Opiates

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 Test Code: 1014 OPIATES
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 Performing Lab: SMA Specialty Medical Lab
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 Clinical Significance: Opiates are a class of compunds that includes morphine, codeine, and heroin. Morphine and codeine are naturally occurring alkaloids that are found in opium, a substance exuded from the unripe seed pod of the opium poppy Papver somniferum. Heroin is a semisynthetic derivative of morphine. Morphine is a potent analgesic.  Codeine is used in analgesic preparations and as a cough suppressant. Heroin is an even more potent analgesic than morphine. Heroin is a drug of abuse that may be snorted, smokes, or dissolved and injected subcutaneously or intravenously. Opiates are absorbed rapidly. Heroin is converted almost immediately to morphine, which is excreted in urine both unchanged and as a glucuronidated metabolite. Excretion takes place over a period of a couple of days. Codeine is excreted in urine as a glucuronidated conjugate, as free and conjugated norcodeine, and as morphine. The presence of opiates in the urine indicates the use of heroin, morphine, and/or codeine. The Atellica CH Op assay tests for morphine, morphine-3-glucuronide, and codeine in human urine and gives a positive result if any of these opiates are present. It also detects synthetic opiates related to morphine, such as hydromorphone, and high concentrations of the analgesic meperidine and the narcotic antagonist nalorphine. Positive results for specimens containing other compounds structurally unrelated to opiates have not been observed. While confirmation techniques other than GC/MS may be adequate for some drugs of abuse, GC/MS is generally accepted as a rigorous confirmation technique for all drugs, since it provides the best level of confidence in the result.
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 Reference Ranges: Negative (<300 ng/mL)
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 Preferred Specimen: Urine
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 Alternate Specimens: n/a
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 Minimum Volume: 3 mL
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 Specimen Container: Sterile Urine Cup, no preservatives
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 Transport Temperature: Room Temperature
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 Specimen Stability: Rerigerated: 30 Days
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 Room Temperature: 7 Days
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 Causes for Rejection Improper Labeling; received with preservatives
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 Methodology: Syva Emit II Plus
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 Setup Days: Monday-Saturday
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 Setup Times: Every Shift
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 Turnaround: 24 Hours
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 CPT Code(s):
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 (The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.)
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 Instrument SIEMENS Atellica CH

ComprehensiveDx Clear™

ComprehensiveDx Clear™
Test Code: 1248
Test Description ComprehensiveDx Clear is a comprehensive panel for hereditary breast, ovarian, uterine, colorectal, pancreatic, prostate and melanoma cancers.
Genes Tested GENE ASSOCIATED CANCER(S) SYNDROME
APC Colorectal, pancreatic and other Familial Adenomatous Polyposis syndrome, Gardner syndrome, and Turcot syndrome
ATM Breast, pancreatic Ataxia-telangiectasia (if both copies of the gene are mutated)
BAP1 Renal, melanoma, mesothelioma Familial Melanoma Cancer Syndrome
BARD1 Breast, ovarian
BMPR1A Colorectal, gastric, pancreatic Juvenile Polyposis syndrome
BRCA1 Breast, ovarian, pancreatic, prostate, male breast Hereditary Breast and Ovarian Cancer syndrome
BRCA2 Breast, ovarian, pancreatic, prostate, male breast, melanoma Hereditary Breast and Ovarian Cancer syndrome;
Fanconi anemia (if both copies of the gene are mutated)
BRIP1 Ovarian, breast Fanconi anemia (if both copies of the gene are mutated)
CDH1 Breast, gastric, colorectal Hereditary Diffuse Gastric Cancer
CDK4 Melanoma, pancreatic Familial Melanoma Cancer Syndrome
CDKN2A Melanoma, pancreatic Familial Melanoma Cancer Syndrome
CHEK2 Breast, colorectal
DICER1 Lung, kidney, thyroid, ovarian
EPCAM Colorectal, gastric, endometrial, ovarian Lynch (Hereditary non-polyposis colon cancer) syndrome
FANCC Breast Fanconi anemia (if both copies of the gene are mutated)
MRE11A Breast, ovarian Ataxia-telangiectasia-like Syndrome (if both copies of the gene are mutated)
MSH2 Colorectal, gastric, endometrial, ovarian Lynch (Hereditary non-polyposis colon cancer) syndrome
MSH6 Colorectal, endometrial Lynch (Hereditary non-polyposis colon cancer) syndrome
MUTYH Colorectal MUTYH-associated Polyposis syndrome
NBN Breast, melanoma, prostate Nijmegen breakage syndrome (if both copies of the gene are mutated)
PALB2 Breast, ovarian, pancreatic, male breast Fanconi anemia (if both copies of the gene are mutated)
PMS2 Colorectal, endometrial, gastric, ovarian Lynch (Hereditary non-polyposis colon cancer) syndrome
POLD1 Colorectal, endometrial Familial Adenomatous Polyposis syndrome
POLE Colorectal, gastrointestinal Familial Adenomatous Polyposis syndrome
PTEN Breast, uterine, colorectal, thyroid, kidney, melanoma Cowden Syndrome / PTEN Hamartoma Tumor Syndrome
RAD50 Ovarian
RAD51C Breast, ovarian Fanconi anemia (if both copies of the gene are mutated)
RAD51D Breast, ovarian
SDHA Gastrointestinal, other Paragangliomas 5
SDHB Gastrointestinal, renal, other Paraganglioma and gastric stromal sarcoma
SDHC Gastrointestinal, renal, other Paraganglioma and gastric stromal sarcoma
SDHD Gastrointestinal, renal, other Cowden Syndrome 3; Paraganglioma and gastric stromal sarcoma
SMAD4 Colorectal, gastric Juvenile Polyposis syndrome
STK11 Colorectal, endometrial, gastric, ovarian, breast, pancreatic Peutz-Jeghers syndrome
TP53 Colorectal, breast, pancreatic, sarcomas, gastrointestinal, adrenocortical, leukemia Li-Fraumeni syndrome
Specimen Requirements Blood (two 4ml EDTA tubes, lavender top) or Extracted DNA (3ug in EB buffer) or Buccal Swab or Saliva (kits available upon request)
Turnaround Time (TAT) 2-3 weeks

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BreastDx Clear™

BreastDx Clear™
Test Code: 1250
Test Description BreastDx Clear is a multi-gene test that analyzes 16 breast cancer susceptibility genes. Although all women have some risk of developing breast and/or ovarian cancer at some point in their lives, having a mutation in one of the breast cancer susceptibility genes increases this risk. Men who have a mutation in one of the breast cancer susceptibility genes have an increased risk of breast, prostate, pancreatic, gastric and other cancer types.
Genes Tested GENE ASSOCIATED CANCER(S) SYNDROME
ATM Breast, pancreatic Ataxia-telangiectasia (if both copies of the gene are mutated)
BARD1 Breast, ovarian
BRCA1 Breast, ovarian, pancreatic, prostate, male breast Hereditary Breast and Ovarian Cancer syndrome
BRCA2 Breast, ovarian, pancreatic, prostate, male breast, melanoma Hereditary Breast and Ovarian Cancer syndrome;
Fanconi anemia (if both copies of the gene are mutated)
BRIP1 Ovarian, breast Fanconi anemia (if both copies of the gene are mutated)
CDH1 Breast, gastric, colorectal Hereditary Diffuse Gastric Cancer
CHEK2 Breast, colorectal
FANCC Breast Fanconi anemia (if both copies of the gene are mutated)
MRE11A Ovarian, breast Ataxia-telangiectasia-like Syndrome (if both copies of the gene are mutated)
NBN Breast, melanoma, prostate Nijmegen breakage syndrome (if both copies of the gene are mutated)
PALB2 Breast, ovarian, pancreatic, male breast Fanconi anemia (if both copies of the gene are mutated)
PTEN Breast, uterine, colorectal, thyroid, kidney Cowden Syndrome / PTEN Hamartoma Tumor Syndrome
RAD51C Breast, ovarian Fanconi anemia (if both copies of the gene are mutated)
RAD51D Breast, ovarian
STK11 Breast, ovarian, colorectal, gastric, pancreatic Peutz-Jeghers Syndrome
TP53 Breast, brain, sarcomas, gastrointestinal, adrenocortical, leukemia Li-Fraumeni Syndrome
Specimen Requirements Blood (two 4ml EDTA tubes, lavender top) or Extracted DNA (3ug in EB buffer) or Buccal Swab or Saliva (kits available upon request)
Turnaround Time (TAT) 2-3 weeks

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ColoDx Clear™

ColoDx Clear™
Test Code: 1251
Test Description Colorectal cancer is the fourth most common type of cancer diagnosed in the United States and the second leading cause of cancer-related deaths in the country.
ColoDx Clear is a multi-gene test focused on hereditary colon cancer syndromes. Pathogenic variants (mutations) in high-risk colorectal cancer genes are associated with several hereditary cancer syndromes and increase the risk of cancer in many organs.
Genes Tested GENE ASSOCIATED CANCER(S) SYNDROME
APC Colorectal, pancreatic and other Familial Adenomatous Polyposis syndrome, Gardner syndrome, and Turcot syndrome
BMPR1A Colorectal, gastric Juvenile Polyposis syndrome
EPCAM Colorectal, gastric, endometrial, ovarian Lynch (Hereditary non-polyposis colon cancer) syndrome
MLH1 Colorectal, gastric, endometrial, ovarian Lynch (Hereditary non-polyposis colon cancer) syndrome
MSH2 Colorectal, gastric, endometrial, ovarian Lynch (Hereditary non-polyposis colon cancer) syndrome
MSH6 Colorectal, endometrial Lynch (Hereditary non-polyposis colon cancer) syndrome
MUTYH Colorectal MUTYH-associated Polyposis syndrome
PMS2 Colorectal, endometrial, gastric, ovarian Lynch (Hereditary non-polyposis colon cancer) syndrome
POLD1 Colorectal, endometrial Familial Adenomatous Polyposis syndrome
POLE Colorectal, gastrointestinal Familial Adenomatous Polyposis syndrome
PTEN Colorectal, endometrial, breast, melanoma Cowden syndrome
SMAD4 Colorectal, gastric Juvenile Polyposis syndrome
STK11 Colorectal, endometrial, gastric, ovarian, breast, pancreatic Peutz-Jeghers syndrome
TP53 Colorectal, breast, pancreatic and other Li-Fraumeni syndrome
Specimen Requirements Blood (two 4ml EDTA tubes, lavender top) or Extracted DNA (3ug in EB buffer) or Buccal Swab or Saliva (kits available upon request)
Turnaround Time (TAT) 2-3 weeks

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ProstateDx Clear™

ProstateDx Clear™
Test Code: 1257
Test Description: The ProstateDx Clear™  Panel examines genes associated with an increased risk for prostate cancer.  This test includes both well-established prostate cancer susceptibility genes, as well as candidate genes with limited evidence of an association with prostate cancer.
Genes Tested: ATM, BRCA1, BRCA2, CHEK2, EPCAM, HOXB13, MLH1, MSH2, MSH6,
NBN, PALB2, PMS2, TP53
Specimen Requirements Blood (two 4ml EDTA tubes, lavender top) or Extracted DNA (3ug in EB buffer)
or Buccal Swab or Saliva (kits available upon request)
Turnaround Time (TAT) 2-3 weeks

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