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 80104

Specifications 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.