Epic Test Code LAB479 Drugs of Abuse Screen, Meconium 5
Additional Codes
MML Code: DASM5
NY State Approved
YesPerforming Laboratory
Mayo Clinic Laboratories in RochesterReporting Name
Drugs of Abuse Screen, Meconium 5Method Name
Competitive Chemiluminescent Immunoassay (CIA)
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Meconium | Frozen (preferred) | 21 days | |
Refrigerated | 21 days | ||
Ambient | 72 hours |
Ordering Guidance
For chain-of-custody testing, order DSM5X / Drugs of Abuse Screen 5, Chain of Custody, Meconium.
Specimen Required
Supplies: Stool container, Small (Random), 4 oz (T288)
Container/Tube: Stool container
Specimen Volume: 1 g (approximately 1 teaspoon)
Collection Instructions: Collect entire random meconium specimen.
Specimen Type
MeconiumSpecimen Minimum Volume
0.45 g (approximately 0.5 teaspoon)
Reference Values
Negative
Positive results are reported with a quantitative liquid chromatography tandem mass spectrometry result.
Cutoff concentrations by competitive chemiluminescent immunoassay:
Amphetamines : 100 ng/g
Methamphetamine: 100 ng/g
Benzoylecgonine (cocaine metabolite): 100 ng/g
Opiates: 100 ng/g
Tetrahydrocannabinol carboxylic acid (marijuana metabolite): 20 ng/g
Phencyclidine: 20 ng/g
Report Available
1 to 2 daysDay(s) Performed
Monday through Saturday
CPT Code Information
80307
80324 (if appropriate)
80359 (if appropriate)
80353 (if appropriate)
80361 (if appropriate)
80365 (if appropriate)
80349 (if appropriate)
83992 (if appropriate)
Reject Due To
Grossly bloody | Reject; Pink OK |
Stool Diapers |
Reject |
Useful For
Identifying amphetamines (and methamphetamines), opiates, phencyclidine, as well as metabolites of cocaine and marijuana in meconium specimens
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
AMPHM | Amphetamines, Confirmation, M | Yes | No |
COKEM | Cocaine and Metabolites, Confirm, M | Yes | No |
OPATM | Opiate Confirmation, M | Yes | No |
PCPMC | PCP Confirmation, Meconium | Yes | No |
THCM | Carboxy-THC Confirmation, M | Yes | No |
Testing Algorithm
Testing begins with immunoassay screen. Positive results are confirmed and quantitated by liquid chromatography tandem mass spectrometry at an additional charge.
Clinical Information
Illicit drug use during pregnancy is a major social and medical issue. Drug abuse during pregnancy is associated with significant perinatal complications, which include a high incidence of stillbirths, meconium-stained fluid, premature rupture of the membranes, maternal hemorrhage (abruption placenta or placenta praevia), and fetal distress.(1) In the neonate, the mortality rate, as well as morbidity (eg, asphyxia, prematurity, low birthweight, hyaline membrane disease, infections, aspirations pneumonia, cerebral infarction, abnormal heart rate and breathing patterns, drug withdrawal) are increased.(1)
The disposition of drug in meconium is not well understood. The proposed mechanism is that the fetus excretes drug into bile and amniotic fluid. Drug accumulates in meconium either by direct deposit from bile or through swallowing of amniotic fluid.(2) The first evidence of meconium in the fetal intestine appears at approximately the 10th to 12th week of gestation and slowly moves into the colon by the 16th week of gestation.(3) Therefore, the presence of drugs in meconium has been proposed to be indicative of in utero drug exposure during the final 4 to 5 months of pregnancy, a longer historical measure than is possible by urinalysis.(2)
Interpretation
A positive result indicates that the baby was exposed to the drugs indicated.
Cautions
If heroin use is suspected, specimen must be sent frozen to prevent loss of 6-monoacetylmorphine (6MAM, heroin metabolite). When refrigerated, a significant percentage of 6MAM will convert to morphine in fewer than 24 hours.
Unless sent frozen, the cocaine metabolite, m-hydroxybenzoylecgonine, will degrade within 72 hours of collection.
Specimen Retention Time
2 weeksForms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.