Drugs of Abuse Screen, Meconium 4

Casandra

Casandra Test Code MC52710Version 1 (DRAFT)

Performing Lab

Lab Mayo Clinic LabLab Test ID DASM4CPT Codes 80307, 80324, 80349, 80353, 80359, 80361, 80365

Drugs of Abuse Screen, Meconium 4

Clinical Use

Use

This test is useful for identifying the presence of amphetamines (including methamphetamines), opiates, and metabolites of cocaine and marijuana in meconium specimens. It is particularly valuable in assessing in utero drug exposure during pregnancy, providing insights into drug use in the final months of gestation, which can lead to significant perinatal complications such as stillbirths, premature rupture of membranes, and fetal distress. The disposition of drugs in meconium suggests fetal drug excretion into bile and amniotic fluid, leading to drug accumulation via direct deposit or swallowing amniotic fluid.

Special Instructions

For chain-of-custody testing, order DSM4X / Drugs of Abuse Screen 4, Chain of Custody, Meconium. If not ordering electronically, complete and send a Therapeutics Test Request form (T831) with the specimen. Ensure the specimen is sent frozen if heroin use is suspected to prevent the degradation of specific metabolites.

Limitations

Heroin metabolite, 6-monoacetylmorphine, may convert to morphine if not sent frozen within 24 hours. Similarly, the cocaine metabolite, m-hydroxybenzoylecgonine, will degrade if not preserved frozen within 72 hours. The method uses competitive chemiluminescent immunoassay, which has specific cutoff concentrations for each drug class. Positives require confirmation by mass spectrometry, which may incur additional charges.

Test Details

New York Approved