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HelpTest Code SOFT: Z0542 Delta-8 and Delta-9-Carboxy-Tetrahydrocannabinol (THC) Confirmation, Random, Urine
Additional Codes
| Ordering Mnemonic | Mayo Test ID |
|---|---|
| EPIC NAME: THC (MARIJUANA), URINE, CONFIRMATION | THCU |
EPIC CODE: LAB447
Reporting Name
Carboxy-THC Confirmation, UUseful For
Detection and confirmation of drug use of cannabis/marijuana and to specifically identify and quantify delta-8-carboxy tetrahydrocannabinol (THC-COOH) and delta-9-THC-COOH
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
UrineOrdering Guidance
For situations where chain of custody is required, a Chain-of-Custody Kit (T282) is available. For chain-of-custody testing, order THCX / Delta-8 and Delta-9-Carboxy-Tetrahydrocannabinol (THC) Confirmation, Chain of Custody, Random, Urine
Additional drug panels and specific requests are available. Call 800-533-1710 or 507-266-5700.
Additional Testing Requirements
If urine creatinine is required or adulteration of the sample is suspected, order, ADULT / Adulterants Survey, Random, Urine.
Specimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container Tube: Plastic urine container
Submission Container/Tube: Plastic, 5-mL tube
Specimen Volume: 3 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative.
Additional Information:
1. No specimen substitutions.
2. STAT requests are not accepted for this test.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 14 days | |
| Frozen | 14 days | ||
| Ambient | 72 hours |
Reject Due To
| Gross hemolysis | OK |
| Gross icterus | Reject |
Reference Values
Not Detected
Cutoff concentration:
DELTA-8 CARBOXY-TETRAHYDROCANNABINOL (THC) by LC-MS/MS: <5.0 ng/mL
DELTA-9 CARBOXY-TETRAHYDROCANNABINOL (THC) by LC-MS/MS: <5.0 ng/mL
Day(s) Performed
Monday through Friday
CPT Code Information
80349
G0480 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| THCU | Carboxy-THC Confirmation, U | 20521-1 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 618770 | Delta-8 Carboxy-Tetrahydrocannabinol by LC-MS/MS | 20521-1 |
| 2497 | Delta-9 Carboxy-Tetrahydrocannabinol by LC-MS/MS | 20521-1 |
| 21186 | Carboxy-THC Interpretation | 69050-3 |
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.Clinical Information
There are over 100 different cannabinoids in cannabis/marijuana. The main psychoactive cannabinoid is delta-9-tetrahydrocannabinol (delta-9-THC), which is the active agent of the popularly abused street drug, cannabis/marijuana. Delta-8 tetrahydrocannabinol (delta-8 THC) is another psychoactive substance found in the Cannabis sativa plant, of which cannabis/marijuana and hemp are 2 varieties. Delta-8 THC is one of over 100 cannabinoids produced naturally by the cannabis plant but is not typically found in significant amounts in the plant itself. As a result, concentrated amounts of delta-8 THC are typically manufactured from hemp-derived cannabidiol.
Following consumption of cannabis/marijuana, delta-9-THC metabolizes to a variety of inactive products, one of them being the carboxy metabolite (delta-9-THC-COOH). In almost all medico-legal cases or when the patient adamantly denies cannabis/marijuana use and the immunoassay test is positive, confirmation of the result by a definitive test is required. This test is a definitive, confirmatory test using liquid chromatography tandem mass spectrometry to identify and quantify delta-8-THC-COOH and delta-9 THC-COOH.
Interpretation
The presence of delta-8 and/or delta-9 carboxy tetrahydrocannabinol (THC-COOH) in urine is a strong indicator that the patient has used cannabis/marijuana.
THC-COOH has a long half-life and can be detected in urine for more than 7 days after a single use.
Chronic use causes accumulation of THC and THC-COOH in adipose tissue, such that it is excreted into the urine for as long as 30 to 60 days from the time chronic use is halted.
Cautions
No significant cautionary statements
Clinical Reference
1. Baselt RC. Disposition of Toxic Drugs and Chemicals in Man. 12th ed. Biomedical Publications; 2020
2. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 43
Method Description
Carboxy tetrahydrocannabinol (THC-COOH) is extracted from urine by making the urine alkaline to hydrolyze THC-COOH glucuronide. The hydrolyzed samples are diluted for analysis by liquid chromatography tandem mass spectrometry using selected ion monitoring.(Unpublished Mayo method)
Report Available
3 to 5 daysSpecimen Retention Time
2 weeksForms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-General Request (T239)
-Therapeutics Test Request (T831)