Technical Highlights of the ARUP Drug Screen Cup
- Requires 30 mL urine.
- Verifies physiological urine temperature (if urine is tested immediately after collection).
- Results are ready in 5 min.
- False positives were uncommon, but were occasionally observed with amphetamines, benzodiazepine, methadone and tricyclic antidepressant tests during evaluation at ARUP. False negatives were observed for clonazepam
- Uses CLIA-waived, FDA-cleared device (NexScreen).
- The following are NOT detected in this screen: buprenorphine, fentanyl, meperidine, methylphenidate, tapentadol, tramadol.
- Collection instruction.
- Template form available to record results.
Confirmation Testing
Any result inconsistent with clinical expectations and pharmacy history should be confirmed using a second, more specific technology such as mass spectrometry.- If the patient is expected to be taking opiates, oxycodone, or benzodiazepines, specific confirmation by quantitative LC-MS/MS is recommended, regardless of screen result.
- Order targeted confirmation testing for drugs not detected by the screen.
Recommended CPT Code(s)
G0434 (Medicare); or 80104Specifications of the ARUP Drug Screen Cup (ARUP validation data & package insert)
| Drugs and Drug Classes Detected | Cutoff* (ng/mL) | Representative Drug(s) | Notes |
|---|---|---|---|
| Opiates | 300 - 3000 |
Morphine Codeine Hydrocodone 6-Acetylmorphine |
Oxycodone may cause a positive result for both the opiate and oxycodone tests. |
| Oxycodone | 100 | Oxycodone | Opiates may cause a positive result. |
| Methadone | 300 | Methadone | Poor sensitivity to EDDP. |
| Benzodiazepines | 300 - 400 |
Oxazepam Alprazolam |
Poor sensitivity to clonazepam. |
| Amphetamine | 1000 | d-Amphetamine | Poor sensitivity to l-amphetamine. |
| Methamphetamine | 1000 | d-Methamphetamine | Poor sensitivity to l-methamphetamine. |
| MDMA (ecstasy) | 500 | MDMA | Methamphetamine may cause a positive result. |
| Cocaine metabolite | 300 | Benzoylecgonine | Poor sensitivity to parent drug |
| THC metabolite | 50 | 11-nor-d9-THC-COOH | Poor sensitivity to parent drug. Sensitivity to synthetic cannabinoids is unknown. |
| Barbiturates | 300 | Phenobarbital | |
| Phencyclidine (PCP) | 25 | PCP | |
| Tricyclic antidepressants | 800 - 1000 |
Nortriptyline Desipramine |
Cyclobenzaprine may cause a false positive result. |
Cutoff concentrations are based on information provided in the package insert for the product (NexScreen). Internal validation studies at ARUP Laboratories suggests that actual detection limits may be lower for nearly all drug classes. Contact pain@aruplab.com for more information.
