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25477 Methamphetamine Chiral Analysis, Urine

Methamphetamine Chiral Analysis, Urine
Test Code: CHIRALM
Synonyms/Keywords
d-methamphetamine, l-methamphetamine
Test Components
d-methamphetamine, l-methamphetamine
Useful For
As a follow-up to a confirmed positive methamphetamine, this test is useful for discriminating between illicit and legal methamphetamine use.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ ​Urine ​Sage urine collection container ​Sterile plastic container with no preservatives ​1.0 mL ​0.5 mL ​0.25 mL
Collection Processing Instructions
Should be ordered as a U-have, on a urine sample previously confirmed positive for methamphetamine.
Specimen Stability Information
Specimen Type Temperature Time
Urine​ ​ ​ ​Ambient ​72 hours
​Refrigerate (Preferred) 30 days
​Frozen ​30 days
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ ​Monday through Friday ​2-4 days ​Gas chromatography-mass spectrometry (GCMS) using selected ion monitoring
Test Information
This test was developed and its performance characteristics determined by Marshfield Labs. This laboratory is certified under the Clinical Laboratory Improvement Amendments (CLIA) to perform high complexity testing.
 
Methamphetamine exists as two enantiomers. The S(+) form, which is also called “d” methamphetamine, is an ingredient in a few legitimate pharmaceutical products available only by prescription, and can be illicitly synthesized from (-) ephedrine or (+) pseudoephedrine. The S(+) or “d” form of methamphetamine is generally considered a drug of abuse. On the other hand, the R(-) form, which is also called l-desoxyephedrine or “l” methamphetamine, is the active ingredient in Vicks inhalers, is a metabolite of the anti-Parkinson drug Selegiline, and is not a drug of abuse. When a specimen gives a confirmed positive result for methamphetamine, this test can be ordered. This test separates the enantiomers and will provide percentage-based information to help determine the source of methamphetamine in the specimen. Note that this test does not provide quantitations; it only provides the percentage(s) of each methamphetamine found in the urine. The urine should be previously tested for methamphetamine and have given a positive result before this test should be ordered.
Reference Range Information
Performing Location Reference Range
​Marshfield ​Negative. The report for this test is a percentage breakdown of any d- and l-methamphetamine found in a previously confirmed positive urine specimen.
Interpretation

If a person’s urine contains more than 20% of the S(+) or “d” enantiomer, that person either obtained methamphetamine prescribed by a physician, or used methamphetamine that was illicitly synthesized. 

If the person’s urine contains significant amounts of both enantiomers, the person probably had access to methamphetamine from an illicit source.

If the specimen contains more than 80% of the R(-) or “l” enantiomer, the person is probably using only Vicks inhalers or the anti-Parkinson drug Selegiline.

Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
80374​
​G0480 For ​Medicare/Medicaid
Classification
This test was developed and its performance characteristics determined by Marshfield Labs. This laboratory is certified under the Clinical Laboratory Improvement Amendments (CLIA) to perform high complexity testing.
Synonyms/Keywords
d-methamphetamine, l-methamphetamine
Test Components
d-methamphetamine, l-methamphetamine
Ordering Applications
Ordering Application Description
​Clinical Order Manager ​Methamphet Chiral Analysis, Ur
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ ​Urine ​Sage urine collection container ​Sterile plastic container with no preservatives ​1.0 mL ​0.5 mL ​0.25 mL
Collection Processing
Should be ordered as a U-have, on a urine sample previously confirmed positive for methamphetamine.
Specimen Stability Information
Specimen Type Temperature Time
Urine​ ​ ​ ​Ambient ​72 hours
​Refrigerate (Preferred) 30 days
​Frozen ​30 days
Useful For
As a follow-up to a confirmed positive methamphetamine, this test is useful for discriminating between illicit and legal methamphetamine use.
Test Components
d-methamphetamine, l-methamphetamine
Reference Range Information
Performing Location Reference Range
​Marshfield ​Negative. The report for this test is a percentage breakdown of any d- and l-methamphetamine found in a previously confirmed positive urine specimen.
Interpretation

If a person’s urine contains more than 20% of the S(+) or “d” enantiomer, that person either obtained methamphetamine prescribed by a physician, or used methamphetamine that was illicitly synthesized. 

If the person’s urine contains significant amounts of both enantiomers, the person probably had access to methamphetamine from an illicit source.

If the specimen contains more than 80% of the R(-) or “l” enantiomer, the person is probably using only Vicks inhalers or the anti-Parkinson drug Selegiline.

For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ ​Monday through Friday ​2-4 days ​Gas chromatography-mass spectrometry (GCMS) using selected ion monitoring
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
80374​
​G0480 For ​Medicare/Medicaid
Classification
This test was developed and its performance characteristics determined by Marshfield Labs. This laboratory is certified under the Clinical Laboratory Improvement Amendments (CLIA) to perform high complexity testing.
For most current information refer to the Marshfield Laboratory online reference manual.