SurePath with HPV PCR reflex if ASCUS : 1005002

Test Code
SUREPHPVREF or 1005002

Alias/See Also
Sure Path

CPT Codes
88142

Includes
If SurePath Pap results are ASCUS or above, HPV by PCR will be performed at an additional charge (CPT code(s): 87624) .

Instructions
Materials needed:
SurePath Preservative fluid collection vial, Broom device OR Combination Plastic Spatula/Brush.

Collection:

Broom--Insert the central bristles into the endocervical canal until the shorter side bristles contact the ectocervical face. Rotate the broom in a clockwise direction only, one complete turn. Detach the broom portion of the collection device into the preservative collection vial.

OR

Plastic Spatula/Brush--Insert the contoured end of the plastic spatula into the cervical os and rotate one complete turn sampling the ectocervix. Detach the end of the spatula and place in the preservative collection vial. Next place the tip of the brush device into the endocervical canal and rotate one half turn in one direction. Detach the end of the brush device and place in the preservative collection vial with the spatula device.

Transport Container
After collection of the sample, secure the lid to the vial. Label the vial with the patient's name, date of birth and specimen source. Place in a plastic specimen bag along with a completed requisition for transport to the laboratory.

Transport Temperature
Ambient.

Specimen Stability
Ambient: 1 month; Refrigerated: Unacceptable; Frozen: Unacceptable

Methodology
SurePath; if reflex, Nucleic Acid Amplification Test (NAAT) based on Roche Cobas 4800 HPV Real-Time PCR

Setup Schedule
Pap: Monday - Friday

If reflex, HPV: Tuesday & Thursday & Saturday

Report Available
Pap:
Negative: 1-2 days
Abnormal: 3-5 days

If reflex, HPV: 1-4 days

Reference Range
Pap: An interpretive report will be provided.

If reflex, HPV: Target Not Detected (TND)

Performing Laboratory
PBM and med fusion



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.