Chronic Pain Drug Screen, Urine, With Confirmation

Orderable EAP code:

LAB100593

Billable EAP Codes:

80001660 x 1
80001661 x 1
80001662 x 1
80001663 x 1
80001664 x 1
80002914 x 1
80002915 x 1

CPT Codes:

80307 x 7

Lab Section:

Core Lab

Includes:

Amphetamines, benzodiazepines, cannabinoids, cocaine, opiate, oxycodone, methadone

Turnaround Time:

Routine: 2 Hours
Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Specimen Requirements:

6 mL urine cup.

Reference Range:

Negative

Comments:

"Positive" results are confirmed by GC/MS analysis except for Cannabinoids and Benzodiazepines. Definitive confirmation by GC/MS requires an additional 24 to 48 hours from receipt of initial urine specimen. Results of confirmation analysis generally available 72 hours following receipt of specimen in laboratory.

SEE: Summary of Compounds that may be detected by OHSU Drugs of Abuse Screening Methods (Opens in a new window).

Synonyms:

Drug Screen, Chronic Pain, Pain Clinic Drug Screen, Urine Drug Screen

Tobramycin, 6 Hour Post (CF)

Orderable EAP code:

LAB102517

Billable EAP Codes:

80001678 x 1

CPT Codes:

80200 x 1

Lab Section:

Core Lab

Turnaround Time:

Routine: 2 Hours
Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Units:

mcg/mL

Specimen Requirements:

4 mL blood in a GREEN top, lithium heparin tube. Specimen to be collected 6 hours (or up to 10 hours) after the end of the infusion.

Pediatric Specimen Requirements:

0.6 mL blood in a GREEN top, lithium heparin tube. Specimen to be collected 6 hours (or up to 10 hours) after the end of the infusion.

Reference Range:

No Therapeutic Ranges established; results of 2 and 6 hour post dosing collections to be interpreted by Pharmacy.

Synonyms:

Tobramycin AUC for Cystic Fibrosis, 6 hour

Tobramycin, 2 Hour Post (CF)

Orderable EAP code:

LAB102516

Billable EAP Codes:

80001678 x 1

CPT Codes:

80200 x 1

Lab Section:

Core Lab

Turnaround Time:

Routine: 2 Hours
Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Units:

mcg/mL

Specimen Requirements:

4 mL blood in a GREEN top, lithium heparin tube. Specimen to be collected 2 hours after the end of the infusion.

Pediatric Specimen Requirements:

0.6 mL blood in a GREEN top, lithium heparin tube. Specimen to be collected 2 hours after the end of the infusion.

Reference Range:

No Therapeutic Ranges established; results of the 2 and 6 hours post dosing collections to be interpreted by Pharmacy.

Synonyms:

Tobramycin (AUC) for Cystic Fibrosis 2 hour

Cell Count Only, Synovial Fluid

Orderable EAP code:

LAB101855

Billable EAP Codes:

80004370 x 1

CPT Codes:

89050 x 1

Lab Section:

Core Lab

Turnaround Time:

Routine: 4 Hours
Urgent: 2 Hours

Test Schedule:

24 hours, 7 days a week.

Critical Values:

WBC greater than or equal to 25,000/cu mm; Intercellular Bacteria; Malignant Cells; Atypical Cells if no previous.

Specimen Requirements:

3 mL synovial fluid in a LAVENDER top tube.

Pediatric Specimen Requirements:

1 mL synovial fluid in a 3 mL LAVENDER top tube.

Reference Range:

WBC less than or equal to 200 cu mm.

Comments:

Cell counts will be attempted on all fluids sent. However, specimen volume and quality may affect or prevent testing (i.e. specimens with small clots will be tested and results reported with a disclaimer that results may be affected, but specimens that are fully clotted cannot be counted). 

Synonyms:

Synovial Fluid, Cell Count

Chronic Pain Drug Screen, Urine, No Confirm

Orderable EAP code:

LAB01051

Billable EAP Codes:

80001660 x 1
80001661 x 1
80001662 x 1
80001663 x 1
80001664 x 1
80002914 x 1
80002915 x 1

CPT Codes:

80307 x 7

Lab Section:

Core Lab

Includes:

Amphetamines, benzodiazepines, cannabinoids, cocaine, opiate, oxycodone, methadone

Turnaround Time:

Routine: 2 Hours
Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Specimen Requirements:

6 mL urine cup.

Reference Range:

Negative

Comments:

"Positive" results are not confirmed by an alternate method. See: Summary of Compounds that may be detected by OHSU Drugs of Abuse Screening Methods. (Opens in a new window)

Synonyms:

Drug Screen, Chronic Pain, Pain Clinic Drug Screen, Urine Drug Screen

OB Strep Screen PCR w/Reflex if Indicated

Orderable EAP code:

LAB01026

Billable EAP Codes:

80003550 x 1

CPT Codes:

87653 x 1

Lab Section:

Core Lab

Turnaround Time:

Routine: 4 Hours
Urgent: 2 Hours

Test Schedule:

24 hours, 7 days a week.

Interpretation:

Pos, Neg, or Indeterminate. If positive, and patient has a documented allergy to penicillin/cephalosporins, a reflex culture is performed.

Specimen Requirements:

Double swab in Liquid Stuarts.

Synonyms:

Group B Strep Screen
OB Strep Screen
Strep B DNA
Strep B OB DNA PCR
Strep B PCR

Opiate Screen, Urine

Orderable EAP code:

LAB00573

Billable EAP Codes:

80001664 x 1

CPT Codes:

80307 x 1

Lab Section:

Core Lab

Turnaround Time:

Routine: 2 Hours
Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Specimen Requirements:

6 mL urine in sample cup.

Pediatric Specimen Requirements:

6 mL urine in sample cup or in 10 mL RED top tube.

Reference Range:

Negative

Comments:

Detects opiates in urine at levels greater than or equal to 300 ng/mL. "Positive" results are not confirmed by alternate method. See Summary of Compounds that may be detected by OHSU Drugs of Abuse Screening Methods. (Opens in a new window)

Synonyms:

Drugs of Abuse, Opiates, Drug Screen, Urine Drug Screen, Heroin, Morphine

RSV by PCR, Rapid

Orderable EAP code:

LAB101755

Billable EAP Codes:

80005342 x 1

CPT Codes:

87634 x 1

Lab Section:

Core Lab

Turnaround Time:

Routine: 4 Hours
Urgent: 2 Hours
 

Test Schedule:

24 hours, 7 days a week.

Critical Values:

All detected targets will be called.

Related Links:

Specimen Requirements:

Nasopharyngeal swab in red-capped viral transport media.

Comments:

This test has not been evaluated for patients without signs and symptoms of respiratory tract infection. Zicam at 15% (w/v) may interfere with the detection of low levels of influenza B and RSV A.

The Xpert Xpress SARS-CoV-2/Flu/RSV PLUS test is a rapid, multiplexed real-time RT-PCR test intended for the detection and differentiation of SARS-CoV-2, influenza A, influenza B, and respiratory syncytial virus (RSV) viral RNA in specimens collected from individuals suspected of respiratory viral infection consistent with COVID-19.

Negative results do not preclude infection and should not be used as the sole basis for treatment or other patient management decisions. Combine results with clinical observations, patient history, and epidemiological information.

Synonyms:

RSV, Respiratory Virus Panel, RSV Antigen

Factor IX Activity w/Reflex to Inhibitor

Orderable EAP code:

LAB101690

Billable EAP Codes:

80001093 x 1
80001100 x 1 (if reflexed)

CPT Codes:

85250 x 1
85335 x 1 (if reflexed)

Lab Section:

Core Lab

Includes:

If factor activity level is less than 40%, an inhibitor test will be performed.

Turnaround Time:

Routine: 1 Day
Urgent: N/A

Test Schedule:

Activities are batched daily 7 days a week. Inhibitors are batched twice per week.

Units:

Factors: %; Inhibitors: Bethesda Units (BU)

Specimen Requirements:

3.2% 2 to 2.7 mL blood in a LIGHT BLUE top tube, 3.2% sodium citrate.

3.2% sodium citrate tubes are acceptable when they are filled to the line on the manufacturers label. Tubes must be full (see comments below). For referral testing, submit 3 tubes of 1.0 mL platelet poor plasma.

Sodium citrate specimens must be processed and frozen within 2 hours of specimen collection.

OHSU Clinics must cab specimens to the Core Lab, Hatfield Research Center (HRC), Room 9D05 if processing is delayed or not possible on site. A phone call is helpful to alert the lab at 503-494-5764.

Detailed instructions are under Hemostasis & Thrombosis section (Opens in a new window).

Pediatric Specimen Requirements:

Sodium citrate tubes are acceptable when they are filled to the line on the manufacturers label.

One 2.7 mL correctly filled in an adult size LIGHT BLUE top tube, or two correctly filled 1.3 mL pediatric BLUE top tubes, 3.2% sodium citrate.

A single 1.3 mL pediatric tube may be sent but will only allow for factor activity testing; the inhibitor, if indicated, may not be performed due to insufficient plasma volume.

For pediatric patients requiring multiple coagulation tests, please call 503-494-7383 regarding draw volumes.

Reference Range:

Reference Range: 65% to 150%
Inhibitor: Less than 0.6 BU

Comments:

Draw volume is critical due to the liquid anticoagulant. Allow tubes to fill by vacuum.

  • Tubes with rubber stopper: fill to line on label.
  • Tubes with plastic (Hemogard) cap: the fill level is above the top of the label.
  • Syringe: do not remove the vacutainer stopper. Insert the needle through the stopper and allow the tube to fill by vacuum. Do not overfill the vacutainer.
  • Pediatric tubes have no vacuum. Remove the cap and add blood to the 1.3 mL mark. Do not overfill.

Avoid warfarin (Coumadin) therapy for two weeks and heparin therapy for 2 days prior to the test.

Inhibitors to factor IX arise in about 3% of persons with severe hemophilia B, which is less common that the incidence of inhibitors to factor VIII in persons with severe hemophilia A. In both types of hemophilia, most inhibitors arise early in life, after only a few injections of the missing clotting factor.

Inhibitors to factor IX are sometimes more dangerous than those to factor VIII. The reaction between factor VIII and its inhibitor-antibody does not cause symptoms. The reaction between factor IX and its inhibitor-antibody may cause severe allergic reactions which can be life-threatening (so-called "anaphylactic reactions"). Such reactions may occur with the very first infusion of factor IX after an inhibitor has developed - before anyone is aware that an inhibitor has arisen. All inhibitors in hemophilia B do not cause allergic reactions on exposure to more factor IX. Development of an inhibitor to factor IX can be predicted, at least in part, by determining the kind of factor IX gene mutation the baby has.

Methodology: clotting, Bethesda assay.

Synonyms:

Factor 9
Inhibitor
FIX

Factor VIII Activity w/Reflex to Inhibitor

Orderable EAP code:

LAB101689

Billable EAP Codes:

80001094 x 1
80001099 x 1 (if reflexed)

CPT Codes:

85240 x 1
85335 x 1 (if reflexed)

Lab Section:

Core Lab

Includes:

If factor activity level is less than 40%, an inhibitor test will be performed.

Turnaround Time:

Routine: 1 Day
Urgent: N/A

Test Schedule:

Activities are batched daily 7 days a week. Inhibitors are batched twice per week.

Units:

Factors: %; Inhibitors: Bethesda Units (BU)

Specimen Requirements:

2 to 2.7 mL blood in a LIGHT BLUE top tub, 3.2% sodium citrate.

3.2% sodium citrate tubes are acceptable when they are filled to the line on the manufacturers label. Tubes must be full (see comments below). For referral testing, submit 3 x 1.0 mL platelet poor plasma.

Sodium citrate specimens must be processed and frozen within 2 hours of specimen collection.

OHSU Clinics must cab specimens to the Core Lab, Hatfield Research Center (HRC), Room 9D05 if processing is delayed or not possible on site. A phone call is helpful to alert the lab at 503-494-5764.

Detailed instructions are under Hemostasis & Thrombosis section (Opens in a new window).

Pediatric Specimen Requirements:

One 2.7 mL correctly filled in an adult size LIGHT BLUE top tube, or two correctly filled 1.3 mL pediatric BLUE top tubes, 3.2% sodium citrate.

A single 1.3 mL pediatric tube may be sent but will only allow for factor activity testing; the inhibitor, if indicated, may not be performed due to insufficient plasma volume.

For pediatric patients requiring multiple coagulation tests, please call 503-494-7383 regarding draw volumes.

Reference Range:

Reference Range: 50% to 150%
Inhibitor: Less than 0.6 BU

Comments:

Draw volume is critical due to the liquid anticoagulant. Allow tubes to fill by vacuum.

  • Tubes with rubber stopper: fill to line on label.
  • Tubes with plastic (Hemogard) cap: the fill level is above the top of the label.
  • Syringe: do not remove the vacutainer stopper. Insert the needle through the stopper and allow the tube to fill by vacuum. Do not overfill the vacutainer.
  • Pediatric tubes have no vacuum. Remove the cap and add blood to the 1.3 mL mark. Do not overfill.

Avoid warfarin (Coumadin) therapy for two weeks and heparin therapy for 2 days prior to the test.

Assay to detect a circulating anticoagulant to factor VIII. Some patients with hemophilia A develop inhibitors to infused factor VIII, which may completely neutralize the action of the factor. In rare cases, individuals without hemophilia may also develop factor VIII inhibitors. For these patients, inhibitors result in spontaneous episodes of bleeding with no prior indication of any coagulation disorder. The action of the inhibitors differs somewhat between patients with hemophilia A and those without the disorder. Inhibitors in hemophiliacs tend to result in complete inactivation of factor VIII when enough inhibitors are present. In contrast, patients without hemophilia who develop inhibitors may still have some factor VIII activity even though the inhibitor is present. Simple vs. complex kinetics noted.

Methodology: Time-temperature dependent factor VIII assay (clotting Bethesda assay).

Synonyms:

Factor 8
Inhibitor
FVIII