Test Summary Sheet for:

Purpose
Exclusion Screen
Method(s)
High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)
Suggested CPT Code(s)
80307
New York State Approval Status

Approved

Turnaround Time

8 days (If Positive: 15 days)

Test Includes
1 Chlorothiazide Diuril® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic
2 Hydrochlorothiazide Microzide® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Antihypertensive, Diuretic
3 Acetazolamide Diamox® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic
4 Hydroflumethiazide Saluron® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic
5 Triamterene Dyrenium® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic
6 Chlorthalidone Hygroton®; Thalitone® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic
7 Furosemide Frusemide; Lasix® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Antihypertensive, Diuretic
8 Metolazone Mykrox®; Zaroxolyn® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic
9 Indapamide Lozol® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic
10 Torsemide Demadex®; Torasemide High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic
11 Bumetanide Bumex® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic
12 Canrenone Spironolactone metabolite High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic

Test Also Known As
Aldactone; Canrenone; Diucardin; Leodrine; Luvion; Phanurane; Saluron®; Spiroletan
Reflex Tests
Test Code Test Name
5594U Diuretics Confirmation (Qualitative), Urine
Specimen Type
Urine
Requested Volume
2 mL
Minimum Volume
0.8 mL
Special Handling
None
Specimen Container
Plastic container (preservative-free)

Additional Collection Instructions

Transport Temperature
Refrigerated
Light Protection
Not Required
Rejection Criteria
Received Room Temperature.

Rejection criteria pertain to clinical specimen submissions only.

Stability
Room Temperature: 2 day(s)
Refrigerated: 28 day(s)
Frozen (-20 °C): 28 day(s)
1 Chlorothiazide Diuril® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic
2 Hydrochlorothiazide Microzide® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Antihypertensive, Diuretic
3 Acetazolamide Diamox® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic
4 Hydroflumethiazide Saluron® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic
5 Triamterene Dyrenium® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic
6 Chlorthalidone Hygroton®; Thalitone® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic
7 Furosemide Frusemide; Lasix® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Antihypertensive, Diuretic
8 Metolazone Mykrox®; Zaroxolyn® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic
9 Indapamide Lozol® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic
10 Torsemide Demadex®; Torasemide High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic
11 Bumetanide Bumex® High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic
12 Canrenone Spironolactone metabolite High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) ng/mL 250 Diuretic

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.