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PAIN MGMT BENZODIAZEPINES RFLX

Test Code
PMBENZ
 
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.
SynonymsTranquilizers; Alpha-Hydroxy-Alprazolam; Temazepam; Lorazepam; Oxazepam Chlordiazepoxide; Clorazepate; Diazepam; Halazepam; Prazepam; Xanax; Restoril; Normison; Ativan; Serax; Valium; Librium; Centrax; Tranxene
SPECIMEN REQUIREMENTS
Container TypeRandom urine
Supply Item Numberpicture1387 or picture1678
Specimen TypeRandom urine
Preferred Volume20 mL
Emergency Minimum Volume10 mL
Collection ProcedureCollect a random urine in a leakproof plastic urine container.
Store and TransportAmbient (room temperature)
StabilityRoom Temp 10 days  Refrigerated 1 month  
Unacceptable ConditionBlood, serum, or plasma samples
CPT Codes80307
Interface Order Code80101.Z217
Billing CodePMBENZ
Test ScheduleMon-Sat
Turnaround Time1-3 days
MethodEnzyme Immunoassay
Test IncludesClorazepate; Diazepam; Oxazepam; Prazepam; Temazepam; Alprazolam; Lorazepam; Nordiazepam; Flunitrazepam; Flurazepam; Clonazepam
Reference Ranges
TitleDescriptorRangesUnits
Benzodiazepine ScreenNegative< 200ng/mL
Reflex Testing
Reflex ConditionReflex Test NameReflex CPT codesReflex Billing codes
If screen for Benzodiazepines 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.Z217Pain Management Benzodiazepines
r80101.Z217Pain Management Benzodiazepines80101.Z193Clonazepamng/mL 16229-7
r80101.Z217Pain Management Benzodiazepines80101.Z206Benzodiazepinesng/mL 9428-4
r80101.Z217Pain Management Benzodiazepines80101.Z2787-Aminoclonazepamng/mL 51776-3
r80101.Z217Pain Management Benzodiazepines80101.Z279Flunitrazepamng/mL 20528-6
r80101.Z217Pain Management Benzodiazepines80101.Z2807-Aminoflunitrazepamng/mL 51777-1
r80101.Z217Pain Management Benzodiazepines80101.Z281Diazepamng/mL 16227-1
r80101.Z217Pain Management Benzodiazepines80101.Z282Nordiazepamng/mL 16228-9
r80101.Z217Pain Management Benzodiazepines80101.Z283Alprazolamng/mL 59615-5
r80101.Z217Pain Management Benzodiazepines80101.Z284Flurazepamng/mL 16231-3
r80101.Z217Pain Management Benzodiazepines80101.Z285Midazolamng/mL 16233-9
r80101.Z217Pain Management Benzodiazepines80101.Z286Alpha-hydroxytriazolamng/mL 49876-6
r80101.Z217Pain Management Benzodiazepines80102.Z148Oxazepam by GC/MSng/mL 16201-6
r80101.Z217Pain Management Benzodiazepines80102.Z149Temazepam by GC/MSng/mL 20559-1
r80101.Z217Pain Management Benzodiazepines80102.Z150Lorazepam by GC/MSng/mL 17088-6
r80101.Z217Pain Management Benzodiazepines80102.Z151Alpha-OH Alprazolam by GC/MSng/mL 16348-5

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