| A B C D E F G H I J K L M N O P Q R S T U V W X Y Z # |
OBSTETRIC PANEL WITH HIV
Test CodeLAB279
Quest Code
12075
CPT Codes
80081, 86803
Includes
CBC (includes Differential and Platelets)
Antibody Screen, RBC with Reflex to Identification, Titer, and Antigen Typing
ABO Group and Rh Type
RPR (Diagnosis) with Reflex to Titer and Treponema pallidum Antibody, IA
Hepatitis B Surface Antigen with Reflex Confirmation
Rubella Antibody (IgG), Immune Status
HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexes
Hepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR
If Antibody Screen is positive, then Antibody Identification, Titer, and Antigen Typing will be performed at an additional charge (CPT code(s): 86870, 86886, 86905). Based on reactions presenting from Antibody Identification, then Direct Antiglobulin Test (DAT) with Reflex to Anti C3 and Anti IgG may be performed at an additional charge (CPT code(s): 86880). If Direct Antiglobulin Test (DAT) is positive, then Anti-C3 and Anti-IgG may be performed at an additional change (CPT code(s): 86880 x2).
If RPR screen is Reactive, then RPR Titer and Chemiluminescence - Treponemal Antibody Immunoassay for Confirmatory testing will be performed at an additional charge (CPT Code(s): 86593, 86780).
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 HIV Antigen and Antibody, 4th Generation Screen is Repeatedly Reactive, then HIV-1/2 Antibody Differentiation will be performed at an additional charge (CPT code(s): 86701, 86702).
If HIV-1/2 Antibody Differentiation is Indeterminate or Negative, then HIV-1 and HIV-2 RNA, Qualitative Real-Time PCR will be performed at an additional charge (CPT code(s): 87535, 87538).
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).
Antibody Screen, RBC with Reflex to Identification, Titer, and Antigen Typing
ABO Group and Rh Type
RPR (Diagnosis) with Reflex to Titer and Treponema pallidum Antibody, IA
Hepatitis B Surface Antigen with Reflex Confirmation
Rubella Antibody (IgG), Immune Status
HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexes
Hepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR
If Antibody Screen is positive, then Antibody Identification, Titer, and Antigen Typing will be performed at an additional charge (CPT code(s): 86870, 86886, 86905). Based on reactions presenting from Antibody Identification, then Direct Antiglobulin Test (DAT) with Reflex to Anti C3 and Anti IgG may be performed at an additional charge (CPT code(s): 86880). If Direct Antiglobulin Test (DAT) is positive, then Anti-C3 and Anti-IgG may be performed at an additional change (CPT code(s): 86880 x2).
If RPR screen is Reactive, then RPR Titer and Chemiluminescence - Treponemal Antibody Immunoassay for Confirmatory testing will be performed at an additional charge (CPT Code(s): 86593, 86780).
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 HIV Antigen and Antibody, 4th Generation Screen is Repeatedly Reactive, then HIV-1/2 Antibody Differentiation will be performed at an additional charge (CPT code(s): 86701, 86702).
If HIV-1/2 Antibody Differentiation is Indeterminate or Negative, then HIV-1 and HIV-2 RNA, Qualitative Real-Time PCR will be performed at an additional charge (CPT code(s): 87535, 87538).
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
Whole blood in a full EDTA (lavender-top) tube and
Whole blood in a full ACD (yellow-top) tube and
11 mL serum
Whole blood in a full ACD (yellow-top) tube and
11 mL serum
Minimum Volume
0.5 mL microtainer or 1 mL EDTA • 1 mL ACD • 8 mL serum
Instructions
EDTA (lavender-top): Maintain specimen at room temperature. Do not refrigerate. Collect EDTA (lavender-top) tube last. Traumatic draw can introduce thromboplastin and trap WBC and platelets. Refrigeration can precipitate fibrin and trap WBC and platelets.
HIV serum: Collect in a serum separator tube or red-top tube (no gel). The tube should be centrifuged after clotting. Spun serum separator tubes may be submitted at room temperature or refrigerated unopened without transfer to a plastic, screw-cap vial. Red-top tube (no gel) serum should be transferred to a plastic, screw-cap vial and submitted for testing.
Submitted tubes must be labeled with patient identifier and submitted only for HIV testing.
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 Container
EDTA (lavender-top) tube and
ACD (yellow-top) tube and
Transport tube
ACD (yellow-top) tube and
Transport tube
Transport Temperature
Room temperature
Specimen Stability
See individual tests
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
See individual tests
Methodology
See individual tests
Reference Range
See Laboratory Report
Clinical Significance
This panel includes tests used for routine prenatal care during early pregnancy, including HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexes and Hepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR, which have been recommended for all women during early pregnancy by the American College of Obstetricians and Gynecologists (ACOG) [1, 3]. Alternative Panels are: Obstetric Panel (test code 20210), Obstetric Panel with Fourth Generation HIV (test code 93802).
Additional tests typically done in early pregnancy (but not included in this panel) include urinalysis, tests for sexually transmitted infections and tuberculosis, and blood glucose testing for women at high risk for gestational diabetes.
The CBC with differential evaluates the levels and types of red blood cells, white blood cells, and platelets in the patient's blood. This information can help identify conditions such as anemia, low platelet count, and other blood cell disorders [1].
The blood type, including ABO and Rh status, as well as the antibody screen, will provide information about a woman's current and/or future risk for hemolytic disease of the fetus and newborn. These tests may also be useful to define any special transfusion requirements [1].
Syphilis, when transmitted from mother to fetus, may cause birth defects and neonatal death [2]. Syphilis testing is performed using a combination of assays. The RPR is performed initially. If the result is reactive, a titer and a confirmatory test (fluorescent treponemal antibody absorption assay; FTA-ABS) will be performed at additional cost.
Hepatitis B, a disease that affects the liver, can be passed from mother to fetus [1]. Hepatitis B screening is performed with the hepatitis B surface antigen test. If positive, additional confirmatory testing based on the test manufacturer's FDA-approved recommendations will be performed at additional cost.
Rubella, or German measles, can cause birth defects if transmitted from mother to baby during pregnancy. Testing of the mother's immune status against rubella will indicate if the mother and baby are protected from infection by the virus during this time. Vaccination for rubella during pregnancy is not recommended [1].
Hepatitis C (HCV) screening is recommended by the American College of Obstetricians and Gynecologists for all pregnant individuals during each pregnancy. HCV screening during the first prenatal blood assessment obtained in every pregnancy is recommended to identify pregnant individuals with HCV infection and infants who should receive testing at a pediatric visit [3]. For the pregnant person, diagnosing HCV infection in early pregnancy gives providers the opportunity to reduce the risk of HCV vertical transmission with preferential performance of amniocentesis over chorionic villus sampling when needed, and avoidance of prolonged rupture of membranes, episiotomy, and fetal scalp monitoring when possible. Furthermore, children born to mothers with diagnosed HCV infection can be tested as early as 2 months of age and monitored for treatment needs to prevent progression to cirrhosis. Finally, persons diagnosed with HCV during pregnancy can receive treatment for hepatitis C, postnatally, to prevent progression to cirrhosis, liver failure, and death as well as reduce the risk of HCV transmission. [4,5]
Note: Test results should be interpreted in the context of pertinent clinical and family history and physical examination findings.
References
1. American College of Obstetricians and Gynecologists. Updated July 2021. Accessed June 14, 2022. https://www.acog.org/Patients/FAQs/Routine-Tests-During-Pregnancy
2. Koumans EH, et al. Am J Obstet Gynecol. 2012;206:158.e1-158.e11.
3. Routine Hepatitis C Virus Screening in Pregnant Individuals Practice Advisory, May 2021 This Practice Advisory was developed by the American College of Obstetricians and Gynecologists (ACOG) in collaboration with Hughes BL, Jamieson DJ, Kaimal AJ, Caughey AB, Eke A, McReynolds M https://opqic.org/acog-practice-advisory-routine-hepatitis-c-virus-screening-in-pregnant-individuals/
4. Schillie SF, Canary L, Koneru A, et al. Hepatitis C virus in women of childbearing age, pregnant women, and children. Am J Prev Med 2018;55:633-41.
5. Andes A, Ellenberg k, Vakos A, Collins J and Fryer K. Hepatitis C Virus in Pregnancy: A Systematic Review of the Literature. Am J Perinatol. 2020 38(S 01):e1-e13. doi: 10.1055/s-0040-1709672.
Additional tests typically done in early pregnancy (but not included in this panel) include urinalysis, tests for sexually transmitted infections and tuberculosis, and blood glucose testing for women at high risk for gestational diabetes.
The CBC with differential evaluates the levels and types of red blood cells, white blood cells, and platelets in the patient's blood. This information can help identify conditions such as anemia, low platelet count, and other blood cell disorders [1].
The blood type, including ABO and Rh status, as well as the antibody screen, will provide information about a woman's current and/or future risk for hemolytic disease of the fetus and newborn. These tests may also be useful to define any special transfusion requirements [1].
Syphilis, when transmitted from mother to fetus, may cause birth defects and neonatal death [2]. Syphilis testing is performed using a combination of assays. The RPR is performed initially. If the result is reactive, a titer and a confirmatory test (fluorescent treponemal antibody absorption assay; FTA-ABS) will be performed at additional cost.
Hepatitis B, a disease that affects the liver, can be passed from mother to fetus [1]. Hepatitis B screening is performed with the hepatitis B surface antigen test. If positive, additional confirmatory testing based on the test manufacturer's FDA-approved recommendations will be performed at additional cost.
Rubella, or German measles, can cause birth defects if transmitted from mother to baby during pregnancy. Testing of the mother's immune status against rubella will indicate if the mother and baby are protected from infection by the virus during this time. Vaccination for rubella during pregnancy is not recommended [1].
Hepatitis C (HCV) screening is recommended by the American College of Obstetricians and Gynecologists for all pregnant individuals during each pregnancy. HCV screening during the first prenatal blood assessment obtained in every pregnancy is recommended to identify pregnant individuals with HCV infection and infants who should receive testing at a pediatric visit [3]. For the pregnant person, diagnosing HCV infection in early pregnancy gives providers the opportunity to reduce the risk of HCV vertical transmission with preferential performance of amniocentesis over chorionic villus sampling when needed, and avoidance of prolonged rupture of membranes, episiotomy, and fetal scalp monitoring when possible. Furthermore, children born to mothers with diagnosed HCV infection can be tested as early as 2 months of age and monitored for treatment needs to prevent progression to cirrhosis. Finally, persons diagnosed with HCV during pregnancy can receive treatment for hepatitis C, postnatally, to prevent progression to cirrhosis, liver failure, and death as well as reduce the risk of HCV transmission. [4,5]
Note: Test results should be interpreted in the context of pertinent clinical and family history and physical examination findings.
References
1. American College of Obstetricians and Gynecologists. Updated July 2021. Accessed June 14, 2022. https://www.acog.org/Patients/FAQs/Routine-Tests-During-Pregnancy
2. Koumans EH, et al. Am J Obstet Gynecol. 2012;206:158.e1-158.e11.
3. Routine Hepatitis C Virus Screening in Pregnant Individuals Practice Advisory, May 2021 This Practice Advisory was developed by the American College of Obstetricians and Gynecologists (ACOG) in collaboration with Hughes BL, Jamieson DJ, Kaimal AJ, Caughey AB, Eke A, McReynolds M https://opqic.org/acog-practice-advisory-routine-hepatitis-c-virus-screening-in-pregnant-individuals/
4. Schillie SF, Canary L, Koneru A, et al. Hepatitis C virus in women of childbearing age, pregnant women, and children. Am J Prev Med 2018;55:633-41.
5. Andes A, Ellenberg k, Vakos A, Collins J and Fryer K. Hepatitis C Virus in Pregnancy: A Systematic Review of the Literature. Am J Perinatol. 2020 38(S 01):e1-e13. doi: 10.1055/s-0040-1709672.
Performing Laboratory
| Quest Diagnostics-Lenexa |
| 10101 Renner Blvd |
| Lenexa, KS 66219-9752 |
Last Updated: April 4, 2023
