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HelpTest Code OXYCX Oxycodone with Metabolite Confirmation, Chain of Custody, Random, Urine
Useful For
Detection and quantification of oxycodone, oxymorphone, noroxycodone, and noroxymorphone in urine
Chain of custody is required whenever the results of testing could be used in a court of law. Its purpose is to protect the rights of the individual contributing the specimen by demonstrating that it was always under the control of personnel involved with testing the specimen; this control implies that the opportunity for specimen tampering would be limited.
Additional Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| COCH | Chain of Custody Processing | No | Yes |
| ADLTX | Adulterants Survey, CoC, U | Yes | Yes |
Testing Algorithm
Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
Reporting Name
Oxycodone w/metabolite Conf, CoC, USpecimen Type
UrineSpecimen Required
Supplies: Chain of Custody Kit (T282)
Container/Tube: Chain of custody kit containing the specimen containers, seals, and documentation is required.
Specimen Volume: 5 mL
Collection Instructions: Collect urine specimen in the container provided, seal, and submit with the associated documentation to satisfy the legal requirements for chain of custody testing.
Specimen Minimum Volume
2.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 28 days | |
| Frozen | 28 days | ||
| Ambient | 14 days |
Reject Due To
| Gross hemolysis | OK |
| Gross icterus | OK |
Clinical Information
Oxycodone is metabolized to noroxycodone, oxymorphone, and their glucuronides and is excreted primarily via the kidney. The presence of oxycodone indicates exposure to oxycodone within 2 to 3 days prior to specimen collection.
Oxymorphone is metabolized in the liver to noroxymorphone and excreted via the kidney primarily as the glucuronide conjugates. Oxymorphone is also a metabolite of oxycodone, and therefore, the presence of oxymorphone could also indicate exposure to oxycodone.
The detection interval for opiates is generally 2 to 3 days after last ingestion.
Chain of custody is a record of the disposition of a specimen to document each individual who collected, handled, and performed the analysis. When a specimen is submitted in this manner, analysis will be performed in such a way that it will withstand regular court scrutiny.
Reference Values
Negative
Cutoff concentrations:
Oxycodone Immunoassay screen: 100 ng/mL
By liquid chromatography tandem mass spectroscopy:
Oxycodone: 25 ng/mL
Noroxycodone: 25 ng/mL
Oxymorphone: 25 ng/mL
Noroxymorphone: 25 ng/mL
Interpretation
This procedure reports the total urine concentration; this is the sum of the unconjugated and conjugated forms of the parent drug.
Cautions
Other drugs in the opioid class, such as fentanyl, meperidine, methadone, and opiate antagonists such as naloxone, are not detected.
Clinical Reference
1. Jutkiewicz EM, Traynor JR. Opioid analgesics. In: Brunton LL, Knollmann BC, eds. Goodman and Gilman's: The Pharmacological Basis of Therapeutics. 14th ed. McGraw-Hill, Inc; 2023:chap 23
2. Baselt, RC. Disposition of Toxic Drugs and Chemical in Man. 10th ed. Biomedical Publications; 2014
3. Hackett LP, Dusci LJ, Ilett KF, Chiswell GM. Optimizing the hydrolysis of codeine and morphine glucuronides in urine. Ther Drug Monit. 2002;24(5):652-657
4. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 43
Day(s) Performed
Monday through Friday
Report Available
2 to 5 daysSpecimen Retention Time
14 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
80365
G0480 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| OXYCX | Oxycodone w/metabolite Conf, CoC, U | 94304-3 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 36300 | Oxycodone Immunoassay Screen | 19642-8 |
| 61728 | Oxycodone-by LC-MS/MS | 16249-5 |
| 42012 | Noroxycodone-by LC-MS/MS | 61425-5 |
| 35964 | Oxymorphone-by LC-MS/MS | 17395-5 |
| 42013 | Noroxymorphone-by LC-MS/MS | 90894-7 |
| 36023 | Oxycodone Interpretation | 69050-3 |
| 36028 | Chain of Custody | 77202-0 |
Method Name
Immunoassay/Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Method Description
Oxycodone and its metabolite, oxymorphone, are analyzed via immunoassay. The assay uses specific antibodies that can detect oxycodone and oxymorphone without any significant cross-reactivity to other opiate compounds. The assay is based on the competition between a drug labeled with glucose-6-phosphate dehydrogenase (G6PD), and free drug from the urine sample for a fixed amount of specific antibody binding sites. In the absence of free drug from the sample, the specific antibody binds the drug labeled with G6PD and causes a decrease in enzyme activity. This phenomenon creates a direct relationship between the drug concentration in urine and enzyme activity. The enzyme activity is determined spectrophotometrically at 340 nm by measuring the conversion of nicotinamide adenine dinucleotide (NAD[+]) to NADH.(Package insert: OXY. Roche Diagnostics; V 3.0, 08/2023)
Confirmation with quantification by liquid chromatography tandem mass spectrometry.(Unpublished Mayo method)
Forms
1. Chain of Custody Request is included in the Chain of Custody Kit (T282).
2. If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.