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HelpTest Code CO-BENZ Benzodiazepines, Urine, Confirm Only by LCMS/MS
Useful For
Detecting exposure to benzodiazepines to monitor compliance in taking prescribed medications or to detect abuse
Synonyms/Keywords
Clonazepam, Temazepam, Diazepam, Chlordiazepoxide, Alprazolam, Flunitrazepam, Flurazepam, Nordiazepam, Chlorazepate, Lorazepam, Xanax, Librium, Valium, Ativan, Serax, Restoril, Date Rape Drug, 7-Aminoflunitrazepam, Roofies, Rohypnol
Specimen Requirements
| Fasting Required | Specimen Type | Preferred Container/Tube | Acceptable Container/Tube | Specimen Volume | Specimen Minimum Volume (allows for 1 repeat) |
Pediatric Minimum Volume (no repeat) |
|---|---|---|---|---|---|---|
| No | Urine | Sage urine collection container | Sterile plastic container with no preservatives | 5 mL | 3 mL | 1.5 mL |
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Urine | Refrigerate (Preferred) | 30 days |
| Ambient | 72 hours |
Test Information
This test was developed and its performance characteristics determined by Marshfield Labs. It has not been cleared or approved by the US Food and Drug Administration. This test is used for clinical purposes. It should not be regarded as investigational or for research.
This test is an LCMS/MS confirmation only for the following benzodiazepines: desalkylflurazepam, nordiazepam, 7-aminoflunitrazepam, oxazepam, temazepam, diazepam, 7-aminoclonazepam, lorazepam, and alphahydroxyalprazolam. It is intended for use only in patients where an initial drug screening test has already been performed at the time of specimen collection (i.e. Point-of-Care drug screening cup, dipstick, etc.). The specimen will not be screened by immunoassay in the laboratory; it will only be tested by LCMS/MS.
Interpretations
Current Cutoff Levels for Toxicology
The benzodiazepine group metabolizes quickly and thus, many of the parent drugs are generally not detected in urine. The detection of a metabolite(s) of the parent drug confirm the use of the drug. Below is a description of some of the more commonly prescribed benzodiazepines and the metabolites that would be present in urine.
Clonazepam (Klonopin) metabolizes to 7-aminoclonazepam.
Flunitrazepam (Rohypnol) metabolizes to 7-aminoflunitrazepam.
Chlordiazepoxide metabolizes to nordiazepam and oxazepam.
Chlorazepate metabolizes to nordiazepam and oxazepam.
Diazepam (Valium) metabolizes to nordiazepam, temazepam and oxazepam.
Temazepam metabolizes to oxazepam.
Reference Range Information
| Performing Location | Reference Range |
|---|---|
| Marshfield |
Negative. Positives are reported with a quantitative LCMS/MS result. |
Marshfield Labs Performing Department
Marshfield Labs Special Chemistry
Performing Information
| Performing Location | Day(s) Test Performed | Analytical Time | Methodology/Instrumentation |
|---|---|---|---|
| Marshfield | Monday through Friday | 2 days | Liquid Chromatography/Tandem Mass Spectrometry (LCMS/MS) using Multiple Reaction Monitoring |
CPT Codes
| CPT | Modifier (if needed) |
Quantity | Description | Comments |
|---|---|---|---|---|
| 80346 | 1 | Benzodiazepine Confirmation by LCMS/MS | ||
| G0480 | 1 | Benzodiazepine Confirmation by LCMS/MS | For Marshfield Clinic and Medicare/Medicaid |
Outreach CPT Codes
| CPT | Modifier (if needed) |
Quantity | Description | Comments |
|---|---|---|---|---|
| 80346 | 1 | Benzodiazepine Confirmation by LCMS/MS | ||
| G0480 | 1 | Benzodiazepine Confirmation by LCMS/MS | For Medicare/Medicaid |
Ordering Applications
| Ordering Application | Description |
|---|---|
| COM | Benzodiazepine, Urine, Confirm |
| Cerner | Benzodiazepine, Urine, Confirm Only by LCMS/MS |