HIV-1/2 Ab Differentiation (Supplemental Use Only) with Reflex HIV 1 RNA, QL RT PCR

Test Code

93170

CPT Codes
86701, 86702 <br>Restricted Use: This code is available for Client # 747, 2006, 2104, 3002, 3769, 3780, 3791, 6785, 7957, 8492, 8668, 50515, 50815, 52098, 52212, 53882, 53883, 54079, 54080, 54081, 54082, 54083, 54325, 54409, 54565, 54636, 55138, 55145, 55266, 55907, 55919, 55977, 56182, 56250, 56474, 56860, 56861, 57227, 57249, 57280, 57281, 57339, 57340, 57428,5 7572, 57577, 57578, 57709, 57710, 57711, 57725, 57792, 57840, 57841, 57842, 54121, 53380, 1010, 51, 56537, 52468, 51940, 3342, 4074, 56784, 55999, 52474, 52561, 52469, 55606, 2619, 54637, 54435, 4541,1213,3603,3424, 6881, 52712, 5184, 55138, 4767, 54734, 3424, 8492, 51907, 3435,54636,54148,1650,2104,57112,56536,55130,57712, 56536, 55130,57718,55266,55265,56296,57923,55267, 57750, 55533, 3024, 55712, 57438, 56088 53141,55359,6738,57556,57559,55723 AND 57560 ONLY.

Includes

If HIV-1/2 Antibody Differentiation is Indeterminate or Negative, then HIV-1 RNA, Qualitative Real-Time PCR will be performed at an additional charge (CPT code(s): 87535).

Preferred Specimen

3 mL serum collected in a serum separator tube (SST)

Minimum Volume

2 mL

Other Acceptable Specimens

Serum collected in: Red-top tube (no gel) • Plasma collected in: EDTA (lavender-top) tube

Instructions

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.

Plasma: Collect in EDTA (lavender top) tube and centrifuge tube within 24 hours of collection. Transfer plasma to a plastic, screw-cap vial, label as plasma, and submit for testing.

Submitted tubes must be labeled with patient identifier and submitted only for HIV testing.

Transport Temperature

Room temperature

Specimen Stability

Room temperature: 72 hours
Refrigerated: 5 days
Frozen -20°: 30 days
Frozen - 70°: Indefinite

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

Gross hemolysis • Frozen serum separator tube (SST)

Methodology
Immunoassay (IA) • Real-Time Polymerase Chain Reaction

Setup Schedule

Set up: Sat-Thurs; Report availaable: 3-9 days

Clinical Significance

To diagnose HIV infection.

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.