Test Summary Sheet for:

Purpose
Therapeutic Drug Monitoring
Method(s)
High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)
Suggested CPT Code(s)
80331x2
New York State Approval Status

Approved

Turnaround Time

8 days

Test Includes
1 Ketorolac Toradol® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 0.1 Analgesic
2 Piroxicam Feldene® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 0.2 Analgesic
3 6-MNA Nabumetone Active Metabolite High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 0.3 Analgesic
4 Flurbiprofen Ansaid® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 1.0 Analgesic
5 Indomethacin Indocin® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 0.1 Analgesic
6 Diclofenac Voltaren® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 0.1 Analgesic
7 Ibuprofen Motrin® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 3.0 Analgesic
8 Tolmetin Tolectin® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 1.0 Analgesic
9 Ketoprofen Orudis® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 0.4 Analgesic
10 Naproxen Alleve®; Naprosyn® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 3.0 Analgesic
11 Oxaprozin Daypro® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 3.0 Analgesic
12 Fenoprofen Nalfon® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 5.0 Analgesic
13 Etodolac Lodine® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 1.0 Analgesic

Test Also Known As
Acular®; Advil®; Aleve®; Anaprox®; NSAID; Nuprin®; Relafen®
Specimen Type
Serum or Plasma
Requested Volume
1 mL
Minimum Volume
0.4 mL
Special Handling
Serum: Collect sample in Red top tube
Plasma: Collect sample in Lavender top tube (EDTA) or Pink top tube.
Promptly centrifuge and separate Serum or Plasma into a plastic screw capped vial using approved guidelines.
Specimen Container
Plastic container (preservative-free)

Additional Collection Instructions

Transport Temperature
Refrigerated
Light Protection
Not Required
Rejection Criteria
Polymer gel separation tube (SST or PST).

Rejection criteria pertain to clinical specimen submissions only.

Stability
Room Temperature: 7 day(s)
Refrigerated: 15 day(s)
Frozen (-20 °C): 15 day(s)
1 Ketorolac Toradol® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 0.1 Analgesic
2 Piroxicam Feldene® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 0.2 Analgesic
3 6-MNA Nabumetone Active Metabolite High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 0.3 Analgesic
4 Flurbiprofen Ansaid® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 1.0 Analgesic
5 Indomethacin Indocin® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 0.1 Analgesic
6 Diclofenac Voltaren® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 0.1 Analgesic
7 Ibuprofen Motrin® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 3.0 Analgesic
8 Tolmetin Tolectin® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 1.0 Analgesic
9 Ketoprofen Orudis® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 0.4 Analgesic
10 Naproxen Alleve®; Naprosyn® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 3.0 Analgesic
11 Oxaprozin Daypro® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 3.0 Analgesic
12 Fenoprofen Nalfon® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 5.0 Analgesic
13 Etodolac Lodine® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) mcg/mL 1.0 Analgesic

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.