5 in 1 [75776]

Test Code
P75776

Alias/See Also
75776

CPT Codes
88175 (Interp 88141), 87491, 87591, 87624, 87661

Includes
Thin Prep(r) (73717RX)
Chlamydia (74506R)
GC (74507R)
HPV (9662R)
Trichomonas (75744R)

Instructions
Pap results requiring physician interpretation will be performed at an additonal charge (CPT code(s): 88141). Gynecologic cytology is a screening test which is subject to both false positive and false negative results. For that reason, the test is most reliable when a satisfactory sample is obtained on a regular repetitive basis. Hence, these results must be interpreted in the context of historic and current clinical information.
INSTRUCTIONS: Endocervical Brush/Spatula Protocol:
1. Obtain an adequate sampling from the ectocervix using a plastic spatula.
2. Rinse the spatula as quickly as possible into the PreservCyt Solution vial by swirling the spatula vigorously 10 times. Discard spatula.
3. Obtain an adequate sample from the endocervix using the brush device. Insert the brush into the cervix until only the bottom-most fibers are exposed. Slowly rotate 1/4 to 1/2 turn in one direction. DO NOT OVER-ROTATE.
4. Rinse the brush in the same vial as quickly as possible by rotating the device 10 times while pressing the brush against the sides of the vial. Swirl the brush vigorously to further release material.
Broom-Like Device Protocol.
1.Obtain an adequate sampling from the cervix using a broom- like device. Insert the central bristles of the broom into the endocervical canal deep enough to allow the shorterbristles to fully contact the ectocervix. Push gently, and rotate the broom in a clockwise direction five times. 2. Rinse the broom as quickly as possible into the PreservCyt Solution vial by pushing the broom into the bottom of the vial 10 times, forcing the bristles apart, As a final step, swirl the broom vigorously to further release material. Discard the collection device.
After Collection: Tighten the cap so that the torque line on the cap passes the torque line on the vial.
Record the patient's name and ID number on the vial.
Record the patient name and medical history on the pathology requisition, including source of specimen, LMP, hysterectomy status, previous malignancy, radiation therapy, drug therapy, use of exogenous hormones, abnormal vaginal bleeding, abnormal Pap results, IUD, and all other pertinent clinical information.

Transport Container
Thin-Prep(tm) Vial


Transport Temperature
Room Temperature

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Thin Prep Vial 30 days at room temp or refrigerated.

Methodology
Transcription-Mediated Amplification

Setup Schedule
Monday - Friday
MD

Report Available
7 days

Performing Laboratory
CompuNet Clinical Laboratories, LLC
2308 Sandridge Drive
Moraine, OH 45439



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.