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Drugs of Abuse Panel, Meconium - Screen with Reflex to Confirmation/Quantitation
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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
Methodology
Qualitative Enzyme-Linked Immunosorbent Assay/Quantitative Liquid Chromatography-Tandem Mass Spectrometry
Performed
Sun-Sat
Reported
1-4 days
New York DOH Approval Status
Specimen Required
Meconium. All meconium (blackish material) excreted until milk/formula based stool (yellow-green) appears.
Transport all available meconium (4 g is preferred). (Min: 2 g or 3/4 inch cube on each side)
Room temperature.
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.
This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.
Laboratory Developed Test (LDT)
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
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 |
Aliases
- Pain Management
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