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NCDDRUGSCREENS2016.pdf

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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.


Browse by tests beginning with: D
Test NumberTest NameTest InformationSpecimen Requirements*CPT CodePrice (Stats are 2x List Price)
975D-DIMER QUANTITATIVE Testing Performed by Reference Lab 1 full sodium citrate (light blue tube) unopened 85379$250
6998DAPTOMYCINSERUM/FROZEN LC/MS/MS Testing Performed STAT and Daily1 ml Frozen Serum from red top tube with no additive/ 100-300 Microliters Frozen Serum (Pediatric Samples) 82542$200
5DAU PROFILE 5/WORKPLACE (NIDA 5)(AMPHETAMINE, COCAINE, MARIJUANA, OPIATE, PHENCYCLIDINE) Testing Performed STAT and Daily All positives must be confirmed by Reflex confirmation by LC/MS/MS. 30 ml urine (plastic urine container) 80101 x5$50
50169DESIPRAMINE QUANTITATIVE PANEL SERUM/BLOODLC/MS/MS (DESPIRAMINE, IMIPRAMINE) Testing Performed STAT and Daily Reference Ranges: Desipramine: 0.05 - 0.60 mg/L Imipramine: 0.05 - 0.20 mg/L 1 full red top tube no gel 80160$60
50169UDESIPRAMINE QUANTITATIVE PANEL URINELC/MS/MS (DESPIRAMINE, IMIPRAMINE) Testing Performed STAT and Daily 50 ml urine (plastic urine container) $90
50171DEXTROMETHORPHAN QUANTITATIVESERUM/BLOOD LC/MS/MS Testing Performed Daily Reference Range: 0.05 - 0.20 mg/L 1 full red top tube with no additive or 1 full grey top tube 82491$58
50171DEXTROMETHORPHAN URINELC/MS/MS Testing Performed Daily Reference Range: Non Detected 30 ml urine (plastic urine container) 82491$58
906DHEA - SULFATETesting Performed by Reference Lab 1 ml serum (collect specimen in tube with gel barrier - wait until blood is clotted before centrifuging - centrifuge for 15 minutes and insure that serum is separated from the blood cells by the gel barrier) 82627$156
41172DIAZEPAM QUANTITATIVE PANEL SERUM/BLOODLC/MS/MS (DIAZEPAM, NORDIAZEPAM) Testing Performed STAT and Daily Reference Ranges: Diazepam: 200 - 2000 ng/ml Nordiazepam: 200 - 1800 ng/ml 1 full red top tube no gel 82491$50
214DIGOXINTesting Performed STAT and Daily Reference Range: 0.5 - 2.0 ng/mL 1 full red top tube with no additive 80162$21
50190DILTIAZEM (CARDIZEM) QUALITATIVE LC/MS/MS Testing Performed Daily Mon-Fri 1 full red top tube with no additive or 1 full grey top tube 82491$90
50195DIPHENHYDRAMINE QUANTITATIVE LC/MS/MS Testing Performed STAT & Daily Reference Range: 0.025 - 0.112 mg/L 1 full red top tube with no additive or 1 full grey top tube 82491$42
205DIRECT BILIRUBINTesting Performed STAT & Daily Reference Range: 0 - 0.5 mg/dL 1 ml serum (collect specimen in tube with gel barrier - wait until blood is clotted before centrifuging - centrifuge for 15 minutes and insure that serum is separated from the blood cells by the gel barrier) 82248$15
50202DISOPYRAMIDE (NORPACE)QUANTITATIVE SERUM/BLOOD LC/MS/MS Testing Performed Weekly 1 full red top tube with no additive or 1 full grey top tube 82491$36
6984DORIPENEMSERUM/FROZEN LC/MS/MS Testing Performed STAT and Daily1 ml Frozen Serum from red top tube with no additive/ 100-300 Microliters Frozen Serum (Pediatric Samples)82542$100
1005DOUBLE STRANDED DNA ANTIBODIESTesting Performed by Reference Lab 1 ml serum (collect specimen in tube with gel barrier - wait until blood is clotted before centrifuging - centrifuge for 15 minutes and insure that serum is separated from the blood cells by the gel barrier) 86225$85
51207DOXEPIN QUANTITATIVE PANEL SERUM/BLOODLC/MS/MS (DOXEPIN, NORDOXEPIN, TOTAL TRICYCLICS) Testing Performed STAT and Daily Reference Ranges: Doxepin : 100 - 250 ng/ml Total Tricyclics: 50 - 300 ng/ml 1 full red top tube no gel 80166$44
51207UDOXEPIN URINE PANELLC/MS/MS (DOXEPIN, NORDOXEPIN, TOTAL TRICYCLICS) Testing Performed STAT and Daily 10 ml urine (plastic urine container) 80166$44
51209DOXYLAMINE (DRAMAMINE) QUALITATIVEDOXYLAMINE (DRAMAMINE) QUALITATIVE 1 full red top tube with no additive or 1 full grey top tube 82491$42
38DRUG OF ABUSE COMPLETE URINE PANEL(ALCOHOL, AMPHETAMINE & ECSTASY, BARBITURATE, BENZODIAZEPINE, BUPRENORPHINE, COCAINE METABOLITE, MARIJUANA, METHADONE/EDDP, OPIATE, OXYCODONE, PHENCYCLIDINE, PROPOXYPHENE, - ALDULTARANTS - SPECIFIC GRAVITY, CREATININE, PH) Testing Performed STAT and Daily Contact Laboratory to have auto reflex testing performed on all positive analytes. Practioners signature required. 30 ml urine (plastic urine container) 80101 x 10$250
5850DRUG OF ABUSE SCREEN BLOOD/SERUM/URINELC/MS/MS & HEADSPACE (ALL PERFORMED ON BOTH URINE & BLOOD IF SENT - AMPHETAMINE, BARBITURATE, BENZODIAZEPINE, COCAINE METABOLITE, FENTANYL, MARIJUANA, METHADONE/EDDP, OPIATE, OXYCODONE, PHENCYCLIDINE, PROPOXYPHEHE, TRICYCLIC, ETHANOL - BUPRENORPHINE ON URINE ONLY, ANALGESIC U, CAFFEINE S/B & U, ANTIHYSTAMINE, ETHANOL S/B & U, FLUOXETINE U, TRAMADOL U, BUPRENORPHINE S/B, NORBUPRENORPHINE S/B) Testing Performed: Routine & STAT- M-F 6:00am to 7:00pm/ STAT Only- M-F 7:01pm- 5:59am/ STAT Only- Saturday & Sunday, all day- This Panel auto reflexes for confirmations (additional charge for each confirmation) 1 full red top tube no gel and 30 ml urine (plastic urine container) 80100$56
625DRUG OF ABUSE SCREEN SERUM/BLOOD/URINELC/MS/MS & HEADSPACE (AMPHETAMINE, BARBITURATE, BENZODIAZEPINE, COCAINE METABOLITE, FENTANYL, MARIJUANA, METHADONE/EDDP, OPIATE, OXYCODONE, PHENCYCLIDINE, PROPOXYPHENE, TRICYCLIC, ETHANOL - BUPRENORPHINE ON URINE ONLY) Testing Performed: Routine & STAT- M-F 6:00am to 7:00pm/ STAT Only- M-F 7:01pm- 5:59am/ STAT Only- Saturday & Sunday, all day- This Panel auto reflexes for confirmations (additional charge for each confirmation) :1 full red top tube no gel and 30 ml urine (plastic urine container) 80100$56
6500DRUG SCREEN SERUM/BLOOD/URINELC/MS/MS & HEADSPACE (AMPHETAMINE S/B/U, BARBITURATE S/B/U, BENZODIAZEPINE S/B/U, COCAINE S/B/U, FENTANYL S/B/U, MARIJUANA S/B/U, OPIATE S/B/U, OXYCODONE S/B/U, METHADONE S/B, METHADONE/EDDP U, PHENCYCLIDINE S/B/U, PROPOXYPHENE S/B/U, TRICYCLIC S/B/U, NICOTINE U, BUPRENORPHINE U, ALCOHOL U) Testing Performed: Routine & STAT- M-F 6:00am to 7:00pm/ STAT Only- M-F 7:01pm- 5:59am/ STAT Only- Saturday & Sunday, all day- This Panel auto reflexes for confirmations (additional charge for each confirmation) 1 full red top tube no gel and 30 ml urine (plastic urine container) 80101$56
50212DYPHYLLINE (ASMINYL) QUALITATIVEDYPHYLLINE (ASMINYL) QUALITATIVE 1 full red top tube with no additive or 1 full grey top tube 82491$38