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HelpTest Code TABSU Targeted Benzodiazepine Screen, Random, Urine
Specimen Required
Only orderable as part of profile. For more information see:
-CSMPU / Controlled Substance Monitoring Panel, Random, Urine
-ADMPU / Addiction Medicine Profile with Reflex, 22 Drug Classes, High Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine
-CSMEU / Controlled Substance Monitoring Enhanced Profile with Reflex, 21 Drug Classes, High Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine
-CSMTU / Controlled Substance Monitoring Targeted Profile, 17 Drug Classes, Mass Spectrometry, Random, Urine
-TBSU / Targeted Benzodiazepine Screen, Random, Urine
Supplies: Sarstedt Aliquot Tube 5 mL (T914)
Collection Container/Tube: Plastic urine container
Submission Container/Tube: Plastic, 5-mL tube
Specimen Volume: 1 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative
Secondary ID
604267Useful For
Qualitatively (present vs not detected) identifying 27 benzodiazepine compounds (parent drug and metabolites) in urine to help determine compliance or identify illicit benzodiazepine drug use
This test is not intended for employment-related testing.
Method Name
Only orderable as part of profile. For more information see:
-CSMPU / Controlled Substance Monitoring Panel, Random, Urine
-ADMPU / Addiction Medicine Profile with Reflex, 22 Drug Classes, High Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine
-CSMEU / Controlled Substance Monitoring Enhanced Profile with Reflex, 21 Drug Classes, High Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine
-CSMTU / Controlled Substance Monitoring Targeted Profile, 17 Drug Classes, Mass Spectrometry, Random, Urine
-TBSU / Targeted Benzodiazepine Screen, Random, Urine
Liquid Chromatography Tandem Mass Spectrometry, High-Resolution Accurate Mass (LC-MS/MS HRAM)
Reporting Name
Targeted Benzodiazepine Screen, USpecimen Type
UrineSpecimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 14 days | |
| Frozen | 28 days | ||
| Ambient | 72 hours |
Clinical Information
Benzodiazepines represent a large family of medications used to treat a wide range of disorders from anxiety to seizures, and they are also used in pain management. With a high risk for abuse/diversion, professional practice guidelines recommend compliance monitoring for these medications using urine drug tests. However, traditional benzodiazepine immunoassays suffer from a lack of cross-reactivity with all the benzodiazepines, so many compliant patients taking either clonazepam (Klonopin) or lorazepam (Ativan) may screen negative by immunoassay but are positive when confirmatory testing is done. The new targeted benzodiazepine screening test provides a more sensitive and specific test to check for compliance to all the commonly prescribed benzodiazepines and looks for both the parent drug and its metabolites in the urine.
Reference Values
Only orderable as part of profile. For more information see:
-CSMPU / Controlled Substance Monitoring Panel, Random, Urine
-ADMPU / Addiction Medicine Profile with Reflex, 22 Drug Classes, High Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine
-CSMEU / Controlled Substance Monitoring Enhanced Profile with Reflex, 21 Drug Classes, High Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine
-CSMTU / Controlled Substance Monitoring Targeted Profile, 17 Drug Classes, Mass Spectrometry, Random, Urine
-TBSU / Targeted Benzodiazepine Screen, Random, Urine
Not detected
Cutoff concentrations:
Alprazolam: 10 ng/mL
Alpha-hydroxyalprazolam: 10 ng/mL
Alpha-hydroxyalprazolam glucuronide: 50 ng/mL
Chlordiazepoxide: 10 ng/mL
Clobazam: 10 ng/mL
N-desmethylclobazam: 200 ng/mL
Clonazepam: 10 ng/mL
7-Aminoclonazepam: 10 ng/mL
Diazepam: 10 ng/mL
Nordiazepam: 10 ng/mL
Flunitrazepam: 10 ng/mL
7-Aminoflunitrazepam: 10 ng/mL
Flurazepam: 10 ng/mL
2-Hydroxy ethyl flurazepam: 10 ng/mL
Lorazepam: 10 ng/mL
Lorazepam glucuronide: 50 ng/mL
Midazolam: 10 ng/mL
Alpha-hydroxy midazolam: 10 ng/mL
Oxazepam: 10 ng/mL
Oxazepam glucuronide: 50 ng/mL
Prazepam: 10 ng/mL
Temazepam: 10 ng/mL
Temazepam glucuronide: 50 ng/mL
Triazolam: 10 ng/mL
Alpha-hydroxy triazolam: 10 ng/mL
Zolpidem: 10 ng/mL
Zolpidem phenyl-4-carboxylic acid: 10 ng/mL
Interpretation
If a benzodiazepine or its corresponding metabolites is identified (present), it indicates that the patient has used the respective benzodiazepine in the recent past. The absence of expected benzodiazepines or their metabolites may indicate noncompliance, inappropriate timing of specimen collection relative to drug administration, poor drug absorption, diluted or adulterated urine, or limitations of testing. The concentration of the drug must be greater than or equal to the cutoff to be reported as present. If a specific drug concentration is required, the laboratory must be contacted within 2 weeks of specimen collection/testing to request quantification by a second analytical technique at an additional charge.
Cautions
No significant cautionary statements
Clinical Reference
1. Jannetto PJ, Bratanow NC, Clark WA, et al. Executive summary: American Association of Clinical Chemistry Laboratory Medicine Practice Guideline-Using clinical laboratory tests to monitor drug therapy in pain management patients. J Appl Lab Med. 2018;2(4):489-526
2. 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 urine sample is diluted with internal standard and then analyzed by liquid chromatography tandem mass spectrometry using a high-resolution accurate mass orbitrap detector.(Unpublished Mayo method)
Day(s) Performed
Monday through Sunday
Report Available
3 to 4 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
80347
G0480 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| TABSU | Targeted Benzodiazepine Screen, U | 94117-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 604871 | Alprazolam | 94116-1 |
| 604867 | Alpha-Hydroxyalprazolam | 19325-0 |
| 604891 | Alpha-Hydroxyalprazolam Glucuronide | 94115-3 |
| 604872 | Chlordiazepoxide | 19385-4 |
| 604889 | Clobazam | 94114-6 |
| 604890 | N-Desmethylclobazam | 94113-8 |
| 604873 | Clonazepam | 19399-5 |
| 604267 | 7-aminoclonazepam | 94112-0 |
| 604874 | Diazepam | 19443-1 |
| 604880 | Nordiazepam | 19624-6 |
| 604875 | Flunitrazepam | 19466-2 |
| 604866 | 7-aminoflunitrazepam | 94111-2 |
| 604876 | Flurazepam | 19474-6 |
| 604868 | 2-Hydroxy Ethyl Flurazepam | 94110-4 |
| 604877 | Lorazepam | 19520-6 |
| 604878 | Lorazepam Glucuronide | 94109-6 |
| 604879 | Midazolam | 19585-9 |
| 604869 | Alpha-Hydroxy Midazolam | 94108-8 |
| 604881 | Oxazepam | 19638-6 |
| 604882 | Oxazepam Glucuronide | 94107-0 |
| 604883 | Prazepam | 19678-2 |
| 604884 | Temazepam | 19698-0 |
| 604885 | Temazepam Glucuronide | 94106-2 |
| 604886 | Triazolam | 19714-5 |
| 604870 | Alpha-Hydroxy Triazolam | 94105-4 |
| 604887 | Zolpidem | 94104-7 |
| 604888 | Zolpidem Phenyl-4-Carboxylic acid | 94103-9 |
| 604949 | Benzodiazepine Interpretation | 69050-3 |
Reject Due To
| Gross hemolysis | Reject |
| Gross icterus | Reject |