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HelpTest Code OXYSX Oxycodone Screen, Chain of Custody, Random, Urine
Useful For
Detection of oxycodone and oxymorphone in urine following chain-of-custody procedures
This chain-of-custody test is intended to be used in a setting where the test results can be used definitively to make a diagnosis. 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 |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| OXYCX | Oxycodone w/metabolite Conf, CoC, U | Yes | No |
Testing Algorithm
Testing begins with screening assay. If oxycodone screen is positive, then the liquid chromatography tandem mass spectrometry confirmation with quantification will be performed at an additional charge.
Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
Reporting Name
Oxycodone Screen, 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: 20 mL
Collection Instructions: Collect a random specimen without preservative 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) | 14 days | |
| Frozen | 14 days | ||
| Ambient | 72 hours |
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Clinical Information
Opiates are the natural or synthetic drugs that have a morphine-like pharmacological action. Medically, opiates are used primarily for relief of pain. Opiates include morphine and drugs structurally similar to morphine (eg, codeine, hydrocodone, hydromorphone, oxycodone, oxymorphone).
Oxycodone is metabolized to noroxycodone, oxymorphone, and their glucuronides and is excreted primarily via the kidney. The presence of oxycodone greater than 100 ng/mL indicates exposure to oxycodone within 2 to 3 days prior to specimen collection.
Oxymorphone is metabolized in the liver 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.
Chain of custody is a record of the disposition of a specimen to document the individuals 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
Screening cutoff concentration:
Oxycodone: 100 ng/mL
Interpretation
A positive result indicates that the patient has used the drugs detected in the recent past.
For information about drug testing, including estimated detection times, see Drug Class Testing on MayoClinicLabs.com.
Cautions
Other drugs in the opioid class, such as fentanyl, meperidine, methadone, and opiate antagonists such as naloxone, are not detected.
Clinical Reference
1. Anderson DT, Fritz KL, Muto JJ. Oxycontin: the concept of a "ghost pill" and the postmortem tissue distribution of oxycodone in 36 cases. J Anal Toxicol. 2002;26(7):448-459
2. Jannetto PJ, Gock SG. Oxycodone: Recognition and Pharmacogenomics. Clinical and Forensic Toxicology News 2003 March
3. Cone EJ, Fant RV, Rohay JM, et al. Oxycodone involvement in drug abuse deaths: a DAWN-based classification scheme applied to an oxycodone postmortem database containing over 1000 cases. J Anal Toxicol. 2003;27(2):57-67. doi:10.1093/jat/27.2.57
4. Baselt RC, Cravey RH. Oxycodone. In: Disposition of Toxic Drugs and Chemicals in Man. 4th ed. Chemical Toxicology Institute. 1995;572-574
5. 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
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; V3.0, 08/2023)
Day(s) Performed
Monday through Saturday
Report Available
2 to 3 daysSpecimen Retention Time
14 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
80307
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| OXYSX | Oxycodone Screen, CoC, U | 19642-8 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 61727 | Oxycodone | 19642-8 |
| 36027 | Chain of Custody | 77202-0 |
Method Name
Immunoassay
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.