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Test Code OPATM Opiate Confirmation, Meconium

Reporting Name

Opiate Confirmation, M

Useful For

Detecting maternal prenatal opiate/opioid use up to 5 months before birth

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Meconium


Ordering Guidance


For chain-of-custody testing, order OPTMX / Opiate Confirmation, 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 Minimum Volume

0.3 g (approximately 1/4 teaspoon)

Specimen Stability Information

Specimen Type Temperature Time Special Container
Meconium Frozen (preferred) 28 days
  Refrigerated  28 days
  Ambient  14 days

Reference Values

Negative

 

Positives are reported with a quantitative liquid chromatography tandem mass spectrometry (LC-MS/MS) result.

Cutoff concentrations for LC-MS/MS testing:

Codeine: 20 ng/g

Hydrocodone: 20 ng/g

Hydromorphone: 20 ng/g

Morphine: 20 ng/g

Oxycodone: 20 ng/g

Oxymorphone: 20 ng/g

Day(s) Performed

Monday through Sunday

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

80361

80365

G0480 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
OPATM Opiate Confirmation, M 69026-3

 

Result ID Test Result Name Result LOINC Value
31848 Morphine 69027-1
31850 Oxymorphone 69028-9
31849 Hydromorphone 68541-2
31847 Codeine 68542-0
31852 Oxycodone 68543-8
31851 Hydrocodone 68544-6
31868 Interpretation 8215-6
31869 Chain of Custody 77202-0

Interpretation

The presence of any of the following opiates (codeine, morphine, hydrocodone, hydromorphone, oxycodone, oxymorphone) at 20 ng/g or greater or 6-monoacetlymorphine at 10 ng/g or greater indicates the newborn was exposed to opiates/opioids during gestation.

Clinical Reference

1. 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; 2006

2. Baselt RC: Disposition of Toxic Drugs and Chemical in Man. 10th ed. Biomedical Publications; 2014

3. Szeto HH: Kinetics of drug transfer to the fetus. Clin Obstet Gynecol. 1993 Jun;36(2):246-254

4. Ahanya SN, Lakshmanan J, Morgan BLG, Ross MG: Meconium passage in utero: mechanisms, consequences, and management. Obstet Gynecol Surv. 2005 Jan;60(1):45-56

5. Langman LJ, Bechtel LK, Meier BM, Holstege C: Clinical toxicology. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:832-887

Report Available

2 to 3 days

Method Name

Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

Forms

If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.