Test Catalog

Test Id : DSSX

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Drug Screen, Prescription/Over the Counter, Chain of Custody, Serum

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Detection and identification of prescription or over-the-counter drugs frequently found in drug overdose or used with a suicidal intent

 

Qualitatively identifying drugs present in the specimen; quantification of identified drugs, when available, may be performed upon client request

 

This test is not intended for therapeutic drug monitoring or compliance testing.

 

This test is not intended for use in employment-related testing.

 

This test is not useful for drugs of abuse or illicit drug testing, including benzodiazepines, opioids, barbiturates, cocaine, and amphetamine type stimulants.

 

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
Lists tests that are always performed, at an additional charge, with the initial tests.

Test Id Reporting Name Available Separately Always Performed
COCH Chain of Custody Processing No Yes

Method Name
A short description of the method used to perform the test

Gas Chromatography Mass Spectrometry (GC-MS)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Drug Scrn, Prescription/OTC, CoC, S

Aliases
Lists additional common names for a test, as an aid in searching

acetaminophen

amitriptyline

amobarbital

bupropion

butabarbital

butalbital

caffeine

carbamazepine

carisoprodol

chlorpheniramine

chlorpromazine

citalopram

clomipramine

clozapine

codeine

cyclobenzaprine

dextromethorphan

diazepam

diphenhydramine

doxepin

doxylamine

fentanyl

fluoxetine

guaifenesin

ibuprofen

imipramine

lamotrigine

lidocaine

meperidine

mephobarbital

meprobamate

metaxalone

methadone

methsuximide

methylphenidate

midazolam

naproxen

nordiazepam

nortriptyline

oxcarbazepine metabolite

pentobarbital

phenobarbital

primidone

promethazine

propofol

salicylate

secobarbital

sertraline

strychnine

theophylline

thioridazine

topiramate

tramadol

trazodone

trimipramine

venlafaxine

zaleplon

zolpidem

levetiracetam

mirtazapine

Specimen Type
Describes the specimen type validated for testing

Serum Red

ORDER QUESTIONS AND ANSWERS

Question ID Description Answers
SUDR Suspect Drug

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Supplies: Chain-of-Custody Kit (T282)

Container/Tube: Chain-of-Custody Kit containing the specimen containers, seals, and documentation required.

Preferred: 10-mL Red top (serum gel/SST are not acceptable)

Acceptable: 5-mL Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 2.75 mL

Collection Instructions:

1. Centrifuge and aliquot serum into plastic vial within 2 hours of collection.

2. Cap, seal, and submit with the associated documentation to satisfy the legal requirements for chain-of-custody testing.

Additional Information: See Emergency/Overdose.

Special Instructions
Library of PDFs including pertinent information and forms related to the test

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.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

1.1 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Red Refrigerated (preferred) 14 days
Frozen 14 days
Ambient 3 hours

Useful For
Suggests clinical disorders or settings where the test may be helpful

Detection and identification of prescription or over-the-counter drugs frequently found in drug overdose or used with a suicidal intent

 

Qualitatively identifying drugs present in the specimen; quantification of identified drugs, when available, may be performed upon client request

 

This test is not intended for therapeutic drug monitoring or compliance testing.

 

This test is not intended for use in employment-related testing.

 

This test is not useful for drugs of abuse or illicit drug testing, including benzodiazepines, opioids, barbiturates, cocaine, and amphetamine type stimulants.

 

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.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

This test looks for a broad spectrum of prescription and over-the-counter drugs. It is designed to detect drugs that have toxic effects, as well as known antidotes or active therapies that a clinician can initiate to treat the toxic effect. The test is intended to help physicians manage an apparent overdose or intoxicated patient, to determine if a specific set of symptoms might be due to the presence of drugs. This test is not appropriate for drugs of abuse or illicit drug testing, including benzodiazepines, opioids, barbiturates, cocaine, and amphetamine type stimulants.

 

Drugs of toxic significance that are not detected by this test are digoxin, lithium, and many drugs of abuse or illicit drugs, some benzodiazepines, and most opiates.

 

Chain of custody is a record of the disposition of a specimen to document the personnel 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.

 

For more information see Emergency/Overdose for detection limits for drugs detected in this test.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Drugs detected are presumptive. Additional testing may be required to confirm the presence of any drugs detected.

Interpretation
Provides information to assist in interpretation of the test results

The drugs that are detected by this test are listed in Emergency/Overdose section of Drug Testing.

 

The pharmacology of each drug determines how the test should be interpreted. A detailed discussion of each drug is beyond the scope of this text. If you wish to have a report interpreted, call 800-533-1710 and ask for a toxicology consultant.

 

Each report will indicate the drugs detected.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Specimens collected in serum gel tubes are not acceptable, as the drug/analyte can absorb on the gel and lead to falsely decreased concentrations.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham C-AD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 43

2. Baselt RC. Disposition of Toxic Drugs and Chemical in Man. 12th ed. Biomedical Publications; 2020

Method Description
Describes how the test is performed and provides a method-specific reference

Screening is by gas chromatography mass spectroscopy.(Unpublished Mayo method)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Sunday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

3 to 4 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

2 weeks

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

80307

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
DSSX Drug Scrn, Prescription/OTC, CoC, S 20785-2
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
36185 Drugs detected: 20785-2
36186 Chain of Custody 77202-0

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | PHP Pdf | CMS Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports