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PAIN MANAGEMENT PANEL 3 RFLX

Test Code
PM3
 
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 in a leakproof plastic urine container.
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, (HCPCS G0480), 80307, 80356, 80365
Interface Order Code80101.Z211
Billing CodePM32017
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-Methamphetamine GC/MSNot 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
Barbiturates ScreenNegative< 200ng/mL
Amobarbital by GC/MSNot Detected< 50ng/mL
Butalbital by GC/MSNot Detected< 80ng/mL
Pentobarbital by GC/MSNot Detected< 50ng/mL
Phenobarbital by GC/MSNot Detected< 50ng/mL
Secobarbital by GC/MSNot Detected< 80ng/mL
Benzodiazepines ScreenNegative< 200ng/mL
Clonazepam by LC-MS/MSNot Detected< 10ng/mL
7-Aminoclonazepam by LC-MS/MSNot Detected< 10ng/mL
Flunitrazepam by LC-MS/MSNot Detected< 10ng/mL
7-Aminoflunitrazepam by LC-MS/MSNot Detected< 10ng/mL
Diazepam by LC-MS/MSNot Detected< 10ng/mL
Temazepam by LC-MS/MSNot Detected< 25ng/mL
Nordiazepam by LC-MS/MSNot Detected< 25ng/mL
Oxazepam by LC-MS/MSNot Detected< 25ng/mL
Lorazepam by LC-MS/MSNot Detected< 25ng/mL
Alprazolam by LC-MS/MSNot Detected< 10ng/mL
Alpha-hydroxyalprazolam by LC-MS/MSNot Detected< 25ng/mL
Flurazepam by LC-MS/MSNot Detected< 10ng/mL
Midazolam by LC-MS/MSNot Detected< 25ng/mL
Alpha-hydroxytriazolam by LC-MS/MSNot Detected< 25ng/mL
Methadone & Metabolite ScreenNegative< 100ng/mL
Methadone Metabolite (EDDP) by GC/MSNot Detected< 90ng/mL
Meperidine ScreenNegative< 200ng/mL
Meperidine by GC/MSNot Detected< 40ng/mL
Tramadol ScreenNegative< 200ng/mL
Tramadol 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
If screen for Barbiturates is positive
If screen for Benzodiazepines is positive
If screen for Methadone is positive
If screen for Meperidine is positive
If screen for Tramadol is positive
If screen for Acetaminophen is positive

Interface Codes
typeorder codetest descriptionresult coderesult descriptionunitsdecimal placesloinc code
o80101.Z211Pain Management Panel 3
r80101.Z211Pain Management Panel 380101.Z193Clonazepamng/mL 16229-7
r80101.Z211Pain Management Panel 380101.Z198Alcohol Screenmg/dL 42242-8
r80101.Z211Pain Management Panel 380101.Z199Amp / Methamphetamine Screenng/mL 33280-9
r80101.Z211Pain Management Panel 380101.Z200Alternate Amphetamines Screenng/mL 19146-0
r80101.Z211Pain Management Panel 380101.Z201Cannabinoids Screenng/mL 42860-7
r80101.Z211Pain Management Panel 380101.Z202Cocaine Screenng/mL 3398-5
r80101.Z211Pain Management Panel 380101.Z203Phencyclidine Screenng/mL 3937-0
r80101.Z211Pain Management Panel 380101.Z204Propoxyphene Screenng/mL 19429-0
r80101.Z211Pain Management Panel 380101.Z205Barbiturates Screenng/mL 20664-9
r80101.Z211Pain Management Panel 380101.Z206Benzodiazepinesng/mL 9428-4
r80101.Z211Pain Management Panel 380101.Z207Methadone Screenng/mL 3774-7
r80101.Z211Pain Management Panel 380101.Z208Meperidine Screenng/mL 58385-6
r80101.Z211Pain Management Panel 380101.Z209Tramadol Screenng/mL 17719-6
r80101.Z211Pain Management Panel 380101.Z230Acetaminophen Screenug/mL159384-8
r80101.Z211Pain Management Panel 380101.Z2787-Aminoclonazepamng/mL 51776-3
r80101.Z211Pain Management Panel 380101.Z279Flunitrazepamng/mL 20528-6
r80101.Z211Pain Management Panel 380101.Z2807-Aminoflunitrazepamng/mL 51777-1
r80101.Z211Pain Management Panel 380101.Z281Diazepamng/mL 16227-1
r80101.Z211Pain Management Panel 380101.Z282Nordiazepamng/mL 16228-9
r80101.Z211Pain Management Panel 380101.Z283Alprazolamng/mL 59615-5
r80101.Z211Pain Management Panel 380101.Z284Flurazepamng/mL 16231-3
r80101.Z211Pain Management Panel 380101.Z285Midazolamng/mL 16233-9
r80101.Z211Pain Management Panel 380101.Z286Alpha-hydroxytriazolamng/mL 49876-6
r80101.Z211Pain Management Panel 380102.Z124Alcohol by GC/FIDmg/dL 46983-3
r80101.Z211Pain Management Panel 380102.Z125Amphetamine by GC/MSng/mL 20410-7
r80101.Z211Pain Management Panel 380102.Z126Methamphetamine by GC/MSng/mL 16235-4
r80101.Z211Pain Management Panel 380102.Z127MDMA by GC/MSng/mL 18358-2
r80101.Z211Pain Management Panel 380102.Z128MDA by GC/MSng/mL 20545-0
r80101.Z211Pain Management Panel 380102.Z129MDEA by GC/MSng/mL 45143-5
r80101.Z211Pain Management Panel 380102.Z130Carboxy-THC by GC/MSng/mL 20521-1
r80101.Z211Pain Management Panel 380102.Z131Benzoylecgonine by GC/MSng/mL 16226-3
r80101.Z211Pain Management Panel 380102.Z132Morphine by LC-MS/MSng/mL 16251-1
r80101.Z211Pain Management Panel 380102.Z133Oxymorphone by LC-MS/MSng/mL 17395-5
r80101.Z211Pain Management Panel 380102.Z134Hydromorphone by LC-MS/MSng/mL 16998-7
r80101.Z211Pain Management Panel 380102.Z135Nor-Oxycodone by LC-MS/MSng/mL 61425-5
r80101.Z211Pain Management Panel 380102.Z136Nor-Hydrocodone by LC-MS/MSng/mL 61422-2
r80101.Z211Pain Management Panel 380102.Z137Oxycodone by LC-MS/MSng/mL 16249-5
r80101.Z211Pain Management Panel 380102.Z138Codeine by LC-MS/MSng/mL 16250-3
r80101.Z211Pain Management Panel 380102.Z139Heroin Metab (6AM) by LC-MS/MSng/mL 19593-3
r80101.Z211Pain Management Panel 380102.Z140Hydrocodone by LC-MS/MSng/mL 16252-9
r80101.Z211Pain Management Panel 380102.Z141Phencyclidine by GC/MSng/mL 16254-5
r80101.Z211Pain Management Panel 380102.Z142Norpropoxyphene by GC/MSng/mL 17377-3
r80101.Z211Pain Management Panel 380102.Z143Amobarbital by GC/MSng/mL 16239-6
r80101.Z211Pain Management Panel 380102.Z144Butalbital by GC/MSng/mL 16237-0
r80101.Z211Pain Management Panel 380102.Z145Pentobarbital by GC/MSng/mL 16240-4
r80101.Z211Pain Management Panel 380102.Z146Phenobarbital by GC/MSng/mL 16241-2
r80101.Z211Pain Management Panel 380102.Z147Secobarbital by GC/MSng/mL 16238-8
r80101.Z211Pain Management Panel 380102.Z148Oxazepam by GC/MSng/mL 16201-6
r80101.Z211Pain Management Panel 380102.Z149Temazepam by GC/MSng/mL 20559-1
r80101.Z211Pain Management Panel 380102.Z150Lorazepam by GC/MSng/mL 17088-6
r80101.Z211Pain Management Panel 380102.Z151Alpha-OH Alprazolam by GC/MSng/mL 16348-5
r80101.Z211Pain Management Panel 380102.Z152Methadone Metab (EDDP) by GC/MSng/mL 58429-2
r80101.Z211Pain Management Panel 380102.Z153Meperidine by GC/MSng/mL 16253-7
r80101.Z211Pain Management Panel 380102.Z154Nor-Meperidine by GC/MSng/mL 58389-8
r80101.Z211Pain Management Panel 380299.Z60D-Methamphetamine%031026-8
r80101.Z211Pain Management Panel 380299.Z61L-Methamphetamine%015404-7
r80101.Z211Pain Management Panel 381000.Z18SpGravity 32965-2
r80101.Z211Pain Management Panel 381099.Z1Prescribed Drug 1  29551-9
r80101.Z211Pain Management Panel 381099.Z10Prescribed Drug 10  29551-9
r80101.Z211Pain Management Panel 381099.Z11Oxidantsug/mL 19146-0
r80101.Z211Pain Management Panel 381099.Z2Prescribed Drug 2  29551-9
r80101.Z211Pain Management Panel 381099.Z3Prescribed Drug 3  29551-9
r80101.Z211Pain Management Panel 381099.Z4Prescribed Drug 4  29551-9
r80101.Z211Pain Management Panel 381099.Z5Prescribed Drug 5  29551-9
r80101.Z211Pain Management Panel 381099.Z6Prescribed Drug 6  29551-9
r80101.Z211Pain Management Panel 381099.Z7Prescribed Drug 7  29551-9
r80101.Z211Pain Management Panel 381099.Z8Prescribed Drug 8  29551-9
r80101.Z211Pain Management Panel 381099.Z9Prescribed Drug 9  29551-9
r80101.Z211Pain Management Panel 382003.Z2Acetaminophen by GC/MSug/mL113622-6
r80101.Z211Pain Management Panel 382541.Z12Tramadol by GC-MSng/mL 20561-7
r80101.Z211Pain Management Panel 382570.Z22Creatininemg/dL02161-8
r80101.Z211Pain Management Panel 383986.Z5pH  2756-5
r80101.Z211Pain Management Panel 399199.Z101Prescribed Drug 1  
r80101.Z211Pain Management Panel 399199.Z102Prescribed Drug 2  
r80101.Z211Pain Management Panel 399199.Z103Prescribed Drug 3  
r80101.Z211Pain Management Panel 399199.Z104Prescribed Drug 4  
r80101.Z211Pain Management Panel 399199.Z105Prescribed Drug 5  
r80101.Z211Pain Management Panel 399199.Z106Prescribed Drug 6  
r80101.Z211Pain Management Panel 399199.Z107Prescribed Drug 7  
r80101.Z211Pain Management Panel 399199.Z108Prescribed Drug 8  
r80101.Z211Pain Management Panel 399199.Z109Prescribed Drug 9  
r80101.Z211Pain Management Panel 399199.Z110Prescribed Drug 10  

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