Test ID: DASM5
Drugs of Abuse Screen, Meconium 5
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Identifying amphetamines (and methamphetamines), opiates, as well as metabolites of cocaine and marijuana in meconium specimens
Reflex Tests Lists test(s) that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial test(s)
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| AMPHM | Amphetamines, Confirmation, M | Yes | No |
| COKEM | Cocaine and Metabolites, Confirm, M | Yes | No |
| OPATM | Opiate Confirmation, M | Yes | No |
| PCPMC | PCP Confirmation, Meconium | Yes | No |
| THCM | Carboxy-THC Confirmation, M | Yes | No |
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
Testing begins with immunoassay screen. Positives are confirmed and quantitated by liquid-chromatography/tandem-mass spectrometry (LC-MS/MS) at an additional charge.
Method Name A short description of the method used to perform the test
Enzyme-Linked Immunosorbent Assay (ELISA)
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Angel Dust (Phencyclidine)
Benzoylecgonine (Cocaine Metabolite)
Cannabinoids (Tetrahydrocannabinol)
Cocaine
Codeine
Coke (Cocaine)
Crack (Cocaine)
Desoxyn (Methamphetamines)
Dilaudid (Hydromorphone)
Drugs of Abuse
Heroin (as Morphine)
Hycodan (Hydrocodone)
Hydrocodone (Hycodan, Vicodin)
Hydromorphone (Dilaudid, Vicodin)
Jane (Tetrahydrocannabinol)
Killer Weed (Phencyclidine)
Lortab (Hydromorphone)
Marijuana (Tetrahydrocannabinol)
MDA (Methylenedioxyamphetamine) Metabolite for Methylenedioxyethylamphetamine (MDEA) and Methylenedioxymethamphetamine (MDMA)
MDMA (Methylenedioxymethamphetamine)
Meconium Drug Screen
Methamphetamines (Desoxyn)
Methylenedioxymethamphetamine (MDMA)
Morphine
Opiates
Oxycodone (Oxycontin, Percodan)
Oxycontin (Oxycodone)
PCP (Phencyclidine)
Percodan (Oxycodone)
Phencyclidine (PCP)
Speed (Amphetamines)
Tetrahydrocannabinol (THC)
THC (Tetrahydrocannabinol)
Vicodin (Hydrocodone)
Mary Jane (Tetrahydrocannabinol)
Methylenedioxyamphetamine (MDA) Metabolite for Methylenedioxyethylamphetamine (MDEA) and Methylenedioxymethamphetamine (MDMA)
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Chain-of-Custody is recommended for this test. Chain-of-Custody Meconium Kit (Supply T653) is available upon request.
Container/Tube: Stool container (Supply T288)
Specimen Volume: 5 g (approximately 1 tablespoon)
Collection Instructions: Collect entire random meconium specimen.
Additional Information:
1. For chain-of-custody information, see Chain-of-Custody Meconium Kit (Supply T653).
2. Specimen that arrives with a broken seal does not meet the chain-of-custody requirements.
3. The laboratory recommends sending chain-of-custody specimens by overnight shipment.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | Grossly bloody reject; Pink OK |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Meconium | Frozen (preferred) | 14 days |
| Refrigerated | 24 hours |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Illicit drug use during pregnancy is a major social and medical issue. Drug abuse during pregnancy is associated with significant perinatal complications, which include a high incidence of stillbirths, meconium-stained fluid, premature rupture of the membranes, maternal hemorrhage (abruption placenta or placenta praevia), and fetal distress.(1) In the neonate, the mortality rate, as well as morbidity (eg, asphyxia, prematurity, low birthweight, hyaline membrane disease, infections, aspirations pneumonia, cerebral infarction, abnormal heart rate and breathing patterns, drug withdrawal) are increased.(1)
The disposition of drug in meconium is not well understood. The proposed mechanism is that the fetus excretes drug into bile and amniotic fluid. Drug accumulates in meconium either by direct deposit from bile or through swallowing of amniotic fluid.(2) The first evidence of meconium in the fetal intestine appears at approximately the 10th to 12th week of gestation, and slowly moves into the colon by the 16th week of gestation.(3) Therefore, the presence of drugs in meconium has been proposed to be indicative of in utero drug exposure up to 5 months before birth, a longer historical measure than is possible by urinalysis.(2)
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.
Negative
Positives are reported with a quantitative LC-MS/MS result.
Cutoff concentrations
Amphetamines by ELISA: >50 ng/g
Methamphetamine by ELISA: >100 ng/g
Benzoylecgonine (cocaine metabolite) by ELISA: >50 ng/g
Opiates by ELISA: >50 ng/g
Tetrahydrocannabinol carboxylic acid (marijuana metabolite) by ELISA: >10 ng/g
Phencyclidine by ELISA: >20 ng/g
Interpretation Provides information to assist in interpretation of the test results
The limit of quantitation varies for each of these drug groups.
-Amphetamines: >50 ng/g
-Methamphetamines: >100 ng/g
-Cocaine and metabolite: >50 ng/g
-Opiates: >50 ng/g
-Tetrahydrocannabinol carboxylic acid: >10 ng/g
-Phencyclidine (PCP): >20 ng/g
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Since the evidence of illicit drug use during pregnancy can be cause for separating the baby from the mother, a kit including all the materials necessary to complete chain-of-custody is available to ensure that the test results are appropriate for legal proceedings.
If heroin use is suspected, specimen must be sent frozen to prevent loss of 6-monoacetylmorphine (6MAM, heroin metabolite). When refrigerated, a significant percentage of 6MAM will convert to morphine in fewer than 24 hours.
Unless sent frozen, cocaine metabolite, m-hydroxybenzoylecgonine, will degrade within 72 hours of collection.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Ostrea EM Jr: Understanding drug testing in the neonate and the role of meconium analysis. J Perinat Neonatal Nurs 2001 Mar;14(4):61-82; quiz 105-106
2. Ostrea EM Jr, Brady MJ, Parks PM, et al: Drug screening of meconium in infants of drug-dependent mothers; an alternative to urine testing. J Pediatr 1989 Sep;115(3):474-477
3. Ahanya SN, Lakshmanan J, Morgan BL, Ross MG: Meconium passage in utero: mechanisms, consequences, and management. Obstet Gynecol Surv 2005 Jan;60(1):45-56; quiz 73-74
Method Description Describes how the test is performed and provides a method-specific reference
Meconium specimen is homogenized in a buffer. The homogenate is analyzed by enzyme-linked immunosorbent assay (ELISA) to detect the presence of drug. If drug presence is indicated by a positive result of ELISA, liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis is performed to verify the presence of the drug.(Unpublished Mayo method)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Saturday
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
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's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
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 Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
80104-Drug screen, qualitative, each procedure
G0431-Drug screen, qualitative, each specimen-government payers (if appropriate)
80299-Tetrahydrocannabinol carboxylic acid (if appropriate)
82145 x 2-Amphetamines (if appropriate)
82520-Cocaine (if appropriate)
83925-Opiates (if appropriate)
83992-Phencyclidine (if appropriate)
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| 32197 | Amphetamine | 26895-3 |
| 32199 | Methamphetamine | 27289-8 |
| 32201 | Cocaine | 26956-3 |
| 32203 | Opiate | 26744-3 |
| 32205 | Phencyclidine | 26829-2 |
| 32207 | Tetrahydrocannabinol | In Process |
| 32208 | Chain of Custody | In Process |
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