Pain Management Drug Screen with Interpretation by High-Resolution Time-of-Flight or Tandem Mass Spectrometry and Enzyme Immunoassay, Urine
Ordering Recommendation

Useful for general testing in contexts of compliance and/or abuse, primarily in the pain management population. Testing is qualitative and uses a combination of mass spectrometry as well as immunoassays with documented low false positive rates.
Results indicate whether findings are consistent or inconsistent with supplied medication information. Refer to Medication Submission Guidelines for details.
Secondary testing is generally not indicated but is available if confirmation or quantitation is desired.
If medication information is not available or interpretation is not necessary, consider Pain Management Drug Panel by High-Resolution Time-of-Flight Mass or Tandem Spectrometry and Enzyme Immunoassay, Urine (2007479).

Qualitative Liquid Chromatography/Time of Flight Mass Spectrometry or Tandem Mass Spectrometry/Enzyme Immunoassay/Quantitative Spectrophotometry
1-4 days
New York DOH Approval Status
This test is New York DOH approved.
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Information on the patient's current medications must be submitted with the order. Include trade name, generic name, dosing frequency and date of last dose, if known. Alternatively, please indicate if no prescription medication or drugs are being taken. 
Random urine. 
Specimen Preparation
Transfer 4 mL each into two (2) ARUP Standard Transport Tubes urine with no additives or preservatives. (Min: 2 mL each) 
Storage/Transport Temperature
Unacceptable Conditions
Specimens exposed to repeated freeze/thaw cycles. 
Ambient: 1 week; Refrigerated: 1 month; Frozen: 3 years 
Reference Interval
Effective November 17, 2014
Drugs covered and range of cutoff concentrations.
Note: Some drugs are identified based on the presence of unique drug metabolites not listed below.
Drugs/Drug Classes
Range of Cutoff Concentrations
Barbiturates200 ng/mL
alprazolam, clonazepam, diazepam, lorazepam, midazolam, nordiazepam, oxazepam,  temazepam, zolpidem
20 - 60 ng/mL
Cannabinoids (11-nor-9-carboxy-THC)20 ng/mL
Ethyl Glucuronide500 ng/mL
Muscle Relaxant(s):
carisoprodol, meprobamate
100 ng/mL
buprenorphine, codeine, fentanyl, heroin, hydrocodone, hydromorphone, meperidine, methadone, morphine, oxycodone, oxymorphone, propoxyphene, tapentadol, tramadol
2-300 ng/mL
Phencyclidine (PCP)25 ng/mL
amphetamine, cocaine, methamphetamine, methylphenidate, MDMA (Ecstasy), MDEA (Eve), MDA, phentermine
100-400  ng/mL

Interpretive Data
Methodology: Qualitative Enzyme Immunoassay and Qualitative Liquid Chromatography-Time-of-Flight-Mass Spectrometry or Tandem Mass Spectrometry, Quantitative Spectrophotometry

The absence of expected drug(s) and/or drug metabolite(s) may indicate non-compliance, inappropriate timing of specimen collection relative to drug administration, poor drug absorption, diluted/adulterated urine, or limitations of testing. The concentration must be greater than or equal to the cutoff concentration to be reported as present. If specific drug concentrations are required, contact the laboratory within two weeks of specimen collection to request confirmation and quantification by a second analytical technique. Interpretive questions should be directed to the laboratory.

Results based on immunoassay detection that do not match clinical expectations should be interpreted with caution. Confirmatory testing by mass spectrometry for immunoassay-based results is available if ordered within two weeks of specimen collection. Additional charges apply.

For medical purposes only; not valid for forensic use.

Creatinine concentration is also provided. The carisoprodol immunoassay has cross-reactivity to carisoprodol and meprobamate.
Hotline History
Component Test Code*Component Chart NameLOINC
0090386Creatinine, Urine2161-8
2007636Codeine (cutoff 40 ng/mL)3507-1
2007637Morphine (cutoff 20 ng/mL)3830-7
20076386-acetylmorphine (cutoff 20 ng/mL)10976-9
2007640Oxycodone (cutoff 40 ng/mL)10998-3
2007641Noroxycodone (cutoff 100 ng/mL)61424-8
2007642Oxymorphone (cutoff 40 ng/mL)11247-4
2007643Noroxymorphone (cutoff 100 ng/mL)
2007644Hydrocodone (cutoff 40 ng/mL)12308-3
2007646Norhydrocodone (cutoff 100 ng/mL)61421-4
2007647Hydromorphone (cutoff 40 ng/mL)9834-3
2007649Buprenorphine (cutoff 5 ng/mL)3414-0
2007651Norbuprenorphine (cutoff 20 ng/mL)58362-5
2007652Fentanyl (cutoff 2 ng/mL)11235-9
2007653Norfentanyl (cutoff 2 ng/mL)43199-9
2007654Meperidine metabolite (cutoff 50 ng/mL)3746-5
2007655Tapentadol (cutoff 100 ng/mL)72485-6
2007656Tapentadol-o-Sulf (cutoff 200 ng/mL)
2007658Methadone (cutoff 150 ng/mL)3773-9
2007659Propoxyphene (cutoff 300 ng/mL)19141-1
2007660Tramadol (cutoff 200 ng/mL)43219-5
2007662Amphetamine (cutoff 100 ng/mL)19343-3
2007663Methamphetamine (cutoff 400 ng/mL)3779-6
2007664MDMA- Ecstasy (cutoff 200 ng/mL)14267-9
2007665MDA (cutoff 200 ng/mL)42253-5
2007666MDEA- Eve (cutoff 200 ng/mL)61048-5
2007668Phentermine (cutoff 100 ng/mL)3957-8
2007670Benzoylecgonine (cutoff 150 ng/mL)3393-6
2007672Alprazolam (cutoff 40 ng/mL)9351-8
2007673Alpha-OH-Alprazolam (cutoff 20 ng/mL)61036-0
2007674Clonazepam (cutoff 20 ng/mL)19245-0
20076757-Aminoclonazepam (cutoff 40 ng/mL)61030-3
2007676Diazepam (cutoff 50 ng/mL)3550-1
2007677Nordiazepam (cutoff 50 ng/mL)3861-2
2007678Oxazepam (cutoff 50 ng/mL)12361-2
2007679Temazepam (cutoff 50 ng/mL)61060-0
2007680Lorazepam (cutoff 60 ng/mL)18187-5
2007681Midazolam (cutoff 20 ng/mL)19585-9
2007682Zolpidem (cutoff 20 ng/mL)33338-5
2007684Barbiturates (cutoff 200 ng/mL)3377-9
2007687Ethyl Glucuronide (cutoff 500 ng/mL)55349-5
2007688Marijuana Metabolite (cutoff 20 ng/mL)3435-5
2007689PCP (cutoff 25 ng/mL)3936-2
2007690Carisoprodol (cut-off 100 ng/mL)21142-5
2007691Pain Management Drug Panel8251-1
2009289EER Pain Mgt Pan, Mass Spec/EMIT Interp11526-1
2009290DRUGS EXPECTED48767-8
2009291Pain Management Drug Panel Interp48767-8
2013281Methylphenidate (cutoff 100 ng/mL)3808-3
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
  • Comprehensive hybrid
  • high res
  • high-res
  • Pain management, (drug screen, targeted, urine)
  • TOF