PAML

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.

Synonyms

Tranquilizers; Alpha-Hydroxy-Alprazolam; Temazepam; Lorazepam; Oxazepam Chlordiazepoxide; Clorazepate; Diazepam; Halazepam; Prazepam; Xanax; Restoril; Normison; Ativan; Serax; Valium; Librium; Centrax; Tranxene

SPECIMEN REQUIREMENTS

Container Type

Random urine

Supply Item Number

1387 or 1678

Specimen Type

Random urine

Preferred Volume

20 mL

Emergency Minimum Volume

10 mL

Collection Procedure

Collect a random urine in a leakproof plastic urine container.

Store and Transport

Ambient (room temperature)

Stability

Room Temp 10 days Refrigerated 1 month

Unacceptable Condition

Blood, serum, or plasma samples

Reference Laboratory

PAML

Reference Lab Test Code

LCA code 910975

CPT Codes

80307

Interface Order Code

80101.Z217

Billing Code

PMBENZ

Test Schedule

Mon-Sat

Turnaround Time

1-3 days

Method

Enzyme Immunoassay

Test Includes

Clorazepate; Diazepam; Oxazepam; Prazepam; Temazepam; Alprazolam; Lorazepam; Nordiazepam; Flunitrazepam; Flurazepam; Clonazepam

Reference Ranges

Title	Descriptor	Ranges	Units
Benzodiazepine Screen	Negative	< 200	ng/mL

Reflex Testing

Reflex Condition	Reflex Test Name	Reflex CPT codes	Reflex Billing codes
If screen for Benzodiazepines positive	Reflex testing built into panel, no additional test code required	Reflex testing built into panel, no additional CPT code required	N/A

Interface Codes

type	order code	test description	result code	result description	units	decimal places	loinc code
o	80101.Z217	Pain Management Benzodiazepines
r	80101.Z217	Pain Management Benzodiazepines	80101.Z193	Clonazepam	ng/mL		16229-7
r	80101.Z217	Pain Management Benzodiazepines	80101.Z206	Benzodiazepines	ng/mL		9428-4
r	80101.Z217	Pain Management Benzodiazepines	80101.Z278	7-Aminoclonazepam	ng/mL		51776-3
r	80101.Z217	Pain Management Benzodiazepines	80101.Z279	Flunitrazepam	ng/mL		20528-6
r	80101.Z217	Pain Management Benzodiazepines	80101.Z280	7-Aminoflunitrazepam	ng/mL		51777-1
r	80101.Z217	Pain Management Benzodiazepines	80101.Z281	Diazepam	ng/mL		16227-1
r	80101.Z217	Pain Management Benzodiazepines	80101.Z282	Nordiazepam	ng/mL		16228-9
r	80101.Z217	Pain Management Benzodiazepines	80101.Z283	Alprazolam	ng/mL		59615-5
r	80101.Z217	Pain Management Benzodiazepines	80101.Z284	Flurazepam	ng/mL		16231-3
r	80101.Z217	Pain Management Benzodiazepines	80101.Z285	Midazolam	ng/mL		16233-9
r	80101.Z217	Pain Management Benzodiazepines	80101.Z286	Alpha-hydroxytriazolam	ng/mL		49876-6
r	80101.Z217	Pain Management Benzodiazepines	80102.Z148	Oxazepam by GC/MS	ng/mL		16201-6
r	80101.Z217	Pain Management Benzodiazepines	80102.Z149	Temazepam by GC/MS	ng/mL		20559-1
r	80101.Z217	Pain Management Benzodiazepines	80102.Z150	Lorazepam by GC/MS	ng/mL		17088-6
r	80101.Z217	Pain Management Benzodiazepines	80102.Z151	Alpha-OH Alprazolam by GC/MS	ng/mL		16348-5

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