Postmortem, Fire Death Screen, Blood (Forensic)

Method(s)

Enzyme-Linked Immunosorbent Assay (ELISA)

Headspace Gas Chromatography (GC)

High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)

Spectrophotometry (SP)

Suggested CPT Code(s)

80307x3

84600

New York State Approval Status

Approved

Turnaround Time

10 days (If Positive: 17 days)

Test Includes


1	Cyanide	CN; Hydrogen Cyanide; Potassium Cyanide	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	mcg/mL	0.1	Environmental/Occupation Toxin
2	Opiates	Codeine; Heroin; Morphine; Opium	Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	20	Narcotic Analgesic
3	Cocaine / Metabolites	Blow; Crack; Snow	Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	20	Stimulant
4	Benzodiazepines	Sedative; Tranquilizer	Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	100	Anxiolytic, Sedative
5	Cannabinoids	Cannabis; Hashish; Marihuana; Marijuana; THC	Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	10	Cannabinoid
6	Amphetamines	Adderall; Amfetamine; Dextroamphetamine; Levoamphetamine	Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	20	Anorexigenic, Stimulant
7	Barbiturates		Enzyme-Linked Immunosorbent Assay (ELISA)	mcg/mL	0.04	Hypnotic, Sedative
8	Methadone / Metabolite		Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	25	Narcotic Analgesic
9	Phencyclidine	Angel Dust; PCP; Sherm	Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	10	Hallucinogen
10	Buprenorphine / Metabolite	Buprenex®; Suboxone®; Subutex®; Temgesic®	Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	0.5	Narcotic Analgesic
11	Methamphetamine / MDMA	Desoxyn®; Ecstasy; Meth; Molly	Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	20	Stimulant
12	Oxycodone / Oxymorphone		Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	10	Narcotic Analgesic
13	Fentanyl / Acetyl Fentanyl		Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	0.5	Anesthetic, Opioid Analgesic
14	Volatiles		Headspace Gas Chromatography (GC)			Environmental/Occupation Toxin
15	Carboxyhemoglobin	COHb	Spectrophotometry (SP)	%Saturation	5	Biological Marker (Exposure)

Reflex Tests

Test Code	Test Name
52167B	Buprenorphine and Metabolite - Free (Unconjugated) Confirmation, Blood
5636B	Cyanide Confirmation (Qualitative), Blood
5637B	Cocaine and Metabolites Confirmation, Blood
5641B	Benzodiazepines Confirmation, Blood
5643B	Fentanyl and Acetyl Fentanyl Confirmation, Blood
5645B	Opiates - Free (Unconjugated) Confirmation, Blood
5646B	Cannabinoids Confirmation, Blood
5652B	Barbiturates Confirmation, Blood
5654B	Carbon Monoxide Exposure Biouptake Confirmation, Blood
5657B	Phencyclidine Confirmation, Blood
5682B	Methadone and Metabolite Confirmation, Blood
5684B	Amphetamines Confirmation, Blood

Sample Type

Blood

Requested Volume

9 mL

Minimum Volume

4.5 mL

Special Handling

Studies have shown that cyanide has variable instability in biological specimens and is particularly unstable in some postmortem specimens. The loss of cyanide can be minimized by shipping the sample to the laboratory for analysis as soon as possible, preferably using refrigerated or frozen transportation and preservation using sodium fluoride / potassium oxalate (grey-top tube). Samples should not be refrozen if previously thawed. The potential for increases in cyanide concentrations, although rare, have also been demonstrated and may be due to microbial action. Preservation with sodium fluoride may reduce this possibility.

Sample Container

Gray top tube (Sodium Fluoride / Potassium Oxalate), Lavender top tube (EDTA)

Additional Collection Instructions

Transport Temperature

Refrigerated

Light Protection

Not Required

Rejection Criteria

None

Rejection criteria pertain to clinical sample submissions only.

Stability

Room Temperature: Undetermined
Refrigerated: Undetermined
Frozen (-20 °C): Undetermined


1	Cyanide	CN; Hydrogen Cyanide; Potassium Cyanide	High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS)	mcg/mL	0.1	Environmental/Occupation Toxin
2	Opiates	Codeine; Heroin; Morphine; Opium	Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	20	Narcotic Analgesic
3	Cocaine / Metabolites	Blow; Crack; Snow	Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	20	Stimulant
4	Benzodiazepines	Sedative; Tranquilizer	Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	100	Anxiolytic, Sedative
5	Cannabinoids	Cannabis; Hashish; Marihuana; Marijuana; THC	Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	10	Cannabinoid
6	Amphetamines	Adderall; Amfetamine; Dextroamphetamine; Levoamphetamine	Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	20	Anorexigenic, Stimulant
7	Barbiturates		Enzyme-Linked Immunosorbent Assay (ELISA)	mcg/mL	0.04	Hypnotic, Sedative
8	Methadone / Metabolite		Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	25	Narcotic Analgesic
9	Phencyclidine	Angel Dust; PCP; Sherm	Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	10	Hallucinogen
10	Buprenorphine / Metabolite	Buprenex®; Suboxone®; Subutex®; Temgesic®	Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	0.5	Narcotic Analgesic
11	Methamphetamine / MDMA	Desoxyn®; Ecstasy; Meth; Molly	Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	20	Stimulant
12	Oxycodone / Oxymorphone		Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	10	Narcotic Analgesic
13	Fentanyl / Acetyl Fentanyl		Enzyme-Linked Immunosorbent Assay (ELISA)	ng/mL	0.5	Anesthetic, Opioid Analgesic
14	Volatiles		Headspace Gas Chromatography (GC)			Environmental/Occupation Toxin
15	Carboxyhemoglobin	COHb	Spectrophotometry (SP)	%Saturation	5	Biological Marker (Exposure)

Example Report (Negative)

Example Report (Positive)

Interface Map

8104B Postmortem, Fire Death Screen, Blood (Forensic) - Current Version
Analyte	Units	Analyte Mapping Code	LOINC®
Cyanide	mcg/mL	CYANIDEcs
Opiates	ng/mL	OPIATES	51691-4
Cocaine / Metabolites	ng/mL	COCAINEMET	73823-7
Benzodiazepines	ng/mL	BENZODIAZ	42662-7
Cannabinoids	ng/mL	THCS	42491-1
Amphetamines	ng/mL	AMPHETS	51690-6
Barbiturates	mcg/mL	BARBIT	3376-1
Methadone / Metabolite	ng/mL	METHADMET	91033-1
Phencyclidine	ng/mL	PCP	51692-2
Buprenorphine / Metabolite	ng/mL	BUPRENMET
Methamphetamine / MDMA	ng/mL	METHMDMA	91034-9
Oxycodone / Oxymorphone	ng/mL	OXYCOXYM	77732-6
Fentanyl / Acetyl Fentanyl	ng/mL	FENTACETF
Volatiles		VOLATILES
Carboxyhemoglobin	%Saturation	COHEM1	32160-4

5684B Amphetamines Confirmation, Blood- Current Version
Analyte	Units	Analyte Mapping Code
Ephedrine	ng/mL	EPHEDRINE
Pseudoephedrine	ng/mL	PSEUDOEPHE
Phenylpropanolamine	ng/mL	PHENYLPROP
Norpseudoephedrine	ng/mL	NORPSEUDO
Amphetamine	ng/mL	AMPHETAMIN
Phentermine	ng/mL	PHENTERMIN
Methamphetamine	ng/mL	METHAMPHET
MDA	ng/mL	MDA
MDMA	ng/mL	MDMA
MDEA	ng/mL	MDEA

5652B Barbiturates Confirmation, Blood- Current Version
Analyte	Units	Analyte Mapping Code
Butabarbital	mcg/mL	BUTABARBIT
Butalbital	mcg/mL	BUTALBITAL
Pentobarbital	mcg/mL	PENTOBARB
Secobarbital	mcg/mL	SECOBARB
Phenobarbital	mcg/mL	PHENOBARB

5641B Benzodiazepines Confirmation, Blood- Current Version
Analyte	Units	Analyte Mapping Code
Diazepam	ng/mL	DIAZEPAM
Nordiazepam	ng/mL	NORDIAZEPA
Oxazepam	ng/mL	OXAZEPAM
Temazepam	ng/mL	TEMAZEPAM
Clobazam	ng/mL	CLOBAZAM
Chlordiazepoxide	ng/mL	CHLORDIAZE
Lorazepam	ng/mL	LORAZEPAM
Clonazepam	ng/mL	CLONAZEPAM
7-Amino Clonazepam	ng/mL	AMINOCLO7
Alprazolam	ng/mL	ALPRAZOLAM
Alpha-Hydroxyalprazolam	ng/mL	ALPHAHYDR
Midazolam	ng/mL	MIDAZOLAM
Triazolam	ng/mL	TRIAZOLAM
Hydroxytriazolam	ng/mL	HYDROXYTRI
Hydroxyethylflurazepam	ng/mL	HYDROXYETH
Desalkylflurazepam	ng/mL	DESALKYLFL
Flurazepam	ng/mL	FLURAZEPAM
Estazolam	ng/mL	ESTAZOLAM

52167B Buprenorphine and Metabolite - Free (Unconjugated) Confirmation, Blood- Current Version
Analyte	Units	Analyte Mapping Code
Buprenorphine - Free	ng/mL	BUPRENORPF
Norbuprenorphine - Free	ng/mL	NORBUPRENF

5646B Cannabinoids Confirmation, Blood- Current Version
Analyte	Units	Analyte Mapping Code
11-Hydroxy Delta-9 THC	ng/mL	HYDROXY11
Delta-9 Carboxy THC	ng/mL	DELTA9CARB
Delta-9 THC	ng/mL	DELTA9THC

5654B Carbon Monoxide Exposure Biouptake Confirmation, Blood- Current Version
Analyte	Units	Analyte Mapping Code
Carboxyhemoglobin	%Saturation	COHEM2

5637B Cocaine and Metabolites Confirmation, Blood- Current Version
Analyte	Units	Analyte Mapping Code
Benzoylecgonine	ng/mL	BENZOYLECG
Cocaine	ng/mL	COCAINE
Cocaethylene	ng/mL	COCAETHYLE

5636B Cyanide Confirmation (Qualitative), Blood- Current Version
Analyte	Units	Analyte Mapping Code
Cyanide	mcg/mL	CYANQL

5643B Fentanyl and Acetyl Fentanyl Confirmation, Blood- Current Version
Analyte	Units	Analyte Mapping Code
Fentanyl	ng/mL	FENTANYL
Norfentanyl	ng/mL	NORFENTANY
Acetyl Fentanyl	ng/mL	ACETYLFENT

5682B Methadone and Metabolite Confirmation, Blood- Current Version
Analyte	Units	Analyte Mapping Code
Methadone	ng/mL	METHADONE
EDDP	ng/mL	EDDP

5645B Opiates - Free (Unconjugated) Confirmation, Blood- Current Version
Analyte	Units	Analyte Mapping Code
Dihydrocodeine / Hydrocodol - Free	ng/mL	DIHYDROCOF
Codeine - Free	ng/mL	CODEINEF
Morphine - Free	ng/mL	MORPHINEF
Hydrocodone - Free	ng/mL	HYDROCODF
6-Monoacetylmorphine - Free	ng/mL	MAMF
Hydromorphone - Free	ng/mL	HYDROMORF
Oxycodone - Free	ng/mL	OXYCODONEF
Oxymorphone - Free	ng/mL	OXYMORPHF

5657B Phencyclidine Confirmation, Blood- Current Version
Analyte	Units	Analyte Mapping Code
Phencyclidine	ng/mL	PCP

LOINC^® Information

8104B Postmortem, Fire Death Screen, Blood (Forensic) - Current Version
Analyte	Units	Analyte Mapping Code	LOINC®
Cyanide	mcg/mL	CYANIDEcs
Opiates	ng/mL	OPIATES	51691-4
Cocaine / Metabolites	ng/mL	COCAINEMET	73823-7
Benzodiazepines	ng/mL	BENZODIAZ	42662-7
Cannabinoids	ng/mL	THCS	42491-1
Amphetamines	ng/mL	AMPHETS	51690-6
Barbiturates	mcg/mL	BARBIT	3376-1
Methadone / Metabolite	ng/mL	METHADMET	91033-1
Phencyclidine	ng/mL	PCP	51692-2
Buprenorphine / Metabolite	ng/mL	BUPRENMET
Methamphetamine / MDMA	ng/mL	METHMDMA	91034-9
Oxycodone / Oxymorphone	ng/mL	OXYCOXYM	77732-6
Fentanyl / Acetyl Fentanyl	ng/mL	FENTACETF
Volatiles		VOLATILES
Carboxyhemoglobin	%Saturation	COHEM1	32160-4

5684B Amphetamines Confirmation, Blood - Current Version
Analyte	LOINC®
Ephedrine
Pseudoephedrine	90446-6
Phenylpropanolamine	29601-2
Norpseudoephedrine
Amphetamine	82967-1
Phentermine	29608-7
Methamphetamine
MDA
MDMA
MDEA	82965-5

5652B Barbiturates Confirmation, Blood - Current Version
Analyte	LOINC®
Butabarbital	75645-2
Butalbital	82971-3
Pentobarbital	82969-7
Secobarbital	72397-3
Phenobarbital	72396-5

5641B Benzodiazepines Confirmation, Blood - Current Version
Analyte	LOINC®
Diazepam	59655-1
Nordiazepam	59717-9
Oxazepam	59726-0
Temazepam	59746-8
Clobazam	59627-0
Chlordiazepoxide	59618-9
Lorazepam	59700-5
Clonazepam	59637-9
7-Amino Clonazepam	59592-6
Alprazolam	59607-2
Alpha-Hydroxyalprazolam	59600-7
Midazolam	59708-8
Triazolam	59759-1
Hydroxytriazolam	59691-6
Hydroxyethylflurazepam	59683-3
Desalkylflurazepam	47404-9
Flurazepam	59675-9
Estazolam	59665-0

52167B Buprenorphine and Metabolite - Free (Unconjugated) Confirmation, Blood - Current Version
Analyte	LOINC®
Buprenorphine - Free	79138-4
Norbuprenorphine - Free

5646B Cannabinoids Confirmation, Blood - Current Version
Analyte	LOINC®
11-Hydroxy Delta-9 THC	80111-8
Delta-9 Carboxy THC
Delta-9 THC

5654B Carbon Monoxide Exposure Biouptake Confirmation, Blood - Current Version
Analyte	LOINC®
Carboxyhemoglobin

5637B Cocaine and Metabolites Confirmation, Blood - Current Version
Analyte	LOINC®
Benzoylecgonine	42856-5
Cocaine	72405-4
Cocaethylene

5636B Cyanide Confirmation (Qualitative), Blood - Current Version
Analyte	LOINC®
Cyanide	43183-3

5643B Fentanyl and Acetyl Fentanyl Confirmation, Blood - Current Version
Analyte	LOINC®
Fentanyl	73938-3
Norfentanyl	73937-5
Acetyl Fentanyl

5682B Methadone and Metabolite Confirmation, Blood - Current Version
Analyte	LOINC®
Methadone
EDDP

5645B Opiates - Free (Unconjugated) Confirmation, Blood - Current Version
Analyte	LOINC®
Dihydrocodeine / Hydrocodol - Free
Codeine - Free	86226-8
Morphine - Free
Hydrocodone - Free
6-Monoacetylmorphine - Free	80115-9
Hydromorphone - Free
Oxycodone - Free	77730-0
Oxymorphone - Free	77729-2

5657B Phencyclidine Confirmation, Blood - Current Version
Analyte	LOINC®
Phencyclidine	58042-3

Some LOINC^® codes may not have been assigned or are not available.

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The CPT Codes provided in this document are based on AMA Guidelines and are for informational purposes only. NMS Labs Does not assume responsibility for billing errors due to Reliance on the CPT Codes listed in this document.

*The information contained in this document represents database configurations, as they will appear on the effective date listed above.