Acute Viral Hepatitis Diagnostic with Reflexes (HAV, HBV, HCV)

Test Code

10306

CPT Codes
80074

Includes

Hepatitis A IgM Antibody
Hepatitis B Surface Antigen with Reflex to Confirmation
Hepatitis B Core Antibody (IgM)
Hepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR

If Hepatitis B Surface Antigen is Positive, then confirmatory testing based on the manufacturer's FDA approved recommendations will be performed at an additional charge (CPT code(s): 87341).
If Hepatitis C Antibody is Reactive or Borderline, then Hepatitis C Viral RNA, Quantitative, Real-Time PCR will be performed at an additional charge (CPT code(s): 87522).

Preferred Specimen

5 mL serum

Minimum Volume

2.5 mL

Other Acceptable Specimens

Plasma collected in: EDTA (lavender-top) tube

Instructions

Dietary supplements containing biotin may interfere in assays and may skew analyte results to be either falsely high or falsely low. For patients receiving the recommended daily doses of biotin, draw samples at least 8 hours following the last biotin supplementation. For patients on mega-doses of biotin supplements, draw samples at least 72 hours following the last biotin supplementation.

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Room temperature: 72 hours
Refrigerated: 14 days
Frozen: 21 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Gross hemolysis • Grossly lipemic

Methodology
Immunoassay (IA)

Setup Schedule

Set up: Mon-Sat; Report available: 1-3 days

Limitations

Results obtained from immunosuppressed patients should be interpreted with caution. Patients receiving mouse antibody therapy may produce false-negative results. False-positives may be detected shortly after immunization to influenza and with patients with hypergammaglobulinemia, positive rheumatoid factor, and connective tissue disorders.

Reference Range

See individual tests

Clinical Significance

This panel is preferred to evaluate symptomatic patients for viral hepatitis and includes testing for hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV); the 3 most common pathogens of viral hepatitis in the United States [1].

Acute symptoms and signs are similar among HAV, HBV, and HCV infection and may include fever, fatigue, loss of appetite, nausea, abdominal discomfort, dark urine, pale stools, and jaundice [1]. This panel includes 4 tests with reflexes that may help establish diagnosis of these 3 viral hepatitis infections in symptomatic patients: HAV IgM antibody; Hepatitis B Surface Antigen (HBsAg) with reflex confirmation; Hepatitis B Core, IgM; Hepatitis C Virus antibody with reflex to HCV RNA.

If acute HCV infection is suspected, the recommended test is Hepatitis C Antibody with reflex to HCV, RNA, Quantitative, Real-Time PCR. If acute HBV infection is suspected, the recommended test is Hepatitis B Surface Antigen (HBsAg) with Reflex Confirmation. This panel is not intended for asymptomatic screening for viral hepatitis. The results of the test in the panel should be interpreted in the context of pertinent clinical history and examination findings.

References
1. Viral Hepatitis Surveillance - United States, 2019. Centers for Disease Control and Prevention. Accessed January 16, 2021. https://www.cdc.gov/hepatitis/statistics/2019surveillance/pdfs/2019HepSurveillanceRpt.pdf

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.