Urine Drug Testing Checklist
- Please clearly fill out patient information on the requisition form
- Please provide full insurance information (copy of the insurance card is best)
- Please fill in the temperature, time and date the specimen was collected, and initial
- Please check off prescribed medications the patient is currently taking
- Please check off any preliminary positive or negative POC results (located on the right hand side of the requisition form)
- Please provide the appropriate ICD-10 diagnosis code
- Z79.891 Long term (current) use of opiates
- Z79.899 Other long Term (current) drug therapy
- Please have patient and physician sign the form
- Please place specimen cup in the specimen bag with the white copy of the requisition form and insurance information in the outside slot (keep a copy of the form for your records)
- Please call our office at (201) 884-9160 for pickup before 5pm
- For UPS pickup please call 1-800-742-5877
- For FedEx pickup please call 1-800-463-3339
