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HelpTest Code CO-METD Methadone, Urine, Confirm Only by LCMSMS
Useful For
Detecting exposure to methadone to monitor compliance in taking prescribed medications, compliance in rehabilitation programs, or to detect abuse.
Synonyms/Keywords
Dolophine
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 | 2 mL | 1 mL | 0.5 mL |
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Urine | Ambient | 72 hours |
| Refrigerate (Preferred) | 30 days |
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.
Methadone (Dolophine) was first synthesized as a morphine substitute. Since it causes marked sedation, it has been used since 1965 as a narcotic maintenance treatment of former heroin addicts. Methadone is metabolized to EDDP (2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidone). When a person uses methadone, the main products that appear in urine are methadone and EDDP.
This test is a LC/MS/MS confirmation only for methadone. 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 LC/MS/MS. The test will detect the presence of parent methadone and EDDP (methadone metabolite).
Interpretations
Current Cutoff Levels for Toxicology
Methadone and EDDP are both excreted in the urine of a person taking methadone. Methadone, however, is highly sensitive to urine pH, whereas EDDP is not. Therefore, it is preferable to monitor EDDP in urine for assessing compliance in drug rehabilitation therapy.
Methadone and EDDP can be detected up to 6-7 days after last use.
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 | 2-4 days | Liquid Chromatography/Tandem Mass Spectrometry (LCMS/MS) using Multiple Reaction Monitoring |
CPT Codes
| CPT | Modifier (if needed) |
Quantity | Description | Comments |
|---|---|---|---|---|
| 80358 | 1 | Methadone Confirmation by LC/MS/MS | If needed | |
| G0480 | 1 | Methadone Confirmation by LC/MS/MS | For Marshfield Clinic and Medicare/Medicaid, If needed |
Outreach CPT Codes
| CPT | Modifier (if needed) |
Quantity | Description | Comments |
|---|---|---|---|---|
| 80358 | 1 | Methadone Confirmation by LC/MS/MS | If needed | |
| G0480 | 1 | Methadone Confirmation by LC/MS/MS | For Medicare/Medicaid, If needed |
Ordering Applications
| Ordering Application | Description |
|---|---|
| Cerner | Methadone, Urine, Confirm Only by LCMSMS |
| COM | Methadone, Urine, Confirm |