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PAIN MANAGEMENT PANEL 1 RFLX

Test Code
PM1
 
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.
Positive results will automatically relex to confirmation testing. Confirmation by GC/MS, LC-MS/MS, or GC/FID.
This test is a lab developed test. For further information, see the Compliance Remarks section below.
Important LinksPatient Prescription Record
SPECIMEN REQUIREMENTS
Container TypeRandom urine
Supply Item Numberpicture1387 or picture1678
Specimen TypeRandom urine
Preferred Volume30 mL
Emergency Minimum Volume15 mL
Collection ProcedureCollect a random urine specimen
Store and TransportAmbient (room temperature)
Required Patient InfoList last 5 days of prescription medicine taken by the patient
StabilityRoom Temp 10 days  Refrigerated 1 month  
Unacceptable ConditionBlood, serum, or plasma samples
CPT Codes80361, 80307, 80356, 80365, (HCPCS G0480)
Interface Order Code80101.Z213
Billing CodePM12017
Test ScheduleMon-Sat
Turnaround Time1-3 days
MethodEnzyme Immunoassay, Confirmations by GC/MS, LC/MS/MS, or GC/FID
Reference Ranges
TitleDescriptorRangesUnits
Alcohol ScreenNegative< 20mg/dL
Alcohol by GC/FIDNot Detected< 8mg/dL
Amp/Methamphetamine ScreenNegative< 500ng/mL
Amphetamines by GC/MSNot Detected< 250ng/mL
Methamphetamine by GC/MSNot Detected< 250mg/mL
D-Methamphetamine by GC/MSNot Detected< 250%
L-MethamphetamineNot Detected< 250%
Alternate Amphetamines ScreenNegative< 500ng/mL
MDMA by GC/MSNot Detected< 250ng/mL
MDA by GC/MSNot Detected< 250ng/mL
MDEA by GC/MSNot Detected< 250ng/mL
Cannabinoids Screen (20)Negative< 20ng/mL
Carboxy-THC by GC/MSNot Detected< 15ng/mL
Cocaine ScreenNegative< 150ng/mL
Benzoylecgonine by GC/MSNot Detected< 100ng/mL
Morphine by LC-MS/MSNot Detected< 50ng/mL
Oxymorphone by LC-MS/MSNot Detected< 50ng/mL
Hydromorphone by LC-MS/MSNot Detected< 50ng/mL
Nor-Oxycodone by LC-MS/MSNot Detected< 50ng/mL
Nor-Hydrocodone by LC-MS/MSNot Detected< 50ng/mL
Oxycodone by LC-MS/MSNot Detected< 50ng/mL
Codeine by LC-MS/MSNot Detected< 50ng/mL
Heroin Metab (6AM) by LC-MS/MSNot Detected< 10ng/mL
Hydrocodone by LC-MS/MSNot Detected< 50ng/mL
Phencyclidine ScreenNegative< 25ng/mL
Phencyclidine by GC/MSNot Detected< 6ng/mL
Propoxyphene ScreenNegative< 300ng/mL
Norpropoxyphene by GC/MSNot Detected< 80ng/mL
OxidantsNormal< 200ug/mL
Urine pHNormal4.5-9.0
Urine CreatinineNormal> 19mg/dL
Specific GravityNormal1.003-1.020
GlucoseNegative< 20mg/dL
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.
Reflex Testing
Reflex ConditionReflex Test NameReflex CPT codesReflex Billing codes
If any Analyte in panel positiveReflex testing built into panel, no additional test codes requiredReflex testing built into panel, no additional CPT codes requiredN/A
If screen for Alcohol is positive
If screen for Amphetamines is positive
If screen for Alternate Amphetamines is positive
If screen for Cannabinoids (THC) is positive
If screen for Cocaine is positive
If screen for Propoxyphene is positive
If screen for Phencyclidine is positive

Interface Codes
typeorder codetest descriptionresult coderesult descriptionunitsdecimal placesloinc code
o80101.Z213Pain Management Panel 1
r80101.Z213Pain Management Panel 180101.Z198Alcohol Screenmg/dL 42242-8
r80101.Z213Pain Management Panel 180101.Z199Amp / Methamphetamine Screenng/mL 33280-9
r80101.Z213Pain Management Panel 180101.Z200Alternate Amphetamines Screenng/mL 19146-0
r80101.Z213Pain Management Panel 180101.Z201Cannabinoids Screenng/mL 42860-7
r80101.Z213Pain Management Panel 180101.Z202Cocaine Screenng/mL 3398-5
r80101.Z213Pain Management Panel 180101.Z203Phencyclidine Screenng/mL 3937-0
r80101.Z213Pain Management Panel 180101.Z204Propoxyphene Screenng/mL 19429-0
r80101.Z213Pain Management Panel 180102.Z124Alcohol by GC/FIDmg/dL 46983-3
r80101.Z213Pain Management Panel 180102.Z125Amphetamine by GC/MSng/mL 20410-7
r80101.Z213Pain Management Panel 180102.Z126Methamphetamine by GC/MSng/mL 16235-4
r80101.Z213Pain Management Panel 180102.Z127MDMA by GC/MSng/mL 18358-2
r80101.Z213Pain Management Panel 180102.Z128MDA by GC/MSng/mL 20545-0
r80101.Z213Pain Management Panel 180102.Z129MDEA by GC/MSng/mL 45143-5
r80101.Z213Pain Management Panel 180102.Z130Carboxy-THC by GC/MSng/mL 20521-1
r80101.Z213Pain Management Panel 180102.Z131Benzoylecgonine by GC/MSng/mL 16226-3
r80101.Z213Pain Management Panel 180102.Z132Morphine by LC-MS/MSng/mL 16251-1
r80101.Z213Pain Management Panel 180102.Z133Oxymorphone by LC-MS/MSng/mL 17395-5
r80101.Z213Pain Management Panel 180102.Z134Hydromorphone by LC-MS/MSng/mL 16998-7
r80101.Z213Pain Management Panel 180102.Z135Nor-Oxycodone by LC-MS/MSng/mL 61425-5
r80101.Z213Pain Management Panel 180102.Z136Nor-Hydrocodone by LC-MS/MSng/mL 61422-2
r80101.Z213Pain Management Panel 180102.Z137Oxycodone by LC-MS/MSng/mL 16249-5
r80101.Z213Pain Management Panel 180102.Z138Codeine by LC-MS/MSng/mL 16250-3
r80101.Z213Pain Management Panel 180102.Z139Heroin Metab (6AM) by LC-MS/MSng/mL 19593-3
r80101.Z213Pain Management Panel 180102.Z140Hydrocodone by LC-MS/MSng/mL 16252-9
r80101.Z213Pain Management Panel 180102.Z141Phencyclidine by GC/MSng/mL 16254-5
r80101.Z213Pain Management Panel 180102.Z142Norpropoxyphene by GC/MSng/mL 17377-3
r80101.Z213Pain Management Panel 180299.Z60D-Methamphetamine%031026-8
r80101.Z213Pain Management Panel 180299.Z61L-Methamphetamine%015404-7
r80101.Z213Pain Management Panel 181000.Z18SpGravity 32965-2
r80101.Z213Pain Management Panel 181099.Z11Oxidantsug/mL 19146-0
r80101.Z213Pain Management Panel 182570.Z22Creatininemg/dL02161-8
r80101.Z213Pain Management Panel 183986.Z5pH  2756-5
r80101.Z213Pain Management Panel 199199.Z101Prescribed Drug 1  
r80101.Z213Pain Management Panel 199199.Z102Prescribed Drug 2  
r80101.Z213Pain Management Panel 199199.Z103Prescribed Drug 3  
r80101.Z213Pain Management Panel 199199.Z104Prescribed Drug 4  
r80101.Z213Pain Management Panel 199199.Z105Prescribed Drug 5  
r80101.Z213Pain Management Panel 199199.Z106Prescribed Drug 6  
r80101.Z213Pain Management Panel 199199.Z107Prescribed Drug 7  
r80101.Z213Pain Management Panel 199199.Z108Prescribed Drug 8  
r80101.Z213Pain Management Panel 199199.Z109Prescribed Drug 9  
r80101.Z213Pain Management Panel 199199.Z110Prescribed Drug 10  

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