Test Id : PANOX
Pain Clinic Survey 10, Chain of Custody, Random, Urine
Useful For
Suggests clinical disorders or settings where the test may be helpful
Detecting drug use involving amphetamines, barbiturates, benzodiazepines, cocaine, methadone, opiates, phencyclidine, and tetrahydrocannabinol
This chain-of-custody test is intended to be used in a setting where the test results can be used to make a definitive diagnosis. Chain of custody is required whenever the results of testing could be used in a court of law. Its purpose is to protect the rights of the individual contributing the specimen by demonstrating that it was always under the control of personnel involved with testing the specimen; this control implies that the opportunity for specimen tampering would be limited.
This test is not intended for use in employment-related testing.
Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| PN10X | Pain Clinic Survey 10, CoC | No | Yes |
| OXYSX | Oxycodone Screen, CoC, U | Yes | Yes |
Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| AMPHX | Amphetamines Confirmation, CoC, U | Yes | No |
| COKEX | Cocaine and metabolite Conf, CoC, U | Yes | No |
| BARBX | Barbiturates Confirmation, CoC, U | Yes | No |
| MTDNX | Methadone Confirmation, CoC, U | Yes | No |
| PCPX | Phencyclidine Confirmation, CoC, U | Yes | No |
| THCX | Carboxy-THC Confirmation, CoC, U | Yes | No |
| OPATX | Opiate Confirmation, CoC, U | Yes | No |
| OXYCX | Oxycodone w/metabolite Conf, CoC, U | Yes | No |
| BNZX | Benzodiazepines Conf, CoC, U | Yes | No |
Additional Tests
Lists tests that are always performed, at an additional charge, with the initial tests.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| COCH | Chain of Custody Processing | No | Yes |
| ADLTX | Adulterants Survey, CoC, U | Yes | Yes |
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods (gas chromatography mass spectrometry for barbiturates, cocaine and metabolites, methadone, and phencyclidine) at an additional charge. Amphetamines, benzodiazepines, opiates, and tetrahydrocannabinol metabolite that screen positive will be quantified with liquid chromatography tandem mass spectrometry at an additional charge.
Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
Method Name
A short description of the method used to perform the test
Immunoassay followed by Gas Chromatography Mass Spectrometry (GC-MS) or Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS) as needed
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
"J" (Jane) Tetrahydrocannabinol)
7-Amino Flunitrazepam (Metabolite of Flunitrazepam (Rohypnol)
Alprazolam (Xanax)
Amobarbital (Amytal)
Amphetamines
Amytal (Amobarbital)
Ativan (Lorazepam)
Barbita (Phenobarbital)
Barbiturates
Benzodiazepines
Benzoylecgonine (Cocaine Metabolite)
Butabarbital (Butisol)
Butalbital (Fiorinal)
Butisol (Butabarbital)
Cannabinoids (Tetrahydrocannabinol)
Chlordiazepoxide (Librium)
Clorazepate (Tranxene)
Cocaine
Codeine
Coke (Cocaine)
Crack (Cocaine)
Dalmane (Flurazepam)
Date Rape Drug (Rohypnol [Flunitrazepam])
Desalkyl Flurazepam (Metabolite)
Desoxyn (Methamphetamines)
Diazepam (Valium)
Dilaudid (Hydromorphone)
Dolophine (Methadone)
Drugs of Abuse
Ecstasy
Fiorinal (Butalbital)
Flunitrazepam (Rohypnol)
Flurazepam (Dalmane)
Halcion (Triazolam)
Heroin
Hycodan (Hydrocodone)
Hydrocodone (Hycodan, Vicodin)
Hydromorphone (Dilaudid, Vicodin)
Hydroxy-Ethyl Flurazepam (Metabolite of Flurazepam) (Dalmane)
Killer Weed (Phencyclidine)
Librium (Chlordiazepoxide)
Lorazepam (Ativan)
Lortab (Hydromorphone)
Luminal (Phenobarbital)
Marijuana (Tetrahydrocannabinol)
MDA (Methylenedioxyamphetamine) Metabolite for Methylenedioxyethylamphetamine (MDEA) and Methylenedioxymethamphetamine (MDMA)
MDMA (Methylenedioxymethamphetamine)
Mebaral (Mephobarbital)
Mephobarbital (Mebaral)
Methadone (Dolophine)
Methamphetamines (Desoxyn)
Methylenedioxyamphetamine (MDA) Metabolite for Methylenedioxyethylamphetamine (MDEA) and Methylenedioxymethamphetamine (MDMA)
Methylenedioxymethamphetamine (MDMA)
Nembutal (Pentobarbital)
Nordiazepam (Tranxene)
Norpropoxyphene (Metabolite of Propoxyphene) (Darvon)
Opiates
Oxazepam (Serax)
Oxycodone (Oxycontin, Percodan)
Oxycontin (Oxycodone)
PCP (Phencyclidine)
Pentobarbital (Nembutal)
Pentothal (Thiopental)
Percodan (Oxycodone)
Phencyclidine (PCP)
Phenobarbital
Restoril (Temazepam)
Rocket Fuel (Phencyclidine)
Rohypnol (Flunitrazepam)
Secobarbital (Seconal)
Seconal (Secobarbital)
Serax (Oxazepam)
Solfoton (Phenobarbital)
Speed (Amphetamines)
TCP (Phencyclidine)
Temazepam (Restoril)
Tetrahydrocannabinol (THC)
THC (Tetrahydrocannabinol)
Thiopental (Pentothal)
Toxicology Screen, Drugs
Tranxene (Clorazepate)
Triazolam (Halcion)
Tuinal (Amobarbital and Secobarbital)
Valium (Diazepam)
Vicodin (Hydrocodone)
Xanax (Alprazolam)
EDDP
Methadone metabolite
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods (gas chromatography mass spectrometry for barbiturates, cocaine and metabolites, methadone, and phencyclidine) at an additional charge. Amphetamines, benzodiazepines, opiates, and tetrahydrocannabinol metabolite that screen positive will be quantified with liquid chromatography tandem mass spectrometry at an additional charge.
Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
Specimen Type
Describes the specimen type validated for testing
Urine
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Supplies: Chain of Custody Kit (T282)
Container/Tube: Chain-of-Custody Kit containing the specimen containers, seals, and documentation is required.
Specimen Volume: 30 mL
Collection Instructions: Collect a random specimen without preservative in the container provided, seal, and submit with the associated documentation to satisfy the legal requirements for chain-of-custody testing.
Additional Information: Submitting less than 30 mL will compromise the ability to perform all necessary testing.
Forms
1. Chain of Custody Request is included in the Chain-of-Custody Kit (T282).
2. If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
20 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 7 days | |
| Frozen | 14 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Detecting drug use involving amphetamines, barbiturates, benzodiazepines, cocaine, methadone, opiates, phencyclidine, and tetrahydrocannabinol
This chain-of-custody test is intended to be used in a setting where the test results can be used to make a definitive diagnosis. Chain of custody is required whenever the results of testing could be used in a court of law. Its purpose is to protect the rights of the individual contributing the specimen by demonstrating that it was always under the control of personnel involved with testing the specimen; this control implies that the opportunity for specimen tampering would be limited.
This test is not intended for use in employment-related testing.
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods (gas chromatography mass spectrometry for barbiturates, cocaine and metabolites, methadone, and phencyclidine) at an additional charge. Amphetamines, benzodiazepines, opiates, and tetrahydrocannabinol metabolite that screen positive will be quantified with liquid chromatography tandem mass spectrometry at an additional charge.
Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
This assay was designed to test for and confirm by gas chromatography mass spectrometry (GC-MS) the following:
-Barbiturates
-Cocaine
-Methadone
-Phencyclidine
This assay was designed to test for and confirm by liquid chromatography tandem mass spectrometry (LC-MS/MS) the following:
-Opiates
-Benzodiazepines
-Carboxy-tetrahydrocannabinol
-Amphetamines
This test uses the simple screening technique which involves immunoassay testing for drugs by class. Oxycodone is not detected well with the opiate screening assay; therefore, confirmation testing is included to detect this drug. All positive screening results are confirmed by either GC-MS or LC-MS/MS and quantitated before a positive result is reported.
Chain of custody is a record of the disposition of a specimen to document the individuals who collected, handled, and performed the analysis. When a specimen is submitted in this manner, analysis will be performed in such a way that it will withstand regular court scrutiny.
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Negative
Screening cutoff concentrations
Amphetamines: 500 ng/mL
Barbiturates: 200 ng/mL
Benzodiazepines: 100 ng/mL
Cocaine (benzoylecgonine-cocaine metabolite): 150 ng/mL
Methadone metabolite: 300 ng/mL
Opiates: 300 ng/mL
Phencyclidine: 25 ng/mL
Tetrahydrocannabinol carboxylic acid: 50 ng/mL
This report is intended for use in clinical monitoring or management of patients. It is not intended for use in employment-related testing.
Interpretation
Provides information to assist in interpretation of the test results
A positive result derived by this testing indicates that the patient has used one of the drugs detected by these techniques in the recent past.
For information about drug testing, including estimated detection times, see Drug Class Testing on MayoClinicLabs.com.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
The test does not screen for drug classes other than those listed previously. More comprehensive screening is available using the serum or urine drug screens (DSSX / Drug Screen, Prescription/Over the Counter, Chain of Custody, Serum or PDSUX / Drug Screen, Prescription/Over the Counter, Chain of Custody, Urine).
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Physician's Desk Reference (PDR). 60th ed. Medical Economics Company; 2006
2. Bruntman LL. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 11th ed. McGraw-Hill Book Company; 2006
3. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 43
Method Description
Describes how the test is performed and provides a method-specific reference
Adulterant:
All results are measured using spectrophotometry at wavelengths specified by the reagent manufacturer. The use of a refractometer may also be used in the specific gravity measurement.(Package inserts: Specimen Validity Test Creatinine. Roche Diagnostics; V3.0, 08/2015; Specimen Validity Test Nitrite. Roche Diagnostics; V3.0, 08/2018, Specimen Validity Test Oxidant. Roche Diagnostics; V 3.0, 08/2018; Specimen Validity Test pH Roche Diagnostics; V3.0, 02/2019, Specimen Validity Test Specific Gravity. Roche Diagnostics; V4.0, 08/2022)
The amphetamines, barbiturates, benzodiazepines, cocaine, methadone metabolite, opiates, phencyclidine, and tetrahydrocannabinol metabolite assays are based on the kinetic interaction of microparticles in a solution as measured by changes in light transmission. In the absence of sample drug, soluble drug conjugates bind to antibody-bound microparticles causing the formation of particle aggregates. As the aggregation reaction proceeds in the absence of sample drug, the absorbance increases. When a urine sample contains the drug in question, this drug competes with the drug derivative conjugate for microparticle-bound antibody. Antibody bound to sample drug is no longer available to promote particle aggregation, and subsequent particle lattice formation is inhibited. The presence of sample drug diminishes the increasing absorbance in proportion to the concentration of drug in the sample. Sample drug content is determined relative to the value obtained for a known cutoff concentration of drug.(Package inserts: AMPS2. Roche Diagnostics; V 10.0, 09/2018; BARB. Roche Diagnostics; V 13.0, 09/2021; THC2. Roche Diagnostics; V 13.0, 03/2022; BNZ2. Roche Diagnostics; V 2.0, 04/2024; COC2. Roche Diagnostics; V 9.0, 03/2019; OPI2. Roche Diagnostics; V 16.0, 01/2022; PCP. Roche Diagnostics; V 13.0, 09/2021; EDDP Specific Urine Enzyme Immunoassay, Immunalysis Corp; 09/2018)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Saturday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
80307
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| PANOX | Pain Clinic Survey 10, CoC, U | 69739-1 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| 36253 | Amphetamines | 43983-6 |
| 36254 | Cocaine | 43984-4 |
| 36255 | Opiates | 70151-6 |
| 36256 | Phencyclidine | 14310-7 |
| 36257 | Tetrahydrocannabinol | 14312-3 |
| 36261 | Chain of Custody | 77202-0 |
| 36258 | Barbiturates | 70155-7 |
| 36259 | Benzodiazepines | 14316-4 |
| 36260 | Methadone metabolite | 41858-2 |
| 61727 | Oxycodone | 19642-8 |
| 36027 | Chain of Custody | 77202-0 |