Hepatitis Panel, General

Test Code

6462

CPT Codes
86704, 86706, 86708, 86803, 87340

Includes

Hepatitis A Antibody, Total
Hepatitis B Surface Antibody, Qualitative
Hepatitis B Surface Antigen with Reflex Confirmation
Hepatitis B Core Antibody, Total
Hepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR
.
Hepatitis B Surface Antigen with Reflex Confirmation: Positive samples will be confirmed based on the manufacturer's FDA approved recommendations 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

6 mL serum

Minimum Volume

3 mL

Other Acceptable Specimens

Plasma collected in: EDTA (lavender-top) tube

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Room temperature: 72 hours
Refrigerated: 14 days
Frozen: 30 days

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

Gross hemolysis • Grossly lipemic

Methodology
Immunoassay (IA)

Setup Schedule

See individual assays

Clinical Significance

This panel provides information on infection and the immune response to hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV), the 3 most common causes of viral hepatitis in the United States. In patients with unexplained elevated liver enzyme levels, this panel may be helpful in evaluating etiology for these viral hepatitides [1-4].

This panel includes 5 tests with reflexes: total HAV antibody, qualitative hepatitis B surface antibody (HBsAb), hepatitis B surface antigen (HBsAg) with reflex confirmation, total hepatitis B core antibody (HBcAb), and HCV antibody with reflex to HCV RNA quantitative real-time PCR. The section below outlines the roles of the analytes assessed with this panel.

Total HAV antibody: Presence of total HAV antibody is consistent with (1) immunity due to prior infection or vaccination; or (2) current HAV infection or recent HAV vaccination [2].

Qualitative HBsAb: Presence indicates resolution of HBV infection or prior vaccination. To determine immune status due to past HBV infection or vaccination (ie, HBsAb titer ≥10 mIU/mL), a quantitative HBsAb test must be ordered [3].

HBsAg with reflex confirmation: Presence indicates that a person has a current HBV infection and is infectious [3].

Total HBcAb: Presence indicates past or current HBV infection [3].

HCV antibody with reflex to HCV RNA: Presence (with detectable HCV RNA) indicates current infection. A positive result with a "not detected" HCV RNA reflex result may indicate a resolved infection or a biological false-positive antibody screening test [4].

The results of the test in the panel should be interpreted in the context of pertinent clinical history and physical examination findings.

References
1. Viral Hepatitis Surveillance - United States, 2019. Centers for Disease Control and Prevention. Accessed January 16, 2022. https://www.cdc.gov/hepatitis/statistics/2019surveillance/pdfs/2019HepSurveillanceRpt.pdf
2. Nelson NP, et al. MMWR Recomm Rep. 2020;69(5):1-38.
3. Roush SW, et al. Chapter 22: laboratory support for surveillance of vaccine-preventable diseases. In: Roush SW, et al, eds. Manual for the Surveillance of Vaccine-Preventable Diseases. Centers for Disease Control and Prevention. Reviewed June 3, 2021. Accessed January 16, 2022. https://www.cdc.gov/vaccines/pubs/surv-manual/chpt22-lab-support.html
4. Centers for Disease Control and Prevention. MMWR Morb Mortal Wkly Rep. 2013;62(18):362-365.

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.