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HelpTest Code CSMHU Controlled Substance Monitoring Hybrid Drug Profile, 20 Drug Classes, High-Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine
Ordering Guidance
This test does not screen for drug classes other than those listed in Reference Values.
Specimen Required
Supplies: Urine Tubes, 10 mL (T068)
Collection Container/Tube: Plastic urine container
Submission Container/Tube: Plastic, 10 mL tube
Specimen Volume: 5 mL
Collection Instructions:
1. Collect a random urine specimen.
2. Submit 5 mL in 1 plastic bottle.
3. No preservative
Additional Information:
1. No specimen substitutions.
2. Submitting less than 5 mL may compromise the ability to perform all necessary testing.
3. STAT requests are not accepted for this test.
Useful For
Detecting drug use involving stimulants, barbiturate, benzodiazepines, cocaine, opioids, and tetrahydrocannabinol
This test is not intended for use in employment-related testing.
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| LPCM | List Patient's Current Medications | No | Yes |
| ADULT | Adulterants Survey, U | Yes | Yes |
| LDPU | Limited Drug Panel, 3, IA, U | No | Yes |
| TOPSU | Targeted Opioid Screen, U | Yes, (order TOSU) | Yes |
| TABSU | Targeted Benzodiazepine Screen, U | Yes, (order TBSU) | Yes |
| TSTIM | Targeted Stimulant Screen, U | Yes, (order TSPU) | Yes |
Testing Algorithm
Testing begins with an adulterant survey. If the sample is found to be adulterated, testing will end, and the remaining tests will be canceled.
If the specimen is normal or only diluted, testing will proceed.
If immunoassay screen is positive, confirmation testing will not be automatically reflexed but can be requested or ordered separately.
Method Name
ADULT: Spectrophotometry
LDPU: Immunoassay
TOPSU, TABSU, TSTIM: Liquid Chromatography Tandem Mass Spectrometry, High-Resolution Accurate Mass (LC-MS/MS HRAM)
Reporting Name
CSM Hybrid Drug Profile,20,HRMS/IASpecimen Type
UrineSpecimen Minimum Volume
2 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 14 days | |
| Frozen | 14 days |
Reference Values
ADULTERANT SURVEY:
Cutoff concentrations
Oxidants: 200 mg/L
Nitrites: 500 mg/L
LIMITED DRUG PANEL:
Negative
Screening cutoff concentrations:
Barbiturates: 200 ng/mL
Cocaine (benzoylecgonine-cocaine metabolite): 150 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.
TARGETED OPIOID SCREEN:
Not detected
Cutoff concentrations:
Codeine: 25 ng/mL
Codeine-6-beta-glucuronide: 100 ng/mL
Morphine: 25 ng/mL
Morphine-6-beta-glucuronide: 100 ng/mL
6-Monoacetylmorphine: 25 ng/mL
Hydrocodone: 25 ng/mL
Norhydrocodone: 25 ng/mL
Dihydrocodeine: 25 ng/mL
Hydromorphone: 25 ng/mL
Hydromorphone-3-beta-glucuronide: 100 ng/mL
Oxycodone: 25 ng/mL
Noroxycodone: 25 ng/mL
Oxymorphone: 25 ng/mL
Oxymorphone-3-beta-glucuronide: 100 ng/mL
Noroxymorphone: 25 ng/mL
Fentanyl: 2 ng/mL
Norfentanyl: 2 ng/mL
Meperidine: 25 ng/mL
Normeperidine: 25 ng/mL
Naloxone: 25 ng/mL
Naloxone-3-beta-glucuronide: 100 ng/mL
Methadone: 25 ng/mL
2-Ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP): 25 ng/mL
Propoxyphene: 25 ng/mL
Norpropoxyphene: 25 ng/mL
Tramadol: 25 ng/mL
O-desmethyltramadol: 25 ng/mL
Tapentadol: 25 ng/mL
N-desmethyltapentadol: 50 ng/mL
Tapentadol-beta-glucuronide: 100 ng/mL
Buprenorphine: 5 ng/mL
Norbuprenorphine: 5 ng/mL
Norbuprenorphine glucuronide: 20 ng/mL
TARGETED BENZODIAZEPINE SCREEN:
Not detected
Cutoff concentrations:
Alprazolam: 10 ng/mL
Alpha-hydroxyalprazolam: 10 ng/mL
Alpha-hydroxyalprazolam glucuronide: 50 ng/mL
Chlordiazepoxide: 10 ng/mL
Clobazam: 10 ng/mL
N-desmethylclobazam: 200 ng/mL
Clonazepam: 10 ng/mL
7-Aminoclonazepam: 10 ng/mL
Diazepam: 10 ng/mL
Nordiazepam: 10 ng/mL
Flunitrazepam: 10 ng/mL
7-Aminoflunitrazepam: 10 ng/mL
Flurazepam: 10 ng/mL
2-Hydroxy ethyl flurazepam: 10 ng/mL
Lorazepam: 10 ng/mL
Lorazepam glucuronide: 50 ng/mL
Midazolam: 10 ng/mL
Alpha-hydroxymidazolam: 10 ng/mL
Oxazepam: 10 ng/mL
Oxazepam glucuronide: 50 ng/mL
Prazepam: 10 ng/mL
Temazepam: 10 ng/mL
Temazepam glucuronide: 50 ng/mL
Triazolam: 10 ng/mL
Alpha-hydroxytriazolam: 10 ng/mL
Zolpidem: 10 ng/mL
Zolpidem phenyl-4-carboxylic acid: 10 ng/mL
TARGETED STIMULANT SCREEN:
Not detected
Cutoff concentrations:
Methamphetamine: 100 ng/mL
Amphetamine: 100 ng/mL
3,4-Methylenedioxymethamphetamine (MDMA): 100 ng/mL
3,4-Methylenedioxy-N-ethylamphetamine (MDEA): 100 ng/mL
3,4-Methylenedioxyamphetamine (MDA): 100 ng/mL
Ephedrine: 100 ng/mL
Pseudoephedrine: 100 ng/mL
Phentermine: 100 ng/mL
Phencyclidine (PCP): 20 ng/mL
Methylphenidate: 20 ng/mL
Ritalinic acid: 100 ng/mL
Interpretation
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 and Result Interpretations, see Controlled Substance Monitoring on MayoClinicLabs.com.
Clinical Reference
1. Physicians' Desk Reference. 60th ed. Medical Economics Company; 2006
2. Bruntman LL Lazo JS, Parker KL, eds. 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
4. Gutstein HB, Akil H. Opioid analgesics. In: Brunton LL, Lazo JS, Parker KL, eds. Goodman and Gilman's: The Pharmacological Basis of Therapeutics. 11th ed. McGraw-Hill Companies; 2006:chap 21
5. Rovine T, Ferrero CL, American Pain Society: Chronic Pain in America: Roadblocks to Relief. Roper Starch Worldwide, Inc; 1999. Updated 2001. Accessed July 16, 2024. Available at http://accurateclinic.com/wp-content/uploads/2016/04/Chronic-Pain-In-America-Roadblocks-To-Relief-1999.pdf
6. Magnani B, Kwong T. Urine drug testing for pain management. Clin Lab Med. 2012;32(3):379-390
7. Jannetto PJ, Bratanow NC, Clark WA, et al. Executive summary: American Association of Clinical Chemistry Laboratory Medicine Practice Guideline-using clinical laboratory tests to monitor drug therapy in pain management patients. J Appl Lab Med. 2018;2(4):489-526
8. McMillin GA, Marin SJ, Johnson-Davis KL, Lawlor BG, Strathmann FG. A hybrid approach to urine drug testing using high-resolution mass spectrometry and select immunoassays. Am J Clin Pathol. 2015;143(2):234-240
9. Cone EJ, Caplan YH, Black DL, Robert T, Moser F. Urine drug testing of chronic pain patients: licit and illicit drug patterns. J Anal Toxicol. 2008;32(8):530-543
Day(s) Performed
Monday through Saturday
Report Available
3 to 4 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
80307
80347
80364
80326
G0482 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CSMHU | CSM Hybrid Drug Profile,20,HRMS/IA | 69739-1 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| LPCM | List Patient's Current Medications | 66423-5 |
| 610273 | Methamphetamine | 19554-5 |
| 20606 | Creatinine, U | 2161-8 |
| 615289 | Barbiturates | 19270-8 |
| 604871 | Alprazolam | 94116-1 |
| 42323 | Codeine | 19411-8 |
| 42324 | Codeine-6-beta-glucuronide | 89310-7 |
| 604867 | Alpha-Hydroxyalprazolam | 19325-0 |
| 615290 | Cocaine | 19359-9 |
| 22312 | Specific Gravity | 5810-7 |
| 610274 | Amphetamine | 19343-3 |
| 610275 | 3,4-methylenedioxymethamphetamine (MDMA) | 19568-5 |
| 23509 | pH | 2756-5 |
| 615291 | Tetrahydrocannabinol | 19415-9 |
| 604891 | Alpha-Hydroxyalprazolam Glucuronide | 94115-3 |
| 42325 | Morphine | 19597-4 |
| 42326 | Morphine-6-beta-glucuronide | 89308-1 |
| 604872 | Chlordiazepoxide | 19385-4 |
| 23511 | Oxidants | 58714-7 |
| 610276 | 3,4-methylenedioxy-N-ethylamphetamine (MDEA) | 59844-1 |
| 610277 | 3,4-methylenedioxyamphetamine (MDA) | 19565-1 |
| 23510 | Nitrites | 32710-6 |
| 604889 | Clobazam | 94114-6 |
| 42327 | 6-monoacetylmorphine | 19321-9 |
| 42328 | Hydrocodone | 19482-9 |
| 604890 | N-Desmethylclobazam | 94113-8 |
| 30914 | Comment | 48767-8 |
| 610278 | Ephedrine | 99108-3 |
| 610279 | Pseudoephedrine | 99109-1 |
| 604873 | Clonazepam | 19399-5 |
| 42329 | Norhydrocodone | 89304-0 |
| 42330 | Dihydrocodeine | 19446-4 |
| 604267 | 7-aminoclonazepam | 94112-0 |
| 610280 | Phentermine | 19674-1 |
| 610281 | Phencyclidine (PCP) | 19659-2 |
| 604874 | Diazepam | 19443-1 |
| 42331 | Hydromorphone | 19486-0 |
| 42332 | Hydromorphone-3-beta-glucuronide | 89309-9 |
| 604880 | Nordiazepam | 19624-6 |
| 610282 | Methylphenidate | 19577-6 |
| 610283 | Ritalinic acid | 99110-9 |
| 604875 | Flunitrazepam | 19466-2 |
| 42333 | Oxycodone | 19642-8 |
| 42334 | Noroxycodone | 89303-2 |
| 604866 | 7-aminoflunitrazepam | 94111-2 |
| 610284 | Stimulant Interpretation | 54247-2 |
| 604876 | Flurazepam | 19474-6 |
| 42335 | Oxymorphone | 19646-9 |
| 42336 | Oxymorphone-3-beta-glucuronide | 89301-6 |
| 604868 | 2-Hydroxy Ethyl Flurazepam | 94110-4 |
| 604877 | Lorazepam | 19520-6 |
| 42337 | Noroxymorphone | 89302-4 |
| 42338 | Fentanyl | 59673-4 |
| 604878 | Lorazepam Glucuronide | 94109-6 |
| 604879 | Midazolam | 19585-9 |
| 42339 | Norfentanyl | 43199-9 |
| 42340 | Meperidine | 19532-1 |
| 604869 | Alpha-Hydroxy Midazolam | 94108-8 |
| 604881 | Oxazepam | 19638-6 |
| 42341 | Normeperidine | 27920-8 |
| 42342 | Naloxone | 42618-9 |
| 604882 | Oxazepam Glucuronide | 94107-0 |
| 604883 | Prazepam | 19678-2 |
| 42343 | Naloxone-3-beta-glucuronide | 89307-3 |
| 42344 | Methadone | 19550-3 |
| 604884 | Temazepam | 19698-0 |
| 604885 | Temazepam Glucuronide | 94106-2 |
| 42345 | EDDP | 93495-0 |
| 42346 | Propoxyphene | 19429-0 |
| 604886 | Triazolam | 19714-5 |
| 604870 | Alpha-Hydroxy Triazolam | 94105-4 |
| 42347 | Norpropoxyphene | 19632-9 |
| 42348 | Tramadol | 19710-3 |
| 604887 | Zolpidem | 94104-7 |
| 604888 | Zolpidem Phenyl-4-Carboxylic acid | 94103-9 |
| 42349 | O-desmethyltramadol | 86453-8 |
| 42350 | Tapentadol | 72485-6 |
| 604949 | Benzodiazepine Interpretation | 69050-3 |
| 42351 | N-desmethyltapentadol | 89306-5 |
| 42352 | Tapentadol-beta-glucuronide | 89300-8 |
| 42353 | Buprenorphine | 93494-3 |
| 42354 | Norbuprenorphine | 82371-6 |
| 42355 | Norbuprenorphine glucuronide | 89305-7 |
| 65059 | Opioid Interpretation | 69050-3 |
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.