OVERVIEW

Purpose: Detection and quantification of alprazolam, clonazepam, diazepam, flurazepam, lorazepam, midazolam, oxazepam, temazepam, triazolam and zolpidem. Preferred test to follow-up presumptive results for benzodiazepine urine screening.

CLINICAL INFORMATION

Benzodiazepines undergo extensive metabolic transformation, with the parent compounds not being identifiable in urine. This test is designed to screen for and confirm the presence of the following substances:

For long-acting benzodiazepines, the clearance half-life exceeds 24 hours. Around 5 to 7 half-lives are needed to eliminate 98% of a drug dose. Hence, the detection of a long-acting benzodiazepine exceeding the quantification limit indicates exposure within a period spanning 5 to 20 days before the collection of the specimen. Following diazepam administration, the drug and its metabolites emerge in urine within 30 minutes. Urinary concentrations peak between 1 and 8 hours.

SPECIMEN COLLECTION

Specimen Type: Random Urine
Preferred Collection Container: Non-sterile specimen container
Specimen Required: 3 mL urine; minimum 1 mL

TEST DETAILS

Methodology: Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Compliance Category: Laboratory Developed Test (LDT)
This test was developed and assessed by DMD in compliance with CLIA requirements for its analytical performance characteristics and clinical application. This test has not been cleared or approved by the U.S. Food and Drug Administration.
Reference Interval: Negative
Drug/Metabolite Tested:
Drug/Metabolite Cutoff concentration 500 ng/mL
7-Aminoclonazepam: 40 ng/mL
Alpha-Hydroxyalprazolam: 40 ng/mL
Alpha-Hydroxymidazolam: 20 ng/mL
Alpha-Hydroxytriazolam 20 ng/mL
Alprazolam 10 ng/mL
Clonazepam 20 ng/mL
Desalkylflurazepam 20 ng/mL
Diazepam 20 ng/mL
Flurazepam 40 ng/mL
Lorazepam 20 ng/mL
Nordiazepam 20 ng/mL
Temazepam 25 ng/mL
Zolpidem 20 ng/mL
CPT code(s): 80346 and 80368
Turnaround Time: 90% < 48 hours, 50% < 24 hours

SPECIMEN PROCESSING

Transport Temperature: Refrigerated (preferred) or room temperature overnight shipping.
Specimen Stability: 3 days at room temperature and 14 days at refrigerated and frozen temperatures (to be further confirmed with our validation).
Rejection Criteria: Stability limits exceeded.

Director: Cheryl Hanau, MD; Donald Hall Jr., PhD; Garth Ehrlich, PhD; Yinghua Qiu, PhD, DABCC

Review Date: 08/28/2023

Note: The billing party has sole responsibility for CPT coding. Any questions regarding coding should be directed to the payer being billed. The CPT codes provided by GML are based on AMA guidelines and are for informational purposes only.

The information on these pages is provided for general information only and should not be used for diagnosis or treatment, or as a substitute for consultation with a physician or health care professional. If you have specific questions or concerns about your health, you should consult your health care professional.

 
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