Test Code MTDNX Methadone Confirmation, Chain of Custody, Random, Urine
Reporting Name
Methadone Confirmation, CoC, UPerforming Laboratory
Mayo Clinic Laboratories in RochesterUseful For
Monitoring for compliance of methadone treatment for analgesia or drug rehabilitation
Assessing compliance with rehabilitation programs
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.
Method Name
Immunoassay/Gas Chromatography Mass Spectrometry (GC-MS)
Specimen Required
Supplies: Chain of Custody Kit (T282)
Container/Tube: Chain-of-custody kit containing the specimen containers, seals, and documentation required.
Specimen Volume: 10 mL
Collection Instructions: Collect urine specimen 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 10 mL will compromise our ability to perform all necessary testing.
Specimen Type
UrineSpecimen Minimum Volume
2.5 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Urine | Refrigerated (preferred) | 28 days | |
Frozen | 28 days | ||
Ambient | 14 days |
Reject Due To
Gross hemolysis | OK |
Gross icterus | OK |
Reference Values
Negative
Positives are reported with a quantitative gas chromatography mass spectrometry result.
IMMUNOASSAY SCREEN
<300 ng/mL
Cutoff concentrations:
METHADONE BY GC-MS
<100 ng/mL
2-ETHYLIDENE-1,5-DIMETHYL-3,3-DIPHENYLPYRROLIDINE GC-MS
<100 ng/mL
Interpretation
The absolute concentration of methadone and its metabolites found in patient urine specimens can be highly variable and does not correlate with dose. However, the medical literature and our experience show that patients who are known to be compliant with their methadone therapy have ratios of 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP):methadone of greater than 0.60.(7)
An EDDP:methadone ratio less than
Day(s) Performed
Tuesday, Thursday
Report Available
3 to 7 daysTest 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
80358
G0480 (if appropriate)
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
MTDNX | Methadone Confirmation, CoC, U | 104626-7 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
21105 | Methadone Immunoassay Screen | 70149-0 |
36208 | EDDP-by GC-MS | 58429-2 |
36209 | Methadone-by GC-MS | 16246-1 |
36210 | Methadone Interpretation | 69050-3 |
36211 | Chain of Custody | 77202-0 |
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.
Additional Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
COCH | Chain of Custody Processing | No | Yes |
ADLTX | Adulterants Survey, CoC, U | Yes | Yes |
Testing Algorithm
Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.