If you are new to compliance monitoring, you probably have a lot of questions about how the process works. Our specially trained representatives can help you with everything from work flow optimization to billing/coding questions.
In-office POC devices allow the clinician to asses what drugs are in a patients system while they are still in the office. You can customize the drug panels that are included to test for a variety of common pharmaceuticals and drugs of abuse. Many offices elect to use CLIA Waived devices that allow them to bill a small amount for interpretation of the cup, while reimbursements vary offices report an average of $10-$30 per cup.
*Important Note: In order to bill for the POC devices, the office must first obtain a CLIA Waiver license. Don't have one? No problem, let us help you understand how easy it can be to obtain one!
The quality and reliability of POC devices varies and it is important for clinicians to understand that false POSTIVES and false NEGATIVES are very common. it is strongly recommended that any result be confirmed using a more sophisticated technique such as LC/MS/MS.
Urine is the most common sample type for prescription drug monitoring due to the ease of collection and well characterized drug metabolism profiles. Most offices utilize a CLIA Waived Point-of-Care (POC) device as a quick screening tool. Since the POC devices are subject to false readings, samples are sent to our lab for confirmation testing before making a final decision regarding the course of treatment.
Testing regulations have recently changed. We can help ensure you are compliant! Learn more HERE.
InSource Diagnostics can analyze for over 50 different drug substances and metabolites at low part per billion (ppb) levels. Tests can be ordered for individual drug substances or as a Custom Panel depending on needs of the patients.
Click on the headers below to see the test menus.
If you would like to download our comprehensive test menu, you can get the PDF version here.
You are busy, we understand. Our 2-page report summarizes our findings into three easy to interpret categories:
More and more states are adopting guidelines that require drug screening for patients undergoing long term drug therapy. Learn more with our state guidelines map.
This table will give you a guideline for how long you can expect to detect different drugs in urine or saliva.
POC devices often show false readings that are the results of cross reactivity of the antibodies. This quick reference chart lists the more common reasons for a false positive.
Drug metabolism is quite complex and drugs are often converted to a related species by the body. These charts help with the interpretation of UDT results.
InSource Diagnostics has many tools and services available to help optimize your monitoring program.
Saliva testing offers a good alternative when a patient is unable to provide a urine sample. Samples are collected using a simple swab device that is placed under the patients tongue until the indicator light turns blue. Drug concentrations more closely match serum levels, so detection levels and windows are different from urine and this must be understood when ordering the test. At this time there are no CLIA waived devices for saliva drug testing.
Click on the headers below to see the test menus.
In most states there is no required frequency, only general guidelines to help you determine what is right for your practice. Any testing policy should be clearly defined and documented in your records.
Many organizations suggest there should be a correlation between the risk of abuse and the frequency of testing. There are several models for risk assessment. Please ask your InSource Diagnostics representative for more information and templates your office can use to set up its own risk assessment program.
|Risk Assessment1||Testing Frequency2|
|Low Risk||Responsible alcohol and medication use, no history of abuse, and no psychological conditions||Infrequent
Randomly for Compliance
|Moderate Risk||Family history of abuse, depression, anxiety, reliance on medication, or history of non-compliance with other meds||Periodic
|High Risk||History of abuse, discharged from a previous physician, or regular non-compliance||Frequent
At Every Visit
|Lost prescriptions, requests for early refill, change in dosage, or apparent intoxication||During Visit|
Limitation of Screening Technologies
The POC would indicate a positive result, but the patient was in fact compliant.
The cup results would indicate a negative result, which could lead you to believe the patient was compliant when they were not.
|Concentrations (ng/mL) of Opiate Compounds that Produce a Result Approximately Equivalent to the 300 ng/mL Cutoff|
|Compound||Concentration (ng/mL) at 300 ng/mL Cutoff|
* Therapeutic or toxic urinary levels of levallorphan and nalorphine are not reported in the literature.
† Meperidine urinary concentrations of 15000 ng/mL have been measured in cases of fatal meperidine overdosage.