Effective March 25, 2024, Clinical Pathology Laboratories (CPL) will implement improvements and updates to the drug monitoring program. All testing will be performed by Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS), including Barbiturates and Buprenorphine screening, which were previously performed by Enzyme Immunoassay (EIA). The panel improvements include refinements of LC-MS/MS methodology to include:

  • Lowered positive cutoff values, increasing sensitivity for most analytes
  • Addition of relevant components to a number of the individual panels
  • Discontinuation of less relevant components
  • Drug classes and groups reorganized to facilitate easier interpretation of reports
  • Delta-8 and delta-9 THC metabolites differentiated and reported separately to discriminate illicit from permitted use
  • New tianeptine and xylazine assays

As previously, the program solicits medication administration record or prescribed drug lists to facilitate close focus on parent-metabolite drug relationships. An enhanced report is available with all testing. This includes an algorithm that elevates Inconsistent Positive and Inconsistent Negative, as well as Consistent Positive, to the top of the report. The enhanced report can be encoded to transmit to compliant EMR’s or may be delivered using the laboratory portal or alternative delivery. CPT coding is overwhelmingly unchanged.

Please review your reports carefully to include components of individual panels, analytic results, and cutoff thresholds. Because the higher sensitivity changes affect a broad number of analyte thresholds in the panels, they will not be exhaustively listed in a table in this announcement, but a table is available for your review, if necessary. The thresholds and components of testing have been communicated to all interfaced EMR’s and accounts by CPL Database team.

A specialty requisition for drug monitoring testing is available from your customer service or at the link below:
www.cpllabs.com/drugmonitoringreq

Please contact your Account Representative or your region’s Customer Service with any questions.