CLIA Waived Tests and CPT Codes

Waived Tests and CPT Codes

This list is for informational purposes only and may not accurately represent current CMS CPT codes. Please verify your tests waived status and CPT code prior to implementing testing.

Test Name/Specific Test System

Manufacturer

Approved CPT

Code(s)

Adenovirus

AdenoPlus (human eye fluid)

Rapid Pathogen Screening, Inc. 87809QW

Quidel, AdenoPlus Test, Adeno Detector, Detecor Plus (Tear Fluid) Quidel Corporation

87809QW

Quidel Corporation, QuickVue Adenoviral Conjunctivitis Test {Tear Fluid}

Quidel Corporation

87809QW

Rapid Pathogen Screening RPS Adeno Detector

Rapid Pathogen Screening, Inc. 87809QW

Aerobic/Anaerobic Organisms - Vaginal

Genzyme Diagnostics OSOM BVBLUE Test Gryphus Diagnostics BVBlue OBGYN-Vph Vaginal Ph Screening Kit

Gryphus Diagnostics, LLC Gryphus Diagnostics, LLC Teco Diagnostics

87905QW 87905QW Pending

Aerobic/Anaerobic/Viral Panel - Respiratory

FilmArray Respiratory Panel 2.0 EZ (RP EZ) (nasopharyngeal)

Biofire Diagnostics, LLC

Pending

Albumin

Abaxis Piccolo Blood Chem Analyzer WB (Chem 13, CMP, Renal) Abaxis Piccolo Point of Care Chemistry Analyzer (Liver Panel Plus Reagent Disc) Abaxis Piccolo xpress Chem Analyzer WB (Chem 13, CMP, Liver Panel Plus, Renal) Arkray SPOTCHEM EZ Chem Analyzer (WB) Genzyme Diag OSOM ImmunoDip (urinary alb) HemoCue Albumin 201 System (urinary albumin) TECO Diagnostics, Albumin Rapid Test Stick and Card

Abaxis, Inc

Abaxis, Inc.

Abaxis, Inc

Polymedco, Inc Genzyme Diagnostics HemoCue AB Teco Diagnotics

82040QW

82040QW

82040QW

82040QW 82040QW 82040QW 82040QW

Alanine Aminotransferase (ALT)

Abaxis Piccolo Blood Chem Analyzer WB (CMP, Chem 6, Chem 13) Abaxis Piccolo Point Of Care Chemistry Analyzer (Lipid Panel Reagent Disc) ALT Abaxis Piccolo xpress Chem Analyzer WB(CMP, Lipid Panel Plus, Liver Panel Plus, Chem 6, Chem 13) Alere Cholestech LDX (ALT)(WB) Arkray SPOTCHEM EZ Chem Analyzer (WB) Cholestech LDX Alanine Aminotransferase (ALT)

Abaxis, Inc

Abaxis, Inc.

Abaxis, Inc Alere, Inc Arkray, Inc. / Polymedco, Inc Cholestech Corporation

84460QW

84460QW

84460QW 84466QW 84460QW 84460QW

Alkaline Phosphatase (ALP)

Abaxis Piccolo Blood Chem Analyzer WB (CMP, Chem 13) Abaxis Piccolo Point of Care Chemistry Analyzer (Liver Panel Plus Reagent Disc) (WB) Abaxis Piccolo xpress Chem Analyzer WB (CMP, Chem 13, Liver Panel Plus) Akray SPOTCHEM EZ Chem Analyzer (WB)

Abaxis, Inc Abaxis, Inc.

Abaxis, Inc Polymedco, Inc

84075QW 84075QW

84075QW 84075QW

Amylase

Abaxis Piccolo Blood Chem Analyzer WB (Chem 13) Abaxis Piccolo express Chemistry Analyzer WB (Liver Panel Plus, Chem 13) Abaxis Piccolo Point of Care Chemistry Analyzer (Liver Panel Plus Reagent Disc)(WB)

Abaxis, Inc Abaxis, Inc

Abaxis, Inc.

82150QW 82150QW

82150QW

DOH 681-018 May 2020

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Test Name/Specific Test System

Manufacturer

Aspartate Aminotransferase (AST)

Abaxis Piccolo Blood Chem Analyzer WB (Chem 6, Chem 13, CMP) Abaxis Piccolo Point Of Care Chemistry Analyzer (Liver Panel Reagent Disc) AST (WB) Abaxis Piccolo xpress Chem Analyzer WB(Chem 6, Chem 13, CMP, Liver Panel Plus, Lipid Panel Plus) Arkray SPOTCHEM EZ Chem Analyzer (WB) Cholestech LDX Aspartate Aminotransferase

Abaxis, Inc

Abaxis, Inc.

Abaxis, Inc Arkray, Inc. / Polymedco, Inc Cholestech Corporation

B-Type Natriuretic Peptide (BNP)

Biosite Triage Meter (WB) (BNP) Biosite Triage Meter Plus (WB)(BNP) Biosite Triage Meterpro (WB)(BNP)

Biosite Incorporated Biosite Incorporated Biosite Incorporated

Basic Metabolic Panel (Calcium, Ionized)

Abbott i-STAT CHEM8+ Cartridge WB

I-STAT Corporation

Basic Metabolic Panel (Calcium, Total)

Abaxis Piccolo Blood Chemistry Analyzer WB (Basic Metabolic Reagent Disc) Abaxis Piccolo xpress Chemistry Analyzer WB (Basic Metabolic Reagent Disc)

Abaxis, Inc Abaxis, Inc

Bilirubin, Total

Abaxis Piccolo Blood Chem Analyzer WB (Chem 13, CMP)

Abaxis, Inc

Abaxis Piccolo Point of Care Chemistry Analyzer (Liver Panel Plus Reagent Disc)(WB) Abaxis Piccolo xpress Chem Analyzer WB(Chem 13, CMP, Liver Panel Plus)

Abaxis, Inc. Abaxis, Inc

Akray SPOTCHEM EZ Chem Analyzer (WB)

Polymedco, Inc

Bladder Tumor Associated Antigen

Alere NMP22 BladderChek Test BTA stat Test (for home use) LifeScan Status BTA Maritech BladderCheck

Alere Bion Diagnostic Sciences Polymedco, Inc Maritech, Inc.

BUN (Blood Urea Nitrogen)

Abaxis Piccolo Blood Chemistry Analyzer (Chem 6 and 13 Panels, CMP, BMP, Metlyte 8, Renal)

Abaxis, Inc.

Abaxis Piccolo xpress Chemistry Analyzer WB (Chem 6, 13, Kidney Panels, CMP, BMP, Metlyte 8, Renal)

Abaxis, Inc.

Abbott i-STAT 6+ Cartridge (WB)

i-STAT Corporation

Abbott i-STAT CHEM8+ Cartridge (WB)

i-STAT Corporation

Arkray SPOTCHEM EZ Chem Analyzer (WB)

Arkray, Inc.

Calcium

Abaxis Piccolo Blood Chemistry Analyzer WB (Chem 13 Panel, CMP, BMP, Renal) Abaxis Piccolo xpress Chemistry Analyzer WB (Chem 13 Panel, CMP, BMP, Renal)

Abaxis, Inc. Abaxis, Inc.

Arkray SPOTCHEM EZ Chem Analyzer (WB)

Polymedco, Inc

Calcium ? Ionized

Abbott i-STAT CHEM8+ Cartridge (WB)

i-STAT Corporation

Approved CPT

Code(s)

84450QW 84450QW 84450QW 84450QW 84450QW

83880QW 83880QW 83880QW

80047QW

80048QW 80048QW

82247QW 82247QW 82247QW 82247QW

86386QW 86294QW 86294QW 86386QW

84520QW 84520QW 84520QW 84520QW 84520QW

82310QW 82310QW 82310QW

82330QW

DOH 681-018 May 2020

Page 2 of 61

Test Name/Specific Test System

Manufacturer

Carbon Dioxide (CO2)

Abaxis Piccolo Blood Chemistry Analyzer (CMP, BMP, Electrolyte Discs, Metlyte 8, Renal) Abaxis Piccolo xpress Chemistry Analyzer (CMP, BMP, Electrolyte Discs, Metlyte 8, Renal) Abbott i-STAT CHEM8+ Cartridge (WB)

Abaxis, Inc

Abaxis, Inc i-STAT Corporation

Catalase

Accutest Uriscreen Rapid UTI Screen

Savyon Diagnostics

Uriscreen (for OTC use), urine

Diatech Diagnostics

Chloride

Abaxis Piccolo Blood Chemistry Analyzer (CMP, BMP, Electrolyte, Metlyte 8, Renal) Abaxis Piccolo xpress Chemistry Analyzer (CMP, BMP, Electrolyte, Metlyte 8, Renal)

Abaxis, Inc Abaxis, Inc

Abbott i-STAT 6+ Cartridge (WB)

i-STAT Corporation

Abbott i-STAT CHEM8+ Cartridge (WB)

i-STAT Corporation

Cholesterol

Abaxis Piccolo xpress Chemistry Analyzer {capillary-finger stick} (Cholesterol) Abaxis Piccolo xpress Chemistry Analyzer WB (Lipid Panel, Lipid Panel Plus) Abaxis Piccolo Point of Care Chemistry Analyzer WB (Lipid Panel, Lipid Panel Plus)

Accu-Check InstantPlus Cholesterol Test System

Abaxis, Inc Abaxis, Inc Abaxis, Inc Roche/Boehringer Mannheim

Accucheck Instant Plus Dual Testing System

Roche Diagnostics

ACON Laboratories Inc., Mission Cholesterol Pro Monitoring System

ACON Laboratories, Inc.

Advanced Care Cholesterol Measuring System

Johnson & Johnson

Alere Cholestech LDX (cholesterol)(WB)

Alere, Inc

Alere San Diego, Inc., Cholestech LDX {WB}

Abbott

Arkray SPOTCHEM EZ Chem Analyzer (WB)

Polymedco, Inc

Biomedix Inc Q Steps Biometer G/C Dual Monitoring System

Biomedix, Inc.

ChemTrak AccuMeter Cholesterol Test System

ChemTrak

Cholestech LDX (Must have software version 1.40 or above)

Cholestech

ENA.C.T. Total Cholesterol & PDU

ActiMed Laboratories, Inc

Germaine Laboratories Inc. AimStrip Tandem Lipid Profile and Glucose Measuring System

OSANG Healthcare Co., Ltd.

Infopia USA LipidPro

Infopia Co Ltd

Infopia USA LipidPro Professional Lipid Profile and Glucose Measuring System Jant Pharmacal LipidPlus Lipid Profile and Glucose Measuring System KPI Healthcare Co., Ltd. CURO L5 Lipid Profile and Glucose Measuring System/Test Strips

Infopia Co Ltd Infopia Co, Ltd OSANG Healthcare Co., Ltd.

Lifestream Plus Cholesterol Monitor

Lifestream Technologies

Lifestream Technologies Cholesterol Monitor

Lifestream Technologies

Approved CPT

Code(s)

82374QW

82374QW 82374QW

81007QW 81007QW

82435QW

82435QW 82435QW 82435QW

82465QW

82465QW

82465QW 82465QW 82465QW 82465QW 82465QW 82465QW 82465QW 82465QW 82465QW 82465QW 82465QW 82465QW 82465QW 82465QW 82465QW

82465QW

82465QW 82465QW 82465QW

DOH 681-018 May 2020

Page 3 of 61

Test Name/Specific Test System

Manufacturer

Lifestream Technologies Personal Cholesterol Monitor for cholesterol

Lifestream Technologies, Inc.

Mission Cholesterol Monitoring System

Monitoring System

and

Mission Cholesterol

Pro

ACON Laboratories, INC

Polymer Technology Systems Bioscanner, Bioscanner Plus, and Polymer Technology Systems,

Bioscanner 2000 PTS

Inc

Polymer Technology Systems MTM BioScanner 1000

Polymer Technology Systems, Inc

Polymer Technology Systems Cardiochek Plus, Cardiochek Home

Use, Home Test System, and Cardiochek PA Analyzer test strips. CardioChek Home Chol+HDL+Glu Test strips

-PTS Panels Lipid Panel test strips

Polymer Technology Systems, Inc

Approved CPT

Code(s)

82465QW 82465QW 82465QW 82465QW

82465QW

82947QW

-CardioChek Home Lipid Panel test strips

82947QW

Roche Diagnostics Accutrend Plus System WB

Roche Diagnostics

82465QW

SD Biosensor USA, Inc., SD LipidoCare (BT) Home Lipid Panel Test Strip) SD Biosensor USA, Inc., SD LipidoCare (BT) Professional System (SD LipidoCare Professional Lipid Panel Test Strip)

Wako APOLOWAKO Analyzer

SD BIOSENSOR SD BIOSENSOR Wako Chemicals USA

Pending Pending 82465QW

Complete Blood Count

XW-100 Automated Hematology Analyzer for CLIA Waived Use (Hematocrit, Hemoglobin, Platelet Count, Red blood cell (RBC) count, White blood cell (WBC) count, White blood cell differential)

Sysmex America, Inc

Pending

Comprehensive Metabolic Panel

Abaxis Piccolo Blood Chemistry Analyzer WB (Comprehensive Metabolic Reagent Disc) Abaxis Piccolo xpress Chemistry Analyzer WB (Comprehensive Metabolic Reagent Disc)

Abaxis, Inc Abaxis, Inc

80053QW 80053QW

Creatine Kinase (CK)

Abaxis Piccolo Blood Chemistry Analyzer WB (Metlyte 8 Disc) Abaxis Piccolo xpress Chemistry Analyzer WB (Metlyte 8 Disc)

Abaxis, Inc Abaxis, Inc

82550QW 82550QW

Creatinine

Abaxis Piccolo Blood Chem Analyzer WB (Chem 6 and 13 Panels, CMP, BMP, Metlyte 8, Renal)

Abaxis, Inc.

Abaxis Piccolo xpress Chem Analyzer WB (Chem 6, 13, Kidney Panels, CMP, BMP, Metlyte 8, Renal)

Abaxis, Inc.

Abbott i-STAT Crea Cartridge (WB)

i-STAT Corporation

Abbott i-STAT CHEM8+ Cartridge (WB)

i-STAT Corporation

Akray SPOTCHEM EX Chem Analyzer (WB)

Polymedco, Inc

Siemens Clinitek 50 Urine Chemistry Analyzer (see also under Urinalysis)

Bayer

Siemens MICROABLUSTIX Reagent Strips

Bayer

Siemens MultiStix PRO 10LS, PRO 11 and PRO 7G Reagent Strips (urine dipstick and urine creatinine nonautomated)

Bayer

82565QW

82565QW 82565QW 82565QW 82565QW 82570QW 82570QW 82570QW

Drugs of Abuse (Use G0477QW for visually read devices or G0478QW for instrument read devices)

1 Step Detect Associates DTX Drug Test Cup Integrated E-Z Split

Key Cup II(amphetamines, cocaine metabolites, MDMA,

Biosite Inc

methamphetamines, opiates, PCP, THC)

80305QW

DOH 681-018 May 2020

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Test Name/Specific Test System

Manufacturer

12 Panel Now (DBA) Hospital Connect Inc, 12 Panel Dip/Cup Tests

(amphetamines, barbiturates, buprenorphine, benzodiazepines, cocaine metabolites, EDDP, MDMA, methamphetamines, morphine, methadone, oxycodone, PCP, propoxyphene, tricyclic

Assure Tech (Hangzhou) Co., Ltd.

antidepressants, THC)

Abbott Diagnostics Signify ER Drug Screen Test(amphetamines,

barbiturates, benzodiazepines,cocaine metabolites, MDMA, opiates, Innovacon, Inc

oxycodone, PCP, propoxyphene, THC, tricyclic antidepressants)

Acon iCassette Multi-Drug, Multi-Line Screen Test Device

(amphetamines, cocaine metabolites, methamphetamines, opiates , Acon Laboratories, Inc. PCP, THC)

Acon Multi-Drug, Multi-Line Screen Test Card with Integrated Cup

{professional use}(amphetamines, cocaine metabolites, MDMA Acon Laboratories, Inc.

methamphetamines, opiates, PCP, THC)

Acon On Call Multi Drug Home Test/Test Cup(amphetamines, cocaine metabolites, methamphetamines, opiates, PCP,THC)

Acon Laboratories, Inc.

Acon One Step Multi-Drug, Multi-Line Screen Test Device

P{professional use}(amphetamines, cocaine metabolites,

Acon Laboratories, Inc.

methamphetamines, opiates, PCP, THC)

Acon Redi-Test Cassette Multi-Drug, Multi-Line Screen Test Device

(amphetamines, cocaine metabolites, methamphetamines, opiates, Acon Laboratories, Inc.

PCP, THC)

Accu-Stat Drugs of abuse Home Test amphetamines, cocaine metabolites, methamphetamines, opiates, PCP,THC)

Accu-Stat Diagnostics, Inc.

Accu-Stat Home Drug Test

-Cocaine

-Marijuana -Marijuana and Cocaine -Marijuana, cocaine, amphetamine,

Accu-Stat Diagnostics, Inc.

-Methamphetamine, opiates, PCP

-Marijuana, cocaine, amphetamine,

-Methamphetamine, opiates, ecstasy, PCP

ACCU News Drug Screening Test Card/Urine Cup (Amphetamines, Methamphetamines, Opiates, Cocaine Metabolites, Cannabinoids)

Coretests, Inc

ADC Multiple Drug Test Card (opiates, methamphetamines, cocaine metabolites, THC, PCP)

Advantage Diagnostics Corp

Accutest Multi-Drug, Multi Line Screen Test Device (amphetamines, THC, cocaine metabolites, methamphetamines. Opiates, (PCP)

Acon

Laboratories, Inc.

Advin Multi-Drug Screen Test (amphetamines, barbiturates,

buprenorphine, benzodiazepines, cocaine, metabolites, EDDP, methamphetamines, morphine, methadone, opiates, oxycodone,

Advin Biotech

PCP, tricyclic antidepressants, THC, MDMA)

Aeon Multi-Drug Urine Test Cup and DipCard (amphetamines, barbituates, benzodiapzepines, buprenorphine, THC, cocaine metabolites, methadone, MDMA, methamphetamines, morphine,

Healgen Scientific Limited

oxycodone, PCP, tricyclic antidepressants, EDDP)

AimScreen Multi-Drug Urine Dip Card, Dip Device CLIA Waived

and Test Cup (Amphetamines, Benzodiazepines, Cocaine metaboities, Cannabinoids, Methamphetamines, Oxycodone,

Healgen Scientific Limitied

Morphine, Barbituates, Buprenorphine, MDMA, PCP, Methadone)

Alatex Scientific Peace of Mind Marijuana Home Drug Test

Advantage Diagnostics Corp

Approved CPT

Code(s)

80305QW

80305QW 80305QW 80305QW 80305QW 80305QW 80305QW 80305QW

80305QW

80305QW 80305QW 80305QW 80305QW

80305QW

80305QW 80305QW

DOH 681-018 May 2020

Page 5 of 61

Test Name/Specific Test System

Manufacturer

Alere Toxicology Service Alere iCup DxPro2 Multi-Drug Test Cup

(Amphetamines, Barbiturates, Benzodiazepines, Benzodiazepines, Cocaine metabolities, Cannabinoids (THC), Methamphtamines, MDMA, Morphine, PCP, Oxycodone, Buprenorphine, Methadone,

Guanhzhou Wondfo Biotech., LTD.

Tricyclic antidepressants)

Marijuana & Cocaine Home Drug Test (OTC)

Alatex Scientific

Multiple Drugs of Abuse Test

Advantage Diagnostics Corp

Alere iCassette Drug Screen (amphetamines, cocaine metabolites, Methamphetamines, Opiates, PCP, THC)

Biosite Inc

Alere Toxicology Services Alere iCassette Dx Drug Screen

(barbiturates, amphetamines, benzodiazepines, cocaine metabolites, morphine, oxycodone, propoxyphene, PCP, tricyclic

Alere

antidepressants, THC, MDMA)

Alere iCUP DX Drug Screen Cup (barbiturates, amphetamines,

benzodiazepines, cocaine metabolites methadone, methamphetamines, MDMA, opiates, oxycodone, PCP, tricyclic

Alere

antidepressants, THC)

Alere iCUP Dx Pro Urine Drug Screening Device (amphetamines,

barbiturates, , benzodiazepines, cocaine metabolites methadone, methamphetamines, MDMA, opiates, oxycodone, PCP, tricyclic

Amedica Biotech, Inc

antidepressants, THC)

Alere iCup DX-14 Drug Screen Cassette Dip Card (amphetamines,

barbiturates, benzodiazepines, buprenorphine, cocaine metabolites methadone, methamphetamines, MDMA, morphine, oxycodone,

Branan Medical Corp

propoxyphene, PCP, tricyclic antidepressants, THC)

Alere iScreen DX Multi-Drug of Abuse Dip Test (barbiturates,

amphetamines, benzodiazepines, buprenorphine, cocaine metabolites, methadone, methamphetamines, MDMA, opiates,

Branan Medical Corp

oxycodone, PCP, tricyclic antidepressants, THC)

Alere iScreen DX Single Dip Card (barbiturates, amphetamines,

benzodiazepines, buprenorphine, cocaine metabolites, methadone, methamphetamines, MDMA, opiates, PCP, tricyclic

Branan Medical Corp

antidepressants, THC)

Alere iCup Rx Mutli-Drug Urine Test Cup (Amphetamines,

Barbiturates, Benzodiazepines, Buprenorphine, Cocaine

Guangzhou Wondfo Biotech

metabolities, MDMA, Methadone, Methamphetamines, Morphine, Co., LtD.

Oxycodone, PCP, THC, Tricyclic anitdepressants)

Alere Toxicology Services, Alere T-Cup Compact Multi-Drug Urine Guangzhou Wondfo Biotech

Test Cup (EDDP, Propoxyphene)

Co., Ltd.

Alere Toxicology Services, Alere T-Cup Compact Multi-Drug Urine

Test Cup (Amphetamines, Cocaine metabolities, Methamphetamines, THC, MDMA, Morphine, PCP, Oxycodone, Buprenorphine, Methadone, Barbiturates, Benzodiazepines,

Guangzhou Wondfo Biotech Co., Ltd

Tricyclic anitdepressants)

Alere Toxicology Services Drugs of Abuse Cup (amphetamines,

cocaine metabolites, THC, methamphetamines, MDM A, opiates, Alere San Diego, Inc

PCP)

Alere Toxicology Services, UScreen Drug Test Cup

(amphetamines, barbiturates, benzodiazepines, buprenorphine,

THC, cocaine metabolites, EDDP, methadone, methamphetamines, Wondfo Biotech Co., Ltd.

MDMA, morphine, opiates, oxycodone, PCP, propoxyphene,

tricyclic antidepressants)

Approved CPT

Code(s)

80305QW 80305QW 80305QW 80305QW 80305QW

80305QW

80305QW

80305QW

80305QW

80305QW

80305QW 80305QW 80305QW

80305QW

80305QW

DOH 681-018 May 2020

Page 6 of 61

Test Name/Specific Test System

Manufacturer

Alere Tox Screen Drugs of Abuse Test Cup(amphetamines,

cannabinoids, cocaine metabolites, methamphetamines, opiates, Alere, Inc

PCP, MDMA)

Alfa Scientific Designs, Inc Confidential Drug Test-Multi Drugs of

Abuse Urine (amphetamines, cocaine metabolites, morphine, THC, Alfa Scientific Designs, Inc

MDMA)

Alfa Scientific Designs, Inc Instant View Multi Drug of Abuse Urine

Test (barbiturates, amphetamines, benzodiazepines, cocaine metabolites, methamphetamines, morphine, methadone, PCP,

Alfa Scientific Designs, Inc

tricyclic antidepressants, THC, MDMA)

Alfa Scientific Designs, Inc Instant View Multi Drug of Abuse Urine

Cup Test (barbiturates, amphetamines, benzodiazepines, cocaine metabolites, morphine, methadone, PCP, tricyclic antidepressants,

Alfa Scientific Designs, Inc

THC, MDMA)

Alfa Scientific Designs, Inc Instant Verdict Multi Drug of Abuse

Urine Test (barbiturates, amphetamines, benzodiazepines, cocaine metabolites, methamphetamines, morphine, methadone, PCP,

Alfa Scientific Designs, Inc

tricyclic antidepressants, THC, MDMA)

Alfa Scientific Designs, Inc Instant Verdict Multi Drug of Abuse

Urine Cup Test (barbiturates, amphetamines, benzodiazepines, cocaine metabolites, methamphetamines, morphine, methadone,

Alfa Scientific Designs, Inc

PCP, tricyclic antidepressants, THC, MDMA)

Alfa Scientific Designs, Inc. Instant-View Drug of Abuse Urine Cup Test (morphine, Oxycodone)

Alfa Scientific Designs, Inc

Alfa Scientific Designs, Inc. Instant-View Multi Drug of Abuse Urine

Test Cup(amphetamines, barbiturates, benzodiazepines, cocaine metabolites, MDMA, methamphetamines, methadone, morphine,

Alfa Scientific Designs, Inc

opiates, PCP, tricyclic antidepressants, THC)

Alfa Scientific Designs, Inc. Instant-View Multi Drug of Abuse Urine

Test Panel(amphetamines, barbiturates, benzodiazepines, cocaine metabolites, MDMA, methamphetamines, methadone, morphine,

Alfa Scientific Designs, Inc

opiates, PCP, tricyclic antidepressants, THC)

Alfa Scientific Designs, Inc., INSTANT-VIEW plus Multi-Drug of

Abuse Urine Test ? Simple Cup (OTC Use) (amphetamines,

barbiturates, benzodiazepines, THC, cocaine metabolites,

Alfa Scientific Designs, Inc

methadone, methamphetamines, MDMA, morphine, PCP, tricyclic

antidepressants, buprenorphine, oxycodone)

Alfa Scientific Designs Instant-View Drug of Abuse Urine Cassette Test (morphine, Oxycodone)

Alfa Scientific Designs, Inc

Alfa Scientific Designs, Inc Multi Drug of Abuse Urine Test

(barbiturates, amphetamines, benzodiazepines, cocaine metabolites, methamphetamines, morphine, methadone, PCP,

Alfa Scientific Designs, Inc

tricyclic antidepressants, THC, MDMA)

Alfa Scientific Designs, Inc Multi Drug of Abuse Urine Cup Test

(barbiturates, amphetamines, benzodiazepines, cocaine metabolites, methamphetamines, morphine, methadone, PCP,

Alfa Scientific Designs, Inc

tricyclic antidepressants, THC, MDM)

AM Diagnostic, LLC, Helse Multiple Drug Cup Test (amphetamines,

barbiturates, benzodiazepines, THC, cocaine metabolites,

Tianjin New Bay Bioresearch

methadone, methamphetamines, morphine, oxycodone, PCP,

Co., Ltd.

tricyclic antidepressants)

Approved CPT

Code(s)

80305QW 80305QW 80305QW

80305QW

80305QW

80305QW 80305QW 80305QW

80305QW

80305QW 80305QW 80305QW

80305QW

80305QW

DOH 681-018 May 2020

Page 7 of 61

Approved

Test Name/Specific Test System

Manufacturer

CPT

Code(s)

Amedica Biotech Amedica Drug Test Cup (barbiturates,

amphetamines, benzodiazepines, cocaine metabolites, methamphetamines, methadone, opiates, oxycodone, PCP, tricyclic

Amedica Biotech Inc.

80305QW

antidepressants, THC, MDMA)

Amedica Biotech The Amedica Home Drug Test Cup (barbiturates,

amphetamines, benzodiazepines, cocaine metabolites, methamphetamines, methadone, opiates, oxycodone, PCP, tricyclic

Amedica Biotech Inc.

80305QW

antidepressants, THC, MDMA)

Amedica Biotech AmediCheck Instant Test Cup: (amphetamines,

barbiturates, benzodiazepines, cocaine metabolites, MDMA, methamphetamines, methadone, opiates, oxycodone, PCP, tricyclic

Amedica Biotech Inc.

80305QW

antidepressants, THC)

Amedica Biotech Instant Test Cup (amphetamines, barbiturates,

benzodiazepines, cocaine metabolites, MDMA, methamphetamines, methadone, opiates, oxycodone, PCP, tricyclic

Amedica Biotech Inc.

80305QW

antidepressants, THC)

Ameditech Inc ImmuTest Drug Screen Cup (amphetamines,

barbiturates, benzodiazepines, THC, cocaine metabolites, methadone, MDMA, methamphetamines, opiates, oxycodone,

PCP,

Biosite Inc

80305QW

tricyclic antidepressants)

American Bio Medica Rapid TOX (barbiturates, amphetamines,

benzodiazepines, buprenorphine, cocaine metabolites, methamphetamines, methadone, opiates, oxycodone, PCP,

American Bio Medica Corp

80305QW

propoxyphene, tricyclic antidepressants, THC, MDMA)

American Bio Medica Rapid Tox Cup II (barbiturates,

amphetamines, benzodiazepines, buprenorphine, cocaine metabolites, methamphetamines, methadone, opiates, oxycodone,

American Bio Medica Corp.

80305QW

PCP, tricyclic antidepressants, THC, MDMA)

American Institute of Toxicology, Inc., AIT Laboratories Drug of

Abuse Card (amphetamines, barbiturates, benzodiazepines, cocaine metabolites, THC, methamphetamines MDMA, morphine,

Guangzhou Wondfo Biotech Co 80305QW

methadone, PCP, tricyclic antidepressants, oxycodone)

American Institute of Toxicology, Inc., AIT Laboratories Drug of

Abuse Cup (amphetamines, barbiturates, benzodiazepines, cocaine metabolites, THC, methamphetamines MDMA, morphine,

Guangzhou Wondfo Biotech Co 80305QW

methadone, PCP, tricyclic antidepressants, oxycodone)

American Institute of Toxicology, Inc., AIT Laboratories Drug of

Abuse Card (amphetamines, barbiturates, benzodiazepines, cocaine metabolites, THC, methamphetamines, MDMA, morphine,

Guangzhou Wondfo Biotech Co 80305QW

opiates, PCP, oxycodone, buprenorphine)

American Screening Corp Discover Drug Test Cups/Cards

(amphetamines, barbiturates, benzodiazepines, buprenorphine,

EDDP, THC, cocaine metabolites, methadone, MDMA,

UCP Biosciences, Inc

80305QW

methamphetamines, morphine, opiates, oxycodone, PCP,

propoxyphene, tricyclic antidepressants)

American Screening Corporation, Inc. Precision DX Panel Dip

M300/Dip M2000/Quick Cup M300/Quick Cup M2000

(amphetamines, benzodiazepines, cocaine metabolites, THC, methamphetamines, morphine, oxycodone, barbiturates,

Assure Tech (Hangzhou) Co., Ltd.

80305QW

buprenorphine, MDMA, PCP, EDDP, tricyclic antidepressants,

propoxyphene, methadone)

DOH 681-018 May 2020

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