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Test Code
If the Provider requires an interpretive comment with results, please order 'PMM1' along with the test. PMM1 will require the last 5 days of prescription medicine taken by the patient to be input at the time of order.
This test may reflex to additional tests depending upon results of this test. No additional fee will be added if the reflex test is necessary.
If this test is ordered alone without additional Pain Management tests please add a PMV1 test to include validity testing for the specimen.
Container TypeRandom urine
Supply Item Number1387 or 1678
Specimen TypeRandom urine
Preferred Volume20 mL
Emergency Minimum Volume10 mL
Collection ProcedureCollect a random urine specimen
Store and TransportAmbient (room temperature)
StabilityRoom Temp 10 days  Refrigerated 1 month  
Reference LaboratoryPAML
Reference Lab Test CodeLCA code 910487
CPT Codes80307
Interface Order Code80101.Z221
Billing CodePMETGS
Test ScheduleMon-Sat
Turnaround Time1-3 days
MethodEnzyme Immunoassay
Reference Ranges
Ethyl Glucuronide/Ethyl Sulfate ScreenNegative< 250ng/mL
Ethyl Glucuronide by LC-MS/MSng/mL
Ethyl Sulfate by LC-MS/MSng/mL
Reflex Testing
Reflex ConditionReflex Test NameReflex CPT codesReflex Billing codes
If screen for ETG/ETS positive Reflex testing built into panel, no additional test code requiredReflex testing built into panel, no additional CPT code requiredN/A

Interface Codes
typeorder codetest descriptionresult coderesult descriptionunitsdecimal placesloinc code
o80101.Z221Pain Management ETG/ETS
r80101.Z221Pain Management ETG/ETS83789.Z26Ethyl Glucu/Ethyl Sulfate Screenng/mL 19146-0
r80101.Z221Pain Management ETG/ETS83789.Z27Ethyl Glucuronide by LC-MS/MSng/mL 58378-1
r80101.Z221Pain Management ETG/ETS83789.Z28Ethyl Sulfate by LC-MS/MSng/mL 58425-0