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22405 Cannabinoids, Urine

Cannabinoids, Urine
Test Code: CAN
Synonyms/Keywords
​CBD, Marijuana, THC, Tetrahydrocannabinol​
Useful For
​Detecting abuse of marijuana
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​ 7 mL​ 5 mL​ 3 mL​
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​
If no confirmatory work is required:
1 day​
 
If confirmatory work is required:
4 days
 Beckman Coulter AU680 Clinical Chemistry System with Emit Immunoassay and Liquid Chromatography/Tandem Mass Spectrometry (LCMS/MS) using Multiple Reaction Monitoring (if needed for confirmation)​
Test Information
This test was developed and its performance characteristics determined by Marshfield Labs.  It has not been cleared or approved by the US Food and Drug Administration.  This test is used for clinical purposes.  It should not be regarded as investigational or for research.
 

Marijuana is composed of more than sixty C21 compounds found in the leaves and flowering tops of the plant Cannabis sativa L.  These compounds and their metabolites, collectively called cannabinoids, are excreted in the urine of marijuana users.  This test screens and confirms two cannabinoids in urine: 

1.       THCA (or 11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid) is the primary metabolite of the psychoactive drug THC found in marijuana and comprises about one third to one half of the cannabinoids found in urine.

2.       CBD (or cannabidiol) is a cannabinoid also found in marijuana, and has seen a recent surge in over-the-counter supplements that fall into the fringe of legality. Unlike THC, it has no known psychoactive properties.  Currently, the only FDA-approved medical use for CBD is treatment of refractory epilepsy.

If the immunoassay screen is positive, this test automatically includes LC-MS/MS confirmation for THCA and CBD. Quantitation and confirmation are charged separately if needed.  It is intended for use only in patients where an initial drug screening test has not already been performed (i.e. point-of-care drug screening cup, dipstick, etc.).

Reference Range Information
Performing Location Reference Range
​Marshfield ALL: Negative.  Positives are reported with a quantitative LC-MS/MS result.
Interpretation

Current Cutoff Levels for Toxicology

The marijuana metabolite is retained in adipose tissue, and has a widely variable detection time.  In general, single-use can be detected up to 3 days afterward; chronic heavy use can be detected 21-30 days after the last use.​

Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
80307​ ​ 1​ Single Drug Class​ ​
80349 ​ 1​ Cannabinoids Confirmation by LC/MS/MS ​If needed
​G0480 ​ ​1 ​Cannabinoids Confirmation by LC/MS/MS ​For Medicare/Medicaid, If needed
Classification
This test was developed and its performance characteristics determined by Marshfield Labs.  It has not been cleared or approved by the US Food and Drug Administration.  This test is used for clinical purposes.  It should not be regarded as investigational or for research.
Synonyms/Keywords
​CBD, Marijuana, THC, Tetrahydrocannabinol​
Ordering Applications
Ordering Application Description
​Cerner Cannabinoid, Urine
​COM ​Cannabinoid, Urine
​
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​ 7 mL​ 5 mL​ 3 mL​
Specimen Stability Information
Specimen Type Temperature

Time

Urine​ Ambient​ 72 hours​
Refrigerate (Preferred)​ 30 days​
Frozen​ 30 days​
Useful For
​Detecting abuse of marijuana
Reference Range Information
Performing Location Reference Range
​Marshfield ALL: Negative.  Positives are reported with a quantitative LC-MS/MS result.
Interpretation

Current Cutoff Levels for Toxicology

The marijuana metabolite is retained in adipose tissue, and has a widely variable detection time.  In general, single-use can be detected up to 3 days afterward; chronic heavy use can be detected 21-30 days after the last use.​

For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​
If no confirmatory work is required:
1 day​
 
If confirmatory work is required:
4 days
 Beckman Coulter AU680 Clinical Chemistry System with Emit Immunoassay and Liquid Chromatography/Tandem Mass Spectrometry (LCMS/MS) using Multiple Reaction Monitoring (if needed for confirmation)​
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
80307​ ​ 1​ Single Drug Class​ ​
80349 ​ 1​ Cannabinoids Confirmation by LC/MS/MS ​If needed
​G0480 ​ ​1 ​Cannabinoids Confirmation by LC/MS/MS ​For Medicare/Medicaid, If needed
Classification
This test was developed and its performance characteristics determined by Marshfield Labs.  It has not been cleared or approved by the US Food and Drug Administration.  This test is used for clinical purposes.  It should not be regarded as investigational or for research.
For most current information refer to the Marshfield Laboratory online reference manual.