Tests Impacted by 2015 CPT Changes

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1 Toxicology Changes for 2015 HPV Examples of Toxicology Panels Molecular Pathology, FISH and Anatomic Pathology 1

2 Toxicology Changes for Test Code Dos Test Name Medicare 5229 Drug Screen, Comprehensive, with Confirmation, Serum 80301, 80329, 80345, G Drug Screen, Comprehensive, with 6640 Drug Screen, Comprehensive, with, Serum Drug Screen, Comprehensive, without Confirmation, Gastric Drug Screen, Comprehensive, with Confirmation, Serum,, Gastric 80301, 80337, 80326, 80329, 80338, 80345, 80339, 80370, 80363, 80368, 80332, 80342, 80358, 80323, 80365, 83992, 80320, , 80337, 80326, 80329, 80338, 80345, 80339, 80370, 80363, 80368, 80332, 80342, 80358, 80323, 80365, 83992, 80320, 80377, 80301, 80329, 80345, , 80337, 80326, 80329, 80338, 80345, 80339, 80370, 80363, 80368, 80332, 80342, 80358, 80323, 80365, 83992, 80320, , 80337, 80326, 80329, 80338, 80345, 80339, 80370, 80363, 80368, 80332, 80342, 80358, 80323, 80365, 83992, 80320, 80377, 80301, 80329, 80345, , 80301, 80337, 80326, 80329, 80338, 80345, 80339, 80370, 80363, 80368, 80332, 80342, 80358, 80323, 80365, 83992, 80320, G0431 G0431 x2 G0431 G0431 x NonSteroidal Anti Inflammatory Drug Panel G Drug Test, General Toxicology, Blood Drug Test, General Toxicology, 80320, 80346, 80356, 80357, 80330, 80354, 80355, 80366, 80337, 80326, 80323, 80353, 80377, 80345, 80340, 80370, 80344, 80333, 80361, 80364, 80358, 80338, 80360, 80348, 80365, 80367, 83992, 80321, 80372, 80198, 80373, 80368, 80359, , 80346, 80356, 80357, 80330, 80354, 80355, 80366, 80337, 80326, 80323, 80353, 80377, 80345, 80340, 80370, 80344, 80333, 80361, 80364, 80358, 80338, 80360, 80348, 80365, 80367, 83992, 80321, 80372, 80198, 80373, 80368, 80359, G0431 G0431 2

3 Test Code Dos Test Name Medicare Drug Test, General Toxicology, Serum 80320, 80346, 80356, 80357, 80330, 80354, 80355, 80366, 80337, 80326, 80323, 80353, 80377, 80345, 80340, 80370, 80344, 80333, 80361, 80364, 80358, 80338, 80360, 80348, 80365, 80367, 83992, 80321, 80372, 80198, 80373, 80368, 80359, G Comprehensive Blood Tox Screen 80345, 80329, 80346, G Substance Abuse Panel 7 plus Heroin and LSD with 80361, 80323, 80349, 83992, 80326, 80345, 80346, 80361, G Test Code Dos Test Name Medicare 451 Drug Screen Panel 1, Meconium 453 Drug Screen Panel 4, Meconium 454 Drug Screen Panel 5, Meconium 463 Drug Screen Panel 2, Meconium 649 Drug Abuse Panel 6-20, Special 855 Strychnine Screen Strychnine Screen, blood Drug Screen, Clinical 1 without Confirmation, Serum 1094 Substance Abuse Panel 7 with 1262 Substance Abuse Panel 8-50 with 2124 Drug Abuse Panel 10-20, without Confirmation 2125 Drug Abuse Panel Ethanol, No Confirmation 80329, 80320,, 82003, 80196,

4 Test Code Dos Test Name Medicare 2126 Drug Abuse Panel with Confirmation, 2127 Drug Abuse Panel with Confirmation, 2128 Alcohol, Ethyl, Qualitative, with 2130 Drug Abuse Panel Plus Ethanol without 2158 Marijuana Metabolites-20 Screen with Confirmation 2179 Drug Abuse Panel Plus Ethanol 2180 Drug Abuse Panel Plus Ethanol with 2593 Substance Abuse Panel plus Ethanol with 2595 Substance Abuse Panel 9 with Confirmation, Special, 3023 Substance Abuse Panel with 3111 Oxycodone, Qualitative, without 3120 Drugs of Abuse Screen (11 Panel), Fluid 3154 Heroin Screen 3198 Acetaminophen Screen G Antihistamines Screen G Levorphanol (Screen) G Substance Abuse Panel 7-50 GC/MS 6065 Butorphanol Screen, Free (Unconjugated) Cocaine Metabolites, Qualitative, /Gastric 6093 Cocaine Metabolites, Qualitative, GC/MS,

5 Test Code Dos Test Name Medicare 6103 Dextromethorphan, Qualitative, or Gastric 6126 Ethchlorvynol, Qualitative, /Gastric 6176 LSD Screen Meclizine Screen Meperidine, Qualitative, Random Methadone, Qualitative, GC/MS, Methaqualone, Qualitative, GC/MS, Phencyclidine, Qualitative, GC/MS, Phenothiazines, Qualitative, Propoxyphene, Qualitative, GC/MS, Marijuana Metabolites-15 by GC/MS, Qualitative, Substance Abuse Panel GC/MS 6403 Substance Abuse Panel 6-50 with Confirmation 6404 Substance Abuse Panel 5-50 GC/MS 6405 Substance Abuse Panel 5-50 GC/MS 6406 Substance Abuse Panel 7-50, GC/MS, 6440 Substance Abuse Panel 10-20, GC/MS Confirmation 6581 Substance Abuse Panel Substance Abuse Panel 7 GC/MS 6633 Substance Abuse Panel with 6636 Substance Abuse Panel 6-50 GC/MS 7170 Amphetamines Screen with Confirmation, 5

6 Test Code Dos Test Name Medicare 7171 Barbiturates Screen, with Confirmation, 7172 Benzodiazepines Screen with Confirmation, 7173 Cocaine Metabolites Screen with 7174 Marijuana Metabolites-50 Screen, with 7176 Methadone Screen with Confirmation 7177 Methaqualone Screen with Confirmation, 7178 Marijuana Metabolites-100 Screen with Confirmation 7179 Opiate Metabolites Screen with 7180 Phencyclidine Screen with Confirmation 7181 Propoxyphene Screen with Confirmation 7182 Substance Abuse Panel 2-50, GC/MS 7375 Substance Abuse Panel 10 with 7376 Substance Abuse Panel Substance Abuse Panel Substance Abuse Panel Substance Abuse Panel Substance Abuse Panel 8-50 with Confirmation 7908 Substance Abuse Panel Volatiles, Qualitative, G Substance Abuse Panel Drug Abuse Panel without 6

7 Test Code Dos Test Name Medicare 8255 Drug Abuse Panel 9-50, without 8262 Drug Abuse Panel 6-50 without 8300 Antidepressant Panel 1, 80337, LSD Screen, G Methylenedioxymethamphetamine (MDMA) Antihistamine Panel Antihistamine Panel, LSD Screen, Blood Ketamine and Metabolite Screen Ketamine and Metabolite Screen, Drug Screen, Clinical 1, without Oxycodone Screen and Nicotine Metabolite Screen G Tox 7 Screen, Opiates Clinical Screen, without Drug Abuse Panel Drug Abuse Panel 8-20 with Confirmation, Drug Abuse Panel 7-20 with Confirmation, Opiates, Qualitative, GC/MS, Benzodiazepines, Qualitative, GC/MS, Barbiturates, Qualitative, GC/MS, Drug Abuse Panel 7-20 with Confirmation, 7

8 Test Code Dos Test Name Medicare Confirmed Infant Drug Abuse Screen #3, Meconium Drug Abuse Panel 7-50 with Confirmation, Drug Abuse Panel Drug Abuse Panel Drug Abuse Panel Drug Abuse Panel 8-50 with Confirmation, Drug Abuse Panel with Confirmation, Drug Abuse Panel Drug Abuse Panel with Confirmation, Drug Abuse Panel 7 with Confirmation, Drug Abuse Panel 5-50 without Amphetamines (1000 ng/ml Screen), without Cocaine Metabolites Clinical Screen, without Methadone Clinical Screen, without Drug Abuse Panel without Cinfirmation, Drug Abuse Panel with Confirmation, Drug Abuse Panel 6-100, without Opiates Clinical Screen with Confirmation Drug Abuse Panel 6-50 with Confirmation, 8

9 Test Code Dos Test Name Medicare Drug Abuse Panel 5-20 with Confirmation, Drug Abuse Panel 8-50 without Drug Abuse Panel without Drug Abuse Panel 4-50 without Drug Abuse Panel 7-50 with Confirmation, Drug Abuse Panel without Drug Abuse Panel Amphetamine Screen with Confirmation, Serum Amphetamine Screen, with Confirmation, Amphetamine Screen with Confirmation, Blood Drug Abuse Panel with Drug Abuse Panel with Confirmation, Drug Abuse Panel 4-50 without 80324, G , , Monoacetylmorphine, Qualitative, Volatiles, Marijuana Metabolites-20 Clinical Screen with Confirmation Alcohol, Ethyl, Qualitative, Barbiturates Clinical Screen, with Propoxyphene Clinical Screen with Confirmation 9

10 Test Code Dos Test Name Medicare Marijuana Metabolites-100 Clinical Screen with Confirmation Amphetamines-1000 Clinical Screen, with Cocaine Metabolites Clinical Screen, with Phencyclidine Clinical Screen, with Opiates Metabolites, GC/MS, 80361, G Substance Abuse Panel 9-50 Plus Ethanol with Progressive Drug Screen # Substance Abuse Panel 8-50 plus Ethanol with Drug Abuse Panel (Refl) Tox 10 Profile, THC 20, with Alcohol, Tox 10 Screen with Alcohol, Tox 8 Profile with Tox 8 Screen, Toxicology 10 Profile, THC-50, Tox 10 Screen, THC-50, Tox 10 Profile, THC 20, Tox 10 Screen, THC 20, Benzodiazepines, Qualitative, GC/MS, Tox 9 Profile with Tox 9 Screen, Alcohol, Ethyl, Qualitative, without Pain Management, Buprenorphine, without 10

11 Test Code Dos Test Name Medicare DAP 5-50, SemiI Quant w/thc Creatiine Ratio, No Confirm Drug Abuse Panel 8-50 with Confirmation, 80301, G Pain Management Base Profile with Pain Management Base Profile without 80301, 82570, 83986, , 82570, 83986, G0431 G Buprenorphine Screen, with Quantitative Buprenorphine, Qualitative, Drug Panel Plus Ethanol with Drug Abuse Panel 6-50, with Confirmation, Fentanyl Screen with Reflex Confirmation G Pain Management Profile 1 with Confirmation, without medmatch, Pain Management Profile 2 with Confirmation, without medmatch, Pain Management Profile 3 with Confirmation, without medmatch, Pain Management Base Profile with Confirmation, without medmatch, Pain Management Profile 4 with Pain Management Profile 4 with Confirmation, without medmatch, Pain Management Profile 4 without 80301, 82570, 83986, , 82570, 83986, , 82570, 83986, , 82570, 83986, , 82570, 83986, , 82570, 83986, , 82570, 83986, G0431 G0431 G0431 G0431 G0431 G0431 G Drug Abuse Panel 9-50 Plus Ethanol without Drug Abuse Panel 5 without Confirmation, 11

12 Test Code Dos Test Name Medicare Drug Abuse Panel 5-50 without Drug Abuse Panel 6-50 Plus Ethanol without Drug Abuse Screen 6 with Confirmation Drug Abuse Panel 8 without Confirmation, Benzodiazepines, Qualitative, GC/MS, Opiates 5, Qualitative, 80361, Pain Management Profile 2 with Pain Management Profile 2 without Pain Management Profile 3 with Pain Management Profile 3 without Pain Management Profile 1 with Pain Management Profile 1 without 80301, 82570, 84311, , 82570, 84311, , 82570, 84311, , 82570, 84311, , 82570, 84311, , 82570, 83986, G0431 G0431 G0431 G0431 G0431 G Phencyclidine, Qualitative, GC/MS, Marijuana, Qualitative, GCMS, Pain Management, Amphetamines, with Pain Management, Barbiturates, with Pain Management, Benzodiazepines, with Pain Management, Cocaine Metabolite, with Pain Management, Marijuana Metabolite, with G

13 Test Code Dos Test Name Medicare Pain Management, Methadone, with Pain Management, Opiates, with Pain Management, Oxycodone, with Pain Management, Phencyclidine, with Pain Management, Propoxyphene, with Pain Management, Buprenorphine, with Pain Management, MDMA/MDA, with Pain Management, Alcohol Metabolites, with Pain Management, Heroin Metabolite, with Drug Abuse Panel 5-50 with THC Quantitative G Fentanyl, Progressive G Barbiturate Presumptive Screen Drug Abuse Panel 6-50 without Drug Abuse Panel 9, No Confirmation Drug Abuse Panel 5-50, No Confirmation Drug Abuse Panel 4 without Confirmation, Drug Abuse Panel 9-50, without Drug Panel 8 (no THC), with Confirmation, Pain Management, Marijuana Metabolite, with Confirmation, with medmatch, 13

14 Test Code Dos Test Name Medicare Pain Management, Methadone, with Confirmation, with medmatch, Pain Management, Opiates, with Confirmation, with medmatch, Pain Management, Oxycodone, with Confirmation, with medmatch, Pain Management, Phencyclidine, with Confirmation, with medmatch, Pain Management, Propoxyphene, with Confirmation, with medmatch, G Drug and Alcohol Screen Buprenorphine and Metabolite Screen Buprenorphine and Metabolite Screen, Blood Opiate Metabolites Screen with Confirmation Substance Abuse Panel 8-50 Plus Ethanol with Oxycodone and Metabolite, with Quantitative Drug Screen, Pain 1 with Confirmation, Drug Screen 1 with Fentanyl Presumptive Screen, G Marijuana Metabolites-50 Clinical Screen with Confirmation Oxycodone, with Qualitative Confirmation, Oxycodone, with Quantitative Confirmation, with confirm code with confirm code80365 G0434 G Hypoglycemic Panel, Qualitative Drug Panel 6, Quantitative, 14

15 Test Code Dos Test Name Medicare Drug Panel , Quantitative with Ethyl Alcohol, Drug Panel 10-50, Quantitative, Drug Panel 10, Quantitative, Tramadol Screen with Reflex to G Drug Panel 10-50, Quantitative, Drug Abuse Panel 9, Serum Drug Abuse Screen 5 without Confirmation, Serum Drug Abuse Screen 7 with Confirmation, Serum Opiates, Progressive Drug Abuse Panel Alfentanil Screen, Drug Abuse Panel with Confirmation, Drug Abuse Panel Plus Ethanol with Drug Abuse Panel 9-50 with Confirmation, Drug Abuse Panel 9-50 with Confirmation, Drug Abuse Panel Ethanol, No Confirmation Drug Abuse Panel Ethanol Drug Abuse Panel 9-50 Plus Ethanol with Drug Abuse Panel 6-50 with Confirmation, 15

16 Test Code Dos Test Name Medicare Drug Abuse Panel 6-50 with Confirmation, Drug Abuse Panel Ethanol, No Confirmation Drug Abuse Panel Ethanol Drug Abuse Panel 6-50 Plus Ethanol, Drug Abuse Panel 5-50 without Drug Abuse Panel Drug Abuse Panel 5-50 with Confirmation, Drug Abuse Panel Ethanol, No Confirmation Drug Abuse Panel 5-50 Plus Ethanol with Confirmations, Drug Abuse Panel 5-50 Plus Ethanol with Confirmations, Drug Abuse Panel Drug Abuse Panel Ethanol Drug Abuse Panel 9-20, No Confirmation Drug Abuse Panel Drug Abuse Panel Drug Abuse Panel 9-20 Plus Ethanol without Drug Abuse Panel 9-20 Plus Ethanol with Drug Abuse Panel Ethanol Drug Abuse Panel 6-20, No Confirmation Drug Abuse Panel 6-20 with Confirmation, Drug Abuse Panel

17 Test Code Dos Test Name Medicare Drug Abuse Panel 6-20 Plus Ethanol without Drug Abuse Panel Ethanol Drug Abuse Panel Ethanol Nalbuphine Screen Free (Unconjugated) G Antidepressant Panel , G Cocaine and Metabolites Screen, Blood Cocaine and Metabolites Screen Marijuana Metabolites-100 Clinical Screen with Confirmation Marijuana Metabolites (THC 50 ng/ml) Clinical Screen with Confirmation Marijuana Metabolites (THC 20 ng/ml) Clinical Screen with Confirmation Drug Abuse Panel Plus Ethanol with Drug Abuse Panel 10 with Confirmation, Drug Abuse Panel 10, No Confirmation Naltrexone and Metabolite Screen, Free (Unconjugated) Substance Abuse Panel with Creatinine , G Drug Screen Panel 9, Meconium Drug Abuse Panel Plus Ethanol without Drug Abuse Panel 9 + Ethanol Drug Abuse Panel 9 + Ethanol Drug Abuse Panel Drug Abuse Panel 10 Plus Ethanol 17

18 Test Code Dos Test Name Medicare Amphetamines (1000 ng/ml Screen), with Barbiturates Clinical Screen, with Benzodiazepines Clinical Screen, with Cocaine Metabolites Clinical Screen, with Methadone Clinical Screen, with Methaqualone Clinical Screen, with Opiates Clinical Screen, with Confirmation, Phencyclidine Clinical Screen with Propoxyphene Clinical Screen, with Substance Abuse Panel 6-50 with Opiates, Substance Abuse Panel 10 with Opiates, Substance Abuse Panel with Opiates, Ipecac Use Markers G Marijuana Metabolites-100 No Confirmation Antidepressant Panel /Gastric, Qualitative Drug Abuse Panel 3-50, without Drug Abuse Panel 8-20, Volatiles, Qualitative, Gastric Marijuana Metabolites-50 No Confirmation 18

19 Test Code Dos Test Name Medicare Drug Abuse Panel 9-50, without Drug Abuse Panel with Confirmation, (Refl) Cannabinoids Panel, Cocaine and Metabolite Screen with Confirmation, Meconium Phencyclidine Screen Drug Abuse Panel (Refl) without Confirmation Drug Abuse Panel 7-50, No Confirmation Drug Abuse Panel 8-50, No Confirmation Drug Abuse Panel 7-50, No Confirmation Drug Abuse Panel 5-50 without Drug Abuse Panel 5-50 without Drug Abuse Panel 6-50 without Drug Abuse Panel 8-50, No Confirmation Benzodiazepines, without Confirmation, Drug Abuse Panel plus Ethanol without Confirmation Drug Abuse Panel 5, No Confirmation Alprazolam and Metabolite Screen Triazolam and Metabolite Screen Drug Abuse Panel 4 without Confirmation, Methamphetamine /Gastric Qualitative LSD Presumptive Screen G

20 Test Code Dos Test Name Medicare Drug Abuse Panel Benzodiazepines Screen Gamma-Hydroxybutyric Acid Screen, Gamma-Hydroxybutyric Acid Screen Drugs of Abuse Screen, Serum And Volatiles Drug Abuse Panel 8-50 Plus Ethanol without Drugs Of Abuse Screen, Serum Sports I Expanded Barbiturates, without Drug Abuse Panel 3-20 with Confirmation, (Refl) Drug Abuse Panel 6 without Confirmation, Drug Abuse Panel 7-50 without Confirmation Drug Abuse Panel 6-50 Plus Ethanol without Drug Abuse Panel Ethanol (Refl) Drug Abuse Panel 8-50, No Confirmation Buprenorphine, Qualitative, without Oxycodone and Metabolite (100), Qualitative, GC/MS, Cocaine Metabolite-100, Qualitative, GC/MS, Methadone and Metabolite (100), Qualitative, GC/MS, Opiates, Expanded (100), Qualitative, GC/MS,

21 Test Code Dos Test Name Medicare Pain Management, Amphetamines, with Confirmation, with medmatch, Pain Management, Barbiturates, with Confirmation, with medmatch, Pain Management, Benzodiazepines, with Confirmation, with medmatch, Pain Management, Cocaine Metabolite, with Confirmation, with medmatch, Pain Management, Buprenorphine, with Confirmation, with medmatch, Work Comp, Base Profile with Confirmation, Pain Management, MDMA/MDA, with Confirmation, with medmatch, Pain Management, Alcohol Metabolites, with Confirmation, with medmatch, Pain Management, Heroin Metabolite, with Confirmation, with medmatch, G Work Comp, Profile 1 with Confirmation, Pain Management Profile 5 with Confirmation, without medmatch, Pain Management Profile 5 without Pain Management Profile 5 with 80301, 82570, 84311, 83986, 80301, 82570, 83986, , 82570, 84311, , 82570, 84311, G0434 G0431 G0431 G Ethyl Glucuronide with Carisoprodol Screen G Phencyclidine Clinical Screen, without Propoxyphene Clinical Screen, without Carisoprodol Screen with Reflex Confirmation G

22 Test Code Dos Test Name Medicare Oxycodone, Qualitative without (REFL) Drug Abuse Panel 9-50 No Confirm (Refl) Synthetic Cannabinoid Metabolites Screen, Expanded, Synthetic Cannabinoid Metabolites Screen, Drug Abuse Panel w meth150, eddp, noconf MDMA/MDA Screen with Confirmation, G G Synthetic Cannabinoids, Qualitative, Blood Synthetic Stimulants, Qualitative, Synthetic Stimulants, Qualitative, Serum Synthetic Stimulants, Qualitative, Blood Synthetic Cannabinoids, Qualitative, Synthetic Cannabinoids, Qualitative, Serum Oxycodone, with Qualitative Confirmation, Synthetic Cannabinoid Panel 1, Synthetic Cannabinoid Panel 2, Drug Toxicology Monitoring 1 with Drug Toxicology Monitoring 2 with Drug Toxicology Monitoring 3 with Drug Toxicology Monitoring 4 with Drug Toxicology Monitoring 5 with G G G G G

23 Test Code Dos Test Name Medicare Drug Toxicology Monitoring 6 with Drug Toxicology Monitoring 7 with Drug Toxicology Monitoring 8 with Drug Toxicology Monitoring 9 with G G G G Drug Toxicology Monitoring 1 Screen, G Drug Toxicology Monitoring 2 Screen, G Drug Toxicology Monitoring 3 Screen, G Drug Toxicology Monitoring 4 Screen, G Drug Toxicology Monitoring 5 Screen, G Drug Toxicology Monitoring 6 Screen, G Drug Toxicology Monitoring 7 Screen, G Drug Toxicology Monitoring 8 Screen, G Drug Toxicology Monitoring 9 Screen, G Drug Toxicology Monitoring, Amphetamines, with Drug Toxicology Monitoring Barbiturates, with Drug Toxicology Monitoring Benzodiazepines, with Drug Toxicology Monitoring Buprenorphine, with Drug Toxicology Monitoring Cocaine Metabolite, with Drug Toxicology Monitoring Alcohol, Ethyl, with Drug Toxicology Monitoring Heroin Metabolite, with G

24 Test Code Dos Test Name Medicare Drug Toxicology Monitoring Marijuana Metabolite 20, with Drug Toxicology Monitoring Marijuana Metabolite 50, with Drug Toxicology Monitoring MDMA, with Drug Toxicology Monitoring Methadone Metabolite, with Drug Toxicology Monitoring Opiates, with Drug Toxicology Monitoring Oxycodone, with Drug Toxicology Monitoring Phencyclidine, with Drug Toxicology Monitoring Propoxyphene, with Drug Toxicology Monitoring Amphetamines, Screen, Drug Toxicology Monitoring Barbiturates, Screen, Drug Toxicology Monitoring Benzodiazepines, Screen, Drug Toxicology Monitoring Buprenorphine, Screen, Drug Toxicology Monitoring Cocaine Metabolite, Screen, Drug Toxicology Monitoring Alcohol, Ethyl, Screen, Drug Toxicology Monitoring Opiates, Screen, Pain Management, Amphetamines, No Pain Management, Benzodiazepines, No Pain Management, Benzodiazepines, No G G G G

25 Test Code Dos Test Name Medicare Pain Management, Cocaine Metabolite, No Pain Management, Heroin Metabolite, No Pain Management, Marijuana Metabolite, No Pain Management, MDMA, No Pain Management, Methadone, No Pain Management, Opiates, No Pain Management, Oxycodone, No Pain Management, Phencyclidine, No Pain Management, Propoxyphene, No Drug Toxicology Monitoring Heroin Metabolite, Screen, Drug Tox Monitoring, Methadone Metabolite, Screen, U G Drug Toxi Monitoring, Opiates, Screen, U G Drug Toxicology Monitoring Oxycodone, Screen, Drug Toxicology Monitoring Phencyclidine Screen, Pain Management Profile 1 with Confirmation, with D/L Isomers, Pain Management Profile 1 with Confirmation, with D/L Isomers, without medmatch, 80301, 82570, 84311, , 82570, 84311, G0434 G Diuretics Screen, Psilocybin as Psilocin, Qualtitative,

26 Test Code Dos Test Name Medicare Marijuana Metabolite-50 with Creatinine Ratio, without Confirmation 80301, G Acetyl Fentanyl, Qualitative, Acetyl Fentanyl, Qualitative, Blood Acetyl Fentanyl, Qualitative, Serum Drug Screen Panel 1, Meconium 453 Drug Screen Panel 4, Meconium 454 Drug Screen Panel 5, Meconium 463 Drug Screen Panel 2, Meconium 649 Drug Abuse Panel 6-20, Special 855 Strychnine Screen Strychnine Screen, blood Drug Screen, Clinical 1 without Confirmation, Serum 1094 Substance Abuse Panel 7 with 1262 Substance Abuse Panel 8-50 with 2124 Drug Abuse Panel 10-20, without Confirmation 2125 Drug Abuse Panel Ethanol, No Confirmation 2126 Drug Abuse Panel with Confirmation, 80329, 80320,, 82003, 80196,

27 Oxycodone, Qualitative, GC/MS, G Amphetamines (200), Qualitative Confirmation, GC/MS, Oxycodone and Metabolite (100), QL, GCMS, Phencyclidine, Confirm by GC/MS, Meconium 80324, G G G Cannabinoids Panel G Cocaine and Metabolites Qual, Hair G DS13, No Confirm G Express Cup Drug Panel w/o Confirm, G Clonazepam G Chlordiazepoxide G Diazepam G Halazepam as Metabolite G

28 3139 Midazolam, Blood G Alprazolam (Xanax) G Temazepam and Oxazepam G Midazolam G Nitrazepam G Benzodiazepines, Quantitative, GC/MS, G Diazepam, Quantitative G Benzodiazepine, GC/MS, G Midazolam as Metabolite, G Pain Management, Benzodiazepines, Quantitative, Pain Management, Clonazepam Metabolite, Quantitative, Flunitrazepam and Metabolites, Quantitative, G G G Flunitrazepam and Metabolites, Quantitative G Benzodiazepines Panel, Blood G Clobazam G Alprazolam, Quantitative, G Lorazepam () G Lorazepam G Benzodiazepines G Clonazepam and 7-amino Clonazepam, G Diazepam G Rohypnol, G Rohypnol, Serum G

29 59436 Clonazepam and Metabolite G Benzodiazepines, Serum G Pain Management, Benzodiazepines, Quantitative, with medmatch, Pain Management, Clonazepam Metabolite, Quantitative, with medmatch, G G Benzodiazepines, Quantitative, G Benzodiazepines, Quantitative, GC/MS, G Diazepam and Metabolite G Clorazepate (Tranxene ) G Oxazepam G Desipramine G Imipramine G Valproic Acid, Total and Free 80164, , Valproic Acid, Free

30 Doxepin G Gold, G Gold G Imipramine G Imipramine G Nortriptyline G Amitriptyline G Pain Management, Tricyclic Antidepressants, Quantitative, with medmatch, Pain management, Tricyclic Antidepress, QN, G6037, G G6037, G

31 Salicylate G Percodan, blood 80329, G Ethosuximide Paramethadione Phenylpropanolamine Phensuximide Phenylbutazone and Metabolite Chloral Hydrate Halazepam as Metabolite Midazolam (B) Naproxen (Blood) Trazodone () Phenazopyridine Scopolamine () Primidone, Phenobarbital and PEMA 80339, 80345, , 80188, Trazodone Naproxen Ibuprofen Phenacemide

32 5389 Pemoline Cyclobenzaprine Dimethylsulfoxide (Blood) Mescaline, Methocarbamol, Serum/Plasma Phenelzine Pseudoephedrine Tolmetin Tranylcypromine Sulfate Zomepirac Orphenadrine Sertraline Citalopram Tramadol and Metabolit Zolpidem Ketamine and Metabolite Coricidin G6039, Dextro/Levo Methorphan, Escitalopram Escitalopram, Aripiprazole, Blood Aripiprazole, Quantitative Rufinamide Quetiapine, Blood

33 16823 Duloxetine Ziprasidone Pregabalin Pregabalin, Quantitative, Paroxetine Mephenytoin and Metabolite Maprotiline Protriptyline (Vivactil ) Chloral Hydrate, Blood Piroxicam (Feldene) Diclofenac (Voltaren) Nefazodone (Serzone) Mirtazapine (Remeron) Fluvoxamine (Luvox) Thiothixene (CIS Isomer) Loxapine Quetiapine, Serum or Plasma Oxycarbazepine Metabolite Baclofen, Serum/Plasma Dextro/Levo Methorphan Doxepin Methsuximide Ritalin Rohypnol,

34 59356 Rohypnol, Serum Olanzapine Tapentadol, Free Zolpidem, Quantitation, Cyclobenzaprine, Paliperidone Methylphenidate Metabolite, Quantitative, Ethosuximide Paramethadione Phenylpropanolamine Acetaldehyde (B) Acetonitrile Exposure Profile, Blood 82491, 82010, , 82010, Acetaminophen G Darvocet 80329, G6039, G Fioricet, 80371, 80345, G6039, 80155, G Fioricet, Blood 80329, 80155, G6039, 80155, G Fioricet, Tissue 80329, 80155, G6039, 80155, G

35 8313 Fioricet, Fluid 80329, 80155, G6039, 80155, G Fioricet serum/plasma 80329, 80155, G6039, 80155, G Coricidin G6039, Acetaminophen Confirmation G Alcohol, Ethyl, Blood G Alcohol, Ethyl, Blood G Alcohol, Ethyl, Quantitative, Random G Drug Toxicology Monitoring Alcohol Ethyl, Quant, G Alcohol, Ethyl (U), QN G Alcohol, Ethyl, Enzymatic G Amphetamines, Quantitative, GC/MS, G Amphetamines (D/L Ratio), Blood G Amphetamines (D/L Ratio) G Amphetamines (D/L Ratio), G

36 3384 Selegiline and Metabolites Amphetamines Panel, Blood 80326, G Phentermine G Pemoline Amphetamine, Confirmation, GC/MS, Serum G MDMA and Metabolite G Amphetamine Confirmation by GC/MS, Serum Amphetamine Confirmation by GC/MS, 80359, G , G Amphetamine Confirmation, GC/MS, Blood 80359, G % Amphetamines Confirmation, Fluid G Pain Management, Amphetamines, Quantitative, G MDMA/MDA, Quantitative, G Methamphetamine Isomers, D and L G Methamphetamine and Amphetamine (B) G Amphetamines Panel, Serum 80326, G Amphetamines Confirmation, GC/MS, Meconium G Amphetamines G Pain Management, Amphetamines, Quantitative, with medmatch, Pain MGMT, Methamphetamine D/L Isomers, urine Pain Management, MDMA/MDA, Quantitative, Pain Management, MDMA/MDA, Quantitative, with medmatch, G G G G

37 91539 Drug Tox Monitoring Amphetamines, QN, Drug Toxicology Monitoring MDMA, Quantitative, G G Methamphetamine and Metabolite, G Drug Toxicology Amphetamines, Quantitative, Oral Fluid Drug Toxicology MDMA, Quantitative, Oral Fluid G G Pain Management Amphetamines with D/L Isomers, Quantitative, Pain Management Amphetamines with D/L Isomers, Quantitative, w medmatch Pain Management, Methamphetamine D/L Isomers, G G G Amobarbital G Metharbital and Metabolite G Pentobarbital G Secobarbital G Barbiturates Panel, Blood G Butalbital G Thiopental and Metabolite G Barbiturates, Quantitative GC/MS Confirmation, Serum G Barbiturates, GC/MS, G

38 8568 Barbiturates, G Mephobarbital and Metabolite G Pain Management, Barbiturates, Quantitative, G Barbiturates G Pain Management, Barbiturates, Quantitative, with medmatch, G Barbiturates Panel, G Drug Toxicology Monitoring Barbiturates, Quantitative, Drug Toxicology Barbiturates, Quantitative, Oral Fluid G G Amobarbital G Metharbital and Metabolite G Pentobarbital G Methsuximide as Metabolite / Carisoprodol and Metabolite Phenylbutazone and Metabolite Trimethadione and Metabolite Clozapine Phenobarbital, Free/Bound

39 6017 Allopurinol and Metabolite Mephenytoin and Metabolite Marijuana Metabolite, Quantitative, Amoxapine and Metabolite Inhalants Panel, Blood (CSA) 84600, Inhalants Panel, (CSA) 84600, Amiodarone OR Carisoprodol and Metabolite Cocaine and Metabolites Qualitative, Hair G Cocaine Metabolites, GC/MS, G Cocaine, Confirmation by GC/MS G Pain Management, Cocaine Metabolite, Quantitative, Cocaine, Confirmation by GC/MS, Meconium G G Cocaine G Work Comp, verify, cocaine metabolite qn, u G Pain Management, Cocaine Metabolite, Quantitative, with medmatch, Drug Toxicology Monitoring Cocaine Metabolite, Quantitative, Drug Toxicology Cocaine, Quantitative, Oral Fluid G G G Cocaine and Metabolites Qualitative, Hair G

40 Methaqualone (Quaalude ) Marijuana Metabolites, GC/MS, Methaqualone, GC/MS, Cannabinoids Ketamine and Metabolite LSD, Quantitative, GC/MS, THC Confirmation, GC/MS with Ratio 80349, Pain Management, Marijuana Metabolite, Quantitative, Cannabinoids Panel marijuana metabolites, quantitative, LSD Trace Analysis (U) LSD Trace Analysis Cannabinoids Panel Qualitative, Meconium Marijuana Confirmation, GC/MS, Meconium Cannabinoids Confirmation, Meconium Baclofen (Lioresal ) Pain Management, Tramadol, Quantitative, with medmatch, Pain Management, Marijuana Metabolite, Quantitative, with medmatch, Drug Toxicology Monitoring Marijuana Metabolite, Quantitative,

41 Hydrocodone and Metabolites, Tissue G Hydrocodone and Metabolites, Fluid G Hydrocodone and Metabolite, G Hydrocodone G Hydrocodone and Metabolite, Serum G Hydromorphone G Dihydrotestosterone, Free, Serum G Dihydrotestosterone, LC/MS/MS G Dihydrotestosterone, Free, Serum G Trimethadione and Metabolite G Dimethadione G

42 Ethchlorvynol G Flurazepam and Metabolites G Glutethimide Carisoprodol and metabolite G Meprobamate G Meprobamate G Pain Mgmt, Carisoprodol Metabolit, QN, Drug Tox Monitoring Carisoprodol Met, QN, U G G Drug Tox Meprobamate, QN, Oral Fluid G

43 Clozapine Alcohol Metabolites, Quant, Risperidone Selegiline & Metabolites Fluoxetine Bupropion and Metabolite, Serum or Plasma Sertraline and Desmethylsertraline, Serum/Plasma Tramadol and Metabolite LSD Confirmation Carisoprodol and Metabolite, Pain Management, Alcohol metab, qn, urine Pain Management, Alcohol metab, qn, urine Venlafaxine and Metabolite Pain Management, Gabapentin, QN, Pain Management, Tramadol, Quantitative, Pain Management, Pregabalin, Quantitative, Clomipramine LSD Trace Analysis, LSD Trace Analysis Diuretic Panel S/P Carbamazepine-10,11-Epoxide Sildenafil and Metabolite

44 70208 Pain Management, Pregabalin, Quantitative, with medmatch, Pain Management, Tapentadol, Quantitative, Pain Management, Tapentadol, Quantitative, with medmatch, Pain Management, Methylphenidate Metabolite, Quantitative, Pain Management, Methylphenidate Metabolite, Quantitative, with medmatch, Pain Management, Synthetic Stimulants Quantitative, with medmatch, Pain Management, Synthetic Stimulants, Quantitative, MDPV Stimulant Designer Drug Test MDPV Stimulant Designer Drug Test, Tapentadol, Quantitative, Bath Salts Panel, Blood Bath Salts Panel, Serum/Plasma Drug Toxicology Monitoring, Tramadol, Quantitative, Drug Toxicology Zolpidem, Quantitative, Oral Fluid Drug Toxicology Marijuana, Quantitative, Oral Fluid Synthetic Stimulants

45 Methsuximide as Metabolite G Methadone G Methadone, GC/MS, G METHADONE BY GC/MS, NCOC G Methadone and Metabolite, G Pain Management, Methadone, Quantitative, Pain Management, Methadone, Quantitative, with medmatch, G G Work Comp, Verify, Methadone, QN, U G Drug Toxicology Monitoring Methadone Metabolite, Quantitative, Drug Toxicology Methadone, Quantitative, Oral Fluid G G Nicotine, Serum G Nicotine and Metabolite, Fluid G Nicotine and Cotinine, LC/MS/MS G Nicotine and Cotinine, LC/MS/MS, G

46 90982 Nicotine and Expanded Metabolites, LC/MS/MS, Nicotine and Expanded Metabolites, LC/MS/MS Drug Toxicology Nicotine, Quantitative, Oral Fluid G G G Codeine and Metabolite (Unconjugated) G Darvocet 80329, G6056, G Morphine G Opiates, GC/MS, G Pentazocine G Percodan 80329, G6056, G Propoxyphene, GC/MS, G Oxycodone and Metabolite, GC/MS, G Opiates Metabolites by gcms 80361, G Opiates 2000, GC/MS, G Opiates, Expanded by GC/MS, 80361, G Opiate Confirmation by GCMS, 80361, G Pain Management, Buprenorphine, Quantitative, Pain Management, Opiates Expanded, Quantitative, G , G Buprenorphine, Quantitative, G Pain Management, Fentanyl, Quantitative, G

47 16905 Pain Management, Meperidine, Quantitative, Pain Management, Oxycodone, Quantitative, Pain Management, Propoxyphene Metabolite, Quantitative, Oxycodone and Metabolite, Quantitative, G G G G Meperidine, GC/MS, G Fentanyl and Norfentanyl, G Morphine, Quantitative, G Fentanyl and Metabolite, Blood G Oxycodone and Metabolite, Quantitative G Heroin Metabolites, Quantitative, 80361, G Opiates Confirmation, Enhanced Sensitivity, Pain Management, Fentanyl, Quantitative, with medmatch, Pain Management, Buprenorphine, Quantitative, with medmatch, 80361, G G G Monoacetylmorphine, GC/MS, G Opiate Confirmation, GC/MS 80361, G Opiates, Expanded by GC/MS () 80361, G Opiates 5, Quantitative, 80361, G Oxycodone Free (Unconjugated) G Opiates, Serum 80361, 80365, G Meperidine G Propoxyphene, Quantitative, GC/MS, Serum G Oxycodone Confirmation, GC/MS, G

48 37449 Morphine (Free and Total) G Opiates Confirmation, GC/MS, Meconium 80361, G Fentanyl and Norfentanyl G Meperidine and Normeperidine, G Pain Management, Meperidine, Quantitative, with medmatch, Pain Management, Opiates Expanded, Quantitative, with medmatch, Pain Management, Oxycodone, Quantitative, with medmatch, Pain Management, Propoxyphene Metabolite, Quantitative, with medmatch, Pain Management, Heroin Metabolite, Quantitative, Pain Management, Heroin Metabolite, Quantitative, with medmatch, G , G G G G G Naloxone, Quantitative, G Buprenorphine and Naloxone, LC/MS/MS 80348, G Drug Toxicology Monitoring Buprenorphine, Quantitative, Drug Toxicology Monitoring Fentanyl, Quantitative, Drug Toxicology Monitoring Heroin Metabolite, Quantitative, Drug Toxicology Monitoring Opiates, Quantitative, Drug Toxicology Monitoring Oxycodone, Quantitative, Drug Toxicology Monitoring Propoxyphene, Quantitative, Drug Toxicology Monitoring Tapentadol, Quantitative, G G G G G G G

49 91602 Drug Toxicology Monitoring Opiates Expanded, Quantitative, 80361, G Opiates Confirmation, LC/MS/MS 80361, G Codeine and Metabolite (Unconjugated) G Darvocet 80329, G6056, G Trifluoperazine G Chlorpromazine G Promethazine G Mesoridazine G Thioridazine and Metabolite G Thiothixene (CIS Isomer) G Perphenazine G Mellaril G Fluphenazine, Serum or Plasma G Fluphenazine G Trifluoperazine G Chlorpromazine G Promethazine G

50 Alcohol, Isopropyl, Blood Alcohol, Methyl, Blood Volatiles Inhalants Panel, Blood 84600, Hydrocarbon and Oxygenated Volatiles Panel 84600, Methanol, Inhalants and Metabolites Panel, 84600, Isopropanol/Acetone Volatiles with ethylene glycol 84600,

51 Examples of Toxicology Panels Test Code Dos Test Name Tricyclic Antidepressant Panel (3) Pain Management, Tricyclic Antidepressants, Quantitative, Tricyclic Antidepressants ID and Quantitation Tricyclic Antidepressant Evaluation Antidepressant Panel, 80337, 80338, Antidepressant Panel, Blood 80337, 80338, Antidepressant Panel 80337, 80338, Antidepressant Panel Drug Toxicology Monitoring 1, Quantitative, Oral Fluid 80324, 80345, 80346, 80353, 80349, 80359, 80369, 80358, 80323, 80348, 80361, 80354, 80356, 80362, 80365, 80367, 80372, 80373, 83992, Drug Toxicology Opioids, Quantitative, Oral Fluid 80348, 80354, 80361, 80365, 80356, 80367, 80362, 80372, Pain Management Profile 1 with Confirm, 80301, 82570, 83986, Pain Management Profile 1 with Confirm,, w D/L Isomers 80301, 82570, 83986, Pain Management Profile 2 with Confirm, 80301, 82570, 83986, Pain Management Profile 4 with Confirm, 80301, 82570, 83986, Pain Management Profile 5 with Confirm,, w D/L Isomers 80301, 82570, 83986, reflex Pain Management Profile 6 with Confirm, 80301, 82570, 83986, Pain Management Profile 7 with Confirm, 80301, 82570, 83986, Pain Management Profile 1 with Confirm,, w/o Medmatch 80301, 82570, 83986, Pain Management Profile 1 with Confirm,, w D/L Isomers w/o Medmatch Pain Management Profile 1 with Confirm,, w D/L Isomers w/o Medmatch 80301, 82570, 83986, reflex , 82570, 83986, reflex

52 Test Code Dos Test Name Pain Management Profile 2 with Confirm, w/o Medmatch 80301, 82570, 83986, Pain Management Profile 4 with Confirm, w/o Medmatch 80301, 82570, 83986, Pain Management Profile 5 with Confirm,, w D/L Isomers w/o Medmatch 80301, 82570, 83986, reflex Pain Management Profile 6 with Confirm, w/o Medmatch 80301, 82570, 83986, Pain Management Profile 7 with Confirm, w/o Medmatch 80301, 82570, 83986, Pain Management Profile 1 without Confirm, 80301, 82570, 83986, Pain Management Profile 2 without Confirm, 80301, 82570, 83986, Pain Management Profile 4 without Confirm, 80301, 82570, 83986, Drug Tox Monitoring 9 with Drug Tox Monitoring 9 Screen, Pain Management Profile 8 with Confirm, 80301, 82570, 83986, Pain Management Profile 8 with Confirm, w/o Medmatch 80301, 82570, 83986,

53 HPV Test Code Dos Test Name HPV (Human Papillomavirus) DNA, High Risk, Anal-Rectal HPV DNA, High Risk HPV DNA, High Risk HPV DNA, High Risk with Reflex to Genotypes 16, reflex to HPV DNA, High Risk with Reflex to HPV Genotypes 16, reflex to HPV DNA, Low and High Risk HPV DNA, Low and High Risk with Reflex to Genotypes 16, reflex to HPV DNA, Low and High Risk, Anal-Rectal HPV Genotype HPV Genotypes 16, HPV Genotypes 16, 18/ HPV mrna E6/E HPV mrna E6/E7 with Reflex to HPV Genotypes 16, 18/ with reflex to HPV mrna E6/E7, Rectal HPV, High Risk, Hybrid Capture II with Reflex 16, reflex to OraRisk HPV SurePath Imaging Pap (REFL) HPV mrna E6/E7 reflex HPV 16,18/ (HCPCS: G0145), reflex to SurePath Imaging Pap and HPV mrna E6/E7 reflex HPV 16,18/ (HCPCS: G0145), with reflex to SurePath Imaging Pap and HPV mrna E6/E7, C. trachomatis, N. gonorrhoeae or 88175; HCPCS: G0144 or G0145; , SurePath Imaging Pap with Reflex to HPV mrna E6/E or 88175; HCPCS: G0144 or G0145 reflex to SurePath Imaging Pap with Reflex to HPV mrna E6/E7, C. trachomatis, N. gonorrhoeae or 88175; HCPCS: G0144 or G0145; 87491, with reflex to SurePath Imaging Pap (Refl) HPV DNA Low and High Risk (HCPCS: G0145) with reflex to

54 Test Code Dos Test Name SurePath Imaging Pap (RL) HPV mrna E6/E (HCPCS: G0145) with reflex to SurePath Pap (Refl) HPV DNA High/Low Risk 87624, SurePath Pap and HPV mrna E6/E , (HCPCS: G0123) SurePath Pap and HPV mrna E6/E7 reflex HPV 16,18/ , (HCPCS: G0123) with reflex to SurePath Pap and HPV mrna E6/E7, C. trachomatis, N. gonorrhoeae 87491, 87591, 87624, (HCPCS: G1023) SurePath Pap with Reflex to HPV mrna E6/E ; HCPCS: G0123 with reflex to SurePath Pap with Reflex to HPV mrna E6/E7, C. trachomatis, N. gonorrhoeae 87491, 87591, (HCPCS: G0123) with reflex to SurePath Imaging Pap and HPV mrna E6/E (HCPCS: G0145), SurePath -FP (Refl) HPV DNA High/Low Risk (HCPCS: G0145) with reflex to ThinPrep Pap reflex HPV DNA and C. trachomatis, N. gonorrhoeae (HCPCS: G0123), 87491, with reflex to ThinPrep Pap reflex HPV mrna E6/E7, C. trachomatis, N. gonorrhoeae (HCPCS: G1023), 87491, with reflex ThinPrep Imaging Pap (Refl) ThinPrep Imaging Pap (Refl) HPV DNA reflex HPV 16, or (HCPCS: G0144 or G0145) with reflex to with possible reflex to ThinPrep Imaging Pap and HPV DNA or (HCPCS: G0144 or G0145), ThinPrep Imaging Pap and HR HPV DNA reflex HPV 16, or (HCPCS: G0144 or G0145), with reflex to ThinPrep Imaging Pap and HR HPV DNA, C. trachomatis, N. gonorrhoeae ThinPrep Imaging Pap and HPV mrna E6/E7 reflex HPV 16,18/45 with CT/NG ThinPrep Imaging Pap and HPV mrna E6/E7, with CT/NG, Trichomonas or (HCPCS: G0144 or G0145), 87491, 87591, , 87624, 87491, with reflex to , 87624, 87491, 87591, ThinPrep Imaging Pap reflex HPV DNA or (HCPCS: G0144 or G0145) with reflex to

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