Test Summary Sheet for:

Purpose
Overexposure/Poisoning Determination
Method(s)
Headspace Gas Chromatography (GC)
Spectrophotometry (SP)
Suggested CPT Code(s)
80307
84600
New York State Approval Status

Approved

Turnaround Time

5 days (If Positive: 9 days)

Test Includes
1 Carboxyhemoglobin COHb Spectrophotometry (SP) %Saturation 5 Biological Marker (Exposure)
2 Benzene Headspace Gas Chromatography (GC) mcg/mL 0.05 Environmental/Occupation Toxin
3 Toluene Headspace Gas Chromatography (GC) mcg/mL 0.3 Environmental/Occupation Toxin
4 Xylene Headspace Gas Chromatography (GC) mcg/mL 0.3 Environmental/Occupation Toxin
5 Acetone Headspace Gas Chromatography (GC) mg/dL 0.5 Environmental/Occupation Toxin
6 Methyl Ethyl Ketone MEK Headspace Gas Chromatography (GC) mcg/mL 0.3 Environmental/Occupation Toxin
7 Iso-Amyl Alcohol Amyl Nitrite Metabolite Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
8 n-Amyl Alcohol Amyl Nitrite Metabolite Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
9 Isobutanol Iso-Butyl Nitrite Metabolite; Isobutyl Alcohol Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
10 n-Butanol Butyl Alcohol; Butyl Nitrite Metabolite Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
11 Cyclopropane Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
12 Ethyl Ether Diethyl Ether Headspace Gas Chromatography (GC) mcg/mL 1 Environmental/Occupation Toxin
13 Chloromethane Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
14 Dichloromethane Methylene Chloride Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
15 Chloroform Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
16 Carbon Tetrachloride Tetrachloromethane Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
17 Chloroethane Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
18 Dichloroethane Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
19 1,1,1-Trichloroethane Methyl Chloroform Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
20 1,1,2,2-Tetrachloroethane Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
21 Trichlorofluoromethane Freon 11 Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
22 Dichlorodifluoromethane Freon 12 Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
23 Trichlorotrifluoroethane Freon 113 Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
24 Methanol Methyl Alcohol Headspace Gas Chromatography (GC) mg/dL 5 Environmental/Occupation Toxin
25 Ethanol Ethyl Alcohol; Metabolite of Ethyl Acetate Headspace Gas Chromatography (GC) mg/dL 5 Hypnotic, Sedative, Volatile
26 Isopropanol Isopropyl Alcohol Headspace Gas Chromatography (GC) mg/dL 1 Environmental/Occupation Toxin

Reflex Tests
Test Code Test Name
5737B Carbon Monoxide Quantitation/Confirmation, Blood
Specimen Type
Blood
Requested Volume
6 mL
Minimum Volume
2.8 mL
Special Handling
Collect sample using alcohol free skin preparation. Ensure that container remains tightly sealed.
Specimen Container
Gray top tube (Sodium Fluoride / Potassium Oxalate), Lavender top tube (EDTA)

Additional Collection Instructions

Transport Temperature
Refrigerated
Light Protection
Not Required
Rejection Criteria
None

Rejection criteria pertain to clinical specimen submissions only.

Stability
Room Temperature: Undetermined
Refrigerated: Undetermined
Frozen (-20 °C): Undetermined
1 Carboxyhemoglobin COHb Spectrophotometry (SP) %Saturation 5 Biological Marker (Exposure)
2 Benzene Headspace Gas Chromatography (GC) mcg/mL 0.05 Environmental/Occupation Toxin
3 Toluene Headspace Gas Chromatography (GC) mcg/mL 0.3 Environmental/Occupation Toxin
4 Xylene Headspace Gas Chromatography (GC) mcg/mL 0.3 Environmental/Occupation Toxin
5 Acetone Headspace Gas Chromatography (GC) mg/dL 0.5 Environmental/Occupation Toxin
6 Methyl Ethyl Ketone MEK Headspace Gas Chromatography (GC) mcg/mL 0.3 Environmental/Occupation Toxin
7 Iso-Amyl Alcohol Amyl Nitrite Metabolite Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
8 n-Amyl Alcohol Amyl Nitrite Metabolite Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
9 Isobutanol Iso-Butyl Nitrite Metabolite; Isobutyl Alcohol Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
10 n-Butanol Butyl Alcohol; Butyl Nitrite Metabolite Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
11 Cyclopropane Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
12 Ethyl Ether Diethyl Ether Headspace Gas Chromatography (GC) mcg/mL 1 Environmental/Occupation Toxin
13 Chloromethane Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
14 Dichloromethane Methylene Chloride Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
15 Chloroform Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
16 Carbon Tetrachloride Tetrachloromethane Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
17 Chloroethane Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
18 Dichloroethane Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
19 1,1,1-Trichloroethane Methyl Chloroform Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
20 1,1,2,2-Tetrachloroethane Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
21 Trichlorofluoromethane Freon 11 Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
22 Dichlorodifluoromethane Freon 12 Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
23 Trichlorotrifluoroethane Freon 113 Headspace Gas Chromatography (GC) mcg/mL 2 Environmental/Occupation Toxin
24 Methanol Methyl Alcohol Headspace Gas Chromatography (GC) mg/dL 5 Environmental/Occupation Toxin
25 Ethanol Ethyl Alcohol; Metabolite of Ethyl Acetate Headspace Gas Chromatography (GC) mg/dL 5 Hypnotic, Sedative, Volatile
26 Isopropanol Isopropyl Alcohol Headspace Gas Chromatography (GC) mg/dL 1 Environmental/Occupation Toxin

Interface Map

LOINC® Information

The CPT Codes provided in this document are based on AMA Guidelines and are for informational purposes only. NMS Labs Does not assume responsibility for billing errors due to Reliance on the CPT Codes listed in this document.

*The information contained in this document represents database configurations, as they will appear on the effective date listed above.