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Respiratory Virus Screen, DFA with Reflex to Identification
Test Code14860
CPT Codes
87300
Includes
If the Rapid Respiratory DFA Viral Screen is positive, the individual virus antigens (Adenovirus, Influenza A, Influenza B, Parainfluenza 1, Parainfluenza 2, Parainfluenza 3, and RSV) will be performed at an additional charge (CPT code(s): 87260, 87276, 87275, 87279 x3, 87280).
Preferred Specimen
3 mL nasopharyngeal aspirate/wash, nasopharyngeal swab or throat swab in VCM medium (green-cap) tube or equivalent
Minimum Volume
1 mL
Other Acceptable Specimens
3 mL bronchial lavage/wash in V-C-M medium (green-cap) tube or equivalent • 3 mL nasopharyngeal lavage/wash or bronchial lavage/wash in sterile screw-cap container
Instructions
To maintain optimum viability, place swab or fluid into VCM (equal volumes of fluid and VCM) or equivalent and transport the specimen to the laboratory as soon as possible. Best recovery is obtained when the specimens are refrigerated at 2-8° C or kept on wet ice following collection and while in transit. If there will be a long delay before processing, specimens in VCM or equivalent should be frozen at -70° C or colder and transported on dry ice. Storage or transport at -20° C s not acceptable. Raw (unpreserved) samples should only be refrigerated and not frozen.
Transport Temperature
Refrigerated (cold packs)
Specimen Stability
V-C-M medium (green-cap) tube or equivalent
Room temperature: Unacceptable
Refrigerated: 4 days
Frozen -20° C: Unacceptable
Frozen -70° C: 30 days
Raw (unpreserved) specimens
Room temperature: Unacceptable
Refrigerated: 72 hours
Frozen: Unacceptable
Room temperature: Unacceptable
Refrigerated: 4 days
Frozen -20° C: Unacceptable
Frozen -70° C: 30 days
Raw (unpreserved) specimens
Room temperature: Unacceptable
Refrigerated: 72 hours
Frozen: Unacceptable
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Throats on <2 year old patients • Specimens received in non viral transport medium • Nucleic acid or bacterial transport media • Non-respiratory specimens • Dry swabs • Received in formalin or other fixatives • Received at room temperature • Received frozen at -20°C
Methodology
Direct Immunofluorescence Assay (DFA)
Setup Schedule
A.M. Sets up 7 days a week.
Report Available
Reports in 1 to 2 days.
Clinical Significance
Influenza viruses are markedly epidemic and known to cause pandemics. "Influenza season" takes place during colder weather, generally regarded as October-May. Complications are a concern in the young, the elderly and in persons with chronic cardio-pulmonary diseases. Superinfections with other viruses and bacteria may occur. Parainfluenza viruses cause croup and pneumonia in children under the age of 5 and are one of the leading causes of lower respiratory illness. These cause upper respiratory illness in adults.
RSV causes mild infections in immunocompetent adults and bronchiolitis and pneumonia in infants, young children and immunocompromised/immunosuppressed adults. Simultaneous co-infections of parainfluenza 3 and RSV have been well documented.
Adenovirus may cause respiratory illness as well as hepatitis, meningitis, encephalitis, diarrhea and rash. The virus may be shed over long periods of time and may be found in respiratory, eye, fecal or urine specimens.
RSV causes mild infections in immunocompetent adults and bronchiolitis and pneumonia in infants, young children and immunocompromised/immunosuppressed adults. Simultaneous co-infections of parainfluenza 3 and RSV have been well documented.
Adenovirus may cause respiratory illness as well as hepatitis, meningitis, encephalitis, diarrhea and rash. The virus may be shed over long periods of time and may be found in respiratory, eye, fecal or urine specimens.
