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HelpTest Code PN10X Pain Clinic Survey 10, Chain of Custody, Random, Urine
Reporting Name
Pain Clinic Survey 10, CoCSpecimen Type
UrineSpecimen Required
Only orderable as part of a profile. For more information see PANOX / Pain Clinic Survey 10, Chain of Custody, Urine.
Supplies: Chain of Custody Kit (T282)
Container/Tube: Chain-of-Custody Kit containing the specimen containers, seals, and documentation is required.
Specimen Volume: 30 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.
Additional Information: Submitting less than 30 mL will compromise the ability to perform all necessary testing.
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 7 days | |
| Frozen | 14 days |
Reference Values
Only orderable as part of a profile. For more information see PANOX / Pain Clinic Survey 10, Chain of Custody, Urine.
Negative
Screening cutoff concentrations:
Amphetamines: 500 ng/mL
Barbiturates: 200 ng/mL
Benzodiazepines: 100 ng/mL
Cocaine (benzoylecgonine-cocaine metabolite): 150 ng/mL
Methadone metabolite: 300 ng/mL
Opiates: 300 ng/mL
Phencyclidine: 25 ng/mL
Tetrahydrocannabinol carboxylic acid: 50 ng/mL
This report is intended for use in clinical monitoring or management of patients. It is not intended for use in employment-related testing.
Specimen Retention Time
14 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| PN10X | Pain Clinic Survey 10, CoC | 69739-1 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 36253 | Amphetamines | 43983-6 |
| 36258 | Barbiturates | 70155-7 |
| 36259 | Benzodiazepines | 14316-4 |
| 36254 | Cocaine | 43984-4 |
| 36260 | Methadone metabolite | 41858-2 |
| 36255 | Opiates | 70151-6 |
| 36256 | Phencyclidine | 14310-7 |
| 36257 | Tetrahydrocannabinol | 14312-3 |
| 36261 | Chain of Custody | 77202-0 |
Method Name
Only orderable as part of a profile. For more information see PANOX / Pain Clinic Survey 10, Chain of Custody, Urine.
Immunoassay
CPT Code Information
80307
Test Classification
This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.Secondary ID
62911Day(s) Performed
Monday through Saturday
Report Available
2 to 3 daysUseful For
Detecting drug use involving amphetamines, barbiturates, benzodiazepines, cocaine, methadone, opiates, phencyclidine, and carboxy-tetrahydrocannabinol
This chain-of-custody test is intended to be used in a setting where the test results can be used to make a definitive 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.
This test is not intended for use in employment-related testing.
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| AMPHX | Amphetamines Confirmation, CoC, U | Yes | No |
| COKEX | Cocaine and metabolite Conf, CoC, U | Yes | No |
| BARBX | Barbiturates Confirmation, CoC, U | Yes | No |
| MTDNX | Methadone Confirmation, CoC, U | Yes | No |
| PCPX | Phencyclidine Confirmation, CoC, U | Yes | No |
| THCX | Carboxy-THC Confirmation, CoC, U | Yes | No |
| OPATX | Opiate Confirmation, CoC, U | Yes | No |
| BNZX | Benzodiazepines Conf, CoC, U | Yes | No |
Testing Algorithm
Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods (gas chromatography mass spectrometry for barbiturates, cocaine and metabolites, methadone, and phencyclidine) at an additional charge. Amphetamines, benzodiazepines, opiates, and tetrahydrocannabinol metabolite that screen positive will be quantified with liquid chromatography tandem mass spectrometry at an additional charge.
Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Clinical Information
This assay was designed to test for and confirm by gas chromatography mass spectrometry the following:
-Barbiturates
-Cocaine
-Methadone
-Phencyclidine
This assay was designed to test for and confirm by liquid chromatography tandem mass spectrometry the following
-Opiates
-Benzodiazepines
-Carboxy-tetrahydrocannabinol
-Amphetamines
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.
Interpretation
A positive result derived by this testing indicates that the patient has used one of the drugs detected by these techniques in the recent past.
For information about drug testing, including estimated detection times, see Drug Class Testing on MayoClinicLabs.com.
Cautions
The test does not screen for drug classes other than those listed above. More comprehensive screening is available using the serum or urine drug screens (DSSX / Drug Screen, Prescription/Over the Counter, Chain of Custody, Serum or PDSUX / Drug Screen, Prescription/Over the Counter, Chain of Custody, Urine).
Clinical Reference
1. Physician's Desk Reference (PDR). 60th edition. Medical Economics Company; 2006
2. Bruntman LL. Goodman and Gilman's: The Pharmacological Basis of Therapeutics. 11th ed. McGraw-Hill Book Company; 2006
3. 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
The amphetamines, barbiturates, benzodiazepines, cocaine, methadone metabolite, opiates, phencyclidine, and tetrahydrocannabinol metabolite assays are based on the kinetic interaction of microparticles in a solution as measured by changes in light transmission. In the absence of sample drug, soluble drug conjugates bind to antibody-bound microparticles causing the formation of particle aggregates. As the aggregation reaction proceeds in the absence of sample drug, the absorbance increases. When a urine sample contains the drug in question, this drug competes with the drug derivative conjugate for microparticle-bound antibody. Antibody bound to sample drug is no longer available to promote particle aggregation, and subsequent particle lattice formation is inhibited. The presence of sample drug diminishes the increasing absorbance in proportion to the concentration of drug in the sample. Sample drug content is determined relative to the value obtained for a known cutoff concentration of drug.(Package inserts: AMPS2. Roche Diagnostics; V 10.0, 09/2018; BARB. Roche Diagnostics; V 13.0, 09/2021; THC2. Roche Diagnostics; V 13.0, 03/2022; BNZ2. Roche Diagnostics; V 2.0, 04/2024; COC2. Roche Diagnostics; V 9.0, 03/2019; OPI2. Roche Diagnostics; V 16.0, 01/2022; PCP. Roche Diagnostics; V 13.0, 09/2021; EDDP Specific Urine Enzyme Immunoassay, Immunalysis Corp; 09/2018)