Ordering Recommendation

Preferred meconium test to detect and document maternal drug use during pregnancy approximately the last trimester of a full-term birth. Targeted single-drug class testing is appropriate if only a particular drug class or classes are of clinical interest, or when quantity of meconium available for testing is very small (eg <1g).

Mnemonic
MEC 9
Methodology

Qualitative Enzyme-Linked Immunosorbent Assay/Quantitative Liquid Chromatography-Tandem Mass Spectrometry

Performed

Sun-Sat

Reported

1-4 days

New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
Collect

Meconium. All meconium (blackish material) excreted until milk/formula based stool (yellow-green) appears.

Specimen Preparation

Transport all available meconium (4 g is preferred). (Min: 2 g or 3/4 inch cube on each side)

Storage/Transport Temperature

Room temperature.

Unacceptable Conditions
Remarks
Stability

Ambient: 1 week; Refrigerated: 3 months; Frozen: 1 year

Reference Interval
Drugs Covered and Cutoff Concentrations
Drug
Screen
Confirmation
Amphetamines 30 ng/g 20 ng/g
Barbiturates 75 ng/g 50 ng/g
Benzodiazepines 75 ng/g 20 ng/g
Buprenorphine 40 ng/g 20 ng/g
Cocaine 30 ng/g 20 ng/g
Marijuana 30 ng/g 5 ng/g
Methadone 40 ng/g 10 ng/g
Opiates 30 ng/g 20 ng/g
Phencyclidine 15 ng/g 10 ng/g

Interpretive Data

Meconium begins to form between the 12th and 16th week of gestation. Meconium drug testing can detect maternal drug use during the last 4 to 5 months of pregnancy. A negative result does not exclude the possibility that a mother used drugs during pregnancy. Detection of drug use depends on the quantity and quality of the specimen tested as well as the pattern and frequency of drug(s) used by the mother. Although not likely, drugs administered during labor and delivery may be detected in meconium. Interpretive questions should be directed to the laboratory.

The concentration at which the screening test can detect a drug or metabolite varies within a drug class. The concentration value must be greater than or equal to the cutoff to be reported as positive.

For medical purposes only; not valid for forensic use.

Compliance Statement B: For laboratory developed tests not using a RUO kit, and for FDA approved, cleared or 510(k) exempt assays with alterations. This test was developed and its performance characteristics determined by ARUP Laboratories. The U. S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

Note

If the specimen screens positive, then Confirmation/Quantitation by LC-MS/MS will be added. Additional charges apply.

Unless ARUP is otherwise notified, reflex confirmation testing will be performed in the following order of priority:

Amphetamines (0.125 g sample required)
Cocaine (0.25 g sample required)
Opiates (0.125 g required)
Buprenorphine (0.125 g required)
Marijuana (0.125 g required)
Benzodiazepines (0.125 g sample required)
Methadone (0.125 g sample required)
Phencyclidine - PCP (0.25 g sample required)
Barbiturates (0.25 g sample required)

Hotline History
N/A
CPT Codes

80307; if reflexed, add 80324; 80345; 80346; 80348; 80349; 80353; 80358; 80359; 80361; 80365; 83992 (Reflexed Alt Code: G0480 )

Components
Component Test Code* Component Chart Name LOINC
0092020 Marijuana, Meconium 31136-5
0092021 Cocaine, Meconium 26956-3
0092022 Opiates, Meconium 29158-3
0092023 Phencyclidine, Meconium 26859-9
0092024 Amphetamines, Meconium 26895-3
0092318 Methadone, Meconium 29159-1
0092319 Barbiturates, Meconium 29161-7
0092517 Meconium Comments 58738-6
0092518 Benzodiazepines, Meconium 29160-9
2011913 Buprenorphine, Meconium 77205-3
* 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.
Aliases
  • Pain Management
Drugs of Abuse Panel, Meconium - Screen with Reflex to Confirmation/Quantitation