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HelpTest Code HYDCS Hydrocodone and Metabolites, Serum
Ordering Guidance
This test should only be ordered by healthcare professionals to monitor patients who have been prescribed hydrocodone.
Specimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube: Red top (Serum gel/SST are not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL serum
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Useful For
Monitoring therapeutic efficacy/compliance in serum specimens of patients who are prescribed hydrocodone
Special Instructions
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Hydrocodone and metabolites, SSpecimen Type
Serum RedSpecimen Minimum Volume
Serum: 0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum Red | Refrigerated (preferred) | 14 days |
| Frozen | 28 days | |
| Ambient | 24 hours |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | OK |
Reference Values
Therapeutic range/Metabolite information (as applicable):
Hydrocodone: 10-100 ng/mL
Norhydrocodone: Metabolite of hydrocodone
Hydromorphone: 1.0-30 ng/mL when used as sole therapy; Metabolite of hydrocodone and minor metabolite of morphine
Dihydrocodeine: 72-150 ng/mL when used as sole therapy, Minor metabolite of hydrocodone
Cutoff concentrations:
Hydrocodone: 1.0 ng/mL
Norhydrocodone: 1.0 ng/mL
Hydromorphone: 1.0 ng/mL
Dihydrocodeine: 1.0 ng/mL
Interpretation
Clinically, the presence of hydrocodone, norhydrocodone, hydromorphone, and/or dihydrocodeine can be used to verify adherence or compliance to prescribed opioids, and discourage drug misuse, abuse, and diversion.
The following adult therapeutic ranges are suggested by literature but must be interpreted alongside other clinical features/test results, symptoms, collection time since last dosage was taken, and signs of abuse/misuse.
Hydrocodone: 10-100 ng/mL
Norhydrocodone: Not established; it is a metabolite of hydrocodone.
Hydromorphone: 1.0-30 ng/mL when used as sole therapy, it is also a metabolite of hydrocodone and minor metabolite of morphine.
Dihydrocodeine: 72-150 ng/mL when used as sole therapy, it is also a minor metabolite of hydrocodone.
Day(s) Performed
Wednesday
Report Available
2 to 9 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
G0480
80361 (if appropriate for select payers)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| HYDCS | Hydrocodone and metabolites, S | In Process |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 623451 | Hydrocodone - Free | 12786-0 |
| 623452 | Norhydrocodone - Free | In Process |
| 623453 | Hydromorphone - Free | 12787-8 |
| 623454 | Dihydrocodeine - Free | 12785-2 |