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HelpTest Code TOSU Targeted Opioid Screen, Random, Urine
Reporting Name
Targeted Opioid Screen, UPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Determining compliance or identifying illicit opioid drug use using urine specimens
This test is not intended for employment-related testing.
Method Name
Liquid Chromatography Tandem Mass Spectrometry, High-Resolution Accurate Mass (LC-MS/MS HRAM)
Additional Testing Requirements
In most cases, no additional testing is needed after the qualitative targeted opioid test is performed if the parent drug or metabolites found are consistent with the patient's prescribed medications. However, if an unexpected opioid parent drug or metabolites are found, confirmatory testing can be requested at an additional charge.
Specimen Required
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
Specimen 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 |
Reject Due To
| Gross hemolysis | Reject |
| Gross icterus | Reject |
Reference Values
Not detected
Cutoff concentrations:
Codeine: 25 ng/mL
Codeine-6-beta-glucuronide: 100 ng/mL
Morphine: 25 ng/mL
Morphine-6-beta-glucuronide: 100 ng/mL
6-monoacetylmorphine: 25 ng/mL
Hydrocodone: 25 ng/mL
Norhydrocodone: 25 ng/mL
Dihydrocodeine: 25 ng/mL
Hydromorphone: 25 ng/mL
Hydromorphone-3-beta-glucuronide: 100 ng/mL
Oxycodone: 25 ng/mL
Noroxycodone: 25 ng/mL
Oxymorphone: 25 ng/mL
Oxymorphone-3-beta-glucuronide: 100 ng/mL
Noroxymorphone: 25 ng/mL
Fentanyl: 2 ng/mL
Norfentanyl: 2 ng/mL
Meperidine: 25 ng/mL
Normeperidine: 25 ng/mL
Naloxone: 25 ng/mL
Naloxone-3-beta-glucuronide: 100 ng/mL
Methadone: 25 ng/mL
2-Ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP): 25 ng/mL
Propoxyphene: 25 ng/mL
Norpropoxyphene: 25 ng/mL
Tramadol: 25 ng/mL
O-desmethyltramadol: 25 ng/mL
Tapentadol: 25 ng/mL
N-desmethyltapentadol: 50 ng/mL
Tapentadol-beta-glucuronide: 100 ng/mL
Buprenorphine: 5 ng/mL
Norbuprenorphine: 5 ng/mL
Norbuprenorphine glucuronide: 20 ng/mL
Interpretation
If an opioid or its corresponding metabolites is identified (present), it indicates that the patient has used the respective opioid in the recent past. The absence of expected opioids 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.
Day(s) Performed
Monday through Sunday
Report Available
2 to 4 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
80364
G0481 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| TOSU | Targeted Opioid Screen, U | 95796-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| LPPO | List prescribed opioids | 29305-0 |
| 42323 | Codeine | 19411-8 |
| 42324 | Codeine-6-beta-glucuronide | 89310-7 |
| 42325 | Morphine | 19597-4 |
| 42326 | Morphine-6-beta-glucuronide | 89308-1 |
| 42327 | 6-monoacetylmorphine | 19321-9 |
| 42328 | Hydrocodone | 19482-9 |
| 42329 | Norhydrocodone | 89304-0 |
| 42330 | Dihydrocodeine | 19446-4 |
| 42331 | Hydromorphone | 19486-0 |
| 42332 | Hydromorphone-3-beta-glucuronide | 89309-9 |
| 42333 | Oxycodone | 19642-8 |
| 42334 | Noroxycodone | 89303-2 |
| 42335 | Oxymorphone | 19646-9 |
| 42336 | Oxymorphone-3-beta-glucuronide | 89301-6 |
| 42337 | Noroxymorphone | 89302-4 |
| 42338 | Fentanyl | 59673-4 |
| 42339 | Norfentanyl | 43199-9 |
| 42340 | Meperidine | 19532-1 |
| 42341 | Normeperidine | 27920-8 |
| 42342 | Naloxone | 42618-9 |
| 42343 | Naloxone-3-beta-glucuronide | 89307-3 |
| 42344 | Methadone | 19550-3 |
| 42345 | EDDP | 93495-0 |
| 42346 | Propoxyphene | 19429-0 |
| 42347 | Norpropoxyphene | 19632-9 |
| 42348 | Tramadol | 19710-3 |
| 42349 | O-desmethyltramadol | 86453-8 |
| 42350 | Tapentadol | 72485-6 |
| 42351 | N-desmethyltapentadol | 89306-5 |
| 42352 | Tapentadol-beta-glucuronide | 89300-8 |
| 42353 | Buprenorphine | 93494-3 |
| 42354 | Norbuprenorphine | 82371-6 |
| 42355 | Norbuprenorphine glucuronide | 89305-7 |
| 65059 | Opioid Interpretation | 69050-3 |
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| LPPO | List prescribed opioids | No | Yes |
| TOPSU | Targeted Opioid Screen, U | No | Yes |