In pain management, the toxicology report is part of the medical record that supports every controlled-substance prescription you write. The lab behind that report matters. Here are the questions worth asking before you choose one, and how Total Lab Solutions answers them.
Does the lab confirm, or only screen?
A presumptive screen tells you a drug class is probably present. It cannot tell you which drug, and it can cross-react with other substances. Definitive testing identifies the specific drug and its metabolites and reports concentrations.
Ask how confirmation is performed. At TLS, definitive testing is done by LC/MS, and you can order a screen with reflex to confirmation or individual confirmations.
Does the menu match what you prescribe and what is in your community?
A panel built years ago will miss what patients are exposed to now. Check that the lab tests for:
- The medications you prescribe, including gabapentin, pregabalin, and muscle relaxants
- Fentanyl and its analogs
- Newer substances such as xylazine and kratom
- Alcohol metabolites (EtG and EtS)
Our urine requisition covers opiates and opioids, benzodiazepines, stimulants, barbiturates, muscle relaxants, sedatives, antidepressants, antipsychotics, ketamine, THC, nicotine, and illicit drugs including synthetic cannabinoids. See the full list on our toxicology testing page.
Is specimen validity checked?
A diluted or substituted specimen makes the rest of the report meaningless. TLS runs pH, specific gravity, and creatinine on every specimen.
Can you order by patient, not by habit?
Payers expect each order to reflect medical necessity for that patient. A lab that only offers one large fixed panel puts your practice at risk. Look for custom profiles by practice and by provider, with the ability to add or remove individual tests on the requisition.
Urine, oral fluid, or both?
Oral fluid collection is observed and harder to tamper with. Urine has a longer detection window for many drugs. A lab that offers both lets you choose by patient. TLS accepts both.
How fast, and how are results delivered?
Results that arrive after the next appointment do not help. Ask for the turnaround counted from when the lab receives the specimen. Ours is 1 to 2 days.
Also ask how results reach you. TLS reports through a provider portal and interfaces with EHRs including athenahealth, Aprima, Allscripts, and eClinicalWorks.
Can you talk to someone about a result?
An unexpected finding sometimes needs a conversation. Reports from TLS show expected and unexpected findings against the patient’s prescribed medications, and our laboratory director is available by phone for consults.
Is the lab accredited?
CLIA certification is the legal minimum. CAP accreditation is a higher, voluntary standard. TLS holds both.
Supplies can be at your office within one business day. To start toxicology testing with TLS, call (248) 800-6626 or open a provider account.
