Quad Screen [30294]

Test Code
MSQUAD

Alias/See Also
30294;
QUAD MARKER,
MATERNAL SERUM SCREEN 4,
TETRA PROFILE,
AFP/4 SCREEN,
AFP TETRA,
QUAD SCREEN

CPT Codes
82105, 82677, 84702 86336 or 81511* *The 2017 AMA CPT codebook contains the component CPT codes and the new MAAA codeset. Please direct any questions regarding coding to payor being billed.

Includes
AFP, unconjugated Estriol, hCG, Dimeric Inhibin A and Maternal Risk Interpretation

Preferred Specimen
3 mL serum

Minimum Volume
1 mL

Instructions
The Quad test in pregnant women should be performed between 14.0 and 22.9 weeks gestational age, although the optimal period is 15.0-16.9 weeks. This time frame allows sufficient opportunity for further diagnostic studies if the initial Quad Screen test results are abnormal. Specimens submitted before 14.0 weeks or after 22.9 weeks gestation cannot be properly evaluated for open neural tube defects, Down Syndrome or Trisomy 18.

Note: For manual orders use "Maternal Serum Screen Requisition"
The Maternal Serum Screen Requisition designed to obtain patient data and the patient's informed consent must be utilized when ordering the Quad Screen test. Because the Quad Screen test results are influenced by certain patient characteristics, the following data must be provided with the specimen in order to permit accurate interpretation of results: date of collection, patient's (maternal) date of birth, patient's estimated date of delivery, patient's weight, patient's race, patient's diabetic status (is patient insulin dependent prior to pregnancy), number of fetuses, and whether this is a repeat sample.

Transport Temperature
Room temperature

Specimen Stability
Room temperature = 14 days
Refrigerated = 14 days
Frozen = 28 days

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

Methodology
Immunoassay (IA)

Setup Schedule
Set up: Mon-Sat; Report available: 3-4 days

Limitations
Quad Screen results consistent with an increased risk of trisomy should be confirmed with amniotic fluid specimen. Results consistent with increased risk of NTD may be followed-up with appropriate diagnostic testing as detailed in the report. Maternal serum screening yields a low percentage of false negatives. A wide range of other chromosomal abnormalities are not identified by maternal serum screening.

Reference Range
See Laboratory Report

Clinical Significance
Maternal serum Quad Screen is used for prenatal screening of Down syndrome (Trisomy 21), Trisomy 18 (Edwards syndrome), and open neural tube defects (ONTD). This profile includes alpha-fetaprotein (AFP), unconjugated estriol (µE3), human chorionic gonadotropin (hCG), and inhibin A. Establishing risk for fetal Down syndrome, using the quad screen achieves a 70-75% detection rate with a 5% false positive rate. Screening for Trisomy 18 detects 60% of affected fetuses with a 0.2% false positive rate. MSAFP screening detects 88% of anencephaly and 79% of open spina bifida with a 3% false positive rate. Normal results do not ensure birth of a normal infant. In addition, 2-3% of newborns have some type of physical or mental defect, many of which may be undetectable with current prenatal diagnostic procedures.

Performing Laboratory
Quest Diagnostics Nichols Institute San Juan Capistrano
33608 Ortega Hwy
San Juan Capistrano, CA 92675-2042



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.