Basic Drug Screen, Umbilical Cord Tissue

Test Summary Sheet for:

Purpose

Perinatal Drug Testing; Drug of Abuse Monitoring; 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

2 days (If Positive: 5 days)

Test Includes


1	6-Monoacetylmorphine - Free	6-MAM; Heroin Metabolite	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	0.2
2	Amphetamine	Benzphetamine Metabolite	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	5	Stimulant, Anorexogenic
3	Benzoylecgonine	Cocaine Degradation Product	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	0.5	Stimulant
4	Codeine - Free		High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	0.5	Narcotic Analgesic
5	Delta-9 Carboxy THC	Inactive Metabolite of Delta-9 THC	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	0.1	Cannabinoid
6	Hydrocodone - Free	Vicodin®; Zohydro®	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	0.5	Narcotic Analgesic
7	Hydromorphone - Free	Dilaudid®; Hydrocodone Metabolite	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	0.5	Narcotic Analgesic
8	MDA	3,4-Methylenedioxyamphetamine; Adam; MDMA Metabolite	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	5	Stimulant
9	MDEA	3,4-methylenedioxyethylamphetamine; Eve	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	5	Stimulant
10	MDMA	3,4-Methylenedioxymethamphetamine; Ecstasy	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	5	Stimulant
11	Methamphetamine	Benzphetamine Metabolite	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	5	Stimulant
12	Morphine - Free		High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	0.5	Narcotic Analgesic
13	Phencyclidine	Angel Dust; PCP; Sherm	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	1	Hallucinogen

Test Also Known As

neonatal

Reflex Tests

Test Code	Test Name
52345UC	Amphetamines Confirmation (Qualitative), Umbilical Cord Tissue
52357UC	Phencyclidine Confirmation (Qualitative), Umbilical Cord Tissue
52362UC	Cannabinoids Confirmation (Qualitative), Umbilical Cord Tissue
52363UC	Cocaine Metabolite Confirmation (Qualitative), Umbilical Cord Tissue
52391UC	Opiates - Free (Unconjugated) Confirmation (Qualitative), Umbilical Cord Tissue

Specimen Type

Umbilical Cord

Requested Volume

10 g

Minimum Volume

10 g

Special Handling

Collect at least 6 inches of umbilical cord (approximately the length of an adult hand). Drain and discard any blood. Rinse the exterior of the cord segment with normal saline or sterile water. Pat the cord dry and place in container for transport. Store at refrigerated temperature.
Unacceptable Specimens: Cords soaking in blood or other fluid. Formalin fixed. Tissue that is obviously decomposed. Samples received without cold pack.

Specimen Container

Plastic container (preservative-free)

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: 7 day(s)
Frozen (-20 °C): 14 day(s)


1	6-Monoacetylmorphine - Free	6-MAM; Heroin Metabolite	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	0.2
2	Amphetamine	Benzphetamine Metabolite	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	5	Stimulant, Anorexogenic
3	Benzoylecgonine	Cocaine Degradation Product	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	0.5	Stimulant
4	Codeine - Free		High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	0.5	Narcotic Analgesic
5	Delta-9 Carboxy THC	Inactive Metabolite of Delta-9 THC	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	0.1	Cannabinoid
6	Hydrocodone - Free	Vicodin®; Zohydro®	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	0.5	Narcotic Analgesic
7	Hydromorphone - Free	Dilaudid®; Hydrocodone Metabolite	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	0.5	Narcotic Analgesic
8	MDA	3,4-Methylenedioxyamphetamine; Adam; MDMA Metabolite	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	5	Stimulant
9	MDEA	3,4-methylenedioxyethylamphetamine; Eve	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	5	Stimulant
10	MDMA	3,4-Methylenedioxymethamphetamine; Ecstasy	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	5	Stimulant
11	Methamphetamine	Benzphetamine Metabolite	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	5	Stimulant
12	Morphine - Free		High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	0.5	Narcotic Analgesic
13	Phencyclidine	Angel Dust; PCP; Sherm	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	ng/g	1	Hallucinogen

Example Report (Negative)

Example Report (Positive)

Interface Map

9351UC Basic Drug Screen, Umbilical Cord Tissue - Current Version
Analyte	Units	Analyte Mapping Code
6-Monoacetylmorphine - Free	ng/g	TOF5-MAMF
Amphetamine	ng/g	AMPS-AMPH
Benzoylecgonine	ng/g	TOF3-ECGON
Codeine - Free	ng/g	TOF5-CODEI
Delta-9 Carboxy THC	ng/g	THC1-9CARB
Hydrocodone - Free	ng/g	TOF5-HYDROC
Hydromorphone - Free	ng/g	TOF5-HYDROM
MDA	ng/g	AMPS-MDA1
MDEA	ng/g	AMPS-MDEA
MDMA	ng/g	AMPS-MDMA
Methamphetamine	ng/g	AMPS-METHA
Morphine - Free	ng/g	TOF5-MORPH
Phencyclidine	ng/g	PCP

52345UC Amphetamines Confirmation (Qualitative), Umbilical Cord Tissue- Current Version
Analyte	Units	Analyte Mapping Code
Amphetamine	ng/g	AMPS-AMPH
MDA	ng/g	AMPS-MDA1
MDEA	ng/g	AMPS-MDEA
MDMA	ng/g	AMPS-MDMA
Methamphetamine	ng/g	AMPS-METHA

52362UC Cannabinoids Confirmation (Qualitative), Umbilical Cord Tissue- Current Version
Analyte	Units	Analyte Mapping Code
Delta-9 Carboxy THC	ng/g	THC1-9CARB

52363UC Cocaine Metabolite Confirmation (Qualitative), Umbilical Cord Tissue- Current Version
Analyte	Units	Analyte Mapping Code
Benzoylecgonine	ng/g	TOF3-ECGON

52391UC Opiates - Free (Unconjugated) Confirmation (Qualitative), Umbilical Cord Tissue- Current Version
Analyte	Units	Analyte Mapping Code
6-Monoacetylmorphine - Free	ng/g	TOF5-MAMF
Codeine - Free	ng/g	TOF5-CODEI
Hydrocodone - Free	ng/g	TOF5-HYDROC
Hydromorphone - Free	ng/g	TOF5-HYDROM
Morphine - Free	ng/g	TOF5-MORPH

52357UC Phencyclidine Confirmation (Qualitative), Umbilical Cord Tissue- Current Version
Analyte	Units	Analyte Mapping Code
Phencyclidine	ng/g	PCP

LOINC^® Information

9351UC Basic Drug Screen, Umbilical Cord Tissue - Current Version
Analyte	Units	Analyte Mapping Code
6-Monoacetylmorphine - Free	ng/g	TOF5-MAMF
Amphetamine	ng/g	AMPS-AMPH
Benzoylecgonine	ng/g	TOF3-ECGON
Codeine - Free	ng/g	TOF5-CODEI
Delta-9 Carboxy THC	ng/g	THC1-9CARB
Hydrocodone - Free	ng/g	TOF5-HYDROC
Hydromorphone - Free	ng/g	TOF5-HYDROM
MDA	ng/g	AMPS-MDA1
MDEA	ng/g	AMPS-MDEA
MDMA	ng/g	AMPS-MDMA
Methamphetamine	ng/g	AMPS-METHA
Morphine - Free	ng/g	TOF5-MORPH
Phencyclidine	ng/g	PCP

52345UC Amphetamines Confirmation (Qualitative), Umbilical Cord Tissue - Current Version
Analyte	LOINC®
Amphetamine
MDA
MDEA
MDMA
Methamphetamine

52362UC Cannabinoids Confirmation (Qualitative), Umbilical Cord Tissue - Current Version
Analyte	LOINC®
Delta-9 Carboxy THC

52363UC Cocaine Metabolite Confirmation (Qualitative), Umbilical Cord Tissue - Current Version
Analyte	LOINC®
Benzoylecgonine

52391UC Opiates - Free (Unconjugated) Confirmation (Qualitative), Umbilical Cord Tissue - Current Version
Analyte	LOINC®
6-Monoacetylmorphine - Free
Codeine - Free
Hydrocodone - Free	86229-2
Hydromorphone - Free
Morphine - Free

52357UC Phencyclidine Confirmation (Qualitative), Umbilical Cord Tissue - Current Version
Analyte	LOINC®
Phencyclidine


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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.