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HelpTest Code DSM4X Drugs of Abuse Screen 4, Chain of Custody, Meconium
Useful For
Identifying amphetamines (and methamphetamines), opiates, as well as metabolites of cocaine and marijuana in meconium specimen
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. Since the evidence of illicit drug use during pregnancy can be cause for separating the baby from the mother, a complete chain of custody ensures that the test results are appropriate for legal proceedings.
Additional Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| COCH | Chain of Custody Processing | No | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| COKMX | Cocaine and metabolite Conf, CoC, M | Yes | No |
| OPTMX | Opiate Confirmation, CoC, M | Yes | No |
| THCMX | Carboxy-THC Confirmation, CoC, M | Yes | No |
| AMPMX | Amphetamines Confirmation, CoC, M | Yes | No |
Testing Algorithm
Testing begins with immunoassay screen. Positive results are confirmed and quantitated by liquid chromatography tandem mass spectrometry at an additional charge.
Reporting Name
Drugs of Abuse Screen 4, CoC, MSpecimen Type
MeconiumSpecimen Required
Container/Tube: Chain of Custody Meconium Kit (T653) includes the specimen containers, seals, and documentation required.
Specimen Volume: 1 g (approximately 1 teaspoon)
Collection Instructions: Collect entire random meconium specimen.
Additional Information:
1. Specimen that arrives with a broken seal does not meet the chain-of-custody requirements.
2. The laboratory recommends sending chain-of-custody specimens by overnight shipment.
Specimen Minimum Volume
0.45 g (approximately 0.5 teaspoon)
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Meconium | Frozen (preferred) | 21 days | |
| Refrigerated | 21 days | ||
| Ambient | 72 hours |
Reject Due To
| Grossly bloody | Reject, Pink OK |
Reference Values
Negative
Positive results are reported with a quantitative liquid chromatography tandem mass spectrometry result.
Cutoff concentrations by competitive chemiluminescent immunoassay:
Amphetamines: 100 ng/g
Methamphetamine: 100 ng/g
Benzoylecgonine (cocaine metabolite): 100 ng/g
Opiates: 100 ng/g
Tetrahydrocannabinol carboxylic acid (marijuana metabolite): 20 ng/g
Day(s) Performed
Monday through Saturday
Report Available
1 to 2 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
80307
80324 (if appropriate)
80359 (if appropriate)
80353 (if appropriate)
80361 (if appropriate)
80365 (if appropriate)
80349 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| DSM4X | Drugs of Abuse Screen 4, CoC, M | 49046-6 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 36172 | Amphetamine | 26895-3 |
| 36173 | Methamphetamine | 27289-8 |
| 36174 | Cocaine | 26956-3 |
| 36175 | Opiate | 29158-3 |
| 36176 | Tetrahydrocannabinol | 26893-8 |
| 36177 | Chain of Custody | 77202-0 |
Method Name
Competitive Chemiluminescent Immunoassay (CIA)
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.