseudophedrine	ng/mL
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z173	Fluphenazine	ng/mL
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z174	Hydroxybupropion	ng/mL
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z175	Methylphenidate	ng/mL
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z176	Oxcarbazepine	ng/mL
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z177	Ritalinic Acid	ng/mL
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z178	Thioridazine	ng/mL
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z179	Toxicology Glucose	mg/dL
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z180	Yeast
r	80100.Z197	Drug Facil Sexual Assault Pnl	80100.Z204	Trazodone/Nefazodone	ng/mL
r	80100.Z197	Drug Facil Sexual Assault Pnl	80101.Z17	Methadone Rflx	ng/mL		70149-0
r	80100.Z197	Drug Facil Sexual Assault Pnl	80101.Z179	Meperidine Screen Rflx	ng/mL		19532-1
r	80100.Z197	Drug Facil Sexual Assault Pnl	80101.Z182	Tramadol Screen	ng/mL		19710-3
r	80100.Z197	Drug Facil Sexual Assault Pnl	80101.Z21	Phencyclidine Screen	ng/mL		3937-0
r	80100.Z197	Drug Facil Sexual Assault Pnl	80101.Z24	Ethanol, Urine	mg/dL		42242-8
r	80100.Z197	Drug Facil Sexual Assault Pnl	80101.Z246	Buprenorphine	ng/mL		58359-1
r	80100.Z197	Drug Facil Sexual Assault Pnl	80101.Z29	Propoxyphene Rflx	ng/mL		19429-0
r	80100.Z197	Drug Facil Sexual Assault Pnl	80101.Z31	Amphet/Methamphet Screen	ng/mL		43983-6
r	80100.Z197	Drug Facil Sexual Assault Pnl	80101.Z37	Barbiturates Screen	ng/mL		70155-7
r	80100.Z197	Drug Facil Sexual Assault Pnl	80101.Z55	MDMA (GCMS)	ng/mL	0	18358-2
r	80100.Z197	Drug Facil Sexual Assault Pnl	80101.Z56	MDA (GCMS)	ng/mL		20545-0
r	80100.Z197	Drug Facil Sexual Assault Pnl	80101.Z6	Cannabinoid Screen	ng/mL		70145-8
r	80100.Z197	Drug Facil Sexual Assault Pnl	80101.Z8	Cocaine Screen	ng/mL		43984-4
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z109	6 MAM (Heroin Metabolite) (LCMSMS)	ng/mL		19593-3
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z11	Amphetamine (GCMS)	ng/mL		20410-7
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z12	Methamphetamine (GCMS)	ng/mL		16235-4
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z14	Amobarbital (GCMS)	ng/mL		16239-6
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z15	Butalbital (GCMS)	ng/mL		16237-0
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z155	Buprenorphine by GC/MS	ng/mL		49752-9
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z156	Norbuprenorphine by GC/MS	ng/mL		49751-1
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z16	Pentobarbital (GCMS)	ng/mL		16240-4
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z164	7-Aminoflunitrazepam (LCMSMS)	ng/mL		51777-1
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z17	Phenobarbital (GCMS)	ng/mL		16241-2
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z18	Secobarbital (GCMS)	ng/mL		16238-8
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z26	Cocaine Metab (GCMS)	ng/mL		53743-1
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z29	Methadone Metab. by GC/MS	ng/mL		58429-2
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z33	Phencyclidine (GCMS)	ng/mL		16254-5
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z36	Norpropoxyphene by GC/MS	ng/mL		17377-3
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z38	Carboxy-THC (GCMS)	ng/mL		20521-1
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z60	Urine Alcohol (GC)	mg/dL		5645-7
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z75	Gamma-Hydroxybutyric Acid Scr GC/MS	mcg/mL	1	43197-3
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z76	Clonazepam (LCMSMS)	ng/mL		16229-7
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z77	Confirm Ketamine (GCMS)	ng/mL	1	20537-7
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z78	Flunitrazepam (LCMSMS)	ng/mL	1	20528-6
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z81	Morphine (LCMSMS)	ng/ml		16251-1
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z82	Oxymorphone (LCMSMS)	ng/ml		17395-5
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z83	Hydromorphone (LCMSMS)	ng/ml		16998-7
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z84	Codeine (LCMSMS)	ng/ml		16250-3
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z85	Oxycodone (LCMSMS)	ng/ml		16249-5
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z86	Hydrocodone (LCMSMS)	ng/ml		16252-9
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z91	Meperidine	ng/mL	0	16253-7
r	80100.Z197	Drug Facil Sexual Assault Pnl	80102.Z92	Normeperidine	ng/mL	0	58389-8
r	80100.Z197	Drug Facil Sexual Assault Pnl	80154.Z34	Diazepam (LCMSMS)	ng/mL		16227-1
r	80100.Z197	Drug Facil Sexual Assault Pnl	80154.Z35	Nordiazepam (LCMSMS)	ng/mL		16228-9
r	80100.Z197	Drug Facil Sexual Assault Pnl	80154.Z37	Alprazolam (LCMSMS)	ng/mL		59615-5
r	80100.Z197	Drug Facil Sexual Assault Pnl	80154.Z39	Midazolam (LCMSMS)	ng/mL		16233-9
r	80100.Z197	Drug Facil Sexual Assault Pnl	80154.Z42	Temazepam (LCMSMS)	ng/mL		20559-1
r	80100.Z197	Drug Facil Sexual Assault Pnl	80154.Z43	Oxazepam (LCMSMS)	ng/mL		16201-6
r	80100.Z197	Drug Facil Sexual Assault Pnl	80154.Z44	Lorazepam (LCMSMS)	ng/mL		17088-6
r	80100.Z197	Drug Facil Sexual Assault Pnl	80154.Z45	Alpha-OH Alprazolam (LCMSMS)	ng/mL		16348-5
r	80100.Z197	Drug Facil Sexual Assault Pnl	80154.Z46	Flurazepam (LCMSMS)	ng/mL		16231-3
r	80100.Z197	Drug Facil Sexual Assault Pnl	80154.Z47	Alpha-OH-Triazolam (LCMSMS)	ng/mL		49876-6
r	80100.Z197	Drug Facil Sexual Assault Pnl	80335.Z1	Amitriptyline	ng/mL		20515-3
r	80100.Z197	Drug Facil Sexual Assault Pnl	80335.Z2	Nortriptyline	ng/mL		61428-9
r	80100.Z197	Drug Facil Sexual Assault Pnl	81000.Z15	Toxicology Specific Gravity		3	5811-5
r	80100.Z197	Drug Facil Sexual Assault Pnl	82491.Z108	Carisoprodol, Urine	ng/mL	0	10979-3
r	80100.Z197	Drug Facil Sexual Assault Pnl	82541.Z11	Tramadol (GCMS)	ng/mL	0	20561-7
r	80100.Z197	Drug Facil Sexual Assault Pnl	82542.Z25	7 amino-Clonazepam (LCMSMS)	ng/mL		51776-3
r	80100.Z197	Drug Facil Sexual Assault Pnl	82570.Z15	Tox Creatinine	mg/dL	0	2161-8
r	80100.Z197	Drug Facil Sexual Assault Pnl	83805.Z3	Meprobamate, Urine	ug/mL	0	3755-6
r	80100.Z197	Drug Facil Sexual Assault Pnl	83925.Z24	Fentanyl	ng/mL	1	3637-6
r	80100.Z197	Drug Facil Sexual Assault Pnl	83925.Z25	Norfentanyl	ng/mL	1	58383-1
r	80100.Z197	Drug Facil Sexual Assault Pnl	83986.Z9	Toxicology pH			2756-5

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